All posts from: February 2012
Last week we reported that the great and the good in housing were called to Number 10 for meetings about the future of smaller supported housing providers.
If nothing else, it showed a clear intent from the government to protect some £1.5 billion of public money in the shape of annual Supporting People contracts.
But more than that, it hinted at a growing concern in the upper echelons that small businesses are missing out as the recessions shows no sign of letting up.
Where councils are looking to save money, they are procuring bigger contracts to achieve economies of scale. Small providers can’t hope to compete with larger providers who inevitably win the contracts. The government called the meetings to find out whether the sector has any solutions, and they did. There were calls to allow big providers to subcontract to smaller organisations, and to allow groups of organisations to club together to form a procurement consortium.
But that’s not the only reason that providers are having a tough time of it. As Vic Rayner, chief executive of Sitra pointed out in a recent blog, it’s increasingly difficult to deliver a service at a price councils are willing to pay.
‘I have spoken with many of our members who have talked about the very real shift in contract pricing – with one recent example talking about contracts which in 2003 paid £27 per hour, and are now offering the contract at £12 per hour,’ she said. ‘In this scenario, it seems unlikely that this kind of shift in price can be matched by anything other than a significant reduction in terms and conditions to bring the service costs in line with the commissioned price.’
Indeed, John Wade, managing director at Bromford Support, said his organisation has walked away from a number of tenders recently ‘because the council would not pay more than £13-14 an hour’.
The organisation – which with 6,000 customers could hardly be called small – is missing out because it says it’s unwilling to compromise on the service.
Do we want to get to a stage where all providers are pushed out except those who will accept rock bottom prices and huge contracts? We need to protect the specialists, the perfectionists and the people who love the nitty-gritty.
Or, as Mr Wade puts it, the sector need to be more like Aldi. The supermarket has bargain basement prices, happy customers and pays the highest wages to its staff who enjoy some of the best terms and conditions in the industry.
He said payment by results models would see more investment in understanding the service, and so employing the best people at good wages. Providers would work more effectively and save money, but also deliver better outcomes.
‘In short they would be able to offer better prices to commissioners; deliver great quality outcomes for customers; and all whilst offering a great reward package to their people,’ he said. Just like Aldi.
So if Number 10 needs any more help, there are a few people lining up already. If there’s one thing people don’t seem to be short of, it’s ideas.
Good news for thousands of people in Birmingham this week, as the council decided not to cut its Supporting People budget by as much as initially proposed.
Birmingham Council’s budget for 2012 said cuts to Supporting People – which as regular readers of this blog will know is one of my particular bugbears – would only be £1.9 million this year, rather than £3.8 million.
It’s a small victory for people who think the money does an excellent job of providing housing-related support to elderly and disabled people across the city. But more interesting is the way that the council was persuaded to change its mind.
Within the budget document is a report of responses to consultations on a variety of issues. It shows an online consultation did not support the cuts: ‘there was a strong feeling from all of the community forums and stakeholder meetings that this preventative service should not be reduced further,’ the report said.
One of the important points that respondents to the consultation made were that Supporting People ‘is a preventative service [and] reducing this would lead to cuts to some groups leading to higher costs later and additional costs to other services’. Overall benefit from preventative services should be taken into account in budget setting – not treated separately, it said.
It also identified a need for adult social care, homelessness, health, young people and probation services to work together more effectively – echoing a report from the government’s health select committee last week.
It’s great that the council reconsidered this cut – and listened to people who use the service when doing it.
More than that, it outlined points of improvements to existing services such as better awareness for residents of what services are available and better referral protocols to make sure people get the care they need.
But a smaller cut is still a cut, and if you look closely at the budget, there are proposals to deliver some services in group sessions, cut down on hours, consider charging people for wardens at supported housing, and consider closing the doors to new customers.
The council might also create waiting lists for access to SP funded services.
Should older, vulnerable and disabled people have to wait – perhaps years – for support they need? Almost certainly not. Birmingham Council has done an admirable job of cushioning people from the worst of the cuts, but there’s still so much more to be done.
The debate about how housing providers should play a role in care services is as old as the hills. It certainly pre-dates my time at Inside Housing anyway.
I’ve lost count of the number of times someone has quoted the Capgemini report at me with its ubiquitous findings: for every £1 spend on Supporting People, £1.17 is saved on other services, like health care or homelessness support.
Housing is important. But then, you all knew that.
Tomorrow, the government’s health select committee will publish a report on evidence it’s heard on social care. It will make a slew of recommendations for consideration by the government before it publishes a white paper on the issue later this year. With funding being cut on all sides and resources stretched to breaking point, it’s an issue that needs debating.
While I can’t report any of the content today – tune back tomorrow for that – I think it’s clear to everyone that housing must get a mention.
David Orr, chief executive of the National Housing Federation was called to give evidence last month: ‘Those of us who have been involved in housing have felt a degree of frustration over the years that the health and social care debate is a health and social care debate,’ he told the MPs. ‘We think it needs to be a housing, health and social care debate, because it is almost impossible, outside the delivery of acute services, to consider how best to meet someone’s needs unless they are properly housed.’
He also made the point that around half of all housing association tenancies are held by people who are 60 or over.
‘It is our assumption that that group of people, as they age and become more frail, are likely to require considerable degrees of support and care, and that very often that support and care will be provided in their home rather than in some external residential setting,’ he said.
But more than that, he made the point that even where housing associations are doing this, there is not the support in place to help them. ‘We do not think the systems and structures are in place yet to ensure that it is properly delivered,’ Mr Orr added.
This group of MPs could really influence care policy ahead of the white paper, so it’s vital that they see housing as central to the continuing work around care. If nothing else, it would stop us all banging on about it.