Supported employment: review report and Scottish Government response

Part 3: Lessons for Future Delivery and Recommendations

Overview

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

3. Standardise quality assurance of supported employment

This section presents high level recommendations that could be taken forward to achieve these goals. The recommendations in this section recognise that there is limited scope to significantly amend delivery through current Fair Start Scotland contracts. There is also an opportune policy window of about 18 months to March 2023 for Scottish Government to develop more specific plans to implement these recommendations. This period coincides with the end of current Fair Start Scotland contracts and Keys to Life strategy.

Reducing Variability of Access and Improving Data Collection

The following policy levers and funding options could present options to align access across Local Authority areas:

No-One Left Behind funding: This is devolved to Local Employability Partnerships and there are increased funding pots becoming available. Funding plans have to be co-produced locally.

• Local Authority supported employment funding: We understand that every Local Authority receives supported employment funding, however it is not ring-fenced, no Local Authority mentioned it in interviews, and it may be being used to support other budget lines.
• Regional Economic Development plans: Local Authorities have to create Regional Economic Development plans, there could be opportunities for people with learning disabilities to co-produce these.
• Adult Social Care and the National Care Service: Employability could feature within the review of Adult Social Care and the National Care Service.

The current funding model for Local Authority provision appears to allow significant local discretion over service provision. This also appears to be the future direction of travel, with No One Left Behind funding devolved to local areas. The ethos around locally owned plans means there are not currently plans for central government to mandate targets around how this funding is used.

The Fair Start Scotland commissioning model is currently centrally driven, but as the quality reviews have indicated, it is very challenging for providers to deliver a locally embedded service to a high needs group as part of a large, nationally commissioned and payment by results driven contract.

We believe that the locally driven model has many benefits, including allowing for high levels of local innovation and responsiveness to need. However, as we have seen, this high level of local freedom can also create risks around high levels of variation in access and outcomes.

We recommend that additional national oversight and accountability is put in place within the next 18 months to reduce the variability of access rates as No One Left Behind funding plans are launched.

One potential solution is additional national oversight in the form of a Scottish "Supported Employment Guarantee". This would include:

• Targets for local areas around supported employment access and outcomes
• Ring-fenced funding for Local Authorities (aligned to target numbers) + provider block funding.
• Quality assurance standards to be followed as a condition of funding • Co‑production of local service delivery plans
• Infrastructure support with:
  • Delivering high-quality services
    • Hands on support to review services, develop improvement plans
    • Support to establish formal communities of practice to share learnings
    • Support with co-production o Workforce development
  • Data collection and national monitoring of outcomes

There is scope to choose how each of these levers are packaged into a guarantee, and we recommend steps are taken to design a Scottish "Supported Employment Guarantee" over the next 18 months.

We understand that there is a move away from national government setting targets or ring-fenced funding for local areas to allow greater partnership working. There is a careful balance to be struck between local freedom and national accountability to reduce the risk of variation in access rates. The less measures such as targets and ring-fenced funding are used, the more important it will be for national government to set clear quality assurance standards and provide nationally commissioned infrastructure support. This is to ensure that areas provide high quality provision and to reduce the risk of variable access rates.

"A Scotland-wide strategy should set out minimum requirements for supported employment in every Local Authority. There is a need to focus on young people coming out of school, to raise their aspirations."

Support worker

Data Collection

There is a recognition that without data showing the needs and disabilities of individuals accessing support, there is a risk that people with learning disability and autistic individuals are made invisible in assessing service quality and may be underserved by provision that is aimed at supporting them.

We recommend steps are put in place to drive consistency and oversight of provision through increased national data collection as part of the Supported Employment Guarantee. This could involve:

• local areas required to report access and outcomes data for supported employment nationally as a condition of receiving funding; and
• a requirement for Fair Start Scotland providers to report the needs and disabilities of individuals accessing supported employment specifically.

We recognise challenges around national data collection, including around individuals securing diagnosis for learning disability or autism, and therefore we recommend support is put in place. This may include:

• standardised spreadsheets or templates to align data standards across areas; and
• resource available to support providers to better collect, report and monitor data, and to aggregate and analyse data nationally.

Standardising Quality Assurance

The recommendations in this section are designed to build on the positive work already underway in Scotland to improve the quality of supported employment services. They also include best practice from services in Scotland, as well as developments in England and Wales. It is split into three sections: developing quality standards, workforce development and finally work with employers. 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.

"It's not just having a job that supported employment helps with – it's helped with relationships, providing your own home. This wouldn't have been possible without finding a job – it's not just finding a job and staying in a job, it's the other things that finding a job brings, buying a house, providing a partner and just a whole lot of other things that help you to live a meaningful life."

Focus group member

1. Developing quality standards

There is positive work underway to develop quality assurance standards which can be built on.

