Supported employment: review report and Scottish Government response

Executive Summary

Introduction and methodology

Social Finance was commissioned by the Scottish Government to conduct an evaluation of supported employment delivery within Scotland. Supported employment is an evidence-based, personalised approach that provides support to people with disabilities or other disadvantaged groups to secure and maintain paid employment in the open labour market.

The research was designed to provide a robust, independent review of how supported employment is delivered, and where gaps in provision lie.

The evaluation sought to address the following core research questions:

• Where is supported employment being implemented and where are the gaps in provision?
• What type of service is being provided by Local Authorities, for whom, and what are the outcomes?
• What are some of the reasons for gaps in the service and how can these be addressed?
• How can the service providers be further supported to promote greater consistency and use of service?

We have employed a mixed-methodological approach to the review. The research has aimed to map the current landscape of supported employment in Scotland, assess the quality of provision and provide recommendations for future delivery using the following methods:

• surveys of all Local Authorities in Scotland;
• semi-structured interviews with Scottish Government, providers, service commissioners, sector stakeholders, employers and individuals with lived experience;
• in-depth quality reviews of a sample of supported employment providers in Scotland; and
• focus group meetings with individuals with lived experience, steering group members and Local Authority service leads.
• The research took place over a four-month period between May and August 2021. At interim stages throughout the research, findings and themes were presented to a project steering group for their input.

All findings in this report are anonymised so that data cannot be attributed to particular Local Authorities or individuals.

Findings: Access

Our research aimed to assess both the access to supported employment, and the quality of provision on offer. In relation to access, three key findings emerged during our research:

1. There is a complex mixture of local and national provision of supported employment across Scotland

Supported employment provision is commissioned nationally through Fair Start Scotland, and locally by Local Authority leads. In general, there is a high degree of local autonomy over what provision is commissioned. This made it complex during the review to map out exactly what is delivered where. 27 of 32 Local Authorities reported providing a supported employment service.

The review found that this locally-led commissioning model had many benefits, including allowing local areas to adapt and innovate. However, it appears difficult for individuals to know what support is available to them locally. Research with focus groups indicated that not everyone had been able to access supported employment, even though everyone we spoke with expressed a desire for support to find and keep work. There also appears to be limited mechanisms in place for national government to hold local government to account for making provision available.

2. There is a high variability in access rates

The review found high variability in access rates, linked to the high level of local autonomy in delivering services. Five Local Authorities do not appear to commission any supported employment, whereas other Local Authorities have excellent, high-quality services. Our analysis showed that there was a large range in the proportion of individuals known to have a learning disability receiving support each year across different Local Authority areas. This ranged between 2% to over 60%.

Similarly, funding levels vary widely across different Local Authority areas. Where there is a supported employment service, the funding per person known to have a learning disability locally ranges from £57 p.a. to £1,795 p.a.

There is also a wide range of access to supported employment delivered through Fair Start Scotland (FSS). In two of the nine geographic lots, there are currently no individuals receiving supported employment. There is a wide range in the number of individuals receiving support across the other seven lots, from under 30 to almost 300.

3. There is an opportunity to improve access for clients with learning disabilities, and autistic people

We do not have data on the number or percentages of people accessing supported employment through Local Authority services, or through FSS, who have a learning disability or are autistic. This means that it is challenging to assess the access rates for autistic people and individuals with learning disabilities.

In particular, data on learning disabilities is not always separated out from within all disabilities, making it challenging to know whether needs are being met. Fair Start Scotland providers we reviewed took the majority of their referrals from Job Centre Plus and therefore were less likely to reach those with more complex learning disabilities. Case files showed that most clients had mental health conditions such as anxiety or depression, suggesting that access could be improved for autistic people and individuals with learning disabilities.

Findings: Quality

The review also found variations in the quality of support on offer throughout Scotland, with some examples of excellent supported employment services, and other examples of services that were not delivering the full 5-stage model and could benefit from additional support to improve delivery.

4. There are a range of supported employment models being delivered, with some examples of excellent support; but variation in outcomes achieved

Across Scotland, there are a range of supported employment models being delivered. The 5-stage model of supported employment and DFN Project Search were most referenced but there are also examples of supported businesses employing and supporting people with learning disabilities.

