Public
Key Decision - Yes

HUNTINGDONSHIRE DISTRICT COUNCIL

Title/Subject Matter:	REVIEW OF SAFER HOMES SCHEME FUNDING
Meeting/Date:	SOCIAL WELL-BEING SCRUTINY PANEL - Date 03 FEBRUARY 2015
CABINET - Date 12 FEBRUARY 2015
Executive Portfolio:	Executive Councillor for Strategic Planning and Growth
Report by:	Housing Strategy Manager
Ward(s) affected:	All
Executive Summary:
This report is to brief Members on the performance of the Safer Homes Service since funding began in 2011/12; advise Members on the proposal for service development across the County and a new joint commissioning approach that is being adopted; and seek a Member decision on whether or not to continue investing in the service in future. Performance of Safer Homes since 2011/12 The Council has contributed funding to Age UK Cambridgeshire since April 2011/12 to run a Safer Homes Service. The service provides a value for money service to older residents, carrying out an initial assessment of their home, making referrals to other services where appropriate and carrying out minor jobs including grab rails, bannister rails, half steps, and key safes. The service is aimed at vulnerable owner occupiers (the majority of older people own their own home) and carries out about 250 jobs per year. The current service costs c.£45k in Huntingdonshire. £25k has been funded by this Council, with the remaining funding coming from health and personal contributions. This service helps fulfil an objective in the Council’s Housing Strategy, ensuring that older people in the district are able to continue living independently in safe, well maintained homes. The service also contributes to the health related objectives in the Council’s Corporate Plan. The service provides low level preventative support and may have prevented the need for more expensive housing, health or social care interventions which could otherwise have been needed. Development of the service in Cambridgeshire A County-wide review of the service in 2013 and subsequent report to the county Health and Well-Being Board resulted in the Board asking the officer group to develop a funding proposal in conjunction with health and social care to provide longer term funding certainty to the service. Following this, the CCG and Cambs County Council have committed funding to the project and it is due to be jointly procured in spring 2015. The proposal is to jointly commission the service between housing / health / social care bodies with Cambridgeshire County Council leading the procurement. A ‘needs modelling’ exercise has been undertaken to ensure that the funding targets areas of need appropriately across the County. This research was based on national findings, applying local variances in population and tenure to identify the relative population at risk and in need of a service. The other Cambridgeshire districts (and city) councils have committed to funding their share of the service. They are funding this from their general fund, not from their housing revenue accounts. Potential for HDC investment in the jointly procured service There are a number of options for continued HDC investment in the service, depending upon the level of service that Members would like to provide. As a principle, the service will not be free, a charging policy is due to be developed by the potential provider of the service, in line with some principles set out by commissioners. Safer Homes interventions may save this Council from having to undertake more expensive Disabled Facilities Grants (DFGs). With the average Safer Homes intervention costing just £175, and the average DFG costing £6k, logic suggests that there is a ‘spend to save’ case for ongoing Council investment in Safer Homes, however this cannot obviously be substantiated through a case review.
Recommendation(s):
Officers recommend that the Council consider adopting Option 2 as set out in the Options Appraisal at Appendix 1: HDC investment of £25k in 2015/16 and £10.4k from 2016/17 - 2018/19 Jointly commission with partners a new countywide service Review the HDC funding position during 2016/17 to consider whether to fund after the end of the contract. on the basis that: The schemes contributes to objectives in the Council’s Corporate Plan and Housing Strategy and this funding level is adequate to meet the needs that have been identified for vulnerable people in Huntingdonshire. Huntingdonshire has an ageing population and a ‘whole systems’ approach to helping people to remain independent in their own homes is required across the public sector. Joint commissioning of a new service with other statutory partners will provide a consistent and enhanced service to older people across the county and meet the aims of the Cambs Older Peoples Strategy to work together on prevention. This option will deliver a reduction in budget in 2016/17 from £25k per year to £10.4k while maintaining a valuable service. Logic suggests that a number of Safer Homes assessments (costing on average £175), could potentially save the Council the need to spend on more expensive Disabled Facilities Grants (costing on average £6k). Ending HDC’s investment in the service will result in a drop in the number of interventions that would be made (from 2014/15), which means that a number of older and vulnerable people could be potentially at risk. A further review of performance of the new Service can be carried out in two years’ time and a decision made on future funding at that time.

