|
Report to: |
Cabinet |
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Date of meeting: |
25 February 2025 |
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By: |
Director of Adult Social Care and Health |
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Title: |
Proposal to reduce the funding for the Housing-Related Floating Support Service |
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Purpose: |
To consider the outcome of the public consultation and to decide on the proposal to reduce funding for the Housing-Related Floating Support Service |
Cabinet is recommended to:
1) Agree to reduce the funding for the Housing-Related Floating Support Service from £4.3 million per year to £500,000 per year from October 2025;
2) Agree that the Council serve a contract variation notice on the service provider, BHT Sussex, to give effect to the reduction of funding set out in recommendation 1; and
3) Delegate authority to the Director of Adult Social Care and Health to take all necessary actions to give effect to the above recommendations.
1.1 Cabinet agreed on 26 September 2024 to launch a consultation exercise relating to the Housing-Related Floating Support Service which provides housing advice to residents across the county (the papers are available: here). The proposal presented to Cabinet in September 2024 was to reduce the funding for this service from £4.3 million per year to £500,000 per year. This would be a reduction in the budget of 88.5%.
1.2 If the proposal is agreed, the change would happen from October 2025 at the earliest, as the Council is required to give six months’ notice to the provider. This proposal, as well as other potential service changes being explored by Adult Social Care and Health, is to help close the Council’s funding gap.
1.3 The consultation ran between 3 October and 28 November 2024. The impact of the new funding settlement for the Council has been considered when making the proposal in this report.
2.1 The Council currently commissions BHT Sussex to deliver short-term direct support to East Sussex residents with housing-related needs. The Housing-Related Floating Support Service is available to East Sussex residents aged 16+ years, living in, or moving to, independent or supported accommodation in all housing tenures who require housing-related support.
2.2 East Sussex County Council has commissioned housing related floating support since April 2014. It originated from the Supporting People Programme under which the Council was in receipt of the Supporting People Grant. From 2011, Supporting People was subsumed into the overall Formula Grant paid to Local Authorities. Unlike many other Local Authorities, the Council has continued to invest in housing related support in recognition of the relationship between suitable housing and improving health and reducing health inequalities.
2.3 The service aims to underpin the strategic priorities of Adult Social Care and Health, and to:
· Enable people with housing related support needs to live independently;
· Identify the key components that enable people to remain living independently in their own homes, and their experiences of accessing existing support and the service;
· Understand the barriers that prevent people from living at home independently and work collaboratively to look at how to improve outcomes and reduce pressure across the system;
· Provide flexible, personalised, and appropriate housing support, stratified to manage a range of levels of need and risk;
· Minimise risk of homelessness and address inappropriate housing;
· Signpost individuals and/or family members as appropriate to health and social care services, education, training, employment and support, voluntary, community and social enterprise sector services that will assist with accessing and maintaining their housing and ability to live independently for longer;
· Provide time-limited follow up support to prevent and reduce risks of homelessness/ unsuitable housing;
· Ensure people are appropriately signposted or referred to mental health, social care, health services and substance misuse services as needed and any other appropriate services according to need.
2.4 During 2023/24 the service supported 5,282 individual adults and their households, 60% of whom were aged 16-59 and 40% aged 60+; with 71% supported to remain in their existing accommodation.
2.5 The table below shows the organisations making referrals to the service:
|
BHT Sussex: Organisations making referrals 2023/24 |
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Adult Social Care |
41% |
|
Districts & Boroughs |
22% |
|
Children's Services |
10% |
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Other (inc. Health, VSCE and other statutory organisations) |
21% |
|
Self-referral (60+) |
7% |
2.6 The table below shows the needs of the those supported by the service:
|
BHT Sussex: Adults by needs 2023/24 |
|
|
Physical / Sensory Disability or long-standing illness / Acquired Brain Injury |
61% |
|
Mental Health Condition |
30% |
|
Learning Disability / Difficulty / Neurodivergent |
7% |
|
Other |
2% |
2.7 The service provides a time-limited intervention of individual support, normally for three to four months, for adults and their households. The services can help those who are:
· at risk of losing their home due to domestic abuse, relationship breakdown, money or health issues;
· already homeless or living in temporary accommodation, such as a bed and breakfast or hostel; or
· living in poor quality or unsuitable accommodation.
