One of the largest areas of spend for a local authority is social care for adults with learning disabilities and/or autism (paying for residential care, supported living, domiciliary care, and day opportunities etc).
Despite the significant spend on these services, very little of it could be classed as preventative and the patterns on where/how money is spent have not changed much in the last decade. There is money in the system, but it’s already allocated and little is available to invest in prevention and innovation.
As we enter a period of further austerity many local authorities face more pressure to do more with smaller budgets. Times of financial hardship can make people more risk averse when the exact opposite is needed. The traditional commissioning model does not always lend itself that well to innovation, yet innovation is exactly what is needed to transform how we support adults with learning disabilities. Giving providers the permission to do things differently achieves better outcomes within the same budget.
In Essex our supported employment service and day services sit under one contract and is a collaboration between the local authority, Essex CC and one provider, ECL. Together we created the LIVE (Learning, Innovation, Volunteering and Employment) programme, a partnership approach designed to have a big impact for working-aged adults with learning disabilities living in Essex.
ECL is a local authority trading company, with an ethos of not for profit, and a vehicle to try new things. Essex CC and ECL knew that they needed to take radical action to provide adults with a learning disability the support they wanted. Namely more community-based and real employment opportunities moving away from the traditional day centre offer. ECL seed funded the supported employment service initially to unlock some of funding tied up in day services. This provided an opportunity for ECL to create a supported employment service, known as Inclusive Employment, within the same financial envelope that day services are commissioned within.
The service is funded by reallocating the budget as people move out of day services into paid employment, freeing up funding to be moved across to the Inclusive Employment service. Both day services and supported employment are provided by ECL under the same management structure, ensuring that the services are not competing but working together to achieve the goals of everyone. Three years into this journey Inclusive Employment is now the default position for anyone entering our services.
Chris Martin, Commissioning Director at Essex CC, commented: ‘Adults with a learning disability said to us that we were commissioning things many of them didn’t want. We knew we needed to move the money to provide a real choice for them and support them to fulfil their aspirations. It doesn’t need to cost more money to get better outcomes, but you have to be brave enough to move the money around your provision. If you’ve got an innovative provider, aligned with the commissioners’ money and commitment, investment can be moved to improve outcomes.’
This approach has freed up significant funding from day services as people have achieved employment outcomes. It costs less to support and sustain someone into employment than it does providing a day service five days a week. The life savings return to Essex CC from this collaborative approach is estimated to be £15m. We’ve facilitated the shift of nearly 40% of the budget from reactive spend (trying to keep individuals independent), to proactive spend (where individuals are leaving education and going straight into Inclusive Employment without entering traditional adult social care services).
Since April 2020, we’ve supported more than 239 individuals into paid employment, and 111 of those have transitioned directly from ECL day services. Between day services and inclusive employment, we’ve facilitated more than 5,395 job applications, 830 interviews and 158 work trials. And helped our local business community to become disability confident employers.
What we’ve done in Essex demonstrates a joined-up approach is more advantageous for everyone. Long term it’s more cost effective, the lifetime savings per individual are considerable. Most importantly, it is better for the people we are supporting.
There’s no doubting the ripple effect this has on the individual and their family, the social value impact, and benefits for local businesses. Our future goal is to support more local authorities to follow a similar model and make their budgets deliver more for the people they support.
Joe Coogan is Director of Operations at ECL
www.ecl.org
@ECLCareCompany
l If you would like to discuss reviewing your day opportunities and supported employment services, please email Andrea Smith, Head of Service, at andrea.smith@essexcares.org
This article is sponsored content for The MJ