1.	WHAT IS THIS REPORT ABOUT?

This report is to brief Members on the performance of the Safer Homes Service since funding began in 2011/12

Advise Members on the proposal for service development across the County, and a new joint commissioning approach that is being adopted.

To seek Member decision on whether or not to continue investing in the service in future.

2.	BACKGROUND

2.1	The Council has contributed funding to Age UK Cambridgeshire since April 2011/12 to run a Safer Homes Service across Cambridge, South Cambs and Huntingdonshire areas. Prior to 2011/12, Huntingdonshire was the only district in the county without a service of this type.

2.2	This service helps fulfil an objective in the Council’s Housing Strategy, ensuring that older people in the district are able to continue living independently in safe, well maintained homes. This is particularly important given the ageing population in Huntingdonshire.

2.3	In line with other Council services and the Facing the Future project, the Council’s contribution to the provision of this service is being reviewed to assess the benefit for the residents of Huntingdonshire, and the relevance to our Corporate Plan objectives.

2.4	As a result of Facing the Future discussions, including with the Executive Councillor for Strategic Planning and Growth, funding from this Council for Safer Homes is included in the proposed budget for 2015/16 with the proviso that a review of options going forward would be carried out and means testing is considered. This report considers those issues, and the impact on the current joint commissioning of the service.

3.	REVIEW OF CURRENT SERVICE

3.1	At the current time, the service is provided by Age UK Cambridgeshire. The service provides a value for money service to older residents, carrying out an initial assessment of their home, making referrals to other services where appropriate and carrying out minor jobs to keep them safe. The service is aimed at vulnerable owner occupiers (the majority of older people own their own home) and carries out about 250 jobs per year. At the current time, contributions are sought from service recipients towards the cost of work but a more robust charging policy will be developed for the newly commissioned service. Demand for the service has been high, however Age Uk has avoided promoting the service more widely due to restricted budgets and capacity to deliver.

3.2	At the current time, this Council provides £25,000 funding each year which is part of the funding required to deliver the service. The total funding required for 2013/14 is shown below:

HDC	£25,000

Health (Falls prevention money)	£10,000

Health /CCS funding	£6,667

Donations	£1,635

Total funding 2013/14	£43,302

3.3	The table below shows the number of assessments completed each year.

Year	Annual Target	No. assessments
2011/12	200	249
2012/13	200	240
2013/14	200	262
2014/15 (first 6 months)	200	219

NB: In 2014/15 additional funding of £20k has been brought forward from an increased Health (CCG) contribution, which has led to the current increase in jobs.

3.4	To give an example of the types of works being carried out, in the first quarter of 2014/15 (April to June) the Safer Homes scheme fitted: 121 grab rails, 18 bannister rails, 21 half steps, 25 key safes, completed 2 small plumbing jobs and 5 bed/furniture moves. Customers often have more than one job done and are also advised of other services available to them locally. Not all assessments result in works being done and some clients are signposted to other services or contractors, if for example works are too large or a major adaptation is required.

3.5	The average cost of an assessment including the cost of works is c. £175. Clients are asked to make a contribution and these can vary from a standard £20 per job to some clients donating much larger sums. Overall the service has been very successful with many clients valuing the service highly. Age Uk Cambridgeshire has also taken the opportunity to add a number of other initiatives into the service. Two examples are they have received funding to carry out Home Energy Checks and complete these, and install energy saving measures at the Safer Homes assessment visit. They have also initiated a pilot project using some of the additional CCG funding, basing an assessor one day a week at Hinchingbrooke Hospital to ensure older people are being discharged to a home that is safe to return to.

4.0	future DEVELOPMENT of the service in cambridgeshire

4.1	Health and Well Being Board Review -

4.1.1	A Review of the service across Cambridgeshire (led by HDC) was carried out in 2012/13. This culminated in a report to the Cambridgeshire Health and Wellbeing Board in April 2013. This report highlighted that provision of this type of service had historically been patchy, with funding granted in a piecemeal fashion from a variety of sources. It highlighted the need for investment from health and social care in order to sustain the service across the county in the longer term. As a result of this, Health (CCG) and Adult Social Care (ASC) agreed to put the service on a firmer financial footing and commit funding to commission a Countywide Service in partnership, potentially with the district councils.

