Planning for the Future 2013-2015

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page

n 1. Introduction 2

n 2. Working in Partnership 3

n 3. Need, Supply and Service Gaps 8

n 4. Consultation evidence 15

n 5. Priorities for development 16

n 5a. Homelessness 16

n Domestic Abuse Services 17

n Young Single People 18

n Older Single People 19

n Mental Health 20

n Substance Misuse 21

n Vulnerable Families 22

n 5b. Older People 23

n Older People & Alarm (Telecare) Service 24

n Dementia 25

n 6. Commissioning Programme 2012 – 2015 28

n 7. Spendplan 29

Content

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The year 2012 will see significant changes to how the Supporting People programme is administered, the Alyward review and the subsequent consultation processes have produced recommendations that will challenge our traditional methods of managing and delivering the programme, amongst his 25 recommendations to be implemented; we will witness the introduction of a new national and regional governance structure, creation of a single Supporting People Programme Grant and national redistribution of that grant between local authorities.

What has not changed is the fundamental nature of the programme, providing a preventative service, delivering support early to avoid crisis situations developing and contributing to both the national and local agenda of improving the communities we all live in.

This document is known as a Local Commissioning Plan, which, will replace the Supporting People Operational Plan and will give a summary of the local authorities commissioning intentions for the next three years.

In Caerphilly, we intend to utilise the format of the ‘Planning for the Future’ documents published for the last two years http://www.caerphilly.gov.uk/supportingpeople/pdf/spop_2011.pdf which will form the basis for the future local commissioning plans, again, we are not going to present too much detail, but rather look for a format that will be easily understandable and focus on the issues and challenges the programme confronts and benefits that the programme can deliver.

As well as outlining commissioning and remodelling intentions the document will show how these conclusions have been reached. Caerphilly Supporting People will ensure that service users are given meaningful opportunities to influence decisions at local level and evidence of this will be reported to the Regional Collaborative Committee.

The local Supporting People Planning Group will scrutinise the Local Commissioning Plan before seeking political approval and submitting to the Regional Coordinating Authority for inclusion in a Regional Commissioning Plan.

1. Introduction

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2. Working in Partnership

Accommodation is one of the most basic needs of any person, with the need to have a roof over our heads and protection from the elements being fundamental to our health and well-being. The Supporting People programme offers support to vulnerable adults that is specifically aimed at their accommodation needs and providing the support needed to attain or maintain accommodation that is suitable and affordable to the individual.

Such support can involve the accessing of accommodation, the provision of specialist support, ensuring their safety, assistance in achieving a healthy lifestyle and ensuring the nurturing of independence through positive inputs including improving motivation and practical assistance in life skills.

The supporting people programme is not delivered in isolation, but rather has part of a much wider welfare provision that includes social care, housing, homelessness, health, criminal justice and many agencies that are aligned to the various strategies that seek to better the communities in which we live.The local governance of the Caerphilly Supporting People Programme includes representatives from the Health, Social Care and Well Being Partnership, Children and Young Peoples Partnership (Incorporating Familes First) and the Community Safety Partnership, in addition there is also housing and voluntary sector representation.

It is important that the existing supporting people services and those that we plan for the future are integrated with many of the complimentary statutory and voluntary services commissioned by the various partnerships. Caerphilly supporting people team has been mapping how the services offered by the programme contribute to the individual aims and objectives identified by our strategic partners.

Examination of the strategies, aims and objectives of other partnerships within Caerphilly show a great deal of common ground in terms of identifying the most vulnerable client groups and agreement on the outcomes sought from care and support interventions. Whilst the links are being made at the strategic level, increasing emphasis is now being made to ensure that the work of the various statutory and commissioned services are being aligned and designed to ensure focus, consistency and provide holistic services to vulnerable people. As can be demonstrated from the following illustration, many of the aims of our partners are at the core of the services we commission and manage.

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Fulfilling Welsh Government’s - Poverty Agenda, Supporting People Guidance, Sustainable Social Services, Ten year Homeless Plan, Housing Bill & Crime Reduction.

PRIMARY AIMS & OBJECTIVESLocal Service Board

n Tackling alcohol misuse. n Tackling Child Poverty.

Health Social Care and Well Being

n To improve public health by promoting factors which contribute to healthy lifestyles and well-being.

n To enable independent living for families and carers by empowering them to make informed choices and offering opportunities for them to get involved in developing local services.

n To develop and strengthen preventative work and service provision for vulnerable children and adults to prevent crisis.

