Public report Cabinet Report

Public report Cabinet Report Cabinet 6 th October 2015 Name of Cabinet Member: Cabinet Member for Children and Young People - Councillor Ruane Director Approving Submission of the report: Executive Director of People Ward(s) affected: All Title: Supported Accommodation for Young People Aged 16-24 Is this a key decision? Yes The proposals within the report will result in significant financial implications and may impact on all wards within the City. Executive Summary: The purpose of this report is to seek Cabinet approval for the procurement of contracted supported accommodation services for young people aged 16-24 to fill gaps in existing provision. These gaps are due to the loss of a significant provider one year into the contract and because the Council was unable to appoint to one lot during the original 2013 tender process. To date, these gaps have been met through short term contracts and spot purchased provision. This report deals with those young people who are eligible for a supported accommodation service. Supported accommodation is the term given to the support the City Council provides to young people aged 16-24, including care leavers, young people who are homeless or at risk of homelessness, children in need, looked after children, young people at risk of or involved in offending, and teenage parents who are pregnant or have children. The City Council has a statutory duty to provide accommodation to persons under 18 who have been assessed as requiring accommodation under the Children Act 1989, or because they are owed a duty under the Children (Leaving Care) Act 2000 and duties towards homeless young people under the Housing Act 1996. In 2013, following a lengthy three-stage consultation with young people, service providers, Housing, Social Care and a range of other stakeholders, the City Council tendered for seven contracts to meet the varying needs of these young people. A

previous tendering exercise prior to this was interrupted by a legal challenge relating to a number of issues including the consultation process and equality impact assessment. As part of the 2013 tendering exercise, significant changes were made to the way supported accommodation was delivered in the city: Budgets from Children s Services, Supporting People and Housing Services were pooled, creating an integrated service and single commissioning process; A single point of entry and brokerage was created through the Council s Placements Team to ensure that all young people received the services they needed; Providers were no longer able to take young people on a direct access basis. One lot (for a call-off contract designed to deal with fluctuations in demand) was not awarded because no bids at an acceptable cost were made. The remaining contracts were implemented in December 2013 with capacity for 160 people in accommodation and 70 units floating support. Approximately 12 months into the contract, a key provider contracted to deliver 81 beds (including 5 emergency beds) exited the contract by mutual agreement, and this, coupled with the inability to appoint to all lots during the original procurement process, has resulted in the use of a number of short term contracts, spot purchasing and use of bed and breakfast accommodation on a temporary basis. The experience of managing the service over the past 18 months, the fact that there is now a much clearer overview of the needs of this cohort of young people via the single point of access, and the loss of a provider, has provided an opportunity to review the service models which will be needed for the remainder of the contracts and beyond. Supported accommodation is a challenging area for a number of local authorities. Some of the strategies put in place elsewhere include: A focus on prevention of homelessness, early intervention and maintaining young people in the community with support, thus diverting them from services; Robust assessment of young people s needs; Specialist provision for young people with complex needs; Services which operate within a co-ordinated pathway, where young people can move from high support through to lower support services (and back again, if necessary). The proposals in this report seek to adopt these strategies for Coventry as appropriate. The new contracts will end at the same time as current contracts on1st December 2017. The reduction of the existing short term spot and block provision will release funding to invest in the services recommended below and reduce expenditure by approximately 0.7m per annum to bring expenditure back within the 2.4m budget. 2

Recommendations: Cabinet is recommended to approve the procurement of the following services: A 20-bed assessment service; A 10-bed specialist service to meet the needs of those young people with complex levels of need and those that pose a risk to themselves and others; A 20-bed service that works with any level of need, but is able to manage significant number of young people with complex needs; A Positive Prevention Service and 10 single units of accommodation, contracts for which expire on 31 March 2016. List of Appendices included: Appendix 1 Appendix 2 Appendix 3 Case study outlining services provided to a young person in supported accommodation. Local Authority Responsibilities Equality Consultation Analysis Other useful background papers: None Has it been or will it be considered by Scrutiny? No Has it been or will it be considered by any other Council Committee, Advisory Panel or other body? No Will this report go to Council? No 3

