Inspection of Supporting People

1. Inspection of Supporting People Leicester City Council Initial Briefing Wednesday 18th July 2007

2. Briefing on potential strengths, weaknesses and areas to explore Inspection Team Lesley Barnard - Principal Inspector (AC) Jenny Hayball - Support Inspector (AC) Dennis Rees - Tenant Inspection Advisor Margaret Little - CSCI Inspector Sarah Mainwaring-Parr - HMIP Inspector

3. Agenda for today • Introduction • Initial thoughts and areas to explore • Judgement One – How good is programme delivery? • Judgement Two – Prospects for improvement? • Conclusion and next stages • Time for questions at the end of each section in the Key Line of Enquiry

4. Judgement 1 How good is the service?

5. What has the service aimed to achieve? • The vision for the Supporting People Programme is “Supporting People, and partner agencies in Leicester, will work with others to support vulnerable people to get and keep a home in the community. It will help vulnerable people to have choice and independence in their lives. This support will be: at the right time, high quality and value for money.”

6. What has the service aimed to achieve? • This is supported by a ten strategic objectives: • To Increase capacity where the number of units is significantly below the regional and national average and where there is evidenced need for the service • Accommodation based generic services should be remodelled to more specific client groups where there is an evidenced need for such services • All Floating Support should be coordinated, delivered across tenure and not tied to specific housing providers • Leicester will endeavour to develop more flexible floating support services over time • There should be a wider role for Community Alarms • Reduce average unit costs where it is shown Leicester’s unit cost for a particular client group is significantly above the national and regional average • The full cost of HRSS services will be reflected in either the unit cost or service charge, introduced over a suitable length of time • New provision will only be funded if there is specific and measurable evidence of need and the need for such a service is evidenced as a priority with the SP Strategy or specific Annual Plan. Such needs data is required to be more than general demographic analysis • Increase the quality of services to better meet need and deliver increased positive outcomes for individuals • Improve the alignment of commissioned services with the priorities of partner agencies

7. What has the service aimed to achieve? • The Community Plan is the key plan to improve the quality of life for people living and working in Leicester City. The Community Plan states that Leicester should be “A premier city in Europe with a thriving and diverse society in which everyone is involved and in which everyone can have a decent, happy and fulfilling life. A city with a strong economy, a healthy caring and educated society, a safe and attractive environment, and an improving quality of life – a sustainable city”

8. Governance & PartnershipsCorporate Commitment Potential strengths • Clear understanding of the council’s role as the ALA • Corporate Commitment reflected in additional budgets to support the administration of the programme • Supporting People related targets incorporated into Council’s annual performance plan • SP funding aligned with the LAA, but work ongoing to move towards pooled budgets Potential weaknesses • Limited reports to Council in last 18 months on Supporting People • Identified more work needed to improve Councillor understanding of the programme

9. Governance & PartnershipsCorporate Commitment Areas to explore • Elected member involvement • Effectiveness of corporate links • Links to the LSP and future reporting arrangements to LSP • Work to improve Councillor understanding of the programme • Outcomes from aligned budget with the LAA and progress in moving towards a pooled budget

10. Governance & PartnershipsCommissioning Body Potential strengths • Strong attendance by Probation and ALA over last 12 months (100%) • Appears to be operating effectively with appropriate level of discussion and challenge • Memorandum of understanding in place includes voting arrangements, and allocation & coordination of SP work. • Conflict of resolution protocol recently put in place Potential weaknesses • PCT only attended 67% meetings in last 12 months • Conflict of resolution protocol states no formal need for conflict of interest rules

11. Governance & PartnershipsCommissioning Body Areas to explore • Effectiveness of Commissioning Body • How conflicts of interest are dealt with • Relationship between the Commissioning Body and other areas of the governance arrangements • Links between Commissioning Body and LSP • Role of CB in LAA – robustness of decision making • Progress with review of memorandum of understanding

12. Governance & PartnershipsCore Strategy Group Potential strengths • Chaired by Accountable officer • Key partners represented on the group • Operating effectively with appropriate level of discussion and challenge • Evidence of outcomes from the Core Strategy Group • Links in place with the Commissioning Body • Conflict resolution protocol in place Potential weaknesses • Limited performance information reported • No service user representatives

13. Governance & PartnershipsCore Strategy Group Areas to explore • Effectiveness of Core Strategy Group • Outcomes achieved by the group • Action taken to address low attendance Links with other parts of the governance structure • Capacity building of members • Robustness of work planning • Application of conflict resolution protocol • Progress in involving service users within the governance arrangements

