City of Westminster

Supporting People Strategy 2005-2010

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CONTENTS

1. Executive Summary

2. Introduction

3. Strategic relevance

4. Current supply

5. Approach to measuring performance and quality

6. Value for money

7. Meeting needs

8. User involvement

9. Policy on charging for Supporting People services

10. Priorities for the next five years

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1. Executive Summary

The overarching aim of our Supporting People (SP) Strategy is:To improve the quality of life for a diverse range of vulnerable adultsand young people in Westminster and enable these residents to achieveimproved health, greater independence and control in making lifechoices.We will seek to achieve this aim through pursuing four key objectives:

Objective 1: To deliver the local targets for housing related support servicesset within our Modernisation agenda for Social Services.

Objective 2: To consolidate services to support vulnerable residents who donot meet the criteria for Social and Community Services care management.

Objective 3: To address Health Related Priorities

Objective 4: To support and develop local initiatives that aim to help protectthe lives and well being of those who live, work or visit Westminster.

In order to achieve these objectives the key priorities for the next five yearsare to reconfigure existing services to make best use of resources bothfinancial and buildings in order to:

• Deliver a city wide floating support service that meets a range ofvulnerabilities

• Expand the range of floating support services to meet the needs offamilies, those escaping domestic violence, young offenders, youngformer asylum seekers, substance misuse, young parents

• Deliver more specialised services to homeless hostel residents leading toa reduction in the numbers of rough sleepers

• Ensure the successful delivery of new pipeline services• Target sheltered housing services for older people at those in greatest

need• Develop a regional approach to the commissioning of services for non

Westminster residents• Increase positive vocational and social outcomes for users of mental

health services• Reconfigure young persons services to meet all young person needs• Deliver services that meet the needs of the National Offender

Management Service and their associated community safety partnerships• Increase the number of people with learning disabilities in receipt of SP

services

Outcome Based Monitoring

The outcomes of the strategy will continue to be monitored actively by theWestminster Commissioning Body in particular through the development of anoutcome based monitoring system moving away from process based targets.

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Financial Resources

The delivery of these objectives must be achieved within decliningfinancial resources and the assumption that Westminster’s allocation willreduce over time underpins the approach set out in this strategy.Westminster’s 2005/06 allocation of £17,330,965 represents an actualreduction of £919,180 (5.04%) against the allocation for 2004/05 andWestminster will set a balanced budget for 2005/06 and beyond. Furtherinitial exemplifications of the distribution formula that will determine thelonger-term grant allocation have been particularly unfavourable toWestminster. Lobbying on the impact of the distribution formula onservices to vulnerable people in Westminster will be key.

Performance, Quality and Service Reviews

Westminster has delivered the review programme one year ahead of ODPMschedule which has enabled the move from a commissioning frameworkbased upon legacy funding to one based upon need. Each review included anassessment of the strategic relevance of each service describing howstrategic priorities and needs are met. Each review has led to an action planbeing developed for each service demonstrating a commitment to continuousimprovement in service delivery.

Service User Involvement

Service users are at the centre of Westminster’s approach to SupportingPeople. No services are commissioned where a service user cannot input intoto their own support plan; each service must have systems in place to enableservice user input into the management of the service; each review hasincluded meeting with tenants to receive feedback aswell as the use ofquestionnaires; a specialist questionnaire for people with learning disabilitieswas developed; a Speakout event for users of hostel services was held whichled into the establishment of a service user review panel.

All these examples of service users' involvement have highlighted the risingexpectations of service users and the need to raise standards and servicequality to meet these expectations.

Cross Authority Commissioning

Supporting People is a local commissioning framework with funding decisionson services taken by local Commissioning Bodies and the drive towardsensuring the strategic relevance of each service has meant that servicereferral and access arrangements have become more focused on local need.As a result this has placed significant pressure on the commissioning ofservices that meet a non-local need. Westminster is unique as a authority inattracting such high numbers of vulnerable people into its services; only 8% ofresidents of Westminster’s 1100+ hostel bedspaces have a local connection.Westminster remains committed to commissioning cross authority servicesbut only where these are committed to the diversion and prevention policies

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followed as part of the Rough Sleepers Strategy and the HomelessnessStrategy, and retain move-on rights into cross authority services provided inother boroughs. Westminster is committed to developing cross-authorityprotocols to support the commissioning of such services.

The development of this strategy reflects Westminster’s commitment toSupporting People as a means of delivering the wider strategic agenda andthe Council is committed to maintaining the successful partnerships that havecharacterised the delivery of Supporting People in Westminster to date.

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2. Introduction

As an authority that has been rated as 'excellent' in its ComprehensivePerformance Assessment, Westminster is not required by the government toproduce a five-year Supporting People (SP) strategy. However, the Councilhas decided to do so as a sign of its commitment to SP and because itbelieves it is good practice to make a clear statement about its strategicpriorities for the next five years, for service users, providers, commissionersand other stakeholders.

SP funding

The main external factor influencing this strategy is the amount of SP grantthat the government will be giving Westminster over the next five years. Weknow that:

the national SP budget is to be reduced from £1.8bn in 2004/05 to £1.72bnin 2005/06 and to ‘around’ £1.7bn in each of 2006/07 and 2007/08;

the government wants to move to a system of allocating SP grant to localauthorities based on an assessment of the need for housing-relatedsupport services within those authorities;

initial exemplifications of such a distribution formula have not beenfavourable to central London authorities like Westminster.

