Agenda item

[Report of the Assistant Director for Planning Regeneration, and Development. To be introduced by the Cabinet Member for Housing, Regeneration and Planning.] Report setting out recommendations for change to supported housing and housing support based on the findings of the Supported Housing Review.

 

Appendix 1 – Working Group Introduction is marked to follow.

 

 

The Cabinet Member for Finance and Health introduced the report which set out the findings of the Supported Housing Review.

 

The review had involved obtaining a range of stakeholder views, through quantitative and qualitative means, on current supported housing provision, support models, and built environments in the borough. This was in light of the changing housing and social care landscape which emphasised the need to modernise and diversify the housing support offer to the boroughs vulnerable residents.

 

The Cabinet Member for Finance and Health referred to the findings of the review, set out at page 64 of the agenda pack, which described: current service models as largely reactive, supported housing not being used in an efficient way, and indicated that best practice methods were not being utilised to maximise independence.

 

There were a total of 11 recommendations from the Supported Housing Review, some universal and others targeted around young people, mental health, learning disabilities and older people.

 

Completion of the review was the 1^st phase of work, and there would be future decisions on the different client groups coming forward to Cabinet as and when the associated phases of work were completed.

 

The Cabinet Member for Finance and Health thanked the members working group and Gill Taylor, the project manager, for all their hard work over the last year in bringing the review and recommendations forward.

 

In response to questions from Councillor Morris, the following information was noted:

 

• There was still significant work to be taken forward, which was recognised and underpinned this framework, to achieve the required changes in supported housing. Therefore the savings figure associated with these changes was expected to evolve .However, there was likely to be savings as a result of the housing provision being better utilised.

 

• It was important to note that the savings were not just the priority but achieving the outcomes of greater independence and the prevention of crisis’s before they occur for clients in supported housing which this framework would enable.

 

• The Assistant Director for Commissioning stressed that these were strategic priorities being followed in the framework and so were not dependent on agreement of the HDV. The Assistant Director continued to provide assurance of the alternative actions that could taken such as work with registered providers to find supported housing placements.

 

 

 

RESOLVED

 

1. To note and consider the introductory report from the Supported Housing Review Members Working Group set out in appendix 1.

 

2. To note and consider the data and intelligence collated as part of the Supported Housing Review, presented in the Needs and Gaps Analysis, set out in appendix 2.

 

3. To approve the vision, strategic principles and initial recommendations for housing support transformation set out below from 3.5 and explored further in the Recommendations Framework at appendix 3.

 

4. To agree that the transformation of housing support should be based on a vision of Haringey as a place ‘where vulnerable residents can access flexible and personalised housing support services that maximise prevention, independence and inclusion within diverse mixed communities.’

 

5. To achieve this vision, Cabinet approved the strategic principles set out below. Using consistent principles to commission new services and support practices would create a more strategically relevant housing support offer that meets the diverse needs of different vulnerable groups with an overarching commitment to preventing homelessness and dependence.

5.1       Cross-cutting Prevention; our housing support offer is genuinely preventative, offering support to at-risk groups at the earliest possible opportunity thereby reducing the social & financial cost of homelessness and housing crisis. Housing support services will offer multiple preventative interventions at individual and community levels; reducing demand on supported housing, preventing escalation of need and offering viable alternatives to residential care.

5.2       Community Inclusion; our housing support offer reduces social exclusion, isolation, stigma and multiple disadvantage by putting people at the centre of the services they receive; to secure housing, work and wellbeing opportunities that bring diverse people and services together. Supported housing services and service users feel encouraged and equipped to work together to create volunteering, employment and relationship-building opportunities that outlast someone’s stay in supported housing, building resilience in our communities and fostering good relationships between Haringey’s diverse cultures, identities and experiences

5.3       Integrating Support & Care; housing support is commissioned in broad pathways of integrated support and care that reduce dependence and increase independence in a safe, personalised and holistic way. To achieve this, the vital preventative function of housing-related support will be integrated with adult social care provision but preserved as a discrete service provision for some groups.