2.8 The service can also help to manage peoples housing issues including debts and benefits, repairs, landlords and neighbours and additionally support to manage their mental health or substance misuse.
2.9 While responsibility for unsuitable or poor-quality housing and homelessness prevention in relation to housing provision is not an ESCC statutory responsibility, improving health and reducing health inequalities is, as well as the duty to prevent, reduce and delay the need for support (under section 2B of the National Health Service Act 2006 and section 2 of the Care Act 2014 respectively).
2.10 The health and wellbeing of people who experience homelessness is poorer than that of the general population and they often experience the most significant health inequalities and have poorer health outcomes. Many have co-occurring mental ill health and substance misuse needs, physical health needs, and have experienced significant trauma in their lives. This is driven/exacerbated by poor living conditions, difficulty maintaining personal hygiene, poor diet, high levels of stress and drug and alcohol dependence.
2.11 The map in Appendix 6 shows the location of adults who used the service in 2023/24.
2.12 BHT Sussex have worked with the Council to add a ‘Homes for Ukraine Sustainment Service’ to the contract. The aim is to support Ukrainian ‘guests’ and their East Sussex hosts to manage and maintain these living arrangements by supporting guests to access health and community services, and employment and educational opportunities to help guests to live independently and move on from host accommodation. This service is not in scope of the proposed savings targets.
2.13 BHT Sussex have also worked with the Council to allocate some of the underspend resulting from recruitment challenges directly to adults for a Voucher Top-Up Scheme for utilities and food, cold weather goods such as blankets, digital inclusion such as SIM cards and smart phones, and an emergency fund for things such as white goods, school uniform, and ID for benefits applications.
3.1 The proposal, which was subject to public consultation, is to significantly reduce funding for the Housing-Related Floating Support Service from £4,372,615 to £500,000 per annum, a reduction of 88.5% in overall funding. This reduction in funding is to take effect from 1 October 2025, following a six-month notice period provided to the service provider, BHT Sussex.
3.2 The estimated annual revenue savings in a full year for this proposal are £3,872,615.
3.3 To determine the potential savings, we took the overall gross contract sum for the service, subtracted the six-month notice period (01/04/2025 to 30/09/2025) and the proposed remaining funding of £500,000 per annum. Therefore, the potential savings for 2025/26 will be a half year effect of £1,936,307 and full year effect of £3,872,615 from April 2026.
3.4 It is anticipated that in the 2024/2025 financial year there will be a further underspend, generated from reduced service levels due to vacancy control measures. This could be used, subject to Cabinet approval, to fund an extension to the Supported Accommodation notice period proposed in a separate report later on the agenda.
4 Insight
4.1 An eight-week public consultation on the proposal ran from 3 October to 28 November 2024. We asked people for their views on the proposal and how they would be affected if it went ahead.
4.2 All the feedback received during the consultation is available within the Members’ and Cabinet Room for Members’ consideration.
4.3 1,425 responses were received across the survey, consultation meetings and other feedback methods for this consultation as follows:
|
Respondent method |
Total |
|
Survey |
1355 |
|
Emails |
17 |
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Consultation meetings (attendees) |
53 |
4.4 Most respondents across all response methods disagreed with the proposal to reduce the funding for the East Sussex Floating Support Service. The responses were as follows:
|
Response |
Total |
Percentage |
|
Strongly disagree |
1118 |
83% |
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Disagree |
118 |
9% |
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Strongly agree or agree |
55 |
4% |
|
Neither agree or disagree, not sure or did not answer |
64 |
4% |
4.5 The final public consultation analysis report is attached as Appendix 4. Members will need to have regard to the key themes raised in the feedback as detailed below and in Appendix 4. At a high level:
· The majority of people and organisations strongly disagree with the proposal to reduce funding for the East Sussex Floating Support Service, with some viewing the proposal as “shameful” and “immoral”;
· The service is immensely valued and seen as a vital lifeline for the most vulnerable in East Sussex. It was reported as very responsive, providing personalised and flexible support, offered face-to-face, including home visits, and has much shorter waiting times than other services.
