Saturday, 19 April 2014

Support on a shoestring

Budgets are being slashed and demand is up but, as Inside Housing and Capita’s exclusive Supporting People survey reveals, many care and support providers are maintaining services for vulnerable people. Lydia Stockdale finds out how they are doing it and if it can last.

‘On a shoestring’ adequately sums up how the vast majority of UK housing organisations are currently running housing-related services for vulnerable people. Their Supporting People funding has been cut, but Inside Housing and Capita’s exclusive Supporting People survey, in which 367 people from across the UK took part, shows that many social landlords and homelessness charities are managing to keep services going - just.

More than three quarters of respondents to the survey, conducted online in May and June, say their SP budget has been slashed by up to 50 per cent during the past 12 months. Fifty five per cent have seen a cut of up to 25 per cent, while a further 22 per cent report that their funding has been reduced by between 25 and 50 per cent.

Crumbling coffers

This is no surprise given that in last year’s comprehensive spending review the government reduced the national SP budget by 11.5 per cent from £6.8 billion to £6 billion. What is astonishing is that, despite this, more than one in five survey respondents have managed to maintain the services they offer to elderly, homeless and disabled people, along with victims of domestic violence and those with mental health problems. Meanwhile, more than a quarter say their organisations have continued to handle the same number of cases with fewer staff members.

When Inside Housing and Capita conducted the same survey this time last year, more than a third of respondents said they had already experienced a ‘significant reduction’ in their SP budgets since the ring fence that previously protected this money was removed in April 2009.

Research in 2008 by consultancy Capgemini showed the £1.6 billion spent on SP initiatives every year while the ring fence was in place saved the public purse £3.4 billion, including £315 million knocked off the cost of running the NHS. Despite this evidence, many of those who completed our survey this year say that SP funding has, in the words of one respondent, been ‘raided’ by councils.

Just how much of the money that was previously spent on SP has been used to fund other services depends upon the decisions taken by individual local authorities. Cornwall Council, for example, has cut its budget by 40 per cent; while in Bournemouth funding dedicated to SP services has been sliced by 44 per cent.

According to some respondents, who took part anonymously, SP budgets no longer exist for some councils. ‘This questionnaire seems to be designed on assumption that every local authority still operates a separate SP programme, which since the ring fence was removed simply is not the case,’ states one.

Growing need

Generally though, as the amount of cash available has decreased, demand for SP services has grown over the past 12 months. Sixty per cent of respondents report need increasing by up to 20 per cent. A further 17 per cent have been dealing with a 20 to 40 per cent additional influx of people needing their help.

There are two main reasons why people are turning to the providers of housing-related support for help, explains Steve Milford-Kemp, chief executive of 136-home Bexley Churches Housing Association. ‘It’s a combination of other services closing and the economic climate meaning that people are finding themselves in difficulties,’ he says.

Mike Barrett, chief executive of charity Porchlight, which works with vulnerable and homeless people in Kent, says his organisation experienced a 60 per cent increase in demand for its services in the first quarter of this year. ‘I thought that might be a blip, but it’s a sustained increase,’ he says.
The closure of non-housing-related services has placed greater pressure on his organisation, he continues. ‘It’s been increasingly difficult to find mental health services and we are now finding that people are coming to us with significantly higher support needs.’

Surviving on a shoestring budget involves making tough decisions about priorities. Porchlight, for example, is continuing to offer its core services, but has had to ‘cut some of the extras, such as projects designed to distract young people away from crime’, Mr Barrett explains. In fact, nearly half of survey respondents say they’ve had to conduct similar streamlining exercises.

With services dangling by an increasingly frayed thread, some organisations have had to find other ways to fund them. ‘We have needed to re-model services or begin to charge for services [that were] funded previously,’ says one retirement housing specialist.

Other organisations have dipped into their own accounts to maintain provision. ‘We have used money from our reserves to give us time to restructure,’ explains a service manager.

One housing association department head, meanwhile, says that her organisation has ‘made a corporate decision to subsidise existing activities as we think they are beneficial to our residents’, though she does not say where this extra money is coming from.

Forty three per cent of those who report that their SP funding has decreased during the past year, however, admit that it’s been necessary to cut both supported housing services and staff. Seventeen per cent of all respondents say that increased demand on their services has meant they’ve struggled to provide services for everyone.

‘We are expected to deal with far more chaotic people for the same funding that we received previously and the attitude of [local authority] commissioners is that if we can’t do it there will be others waiting in the wings to deliver,’ says one housing association chief executive, summing up the experiences of nearly one fifth of respondents who say they’ve been unable to meet demand for their services due to cuts to SP budgets.

Political plans

In light of the troubles they’re facing a massive 89 per cent of those who completed our survey believe housing minister Grant Shapps should be doing more to prevent councils from cutting spending on Supporting People.

In response to our survey’s findings, Mr Shapps says: ‘The importance of the SP programme in helping vulnerable people was clearly recognised in the spending review [October 2010], with councils nationally receiving 99 pence this year for every pound they received last year.

‘The government has made clear its intention to protect the most vulnerable as work continues to tackle the deficit, and we would encourage all authorities to do the same and not make disproportionate cuts to their front line services.’

He adds: ‘Simply mandating SP expenditure from Whitehall doesn’t automatically mean that funds are better spent and quite often leads to the wrong action being taken locally.’