Children and Young Peoples Partnership and Families First

n Families are supported and children and young people are safe.

n All children and young people have improved work related skills.

n Children, young people and families are as healthy as possible.

Caerphilly Housing Strategy

n To reduce the incidences of homelessness and repeat homelessness, and to eliminate rough sleeping.

n To promote the provision of high quality housing services to enable older people to live independently.

n To meet the housing requirements of vulnerable people through better access to a range of high quality, specialist housing and support services.

Community Plan

1. Make Caerphilly a safer place to live

2. Sustain the range of Employment Opportunities for residents

3. Improve the skills level for Children and Young People

4. Promote Benefits of a Healthy and Active Lifestyle

Community Safety Partnership

n Reduce anti social behaviour & improve the street scene. n Reduce the harm caused by Alcohol.

Community Firstn Reducing Child Poverty.

n Engaging with the least healthy and those at risk of poor health.

n Preventing/Targeting Young People Disengaged with Education and Training.

ABHA & Homeless and Vulnerable Groups Health Action Plann Improving the Health of Homeless and Vulnerable Groups.

n Improving access to primary and secondary health services.

n Preventing/Targeting Young People Disengaged with Education and Training.

Probationn Change the behaviour of an offender.

n Reduce re-offending and protect the public.

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Whilst the SP programme aims to contribute to the various aims and objectives identified by our partners, we also appreciate the requirement to demonstrate and evidence that supporting people has made a positive impact on vulnerable peoples lives and has in turn produced benefits that ultimately contribute to a persons move to independence and produce wider benefits to our partners and society as a whole.

In order to evidence that the services we commission are positively impacting on vulnerable people lives we have required all agencies that contract with us, will, from April 2012 report on the outcomes they achieve with every individual they support.

The following provide the core principles that all should adhere to when considering what outcomes have been achieved by the individuals we support.

n People have the right to aspire to safe, independent lives within their community and the financial security and health to enjoy that community.

n People differ in the barriers they face in achieving these aspirations. Housing related support seeks outcomes for people that are steps on the way towards these ultimate aspirations.

n Outcomes should be person centred, purposeful, negotiated and agreed with the individual and, if appropriate, with their advocates, supporters or carers through the support planning process.

n Outcomes will be achieved through support interventions that resolve identified need and enable maximum possible control, involvement and understanding for an individual across the outcome areas.

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Feelingpart of the community5

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The following diagram indicates the themes within which we be collecting information.

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Supporting people Outcomes Examples of Support Offered Meeting strategic aims

Promoting Personal & Community Safety

1. Feeling safe.

2. Contributing to the safety and well-being of themselves and of others.

4 Access to telecare and community alarm.

4 Helping with security.

4 Access grants for adaptations.

4 Accessing accommodation.

n Make Caerphilly a safer place to live.

n Promotion of high quality housing services.

Promoting Independence & Control3. Managing accommodation.

4. Managing relationships.

5. Feeling part of the community.

4 Helping with appliance use.

4 Building relationships.

4 Being good neighbours.

n Reduce re-offending and protect the public.

n Reduce anti-social behaviour.

n Empowering people to make informed choices.

Promoting Economic Progress & Financial Control6. Managing money.

7. Engaging in education/ learning.

8. Engaged in employment / voluntary work.

4 Reducing debt.

4 Accessing education.

4 Developing learning skills.

4 Budgeting.

4 Accessing volunteering and employment opportunities.

n Improve work related skills of young people.

n Sustain a range of employment opportunities.

n Preventing /targeting young people disengaged with education and training.

Promoting Health & Well-being9. Physically healthy.

10. Mentally healthy.

11. Leading a healthy and active lifestyle.

4 Arranging access to health services.

4 Cooking skills.

4 Healthy diet.

4 Basic Hygiene.

n Tackling alcohol abuse and reducing harm.

n Improve healthy lifestyles and well-being.

n Children and young families are as healthy as possible.

n Improving access to primary and secondary health services.

Promoting Independ

ence

The collection of outcomes from people who have received support will help demonstrate how we contribute to the strategic aims identified by our partners.

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Mapping local needs and identifying suitable provision are vital in developing an understanding of the local accommodation and the support needs landscape, there are three basic activities that must be undertaken in conducting this baseline analysis

n Profiling those vulnerable groups who are most likely to be in need of accommodation and support.

n Auditing existing housing provision and support services for vulnerable people in the area, including accessibility and suitability.

n Gap analysis – The comparison between the provision and need.

