Transforming Housing Related Support Suffolk County Council. Future service models and timescales

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1 Transforming Housing Related Support Suffolk County Council Future service models and timescales

2 What is HRS and who is using it

3 What is HRS? HRS helps a variety of different people to attain and sustain accommodation and/or independent living. 21 different client groups in all. HRS currently provides support to 6,276 people across Suffolk either through floating support or accommodation based support, including people living in sheltered housing.

4 What is HRS? HRS keeps people from being homeless, returning to a life of offending, or accessing other statutory services which incur other costs to the public purse. Support is to empower & enable people in including life skills such as budgeting, employment education and training, social interaction and activities, cleaning and cooking, taking medication HRS is a preventative service - prevents people needing more costly services.

5 Consultation findings All customer groups People have higher needs than they used to. The current split of high, medium and low level units needs review. Floating support customers Main problems for customers are in managing finances and paying the rent, with many at risk of eviction. Accommodation-based services Increased mental health problems common, customers identified were at risk of self-harm and suicide. A need for an assessment process in order to receive the right service first time Older People Mixed messages.

6 Changing needs Current mix (based on 2010 research) Latest needs (2014/15) High needs standard needs low needs High needs Crash pad Standard Refuge Move on (low) 11% 10% 1% 42% 22% 10% 36% 68%

7 Needs identified from referral data for shortterm accommodation (men) Older offenders, medical problems (24%) Self-harming offenders (20%) High level physical & mental health issues, some substance misuse issues, tend to be in short term accommodation, tend to be 25 to 54. Very high need, physical and mental health issues, some learning disability, high risk of self-harm / suicide, some substance issues, wide age range (18 to 44). Lower need, homeless (35%) Some rough sleeping approx. 50% offenders, tend to be homeless or in short-term accommodation, tend to be between 18 and 44. Young and at risk (21%) Most likely male class to be at risk, some learning disability, some leaving care, tend to be living with friends / family or in short term accomm, aged 15 to 24

8 Needs identified from referral data for shortterm accommodation (women) Young, at risk but low need (48%) Low need group except that some are at risk, often living in short term accommodation or homeless, tend to be very young (15-24) Unwell, self-harming and at risk (28%) Complex, mental health problems (24%) High mental and physical health problems, very high self-harm and suicide risk, also at risk with some leaving care, tend to be living with friends / family or in short-term accommodation, tend to be young (15-24) High mental and physical problems, some have substance abuse problems, at risk of self-harm and suicide, likely to be offenders, tend to be homeless or in short-term accommodation, tend to be older (25 to 54)

9 Needs identified from referral data for support at home (men) Single, facing eviction (27%) At risk of eviction, financial problems, low need in other areas, often not working, living in a tenancy or private accommodation, a wide age range (25+). Families with financial problems (19%) Single with health problems (27%) Young, single in temporary accommodation (26%) At risk of eviction, financial problems, low need in other areas, often not working, living in a tenancy or private accommodation, aged between 25 and 44. Some substance misuse and mental health problems, tend to have a disability, not employed due to poor health, tend to live in a tenancy, some financial problems, tend to be 45+. Tend to not be working or sick/disabled, living in temporary accommodation, some substance misuse and financial problems, some learning disabilities and at risk (18 to 34).

10 Needs identified from referral data for support at home (women) Families with financial problems (24% of females) At risk of eviction, financial problems, many clients not working, mostly living in tenancies, generally between 25 and 44 years old. Mature, health & financial problems (23% of females) Single with financial problems (37% of females) Young single and at risk (16% of females) At risk of eviction, financial problems, mostly sick/disabled, some mental health problems and disability, likely to be in a tenancy or private accommodation, aged between 35 and 54. Low level of need except for financial problems and at risk from eviction, both not working and working, in a tenancy or private accommodation, aged between 18 and 44. All single with a high likelihood of being at risk, mostly not working and in temporary accommodation, a younger age group (18 to 34).

11 Other findings. Units for people with very chaotic behaviour There is a small group of people with extremely high needs and chaotic behaviour who cannot be accommodated in traditional hostel accommodation. Typically will have a history of repeat homelessness, offending behaviour, drug / alcohol misuse and a mental health problem. There is a need for a small number of jointly funded highly staffed units across the county where these individuals can be accommodated for a short time in order to stabilise them before moving into more traditional hostels

12 Links to SLCC

13 Supporting Lives Connecting Communities SLCC

14 HRS Links to SLCC Tier 3 Most HRS customers would not be eligible for Tier 3 support at the time of intervention Tier 2 Most of customers fall in to Tier 2 HRS provides short term crisis and preventative support for Domestic Abuse, drug & alcohol, older people and the homeless HRS is a preventative service that helps people regain independence through low level enabling support that delivers prevention and enablement. Tier 1 prevention linked to community asset based offers (very low level floating support i.e. drop in centres and telephone support)

15 Transformation of HRS future vision and the detail

16 The vision for Short term accommodation based HRS services Assessment Beds. Up to 28 days One Gateway for all HRS Services Allocated appropriate housing accommodation based Including some high level beds that are jointly funded Floating support wrap around and preventative. Time limited intervention

17 HRS Gateway SCS and Cara contracts extended until Sept 2016 Work with sector and SCS & CARA to develop new model February 16 got to Market for both provider and system Sep 16 new model of single Gateway goes live

18 HRS Re-commissioning timeline for STABs and Floating Support October Out to market. All services commissioned at an agreed hourly rate. October 2015 to April Ongoing work to assess needs and discussion with strategic partners including options re future joint funding. April Framework agreements in place. Collaborative work with successful providers and wider sector will continue to redesign services. This measured approach enables continued collaborative working with providers to maintain stability, ensure that services meet need, that any risk is minimised as much as possible April 2017 Call off contracts in place for redesigned services.