The City of Westminster received confirmation from the Office of theDeputy Prime Minister on 2nd December 2004 of a Supporting PeopleGrant allocation for 2005/06 of £17,330,965. This represents an actualreduction of £919,180 (5.04%) against the allocation for 2004/05 andWestminster will set a balanced budget for 2005/06 and beyond.Lobbying on the impact of the allocations formula on services tovulnerable people will be key. At the same time the assumption thatWestminster’s allocation will reduce over time underpins the approachset out in this strategy.

Strategy development

The development of this strategy has been an ongoing process since workbegan on the SP Shadow Strategy back in 2002. Westminster has taken apartnership approach to SP since the start, reflected in the composition of itsCommissioning Body and support of an active Provider Forum. Both bodieshave met regularly since 2002 and have discussed strategic as well asoperational issues.

The Council is pleased to report that its programme of SP service reviewsshould be completed by April 2005, a year ahead of the deadline set by theODPM. These reviews have been organised on a client group by client groupbasis, which has enabled the Council to review its 'strategy' for each clientgroup in turn, with reference to key strategies that already exist in eachservice area.

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Westminster produced the 2003/04 shadow strategy in line with centralgovernment requirements and following this a strategy for 2004/05 wasproduced when ODPM delayed the timetable for completion of a 5 yearstrategy. The widespread consultation undertaken for the 2004/05 strategyhas informed the development of this five-year strategy.

Strategy content

For all the above reasons, this document should contain no surprises forservice users, providers, commissioners and other stakeholders. It starts bysetting the scene with regard to the strategic relevance and supply of SPservices within Westminster. After this we set out our approaches tomeasuring the performance and quality, value for money, and need forservices. User involvement is a key feature of the Council's approach to thedelivery of its SP programme, so we devote a section to describing the workthat has been done on this, followed by a statement of our policy on chargingfor SP services. Finally, we draw this all together into our proposals for a five-year strategy and the Commissioning Body annual business plan for 2005/06.

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3. Strategic relevance

The table below shows how this SP Strategy fits into the framework of inter-linked departmental, corporate and City wide strategies and plans.

Planning Level 1

Plans at the broadestlevel

City PlanBest Value Performance

Civic Renewal

Planning Level 2

The major universalplans

Children andYoungPeople’sStrategic Plan

Crime andDisorderStrategy

Programme fora HealthierWestminster

HousingStrategyStatement

NeighbourhoodRenewal Strategy

Planning Level 3

Focused, centrally-prescribed plans

PAFPositionStatement

YouthJusticePlan

CAMHSDevelop-mentStrategy

TeenagePregnancyStrategy

DrugActionTeamStrategy

SupportingPeopleStrategy

Homeless-nessStrategy

Planning Level 4

Improvement andaction plans

SocialServices &HousingPlan

NSF ActionPlans- olderpeople,children etc.

Supply &Allocation ofSocialHousing andLow CostHomeOwnership

BV ActionPlans

Postinspectionaction plans-eg. CPA,SSI

RaceEqualityAction Plan

Examples of the ways in which SP contributes to these various strategies andplans include:

Civic Renewal Programme - many SP services help to reduce crime andnuisance and thus contribute to the City Guardian priority within thisProgramme

City Plan (Community Strategy) - this includes specific targets for a rangeof client groups, including for older people and rough sleepers where thereis a direct link to SP-funded services

Neighbourhood Renewal Strategy - the location of SP services reflectsthe priority areas outlined in the strategy, and services target vulnerableclient groups that are identified as priority groups in the strategy, e.g. olderpeople, rough sleepers

Crime and Disorder Strategy - many of the housing related supportservices funded by SP are designed to address needs linked to youngpeople, substance misuse, mental health and successful rehabilitation ofoffenders, all of which are a focus of this strategy

Housing Strategy - working in partnership to maximise benefit forvulnerable people through the SP regime is a key priority of this strategy

Homelessness Strategy - housing related support services areintrinsically linked with the Homelessness Strategy, particularly given thelarge number of services that exist for single homeless/rough sleepers

Best Value Action Plans - the Mental Health Strategy for housing andrelated support services was developed following a Best Value Review ofthose services and provided the strategic framework for the SP reviews ofthose services

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Government strategic targets

The government has identified the following strategic targets and objectivesthat it expects SP to contribute to:

• Tackling social exclusion and delivering neighbourhood renewal• Tackling homelessness• Increasing the range and choice of housing open to people with learning

disabilities to enable them to live as independently as possible• Improving the quality of life and independence of vulnerable older people

by supporting them to live in their own homes where possible, by:• increasing the proportion of older people being supported to live in their

own home by 1% annually in 2007 and 2008, and• increasing, by 2008, the proportion of those supported intensively to

live at home to 34% of the total of those being supported at home or inresidential care

• Increasing the participation of problem drug users by 100% by 2008 andincreasing year on year the proportion of users successfully sustaining orcompleting treatment programmes

• Protecting the public and reducing re-offending by 5% for young offendersand for both adults sentenced to imprisonment and adults sentenced tocommunity sentences

• Improving health outcomes for people with long-term conditions by offeringa personalised care plan for vulnerable people most at risk; and to reduceemergency bed days by 5% by 2008, through improved care in primarycare and community settings for people with long-term conditions.

