146. The LGA and the Association of Directors of Adult Social Services told us that many local authorities have found the reporting and monitoring requirements of the Supporting People programme overly burdensome and bureaucratic, and suggested that this has particularly been the case in two-tier authorities. On the other hand, several local authority witnesses to our inquiry seemed confident that they have achieved a reduction in bureaucracy under the Supporting People programme. Stoke-on-Trent, for example, asserted: "We believe that efficiency has been increased and, since the inception of the programme, bureaucracy reduced."[181]

147. We have noted that the competitive tendering regime for Supporting People contracts is viewed by many witnesses as a burden. However, there are other administrative demands on commissioners and providers which appear to have been more welcome—albeit as 'necessary evils', as Look Ahead Housing and Care describe:

All providers of SP services regularly complete several data monitoring exercises including an 'Outcomes Framework'. […] the extensive and wide ranging data set makes SP one of the most monitored areas of its type. While as a provider we would never advocate for unnecessary or disproportionate information requirements we recognise the many benefits which have been gained as a result of the breadth of information available. Firstly it has placed both commissioners and providers in a much stronger position with regards to evidence-based policy making […] As the outcomes of particular actions are known and reported both parties are able to identify what works and to share that good practice […][182]

148. The provider organisation Casa Support similarly argued that "The SP programme brought many challenges to the sector, but it is our opinion that these challenges have benefited service users and made the sector accountable and outcome focused."[183] Casa recommended that

the administrating authority should maintain use of the QAF and the measurement of outcomes [the Outcomes Framework]. We see little point in reducing the accountability of providers and the SP team. Demand for services is increasing and the protection of vulnerable people is of paramount importance and accordingly we believe that clear accountable and robust structures need to be in place.[184]

149. An area in which witnesses could see room for improvement, however, was the consistency with which local authorities used the Quality Assessment Framework. Rethink's evidence declares that

[…] there is little agreement between local authorities in the way that services are audited, with each authority interpreting the Quality Assessment Frameworks (QAFs) differently. In some areas it was felt this was done well, with the QAFs being a good tool with firm targets to help improve services. In other authorities, area service managers felt that services received a poor grading only because it was not made clear what that authority expected was different.[185]

150. We were also alerted to the fact that local authorities are using different versions of the QAF, which has increased the administrative burden on providers in some instances:

following the development of the refreshed QAF, one of the local authorities with whom we work has declared it is going to stay with the old version. This will in effect mean that we and other providers are preparing for two different assessments. [This] could be remedied by a directive from the CLG that local authorities use standard methodologies.[186]

151. Apart from the issues with competitive tendering which we discuss above, the administration and bureaucracy associated with managing Supporting People contracts and services seems appropriate—a 'necessary evil', producing useful outcomes. However, the inconsistent use of the QAF—and the use of different versions of the QAF in different areas—is a concern. We have already recommended the retention of the QAF as a requirement. We further recommend that local authorities be required to use the same version of the Framework, to ensure consistency to providers of SP services across local authority boundaries.

Regulation of service providers

152. Although alluded to by just a couple of witnesses, we were concerned to hear of an extra layer of bureaucracy being brought about by a lack of joining up of the regulatory frameworks for housing-related support services.

153. Peter West of the Care Quality Commission (CQC) explained to us that a 'grey area' exists between the services CQC registers as personal care, on the one hand, and housing support, which does not need to be registered, on the other. In oral evidence, Mr. West told us that:

The perception is that our two relevant government departments, CLG and the Department of Health, generally have quite big agendas which are separate from that boundary issue. We are concerned that that boundary is not being sufficiently focused on. Practically speaking, a supported housing scheme with workers who may provide personal care would trigger a registration with CQC and from April 2010 it will also be registered with the Tenant Services Authority. Both departments and their regulators are currently consulting on new regulatory frameworks. It is not apparent to us sitting in the middle that those regulatory frameworks are sufficiently aligned […] The Care Quality Commission believes that that has significant implications for the number of supported housing providers that might need to be registered with us.[187]

154. In other evidence, UNISON described how the current system allows providers to make a somewhat arbitrary selection of regulator on the basis of the burden of bureaucracy associated with registration:

Increasingly, the dividing line between the housing-related social services provided under Supporting People and health and social care services is becoming blurred in terms of how services are delivered. Yet regulation regimes remain separate and have different administrative requirements. One major provider of support services for people with learning disabilities has discussed with UNISON how it wishes to switch some projects from one regulator to another (for example from CSCI [now CQC] to the housing regulator), because this would reduce the administrative burden imposed on the organisation by regulation. But such a change was not linked to any change in the way the service was being delivered. Such choice of regulation is surely a weakness in the way social care services for vulnerable people are provided.[188]

155. When we asked how this issue was being flagged to the Care Quality Commission's parent department, the Department of Health, the CQC witness told us "I spoke to our sponsoring department this morning to say I was coming here. I was a bit surprised that this issue was not quite on their radar."[189]

156. We are concerned that decisions about future regulation appear to be made by CLG and DOH in separate silos. With an increasing emphasis on housing-related services being ever more joined up and flexible, providing a continuum of support to service users, from low-level preventative interventions to high end critical care, the risk of support services which straddle the line between social care and housing becoming lost in the complexities and bureaucracy of insufficiently aligned regulatory regimes represents a huge threat to the sustainability of many providers of housing-related support and care services. We recommend that CLG take the lead in addressing this issue of regulation with the Department of Health, with a view to creating a more joined-up approach to the regulation of housing and social care services.

182   Ev 91 Back

183   Ev 122 Back

184   Ibid. Back

185   Ev 98 Back

186   Ev 121 Back

187   Q 258 Back

188   Ev 88 Back

189   Q 260 Back