This exercise will help identify gaps in accommodation and support provision that currently exist in the county. The data collected can be used to inform both local, Regional supporting people and homelessness strategies to ensure the housing support needs of vulnerable people are considered in the future.

Profiling those in need.

Profiling can be a complex and time-consuming activity. There are several factors that need to be considered:

n Demography of those clients in need of accommodation, e.g. information on gender, age, family, ethnic background, care status, current accommodation type

n Special needs or circumstances, e.g. known issues with drugs, alcohol or mental health, being young parents, homelessness

n Accommodation and housing support requirements.

There are a number of existing data sources that can be used to inform the profiling activity.

The following diagram indicates the sources of information utilised to establish a landscape of need for housing support within Caerphilly, some of the most significant and meaningful statistics appear later in this document, however, a full data need map will be published at a later date on the Caerphilly Supporting People website.

The approach should examine the profiles of vulnerable people who are in need of accommodation over a set period of time. This exercise will provide a snapshot of the level of housing need by vulnerable client groups within the county at a given point in time, as well as the client group characteristics. The exercise should be repeated annually at the same time each year so that comparisons be made and trends identified.

3. Need Supply and Service Gaps

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Drivers of NeedFollowing the gap analysis many client groups have demonstrated some need for remodelling of existing schemes or development of new services, it has become clear from analysis of the above that a number of factors will significantly impact upon the vulnerable people of the county over the forthcoming three years and beyond, the major of these factors are:-

The Welfare Reform Act Introduced by the coalition Government, Universal Credit is a new benefit for people of working age, which will be introduced over a four year, period from 2013 to 2017. It will replace existing means-tested benefits and tax credits (including income-based Jobseekers Allowance and Employment and Support Allowance; Income Support; Child Tax Credits; Working Tax Credits; and Housing Benefit). It is the Government’s key reform to simplify the benefits systems and to promote work and personal responsibility.

It is expected to have a significant impact on those people on benefits, particularly in respect of those on housing benefit. The effects of changes to housing benefit in the private sector have already began to be introduced and further impact is expected with new reforms being introduced in April and October 2013. Welsh Government have recently commissioned a report that looks at the impact of the proposed welfare reforms on the population of Wales and some of the national and county impact assessments are outlined below.

Gwent Needs

Mapping Forms

SP Service monitoring

statistics

Needs gathering days

Communities First

Social service registers

Researchers (Rowntree

Trust)

WHO12 – Homelessness

Returns

Voluntary sector non SP stakeholders

Good Practice Research

Landlord waiting

lists

Local, Regional, National surveys

Provider

Partnerships (HSCWB, CYPP, Community

Safety)

Substance misuse agencies (CRI, Drugaid, Kalidoscope)

Health (Aneurin

Bevan Trust & Public Health)

Lobby Groups (e.g shelter,

Women’s Aid)

Probation

Welsh Government

SP Review outcomes

CensusAdult Services

Welsh index

multiple deprivation

Home Office

Family First

Bond schemes

Wales Data Unit

Department

Work

Pensions

Children ServicesYOT

DAF

Police

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“Looking at the proportion of the population claiming out-of-work benefits together with the distribution of low-income households in Wales suggests that the South Wales Valleys and the inner city areas of Cardiff, Newport and Swansea are most likely to be disproportionately impacted by the benefit changes.”Welsh Government Welfare reform impact report.

The following statistics give an indication of the potential affect of the benefit reforms on the population of Caerphilly.

n Caerphilly has 25,660 benefit claimants, 4th highest in Wales, comprising 15% of the population.

n Increasing levels of youth unemployment (Unemployment in Caerphilly County Borough has increased by 16% in the last 12 months. According to figures from the Office for National Statistics, the number of people claiming Jobseekers’ Allowance went from 5,279, in April 2011, to 6,127 in April 2012 – an increase of 848). 3rd highest in Wales.

n Over 12,000 Welsh workless households affected by Tax Credit changes totalling a potential drop in income to 2014 of £8.7 million – Caerphilly (12% population) 4th in Wales.

n Over 33,200 Welsh households affected by Housing Benefit changes – Caerphilly hb claimants 15,610 (13%) 3rd in Wales Based on DWP impact assessments, these changes to HB will amount to a total average loss of £1,217,605 per week in Wales.