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Report title: Supported Accommodation for Young People Aged 16-24 1. Context (or Background) 1.1 This report deals with young people who are eligible for a supported accommodation service. 1.2 Supported accommodation services provide accommodation and support to young people aged 16 24 years who are homeless, vulnerable and unable to live independently. The young people in these services are amongst the most vulnerable in the city and may have a range of needs relating to substance misuse, mental health, unemployment and low skills, sexual exploitation, or youth offending (a case study is provided at Appendix 1). Some of them will have been through the care system, or they or their families may have been in receipt of preventative or other services. Some do not reach the threshold for adult services, yet require significant help and support in order to be able to live independently and access employment or training. 1.3 Young People are eligible for support under the Children Act 1989, the Children Leaving Care Act or the Housing Act. Appendix 2 outlines Local Authority Responsibilities that are dealt with, in part through supported accommodation. The young people in the service must have a demonstrable need for support and they include: Vulnerable single people aged 16-24 Care Leavers; 16-17 year old vulnerable young people at risk of homelessness including those assessed as Child In Need; Vulnerable teenagers who are pregnant or may be parents aged 16-24; Under 18 year old YOS clients. Exceptionally, young people aged 18-19 under specific orders involving on-going support from YOS; Other vulnerable young people at risk of homelessness aged 18 to 24. 1.4 Coventry City Council tendered for supported accommodation services in July 2013 and new contracts were implemented in December 2013. A number of positive changes were introduced at this time: budgets were pooled across Children s Services, Supporting People Services and Housing; a brokerage service and single point of access was created to ensure that young people received equality of access and were matched appropriately to available services and create a single point of access.. 1.5 During the procurement process, one lot (for a call-off contract designed to deal with fluctuations in demand) was not awarded because no bids at an acceptable cost were made. Subsequently, short term contracts were put in to place to meet gaps. A Positive Prevention Service was put in place shortly after the contracts commenced to provide mediation work and an initial assessment. 30 additional floating support places were also commissioned to support mediation home and move-on. 5

1.6 In January 2015, one provider contracted to provide 81 beds left the contract by mutual agreement with the City Council. This, together with the inability to appoint to one lot tendered in 2013, has led to a lack of choice of accommodation, placed pressure on remaining providers and required the use of spot purchased accommodation and temporary use of Bed and Breakfast to prevent homelessness. Out of hours placements, and placements for young people with significant and complex needs (such as those supported by the Youth Offending Service who have a history or arson or sexual offences) have been difficult to source. 1.7 Supported accommodation is a challenging area for a number of local authorities. Some of the strategies put in place elsewhere include: Accommodation based assessment unit/s and specialist provision with 24/7 support staffing, to manage the most vulnerable and complex young people. A clear pathway from assessment and specialist services through to progress and move on services. When a pathway is not in place, there are fewer levers to ensure that young people engage with services to develop the skills they need to move towards independence. Services working together as a system and more effective interagency work. Consideration about a single provider model of service delivery after contracts end in 2017, where one provider delivers all elements of supported accommodation system of services as is practice in other Local Authorities. 1.8 The proposals in this report seek to adopt these strategies as appropriate for Coventry. 1.9 In the interim, a range of initiatives have been put in place to improve the quality of provision and to improve multi-agency working, both between providers and between providers and other services in the city who can help support the needs of this cohort of young people. These include: Robust contract monitoring, including visits to provision and spot checks of individual case files; A multi-agency improvement plan involving providers, fire and police services, housing, public health, community safety, drug and alcohol services, Rightstep and the CSE Team. A monthly Supported Accommodation Access to Resources Panel, to which providers bring cases of young people about whom they have particular concerns. The Panel is attended by commissioners, Housing, Route 21, Compass, Community Safety, Children and Family First Service, YOS, CSE Team and is resulting in improved multi-agency working with regard to individual young people. 1.10 These initiatives are having a positive impact on the way services work together to provide coherent, joined-up responses to young people s needs. 6

1.11 Current Service Provision 1.11.1 Current contracted services comprise 128 accommodation units and floating support for 100 young people and this is detailed below. Service Initial Assessment, Referral and Mediation Service (St Basils Positive Prevention) Foyer style accommodation (Midland Heart) Specialist teenage parent accommodation and floating support (Valley House) Specialist independent, single units of accommodation in the community (Key Two and Elysian Fields) Floating Support (St Basils) Floating Support (St Basils) Block Contract Contract End Date Capacity _ March 2016 63 beds November 2017 16 beds and 25 floating support November 2017 49 beds March 2016 45 November 2017 30 March 2016 1.11.2 Demand for the service fluctuates and can be unpredictable. Current estimated demand is for 165 beds per day. This is based on six months average occupancy data from January June 2015, over a period of relative stability after one provider had exited the contract. Demand exceeds current capacity therefore spot purchasing and use of bed and breakfast will continue unless action is taken to put alternative service provision in place and stabilise the system. 1.11.3 The new service model will deliver 147 beds in the city. It is anticipated that demand will be managed down in the future by working with social care to minimise the need for supported accommodation; more robust floating support and mediation to prevent young people entering the supported accommodation system; proactive management to ensure timely move on of young people aged 18 and over from services; possible positive impact of the imminent re- launched Staying Put scheme to keep young people in foster care for longer and appropriate placement of offenders aged 18 and over in alternative commissioned services in the city. 7