SP in Westminster contributes to the meeting of these strategic targets andobjectives by:

Ensuring that services are focussed on meeting key strategic priorities,such as those set out in the Neighbourhood Renewal Strategy and theHomelessness Strategy

Bringing together the expertise and knowledge of staff from Housing,Social Services, the PCT and Probation Service to make commissioningdecisions that will increase opportunities for greater independence forpeople with learning disabilities, older people, problem drug users andpeople with long-term conditions

Engaging the Probation Service more closely in the monitoring and futureplanning of services for ex-offenders and those at risk of offending

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4. Current supply

Westminster has a good understanding of the SP 'market' because theCouncil has in the past strategically commissioned most of the services thatcame under the SP umbrella from April 2003. In addition, the Council took aresponsible approach to preparing for SP and there was therefore not a hugeexpansion in services in the years leading up to its introduction.

The key features of the SP provider market in Westminster are:

There are 55 providers of SP services providing 170 services Providers are mostly RSLs (30 providers) or voluntary organisations (22),

with the local authority and a mental health trust completing the providermarket

6 providers account for 52% of total grant expenditure 15 providers account for 81% of total grant expenditure

The table below sets out a summary of the SP services that currently exist foreach client group by number of units and spend.

Service area Units % SPBudget

Single Homeless with Support Needs 1009 41.67Rough Sleepers 74 3.87People with Drug and Alcohol Problems 60 4.22People with Mental Health Problems 478 17.22People with Learning Disabilities 99 3.90Young People at Risk or leaving care 227 12.85People with HIV / AIDS 51 1.17Generic 72 0.87Offenders or People at risk of Offending 20 0.86Refugees 12 0.28People with a Physical or SensoryDisability

13 0.33

Women at Risk of Domestic Violence 40 1.81Frail elderly 62 0.64Older people with support needs 2191 10.32*Totals 4336 100* includes emergency link and mobile warden services

Cross-authority statement

Westminster has an unusually large number of services that cater for 'crossauthority' service users. Most of these services are provided in homelesshostels, which account for over 60% of Westminster's SP budget.Westminster is unique in such a concentration of hostels and their dominancewithin the SP budget. The Council recently completed a Hostels Review thatconcluded the hostels sector is one that is well established, the quality ofaccommodation has consistently improved through significant capital

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investment and the vulnerability of individuals housed and the quality ofservices provided is generally high. At the same time only 8% of clientsaccepted into hostels gave their “last settled address” as being withinWestminster.

Westminster accepts the hostel sector’s historical reality and recognises thatover the period of the strategy Westminster has the task of managing thisessentially national resource. If Westminster is disadvantaged by the finalallocation formula, it is likely to be because the formula intended for generalapplication, even if the single homelessness weighting is strengthened, doesnot properly reflect the extent to which we are different in this respect.However if, as seems likely, the allocation’s formula does reducesWestminster’s budget these services will be at risk because Westminster willprioritise its own residents for receipt of SP services.

We are committed to seeking to ensure that effective protocols areestablished between authorities within London to govern the future planning ofthese kinds of services, particularly in relation to access arrangements andmove on. Westminster is doing this through working closely with:

• the ALG London Strategic Forum

• the North London Housing Sub-Region

• neighbouring authorities that share common profiles of services andcommon providers.

In addition Westminster will be lobbying strongly on the potential impact onservices to vulnerable people if the final allocations formula is unfavourable toWestminster.

Sub regional working

The North sub-region SP group has agreed its annual business plan for2005/06. A key element of this is a clear commitment to the joint procurementof a floating support service for offenders as an area in which a regionalapproach to commissioning is advantageous.

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5. Approach to measuring performance and quality

Partnership approach

In keeping with the SP theme of supporting the delivery of a wide range of keyCouncil strategies, a partnership approach towards the monitoring and reviewof services has been adopted. Both quarterly monitoring meetings withservice providers and service reviews include, where possible, a relevantrepresentative of the Social Services, Housing, PCT or Probation Service‘commissioner’ of services for that client group.

Many of the services that have come within Supporting People since April2003 are well known to different officers within the Council. The performancemonitoring and review process has built upon their knowledge of the sector,confirming information held and reinforcing the strategic direction. Forexample, a Best Value Review of housing related mental health services wasundertaken in 2002 and the mental health services reviews confirmed theoutcome of this.

The theme of partnership also applies to the way in which the Council workswith providers on monitoring and reviews. It was recognised that theimplementation of SP and the new quality and performance reportingrequirements would necessitate an investment in training for providers on SPmonitoring and review processes. In 2003/04, over 100 staff from providersattended workshops on how to complete the monitoring forms, and theCouncil organised four one-day SITRA training courses on Preparing forReviews together with a one-day workshop on Quality and Monitoring thatwas specifically aimed at small providers.

User involvement is also a key element of the Council's approach towardsmeasuring performance and quality, and this is described in detail in section 8of this Strategy.

Performance Management

Each provider of Supporting People services is required to complete aquarterly performance monitoring return that reports on service availability,service utilisation and staffing levels. Service performance against thesetargets is monitored in the quarterly performance meeting each provider haswith a SP Contracts Manager and a 'commissioner'. Thus, for the first time,the Council routinely monitors all providers of housing related supportservices and this enables identification both of issues facing the sector andthose that are specific to a service.