Particular concerns are expressed over:

i) The extension of the single room allowance to under 35’s.

ii) Implementation of the under occupancy rules.

iii) Housing benefit payments direct to tenants.

n Over 25,000 individuals in Wales will be affected by the changes to Incapacity Benefit –14,590 in Caerphilly 4th in Wales (14%).

n Over 39,000 individuals in Wales will be affected by the changes to DLA with a potential reduction in income received of £12.1 million to 2014 –18,600 in Caerphilly (15.6%) 4th Wales.

n Over 5,300 lone parents in Wales will be affected by Income Support changes – 6,300 in Caerphilly 4th highest in Wales (5.3%).

n Over 6,200 individuals in Wales will be affected by changes to Employment Support Allowance with a potential reduction in income received of £24.8 million by 2014.

Sources: Office of National Statistics (nomis), DWP and Welsh Government welfare reform impact report.

In addition to the changes being introduced through welfare reform, further changes through the Local Government and Finance Act will affect many benefit claimants. Council Tax Benefit is to be replaced by localised support for Council Tax. Local authorities will set up new schemes to support people in their own areas within a 10% reduced budget. Enquiries to the local Citizen Advice Bureau’s would suggest that the economic downturn is affecting Caerphilly residents.

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This is supported by evidence from a YOU GOV Welsh survey conducted in June 2011.

n 21% of respondents who pay rent or mortgage had reduced the amount they spend on heating to meet rent or mortgage payments in the last two years, up from 14 per cent from our survey of 2010.

n 28% said that they spent less on food because of rent and mortgage costs, up from 23 per cent in 2010.

n 55% of respondents who pay rent or mortgage said that they struggled at least some of the time with payments, compared to 49 per cent in 2010.

n Just over a fifth (21%) of those responsible for mortgage or rent costs said they had increased their use of credits cards or loans to meet day to day expenses.

n Nearly a quarter (24%) of all Welsh adults said that paying the rent or mortgage were a source of anxiety in their households, rising to 30% of 18-34 year olds and 35% of 35-44 year olds.

n Nineteen per cent said that changes to housing and welfare benefits were a source of anxiety in their households, rising to 29% of those aged 45-54 and 56% of those who were unemployed or not working.

n Of 18-34 year olds, a fifth had reduced spending on heating and 30% had reduced spending on food to meet rent or mortgage payments in the last two years.

The reduction in the level of benefits at a time of economic uncertainty is expected to place stress upon those families and individuals that have relied on them, it is anticipated that this reduction in family incomes will result in increased homlessness, family breakup and increased criminality and substance misuse.

Enquiries to Citizens Advice Bureau - Caerphilly County

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Benefits Debt Finance Housing

2500

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1500

1000

500

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2513

1464 1523

1011

215 104

456265

2011/12 2007/08

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There are also additional factors that are taken into account, in building up a picture of need within the county, these include demographic changes and actions by other councils that may have an impact upon Caerphilly, these include:

n Introduction of ‘Gateway access’ to Cardiff and Newport hostel projects and the effect of funding cuts to the Cardiff supporting people programme.

n Increasing elderly and frail population.

n Proposed introduction of new Housing Act (Particularly in relation to need for greater prevention services and duty to provide interim accommodation for those people deemed to not ‘be safe’).

n Constriction on Social Housing Grant availability ( Social housing starts fell by 22 per cent in the three months to July, according to construction data analyst Glenigan).

n Revised Supporting People Guidance from Welsh Government (Particular reference to changes to older person services).

Auditing existing housing provision and support services. It is important to identify the accommodation and support resources that are currently available in each area in order to identify gaps between need and provision. There are several sources of information available to help build a picture of local provision. These include: n Local housing authority housing and homeless strategies.

n Local Supporting People strategies (which provide a complete supply map of supported housing that is available in the area).

n Local housing associations/RSLs and private sector landlords.

In addition to those services that are locally available, it is also an opportunity to audit those support services delivered regionally or available in adjacent counties. Account needs to be taken of external factors such as ‘redistribution’ of supporting people funding and alterations to access services that may have an adverse affect on transient individuals from within the county. We regularly review and monitor all our support agencies and projects and through that process we are able to ascertain the demand and need for both accommodation based and floating support services.Over the past two years we have introduced a centralised referral system for many of our services, which again supplies us with information from referring agencies in terms of the developing needs of the vulnerable client groups within the county. A full breakdowns of existing supporting people services is available on the Caerphilly Supporting People website.

Gap analysis A comparison should be drawn between existing housing provision and the needs of vulnerable people in order to identify any gaps in provision. This document is the result of this gap analysis. The analysis has provided us with a clear sense of the nature of accommodation required, the location and the number of units of each type likely to be required over the lifetime of the strategy. The findings of the mapping, profiling and gap analysis will be presented to all key local agencies and stakeholders. This will ensure that the information is used to inform the future development of local housing policy and provision.