14. Governance & PartnershipsAccountable Officer Potential strengths • Accountable officer at an appropriate level of responsibility Areas to explore • Role and effectiveness of Accountable Officer • Corporate influence of the Accountable Officer • AO links with other relevant strategies and initiatives

15. Governance & PartnershipsHealth, Housing, Social Care and Probation wider partnership arrangements Potential strengths • Leicester Probation Service 2004-07 Accommodation Strategy informed by SP needs analysis & 5 year strategy and SP integrated in the LPS 2007/08 Business Plan • Positive protocol in place between Leicestershire and Rutland Probation Area and LCC for housing high risk offenders in the city and SP involved in this arrangement • Effective reciprocal arrangements between neighbouring counties for accommodating high risk offenders • Supporting People well integrated in the Housing Strategy 2005-2010, BME Housing Strategy 2004,the Homeless Strategy 2003-08, and Older People Strategy 2006 with number of key actions relating to Supporting People • Frontline working between health and SP is improving resulting in outcomes such as development of new Direct Access Hostel • SP officers are members of planning groups for wide range of client groups • Number of examples of multi agency approaches to delivery of the programme e.g. rough sleepers pathway project, teenage parent project • Inclusive forum in place to enable wider stakeholder involvement

16. Governance & PartnershipsHealth, Housing, Social Care and Probation wider partnership arrangements Potential weaknesses • SP programme not clearly featuring in health documents Areas to explore • Wider strategic links between Supporting People and key partners such as health, probation and housing • Approach to wider adult and child protection issues • Plans to review LPS Accommodation Strategy • Links between LPS Accommodation Strategy and mandatory reduction in re-offending LAA targets • Robustness of MAPPA arrangements and liaison arrangements with SP • Consistency of service specifications in place across all offender provision • Involvement of YOT in the programme, and provision for young offenders • Effectiveness and impact of protocols for hospital discharge • Plans to update Hospital Discharge Guidance with identified changes • Delivery of Supporting People elements of linked strategies • Contribution to and outcomes from membership of planning forums/groups

17. Governance & PartnershipsService Providers Potential strengths • Commitment to supporting and working with providers reflected in vision and values of the programme • Provider forum in place which is now led and administered by providers with time for providers only at meetings • 6 providers represented on the CSDG and links appear to be operating effectively with feedback at each provider forum • Examples of where providers have led change in the programme • Support for small providers through a voluntary sector provider forum, supported by one post funded by SP • Evidence of providers involved in the development of some areas of programme delivery

18. Governance & PartnershipsService Providers Areas to explore • Effectiveness of providers forum • Effectiveness of training and support for Providers • Effectiveness of SP newsletters • Accessibility to and satisfaction with training provided • Communication with providers • Supported provided to small providers • Consistency in support between internal and external providers • Provider satisfaction with involvement in the programme delivery • Level playing field for all providers?

19. Governance & PartnershipsVoluntary & Community Sector (VCS) Potential strengths • Voluntary and small SP providers group in place providing peer support, sharing good practice, resources etc. • One off grant funded post to support the voluntary sector provider forum • a local Voluntary & Charitable support organisation (funded by the Council) Voluntary Action Leicester provided training on policies and procedures in line with the QAF lite. • SP Team is working with colleagues with central procurement to link training currently available to Small and Medium Enterprises funded through the European Social Fund. Potential weaknesses • Lack of well established links with the wider non SP funded voluntary sector

20. Governance & PartnershipsVoluntary & Community Sector (VCS) Areas to explore • Links between SP and the voluntary sector • Voluntary sector involvement in governance arrangements • Outcomes from Voluntary and Small providers group • Capacity building for when one off grant funding ends • Progress with Small and Medium enterprise work

21. Grant Compliance, Strategy & NeedsGrant Conditions and eligibility criteria Potential strengths • Reviews used to identify ineligible funding and now transferred to appropriate budgets, based on eligibility principals agreed in 2003 • Comparably lower levels of ineligible funding due to ongoing work to ensure eligible services funded from point of introduction of SP • New robust eligibility policy developed April 07, particularly for use in new service specifications • Number of examples provided where services decommissioned or changed as a result of eligibility of support Potential weaknesses • Historically there has not been a published eligibility criteria

