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Luton Supporting People strategic review. Summary findings 29 November 2010. Kate McAllister. Outline of presentation. Methodology Summary of service summary findings Summary of strategic review findings Overarching messages Key recommendations. Methodology.
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Luton Supporting People strategic review Summary findings 29 November 2010 Kate McAllister
Outline of presentation • Methodology • Summary of service summary findings • Summary of strategic review findings • Overarching messages • Key recommendations
A good service (based on desk top analysis) Strategically relevant -good stakeholder feedback In demand Good performance in comparison to peers • At least QAF level C overall • Within acceptable benchmarks for service type (hourly rate, weekly cost and hours per user per week)
An ‘OK for now’ service (based on desk top analysis) Strategically relevant Reasonable demand Fair performance in comparison to peers • QAF level C overall • Within or slightly above acceptable benchmarks for service type (hourly rate, weekly cost and hours per user per week)
A poor service (based on desk top analysis) Not strategically relevant No evidence of demand Poor performance in comparison to peers, particularly Poor move-on for short-stay services Under-utilised Staffing shortages Operating at significant surplus • QAF level D for any objective • Above acceptable benchmarks for service type (hourly rate, weekly cost and hours per user per week)
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 • 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.
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 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).
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 • 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.