4.6 The key messages included the following themes:
· Cutting the service would target the most vulnerable;
· Many people praised the service and the staff who deliver it, saying that no other service provides the same level of personalised and flexible support;
· The service has much shorter waiting times than other services and people really value the fact it offers home visits and face-to-face support;
· Professionals from other organisations rely on referring people to the service and value how knowledgeable and skilled the staff are;
· The size of the cut is too great and it would have far reaching impacts for the housing system;
· It would cause greater demand for other services including within the Council and the NHS, local housing authorities and charities;
· Staff from other organisations say they would not be able to fill the gap, meaning that people’s needs would go unmet;
· People would lose out on funding they are entitled to and be at risk of remaining in unsuitable accommodation;
· More people and families would end up in crisis and would be at risk of becoming homeless or dying;
· The services people would end up getting support from instead would be more expensive than maintaining the budget for this preventative service;
· People and organisations said the budget shouldn’t be cut for this service, with some saying it should get more money not less;
· Some people said if the proposal has to go ahead, the amount being cut should be reduced. It would also be important to ensure there is accessible support for the most vulnerable.
4.7 At the County Council meeting on 11 February 2025, a petition was presented to the Chairman by Councillor Daniel Shing, calling on the Council to “protect and retain the East Sussex Floating Support Service”. The petition has not reached the 5000-signature threshold to trigger a Full Council debate. However, Standing Orders provide that the Chairman will refer the petition to the Cabinet or relevant Cabinet member to consider. The Chairman has referred this petition to Cabinet to consider as a relevant factor when deciding whether or not to implement the proposal set out in this report. A copy of the petition is available in the Members’ and Cabinet Rooms.
Equalities Considerations
4.8 In considering these proposals, Cabinet must have due regard to the need to:
(a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Equality Act 2010;
(b) advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it;
(c) foster good relations between persons who share a relevant protected characteristic and persons who do not share it,
as required under s.149 of the Equality Act 2010.
4.9 To better understand the likely impacts of the Proposal on those who have one or more protected characteristics, an Equality Impact Assessment (EqIA) has been carried out (a copy of which can be found out in Appendix 5).
4.10 The responses from the consultation were used to inform the analysis carried out in the EqIA. Cabinet members must read and have regard to the EqIA when making the decision about this Proposal.
4.11 Key findings were that the service is skilled in engaging with people whose conditions and circumstances make it harder for them to engage with services due to cognitive difficulties and age-related frailty, long-term health conditions or disability, rurality, race and ethnicity, caring responsibilities and low income. Therefore, a significant reduction in funding and subsequent reduction in service will particularly disadvantage these communities.
4.12 Impacts identified from the EqIA are as follows:
· It is likely that this proposal will impact older people negatively as the proportion of older people that are supported by the service (40%) is higher compared with the general East Sussex population (26%);
· This proposal is likely to negatively impact people of working age as the service supports a greater proportion of people aged 16-59 (60%);
· People who have a mental health condition are more likely to be affected by the proposal than those in the general population - 40% of the people the service supported self-report a concern with their mental health at the time of referral;
· Applying for welfare benefits, and other financial support is challenging for people who use this service due to cognitive difficulties and age-related frailty, long-term health condition or disability, rurality, race and ethnicity, caring responsibilities and low income;
· Face-to-face visits, which are part of this service, were reported as vital for people who find it difficult to engage with and navigate health and care systems and access support due to cognitive difficulties and age-related frailty, long-term health condition, disability, rurality, race and ethnicity, caring responsibilities and low income;
· The service supports an above average proportion of the population that identify as Black and Minority Ethnic. The data tells us that the service supported a higher proportion of people from ethnic minority backgrounds (12.9%) compared to the East Sussex average of 8.0%. Withdrawal or reduction of face-to-face visits is likely to impact negatively on mitigating barriers to translation and interpretation when accessing information, advice and support. People from Black and Minority Ethnic groups will be disproportionately affected as they are more likely to experience homelessness and poor housing;
· There is a lack of alternative housing-related support services that can support pregnant women and those with young children;
· The service supports an above average proportion of the population that identify as not heterosexual. Prevalence of a mental health condition is known to be significantly higher in LGBTQI+ people. This can create a cumulative impact which contributes to an increased risk of homelessness. There is a lack of alternative housing-related support services with expertise in supporting people from LGBTQI+ communities.