22. Grant Compliance, Strategy & NeedsGrant Conditions and eligibility criteria Areas to explore • SP involvement in de-registration of former residential care homes, and any issues? • Appropriateness and consistent application of eligibility criteria (provide copy of that used to support individual service reviews) • Involvement of partners and providers in development of eligibility policy • Provider and partner understanding of the eligibility policy • Progress with implementation of new eligibility policy and outcomes to date • Any issues from registration of Domiciliary Care Providers also providing SP services? • Effectiveness of and current position of retraction plan • Detail of retraction plan and its implementation – provider satisfaction • Involvement of partners in agreeing plans for transfer of ineligible funding

23. Grant Compliance, Strategy & NeedsFive Year Strategy Potential strengths • Comprehensive five year strategy in place for 2005-10, supported by annual plans • Clearly identifies actions and priorities for delivery with robust criteria in place for the identification of service development priorities • Easy read version of the strategy available for service users, including translation into 3 main community languages • Links made to other strategies and plans including teenage parents, learning disabilities, older people • Range of methods used to consult stakeholders, providers service users, partners and elected members in development of the strategy • SP involvement in client group planning forums used to inform the strategy • Appropriate prioritisation system in place to for existing services and proposed developments including relative levels of provision, contribution to partners strategies & risk to service users Potential weaknesses • Links to priorities, targets and objectives of partner agencies not clear

24. Grant Compliance, Strategy & NeedsFive Year Strategy Areas to explore • Provider, partner and stakeholder satisfaction with opportunity to contribute to development of the strategy and associated annual plans • Accessibility of the five year strategy and annual plans • Provider, partner and stakeholder awareness of strategy and key priorities • Future plans for reviewing the strategy • Outcomes from delivery of the strategy • Links to other key strategies and plans

25. Grant Compliance, Strategy & NeedsNeeds mapping, analysis and review Potential strengths • Template used to collate client group needs information and used to inform the five year strategy • Comprehensive needs analysis of offenders completed in 2003 to inform the LPS 20054-07 Accommodation Strategy and the offender section of the SP 5 year strategy • Access range of needs information from other sources and agencies (see weakness) • Summary of updated needs information used to inform development of the annual plans Potential weaknesses • Ad hoc approach to collection of needs information – recognised as an area for improvement by LCC, and proposing to develop strategy to take forward • Some gaps in needs data for specific client groups which don’t appear to have been addressed e.g. physical disabilities • Reliance on 2001 census data to identify local needs for services for some service user groups

26. Grant Compliance, Strategy & NeedsNeeds mapping, analysis and review Areas to explore • Robustness of needs data for each client group • Use of needs information collected since the five year strategy • Use of individual budget and extra care needs assessments to inform service provision • Use of client group planning forums to collect and update needs assessments • Information sharing arrangements with partners and providers • Evidenced impact and outcomes of the use of needs data • Action taken to address the gaps in needs information identified in the five year strategy • Current gaps in needs data, and action being taken to address these • Reason for detailed needs assessment of teenage parents and approach taken • Other areas where detailed needs assessment completed • Use of needs information to inform joint commissioning decisions

27. Grant compliance, strategy and needsStrategy for access to move on accommodation Potential strengths • Interim move on strategy in place • Strategy identifies number of initiatives which support positive move on • Move on survey underway with relevant providers and stakeholders • £1.7m of overall £4.8m floating support allocation budgeted to deal with post crisis support (i.e. move on related support) Potential weaknesses • Lack of strategic approach to dealing with move on • Interim strategy not accompanied by a SMART action plan • Gaps in provision of move on accommodation for offenders

28. Grant compliance, strategy and needsStrategy for access to move on accommodation Areas to explore • Awareness of the ability to move on and potential barriers – results from move on questionnaire • Effectiveness of current move on arrangements • Evidence of partnership approach to resolve to move on issues • Outcomes from the initiatives identified to support move on • Progress with formation of strategic move on group • Access to floating support services as part of move on arrangements • Action taken to extend housing options for service users

29. Delivery ArrangementsSupporting People team Potential strengths • Team of 14 staff to deliver the programme including policy and service development officers, and finance and monitoring officers • Evidence of support from other corporate teams e.g. corporate procurement and legal • SP team contributes to the client group planning forums • Monthly team meeting and management meetings • Team standards in place including communication and learning and development Potential weaknesses • Staff vacancies in team had some impact on completion of QAF validation visits in line with the review programme

30. Delivery Arrangements Supporting People Team Areas to explore • Team skills particularly with changing focus of programme delivery • Examples of specialist support form other council officers/teams and outcomes • Project and contract management skills of the team • Management and monitoring arrangements within the team • Links between team and other partners/agencies • Training opportunities & take up? • Understanding & application of adult & child protection arrangements