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The following map shows

the locations of a number

of key accommodation

based services that

currently deliver support

within Caerphilly.

Domestic Abuse

Homelessness

Mental Health

Substance Misuse

Young Person

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Service users lie at the heart of the Supporting People Programme, they are the reason the programme exists and the customers who experience how the programme operates in terms of meeting their needs.

Caerphilly supporting people are increasing their review and monitoring capacity to.

Caerphilly supporting people have.

n DVD Projects with young people, older people and people with learning disabilities that focused on their housing needs (Link).

n Service users have been involved in tender assessment process for new services.

n Service user consultation is integral part of the Caerphilly review and monitoring process.

n Service users are involved in the design and implementation stage of commissioning process.

Meaningful service user involvement takes time and effort to develop and needs constant monitoring and improvement to meet the changing needs of the client group you are working with.

The mainstay of user consultation should and will remain with the providers and their staff who have the most contact with customers of our commissioned services and whose actions have the potential to have positive benefits for their clients, however, we as commissioner understand the importance of listening to service users and ensuring that their views are used to shape services and ensure that positive outcomes are achieved.

Caerphilly Supporting People will work with the Regional Collaborative Committee at methods to improve how we can better link with services users.

4. Consultation Evidence

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The analysis of the housing need data and future projections in terms of financial and equality impact assessments, tend to lead us towards the conclusion that homelessness and older person services are the two areas that we need to prioritise for future commissioning proposals.

N.B. An equality impact assessment is available on the Caerphilly Supporting People website.

5a. Homelessness The county is already experiencing increasing levels of homelessness that are anticipated to rise significantly over the forthcoming years, affecting many different client groups including the young and older single people, those experiencing domestic abuse, vulnerable families, those with mental health and substance misuse issues.

Evidence Window. From July to September 2011, 1,845 households were accepted as homeless in Wales. This represents an increase of 15 per cent on the same period in 2010 and is 25 per cent up from two years previously - source shelter.

5. Priorities for Development

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Number referrals to supporting people services.

Gwent Needs Mapping Exercise – Increasing numbers of ‘Supporting People Needs Mapping Forms’ being completed for people homeless or in danger of becoming homeless.

The second quarter 2012 average of 100,400 in severe arrears ( 2 months +) in England and Wales represents a 24 percent increase on the same time last year, and is the highest number on Templeton LPA’s records, which extend back to 2008.

Eviction notices have also increased in 2012. In the first quarter of 2012, 26,000 received notices of eviction, up six percent on the final quarter of 2011, and up five percent on the same period in 2011.

Homelessness is a generic term that encompasses many different vulnerable client groups, evidence from our analysis points to the need to prioritise services for the following services.

Dates – WHO12 Quarter Households (numbers) Percentage change

July - Sept 2008 65 -

July - Sept 2010 67 + 2.9%

July - Sept 2011 71 +5.6%

July 2008 - Sept 2011 - +8.4% change overall

Financial year Homeless

01/04/2011 to 31/03/2012 412

01/04/2010 to 31/03/2011 233

Caerphilly households accepted has homeless -3 month comparison over 3 year period.

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Domestic Abuse ServicesThe Gwent pilot report on the modernisation of domestic abuse accommodation services highlighted within Caerphilly a need to develop supported housing to compliment refuge provision, these supported houses could be used to temporarily accommodate larger families and those with needs that cannot be affected accommodated within a traditional refuge environment.

Caerphilly Supporting People is working with the local landlords and Llamau Women’s services to identify properties that can be utilised for this purpose.

Additionally, a spot contract has been agreed with BAWSO to assist the ethnic communities within the county and ensure that the particular cultural issues of those communities are adequately addressed.

Evidence Window More than 16,000 cases of domestic abuse were reported to police in Gwent over the past two years – almost 23 a day. The figures from Gwent Police show the number of domestic abuse incidents in 2009/10 and 2010/11 amount to more than twice the number of burglaries.

A total of 8,659 incidents of domestic abuse were reported in 2009/10 compared to 3,068 burglaries, and in 2010/11 there were 8,093 domestic abuse incidents and 2,873 burglaries.

Figures from Llamau Women’s Services n Number of voids in refuges decreasing each year.

n Number of women being referred on to other refuges has increased in past year.

n Waiting list for floating support service continuing to increase

n More women approaching service with complex issues including mental health and substance misuse needs.

