Cost Benefit Analysis Brighton & Hove Supporting People Programme November 2009

1. Cost Benefit AnalysisBrighton & Hove Supporting People ProgrammeNovember 2009 Daniel Parsonage Commissioning Officer t: +44 (0)1273 293081 e: daniel.parsonage@brighton-hove.gov.uk

2. Brighton & Hove 250,000 people in 120,000 homes High property prices and low incomes High levels of mental health, physical disability, drug use Non-decent housing across all tenures, primarily affecting the vulnerable Around 1 in 5 households contain someone with a vulnerability Supporting People fund nearly 5000 units of support

3. Local Strategies • Brighton & Hove Housing Strategy 2009-2014 • Supporting People Strategy 2008-2011: to be refreshed in 2010 • WAMHS Commissioning Strategy (due 2010) • LD Commissioning Strategy (2009) • Single Homelessness Strategy (2009) • Youth Homelessness Strategy • Older People’s Housing Strategy

4. Local Area Agreement • National Indicator Set & Local Area Agreement • 198 national indicators, 35 in LAA • Key housing indicators in the B&H LAA: • NI 141: Number of vulnerable people achieving independent living • NI 142: Vulnerable people who are supported to maintain independent living • NI 143: Proportion of offenders under probation supervision in settled and suitable accommodation at the end of their order or licence • NI 145: Proportion of adults with learning disabilities in settled accommodation • NI 149: Proportion of adults in contact with secondary mental health services in settled accommodation

5. Cost Benefit Analysis - Making a Difference • In June 2009 it was agreed to map and measure in impact of support services: • Accurate costing for contracted services • Quantitative data • Qualitative data • Strategic relevance • Impact on services • Outcomes for service users • Shared outcomes for the city

6. What is a cost benefit analysis? “Cost-benefit analysis is a term that refers both to: • a formal discipline used to help appraise, or assess, the case for a projector proposal, which itself is a process known as project appraisal and • an informal approach to making decisions of any kind. Under both definitions the process involves, whether explicitly or implicitly, weighing the total expected costs against the total expected benefits of one or more actions in order to choose the best or most profitable option”

7. Executive Summary • The model shows that the Supporting People makes the city a £36.6million net savings for a spend of £11.3million which equates to the fact that for every £1 we spend on SP the city saves £3.24. This takes into account reductions in costs for housing departments, DWP, NHS, and other social costs such as crime and homelessness. • The methodology is based on examining the financial impact if SP funded services were replaced by the most appropriate positive alternatives – these are referred to as counter-factual scenarios

8. Counter Factual Scenarios • Evidenced alternatives based on national data to SP funded services including positive and negative impacts on other services and the city • Assumes that accommodation would remain when support was withdrawn i.e. providing a homeless person with accommodation, benefits or support through Jobcentre Plus but not advice on maintaining a tenancy, accessing services or managing bills. • Assumption are client group specific • Impacts are ‘immediate or near immediate’ • Local & national costs researched by Capgemini & CLG 2004-2009

9. OVERALL FINANCIAL SUMMARY Cost Category Totals (£M) Baseline Counterfactual Net Benefit Baseline Counterfactual Net Benefit All client groups SP Package £11.3 - -£11.3 Residential Package - £32.7 £32.7 Housing Costs £48.3 £49.3 £0.9 Homelessness £2.4 £7.9 £5.5 Tenancy failure costs £0.3 £0.4 £0.1 Health service costs £14.6 £18.6 £4.1 Social services care £12.4 £10.2 -£2.2 Crime costs £72.3 £79.8 £7.5 Benefits & Related Services £21.0 £20.4 -£0.5 Charitable Services - - - Other Services £2.3 £2.0 -£0.2 - - - £184.8 £221.4 £36.6

10. Headlines • Single homeless, alcohol, older people, and drug services offer the highest ratio of benefit • Services for young people, teenage parents, offenders, and DV services offer the least benefit • Support services play a vital role in prevention evidenced financially • Support services contribute directly and indirectly to the LAA indicators

