Domestic Violence Strategic Review 2006

ITEM SP6

Supporting People

Domestic Violence Strategic Review 2006

Index Page

Recommendations ……………………………………………………….2

Executive Summary…………………………………………………….3

Main Report ……………………………………………………………..7

1Current provision and context 7

Summary of the current provision, remit, value and geographical

split by District/ City of current services.

Strategic context linked to themes and priorities from the

Supporting People five year strategy 2004-9

Financial context

2Strengths and areas for development linked to current11

servicesand partnership arrangements

Access and referral routes

Assessment processes

Judging quality of support work

Links with partners

Duration of support provided

Cost of provision

3Proposals for change: analysis of options and proposals17

4 Outline implementation plan including areas for further work 19

Appendices

Appendix 1 Map of key decision making groups in domestic violence

Appendix 2 Cost and performance information

Appendix 3 Suggested strategic aims and initial areas for action

Appendix 4 Views from service users and stakeholders

Appendix 5Draft service specification for comment

Appendix 6 Best practice and approaches elsewhere, together with

detail of central government targets under Best Value Performance Indicator 225 (Domestic Violence)

Appendix 7 Sources of evidence
Recommendations

1Re-commission all existing refuge provision.

2Put in place a new service specification to include:

Ensuring access by local housing and homelessness departments for local women at risk
Support for women to access training and employment.
Formally making links with Children’s Services in Social and Community Services.
Proposing a staff structure for agreement by the Supporting People team and key stakeholders, that takes into account issues such as risk assessment, lone working and the coordination of telephone contact between local refuges to facilitate effective access.
Active links and development of working protocols with key local organisations e.g. Police, substance misuse services, domestic violence champions, floating support services.
Establishment of a service user support group, including those who’ve moved on from a refuge, to facilitate peer support and mutual learning.
Proposals to consider and reduce high rents wherever possible, that hinder women’s opportunities to return to work.
A wide range of needs identified by service users within this review.
Re-emphasis of the need to keep occupancy at acceptable levels and liaise with stakeholders if this falls to a low level.

3Existing refuge providers should be supported through this process, so they are in a good position to prepare for and submit a successful tender if this is required.

4Consult formally with neighbouring Supporting People teams, to reflect the sub-regional and national nature of domestic violence.

5The Commissioning Body instructs the Oxfordshire Supporting People Team to implement the commissioning and procurement outcomes of the decisions in partnership with the commissioning partners and in conjunction with the Oxfordshire County Council Legal and Procurement Services.

Executive Summary

Current position

Refuge provision has been expanded significantly in the run up to Supporting People in 2003 – from 1 refuge to 3. This provision is delivered through 3 providers (one working with Asian women) and has access to 29 bed spaces. The total annual spend is £267k per year).

Despite this, the total bed spaces is still below central government targets for Oxfordshire, based on the Best Value Performance Indicator target of 1 bed space per 10, 000 population), which gives a target of 55 bed spaces (based on population figure of 553, 500 (source, South East Regional Supporting People Consultation document, 2006). There are currently 29 bed spaces in total in Oxfordshire which is equivalent to 0.52 bed spaces per 10,000 of population.

The five-year strategy prioritised refuges and highlighted issues such as move on, increasing the coverage of floating support type services though out the County and the needs of women with complex needs.

Summary of findings

Access routes and referral systems could be more streamlined, coordinated and more closely linked with housing and homelessness departments, particularly to encourage the maximum level of local access.

Assessment process needs to link much more closely with the Police Risk assessment process and prioritise safety issues.

Quality of service is not routinely discussed amongst stakeholders and providers, although the Supporting People systems collects a wide range of qualitative and quantitative feedback. Outcome measures need to be developed.

There have been issues with low occupancy and staffing levels within local refuges in 2005/06.

Providers have requested ‘fast track’ referrals into some statutory services such as counselling.