Referrals made to Llamau Women’s Services n Number of people supported by the domestic abuse floating support services increasing.

Financial year Homeless

01/04/2012 to 28/08/2012 360 (5 months)

01/04/2011 to 31/03/2012 702

01/04/2010 to 31/03/2011 466

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Young Single People (Under 25)Increasing numbers of young people under the age of 24 are approaching the local authorities homeless and social services departments. Many of the young people are aged 16 and 17 and the local authority as a statutory duty to ensure that they are safe and adequately supported.

The authority has already commissioned schemes that will largely ensure that the most vulnerable young people aged 16/17 years will not need to placed in bed and breakfast, but will rather be accommodated in 24hr supported housing projects.

Increasing demand is being experienced by the longer term young person supported housing schemes and we are recommending the establishment of a fourth such scheme in the Blackwood/Newbridge area.

The ‘move on’ process from our supported housing schemes is operating effectively, however, the lack of suitable one bed accommodation is proving to be a challenge to moving people at the rate desired.

Occasionally young people present with challenging behaviour that cannot be supported in traditional settings, Caerphilly have in partnership with Newport commissioned a specialist project with Solas in George Street, Newport that will provide the more intensive support to assist these young people.

Evidence Window The Caerphilly Housing Advice Centre are reporting increasing numbers of under 25’s presenting - HAC 145 under 25’s presenting in 2011/12, with 24 of them aged 16/17 (Sadie).

The Emergency Housing Manager reports 90 young people being placed in bed and breakfast in 2011/12, this is a 12.5% increase on the previous year.

Social services also report accepting more young people in the past twelve months, again an increase on the previous year.

The young person mediation service is also reporting increased demand for their services. Rising from 105 cases in 2009/10 to 145 case in 2011/12.

Leaving Care reports an increase in number of young people placed in bed and Breakfast during 2011/12.

Numbers supported by the young person floating support services.

GNME’s - Increasing numbers of ‘Supporting People Needs Mapping Forms’ being completed for young people homeless or in danger of becoming homeless.

Financial year <25’s

01/04/2012 to 28/08/2012 360 (5 months)

01/04/2011 to 31/03/2012 702

01/04/2010 to 31/03/2011 466

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Older Single People (25 - 55 years)The local authority has a statutory duty to assist ex offenders who have been in prison in excess of one year; however, increasing numbers of single people have approached the authority that in the past have been referred to hostels in Cardiff and Newport.

Access to these traditional hostels is becoming increasingly difficult due to budgetary pressures and increasingly restrictive access criteria; the result has been a measurable increase in ‘rough sleepers’ within the county. The expectation is that the situation will worsen and that the local authority will need to make provisions for those single people that we have not housed in the past.

The Welsh Assembly Housing Bill also states that there will be an expectation that local authorities will provide interim accommodation to anyone whose safety is compromised by homelessness, this could include many of those who approach the authorities housing advice centre.

Evidence Window Evidence in respect of this particular client group is limited, however, measures are now being taken to commence recording older single people approaching the authority who have in the past been given advice but not given any form of accommodation.

Numbers of single people being accommodated

GNME’S - Increasing numbers of ‘Supporting People Needs Mapping Forms’ being completed for single people homeless or in danger of becoming homeless.

Year Hostel B&B Other Total

2009/10 60 149 103 312

2010/11 90 213 99 402

2011/12 95 228 100 423

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Mental HealthThere is a need to develop a medium level supported living project for adults with a long-term mental health need, which will provide appropriate support to enable individuals to be able to live independently. The lack of this facility means that individuals have to be placed in such facilities outside the County Borough, away from their families, support services and communities.

The Welsh Assembly Government Adult Mental Health National Service Framework requires each Local Authority to develop a range of housing options for people with mental health needs, in collaboration with housing agencies and registered social landlords. The need for this particular type of housing support for Caerphilly County Borough has been identified by the Wales Audit Office in their Baseline Review of Adult Mental Health services in Caerphilly County Borough (2005) and the review of Adult Mental Health Services (2007) by the external consultancy firm, Research & Development in Mental Health, commissioned by the Local Authority and Local Health Board.

The development of this scheme is a Priority target (7.2.4) within the Social Services Directorate Mental Health Commissioning Strategy 2008 – 11. Following the criticism of Caerphilly County Borough Council by the Wales Audit Office on meeting Mental Health’s NSF targets around Housing and Accommodation, this scheme will contribute towards Caerphilly County Borough Council demonstrating its commitment to meeting its commitments to people with mental health needs to future anticipated audits.