4.2	DESCRIPTION OF THE new SERVICE

4.2.1	The joint commissioning partners are currently drafting an outcome focussed specification, outlining the type of service that they wish to see delivered. The core element of the service is the initial assessment of the older person’s needs in order to keep them safe in their home. This service provides a ‘foot in the door’ and access to many older people who may not currently be users of services and who would not willingly contact Adult Social Care asking for help. Minor jobs can be carried out to enable the older person to live independently and avoid the risk of falls and promote a sense of wellbeing. General sign-posting and benefits advice will also be provided through a holistic client centred approach.

4.3	COMMISSIONING PROPOSAL

4.3.1	Cambridgeshire County Council is leading on a joint commissioning project with the service going out to tender in Spring 2015 for a three-year contract. In order to go ahead, a decision on partner funding commitment needs to be made. The other Cambridgeshire districts have committed to funding their share of the service according to the needs model. It is timely therefore that this report is being considered now.

4.4	CHARGING REGIME

4.4.1	It has been agreed between County, Health and district partners that the new service will NOT be a free service. When tendering there will be agreed charging principles within the specification and providers will be asked to design an appropriate Charging Policy. The consultation showed that most people are happy to contribute towards a service. The principles will cover issues such as when it may not be appropriate to charge e.g. moving a bed and installing a key safe in end of life cases.

4.5	ASSESSMENT OF NEED FOR THE SERVICE

4.5.1	An assessment of the need for the service in Cambridgeshire has been carried out to ensure that the funding targets areas of need appropriately across the County. Previously contributions from Health and Adult Social Care have been divided equally between the five districts with no consideration of differences in populations or tenure. The recent research was based on national survey findings, and included consideration of Census data for the older population, and tenure, to identify the relative population at risk and in need of a service. This research established that 25% of the county’s need for a service is within Huntingdonshire. The new County and CCG funding allocated to the County will be split according to this formula with 25% of their funding being put into delivering a service in Huntingdonshire. While it may have been helpful to try to establish the exact numbers of assessments needed, this would have required a significant and costly piece of research that could not be justified.

4.6	FUNDING THE NEW SERVICE

4.6.1	It is anticipated that the new service will cost in the region of £250,000 to run, based on the demand for the existing service and the opportunity to promote the service more widely to meet the respective outcomes and priorities of commissioners. It is proposed that funding could be split into three with the County Council paying for 1/3, CCG funding 1/3 and the districts funding the final 1/3 (split according to the % of need in their district). So in order to consider the potential Huntingdonshire district contribution the sum is as follows:

Total cost : £250,000 / 3 = £83,333 per partner

£83,333 / 25% = £20,833 (without client contributions included)

4.6.2	Total cross-partner funding of £62,500 per year is thought to be required to meet the need identified in Huntingdonshire. This would result in a baseline of c.350 jobs per year for our older population. With the investment from Health and the County Council, this Council’s funding could reduce from £25,000 per year. If the full £62,500 were to be funded, this would consist of:

Health /CCG funding	£ 20,833

County (adult social care)	£ 20,833

Income from charging	(estimated)	£ 10,500

Potential contribution from HDC	£ 10,334 (see options appraisal at Appendix 1)

4.6.3	The new service is due to be commissioned from the autumn 2015. The actual amount needed to deliver the service will be established through the tendering process.

5.	COMMISSIONING OPTIONS 2015/16 – 2018/19

5.1	An options appraisal for future funding of the service is set out an Annex 1. This considers this Council’s options for future investment in the service.

6.	COMMENTS OF OVERVIEW & SCRUTINY PANEL

6.1	To be considered on 3rd February 2015.

7.	KEY IMPACTS/RISKS

HOW WILL THEY BE ADDRESSED

7.1	The risk to the current service is that the six-month delay in the joint commissioning may result in a gap in service between April and October 2015 when the new service is due to start.

7.2	Discussions have taken place with the current service provider and it is believed that the current service can continue over this period if six months funding is confirmed for 2015/16.