We heard that, regardless of the specific model of supported employment delivered, there needs to be more clarity over quality supported employment standards to ensure clients receive a good service. There was a significant range in outcomes reported, with one Local Authority reporting that they had supported 10% of clients into work whilst another reported helping 83% of clients to secure a paid job. Similarly, the funding per person supported per Local Authority ranged from less than £1000 per year to over £7000.

The data available on cost per outcome, although a small sample, indicates that Local Authorities with higher budgets per person supported a higher proportion of individuals into work. We heard that funding security allows services to successfully upskill and retain staff, fund in-work support and upskill employers and reduce time and energy spent on funding applications.

Conversations with Fair Start Scotland providers suggested that the current payment by results model acted as a barrier to further investment in supported employment delivery in their locality. This is because the supported employment model requires significant up-front time commitment in vocational profiling with the client and identifying suitable job matches, with no guarantee of a job outcome after this work. This can be challenging when funding is dependent on job outcomes.

We also heard that some funding is contingent on supporting clients into 16+ hours of work. Many clients accessing supported employment may want to work on a part time basis initially, with the aim of working towards full time employment in future. This funding requirement where it exists is therefore a barrier to working with all clients.

Finally, we heard that there are specific challenges to offering quality supported employment in rural areas. These include; the need for long supply chains, raising aspirations and moving away from day centres towards employment support, a lack of local providers, funding insecurity leading to experienced services closing and challenges with access to transport.

5. There is limited use of consistent quality standards throughout Scotland, but work is underway to address this

Our review conducted four deep dive quality assessments of services, following the British Association for Supported Employment (BASE) quality assessment methodology. The sites were selected based on initial data analysis and designed to give a representative sample of commissioning structure, location, and service type.

The deep dive reviews found that there was significant variation in the quality of service delivered across different areas. One Local Authority area had excellent, high-quality provision and high fidelity to the 5-stage model of support, with low caseloads and strong outcomes evidenced. The other Local Authority area offered a pan-disability service with evidence of good practice on some of the 5-stage model, but only very light touch job matching and in-work support. This service also received few referrals for individuals with learning disabilities and autistic people. The Fair Start Scotland services were found not to be delivering the 5-stage supported employment model, had very high caseloads and were not supporting individuals with more moderate or severe disabilities.

There is currently limited use of consistent quality standards for supported employment in Scotland. We heard that this makes it challenging for commissioners to understand the quality of supported employment services. Feedback received suggested that performance management tools used by local commissioners are not designed for supported employment. As a result, providers may offer a "supported employment" service with the best of intentions, but the offering may fall short of the expectations initially set out by commissioners, demonstrated by below-target paid work outcomes. Central standards and regular quality assessment may help here.

Positive work is underway to address the shortfall in consistency. Scottish Union of Supported Employment (SUSE) has developed a 6-stage quality assessment model tailored to the Scottish landscape. This includes assessment of the five stages of supported employment as well as leadership and organisational capacity.

Local Authority leads have done some local work to develop standards and quality assurance that they could take forward and would welcome central standards and assessment. This would include common data standards, collection, and benchmarking of performance.

6. There are examples of high-quality employer engagement in Scotland, but opportunities to increase co-production

We came across many examples of strong relationships between service providers and employers in Scotland. Particularly successful are non-judgemental relationships developed over a period of years through partnership working. We also heard that the Public Social Partnership (PSP) hosted by SUSE is developing innovative ways of engaging employers and showcasing the strengths of employees with learning disabilities and neurodiversity. Building these relationships requires investment on the part of service providers up front, which can be challenging given the short-term nature of many service providers' funding streams.

Semi-structured interviews and focus groups highlighted the importance of co-production in building relationships with employers and quality assuring service delivery. Although there are some local examples of high-quality and meaningful engagement with people with lived experience (for example, organisations facilitating training to employers lead by people with learning disabilities), we heard that there was an opportunity to do more on this. There was a request for more examples of people with lived experience on boards of supported employment providers or working within them.

Providers felt that long-term co-production work is made challenging by fixed term contracts and short funding cycles. Because there is a range of standards in support, we also heard that clients themselves aren't informed about what is on offer. This makes it difficult for clients to hold providers to account so they deliver a high-quality service.