11. Client group by client group

12. How is the benefit calculated? Example – Mental Health Services • We fund 407 units of support • The average cost per annum locally is £7931 for accommodation and £3220 for floating support • CLG estimate that this part of £23,458 (benefits, housing, social services and health costs) required for the individual plus £3,003 in event costs such as admissions • Locally the total cost of supporting this client groups is estimated as: £10.6million

13. So what are the benefits of SP? • Counter factual assumptions: • 59% of people would not require alternative provision • 8% would require residential care • 33% would need inpatient treatment • Increase in events such as homelessness • These alternative costs would total:£16.9million Therefore the cost benefit is: £6.3million

14. Major client group highlights – Single Homeless & the ISP • Innovative process for the city to support the pathway to independence • 5 bands moving people to greater independence with support for employment, addiction, life skills etc.. • High savings due to reduced acquisitive crime and drug rehab services

15. Re ablement and support services • SP services have an ethos of being time limited • Planned Move On is a focus • DoH acknowledge that support services are central to the pathway to greater independence • Reduces use of acute and institutional care

16. Supporting People Ethos • The Supporting People programme offers vulnerable people the opportunity to improve their quality of life by providing a stable environment which enables greater independence. • It will deliver high quality and strategically planned housing-related services which are cost effective and reliable, and complement existing care services

17. Personalisation & Empowerment • QAF links quality directly with user involvement at every step on the ladder of participation – “there is a commitment to empowering clients and supporting their independence” • Person-centred outcome focussed support planning • Active user involvement programmes • Partnership working for the benefit of the service user

18. Outcomes & Performance • Since 2005 positive move on in short term services has increased from 44% to 72% • Long term services achieve a near 100% record of maintaining independence • Quality against the QAF has increased year on year with 56% achieving ‘best practice’ on all objectives • Diversity data collected to inform impact assessments and commissioning • Outcomes Framework - 1 in 10 service users have significant slef harm issues – 80% resolve this with an SP service

19. SP Budget • Real VFM – better outcomes with reduced spend • Supporting People Budget • 07/08 - £12,464,495 • 08/09 - £11,841,270 • 09/10 - £11,249,207

20. Innovative commissioning… Despite this we have continued locally to commission innovative services that maintain and improve independence these include: • Translation and interpreting service • Outreach service for street drinkers • Deposit guarantee scheme • LD Access service • Sheltered Housing Access service • High Risk offenders floating support • Behavioural support for single homeless people • Three work and learning services for single homeless people • BHT Crisis response service • A drop in service for the ISP • Peer support service …Also we have decommissioned services which have been shown to have a negative impact on independence.

21. Conclusion • The Supporting People programme saves the city £36.6 million per year • The programme is at the forefront of the personalisation agenda • The quality of services has improved year on year with VFM reflecting this

22. What does all this mean..? • "If I could not have moved into [the SP] projects then I don’t know where I would have gone" • Quote from a service user at a BHT mental health accommodation service • "I have felt better in my head because I have had a secure environment and planned move on goals" • Quote from a service user at a BHT mental health accommodation service • "Key working encourages me to think and plan for the future and move on - opening up ideas and looking forward to the future" • Quote from a service user of a hostel for single homeless people • At times, without work, I have seen the dearth of facilities for homeless people [but] there is nowhere in Britain that puts in effort like Brighton.  I love it • Quote from a service user of a hostel for single homeless people • This experience has identified this whole service to me. The department makes a big difference • Quote from a service user of BAOH after a work placement with the team

23. Next Steps

24. Thank You for Your Time Commissioning Team, Brighton & Hove City Council, 4th Floor Bartholomew House, Bartholomew Square, Brighton, BN1 1JE t: +44 (0)1273 292078 e: commissioningteam@brighton-hove.gov.uk