Transcript Luton SP strategic review

Luton Supporting People
strategic review
Summary findings 29 November 2010
Kate McAllister
Outline of presentation
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Methodology
Summary of service summary findings
Summary of strategic review findings
Overarching messages
Key recommendations
Methodology
Findings – review of
current services
Overall totals and as % of total income
£9,297,402
£8,693,423
£4,113,573
£718,880
-£603,979
Total expenditure
106.9%
Total income
100.0%
SP Grant
47.3%
Overheads
Surplus/Def icit
8.3%
-6.9%
Current hourly rates
£30.00
£25.00
£20.00
£15.00
£10.00
£5.00
£0.00
Current weekly costs
£600.00
£500.00
£400.00
£300.00
£200.00
£100.00
£0.00
Service summaries
A good service (based on desk
top analysis)
• At least QAF level C
overall
• Within acceptable
benchmarks for service
type (hourly rate, weekly
cost and hours per user
per week)
• Strategically relevant good stakeholder
feedback
• In demand
• Good performance in
comparison to peers
An ‘OK for now’ service (based
on desk top analysis)
• QAF level C overall
• Within or slightly above
acceptable benchmarks
for service type (hourly
rate, weekly cost and
hours per user per week)
• Strategically relevant
• Reasonable demand
• Fair performance in
comparison to peers
A poor service (based on desk
top analysis)
• QAF level D for any
objective
• Above acceptable
benchmarks for service
type (hourly rate, weekly
cost and hours per user
per week)
• Not strategically relevant
• No evidence of demand
• Poor performance in
comparison to peers,
particularly
– Poor move-on for shortstay services
– Under-utilised
– Staffing shortages
• Operating at significant
surplus
Traffic lit VFM assessment
Traffic lit VFM assessment
Traffic lit VFM assessment
Findings – strategic review
Luton context
 Approximately 35% of the population is from Black and Minority
Ethnic (BME) communities, with significant Pakistani, Bangladeshi,
Indian and African Caribbean communities.
 The population is expected to change and, based on current
projections up to 2021, the number of children (aged 0-19) will
increase, the number of working aged adults (20-64) will increase
and then drop, and the number of older people aged over 65 years
will increase.
 Luton has, like London’s inner Councils, a significant transient
population, with an above average level of substance misuse and
other associated problems.
Latest relevant issues
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Comprehensive spending review implications
NHS White Paper
‘Big Society’ and localism
Personal Budgets
Right to Control
Community Budgets
Prevention and early Intervention
Over-arching messages
 Services need to be coordinated, flexible and encourage
empowerment/self-determination
 The demand for open access services continues to be
high and is expected to remain so.
 Accommodation - In many areas there is not enough
accommodation and/or it was of poor quality, and/or it
was not in the appropriate locations.
• Increase/maintain/develop harm reduction and
prevention services
Over-arching messages
 Only the most acute need is being met in a number of
service areas
 A need has been identified in a number of service areas
to move from sheltered and residential care services to
community, extra care, floating support
 A number of service areas have identified a need for
information about services to be up-to-date
 There is some conflicting information from different
reports about the same subject (e.g. number of rough
sleepers, teenage pregnancies)
Stakeholder rating of current SP
funded services
 Responses show that a majority (61%) agree that in
the main there are effective referral routes for
people trying to access services.
 However, 38% feel that service users don’t find it
easy to access the services they need.
 46% agree that housing support services in Luton
are normally fully occupied, but 61% disagree that
these services are fully meeting the needs of their
clients.
Socially excluded groups
Families with complex needs
Service gaps

Existing domestic abuse services are often unable to
meet the demand - agency intervention thresholds filter
out all but the most pressing cases
 Provision of specialised accommodation and support for
single women with children, expectant mothers and
teenage pregnancies.
• Hostels/services for families.
Families with complex needs
Service gaps
• Develop support for partners and family members of
problematic drug and alcohol users.
• Need for joint working identified to establish how additional
housing support can be given to young parents. Plans to
provide additional supported housing for this group are
currently under discussion with partner RSLs.
Young people with complex
needs
Service gaps
 Concern re children with emotional and behavioural
needs who become young adults and do not necessarily
meet the criteria for mainstream Adult Social Care but
have a degree of vulnerability.
• Not enough housing stock for future projections of
needs.
• Lack of funding to support young people.
Young people with complex
needs
Service gaps
 Young people with mental health difficulties, and young
people with mild learning difficulties, are very difficult to
refer.)
 There is a lack of specialised, supported small units for
young people with higher needs, especially those with
mental health and drug misuse problems.
Young people with complex
needs
Service gaps
 There needs to be more resources for young homeless
people.
• The capacity of alcohol services for young people needs
to be increased in order to meet demand.
• More information and support for young people who are
vulnerable and at risk.
Single people with complex
needs
General service gaps
• More work is required targeting ex-offenders, people
living with domestic violence, alcohol and drug issues.
– There are waiting lists for housing-related support services for
drugs and alcohol. The Supporting People housing-related
support service for drug and alcohol users is working to capacity
• High demand for accommodation support for over 25.
Single people with complex
needs
Service gaps – homeless people
• Further investigation of number of rough sleepers is
required (conflicting evidence received).
• There is a need for a brokerage service to enable
homeless clients to access accommodation in the private
rented sector.
Service gaps – women
• Female clients are less likely to engage with open
access services.
Single people with complex
needs
Service gaps– offenders
• Finding available accommodation that will take offenders
needs to be increased, as does the support to settle into
accommodation, and then access to floating support
quickly enough.