5.4       Commissioning for the Future; our housing support offer maximises the reach of funding and is flexible enough to meet the changing demographics and support needs of Haringey residents. Commissioning will deliver improved value for money, encourages innovative collaborations between the Council and its stakeholders and creates a housing support sector that is responsive to the changing political and economic landscape.

 

6. To ensure supported housing tenants were involved, informed and assured of the Council’s commitment to improvement, Cabinet approved the development of a Supported Housing Tenants Charter. As well as detailing the explicit commitments and opportunities for supported housing tenants as part of the Housing Support Transformation work, the Charter would act as a pledge. As a pledge it would actively involve, empower and give a platform to under-represented groups such as the older LGBT community, vulnerable women and people with learning disabilities. It was agreed that the development of the Charter be created by the Housing Support Transformation Members Working Group in partnership with service users and supported by Council officers with final approval by the Cabinet Member for Housing, Regeneration and Planning.

 

7. To note that housing support transformation would require universal and targeted change. Cabinet agreed that the five universal recommendations and the twelve specific recommendations for the four priority client groups; young people, mental health, learning disabilities and older people, identified below, should be implemented by the Council in line with the proposals for delivery in appendix 3.

 

Universal	7.1 To create the Supported Housing Tenants Charter outlined in 3.7 that sets a foundation for our commitments to supported housing service users affected by changes as part of this programme 7.2 To amend the current social lettings quotas for people           leaving supported housing to accurately reflect data on need and vulnerability   7.3 To note that the Housing Strategy commitment to build new specialist housing should be rigorously explored for all new proposed development work in the borough to increase the available supply of supported housing   7.4That a commissioning practice should mandate improved and streamlined data collection and outcomes monitoring practices in supported housing as well as a commitment to provider collaboration that strengthens relationships between vulnerable people and their communities.   7.5 To build on the proud LGBT history in Haringey by addressing the lack of data, professional training and visibility of the LGBT supported housing community, with particular focus on older and younger people, people from BAME communities and those with disabilities.
Young People	7.6To commission an entirely new and integrated pathway of supported housing for homeless young people and care leavers, with a range of provision types, settings and support-levels that enable young people to build on their skills, interests and assets towards independent living.   7.7 To create a specially designed resilience and independent living skills programme for young people in supported housing as a prerequisite to move-on, ensuring young people leave supported housing with the skills and confidence to never return, to reduce tenancy failure, boost employability and strengthen healthy and positive choice-making.
Mental Health	7.8 To create a peripatetic access and intervention team, aligned with locality mental health models, housing offices & support services; offering short-term tenancy sustainment interventions, medication support, pathway assessment and ongoing referrals/signposting for people at risk of homelessness or hospitalisation due to mental health conditions.   7.9 To conduct a short and separate evaluation of the mental health supported housing pathway with specific focus on contributions to reducing hospital admissions, reducing delayed discharge from hospital, employability, skills and community contributions and reducing risk and offending behaviour   7.10 To increase the capacity of the Housing First scheme, in recognition of the excellent outcomes and value for money it has demonstrated supporting adults with very complex mental health and homelessness histories   7.11 To pilot the Psychologically Informed Environment approach to create a designated service for women with complex needs around trauma, substance use and homelessness.
Learning Disability	7.12 To remodel and rebalance the supported housing provision for adults with learning disabilities to create more supported housing for those with higher needs which is much needed as an alternative to residential care and to support adults with more complex and interconnected disabilities and health conditions   7.13 To create a 10-unit social lettings quota for adults with learning disabilities as a route into independent living out of supported housing.   7.14 To commission a specialist floating support scheme for those living independently, which enables people to build strong peer and community networks, pool resources and add value to the communities in which they live
Older People	7.15 To support Homes for Haringey to remodel the current supported housing offer for older people, moving to a hub and cluster approach with 8 open-access hub services spread equally between the east and west of the borough that will make better use of facilities as well as supporting older people in a more personalised way.   7.16 To commit to building 200 units of Extra-Care provision in the borough by exploring the potential redevelopment of existing sheltered housing schemes for this purpose. This will start with in-depth appraisals of nine Council sheltered schemes as well as discussions with RSL’s about other suitable sites in the borough.   7.17 To increase the availability of floating support for older people to enable extended independence in the community and ensure earlier access to assistive technologies, adaptations and social inclusion activities