19 New underpinning principles There will be no block contracts for HRS services in future. Services will be commissioned using a framework agreement to provide flexibility. HRS services will be commissioned based on clearly defined outcomes for individuals, with agreed time limits.

20 New underpinning principles (continued) HRS will deliver a person-centred outcomebased service that can be flexed according to changing needs. Other stakeholders, District Councils, Public Health, Probation, Mental Health Trusts have a legitimate interest in changes to the services commissioned. SCC will look to other agencies involved to contribute where applicable SCC is committed to ensuring that providers can pay a living wage.

21 Assessing need for services Work has begun to needs assessments in respect of all individuals in receipt of housing support services. These assessments will involve the following: Service visits Interviews with front line staff sample interviews with a range of customers at each service. Interviews with partners where appropriate Analysis of performance returns and SQT quality visit findings This work will be completed by September 2016.

22 Accommodation-based services (shortterm)

23 Short-term accommodation-based services We will go to market in October 2015 for a framework of accommodation-based providers who can provide suitable accommodation. Suitable accommodation can include: Hostel style provision Shared houses Self contained flats Mixture of above Unit numbers will remain as existing and we will specify the number of units required for each accommodation-based service when the tender issued. If the support provider is different to the landlord then there needs to be a Service Level Agreement, lease or mgmt. agreement between the two for Housing Benefit purposes

24 Short-term accommodation-based services From April 2016, payment will be based on agreed hourly rate, 5 hours per person per week for non-24-hour and 7 hours per person per week for 24- hour support. Bidders will find themselves better placed to submit prices which are lower than the current standard price of per hour. Unit numbers and hours to stay as existing until reconfiguration work complete. From April 2016, successful providers will be on a framework agreement. New call off contracts for services once new models agreed.

25 Short-term acc-based services (except Domestic Abuse (DA)) Successful providers must be prepared to work collaboratively with SCC from April to September 2016 in order to co-design new system based on following: Assessment stage High level intensive beds to be agreed (joint funded) Generic beds based on basket of hours Close links to floating support available both pre and post acc-based stage continuous pathway. picture Following slides set out the above in more detail

26 Assessment stage First step triage type assessment by skilled staff at new Gateway. Decision made whether to signpost to e.g. CAB etc for short-term help, refer to preventative floating support, or refer to acc-based service in area, which will accept the level of needs that the individual presents with. Each provider required to take referral for minimum 24 hours and maximum 28 days while they conduct an agreed assessment process. At end of 28 days provider reports back to Gateway re whether they can keep the referral. If not, the individual is moved to a more suitable service. Whole process overseen by multi-agency review panel. Requirement for providers to participate in above included in new specifications.

27 High needs beds Not in scope to tender from September We will work with providers, districts and local agencies to determine how many are needed in each area and what other funding is available. Aim is to develop multi-agency partnerships to oversee and possibly joint fund We will also assess appetite for joint funded preventative rough sleeping service

28 All other accommodation-based units Providers on framework agreement with call off contracts. We will complete light touch needs assessments to find out current level of needs in acc-based services. We will examine current service utilisation, outcomes etc., to establish the current amount of acc-based units. Once we know the mix of needs in terms of high, medium and low, and are sure about numbers, we will apportion these out across all services.

29 Floating support

30 Floating support We will go to market in October 15 for a generic floating support service. From April 2016, payment will be based on agreed hourly rate Bidders will find themselves better placed to submit prices which are lower than the current standard price of per hour. Floating support delivered on needs-led basket of hours based on initial max 3 months duration Providers on framework agreement with call off contracts from April Specialist skills (e.g. for older people with mental health problems) will be required as part of wider floating support service.

31 Floating support First step is a triage type assessment by skilled staff at new Gateway. Decision then made re whether to signpost to e.g. CAB etc for short-term help, or refer to HRS floating support service People who require longer must have approval from SCC/Gateway following review Services to work closely with Housing Options and offer support to keep people at home and not in hostels.

32 Domestic Abuse services We will go to market in October 2015 for a framework of providers who can provide accommodation-based support and can offer appropriate accommodation. From April 2016, payment will be based on agreed hourly rate, 5 hours pp per week for non-24-hour and 7 hours pp per week for 24-hour support. Bidders will find themselves better placed to submit prices which are lower than the current standard price of per hour. Unit numbers to stay the same for now. A separate strategic review of DA services is already underway and will inform future call-off contracts. Existing providers and key partners will be asked to contribute to this review. Providers on framework agreement with call off contracts.

33 Young people Ongoing work with CYP re: Ensuring seamless joint working where possible between CYP and HRS Young Persons Pathways. Need to retain crash pads as part of service model for young people.

34 Community Engagement New specs will require providers to signpost to meaningful day time activities and measure as an outcome. Building on Chapman Centre model and linking into Connect Ipswich, Connect Sudbury and Lowestoft Rising.

35 Questions What 3 key outcomes should we focus on for HRS? Suggestions for engaging with customers during this period of change?