For example, sector-wide issues that have arisen out of the performancemonitoring include:

• Void levels across the sector are very low indicating high service demand,with the single homeless sector in particular operating at an average of97%+ occupancy level

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• Recruitment and retention of front-line staff is an increasing challenge anduse of locum staff is common

• It is rare for units to be unavailable for occupation, but where this takesplace the most common cause is delays in major repairs

Once the review programme has been completed, Westminster intends tomove to more outcome-based measurements of performance. In particularthere will be an expectation that provider organisations will have systems inplace that monitor and review the outcomes for individual service users andWestminster will undertake work with provider organisations to developcommon approach to measuring outcomes for service users. Westminster willcontribute to the ALG and London Housing Federation work on developingcommon outcomes based monitoring.

Quality Assurance

Westminster uses the tool developed by the government to achieve qualityassurance and continuous improvement within SP, which is known as theQuality Assessment Framework (QAF). As part of the service review process,each provider is required to carry out a self-assessment against the CoreService Objectives in the QAF. The SP Contracts Manager andCommissioner validate this assessment and the provider develops an actionplan to address areas of weakness and further improve service quality.

Outcomes from service reviews

In Westminster, reviews have been programmed on a client group basis and acommitment has been given that no decision will be taken on an individualservice until all services for that client group have been reviewed.

The review process has been a learning experience both for the Council andfor providers and has proved more complex and resource intensive thanoriginally envisaged. This was due in part to the Council’s decision to visit allservices rather than use a desk-top approach and the volume of paperworkinvolved to bring together strategic relevance assessments, complete thequality assessment framework, obtain stakeholder feedback, arrangemeetings with tenants, etc. The level of complexity and the amount ofinformation collected required a template to be developed to report theoutcome of reviews to the Commissioning Body that incorporated a 'trafficlight' system to indicate where there were any concerns about services.

Notwithstanding this, it is likely that all service reviews in Westminster will becompleted by April 2005, which is a year ahead of the deadline set by thegovernment. This achievement is due to the sterling work of the SP Contractsteam and their partner commissioners and the fact that the Council alreadyhad a good understanding of the market due to previous strategiccommissioning of services.

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The review programme has installed a culture of performance and qualitymanagement within the SP sector. The following conclusions from thecompleted reviews can be drawn:

• The high level commitment, skill and knowledge of service users displayedby the great majority of front-line staff was particularly positive

• Only one service was assessed as ‘not strategically relevant,’ this wasaccepted by the provider

• The great majority of services fell within the B/C categories of the QAF• SP grant in Westminster is funding eligible housing related support

services and there is no funding of ‘care’ services.

The process has been very worthwhile and has enabled the Council to gainownership and knowledge of the sector, develop practice and quality andbetter support the delivery of the Council’s key strategic objectives.

Some examples of service improvements arising from reviews are set outbelow:

improving health and safety in a hostel for single homeless peoplewith support needs - concerns about this were raised by service users ata Speakout event (see section on user involvement). During the review theteam assessed these particular issues, confirming the indications given byresidents and identifying causes and possible solutions. Discussionsduring validation resulted in some risks being removed within 24 hours,thus establishing immediate improved safety. Other issues relating to thedynamics of the hostel were addressed and resolved within a week.Longer term the organisation has decided to formally involve residents inits health and safety planning processes within the hostel, showing acommendable determination to engage the expertise of short-termresidents in addressing long-term safety and vulnerability issues.

improving service user involvement in sheltered housing - in onescheme the tenants reported that the formal Tenant Forum for consultationwith tenants did not meet their needs for consultation and participation.They had gone so far as to form their own Tenants’ Association for thescheme. The Review Team raised this issue as part of the formalfeedback to the provider. Discussions between this tenant group and theprovider resulted in a review of the selection process for tenantrepresentation to the Tenant Forum. This was changed to that suggestedby the tenants and also the number of tenant representatives wasincreased from one to two. This met the tenant group's desired outcomesso that they felt more involved in the consultation process.

improving access to a service for ex-offenders to ensure strategicobjectives are met - for some years there was a mis-match between thestrategic aims of London Probation and the profile of service usersaccepted into the service. It was not possible to verify that those acceptedinto the scheme had strong connections with Westminster. At the sametime local Probation Offices and Youth Offender Teams were having to

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refer urgent cases to ‘out of borough’ placements. Finally the scheme had20% of spaces set aside for people “at risk of offending”. This was poorlydefined and meant, in effect, that these places were allocated to serviceusers who were less of a risk to the community than those governmentexpects Probation and Westminster to target. As a direct result ofnegotiation during and following the review, this referral system waschanged. Now all referrals come through a designated Partnership Officerbased within the Probation Service who identifies those offenders in mostneed and with the strongest links to Westminster, and refers them to theprovider for consideration. The outcome is that the provider is making bestuse of an experienced and effective team to meet the joint objectives of allpartners in tackling this particular risk of offending.

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6. Value for money

Introduction

Examination of the value for money of services is a key part of the servicereview process within Westminster. However, concerns over the futurenational funding of SP led the Council to undertake a ‘value for money’exercise separate to the review process during May/June 2004.

In this exercise, a meeting was held with every provider of SP services inWestminster with a grant value of over £35K. The purpose of the meeting wasthreefold:

for Westminster to gain a better understanding of the cost of servicescommissioned in order to inform the setting of grant levels for2005/06 once Westminster’s allocation is known

to identify services that appear expensive and negotiate a reasonablegrant level

to give an opportunity for provider organisations to present anddiscuss key financial issues relating to the funding of the service

It was further emphasised to our providers that SP works within a contractualframework and any changes outside this framework, either to the service interms of levels of support provided or to the value of the contract, must bemutually agreed.