Evidence Window n Caerphilly not meeting targets in respect of the Mental Health National Service Framework.

n Comparison figures with adjacent local authorities for supported accommodation for people with mental health needs evidences a lack of sufficient accommodation.

n Number of contacts and assessments with people with mental health needs is increasing (Caerphilly Social Services).

n Waiting list for floating support services for people with mental health needs is increasing.

n Increasing number of vulnerable adults with mental health needs approaching homeless advice centre.

21

Substance MisuseCaerphilly has limited capacity in terms of assisting those with substance misuse issues comprising of a single 8 bed project and floating support scheme (Fynnon) both operated by Gwalia Care and Support. Evidence is that substance misuse, particularly in respect of alcohol is increasing and the result self harm and damage to society is becoming increasingly apparent on our streets.

Increasing levels of youth unemployment and constriction of family budgets seems to be accelerating the situation.

Evidence Window n Cuts to benefits and more stringent benefit entitlement rules may push people out of unemployment

and into crime activities. There is also some evidence that the timing and frequency of welfare payments can impact on crime levels – Welsh Government Welfare Reform Report

n Increasing levels of violence related to alcohol being recorded.

n Increasing levels of ill health due to alcohol abuse being recorded.

n Tackling alcohol abuse major aim of Local Service Board and Community Safety Partnership

n Number of contacts and assessments with people with substance misuse needs is increasing (Caerphilly Social Services).

22

Vulnerable familiesSupporting People has worked closely with the Children and Young Persons Partnership to assist with implementation of family first and coordinate with ‘Team around the Family.’

The partnership as identified to make the most impact over the next 3 years it was agreed to focus on 3 key Priority Outcomes.

These are that families are: 1) Supported and children and young people are safe,

2) All children and young people have improved work related skills and that,

3) Children and young people are as healthy as possible.

It is acknowledge the current economic and financial challenges facing everyone both at a local and national level. To respond to these challenges in terms of our commitment to outcomes for children and young people, we need to make best use of our resources as a partnership, by working together with the wider partnerships and, where opportunities exist, on a regional basis.

The research undertaken on poverty by the Monitoring Poverty and Social Exclusion Service in Wales highlights a range of factors that identify those children most at risk of poverty. Those particularly relevant to Caerphilly county borough are children:

n With a lone parent;

n In households where parents do not work, and or have more than 1 generation of the family unemployed;

n With families where at least one parent has a disability;

n in care/ Looked After Children.

We know that poverty affects the whole family and it is anticipated that the current economic climate within the county borough will have an adverse impact on the outcomes for children and young people. All services need to consider how they can address poverty and work together to ensure the needs of the whole family are met.

Evidence window: n Disposable household income within Caerphilly county borough is currently placed the 3rd lowest

in Wales.

n In 2008 the percentage of lone parents in employment was 48.5%, which is the lowest out of the 22 local authority areas in Wales.

n 22.3 % of pupils are entitled to free school meals, which is the 5th highest in Wales.

n Almost 23% in Caerphilly county borough have no qualifications compared with 14.8% in Wales overall.

n In 2009 of the 32,700 households there were 8,700 worklessness households and 26.6% of children in workless households.

n Increasing numbers being supported on waiting list of agencies that support vulnerable families

23

Teenage conceptions, Caerphilly

n Child protection register shows increasing numbers of children being registered.

Child Protection Register

Under 16

Average number Rate

28 8.1

Under 18

Average number Rate

150 43.1

Under 20

Average number Rate

395 70.3

At 31 Mar 2010 210

At 31 Mar 2011 225

At 31 Mar 2012 248

n Families with children are expected to lose proportionately more of their income across the income distribution compared to pensioner households and working-age households without children. Welsh government - Welsh Government Welfare reform impact report.

n Teenage conception rates in Caerphilly are amongst the highest in Wales.

24

Demographic changes in older people will place increasing stress on support services and incidences of dementia and sensory impairments are increasing and predicted to increase substantially in the foreseeable future and the requirement by Welsh Government to better target resources for older people have also influenced this commissioning plan. Discussions are ongoing with landlords of sheltered services to ensure that support is better targeted and that appropriate funding is identified for housing management type services.

Older People Sheltered and Alarm (Telecare) serviceThe increasing elderly population and concerns expressed over the lack of support services for this client group, prompted Caerphilly supporting people team to tender for an older person floating support service in 2010. This service has proved to be extremely popular, oversubscribed and delivers support to elderly people regardless of tenure.

