Small Supports Evaluation reports

This report presents details of the evaluation of the Small Supports programme, delivered in partnership between NDTi, Beyond Limits, C-Change and Positive Support for You, funded by NHS England and the Local Government Association.

The Small Supports programme’s vision is for people with learning disabilities and/or autistic people who have been burdened by the reputations they have been given because of behaviours, reactions, support requirements, and large funding packages, to get support that’s right for them and provides them with a choice about where they live and what they do.

The programme is delivering four strands of activity (on going from April 2019):

1. An online network to connect small supports organisations to offer mutual support and maintain a benchmark of quality.
2. Recruiting 8 new sites who want to take this approach in order to widen the market offer.
3. Residential and cross site learning days to share learning.
4. A business school to support small support providers with information around financial process, funding, structures, and monitoring.

This report evaluates strands 2 and 3 of the programme, providing details of how these strands have been going, what has been working well, what has been challenging and presenting recommendations for the future of the programme.

This report explores the costs and benefits of individuals with a learning disability, mental health condition and/or autistic people receiving support from a Small Support organisation in England. Small Support organisations are unique support providers that have several things in common, including planning and delivering support in a truly person-centred way; person-led staff recruitment and training; structuring and using funding around the person; a separation of housing and support; strong partnerships between the individual and family, commissioners, and providers; and staying small.

Through a series of five costed case studies, based on real people who are currently supported by a Small Support organisation in England, this report details the fiscal and social values of these individuals being supported by a Small Support organisation in comparison to within an Assessment Treatment Units (ATUs).

Whilst it is important to remember that reducing costs to the public purse is not the primary aim of any Small Support organisation, this report highlights that such support arrangements can provide truly person-centred, bespoke, support to individuals whilst saving the public purse significant sums every year (over half a million pounds for the five individuals detailed in this report).

It is important to note, that the previous costs presented in this report were provided by small supports organisations themselves, so are an indication of cost rather than a detailed breakdown. They do not include, for example any dowry payments that some individuals leaving long term secure settings receive, 117 or pooled budgets. Furthermore, the hidden costs to individuals, families, local areas/authorities and the UK economy are not presented, including, but not limited to:

• Travel (and time) costs associated to families, carers and staff travelling to visit people in hospital.
• The environmental cost of travelling to visit people in hospital.
• Costs related to supporting families/carers around relatives being away.
• Costs related to families, such as those associated to limited work opportunities due to relatives being in a secure setting. This reduces family income and income tax revenues. This cost is particularly associated to female family members/carers and therefore exacerbates gender inequalities in the UK.
• Costs associated to secure services being delivered outside a local area, resulting in that area not benefiting from the “multiplier effect” of earnings and spending even though it is often that area that covers the costs of hospital care.
• Cost to UK economy of some secure settings being owned by private companies based outside the UK.
• Administrative costs of attending CTR’s, and tribunals etc. in secure settings.