In addition to funding limitations, providers face ongoing challenges to overcome common myths associated with employing people with learning disabilities. This can be particularly challenging in the instances where providers' key workers have caseloads of 50-60 clients at any one time. The challenge posed by larger caseloads was felt particularly by Fair Start Scotland providers.

7. There is positive work underway to develop the workforce

Efforts to develop staff members within the supported employment space are aided by a range of training opportunities. Positive work is being done by the NIDMAR programme which aims to professionalise the workforce. Some staff are undertaking the Professional Development Award (PDA) in supported employment. Training Systemic Instruction (TSI) also offers a structured approach to teaching vocational and independent living skills, in particular for those with learning disabilities.

In interviews with providers, the PDA was consistently highlighted as being the most useful and relevant qualification for supported employment professionals. Interviewees liked the length of the investment in learning required and noted that the content was very tailored towards their day to day work.

We also heard that there could be value in refreshing the PDA content and ensuring it is up to date for adapted ways of working through COVID, such as more remote working. Interviewees also noted that the training was more suitable for individuals with experience delivering supported employment, and so an entry level course may be useful as an additional course. Finally, interviewees noted that people with learning disabilities deliver supported employment and therefore the qualification should be reviewed to ensure it is accessible for individuals with learning disabilities.

Providers also noted that there is a challenge around marketing, recruiting and funding the role, and the work being done by Scottish Government and the NIDMAR programme to professionalise the workforce is therefore welcomed. We heard calls for more clearly defined career pathways with suggested pay grades, along with a shorter introduction training programme for professionals who are new to supported employment.

Recommendations

The research identified three key themes and goals to be addressed in future supported employment delivery. These goals were agreed by the project steering group:

1. reduce variability of access across different Local Authority areas;

2. increase transparency of data collection and outcomes; and

3. standardise quality assurance of supported employment.

There is an opportune policy window of about 18 months to March 2023 to develop plans to implement the recommendations within this report. This period coincides with the end of the current Fair Start Scotland contracts and Keys to Life strategy. Underpinning all these recommendations is a goal of creating a culture of high expectations for people with learning disabilities and a focus on mainstream paid employment. This theme came through strongly in focus groups and conversations with people with learning disabilities.

1. We recommend steps are taken to design a Scottish "Supported Employment Guarantee" over the next 18 months. This would include funding and targets for local areas to drive consistency in access rates. The Guarantee should allow for local co-design of service delivery with people with lived experience.

2. We recommend steps are put in place to drive consistency and oversight of supported employment provision through data collection. This would include access, outcomes and information on the needs and disabilities of individuals accessing support, including through Fair Start Scotland.

3. We recommend that supported employment quality standards and an assurance approach for Scotland is developed. Establishing a steering group of providers, commissioners, national government, employers and people with lived experience can support this work.

4. We recommend that a national supported employment infrastructure programme is developed and commissioned. This programme will:

• support the implementation of the Supported Employment Guarantee by undertaking quality reviews, driving high performance through data and operational support, and will support workforce development; and
• facilitate the work of the supported employment steering group.

5. We recommend that work continues to support the professionalisation of the supported employment workforce. This will involve:

• developing entry level training materials for individuals new to supported employment;
• reviewing existing training programmes, including NIDMAR and PDA to ensure that they are accessible for individuals with learning disabilities, and are tailored to supported employment delivery; and
• creating a career pathway for supported employment professionals, including marketing of the role and creation of pay standards across the sector.

6. We recommend employers are encouraged to deliver more support to people with disabilities. This may be through:

• taking forward the work of the Public Social Partnership (PSP) hosted by the Scottish Union of Supported Employment (SUSE). This may include setting up a Scottish Centre of Excellence for employers to share best practice; and
• making funding available for people with lived experience to deliver training to employers, myth bust and raise aspirations.

7. We recommend options are explored with DWP to allow supported employment providers to claim Access to Work directly

8. We recommend exploring how "anchor institutions", such as NHS Scotland, Scottish Government and Local Authorities, can increase the number of jobs available for people with disabilities

9. We recommend making changes to Fair Start Scotland contracts to remove the requirement for 16+ hours of work, and to require data reporting of the disabilities of individuals accessing supported employment.

N.B.: this project was completed virtually due to the impact of COVID-19 over the duration of 2020/21.