7.3	Fewer early interventions may lead to more DFG applications.

8.	WHAT ACTIONS WILL BE TAKEN/TIMETABLE FOR IMPLEMENTATION

8.1	The County Council has delayed the tendering process for a jointly procured service until Spring 2015 due to uncertainty about HDC’s partner funding. Once a decision is made, the tender will be issued in the Spring. The new service is due to start in October 2015 on a three-year contract.

9.	LINK TO THE CORPORATE PLAN

9.1	The Council’s Corporate Plan 2014-2016 contains four strategic themes including:

Improve health and wellbeing – this incorporates the following:

Meet the housing and support needs of our ageing population;

Enable people to live independently through the provision of adaptation, accessible housing and support

Work with partners to improve health and reduce health inequalities

The Council’s Housing Strategy 2012-2015 also contains an objective to:

Enable people to live independently through the provision of adaptations accessible housing and support with a specific action to:

Work in partnership across housing/health/social care to develop a sustainable long term business plan for the Safer Homes scheme.

9.2	To date, there has been a very clear strategic direction for the development of the Safer Homes scheme. This has led to the achievement of both the partnership working towards developing a sustainable long term business plan for the service, and in making the case to Health and Adult Social Care partners of the value of the scheme and obtaining commitment to future funding.

10.	CONSULTATION

10.1	The County Council has led on consultation with the public on the need for this type of service and whether or not people would be willing to pay for it. The results indicate that older people would use this type of service and would be happy to contribute towards it to get a trusted workman. They also would like to see decorating and gardening included in a service but it has been agreed by commissioning partners that while a provider may choose to offer these services these would not be subsidised by public sector funding and would be fully chargeable.

10.2	The current service provider has been consulted and has been fully informed of developments in relation to the service.

11.	LEGAL IMPLICATIONS

11.1	There are no legal implications other than ensuring that any agreement for the procurement process properly represents HDC’s commitment, and that there are appropriate service level agreements or memorandum of understanding between the partners to set out delivery of the service.

12.	RESOURCE IMPLICATIONS

(Comments from the Head of Resources)

12.1	Due to the additional funding secured from other partners the Council’s funding can reduce from £25k pa delivering a budget saving.

13.	OTHER IMPLICATIONS

13.1	This Safer Homes Scheme makes a positive contribution to meeting the needs	of older people.

14.	REASONS FOR THE RECOMMENDED DECISIONS

14.1	Officers recommend that Members consider the options for future investment	in Safer Homes, presented at Appendix 1. Officers recommend the Council	consider adopting Option 2:

HDC investment of £25k in 2015/16 and £10.4k from 2016/17 -2018/19

Jointly commission with partners a new countywide service

Review the HDC funding position during 2016/17 to consider whether to fund after the end of the contract.

On the basis that:

The schemes contributes to objectives in the Council’s Corporate Plan and Housing Strategy and this funding level is adequate to meet the needs that have been identified for vulnerable people in Huntingdonshire. Huntingdonshire has an ageing population and a ‘whole systems’ approach to helping people to remain independent in their own homes is required across the public sector.

Joint commissioning of a new service with other statutory partners will provide a consistent and enhanced service to older people across the county and meet the aims of the Cambs Older Peoples Strategy to work together on prevention.

This option will deliver a reduction in budget in 2016/17 from £25k per year to £10.4k while maintaining a valuable service.

Logic suggests that a number of Safer Homes assessments (costing on average £175), could potentially save the Council the need to spend on more expensive Disabled Facilities Grants (costing on average £6k).

Ending HDC’s investment in the service will result in a drop in the number of interventions that would be made (from 2014/15), which means that a number of older and vulnerable people could be potentially at risk.

A further review of performance of the new Service can be carried out in two years’ time and a decision made on future funding at that time

15.	LIST OF APPENDICES INCLUDED

Appendix 1 – Options appraisal

Appendix 2 - Safer Homes Leaflet

Appendix 3 – National Memorandum of Understanding to support joint action on improving health through the home.

BACKGROUND PAPERS

Report to Cambridgeshire Health & Wellbeing Board April 2013

Establishing the relative need for handyperson services in Cambridgeshire – HGO Consulting

CONTACT OFFICER

Trish Reed, Housing Strategy Manager

Tel: 01480 388203