Methodology

The key measure of value used was the cost per hour of support provided asthis allowed direct comparison between services regardless of staffing levels(unlike the use of unit cost per bedspace.) Thus the hourly rate for eachservice was calculated and discussed as the focal point for each meeting,alongside the budget for each service. Whilst the format of budgets varied thequality and clarity of information submitted was high.

Hourly Rate Benchmark

It was acknowledged that any assessment of value for money required abenchmark to be established against which value could be assessed. A figureof £25 per hour was used, representing an increase of 50% above the valueof a domiciliary care service, reflecting the complexity of providing housingrelated support services. This figure was a benchmark for discussion andnegotiation and did not represent a ceiling above which services would not becommissioned.

Outcome

The meetings involved Council officers from SP, Finance and Contracting whofelt they were very positive and helpful. The quality of information provided,and the understanding of the financial and budgetary issues demonstrated

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was very high and indicated that the sector was very conscious of the need tomake best use of available resources. The key financial and strategicheadline outcomes were as follows:

• Only 8 organisations managed services that fell significantly outside thebenchmark. Negotiations took place with each organisation and a revisedgrant level was agreed and this exercise delivered the savings required in2004/05.

• All SP services in Westminster have been assessed against a benchmarkstandard of value and the anomalies identified following the SPimplementation phase have been identified and resolved.

• It can be concluded in procurement terms that SP services in Westminsterprovide value for money.

• There was no correlation between the level of cost and client groupbeyond the fact that sheltered housing services (with one exception) weresignificantly cheaper than any other service. This is likely to be a reflectionof the fact that salary costs are cheaper (frequently linked withaccommodation) and that the flexibility allowed by Transitional HousingBenefit could not be used to increase costs.

• Similarly there was no link between cost and organisational size or type(whether RSL or voluntary agency) i.e. that larger organisations wouldhave the advantage of economies of scale or that smaller ones have anadvantage of lower central costs

Central Management Costs

Westminster recognises that central costs are integral to the delivery of aquality front-line service and that there is a need for each organisation todevelop a reasonable level of cash reserves. An important element of eachdiscussion therefore centred on the level of central management costs.Other than those services identified as lying significantly outside thebenchmark costs, all organisations’ central costs were either within 15% of SPgrant income or there were particular circumstances that explained anyexcess.

Next steps

This exercise demonstrated that:

the Council is committed to sound financial management of SP SP services procured in Westminster provide value for money the anomalies of the implementation phase that have led to the current

financial pressures nationally have been resolved in Westminster.

Having delivered this, the objective is to move to a more performance andoutcome based approach to commissioning, making use of the knowledgeand understanding of the finances of the sector gained to allow providerorganisations more flexibility to allocate resources.

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7. Meeting needs

Westminster commissions SP services to meet a range of needs across alarge number of different client groups. In compiling our SP Shadow Strategyand SP Strategy 2004/05, we collated and updated needs information acrossall those groups and these were reflected in the list of new services includedin the 2004/05 strategy.

This strategy is intended to be a brief accessible document. We havetherefore decided not to spell out what the need is in each client group areabut rather to set out what our approach is to meeting those needs, with someexamples of how that approach is being put into action.

Our approach is largely determined by the funding situation, which means thatit is difficult to plan to develop completely new services and we must insteadconcentrate on reconfiguring existing services. All SP services have beenreviewed jointly with 'commissioners', either from Social Services, Housing orProbation. Those commissioners are up-to-date with the needs of their clientgroups and have therefore been able to inform reviews about whetherindividual services are addressing those needs.

At the same time Westminster will be undertaking a comprehensive housingneeds survey in 2005 that will include analysis of vulnerable groups.

The take-up of services by BME groups will be closely monitored, in particularaccess to floating support services and this will influence futurecommissioning decisions.

As noted earlier, reviews to date have found that most services are indeedmeeting needs as identified in the relevant strategies. In a few isolated caseswhere they are not, those services are being decommissioned.

Certain service type areas are being reconfigured to better meet needs. Forexample, our Hostels Review discovered that while 50% of hostel residentsare thought to have some degree of vulnerability, only 9% of hostelbedspaces are explicitly set aside to meet specialist needs such as alcohol,drugs or mental health problems or a combination of these. Hostel serviceswill therefore be reconfigured to address these needs more effectively. This isparticularly relevant to the target to increasing the participation of problemdrug users by 100% by 2008 and increasing year on year the proportion ofusers successfully sustaining or completing treatment programmes given thesignificant levels of substance misuse experienced by people living in hostelservices.

Similarly, our analysis of floating support provision in Westminster indicatesthat there are gaps in the provision of such services across the followinggroups:

• People with substance misuse issues• Offenders and those at risk of offending

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• People living with HIV/ AIDS (not living in current provision)• Women at risk of domestic violence• Other single vulnerable people and families with support needs that impact

on tenancy sustainment

Floating support services are therefore being reconfigured to meet thesegaps.

In services for young people at risk or leaving care, a need has been identifiedfor better linking up between services and better targeting of services towardscare leavers, homeless offenders and homeless 16/17 year olds. Discussionsare therefore under way with providers to change access arrangements towhat are currently more generic young single homeless services.

Finally, our review of services for ex-offenders found that there was a mis-match between the strategic aims of the London Probation Area and theprofile of service users being accepted into the services. The referral systemhas now been changed to ensure that the strategic priorities of both theCouncil and Probation are being met.

