SCSH Briefing

April 2001

Floating Support

This briefing is part of the information process about Floating Support which will focus on its different aspects and draw on the experience of a number of participants in the process. This briefing highlights:

• the development of Floating Support
• the evolution of housing with support
• the delivery of Floating Support in West Lothian

THE DEVELOPMENT OF FLOATING SUPPORT

Floating Support services were pioneered by the Housing Services Agency in the early 1980's in partnership with local housing associations. Their innovative approach was a response to the expressed preference of people with support needs for living in self contained mainstream accommodation. The services made a crucial distinction to traditional supported accommodation - support could follow the person rather than being tied to the accommodation. By seeking the separation of support and accommodation, it has been possible to transform the way housing with support is approached. Although Floating Support was recognised as having the potential to provide longer term housing solutions, it was slow to gain ground because of difficulties in accessing resources. More recently though, new funding mechanisms have encouraged its development.

IDENTIFYING FLOATING SUPPORT IN SCOTLAND

Floating Support is not a common term within housing support services in Scotland. Yet a range of services including outreach, re-settlement, follow-on/up, advocacy, demonstrates that Floating Support is established in Scotland. Practice also identifies that Floating Support:

• is responsive to individual needs
• links to the person and not the accommodation
• is flexible
• is delivered to people in their own homes or accommodation
• varies in intensity and duration
• has clear access and exit points
• is diverse - it means different things to different people and different organisations

Further, Floating Support is innovative in that:

• support plans allow for structured reviews which involve service users. This ensures services are appropriate, assists in cost effectiveness and complements Best Value
• its brokering role is central to the process of seamless service delivery
• it is accessible throughout all tenure types
• it provides many of the wider generic support services that independent living can create
• it is relevant to a range of service user groups beyond those funded by Community Care
• by its very nature, it stays with or leaves the individual as their needs change, it mirrors the real world of complex and fluctuating needs

Although regarded as a preventative service, the principles of Floating Support also preserve the rights of people with support needs to create and sustain independent living in mainstream housing.

HOUSING WITH SUPPORT

The theory and practice of housing with support has evolved alongside changing funding mechanisms and political debate. To a certain extent this process has been linked with developments in Community Care. The foundations of the modern debate about community care were set in the late 1980's when the Secretary of State requested a review of community care services. The following remit was set out

To review the way in which public funds are used to support community care policy and to advise me on the options for action that would improve the use of these funds as a contribution to more effective community care

This review resulted in the published report Community Care: Agenda for Action (1988). The author, Sir Roy Griffiths advocated a thorough re-appraisal of the principles and practice of community care. The report included the following recommendations:

• there should be a clearer strategic role for central and local government
• commitment to collaboration at local level between different agencies should continue
• there was a need for new financing methods
• improved mechanisms for matching policy aspirations and resource availability were required

The National Health Service and Community Care Act (1990) then set the statutory framework for community care. This process placed local authority social work departments at the centre of care service planning and delivery (needs assessment, planning and managing care packages). The policy led to people with support needs moving away from large-scale residential institutions to be housed in local communities with care and support. This gave rise to projects and schemes that housed people with support needs in purpose built/adapted group accommodation. Although Community Care seemed to offer service users more options, it had limitations:

• moves towards creating a support model where there was greater integration and more independence was only partially effective. As in many cases the levels of care didn't reduce dramatically, service users, although housed in smaller units, still weren't learning life-skills
• people were housed together because of similar support requirements. This segregation could work against service users i.e. their exclusion by local communities
• expertise within housing services was not used to its best effect. Although it was always emphasised that housing was crucial to Community Care, its role largely concentrated on providing accommodation

Further, accommodation was made available because of a particular support requirement. Once a person's support needs had changed they would often be required to move on. One effect of this was that some service users left the system without support, or were living unsettled life-styles within the system. At this stage Floating Support - a flexible but structured support mechanism offered in mainstream housing - should have gained wider acceptance as a means to address shortcomings. Its growth turned out to be more complicated though and the reasons for this will be discussed in another paper.

PARTNERSHIP WORKING IN WEST LOTHIAN

In West Lothian, Penumbra and West Lothian Council work together to deliver the Tenancy Support Project. The current project extends their partnership set up in 1988 through the West Lothian Support Service and moves beyond traditional services and policies. Primarily about prevention, Tenancy Support is delivered on a problem-solving basis with a recognised time period in place. It is expected that 30 tenants will be supported in the first year.