Staff turnover, particularly amongst managers in refuges, is particularly problematic as it hampers the development of relationships with key stakeholders and the development of new processes e.g. support to house those with more complex or challenging needs e.g. linked to substance misuse.

Supporting People and key domestic violence decision-making groups could be more closely linked to ensure quality and working practices are monitored and developed together.

Simple systems need to be developed to measure the period women are waiting to move on from refuges, so that this can be raised with housing organisations to see if it can be reduced if there are long delays.

The cost information indicates that services are comparable with other types of service, but a fuller analysis is needed together with more detailed information from scheme-level budgets to come to a more robust and detailed assessment. There could be an issue of funding being too low and/ or unsustainable.

Future pattern of services

The focus in the future is to keep the existing pattern of service essentially the same, maintaining all existing refuge provision as it provides the bed-rock of any domestic violence strategy. Local needs information justifies the need for maintaining refuge provision and the current level of provision is also below central government targets

The development work proposed within the review concentrates on putting in place a significantly revised service specification that focuses on issues and themes raised by service users and stakeholders. Specifically, these are:

Ensuring access by local housing and homelessness departments for local women at risk
Support for women to access training and employment.
Formally making links with Children’s Services in Social and Community Services.
Proposing a staff structure for agreement by the Supporting People team and key stakeholders, that takes into account issues such as risk assessment, lone working and the coordination of telephone contact between local refuges to facilitate effective access.
Active links and development of working protocols with key local organisations e.g. Police, substance misuse services, domestic violence champions, floating support services.
Establishment of a service user support group, including those who’ve moved on from a refuge, to facilitate peer support and mutual learning.
Proposals to consider and reduce high rents wherever possible, that hinder women’s opportunities to return to work.
A wide range of needs identified by service users within this review.
Re-emphasis of the need to keep occupancy at acceptable levels and liaise with stakeholders if this falls to a low level.
Information on the governance of the organisation, together with copies of management committee papers and minutes.

The above aims to contribute to the development of an integrated Domestic Violence Strategy that promotes early intervention, as emphasised by members of the Oxfordshire Domestic Violence Steering Group. This focuses on the importance of:

More effective early preventative work, combined with an
Increase in planned short term admission for women at risk (for respite so that the woman can safely consider her options) and
A reduction in crisis admissions.
Moving support wherever possible with a woman as her needs and circumstances change, to meet her needs as she makes decisions to leave an abusive situation (or is forced to leave) and moves through a number of different stages.
Working through a multi-agency approach and common systems e.g. assessment.
Provision for people with multiple or complex support needs.
Ongoing support and monitoring of support within refuge services.
Look to develop a better understanding and agreement linked to local needs so that a more rational distribution of funds can be agreed to meet needs in part of the County that currently do not have a refuge. This should be linked to priorities in District / City strategies e.g. Community Safety or Local Plans.

The Core Strategy Group has recommended that the Asian specific refuge should be continue to be funded, in the longer term if the need for this quantity and type of provision is reconfirmed. The Core Strategy Group have recommended that the investigation should consider whether the needs of this group could be met within an existing refuge service and whether alternative accommodation is more appropriate (to meet the needs of women with children, as the existing provision is for single Asian women only).

Formal advice needs to be sought from colleagues in Procurement within Social and Community Services to establish if the new service specification leads to the need for a tendering process under the relevant County wide procurement procedures. This will determine the focus of putting in place the new tender and working arrangements, through a tender evaluation and process or through negotiation and dialogue with existing providers.

Members of the sounding board have noted that any tendering process needs to be carefully managed, to minimise bureaucracy for the Voluntary and Community Sector, offer support to provider organisations, whilst also pursuing quality and value for money.

Summary of work undertaken

Establishment of a multi-agency ‘sounding board’ including statutory and provider organisations working with women who are escaping violence and/ or abuse, including:
Members of the Supporting People Core Strategy Group
Colleagues in Procurement from Social and Community Services
Police
Primary Care Trust
Providers and stakeholders. The input, ideas and time of those involved in the sounding board is gratefully acknowledged.

