Issues that affect the Trust

Contracts
The Disabilities Trust is experiencing increasing difficulties when negotiating contracts with local authorities, particularly in the southeast of England, and many local authorities appear increasingly unable to fund the third sector.

The majority of the Trust’s contracts are year-to-year, which means that every twelve months we must go back to the funding authority and re-negotiate the contract and secure a yearly uplift that takes account of our costs. This can create uncertainty and impacts on our ability to plan services over the longer term, as well as incurring additional costs in terms of the time spent negotiating with authorities. The Government has recently introduced three year funding settlements for government departments and local authorities and the Trust believes that if local authorities entered into longer-term contracts with the third sector it would create a more stable funding environment for third sector providers, help overcome the tendency sometimes for both parties to take an adversarial approach to negotiations and would aid service planning both for the sector and for local authorities themselves. In addition some authorities are using the conclusions of the 2004 Gershon Report on public spending to force down fee levels. In our view this is not what the report intended, as the savings recommended are for local authorities to make not to seek to pass on to third sector providers.

We have also come across a worrying development in local authority commissioning policy. A number of authorities in one area appear to be grouping together to negotiate as one with third sector providers. During these negotiations they often demand very detailed information from potential service providers, some of it very sensitive, and seek to agree a single fee they are prepared to pay for contracts with all third sector providers. This development is a real concern because if local authorities use this model to negotiate a single fixed fee with all potential service providers, then it might leave many with a real difficulty in achieving full cost recovery. We have also had experience of authorities effectively saying either sign up to this model or we will not refer in future and there are further questions as to whether this approach fits with a genuinely competitive market in social care provision.

The Disabilities Trust acknowledges the acute pressures on local authority finances and the much tighter public spending settlement in the recent CSR. However we believe it is vital that there is a continued commitment to adequate and sustained funding of services for people with disabilities.

Ordinary Residence
Another pressing problem is the issue of ‘ordinary residence’. Ordinary residence is the criteria local authorities use to define the normal place of residence of an individual when considering whether they have an obligation to fund their care, support or residential accommodation. In effect if someone is not defined as ordinarily resident in that local authority’s area of responsibility then they do not have a statutory obligation to fund their support. The concept dates from the original National Assistance Act in the 1940’s and despite revised guidance from the DoH in the early nineties it still seems to be subject to considerable interpretation by local authorities.

Problems over ordinary residence become particularly acute when funding packages such as Supporting People are reduced or withdrawn or when service users wish to move from residential to new supported accommodation and therefore need a revised funding package. Sometimes the local authority in the area where they are living will dispute whether they are still responsible for continuing the funding of an individual if that person has moved to them from another part of the country under a previously agreed funding package (such as joint NHS/social services funding). To further complicate matters the authority from where the individual previously resided may also themselves dispute whether they have any responsibility for funding as the person concerned has now moved. With local authorities under ever greater financial pressure and as many are seeking to redefine need or will only fund what they regard as those most in need, these kinds of disputes are likely to increase.

The Disabilities Trust believes that it is essential that this problem be addressed so that service users are able to move around the country and continue to receive the services they require.

Funding for Autism and Acquired Brain Injury
Currently there is no statutory obligation for local authorities to fund services for people with conditions such as autism or acquired brain injury. The funding for such services often comes from funds allocated to meet statutory obligations, such as services for people with a learning disability. Unfortunately, because there is no requirement to fund services specifically designed for people with autism and brain injury, this can lead to individuals being placed in services that are not specifically tailored to meet their needs. This is something that particularly seems to affect people with autism, some of whom may be placed in learning disability services even though autism is not a learning disability.

The Disabilities Trust believes that these unique and complex conditions should be specifically acknowledged as disabilities in their own right and that local authorities should have a statutory duty to fund specialist services for people with autism and acquired brain injury.

Regulation of the Third Sector
The Disabilities Trust fully supports a strong regulatory regime that can ensure stakeholders have full confidence in the sector. There are however continuing problems with the way in which regulations are sometimes interpreted and applied.

The interpretation of regulations is an ongoing concern. Individual inspectors can sometimes interpret regulations in very prescriptive or widely varying ways leading to a lack of consistency with what are supposed to be clear, national standards. Furthermore for the purposes of inspection, the social care regulator the Commission for Social Care Inspection (CSCI) does not specifically recognise autism and acquired brain injury and so will often inspect and judge a service based on criteria appropriate for other services such as learning disability. This can be particularly inappropriate in the case of services for people with autism where for example the sensory environment that you might see in a learning disability service may be highly detrimental to the well-being of someone with autism. In addition the Government has decided yet again to restructure regulation of the sector, integrating health and social care in another new body, the Care Quality Commission, which will have more powers to close services it believes are not up to standard. It is to be hoped this latest re-organisation will not lead to further confusion and uncertainty in regulatory practices or to overly draconian use of the new powers.

The Disabilities Trust believes that regulation of the voluntary sector must be proportionate and consistent and that a regulatory regime that is too inflexible, prescriptive and costly may adversely affect the sector’s unique strengths and diversity.

If you would like further information about any of these issues please contact Matt Townsend, Public Affairs Officer on 01444 237 295 or email matt.townsend@disabilities-trust.org.uk