1.12 Data and Needs Analysis 1.12.1 The data below covers the period January June 2015 in relation to accommodation services only. A total of 317 young people were placed with the main commissioned supported accommodation providers. The status of these 317 young people is listed below: 20 (6%) were looked after children in the service as part of their plan for independence 70 (22%) were care leavers 139 (44%) were aged 16/17 year olds 88 (28%) were aged 18+ 1.12.2 The table below shows average occupancy from Jan 2015 to June 2015. Number of commissioned beds 128 Average occupancy per day across commissioned services Average occupancy per day across spot purchased services Average usage of Bed and Breakfast accommodation per day requiring supported accommodation Total average usage for all supported accommodation per day 124 32 9 165 1.12.3 The average length of stay for all young people who required supported accommodation and were placed in bed and breakfast was 10 days between April August 2015. 1.12.4 There are a small number of 16 17 year olds who have been placed in bed and breakfast while they wait for beds in supported accommodation. There were a total of 21 young people between April August 2015. Each case is signed-off, by the Interim Assistant Director, Children s Social Care and Early Intervention Service. Statutory guidance states that 16 17 year olds should not be placed in bed and breakfast, however on occasion they are placed there with support for a short period of time to avoid street homelessness. A number of options are being explored to reduce the use of bed and breakfast for this cohort over the next six months, and post April 2016 under the new contracts, providers will be required to manage their beds so that there is capacity to accommodate 16 17 year olds in emergencies. 1.12.5 The length of stay of 566 young people in accommodation since the start of the contracts (December 2013 June 2015) ranged from 33% remaining for 3 months or less, 47% remaining for a year, 18% remaining for 2+ years and one unaccompanied asylum seeking minor with no recourse to public funds for 4 8

years (the latter two groups includes people that were receiving services before the start of the current contracts). 1.12.6 A case audit of young people placed in supported accommodation since the beginning of the contracts identified that: 10 young people would have benefitted from a specialist 24/7 service due to the complexity of their need and risk; There is a continuing need to place approximately 10 young people in independent accommodation in the community because they would not be suitable for shared accommodation; A service accommodating 20 young people is needed to provide a service to young people with all levels of need, including those with complex need and risk. An average of 11 new admissions per month will require intensive assessment services (this will exclude care leavers who already have assessments in place, and young people with low needs. It is envisaged that young people who enter an assessment service will remain there anywhere between 1-3 months, and that provision is required for approximately 20 beds 1.12.7 Preventing young people from entering the service is a key objective. There are already measures in place to do this, and there will be a continuing focus on improving these in order to reduce demand. 1.12.8 When services were commissioned in 2013, the market was not well developed in Coventry or the rest of the UK. In preparing for this next round of commissioning, a significant amount of work has been done with providers, including a market engagement event in July 2015, which 29 local and national providers attended. If the proposals in this report are implemented, it is anticipated that improved market diversity, improved quality and better value for money will be achieved. 2. Options considered and recommended proposal 2.1 Option 1 2.1.1 The preferred option is to procure the services set out below to fill the current gaps and provide suitable and sufficient accommodation, thus stabilising the current supported accommodation system. The indicative numbers are based on demand profiles, evidence of current usage, throughput and the expected impact of preventative services: 20 bed assessment based accommodation service 10 bed specialist service to meet the needs of those young people with complex levels of need and those that pose a risk to themselves and others 20 bed service that works with any level of need, but is able to manage significant number of young people with complex needs 9