31. Delivery ArrangementsWork Planning Potential strengths • Work planned through comprehensive annual plans which clearly link to delivery of the strategy • Annual plan reviewed and updated bi monthly through team meetings • Some evidence of linking to individual work plans • Strategy action plan updates regularly provided to Commissioning Body and Core Strategy Development group Potential weaknesses • Resources and expected outcomes not identified to support delivery of actions in the strategy action plans • Links to health and probation targets and other corporate plans not evident

32. Delivery ArrangementsWork Planning Areas to explore • Team awareness of action plans and priority actions – consistency and comprehensiveness of individual work plans • Links to governance action planning and level of challenge made • Links to other department and corporate plans, and probation and health targets • Monitoring arrangements for action plan delivery • Progress in delivering annual plan and service plan

33. Delivery arrangementsLocal Area Agreements Potential strengths • Ongoing work to pool SP grant by 2009 Potential weaknesses • Lack of evidence to support decision to align SP funding in the LAA • Links to the LSP and LAA not made clear in the Annual Plans and Five Year Strategy Areas to explore • Effectiveness, relevance and outcomes of SP links to the LAA and LSP, including lines of accountability between LSP and CB • SP funding levels in the LSP and outcomes • Timeliness and accuracy of returns to CLG

34. Delivery ArrangementsPerformance monitoring and management Potential strengths • Regular reporting of performance and financial information to CSDG and CB • Some evidence of more detailed performance analysis and trends • Evidence of appropriate financial controls in place Potential weaknesses • Limited performance information reported with focus on the two national KPIs and no analysis of information • Limited challenge of performance and financial information at both meetings given the level of information reported • Outcomes not reported to Commissioning Body or Core Strategy Group • Internal audit of financial and payment systems carried out identified 3 areas for improvement

35. Delivery ArrangementsPerformance monitoring and management Areas to explore • Effectiveness of performance management system • Effectiveness of financial monitoring • Outcomes achieved through performance monitoring in terms of active responses to pursue improvements • Extent to which more detailed performance information has been produced, and impact of use • Progress in addressing recommendations from internal audit report

36. Delivery Arrangements Fairer Charging Potential strengths • Reminder of provide duty around fairer charging assessments included in inflationary increase letters to providers Potential weaknesses • Very low level of applications – only 3 requesting a Fairer Charging assessment to date - recognise this is partly due to 77% of users subsidised via HB • Limited evidence of information for service users on availability of fairer charging – not included in standard SP leaflet • No evidence of the assessment of potential take up • No evidence of promotional work with providers and service users to encourage take up – aware some work planned

37. Delivery Arrangements Fairer Charging Areas to explore • Efficiency of Fairer Charging arrangements including completion of assessment and issuing of invoices to service users • Top up charges – any local providers charging fees over and above the SP grant? • Integration with other income maximisation work across the city • Promotion of Fairer Charging with providers and service users, including provider awareness of opportunities for fairer charging assessments • Links to other corporate fairer charging assessments

38. Delivery Arrangements Risk Management Potential strengths • Comprehensive risk register incorporated into annual plans • Some business critical risks identified for inclusion within the departmental risk register Potential weaknesses • Council has major incidence contingency plan in place, however only appears to relate to Flu epidemic in relation to supporting people • Identified as area for improvement to firm up SP team procedure for responding to risks specific to the SP market Areas to explore • Effectiveness of risk management in decommissioning services • More detailed risk assessment in place e.g. provider level? • Evidence of effectiveness of risk management arrangements, reviewing and reporting within the programme and corporately • Partner involvement in risk management • Use of service reviews and contract monitoring arrangements in the identification and management of risk

39. Delivery Arrangements CLG Monitoring (SPLS data upload) Potential strengths • Appropriate arrangements in place to ensure uploads are timely Areas to explore • Quality and timeliness of uploads • Arrangements in place to check the quality and accuracy of data

40. Commissioning & PerformanceContracts Potential strengths • All service reviews completed by March 2006 • Automated tools used to progress and record service reviews • Steady state contracts in place for all external contracts • Draft contract management framework • New contract monitoring arrangements include involvement of service users • Comprehensive Provider Information Pack produced for reviews • Comprehensive review officer guidance document • Questionnaire used to collect providers views on how the scheme review process Potential weaknesses • Not all services subject to QAF validation as part of the review process to ensure March 06 deadline could be met • Not clear how links have been made to shared targets through service reviews and contract negotiations