This will offer little comfort to the many respondents who argue the minister should convince the government to reinstate the ring fence around SP funding. Failing that, some suggest, he should enforce tighter controls on how local authorities use the money. ‘There should be clear direction about how the money should be spent,’ argues one departmental head for a housing and care provider.

Housing professionals are likely to be apprehensive about government plans, announced last month, to withhold SP contractual payments until housing organisations can prove how good they are, under a new payment-by-results model (Inside Housing, 24 June). This would see landlords with SP contracts receiving 80 per cent of their payment upfront and 20 per cent if the projects’ outcomes are measured to be a success. This scheme will be piloted for two years before a possible national roll-out.

In the meantime, respondents to our survey are very concerned about what’s going to happen over the next 12 to 18 months. Just 16 per cent of them didn’t suffer a reduced SP budget last year, and the majority of all of those who answered our questions are anxious about what the immediate future holds.

Three quarters of those who took part in the poll say they are most worried about having to scale-back services, and 72 per cent say they’re worried about services closing altogether.

‘I expect it’s going to get worse,’ sums up Mr Milford-Kemp. ‘The concerns are that we won’t be absolutely certain that vulnerable people will continue to get the services they require.’

The concerns don’t end there. Our poll reveals that more than half the housing professionals who took part are concerned about job losses, naming ‘staff reduction’ as one of their three primary anxieties. ‘The skill-set of staff in supported housing is being lowered due to the effect of tendering on costs per hour,’ says one housing association care and support head.

Reducing services

Worryingly more than half of respondents confirm that they’re planning to cut more services in the next 12 months in order to make further savings (see graph 5, page 29). Older people services are most likely to be hit, with 43 per cent of respondents naming it as the area in which they expect to make cuts (see graph 4, page 29).

This may be explained in part by the profile of those who completed the survey, a third of whom work in supported or sheltered housing. Vic Rayner, chief executive of supported housing umbrella body Sitra, however, points out that of 1 million people who receive SP services around 800,000 are older people, so it is unsuprising that many respondents expect to see cuts in this area.

Thirty per cent of poll respondents plan to cut services for 18 to 24-year-olds, one in five will cut drugs and alcohol advice services, and nearly a quarter will slash housing advice services. Others believe spending on floating support services will be first to be slashed.

Care and support providers are bracing themselves for hard times ahead and they’re looking for ways to continue running their services with potentially even less money. One of the areas Mr Milford-Kemp says he’s looking into is other sources of funding such as charitable funds.

Ms Rayner says SP service providers need to be able to demonstrate the value they offer to these funders. ‘It’s about understanding preventative services and how they can save money in the short and long term.’ The Communities and Local Government department used to collect data that would provide the proof needed, but this stopped in April. Sitra is now conducting a data consultation which closes on Monday, which asks SP providers which information they think should be continued to be compiled.

The appliance of science

Technology is another area that survey respondents are exploring in order to make their money go further. Nearly two thirds believe it is possible to make efficiency savings through the use of appropriate technology. ‘They’re asking “How can we deliver our services in a more effectual way?”,’ explains Stewart Davison, product launch manager at Capita Software Services, which is working on a SP content management system to save Darlington Council £400,000 across its SP contracts.

More than two thirds of respondents believe mobile working is the area in which most savings can be made. ‘We are providing front line staff with net-books and looking at hot desking rather than offices,’ sums up one chief executive.

Some respondents plan to club together to continue offering SP services. Twelve per cent of them have already joined a consortium of providers, and a further 13 per cent plan to be become part of one in the next 12 months. Mr Milford-Kemp says Bexley Churches Housing Association expects to begin offering services with other organisations in its area in the next six to nine months.

‘I think it will create more of a one-stop-shop so customers can go to one body to receive support,’ he says.

Louise Beard, director of housing and care at Coastline Housing in Cornwall, says her 3,700-home organisation teamed up with arm’s-length management organisation Carrick Housing and Devon and Cornwall Housing Association to offer joint services to its 650 older residents in April 2009. The two-year pilot ended this April, but the project has seen her organisation already streamline its services, making it better prepared for the 40 per cent cuts to SP funding made in Cornwall.

Efficiencies were achieved by revisiting the support plan of each individual resident and, in some cases, downgrading the level of intervention they receive. Daily visits from a care worker, for example, have been swapped with daily phone calls and two visits a week.

Even if these kind of savings can be made, some respondents still wonder how their services will survive as demand increases. ‘We’re looking at a maintenance culture rather than positive intervention,’ sums up a worried-sounding Mr Barrett, who believes that, generally, the housing-based support on offer currently will be pared right back.

Certainly, our survey shows SP providers are so far managing to maintain services on a shoestring budget, but a question remains over how long will it be before increased demand causes that string to fray, dangle - and then snap.

‘The situation could deteriorate to the point where [those who need services, but are unable to access them] will end up in prison or admitted to hospital,’ fears Mr Barrett. ‘The waste of life and opportunity is astounding.’

In numbers

77% of respondents have seen their Supporting People budget decrease by up to 50 per cent during the past 12 months

27% of respondents have handled the same number of cases but with fewer staff during the past year

46% of respondents have had to ‘streamline’ services during the past year

89% of respondents say the housing minister should do more to prevent councils from cutting spending on Supporting People

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