2.1.2 Re-commission the Positive Prevention Service and single units of accommodation, contracts which expire on 31 March 2016 in a tender process. 2.1.3 Begin to establish a pathway approach to supported accommodation, across existing and new services, and analyse the effectiveness of the individual service elements and the overall pathway. 2.1.4 It should be noted that demand may reduce, and therefore commissioning higher numbers of beds may result in provision in excess of what is required in the longer term. All services are due to be re-commissioned by December 2017, therefore putting the above model in place with a focus on prevention and moveon will help to plan for this commissioning activity. 2.2 Option 2. 2.2.1 Continuing with the current accommodations arrangements, with spot purchasing of additional accommodation that does not contribute to a positive accommodation and support pathway until the tendered contracts end in 2017 is not a suitable way forward as young people are placed in unsuitable accommodation. Spot purchasing arrangements do not deliver value for money and make it harder to monitor quality and outcomes. 3. Results of consultation undertaken 3.1 The attached Equality Consultation Analysis (Appendix 3) contains full details of the consultation carried out between May and July 2015 with providers, professionals and young people. Their views have informed the proposed service model and the proposed tendering process. Key points fed into the consultation are listed below: There is a need for accommodation based assessment unit/s and specialist provision with 24/7 support staffing, to manage the most vulnerable and complex young people. There is a need for a clear pathway of services including mediation, assessment, specialist 24/7, progress services and move on services. Because this pathway is not in place, there are fewer levers to ensure that young people engage with services to develop the skills they need to move towards independence. The pathway should allow for movement within it as young people improve or suffer from a setback. Operational and interagency work needs further development to improve joint working and pro-active management of a supported accommodation system Availability of housing stock will shape the size/ location of services and is a challenge for providers. Numerous ideas were shared about the issues, risks and challenges involved in placing young people with complex needs and about how to engage with young people, identify and reduce barriers. Suggestions focused on the skills and quality of staffing, methods of working with young people and innovative schemes to improve services. Some of this information may be reflected in service specifications. 10

Providers suggested that commissioners should encourage innovation by identifying the financial envelope, need and outcomes and allow providers to shape the solution. Young people shared some key messages about how services could be improved in the future and this will be shared with providers that submit tenders. The ideal model for most young people that were consulted is to live independently in flats with support when they need it. However, where preferred styles for future accommodation were discussed, comments were made by young people about the need for rigorous assessment prior to living alone in an independent flat in the community and that this was not suitable for the most vulnerable young people. Provision of 24 hour support for those that need it the most was suggested, but the size of the unit should not be too large, one example was self-contained flats for up to 10 young people. Young people highlighted that they should not be placed in high priority neighbourhoods where there is deprivation. 4. Timetable for implementing this decision 4.1 A tender will be released in October 2015 and new services will be in place by April 2016. The effectiveness of the new services will be reviewed which will contribute to the development of service models and service specifications to be put in place from December 2017 onwards. Monitoring of services will be carried out through submission of monthly occupancy data, quarterly and annual contract monitoring information from providers, quarterly quality assurance checks at the provider s site and quarterly meetings with providers. 5. Comments from Executive Director, Resources 5.1 Financial implications In 2015/16 the total budget for Supported Accommodation Services for vulnerable 16-24 year olds is 2.4m. This budget pays for accommodation and support for eligible young people aged 16-24. The 2014/15 outturn position for Supported Accommodation was expenditure of 3.0m against a budget of 2.2m, resulting in an over spend of 0.8m. Although the forecast overspend position for 2015/16 is forecast to be less than the 2014/15 outturn, the position is not affordable within the planned budget. As a result of not being able to award to Lot 7 in the original tender process and the mutual agreement to end a contract with another provider the remaining contracts from the original tender are forecast to cost 0.5m. To manage the demand for the services it has been necessary to purchase alternative provision. This provision has been managed through block contracts with two organisations costing 1.0m, plus additional spot provision with these providers forecast to cost 0.5m in 2015/16. 11

Current spend on Supported Accommodation is detailed in the table below:- m m Original Contracts 0.5 Temporary block provision 1.0 Temporary spot provision 0.5 Bed & Breakfast provision 0.3 Out of City placements due to lack of in city provision 0.3 Total temporary block and spot 2.1 Out of City Placements 0.2 Additional floating support & mediation 0.2 Housing costs for young people with no recourse to public funds 0.5 Total Forecast Spend 3.1 0.1 The forecast overspend relates to the use of temporary block and spot purchase provision to accommodate young people, which will reduce as a result of this tender exercise. This will reduce expenditure by approximately 2.1m and release budget to invest in the proposals outlined in this report. The proposed tendered services include a 20 bed assessment service, 30 beds of 24/7 provision, and a number of spot purchased single flats with support. These services are forecast to cost approximately 1.4m which will deliver a 0.7m reduction in expenditure bringing overall spend on supported accommodation back within budget. There will be a period of transition from the current arrangements to the new, which will result in the requirement to continue purchasing spot provision for a period of time whilst young people transfer to the new service or are moved on to independence. Based on current numbers, and assuming the transition will take place over a 4 month period this could cost between 0.2m and 0.3m. This will need to be managed through the budgetary control process. The Placements Team will actively seek to manage this by implementing a planned transition period to minimise spot purchase placements past 31 March 2016. It should be noted that there is continued financial risk with the supported accommodation budget which needs to be closely monitored and managed. This is due to the reactive nature of service and fluctuations in demand which have been hard to forecast. The Service aim to mitigate this risk through this proposal to ensure young people who are referred receive mediation to support a return home or use of alternative accommodation. It also seeks to ensure that those who do receive a service achieve independence as quickly as it is appropriate to do so. 12