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8. User involvement

Introduction

Westminster is committed to involving users in all aspects of SP and iscontinually seeking out innovative ways of ensuring that the views of usersand potential users of SP services are obtained. The Council will onlycommission services that have mechanisms in place that enable users to

influence the ways in which those services are delivered have input into their own individual support plans

This section of the strategy describes some of the ways in which serviceusers have been involved in SP in Westminster to date.

Strategy development

The 2004/05 strategy was taken for comment to a number of service userforums and meetings at which service users were present. Views expressedat these meetings were subsequently taken into account in the review of therelevant services and the development of this strategy.

For example, at one of the meetings, people with learning disabilities outlinedtheir priorities for supported housing service commissioning as being:

• enabling service users to live near families and maintain existing socialcircles

• properties to be soundly built and in good condition• opportunities to move should be available to all and not linked to need• project security• flexibility of support provision

These views have been incorporated into the future plans for these serviceswithin this strategy.

Service reviews

Obtaining feedback from service users is an important part of the SP reviewprocess in Westminster. A key element of that process is the validation of theQuality Assessment Framework (QAF), the provider self-assessment ofservice delivery. Amongst other things, this validation involves speakingdirectly with service users regarding their experience of the core serviceobjectives of the QAF, such as needs and risk assessment and supportplanning. This process has taken place in all reviews to date with group andindividual meetings being held with residents and questionnaires being sentout.

Westminster has been particularly innovative in this area. For example, userinvolvement questionnaire sheets have been developed for people with

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learning disabilities that make use of symbols as much as text against each ofthe Quality Assessment Framework standards an example of which is below.)

C1.1 – Needs assessment and support planningThis section is about type of support and how much you need.

What do the staff help you with?

Do you have a copy of yourassessment and your supportplan?

Were your viewsincluded in the support plan?

Is there anything you would changeabout the support you receive?

How would you change the support youreceive?

How good is the support you receive?

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Additionally, the review of single homeless services built upon the success ofthe Speakout event (see below) to enable hostel residents themselves toobtain feedback from current users of hostel services to inform the reviewprocess.

Examples of changes to services that have taken place as a direct result ofservice user involvement in reviews include the following:

changes in a complaints procedure - service users said that in the laterstages of the complaints procedure it was unclear what time-table therewas for reaching a decision and how the senior manager from Head Officewould communicate the outcome of the enquiry. This has been addressedso that service users will now not only know the timeframe for initialenquiries but also will be kept up to date with the expected time for theconclusion of the enquiry. The organisation has also taken on boardaddressing how it communicates the outcome of an enquiry whendisciplinary action against staff is the result. This has not been resolvedyet as it recognises the difficult balance to demonstrate the seriousness itattributes to the service user’s complaint while still preserving the privacyof the staff member.

changes in application procedures - service users had commented thatin the period between being accepted as suitable and being given a dateto move in there was poor communication from the provider about howtheir successful application was progressing. They had no idea of how farup the waiting list they were and how much longer they might have to wait.The system was that applicants had to phone the scheme every twoweeks to be given a progress report. This was informally seen as a test oftheir commitment: while never being specifically identified as such withapplicants. Applicants complained that neither they nor their ProbationOfficers felt informed of progress, and that the member of staff they spoketo might not know clearly what their individual position was. As a result ofdiscussions raised by the SP Review Team this system has now beenchanged. The provider pro-actively contacts the referring ProbationOfficer weekly to detail progress in a clear way. They are also activelyconsidering sending updates to the applicant by text message, thus savinga homeless person the expense of a sometimes lengthy phone call.

Speakout

In April 2004, the Council held its first ever ‘Speakout’ for users and potentialusers of hostels for single homeless people. The event was planned by asteering group of service users and staff from the Council and hostelproviders. Service users were also involved in the actual running of the eventon the day.Over 100 service users and staff from hostels and other agencies attendedthe Speakout. One of the principal outcomes from the day was an agreementthat that the steering group should continue to meet and more service usersshould be invited to join it. It was also agreed that the group's main work over

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the following months should be to consider how service users could best beinvolved in SP service reviews of hostels.

During subsequent discussions at the steering group, one of the viewsexpressed by service users was that more effective feedback of hostel users’views would be gained if meetings and interviews were held with current orformer hostel residents. A proposal was therefore put to, and agreed by, theCommissioning Body that the service user members of the steering groupshould be involved in meeting with current hostel residents as part of thereview process to validate the provider self-assessment of the QAF.

Five service users have subsequently been trained to carry out this functionand, at the time of writing, validation meetings are being organised.

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9. Policy on charging for Supporting People services

A decision was taken before the implementation of SP not to charge inWestminster based upon the low projected income levels and theadministrative complexity of SP charging. This issue is being revisitedas part of the wider review of Fairer Charging.

As a result Westminster City Council as the Supporting Peopleadministering authority is considering introducing charging for SPservices in 2005/06. A number of issues to be addressed have beenidentified but the following core assumptions will apply:

• Providers of services will receive SP grant paid gross of chargesand responsibility for collection lies with the authority

• No individual in receipt of Housing Benefit would be required to payany charges and all tenants will meet the Minimum IncomeGuarantee

• All new tenants of longer-term services would be charged andautomatically offered a Fairer Charging Assessment where there isno HB passport

• A reasonable ceiling and minimum charge level will need to beagreed

• Systems development will be particularly challenging given theneed for data collection and interfaces between providerorganisations, benefit services, Supporting People, fairer chargingand finance accounting

A decision will be taken on how to proceed in 2005.