Arrangement of 2 service user focus groups (one in Oxford, one in Banbury) where views and experiences were gathered on a wide range of issues linked to women’s experiences.
Distribution of questionnaires to refuges based in Oxfordshire and Berkshire Women’s Aid and the outreach service in West Oxfordshire.
Distribution of questionnaire to organisations on sounding board asking for views on future commissioning priorities and feedback on key issues.
Meetings with individual providers and stakeholders.
Circulation of agendas, working papers and notes of Supporting People to Core Strategy Group members in which current refuges located (or their nominated representatives)

Supporting People

Domestic Violence Strategic Review 2006

Main Report

Current Provision and context

Summary of Current Domestic Violence Provision
Number of services / 3 / Oxfordshire Women’s Aid (13 bed spaces)
Banbury Refuge (12 bed spaces)
Sahara Asian Women’s Project (Banbury - 4 bed spaces)
Number of service users / 29 bed spaces in total
(13 in Oxford City,16 in Banbury)
Spend (total and by district) / £267k / Oxford - £116k (43.45% of total spend)
Cherwell £151k (56.55% of total spend)
Remit of Current services / All services are open access, taking referrals from organisations in contact with women who are at risk or experiencing violence. Referrals are from both national help lines and also through locally based organisations (such as the Police) as well as self referrals to any of the three projects.
All projects work with women from all sections of the community and respond to their needs which are often complex, including physical, legal, emotional and practical needs.
Sahara has a particular remit to work with women from Asian communities in recognition of the particular cultural barriers mainstream services face in reaching women at risk within Asian communities. It cannot accommodate women with children.

The above Supporting People services operate along side a wide range of other domestic violence services that include community outreach posts funded as part of Community Safety type initiatives. Information received to date indicates this consists of:

1 Full time worker in Oxford City
1 Full time worker linked to Oxfordshire Women’s Aid.
1 Part time worker in West Oxfordshire (2 days a week)
1 Full time worker (from 2008/ 06) in South Oxfordshire (linked to Berkshire Women’s Aid)
A potential part time post in development in the Vale of the White Horse District

The strategic planning groups linked to domestic violence are listed at Appendix 1.

Strategic context – Supporting People five-year strategy and role of domestic violence support services

The following is a summary of the key issues and data from extracts included in Oxfordshire Supporting People Strategy 2004-09:

There has been a significant increase in refuge projects and bed spaces linked to the introduction of Supporting People in 2003 (before 2003, there was one refuge compared to 3 currently)
No national prevalence data existed for incidence of domestic violence

In the two years 2002/03 and 2003/ 04, the majority of women accessing refuges were from outside of Oxfordshire – 61% and 56% respectively. The most recent figures for comparison are included in the table below:

04/05

Local Authority / Total / Percentage
From Oxfordshire / 58 / 43%
Not from Oxfordshire / 72 / 53%
Unknown / 6 / 4%
Total / 136 / 100%

05/06

Local Authority / Total / Percentage
From Oxfordshire / 48 / 42%
Not from Oxfordshire / 60 / 53%
Unknown / 6 / 5%
Total / 114 / 100%

The provision of refuges is a priority for all Supporting People partners and members of the Commissioning Body and all services meet strategic priorities.

Move on is an issue which can prevent access of other women in need as people have to stay longer in a refuge than they need to.
A lack of 24 hour support at one refuge reduces the support that can be provided and means the most socially excluded may not be able to be accommodated.
No provision exists for those with complex needs and/ or who have issues linked to substance misuse and need to think about how this can be improved in future.
Need for floating support for women in the community (as opposed to a refuge) and moving on from a refuge.
Need to continually think about needs of children in refuges and Asian women with children.
Service users not involved in developing strategy, but involvement in service reviews was more effective.
Although estimating needs was noted to be difficult, the view was that Oxfordshire did not have the level of refuge provision that was required.