5 Alternatives considered
5.1 Our priority in Adult Social Care and Health is to meet our legal duties under the Care Act. To help us to do this, we have identified funding areas that we think need to be protected when we are looking at savings options.
5.2 These priority areas are the community care budget, carers support services, funding for the voluntary and community enterprise sector (VCSE), and funding for staffing frontline and care market roles.
5.3 While we recognise the importance of these services, the budget pressures we face mean that we have to make difficult decisions about how we spend our money. We have continued to fund housing support services over the last decade, despite the budget reductions we have experienced. This is because we recognise the value they provide to our residents and because they help prevent the need for other services from the Council and other organisations including the District and Borough Councils in East Sussex. The legal responsibility for providing advice, help and housing to those who are homeless, or at risk of becoming so, lies with the District and Borough Councils. We are therefore not required by law to provide these information and advice services for housing.
5.4 Given the feedback from the consultation and the impacts identified through the Equality Impact Assessment, officers have explored whether there are any alternative options that would safeguard the floating support service but still deliver the same level of savings.
5.5 BHT Sussex who currently provide the service suggested an alternative proposal to reduce the contract value by £2 million (46% reduction) instead of the proposed 88.4%. They have indicated that this would enable 3,500 people to be supported based on the current commissioned service model and noted that further remodelling of the service could further increase the number of people supported and safeguard service quality and successful outcomes. However, reducing the level of budget reduction would not achieve the required savings and therefore this is not considered a viable alternative option.
5.6 The five local housing authorities have stated that they would welcome an opportunity to work with partners to scope a cross-sector approach to homelessness prevention. This would include providers and partners from across health, care and criminal justice and would build on the good practice already underway in existing services. The local housing authorities have therefore recommended that the Council consider extending the transition period for the Floating Support contract, i.e. delaying the implementation of the reduction in funding, to enable systems partners to develop a cross-sector approach to homelessness prevention services.
5.7 However, again, any extension to the transition period to enable systems partners to co-design a cross-sector approach will not generate the required savings and therefore it is not possible to recommend this as an alternative option.
5.8 Appendix 1 sets out in more detail alternatives put forward through the consultation process.
6 Impacts and risks
6.1 This section explores the impacts and risks of going ahead with the proposal, including those outlined in the EqIA (see Appendix 5).
6.2 Older people, disabled people, carers and people living in rural areas are likely to experience a cumulative impact of the savings proposals.
6.3 Support to apply for and navigate welfare benefits, and other financial support can be challenging for people due to cognitive difficulties and age-related frailty, long-term health condition(s) or disability, rurality, race and ethnicity, caring responsibilities and low income thus impacting on their ability to access safe, secure housing and/or live independently in their own home. This can additionally be compounded for those who are living in poor quality/insecure/unsafe housing and/or are digitally excluded.
6.4 Financial implications
The proposal to reduce funding for the Floating Support service contributes to the required Council savings as set out in the table below:
|
Current Budget |
Revised Budget |
Total Savings |
||
|
2024/25 |
2025/26 |
2026/27 |
||
|
£'000 |
£'000 |
£'000 |
£'000 |
|
|
Expenditure budget |
4,373 |
2,436 |
500 |
|
|
Income budget |
0 |
0 |
0 |
|
|
Net budget |
4,373 |
2,436 |
500 |
|
|
|
|
|
|
|
|
Net savings |
0 |
1,937 |
1,936 |
3,873 |
6.5 The wider system financial implications identified through the consultation are set out in detail in Appendix 2. In summary, it is estimated that with a significantly reduced Floating Support service, this would:
· generate an additional cost to the housing authorities in the region of £9,900,000 per annum;
· risk the loss of Benefits income of approximately £900,000 per annum;
· increase the cost to Children’s Services of supporting families found intentionally homeless;
· increase time required by ASC staff to work with people as they will not be able to refer as many people on for alternative support with housing and/or benefits issues.
6.6 Any future service model will need to be designed and where possible seek to mitigate some of the risks in the last two bullet points above.
