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Overview Report Portsoken All Age Early Intervention Review City of London Corporation March 2013 Updated July 2013 Caroline Masundire Associate Director T: 020 7253 6289 E: [email protected] Rocket Science UK Ltd 70 Cowcross Street London EC1M 6EJ Contents 1. About the review 16 2. Key issues 17 3. Priorities for action 20 4. Options 21 5. Conclusions 26 6 Next Steps 15 15 1. About the review The need for a review of early intervention services emerged from work undertaken by the Director Leadership Team to develop a Health and Wellbeing Commissioning Strategy as part of the City‟s new role in leading public health from April 2013. The Portsoken ward was selected on the basis that it is the most deprived ward in the City and that this review could act as a pilot to test whether similar reviews could be undertaken in other wards of the City. This review of early intervention services aims to inform how the City might most effectively manage rising demand for services at a time of increased pressure on public sector spending. Hence it identifies and prioritises those interventions that can have the greatest impact on community wellbeing, whilst reducing potential future dependency on more expensive public services. This short report provides an overview of the key issues and recommendations that have emerged from the review alongside an implementation plan to support the dissemination of the findings to the community and providers and to work with the City of London to develop ONE Portsoken over the next twelve months. The proposed action plan and timetable was agreed by the Members of Portsoken at a meeting held on the 24th July 2013. Detailed analysis and supporting evidence can be found in the following Appendices; . Appendix 1 – Portsoken in Numbers – Brings together key data from the Census 2011 and other sources providing an analysis of socio-economic trends in Portsoken, including wellbeing and health indicators; . Appendix 2 - Portsoken in Focus – Presents the findings of the first stage of the review which involved extensive consultation with City of London Corporation members and officers, service providers and stakeholders, residents and users between September 2012 and January 2013; . Appendix 3 – Consultation Report – A record of a wider consultation process based on the findings of a commissioning workshop with residents, providers and stakeholders held in January 2013 and a further call for contributions and comments during February and March 2013. The following documents have also helped to inform this review: . City and Hackney Health and Wellbeing Profile 2011/2012 . Children and Young People‟s Plan 2012-2015 . Children‟s Centres reports 2012 . Family Profiling reports 2012 . Supported Living Review 2012 . Youth Needs Analysis 2012 . Portsoken GP Review 2011 . Improving Services in the City 2012 . Census 2011, NOMIS and ONS Neighbourhood Statistics . The Aldgate and Tower Area Strategy 16 We would like to thank those that have provided information and insight and taken part in various discussions and interviews during the course of the review. 2. Key issues Consistency is needed to collect data on residents and demand for services. Following extensive consultation with staff at the beginning of the review, we recognised that there was no consistent way of collecting resident data or data relating to the provision of, or demand for, services in the ward. Data protection was given as a reason for non-disclosure of information on spend, demand or related research, alongside the fact that some services were either contracted out or universal across the City, such as homeless outreach and hence not unique to Portsoken. A consistent way of capturing demand data across all services and contracts will need to be put in place if the City wants accurate information on spending and the use of services at ward level in future. This would also help facilitate information sharing across departments so that efforts and resources are not duplicated and would help with future service planning and forecasting, which can then be focused around an individual‟s or a family‟s needs, rather than one particular service. Demand for support to more vulnerable residents is likely to increase. The ward is home to many older residents, 40% of residents living in Middlesex Street and 31% of residents living in Mansell Street are elderly. There is a high level of reported disability, with 30% reporting a disability in Middlesex Street and 16% in Mansell Street. The Supported Living Review identified the growth of an ageing population and the likely demands on service provision. Promoting independence is welcomed but this must not be at the risk of increasing social isolation. Existing services and support, such as the Befriending Service and schemes like the Good Neighbour Scheme need to continue and be developed. A consistent approach in how support for housing issues is provided for the more vulnerable on both estates is needed, as this varies between how both landlords (the City and Guinness Trust) manage issues; residents should not feel that one estate gets a better service than the other. Priority for spending must focus on those that are most vulnerable. Poverty is a big issue for the elderly and families and will be made worse by welfare reforms. The ward has the highest level of pensioner and child poverty in the City. Welfare reforms present a range of challenges for residents. Whilst the bedroom cap only applies to a few residents, other aspects of the reforms will have a significant impact: 17 The cap on benefits will hit workless families hard, even though a 16 hour part- time job could be a way out, access to affordable childcare, caring responsibilities, lack of job opportunities or skills are likely to make it difficult for families to cope financially. “Digital by default” requires claimants to make and manage their claims on-line. Access to the internet is just one issue. Residents will need to be e-literate and able to understand written English. This may make it difficult for residents that already have ESOL needs to manage this effectively. Increased exposure to indebtedness is a big risk; the ward already has the highest levels of indebtedness compared to other wards in the City. Direct payment of benefit (Universal Credit) to households runs the risk that rent arrears go up as people choose to prioritise other expenditure, and especially if households are required to manage their budgets on a monthly basis rather than fortnightly as now. Most residents on the Mansell Street estate are in receipt of benefits. Interventions to support residents exposed to these changes need to be put in place. A longer term intervention must be focused on helping unemployed residents access sustainable employment that pays a living wage. This is not just about providing job entry schemes, but must also focus on upskilling and career development for the “working poor” i.e. those already in low-paid, entry-level or part-time employment. Early intervention is happening and working! The City of London Corporation is already providing a range of early intervention services that are working and making a difference to the lives of residents: The Sir John Cass School and Children‟s Centre provides a highly regarded and supportive service to parents in and outside the ward. 40% of the City Advice Service is delivered in the Portsoken ward. Demand for services is high and it is having an impact, helping residents with their debt and benefit issues. Support for the more vulnerable through the CSV Befriending Service is making a big difference for residents that are isolated and cannot get out and about. Building the capacity of the Bangladeshi community is starting to make a difference through the presence of the Community Health Worker, bringing women‟s groups together and creating a better link into the community and to health services. But there is much duplication and overlap and not enough joint working between City services and partners. There is a widely held view among City of London Corporation staff, providers and residents that although there are many services on offer, there is little coordination between what is provided, where it is delivered and whom it is targeted at. Paradoxically, in spite of an overload of communication about different services, there is an apparent lack of awareness of what is going on. All commissioned services are targeting the same residents (and in some cases none) but there is little joined-up working to ensure messages are coordinated and targeted to the right resident at the right time. 18 There are emerging examples of improved communication. The committee for the Portsoken Health and Community Centre has, with support from a co-ordinator, worked to improve communication and collaborative working. But information sharing with providers and City officers tends to be on a reactive basis. The recent Census 2011 revealed that 23% of Portsoken residents do not live on the two estates. These are residents that are either living in City Worker accommodation (i.e. Monday to Friday) or in private rented or owned properties. Very little is known about this group of residents which comprises more than 1/5th of the total. There is a need for greater joint planning and collaborative working internally, between commissioners and providers, and externally with partners and, importantly, with residents, to gain a better understanding of their different needs. To help build community capacity, residents need to be at the heart of service design and commissioning. The new youth service is an excellent example of how users have been involved in the design and commissioning of a service for young people in the City and provides a potential model for future working.

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