41. Commissioning & PerformanceContracts Areas to explore • How robust have service reviews been in assessing ineligibility and value for money • Have changes been implemented following service reviews • Involvement of other partners in service reviews, contract negotiations and management e.g. probation, health • What is the current position on contracts across the programme (how many on steady state / interim / expired) • Progress in development of new contract monitoring arrangements • Training for providers on approach to reviews and contract monitoring arrangements, particularly support for small providers • Effectiveness of new contract negotiation and monitoring arrangements and consistency between internal and external providers • Involvement and satisfaction of service providers and service users with methodology • Extent of any joining up of commissioning and monitoring • Results and outcomes from scheme review consultation

42. Commissioning & PerformanceQuality Assurance Potential strengths • Internal panel used to quality assure outcomes of review prior to submission to CSDG and CB • Clearly laid out guidance for officers and providers to help ensure consistency in approach • CSDG have reviewed all review reports prior to submission to CB Potential weaknesses • Not all services have had a QAF validation visit to date – to be completed by September 2007, with 16 services outstanding out of the 185 services • Arrangements for quality assurance in the new contract monitoring arrangements to be developed

43. Commissioning & PerformanceQuality Assurance Areas to explore • What is the current position with QA – anything documented, anything started, If so what was the outcome and has anything changed • Arrangements for ensuring continuous improvement • Development of quality assurance arrangements for new contract monitoring arrangements • Progress in completion of outstanding QAF assessments

44. Commissioning & PerformanceReporting Potential strengths • Comprehensive review reports automatically produced using workbook • Reported to commissioning body and evidence of in depth discussion in some cases • Dedicated time set aside at CB and CSDG to ensure appropriate consideration given to review reports and the recommendations made Potential weaknesses • Limited challenge to outcomes of review reports at Commissioning Body Areas to explore • Effectiveness of current reporting arrangements and challenge made • Action taken as a result of identified areas of concern • Timeliness and quality of reporting to providers, particularly following the Commissioning Body meeting

45. Commissioning & PerformanceCross Authority Potential strengths • Involved in work to develop joint or similar working practices across neighbouring authorities Signed up to Joint Accreditation Protocol through the Midland Region Contract Group • Some schemes operating jointly in LCC and neighbouring authorities so joint approach taken to service review process Potential weaknesses • Delays in accrediting providers due to capacity issues Areas to explore • Effectiveness of accreditation and passporting arrangements • Outcomes from cross authority work • Integration into work planning • Reporting progress to governing bodies

46. Commissioning & performance Improvement planning Potential strengths • Target set in five year strategy for all providers to be level B by 2008 • Actions plans developed through service review process – 103 action plans issued to date • Review officers have responsibility for ensuring timely completion of action plan • Training provided to small providers through voluntary provider forum to help improve performance against the QAF Areas to explore • Criteria for production of action plan • Effectiveness of improvement planning arrangements, including consistency of monitoring • How ambitious are the improvement targets set? • Outcomes from training for small providers • Use of QAF validation and plans for future • Use of supplementary QAFs

47. Commissioning & PerformanceComplaints Potential strengths • Clear guidance on the approach to complaints including timescales and 3 stage escalation policy • Complaints to be considered as part of new contract monitoring arrangements Potential weaknesses • No evidence of complaint reporting to CSDG or CB Areas to explore • Publicity and awareness of complaints procedure • Protocols to enable & refer issues of adult & child protection • Level of complaints received and effectiveness of application of the complaints procedure • Monitoring and reporting of complaints • Use of complaints to improve services provided or programme delivery • Engagement of partners in dealing with complaints

48. Commissioning and PerformanceAppeals Process Potential strengths • Details of appeals process included in the Provider Information Pack on service reviews • 4 stage appeals process in place with clear timescales and delegation processes • Includes use of an appeals panel where satisfactory outcome achieved comprising CB representative, CSDG representative and an third independent representative Only one appeal to date – settled at stage one Areas to explore • Service provider satisfaction with the process • Publicity and awareness of appeals procedure • Details of the appeal made and how this was dealt with and reported

49. Commissioning & PerformanceOutcomes Potential strengths • Some changes to service provision following the reviews – 155 units of support decommissioned • Evidence of meeting top priorities identified in the five year strategy • Strategic review of floating support resulting in outcome based set of services being introduced Areas to explore • Extent of decommissioning • Any outcomes from contract monitoring and improvements flowing from service improvement plans • QAF levels of providers and trends • Evidence of service improvements • Impact of floating support strategic review • Future strategic reviews planned?

50. Value for moneyDefining VFM Potential strengths • Commitment to value for money through consideration of the cost and quality of services is reinforced through the LCC SP vision and number of objectives Areas to explore • Team, provider and partner understanding of the definition and approach to value for money