The above is demonstrated by the comparison with the target level for Oxfordshire (based on the Best Value Performance Indicator target of 1 bed space per 10, 000 population), which gives a target of 55 bed spaces (based on population figure of 553, 500 (source, South East Regional Supporting People Consultation document, 2006). There are currently 29 bed spaces in total in Oxfordshire which is equivalent to 0.52 bed spaces per 10,000 of population.

It should be noted that the spread of bed spaces and resources has not been linked to needs analysis or projections of need either within or across Oxfordshire, as it the development took place before Supporting People was in place (or prior to Supporting People ), and the development of services was more opportunistic (linked for instance to the availability of buildings).

By 2009 the strategy anticipated that:

Accommodation-based provision will remain

Support will be available in a wider range of locations and areas

Generic floating support will be able to support men and women

Staff advising women will have good links and information on the full range of substance misuse and mental health services to support referrals and provision of appropriate support.

Key action points from the strategy and comments linked to resources needed:

Increase move on and look at referral routes (revenue or funding increase required to take forward)

Utilise staff in refuges to support moving on and in the community (revenue increase required to take forward)

Ensure generic and specialist floating support able to support women experiencing domestic violence

Work on referral and access and routes to ensure women able to access the services which best meet their needs.

It should be noted, that since the publication of the strategy in 2004, central government has been developing a new national Supporting People strategy. Although the consultation and discussion process is not complete, it is seems clear that domestic violence services are likely to remain a very high priority of central government and are to continue to be part of the Supporting People programme.

Financial Context

There is not a specific savings target linked to this strategic review, although there are very real pressures on the Supporting People Grant more broadly, which the Supporting People Core Strategy Group and Commissioning Body are discussing and deciding how best to respond to. It is not clear at this stage what impact this will have in the longer term on any part of the Supporting People programme.

Because of the unavoidable pressure on the Supporting People grant, there is an analysis of current costs in Appendix 2 and this is explored in more detail in section 2 below.

Because of this budgetary pressure it seems relevant to note that any increase in costs proposed either by commissioning organisations, funders or providers will need to be considered against a challenging financial environment and a reducing Supporting People grant.

Strengths and areas for development of current provision and partnership arrangements

The following comments and analysis build on discussions at the sounding board, feedback from providers and stakeholders.

Access and referral routes

Strengths

Planned admissions to refuges.

Areas for development

View amongst some referrers that refuges seem to be full nearly all of the time, and so are not available for emergency admissions, that can result in a woman being placed in Bed and Breakfast accommodation, where she is at possible risk of not being supported emotionally and/ or possibly more likely to return to a violent or threatening partner.
Routes and mechanisms for 24 hour access could be clearer as a good level of familiarity with local systems is needed currently
Consideration should be given to coordinating telephone help lines in some form to provide uniform cover across the County. There is support for putting in place systems to analyse by daytime/evening and weekday/weekend to check that the helpline is operational and accessible at all times, and that the number of calls received has some relationship to national averages or good practice where known.
Putting in place refuge places for those with substance misuse support needs (currently no ability to accommodate in Oxfordshire, so women are referred to other parts of the country).
Need more outreach work to help access to refuges.
Lack of availability of temporary accommodation away from the Oxford City, when requests for this come from refuges.
Liaison by refuges with housing and homelessness departments when women accommodated who haven’t been referred by housing departments to register on housing waiting list (or support to register as homeless), advise on housing options, link into local services etc.
Possibly some refuges may have an exclusion policy in place linked to women from Oxfordshire, even after reassurances from the police for example.
No coordinated prioritisation of women accessing refuges. Currently carried out by refuge on a case by case basis, but could possibly be reviewed on a multi-agency basis in partnership with providers to get a better overview of needs, gaps, delays, what works, partnership working with other key organisations etc.

Assessment processes