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Commissioning in Supporting People - The ignorant in search of the impossible

Last post 03-05-2008 11:21 AM by SPeye. 4 replies.
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  • 02-28-2008 10:37 AM

    • SPeye
    • Top 50 Contributor
    • Joined on 02-27-2008

    Commissioning in Supporting People - The ignorant in search of the impossible

    ODPM and CLG lauded the Value Improvement Projects or VIP as models of best practise. In simple terms, central government gave monies to individual authorities to develop (claimed) best practise that other authorities in SP should follow.

    Cornwall was a case in point with their best practise model of procuring floating support services. Infamously, this led to one organisation being awarded a large scale FS contract – a model adopted elsewhere with undue haste despite the obvious risks this entailed for all concerned. The Cornwall Model has failed miserably less than a year into this experiment.

    Cornwall’s published Commissioning Body (CB) minutes reveal major concerns were evident in June 2007 just 3 months after contract began in April 2007. A communication statement from Cornwall County Council I have witnessed reveals than service failed a review in August 2007. Also, that the provider terminated parts of the contract in December 2007 and that the provider gave notice to terminate the rest of the contract two weeks ago.

    This contract was the one reported to have seen the ‘provider’ organisation (and I use that term loosely) win the contract based on circa £13.60 per hour and then offer other providers, from whom they had taken the contract, about £10.00 per hour to continue. Clearly, the fact that the official national figure of FS of £23.08 per hour seems to have played no part in the initial decision-making process is an issue here. Do you get what you pay for?

    Cornwall heralded the massive (potential) savings at the time to them with their published best practise project brief stating the risk of provider failure of such a contract to be low. This is clearly not the case as events have unfolded. The self-evident risks in awarding large scale FS contracts – the basis of the Cornwall Model – have come home to roost. The re -tendering process that Cornwall now has to embark upon will have wiped out the alleged potential savings of the Cornwall Model. Indeed it appears likely that new costs will be more than the claimed savings in the first place, just in financial terms.

    Yet this process that has been replicated elsewhere, has seen support staff being TUPE’d twice in less than a year and the new re-tendering will mean they will be TUPE’d again - for the third time - within the first year. What impact doe this have on service delivery, morale and service quality are questions that spring to mind? How could any AA be convinced of provider quality in April and then have serious concerns just 3 months later? There are many more serious questions about the judgements made by Cornwall here.

    However, what is the impact here on CLG? They champion the Cornwall model as best practise. That model has been replicated in many areas by other AAs, as was its intention. Will the CLG now issue guidance to all AAs not to follow this model? Will they even circulate a letter to all AAs to urge them to seek caution in following such a model? I doubt it. Yet we all noted CLG taking praise for developing this claimed ‘best practise’ model when it was launched – a fair weather ‘friend’ to authorities perhaps?

    Many at the time raised these risks and predicted that such a model was bound to fail, myself included. The adoption of FS as a universal panacea and the rush to make (alleged) savings were clearly self-evident in the Cornwall Model ….irrespective of the consequences.

    Yet consequences to whom? Service users have undoubtedly suffered due to this farce. Support staff clearly have. Providers who lost this contract inevitably will have taken years of experience and specialist knowledge away from service provision in Cornwall. But, here we have a council that is funded and lauded by central government in developing a ‘model’ that was supported by (so-called) leading academia in this area. The council has clearly messed up here, but what council officials are ever going to be sacked say, for awarding a contract with such an audit trail and such backing? None!

    This sorry episode exposes the rush for savings by councils to be no risk whatsoever to individual decision-makers within councils or to councils corporately. It does expose that even highly regarded academia and CLG and the best efforts of Cornwall SP and CB has failed to grasp the complexities and individualities inherent within supported housing, inherent by its nature – all in the pursuit of ‘savings.’ Authorities that rush into such models which all are based on the ridiculous notion that support – whether floating or accommodation-based – can be generic, or large parts of it can be ‘generic’ are treading dangerous ground. Yet while these self-evident risks and deluded theory carry little if any risk to authorities and no sanction why would these cease?

    Whilst AAs continue to see and treat vulnerable people as units; while they retain deluded notions that support can be generic or largely generic; while they rigidly seek savings, savings, savings as some form of mantra; and while they have no accountability or sanction, then such high-risk, narrow-minded and frankly offensive policies will continue.

    Or in simple terms, decision makers in local and central government will continue to get away with experimenting with the lives of vulnerable people and have the audacity to claim this is in the best interests of the public purse. But because they are at least one step away from dealing directly with such vulnerable people this wont get called what is it, and that is abuse borne out of too much control and too many conflicts of interest coming home to roost.

    Back before SP began concerns were raised over transferring a demand led benefit into a cash limited pot. Accountability was needed was the argument for the good of the public purse. Little of the argument focused upon the transfer of 'control' that authorities now have to commission or buy services yet clearly not having the expertise to know what they are buying or even want to buy. In this 'model' it was deemed a low risk that "The resulting model for floating support fails to address the identified business needs" and a low risk that "Service Providers fail to deliver services to the required standard" And low risk that "The Project gets service delivery model wrong resulting in a decline in service standards" And finally low risk that Little or no project methodology experience within the authority" will have an impact.