• Residential rehab services for ex-offenders
• Women - continue to develop and implement
improvements for women offenders, including working
with Third Sector, to have appropriate interventions for
women offenders under statutory provision.
Single people with complex
needs
Service gaps – offenders
• Develop and implement provision for Mentally Disordered Offenders
taking into account the recommendations in the Bradley Review.
• Mainstream floating support does not reach far enough.
• Floating Support Plus set up specifically for high crime causers is
exactly what is needed for 80% of offenders, but only supplied for
20%.
• The need to find accommodation for sex offenders on release who
are not deemed to be a high risk.
• Particular problems with PPOs (Prolific and Priority Offenders)
compared with other offenders
Older people
Older people
Service gaps
• A need has been identified to move from sheltered and
residential care services to community, extra care,
floating support
• Overall, more effective models of support are needed.
There is an ongoing review of sheltered housing
provision which should address these issues.
Older people
Service gaps
• More floating support.
• More services are needed to enable older people to stay
in their own homes, e.g. floating support, assistive
technology, using existing sheltered services as
community hubs, extension of local home improvement
agency.
• More extra care sheltered provision is required (including
possible conversion of some existing sheltered or
registered care to extra care).
Health and social care
Learning disabilities
Service gaps
 45% of people with learning disabilities are housed
outside of Luton so that maintaining connections with
family and Luton services is more difficult.
• Review of sheltered housing stock and new extra care
schemes to examine the scope for providing for people
with a learning disability with either complex needs
and/or challenging behaviour.
Learning disabilities
Service gaps
• Commission a year-on-year allocation of supported
tenancies from Registered Social Landlords for those
with a learning disability, alongside securing a regular
supply of council housing tenancies.
• Examine ways of making more cost-effective use of
supported living units, with the aid of TeleCare and
TeleHealth assistive technology and more flexibly
deploying staff in support of more dispersed day
opportunities
Learning disabilities
Service gaps
• Use technology to enable people with dementia to live
more independently.
• Earlier interventions, role models and mentoring
schemes for young people with LD to reduce teenage
pregnancies.
• Target more services towards older people with a
learning disability.
• Need to plan for future housing for those living with
ageing parents.
Mental health
Service gaps
• The demand on services for clients with mental health
issues is substantial and only the most acute needs are
met.
• Need to look at access arrangements to services
traditionally provided only for working age adults, and
make sure that older people make up at least 10% (tbc)
of the total number of adults accessing existing services.
• Increase the commissioning of specialist services for
older adults with acute functional mental illnesses
particularly day opportunities, respite and home care
services.
Mental health
Service gaps
• Further planning needed on services for single men over
25 leading chaotic life styles (mental health problems).
• Need to review service provision for 16-17 year olds,
including access to in-patient facilities to ensure
compliance with new Mental Health Act requirements.
• Need to develop clear guidelines to cover all aspects of
transition both to adult services and between services at
all ages.
Mental health
Service gaps
• Link the day opportunity needs of people with
mental health problems into the wider
modernisation of day services in Luton.
• Review the support available for people to move
into or back into paid employment – in particular
people with chronic mental health problems
currently reliant on institutionalised services or
care.
Physical disabilities
Services currently in place
• The Council’s residential home for people with physical
disabilities has now been replaced by a series of
individually tenanted bungalows, with assisted technology
helping to promote peoples’ independence.
Gaps or more/different provision required
 Use the above example as a template for future
development of self-determined care.
BME groups
Service gaps
• Develop culturally appropriate services for Luton’s diverse
communities – either integrated services fully accessible to
all, or targeted services
– Need to complete the research commissioned by the CYPSP to
assess the needs of children and young people with disabilities from
the South Asian communities.
– adults 50+ from specific BME population with alcohol related issues
– infrastructure support for voluntary and community groups who
support families and individuals who are living with status issues,
are refugees and/or migrant workers
– Use the Learning Disability Development Fund to create a
Development Worker to work within the minority ethnic communities
in Luton
BME groups
Service gaps
• Use of floating support in order to maintain stability for
the household and children of gypsies and travellers
– Increase engagement with traveller men.
– Action is required to address the mental health issues within this
community.
– Newly arrived minority ethnic groups, gypsies and travellers, or
people with no recourse to public funds
BME groups
• Local, specialised, support for lesbian, gay, bisexual and
transgendered (LGBT) people
• same sex relationships where there is evidence of abuse
• People experiencing other forms of gender-based
violence - there is an urgent need for longer term support
for victims of sexual crime.
• No strategy for working with prostitution trafficking,
forced marriage or honour-based violence
HIV/AIDS
Gaps or more/different provision required
•
Tailored employment support and skills for work. (Centre for All Families
Positive Health CAPFH)
Key recommendations
Key recommendations
 Ensure that principles of personalisation and choice are
taken account of wherever possible.
 Work with partners and key stakeholders to agree and
deliver Luton’s emerging Prevention and Early Intervention
Strategy.
 Ensure that you have a good understanding of what locally
commissioned services should cost (for example by making
use of CLG’s cost modelling tool) then maximise best
value.
 Improve joint working between key strategic partners and
commissioners to ensure that newly commissioned
services have shared goals and jointly agreed service
specifications.
Key recommendations
 Improve service mapping so that all involved in the
commissioning and delivery of services for disadvantage
groups are aware of what is available.
 Develop services specifically targeted at Luton’s BME
community and improve latest understanding of the
needs of these groups.
 Bring together all commissioners of services for young
people (perhaps via an Appreciative Inquiry) to
determine common issues and potential synergy in
terms of the commissioning of future services for this
group.