6.7 The potential impacts the proposal would have on the health and care system, housing system, other organisations, services and residents are set out in Appendix 3. In summary, there would be a significant risk to the system and people using a wide range of services with an increase in homelessness and increased pressure on already challenged services. The floating support service is a critical component to the countywide approach to homelessness prevention. Reducing these services will result in increased demand for statutory homelessness and care services, and a further rise in the number of people living in temporary accommodation and the length of time before people can secure move on accommodation. The proposed reduction to this service will fundamentally challenge the gains made in reducing homelessness and placements into emergency accommodation. This, in turn, would place further pressures on districts and boroughs in terms of unaffordable and unavoidable costs. As set out below, we will engage with our Strategic Partner and key stakeholders to redesign services within the remaining limited financial envelope, and it may be possible to identify some mitigations once this work has been undertaken. However there are no comparable services or significant mitigations to the potential impact of the proposal.
6.8 The main risks of going ahead with the proposal are:
|
Risk |
Impact |
Mitigation |
|
The proposed significant reduction in funding will have a negative impact on older people, pregnant women, households with children, people with disabilities, those from ethnic minority communities and those who have experienced multiple disadvantages. |
This is likely to have a knock-on effect to many areas ranging from Adult Social Care, Children’s Services, District and Borough Housing teams, local VCSE services, health and criminal justice services. |
We will engage with our Strategic Partner and key stakeholders to redesign services within the limited financial envelope. It may be possible to identify some mitigations once this work has been undertaken. |
|
Ability to offer Housing Related Floating Support home visits will be lost. |
Identification of a range of issues facing adults using the service will be lost. The direct contact and referrals these professionals provide enables other services to provide suitable onward support, ensuring there is less ‘slip-back’ or, worse, acceleration into additional support services. May particularly impact people living in rural areas and those who are digitally excluded |
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Significant reduction in Housing Related Floating Support service delivery. |
Increased risk of homelessness. |
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Potential increased demand for statutory homelessness and care services. |
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A further rise in the number of people living in temporary accommodation and the length of time before people can secure move on accommodation. |
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Loss of support to access private rented sector. |
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Potential impact on health and wellbeing as a result of living in unsuitable accommodation. |
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Added pressure on other VCSE agencies such as Citizens Advice and Money Advice/Welfare Benefits services. |
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Increase in fuel poverty and subsequent impact on individuals’ health and greater risk of death. |
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Reduces opportunity to carry out preventative work with families who are facing eviction and housing issues including rent arrears and housing related debt and could lead to more families and children facing homelessness and the negative outcomes that come with this for both parents and children. |
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Potential increase in delayed discharges and A&E attendances. |
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Adversely impact population health and healthcare outcomes and increase health inequalities. |
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Older people served by this support tend to have complex and enduring mental health problems, cognitive difficulties, co-morbid health issues and are socially isolated. They often experience problems with debt and are struggling to navigate other systems of support for housing and benefits. |
Unable to access other services. |
|
|
Unmanaged debt is known to be a risk factor for suicide. |
||
|
Lack of resettlement support. |
Individuals more likely to be unable to sustain new accommodation. |
|
|
Lack of support to maintain independent living. |
Increased risk of older people developing greater need for care and support / moving to long-term care. |
|
|
Some individuals may be affected by more than one of the proposed service changes and experience an aggregated effect, including those with drug and alcohol dependencies, and people at risk of homelessness. |
Homelessness leads to premature mortality, and the ONS reported in 2021 that 35% of all deaths of homeless people were attributed to drugs or alcohol. Older people, disabled people, carers and people living in rural areas are likely to experience a cumulative impact of the savings proposals. |
|
|
The proposal to cease funding for the on-site support for adults with mental health and additional needs in supported accommodation could be exacerbated by the significant reduction in funding for the Floating Support Service. |
The proposed changes may restrict people’s access to essential prevention and support services, which in turn may negatively impact their mental and physical wellbeing, place pressure on other services and potentially have cost implications in the longer-term. |
|
|
Making financial reductions in one part of local government can adversely impact, other parts of the sector. |
The interrelated issues between social care and housing services, and potential gaps in provision at county council level may result in Districts and Boroughs needing to fill these to ensure the needs of customers continue to be met; however, budgets for this are already challenged. |
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|
Increased use of temporary accommodation. |
Significant cost to Districts and Boroughs. |
|
|
Potential increase in child protection and safeguarding issues, reduced access to health and education and a direct impact on the health of children living in poor standard housing. |
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Reduction in successful benefit claims (e.g. Attendance Allowance, PIP, Council Tax Reduction, Pension Credit). |
Reduces individual independence and increases demand for funded services from Adult Social Care. |
|
|
Residents turn to other voluntary sector services support. |
No capacity to support additional numbers of people needing services. |
|
|
Potentially ceasing the on-site support provided at five Supported Accommodation services for adults with mental health needs, and adults with additional support needs who are homeless or at risk of homelessness.