 

8. To note that specific delivery plans would be developed for the implementation of the above recommendations and to agree the Decision Roadmap proposed on pg.20 of appendix 3 as this sets out the indicative milestones for the first year of implementation. The roadmap sets out the following proposed milestones:

 

March 2017; following Cabinet approval,work on the transformation recommendations set out in this document will commence.

Autumn 2017; Officers to return to Cabinet with an update on progress, including details of proposed model of support in sheltered housing, the outcome of site appraisals completed on sheltered sites and the final designs of the young people’s supported housing pathway. Dependent on the outcome of the site appraisals, this report will likely include a request for approval to formally consult with sheltered housing tenants.

Winter 2017/18; Officers to return to Cabinet with a request to agree the award of contracts for the newly designed young people’s pathway and the outcome of the consultation with sheltered housing tenants.

Spring 2018; Officers to return to Cabinet with an update on project progress; implementation of the young people’s pathway, remodelling of the learning disability supported housing offer and the revised model of support in sheltered housing.

           

9. To agree that the following supplementary areas of work, as recommended by the Supported Housing Review Members Working Group be completed:

 

Supplementary

9.1 Assessment of opportunities for move-on from supported housing, exploring shared housing models, rent deposit schemes, tenancy resilience training and nominations into social housing properties.   9.2 To support Homes for Haringey to improve the downsizing offer for under-occupiers in Haringey, to include exploration of seaside and country moves, incentive payments and home-sharing initiatives.

 

Reasons for Decision

 

Cabinet is required to approve the recommendations from the Supported Housing Review set out in the Supported Housing Recommendations Framework.

 

Approval is required to support the delivery of the Council’s strategic priorities for vulnerable adults as part of the Corporate Plan (2015-18) and commitments made in the Medium Term Financial Strategy (2017/18).

 

Approval is required to address the issues, gaps and opportunities identified by the Supported Housing Review, briefly outlined below and described in detail in appendices 2 and 3;

 

Young People – our current supported housing for young people and care leavers is not effectively contributing to our responsibilities as outlined by the Children Leaving Care Act (2000), Housing Act (Amended 2002) and the judgement in LB Southwark vs. G (2009). Additionally, the cohort of care leavers for whom we are responsible is due to increase as a result of the responsibilities outlined in the Children and Social Work Bill, due to be enacted in Autumn 2017. This will require local authorities to support care leavers not in education, employment and training until the age of 25 years old, a cohort who typically have a range of complex and interrelated issues and experiences who are commonly living in supported accommodation and frequently experience eviction, tenancy failure and debt as a result of gaps in available support and expertise. The current provision will not sufficiently deliver our new responsibilities and does not deliver best value or best practice. In recognising this the Council proposes to bring supported housing into its work to develop a strong care leaver offer in Haringey with support from successful bids to the Design Council and Department for Education (outcome pending). Failure to make changes to supported housing for young people will result in unsustainable future costs and a service which is unable to meet the needs of vulnerable members of the cohort as well as legal requirements to support a larger cohort. Approval is required to realise the opportunities identified by the Supported Housing Review which will significantly improve the quality of housing support as well as savings proposed in the Medium Term Financial Strategy (2017/18).