    If commissioners dont know what is possible to achieve then how can they commission at all?

  • 02-28-2008 11:54 AM In reply to

    Re: Commissioning in Supporting People - The ignorant in search of the impossible

     I used to write a lot about Supporting People and it's interesting to see what direction it's going in. I know a lot of people were concerned that some of the tendering processes were driving costs down way too low. Housing support had always been seen as a skilled and reasonably-paid job but some predicted a future where it would end up going the same direction as the care sector, with costs kept rock bottom and unskilled minimum-wage workers struggling to provide a decent service. 

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  • 03-04-2008 4:53 PM In reply to

    Re: Commissioning in Supporting People - The ignorant in search of the impossible

    Theoretically, Supporting People is part of the government's wider vision for personalised care and support - indeed it should eventually become part of individual budgets (as with the current pilots).

    This looks like another case where the financial imperatives and the pressures to make efficiencies that all councils are under come into direct conflict with the government's avowed intention to make care and support personalised and individualised.

    I remember the former care services minister Stephen Ladyman being bold enough to admit this conflict some years ago but at the moment the government appears to be ducking this issue.

     

  • 03-04-2008 6:20 PM In reply to

    • SPeye
    • Top 50 Contributor
    • Joined on 02-27-2008

    Re: Commissioning in Supporting People - The ignorant in search of the impossible

    Mithran, I disagree that the tension here is the personalisation agenda.  In this case the key factor is cost and alleged savings. 

    Scenario

    If provider only paid £10 per hour and staff costs amount to 80% of expenditure costs, that is £8.00 per hour and on-costs are 20% then most support staff can be paid is £6.66 per hour or an annualised salary of £12,800 based on 37 hour week.  What experienced support worker can be employed on such a salary?  Can a house be bought in Cornwall on such a salary?  I could go on along the lines that paying peanuts attracts monkeys, etc., and even ignore the fact that many support providers have to pay far more than this to agency staff etc.  All of these show the futility of this idea in financial terms vis-a-vis likely service and service quality.

    Personalisation agenda and IBs?  Where will individuals in need of support find suitable support staff willing to work for such meagre wages?  I dont think they could.  So whilst I accept the argument that IBs can be seen as a way of pressurising costs downwards in this case it couldn't apply in my view. 

    The fact that Cornwall took a huge risk in appointing a sole provider based we must assume primarily on cost was a massive risk and a risk too far.  What does this say about the knowledge, intent and competence of commissioners there?  When we add in the fact that the "Cornwall Model" was at the behest of central government to develop and then disseminate as best practise, do we also assume that CLG approving this also shows their ignorance of commissioning in general and supported housing in particular? I think it does.  The fact that Cornwall has additional money to develop the model and that they commissioned academic support and advice in developing the model add to these points.  In summary commissioners in Cornwall have made massive errors here with the best advice and resource yet remain in situ with little or no accountability.  That is unacceptable.

    The financial manifestation is that the alleged cost savings anticpated by Cornwall will most likely be eroded or cost more than previously due to the significant resource costs in retendering.  But so many other local authorities in SP have followed this clearly flawed "Cornwall Model."  CLG still advocate this model by the fact that they have not issued guidance or steer to all SP authorities to at worst proceed with caution.

    I wonder how social workers and other care staff would feel if their jobs and services were tendered? Or how they would feel about being TUPE'd three times in less than a year?  What is the impact on service provision for vulnerable people with such demoralised staff?  These are the key issues here and all in my view far more significant than the personalisation agenda in this case.

     

  • 03-05-2008 11:21 AM In reply to

    • SPeye
    • Top 50 Contributor
    • Joined on 02-27-2008

    Re: Commissioning in Supporting People - The ignorant in search of the impossible

    The financial manifestation of the Cornwall Model for support staff is obvious when the figures are looked at in any form of detail.

    Support workers in SP have the primary objective of supporting vulnerbale people to be able to maintain or sustain a tenancy.  Yet given that the Cornwall Model allows a maximum salary for support workers of £12,800 per year then they cannot afford a tenancy of their own!

    How ironic that the people employed with advising tenants / licensees / vulnerable people to sustain or maintain a tenacy cannot even afford to sustain or maintain one themselves due to wages equating to half the national average.

    Why did commissioners not see this obvious consequence of their decision?  Surely any public body awarding a contract has to be sure that service delivery is sustainable?  The proposed service at the contracted cost is and always was unachievable in theory never mind in practise.  Yet the council went ahead and even promoted this nationally in cahoots with central government in the form of the CLG as best practise.

    The similarities with the personalisation agenda are stark.  I am aware of many individualised budget (IB) situations in which the support / care workers are paid between £7 and £8.00 per hour on a self-employed basis (and promoted by councils in this).  This simply cannot be sustainable.  It further shows that the argument for IBs of alleged individual choice is a nonsense.  Services cannot be delivered for such sums and so demand can never be attained purely due to cost and so these providers will exit the market leaving even less choice for vulnerable people.

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