|
If these proposals go ahead this will further exacerbate the impact on East Sussex residents as a result of the significant reduction in funding for housing-related floating support services. |
7 Outline implementation plan
7.1 If this Proposal is agreed, the provider will be given six months’ notice of the decision to reduce the annual funding. The intended notice period is 1 April to 30 September 2025. During the six month notice period, we will work with our Strategic Partner and District and Borough Authorities to redesign and co-produce a targeted service around homelessness prevention. Work is ongoing to explore funding options for a reduced, but targeted homelessness prevention service, which may include contributions from the Council, Districts and Borough Councils or other financial arrangements.
7.2 As this is a short-term service, existing adults using the service will not be directly affected; however, in order to manage such a significant reduction, the provider will need to gradually reduce referrals into the service in advance of the implementation date of 1 October 2025. This will ensure that all adults accepted into the service during that period will receive the support needed to meet their outcomes from the start of the remodelled service.
7.3 Implementation Plan:
|
Milestone |
Action |
|
March 2025 |
Inform provider of outcome of Cabinet decision. |
|
March -June 2025 |
Set up workshops with key stakeholders including the provider and District and Borough Housing Authorities to co-design a cross-sector approach to housing advice and homelessness prevention services. |
|
01 April 2025 |
Issue notice to the provider of the reduction in contract value. |
|
April – September 2025 |
Provider to restructure service within the available financial envelope. |
|
July 2025 |
Determine model, levels and scope of service within the available financial envelope. |
|
June – September 2025 |
Provider to start stepping down capacity of service and reduce number of referrals to ensure there are no adults unable to receive a service from 1 October 2025. |
|
August 2025 |
Issue contract variation to provider for signing. |
|
September 2025 |
Communications rolled out to residents and referrers describing the remodelled service. |
|
01 October 2025 |
Remodelled service commences. |
|
January 2026 |
Quarterly review of remodelled service. |
7.4 Once the remodelled service has been agreed, communications to a wide range of referrers and the wider public will be undertaken to explain the changes to the service.
8 Conclusions and reasons for recommendations
8.1 The Council is required to set a balanced budget. The ‘State of the County’ report presented to Cabinet in June 2024 set out a projected £55m deficit on the 2025/26 budget. Savings proposals requiring public consultation that would help to close this gap were presented to Cabinet in September 2024.
8.2 The total savings proposals for the Medium-Term Financial Plan for 2025/26-2027/28 set out in November 2024 were £20.628m, across all Council departments. The Adult Social Care & Health (ASCH) contribution to the savings total is £11.455m. In addition to these savings proposals, in order to achieve a balanced budget, the Council is also drawing on its financial reserves.
8.3 The Housing Related Floating Support service is a highly valued service that provides support for people with significant, housing related, support needs.
8.4 The Council has noted the significant concerns raised through the consultation, the potential impacts for those with protected characteristics identified through the EqIA and the potentially significant additional costs and pressures that will be placed on other parts of the system if the proposed funding reduction for these services is agreed.
8.5 It has not been possible to identify any viable alternative proposals that would achieve the required savings from the ASCH budget. Consequently, given the Council’s funding gap and the need to make savings, Cabinet are recommended to agree that the funding for the Housing-Related Floating Support Service is reduced from £4.3 million per year to £500,000 per year with effect from October 2025.
Director of Adult Social Care and Health
Tel. No: 07881 282732
Email: tamsin.peart@eastsussex.gov.uk
Local members
All.
Background Documents
Consultation responses
Appendices
Appendix 1: Alternatives Considered
Appendix 2: Wider System Financial Implications
Appendix 3: Impact of savings proposals on the wider system
Appendix 4: Consultation Report
Appendix 5: Equality Impact Assessment
Appendix 6: Profile of Services