5.2 Legal implications A number of duties may arise for the City Council in the provision of housing support to 16-24 year olds These duties will depend on the individual needs and circumstances of the young person and may include leaving care support and homelessness duties. 6. Other implications 6.1 How will this contribute to the Council s priorities? http://www.coventry.gov.uk/councilplan The proposed supported accommodation services for young people aged 16-24 will keep young people safe in suitable accommodation; provide better housing choices for young people at risk of homelessness; encourage young people are encourage to be healthier, make a positive contribution and support young people to move on to independent living. 6.2 How is risk being managed? There are a number of risks associated with Supported Accommodation, both financial risks and risks in delivering the City Council s statutory duties to this group. Financial risk will be mitigated through the commissioning of the additional provision outlined above and by consideration of future service models post contract end date in December 2017. A risk assessment tool is being used to highlight key risks in commissioning and procurement process and action to mitigate them. Operational risks have been mitigated through contract monitoring, through improved multi-agency working and by actions such as implementation of the Supported Accommodation Resources Panel. 6.3 What is the impact on the organisation? The use of available staffing has been prioritised to focus on the development and procurement of services in a timely manner. 6.4 Equalities / EIA The attached Equality Consultation Analysis (Appendix 3) was completed to assess the equality impacts on current service users. It indicates that the commissioning of supported accommodation services is likely to have a positive impact on all young people as a better range of services will be available. Specific beneficiaries will be those young people that are currently accommodated in single flats in the community, who would benefit from a provision that has support staff on site, and those that are in bed and breakfast accommodation, particularly those aged 16-17 who the local authority has a duty to place in suitable accommodation. Service specifications for the new services will require providers to deliver accessible, non-discriminatory services that meet the needs of all young people from protected groups, who are assessed as being 13

eligible for supported accommodation. They will also be required to collate data about protected groups. 6.5 Implications for (or impact on) the environment None identified. 6.6 Implications for partner organisations? Supported accommodation services are commissioned from a range of organisations in the voluntary sector. Continuing to work with these organisations to ensure the difficulties in managing high levels of demand within a limited resource will be essential to the long term success of this work. Report author(s): Name and job title: Milan Jagatia Children s Commissioning Officer Sally Giles Head of Children s Commissioning Directorate: People Tel and email contact: Milan Jagatia 024 76833598 Milan. Jagatia@coventry.gov.uk Sally Giles 024 76833699 Sally.Giles@coventry.gov.uk Enquiries should be directed to the above person Contributor/approver name Contributors: Bob Dhammi Title Directorate or organisation Date doc sent out Date response received or approved Group Services People 7.9.15 8.9.15 Manager Jivan Sembi Head of People 28.8.15 1.9.15 Childrens Regulatory Services Lara Knight Governance Resources 15.9.15 15.9.15 Services Coordinator Amanda Mayes Strategic Lead Resources 26.8.15 15.9.15 14

Angela Kirby Sally Giles Pete Fahy Georgina Kell Liam Nagle Richard Adams Julie Kendall Anthea Smith Names of approvers for submission: (officers and members) Finance: Rachael Sugars Category Manager, Procurement and Commissioning Services Head of Strategic Commissioning Assistant Director Commissioning and Transformation YOS Service Manager Offender Management Strategic Officer, Community Safety Team Lead Accountant Business Support Officer, Placements Team Housing Options Service Manager Resources 28. 8 15 15.9.15 People 28. 8 15 15.9.15 People 26.8.15 15.9.15 People 28.8.15 1.9.15 People 28.8.15 1.9.15 Resources 28.8.15 15.9.15 People 28.8.15 15.9.15 Resources 15.9.15 15.9.15 Finance Resources 14.8.15 15.9.15 Manager Legal: Julie Newman Senior Solicitor Resources 15.9.15 15.9.15 Assistant Director: Yolanda Corden People 15.9.15 15.9.15 Members: Councillor Ruane Assistant Director, Social Care and Early Intervention Cabinet Member Children and Young People 9.9.15 15.9.15 This report is published on the council's website: www.coventry.gov.uk/councilmeetings 15