We recommend the creation of Supported Employment Quality Standards for Scotland. These should build on existing work undertaken by SUSE and Local Authorities and ensure standards are tailored to Scottish landscape. It is important that client voice and co-production is incorporated into standards and a quality assurance framework.

We recommend a supported employment steering group established composed of providers, commissioners, national government, employers and people with lived experience. The group will convene to develop and agree a supported employment quality assurance framework for Scotland.

We recommend support is put in place to ensure delivery is in line with standards, through a national infrastructure programme to be developed and commissioned within the next 18 months.

This programme will support the implementation of the Supported Employment Guarantee by Local Authorities through No One Left Behind by undertaking quality reviews, delivering operational support, data management and workforce development. It will also facilitate the work of the supported employment steering group by hosting and chairing these meetings and taking forward actions from this group.

2. Professionalising the Workforce

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 tailored to supported employment delivery
• Creating a career pathway for supported employment professionals, including marketing of the role and creation of pay standards across the sector.

3. Employer Support

There is an opportunity for employers to deliver additional support and for aspirations to be raised.

We recommend employers are encouraged to deliver more support to people with disabilities.

The Public Social Partnership (PSP) coordinated by SUSE has trialled approaches with employers that could be mainstreamed in future. The review heard positive feedback about the innovative work the PSP is delivering and its role in bringing together different organisations across the supported employment sector.

We recommend that the work of the PSP is taken forward. This may include setting up a Scottish Centre of Excellence for employers to share best practice.

We have also heard positive examples of supported employment providers delivering training to employers through individuals with lived experience to raise aspirations, break down myths and encourage more job opportunities to be made available.

We recommend that funding is made available for people with lived experience to deliver training to employers, myth bust and raise aspirations.

We recommend that Scottish Government explore with DWP options to allow supported employment providers to claim Access to Work directly.

The review has heard that providers struggle to benefit from Access to Work funding for in work support, as applications generally have to be completed by employers which is time consuming and complex to navigate, particularly for small and medium employers.

We understand that in other parts of the UK, supported employment providers have been able to access dedicated Access to Work coordinators and the ability to apply for in work support funding directly from Access to Work. The recently announced proof of concept of Access to Work passports, as well as the existing Access to Work forum in Scotland may both present options to take this work forward.

We recommend that Scottish Government explore how to use "anchor institutions" to increase the number of jobs available for people with learning disabilities and autistic people.

"Anchor institutions" are those institutions which play a particular role within local economies in maintaining and generating jobs. These employers tend to employ a significant number of people locally, but are also relatively able to withstand periods of recession. Although the impact of COVID on the labour market now looks to be less severe than originally predicted, there are worrying signs that individuals with disabilities are being impacted disproportionately, and that the disability employment gap may be widening.^[2] With COVID employment policies such as Kickstart there is a risk that jobs that would otherwise have been available to individuals with learning disabilities and/or autistic people are made available instead to individuals eligible for these schemes. Anchor institutions can play an important role in addressing this. They include the NHS, Local Authorities, Universities, colleges, and other public sector service providers.

NHS England has developed a Learning Disability Employment Programme (LDEP),^[3] which encompasses autistic people, as part of government commitment to employ tens of thousands of people with a learning disability. The Senedd has recently recommended the same to Welsh Government.^[4]

We recommend that Scottish Government develop a learning disability and autism employment plan for NHS Scotland, Scottish Government and Local Authorities. This could form part of the review of health and social care.

Fair Start Scotland Changes

We understand there is limited scope to make changes to Fair Start Scotland contracts, which is why these recommendations have focused on developing the support that comes after Fair Start Scotland. However, we recommend some specific changes are made to Fair Start Scotland contracts in the interim period. This includes:

removing the requirement for individuals to want to enter 16+ hours of work to allow providers greater freedom to work with individuals who want to enter part time work; and

requiring Fair Start Scotland providers to report data on the needs and disabilities of individuals who are receiving supported employment.

Summary of Recommendations

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 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 support workforce development.
• 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 tailored to supported employment delivery
• 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 PSP. This may include setting up a Scottish Centre of Excellence for employers to share best practice.
• 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 SE providers to claim Access to Work directly

8. We recommend exploring how "anchor institutions" 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.

Conclusion

The review has identified a very positive landscape from which to develop high quality supported employment services across Scotland. This includes providers with many years of experience, motivated and committed policy makers and innovative Local Authority commissioners. And importantly, many individuals with learning disability and autistic people who are passionate about working and with so many skills, experiences and ideas to offer to employers and wider society.

The challenge that this review has identified and sought to address is how to spread these examples of excellent practice across the country and improve consistency and quality of the service offer. This is all with the aim that individuals with learning disability and autistic people can have the support that they rightly deserve to enter and keep meaningful work, with all the benefits that this brings.

We hope that the recommendations in this report will serve as a strong foundation to build this support. Scotland has the opportunity to become the world leader in supported employment delivery and we hope that this review can act as one of the first steps in this journey.