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10. Priorities for the next five years

Overall aim

The overarching aim of our SP Strategy is:

To improve the quality of life for a diverse range of vulnerable adultsand young people in Westminster and enable these residents to achieveimproved health, greater independence and control in making lifechoices.

We will seek to achieve this aim through pursuing four key objectives:

Objective 1: To deliver the local targets for housing related support servicesset within our Modernisation agenda for Social Services.

Objective 2: To consolidate services to support vulnerable residents who donot meet the criteria for Social and Community Services care management.

Objective 3: To address Health Related Priorities

Objective 4: To support and develop local initiatives that aim to help protectthe lives and well being of those who live, work or visit Westminster.

Where we want to be in five years' time

Our vision is that, in five years' time if not before, we will have:

more services targeted at Westminster residents to ensure that everyonein Westminster with housing related support needs can access a service

more floating support services so that tenure is not a barrier to receipt ofservices

services that better meet the needs of rough sleepers so that the numberof rough sleepers in Westminster is in double figures

services that better meet the strategic priorities of the National OffenderManagement Service (NOMS) so that targets for the reduction of re-offending, drug treatment testing orders and MAPPA clients are met

some services that have been commissioned in conjunction with otherlocal authorities in order to enhance value for money

more services linked up with each other to make best use of resources

We want to see better services for:

single homeless people with support needs, as a result of capitalinvestment in hostels and reconfiguration of those services

people with mental health problems, as a result of accommodation basedservices having a higher proportion of self contained units, and bettertargeting of floating support services

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young people at risk or leaving care, as a result of reconfiguring someaccommodation based services and better targeting of floating supportservices

homeless families with support needs, as a result of better targeting offloating support services

women at risk of domestic violence, as a result of providing access tofloating support services

older people with support needs, as a result of targeting sheltered housingservices more at people who need them

people with learning disabilities to enable more opportunities to liveindependently for people in self contained units with floating support.

Achieving our objectives

In order to achieve these objectives the key priorities for the next five yearsare to reconfigure existing services to make best use of resources bothfinancial and buildings in order to:

• Deliver a city wide floating support service that meets a range ofvulnerabilities

• Expand the range of floating support services to meet the needs offamilies, those escaping domestic violence, young offenders, youngformer asylum seekers, substance misuse, young parents

• Deliver more specialised services to homeless hostel residents leading toa reduction in the numbers of rough sleepers

• Ensure the successful delivery of new pipeline services• Target sheltered housing services for older people at those in greatest

need• Develop a regional approach to the commissioning of services for non

Westminster residents• Increase positive vocational and social outcomes for users of mental

health services• Reconfigure young persons services to meet all young person needs• Deliver services that meet the needs of the National Offender

Management Service and their associated community safety partnerships• Increase the number of people with learning disabilities in receipt of SP

services

New services

A key priority for Westminster since the start of SP has been the successfulopening of a number of strategically commissioned services that have been atdifferent stages in the development pipeline. All of these services contribute tothe key objectives in this strategy.

The services that have already opened since April 2003 are:

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• A 10 bed supported housing service provides an alternative to bed andbreakfast provision for single homeless people with a severe andenduring mental illness who are referred by the Housing Options

• Penfold Court – this is an extra care sheltered housing scheme thatrepresents a major partnership between SP, Social Services, PCT andthe RSL provider

• Kilburn Lane – this service is for people with a physical disability andadditional support needs who would otherwise be in hospital orregistered care, and is another example of the strong partnershipbetween SP and Social Services

• Gosfield Street – this building housed an existing service that wasdeemed to not be strategically relevant and is now being used,following minor refurbishment, for young people at risk

Services that are due to open after April 2005 are:

• Mozart Street - this building also housed an existing service that wasdeemed to not be strategically relevant and will be used, followingminor refurbishment, for people with mental health problems

• Cardinal Hume Centre extension – this service will provide additionalprovision for young people leaving care

Floating support

Westminster currently has a large number of relatively small floating supportservices that provide for a variety of client groups. We feel that this is not asatisfactory situation and we are therefore currently inviting organisations totender to provide a city-wide floating housing related support service that will:

• support people who are vulnerable because of mental health problems• support people who are vulnerable because of a range of other needs, e.g.

substance misuse, living with HIV• support people who are at risk of offending• be open to people living in all tenures• have multiple referral routes, including self referrals• be available seven days a week

In addition, we have identified gaps in floating support provision for homelesshouseholds in temporary accommodation, young people at risk, and womenat risk of domestic violence and therefore will soon be exploring with providersthe best ways to fill these gaps.

In proposing changes to the current configuration of service provision,Westminster recognises that it is essential that the strengths of currentservices are not lost. The mental health services in particular are well-established and meet need identified by a range of referring agencies.

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Hostels

The broad conclusion from the Hostels Review was that Westminster has alarge number providing a similar generic service. To address this situation, itis planned to:

• rationalise access - Westminster's Rough Sleepers' Strategy focuses ondiverting people back to their host authority particularly with the move tobuildings based services that will mean that day centres will become themain source of referrals for hostels. We also intend to establish anAssessment Centre in an existing hostel.

introduce a greater degree of specialisation in order to cater better for thevariety of needs that hostel residents have - we have already started tomake changes in hostels to achieve more specialisation, e.g. theCentrepoint Berwick Street hostel changed in June 2004 from being ageneric service for young single homeless people to one specificallytargeted at statutory homeless 16/17 year olds.

address specific physical problems where possible (see below).