However, most of the supporting people budget for older people is concentrated on funding sheltered housing and alarm services that are delivered regardless of the need of individuals. Welsh Government have now issued guidance that funding for the elderly needs to be better targeted at those who would most benefit from support and have directed that each local authority needs to submit a plan to the Regional Collaborative Committee by April 2013 that clearly shows how services are to be better directed.

Caerphilly are currently in discussion with landlords of sheltered housing schemes which include both Registered Social Landlords and Public Housing with the intention to review existing services and agree a programme to be implemented over the next two years that will result in delivery of targeted support to more older people.

5b. Older People

25

Evidence box:n Correlating to an ageing population, and underlying health issues such as obesity and diabetes, the

number of people with sight loss alone can be expected to double in the next 25 years. The numbers of those with hearing loss is expected to increase by 14 per cent every 10 years and by 2030 adult onset hearing loss will be in the top 10 disease burdens in the UK, above diabetes. The incidence of dual sensory loss is expected to grow by 60 per cent in the next 20 years – WLGA.

n Number of contacts and assessments with older people is increasing (Caerphilly Social Services).

n Numbers being supported by older person floating support service.

n Among those aged 55+, more than a quarter (26%) had cut the amount the spend on heating and 29% had cut their spending on food to meet rent or mortgage payments in the last two years. Source: YOU GOV June 2011.

Financial year

01/04/2012 to 28/08/2012 581 (5 months)

01/04/2011 to 31/03/2012 1130

01/04/2010 to 31/03/2011 475

Population projections – Caerphilly (source Welsh Assembly Government)25,000

20,000

15,000

10,000

5,000

0

65 - 74 years 75 - 84 years 85+ years

2008 2013 2018 2023 2028 2033

26

DementiaDementia is a progressive cognitive disorder, as a result of which, those affected gradually lose the ability to carryout normal, everyday tasks. This progression will vary from person to person and each will experience dementia in a different way.

In the UK today, approximately 800,000 people have the illness generically known as dementia and by 2021 it is estimated there will be over 1 million people with dementia. That figure is likely to double in 30 years’ time. One in 3 over 65’s will be diagnosed with dementia. Dealing with dementia currently costs the UK over £23 billion a year. Source: The Alzheimer’s Society, June 2012.

Caerphilly social services have identified dementia as one of the critical areas where supporting people can assist in.

Evidence box:n There will be over a million people with dementia by 2025.

n Two thirds of people with dementia are women.

n The proportion of people with dementia doubles for every 5 year age group. One third of people over 95 have dementia.

n 60,000 deaths a year are directly attributable to dementia. Delaying the onset of dementia by 5 years would reduce deaths directly attributable to dementia by 30,000 a year.

n The financial cost of dementia to the UK in 2007 was over £17 billion a year.

n Family carers of people with dementia save the UK over £6 billion a year.

n 64% of people living in care homes have a form of dementia.

n Two thirds of people with dementia live in the community while one third live in a care home.

n Number of people in the uk with dementia will double in the next forty years Increasing numbers of young people exhibiting with Korsakoff’s syndrome (alcohol related).

Source: National Alzheimer’s Society.

Source 30-64 65-74 75+ Total% of all

people 65+ with dementia

% of all people with

dementia

Caerphilly (Alzheimer’s society)

22 139 704 864 6.56 0.96

27

Floating support servicesCaerphilly supporting people has entered into a number of cost/volume contracts with providers that are based on an hourly rate. These types of contracts offer the flexibility to expand and contracts services according to demand.

These contracts will specifically allow us to quickly increase hours for the following services.n Domestic Abuse.

n Generic Homelessness.

n Mental Health services.

n Substance misuse.

n Older person services.

In 2011 Caerphilly supporting people entered into a framework agreement overseen by the local author-ity’s procurement department that allowed for many providers to be in a position to quickly respond to the need for additional support services. In addition, the framework, also allowed for spot contracts to be agreed for more specialist support services.

ConclusionOur conclusion is that future pressures will revolve around our homelessness and older person services; we have specifically identified needs in respect of domestic abuse, mental health, substance abuse, single people, vulnerable families and people suffering early stage of dementia.

Our commissioning intentions for the next three years will reflect the usage of additional funding allocated to Caerphilly through redistribution to be utilised to develop the following commissioning programme.

Source 30-64 65-74 75+ Total% of all

people 65+ with dementia

% of all people with

dementia

Caerphilly (Alzheimer’s society)

22 139 704 864 6.56 0.96

28

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