 

Older People – the population of older people in Haringey has changed significantly in recent years, with larger numbers of people aged over 75 years old with complex health and care needs and lower numbers of younger older people who are living independently until later in life. This has resulted in our sheltered housing offer no longer meeting their needs effectively. Data and intelligence collated by the Supported Housing Review shows clear unmet need and financial imperative for 200 additional units of Extra-Care housing as an alternative to residential and nursing care. Initial site-appraisals, conducted on all sheltered housing properties owned by the Council as part of the Review, identified nine potential sites where extra-care could be developed to bridge this gap. Engagement work with sheltered housing tenants also identified that loneliness, poor health and social isolation were not being sufficiently addressed by the current models of support available and that under-used communal spaces provide opportunities to address this by creating hub services. Approval is required to ensure that housing support for older people is in line with the known needs of older people in the borough, and actively contributes to the early intervention and prevention of social care dependence, unplanned hospital admissions and financial savings in Adults Social Care.

 

Learning Disability – our current supported housing offer for people with learning disabilities has not been refreshed in some years and the support available is dated, expensive and not aligned with our strategic priorities. It has been identified as part of the Medium Term Financial Strategy (2017/18) that remodelling the supported housing for this cohort will create suitable alternatives to residential care for adults with severe disabilities and opportunities for independence for those currently stuck in supported housing due to lack of move-on options in the community. Approval is required to remodel supported housing for people with learning disabilities to deliver our commitment to choice and control set out in the Corporate Plan and to realise financial savings identified in the Medium Term Financial Strategy (2017/18).

Mental Health – the supported housing review identifies an increasing demand for mental health supported housing both through increased homelessness within this cohort and the need to find alternatives to residential care. Current mental health supported housing is struggling to adequately support the cohort in need, with referral and assessment delays, issues with acquiring suitable buildings and concerns about a small cohort of vulnerable women whose needs are not being addressed. In contrast, intensive Housing First support models recently piloted in the borough have been highly successful in reducing hospital admissions, care packages and interaction with the criminal justice system. Approval is required to introduce preventative support for this client group to manage demand for finite supported housing options, respond to early signs of crisis to prevent homelessness and hospitalisation and reduce the costs associated with repeat homelessness and complex trauma for vulnerable women.

 

 

Alternative Options Considered

 

The Council already has a range of commissioning plans for housing related support and supported housing. However, the Supported Housing review has found firm evidence of changing and unmet need for housing support in the borough. Additionally, and the Council must find alternatives to residential care and reduce temporary accommodation usage as a matter of urgency. Attempting to continue with unchanged supported housing provision would incur immediately unsustainable financial costs across social care and housing. Adult Social Care costs are expected to rise by 30% in the next two years and this will increase further if suitable alternatives are not found for the rising needs of the boroughs population. As an example, failing to address the unmet demand for Extra-Care housing incurs additional costs of around £26,000 per year per person for every unit of residential or nursing care used instead. With a shortfall of 200 Extra-Care units, making no changes at all, in this area alone, is clearly not an option.

 

The Council could also consider carrying out individual refreshes of existing service models and contracts, with the view to driving forward better quality and efficiency on a service-by-service basis. However, the extent of local and national policy changes in recent years are such that this would not enable the Council to adequately meet the challenges it faces in supporting vulnerable residents. Further, this approach would fail to balance the full spectrum of client groups and needs against the available revenue funding and capital assets to make the best use of finite resources.

 

Alternatively, the Council could move forward without a strategic framework for housing support as there is no statutory requirement for a local authority to produce one. However, having a coherent commissioning framework and approach, founded in evidence of current and projected need, is considered best practice. Equally important is the articulation of how the Council will meet housing and social care challenges and deliver its objectives and priorities as set out in the Corporate Plan 2015-18.

 

The Recommendations Framework outlines a vision, principles and recommendations for change in housing support that aim to achieve the Council’s priorities to support vulnerable residents. Alternative options were discounted where they:

·         Would not be consistent with the data and intelligence about housing support need in the borough

·         Would not have been consistent with the general tenor of feedback and engagement with service users, service providers and technical specialists

·         Did not comply with current and forthcoming government legislation

·         Would have represented policy choices that are unachievable given known and likely constraints