The availability of capital funding from the ODPM for capital works to hostelsover the next four years is clearly of major assistance in achieving the plan toaddress specific physical problems in hostels. The main purpose of thisfunding is to tackle those hostels where physical conditions, in terms of overallsize, inadequate facilities or general 'institutional' feel, are deemed to bedetrimental to the quality of support that can be offered.

Westminster has accordingly worked in partnership with providers to identify anumber of projects that meet the criteria for funding. Projects approved so farinclude:

refurbishment by Novas Ouvertures of their Dean Street hostel to providea greatly improved environment in which to deliver a remodelled servicethat better meets the needs of its traditional client group of singlehomeless people with support needs

acquisition by The Passage of the St Vincent's building, which will enableremodelling of the three single homeless schemes located there

acquisition and refurbishment by De Paul Trust of St Stephen's Crescent,which will enable the relocation of the Trust's New to London service foryoung people at risk from its current insecure building, the elimination ofsharing and provision of a more appropriate service

acquisition by St Mungo's of a hostel in Francis Street for use as first stagemove on accommodation from front line services, thus assisting with theimplementation of changes elsewhere in the sector

Other proposals are under consideration for funding in later phases of theprogramme. Some will be for relatively small sums for minor modifications tobuildings that will enable a more effective support service to be provided,while others may be for much more extensive refurbishment projects. In allcases, funding will only be approved if the projects assist the Council toachieve its key SP objectives.

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City of Westminster Commissioning Body 2005/06 Annual Business Plan

This plan sets out the key business objectives for the Supporting People Commissioning Body in 2005/06, the successfuldelivery of which ensures the delivery of the 2005/10 SP Strategy and establish a strategic, integrated policy and fundingframework delivered locally in response to identified local needs. This will deliver a Supporting People framework that ensures:

• Supporting People contributes to partnership wide goals and targets• Service reviews are delivered according to timetable, the outcomes implemented and services configured to meet local

need.• Robust needs analysis identifies housing related support needs, identifying gaps• Effective service user involvement across the range of SP services• The procurement of SP services achieve value for money including implementing tenders for services• Delivery and setting of a balanced budget, including responding to consultation on national grant allocation• The structures and policies to deliver and develop programme are established. There is a clear understanding by all

partners of the opportunities and responsibilities the programme presents.

Key Theme: Partnership working and Service User InvolvementAction Commissioning Body Decision Date

Contribution to range of partnerships andstrategies including DAAT, CJIP, DomesticViolence, Adult Protection, LD Housing, CYPSP,Homelessness Strategy, rough sleeping,Community Safety, older persons, mental health

Report on how successful delivery of SP outcomes isincluded as part of delivery of range of strategies

1/06

Update map of user involvement forum User involvement forum used for development of SPstrategies updated

10/05

Attend user and partnership forum to present anddiscuss SP strategy and development

Report on attendance at user and partnership groups 01/06

Assess and analyse needs of service userspresenting to SP funded services

Housing related support needs analysed across each servicearea, identifying trends and gaps

01/06

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Key Theme: Service DevelopmentAction Commissioning Body Decision Date

Single homeless, domestic violence, HIV andgeneric service review outcomes reported

Review outcome report including all standard informationcompleted

04/05

Recommendations made for configuration ofsingle homeless and domestic violence services

Strategy to reconfigure single homeless services includingany tenders agreed

07/05

Outcome of young persons service reviewsfollowing additional information request reported

Strategy developed for configuration of young personsservices, including agreeing any service tenders

04/05

Quarterly updates on implementation of youngpersons and single homeless service review

Quarterly update reports completed 07/05 –01/06

Outcome of floating support tender reported toCB

Tender for configuration of floating support services for singlevulnerable adults completed

04/05

Complete update report on new floating supportservices

Report on implementation of new services completed 01/06

All services complete an annual QualityAssessment Framework

Review of 2005 QAF against those submitted as part of thereview

01/06

Key Theme: Financial ManagementAction Commissioning Body Decision Date

Complete meetings with all providers of servicesthat have high unit or total costs

Report on outcome of meetings with providers and thefinancial implications

04/05

Audit information requested from providers oflower cost services

Report on provider returns and financial implications 04/05

Implement consultation on ODPM draft nationalallocations formula

Feedback on draft formula submitted to ODPM as part ofconsultation process

04/05

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Produce 2006/07 draft budget including value ofall services

Draft budget that includes implications of efficiency exercise,the configuration of single homeless and young personsservices and outcome of any tenders

01/06

Key Theme: GovernanceAction Commissioning Body Decision Date

Develop conflict resolution protocol Conflict resolution protocol that confirms the CB decisionmaking process is agreed

10/05

Development of SP eligibility criteria Criteria sets out the services and functions elligible forfunding by SP grant

10/05

Develop Memorandum of Understandingbetween Commissioning Body and AdministeringAuthority

Memorandum that sets out responsibilities of CommissioningBody and City Council agreed by Commissioning Body

10/05

Key Theme: Commissioning and ProcurementAction Commissioning Body Decision Date

Agreement of steady state contract Permanent ‘Steady state’ SP contract agreed followingconsultation with provider organisations

04/05

All providers of SP services accredited Providers accredited against five criteria in AccreditationPolicy following North London regional process

07/05

Second review timetable agreed Review timetable for second phase of service reviews agreed 01/06