The aim of the service is:

• To support tenants, (or potential tenants) within their own homes where at least one member of the family has
• a social or behavioural difficulty or displays special needs.

The objectives are:

• to offer flexible and responsive support where a tenant may require it for a transitional period
• to prevent any unnecessary re-admissions to hospital as a result of temporary mental health difficulties
• to prevent any unnecessary evictions or rent arrears accruing as a result of mental health difficulties
• to assist in crisis intervention where an independent organisation is deemed to be more appropriate

The process involved:

Setting Up - Initial meetings between Penumbra, Housing and Social Work were established in January 2000 to develop support services where tenants were at risk. Over the next 3 months the working group met regularly to develop the process and mechanisms for referring, recording and monitoring the service which was acceptable to the partner agencies. In April 2000, Penumbra seconded a member of staff from Falkirk to develop and refine the management and delivery of the service. The first support was delivered in June 2000.

Finance - Finance is accessed from a variety of sources including both Housing and Social Work budgets. A service charge is levied on top of the normal rent and where the support falls within the scope of Transitional Housing Benefit guidelines, the costs can be met through housing benefit. In this case the housing provider receives the rent and service elements and in turn pays Penumbra for the support costs. Initial evidence suggests that hybrid packages of finance are becoming an established part of the service and preferences.

Referrals - At present, referrals are taken from any source (with a majority from Housing and Social Work departments). The service objectives' criteria are the gauge for accepting referrals. The tenant needs to know about the referral prior to its implementation.

Service Delivery - The support package, in the first instance, is set to cover a 3 month period. An initial visit is made by housing services resettlement staff to assess the relevance of the referral. Once the support plan has been agreed the service provider, tenant and landlord all sign the agreement form. The weekly time planner is integral to the support plan, to ensure that each stage of the support is clear to all participants. Agreed times, start and review dates are set out along with the areas in which the client requires the support.

Recruitment - All support staff receive the formal policies and procedures on recruitment. Initially new staff double up with more experienced staff. All staff receive mental health awareness training and are regularly supervised and monitored. Recruitment is flexible taking account of the identified pattern of needs.

Monitoring and Evaluation - A series of questionnaires involving staff, service users and referrers is central to monitoring the service. There is also a monitoring group, with representatives from Housing Social Work and Penumbra, which meets every 12 weeks.

"I feel I have benefited from Penumbra's support and time as I now use a lot more facilities and get out and about more in the area. My support worker also advocates on my behalf where I feel a lack of confidence to communicate with people, such as Benefits Officers, Housing Officers, GP's etc."

The partnership model between Penumbra and West Lothian demonstrates many positive aspects of Floating Support services:

• A commitment to detail at the planning stage (particularly important when creating a framework for providing flexible services). This is a well structured project that benefits from expertise gained through previous collaboration. Partnership working also demands that the set up process is thorough to ensure that common agreements and protocols are workable for both partners
• There are clear aims and objectives which ensures that boundaries of the support - what it can and can't do - are easily recognised. They also form the initial criteria for evaluation and review
• The working documentation ensures that all participants have a clear understanding of the support process - by setting out what is expected of each participant. The documentation further develops performance monitoring and measurement
• The referral system and its criteria ensure that access to the support is appropriate. Common referral criteria are also important for work with referring agencies with different protocols.
• The support plan maintains a service that is appropriate and responsive to fluctuating needs. It also acts as the first stage of an exit mechanism.
• The recruitment process for the support workers is thorough. Given that Floating Support is a key model for supporting fluctuating needs, the recruitment of sessional support workers ensures quick responses to identified support patterns
• Both partners are committed to the concept of Floating Support. This positive outlook is vital to the development of person centred preventative support services
• The effectiveness of providing this type of service has already been noted - the council have already extended the service to tenants outwith the original client group
• The support activities (e.g. 'securing your home', 'maintaining your home') outlined in the formal paperwork reflect the Transitional Housing Benefit scheme's eligibility criteria (annex B, circular HB/CTB A47/99). This provides the means for accessing longer term funding

REVIEW

In the first 6 months:

• all referrals have been appropriate.
• the criteria have enhanced the clarity of the project's aims and objectives
• the service has been an effective broker (access to and involvement of 4 other agencies)
• The inter-relationship between rent arrears, budgetary support and claiming benefits
• 8 staff supported 15 tenants
• 868 support hours were provided
• 17 assessments were completed

© 2001 Scottish Council for Single Homeless