An anonymous account of how one service provider saw services for people they support cut after a new round of 'supported living' reviews.
Author: Anonymous
On 10th March a Supported Living House with 5 tenants was subjected to a Whole Service Review by Devon County Council (DCC).
DCC commission support for this service in South Zeal. Each person was ‘re-assessed’ by local authority staff as part of the DCC review and the reorganization of local Supported Living Services. These assessments took place only a few months after tenant reviews (assessments) had been completed by the DCC. Naturally and reasonably (given the outcome) this process has all the appearance and hallmark of a crude cost cutting exercise. At least, there was no discernible alternative purpose.
From our overall perspective, experience and observation the process was rushed, poorly managed, suffered from a terrible lack of transparent communication and was neither tenant nor provider inclusive. It culminated in the rather perverse outcome where the Provider is being paid more to support these same 5 people but the tenants packages of support have been cut, in some cases with a significantly detrimental impact to their health, safety, welfare and finances.
In the examples below the names have been changed for the sake of privacy. Here you will see the odd and unnecessary outcomes that harm 2 people:
Originally Mary was entitled (following an earlier Service Review) to 25 hours of weekly 1:1 support, shared night support and 2 days of daycare funded by the local authority. The total cost of this Support Package was £560 per week.
Following the ‘Re-Assessment’ Mary has 21 hours per week of shared support, shared nights and 9 hours of weekly 1:1 support. She also now makes contribution to her daycare of 3 hours per week, leaving her with only 6 hours of weekly 1:1 support. The total service cost is now £542.12 per week. A small saving for the local authority, but a big negative impact for this individual.
The change of life plan means there are now lots of activities that Mary can no longer do. She was given just 3 days notice of these changes. Local authority support was also removed. No local authority Care Plan was produced. There was no Easy Read information. Any day support options could only be retained if Mary was prepared to sacrifice some of her minimal 1:1 support left remaining.
How is this a positive outcome for Mary?
Joe originally (following a previous Service Review) received 12 hours of weekly 1:1 support plus shared nights. He also attended a local day opportunities service run by Social Services for 4 days per week and had done so for about 10 years. Additionally Joe was funded to be part of a local Community Theatre Group. (This was added into package in December by the local authority, but was removed in February in an assessment carried out by the same Social Worker.) The total cost of his personal budget was £649 per week.
After his new assessment (re-assessment) his package was reduced, leaving him with shared support in the day plus shared nights and 9 hours 1:1 support pw. The new total cost was now £540.
The day-care provision was ‘cut’ despite positive attendance at the same facility for many years?
Following representation to the local authority, another round of review meetings were arranged in an effort to finalise the ‘offer’. These Review meetings took place in the absence of the service provider and with only the person present (and with no other representation.) Given the service providers role in implementing and managing such profound changes such a policy is hard to understand.
Our experience leaves us to report that we do not believe the process was person-centred or inclusive. To date, no Easy Read documentation has been provided to outline the changes in a format that can be easily understood by the client. There have been no discussions or any support plan for the individual that shows any understanding of the impact of the changes for them (for example, learning how to budget so that they can pay for day opportunities that they have had funded for 10 or more years).
Implementation was within one month, with no transitional plan. Four months later we still do not have all the support plans, and neither do the tenant or family.
If the local authority’s intention had been to shut down their own day services then arguably a better managed process would have made this objective clear from the outset. This Provider would have appreciated a more open, honest and inclusive attitude from the local authority. We believe that true partnership working would have yielded a completely different and ultimately better set of outcomes for all and we simply do not understand the rationale other than to save money which they have not truly achieved. However, we have witnessed disruption, uncertainty, anxiety and acrimony. Furthermore, any and all attempts to discuss and help the local authority to improve their performance was met with strong and unhelpful resistance.
Not safe - some people's support cut to potentially dangerous levels (in our view)
A final peculiarity sees the local authority now paying us for empty rooms (voids) at £360 per week for 3 months. Whilst this arrangement might suit the service provider I would prefer to manage my own staffing and house needs and put the money instead into the packages of support for the clients.
If they had needed to save money I wish they had just asked us to give them some ideas, rather than implementing what can only objectively be described as a deeply flawed, wasteful and alienating process.
[This article was written by the manager of a large service provider based in Devon. If you want to be put in touch with the author please contact the Centre for Welfare Reform.]
The publisher is the Centre for Welfare Reform.
Devon County Council Supported Living Service Review © Anonymous 2016.
All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.
