Comparing Models against Performance Objectives

In operations, there are five commonly accepted strategic performance objectives: quality, speed, dependability, flexibility and cost (Slack and Lewis, 2011:47). "Strategic operations performance objectives are essentially related to satisfying customer requirements" (Batista, 2012:127). Mapping these established performance objectives against the two support service structures provides a theoretical anchor for the analysis, encouraging the consideration of the services operational abilities to meet market requirements, from all angles.

Quality

Measuring the quality of support is complex, as good quality support is dependent on what it is the client needs. Slack and Lewis (2011:48) advocate considering the hard and soft dimensions of the service specification and its ability to conform to that specification. Hard dimensions consider more objective elements that are easy to measure, such as the amount of time spent with each client. However, soft dimensions are arguably more important here, as there is little point in a warden who spends a decent amount of time with each client but does not help them in any way. By their very nature, soft dimensions of quality are difficult to measure. Subjective judgement results in an inability to place a value on the quality of the relationships between the client and worker and this is an issue that is also experienced in social care (Malley and Fernandez, 2010). However, soft dimensions cannot be disregarded as the Personalisation Agenda has placed an emphasis on a more client-centred approach, so meeting the needs of the client is now at the heart of the whole system of care.

Due to the fact that they are onsite daily, onsite wardens develop a strong knowledge of their community and their tenants, which enables them to notice any changes to a tenant’s health and signpost the appropriate local services to deal with that change, thus offering a better quality service from the soft dimension. There is an opportunity to take this further by providing wardens with details of local services and encouraging them to refer tenants for direct payments if they are unhappy with the care they are receiving. There is an opportunity to improve the signposting of other services provided by wardens in sheltered housing, and to develop this as a

166 key feature of support. It is in a sheltered housing provider’s interests to provide information about preventative services, because if a tenant's health and ability to live independently deteriorate too much, then they will have to move out of sheltered housing and into housing with care, such as extra care housing or a residential home.

Services involving signposting rely heavily on the concept of coproduction with clients. Coproduction has been defined as “the mix of activities that both public service agents and citizens contribute to the provision of public services. The former are involved as professionals, or ‘regular producers’ while ‘citizen production’ is based on voluntary efforts by individuals and groups to enhance the quality and/or quantity of the service” (Parks et al, 1981:1002). Whilst it is the signposter’s job to refer the client to appropriate services, it is the client’s job to follow up on referrals and generally exploit the opportunities. Onsite wardens are perfectly placed for coproduction, as they see tenants regularly and are therefore better able to follow up on any advice given, thus increasing the chances of citizen production and offering a more complete, better quality service.

Offsite support means tighter schedules and a rotation of wardens, so there is less opportunity to build relationships casually with clients. Consequently, the client may feel less comfortable sharing important personal information, such as if they are struggling with bills and need financial advice. The complex nature of scheduling for this type of service means that a tenant may be visited by numerous support officers, so deterioration in their health may not be noticed as quickly; human disasters in social care due to fragmented supply networks are well documented (see Ham et al, 2012). Complex scheduling is necessary to ensure that expensive travel costs and wasted time are kept to a minimum. However, it gives tenants less control over the times they are visited. Clients may be left unsure of whom to contact to change a visit time or to ask questions. This therefore goes against the Personalisation Agenda’s emphasis on client’s choice and involvement.

Offsite support therefore does not perform as well against the soft dimensions of quality as onsite support. It is a more transaction-based relationship between the customer and service provider, which limits relationship development and

167 coproduction. However, for the hard dimensions of quality, tighter scheduling increases the number of clients that can be visited in a day, leading to a more efficient service. The major benefit of offsite support is that the service can cover a wide area, visiting tenants of sheltered housing on a needs basis only, so it fits with the government’s new Supporting People policy, ( i.e. needs-based funding) and thus meets the specification of the service as established by the Welsh Government. It is argued that technological advancements mitigate the need for high level, residential support, as tenants of sheltered housing can feel safe and secure in the knowledge that they have an emergency alarm fitted. On top of this, Social Services can assess the tenants to see if they would benefit from Telecare products to reduce their vulnerability.

Flexibility

Flexibility represents the ability to fulfil existing customer requirements in different ways (range) as well as being able to change (adapt) the operations to fulfil new requirements (Batista, 2012). Onsite wardens also have a responsibility to their scheme, they trigger building maintenance when necessary and encourage the growth of the community, demonstrating range. Offsite support teams do not have these duties as part of their role and therefore the reduction in the cost of support provision will lead to costs elsewhere, as these functions will need to be performed by someone else. The taxonomy shows that the move away from residential wardens is leading to the introduction of another person to act as the community organiser. Another option is to see it as an opportunity to empower tenants to run their own scheme by reporting problems with the building and volunteering to set up community activities. This could reduce the attractiveness of sheltered housing; as such coproduction might not appeal to everyone in later life. Thinking more innovatively and positively, it might provide the basis for a social enterprise to engage some older people as well as other people in the community.

However, an offsite support team is a more flexible service in terms of adaptability, as the team is not tied to a particular scheme, area or type of housing. This enables offsite support services to support a wider target market and offer out of hours rapid response. "The move towards reducing onsite wardens needs to be set against the

168 positive developments in the role of mobile wardens in rural areas, able to develop a role in delivering services to people who want this kind of service in whatever tenure they happen to live in" (Bevan et al, 2006:18). A floating support service improves choice for people living in their own homes, but worsens choice for those living in sheltered housing.

Speed

In this system, speed is important in terms of the amount of time it takes for a warden to get to a tenant in an emergency. As the warden is based on site from 9 to 5, this system meets this performance objective, but only during these hours. Outside of these hours, there is no cover on the scheme, so the call would be passed through to a relative or the emergency services.

With offsite support, there is increased flexibility in the development of the service and therefore, more scope to develop an out of hours rapid-response service. With a team of people to call in an emergency instead of just one, this service is better able to respond, regardless of the time of day.

Dependability

Dependability is the "ability to deliver products and services in accordance to the promises made to customers" (Barnes, 2008:24). Onsite support is a more traditional model than offsite support, and it meets the criteria of what is promised to tenants when they move in to sheltered housing. However, support is not a one-off purchase and the link between support and sheltered housing is over fifty years old. Developments in technology have meant that all sheltered housing schemes are now fitted with an alarm for emergencies, and if this provides an appropriate level of support during the night, then it should also be appropriate during the day. Perhaps it is time that this service is brought up to date with modern day society, with a focus on efficiency and equality.

It is important that a change in the structure of a support service is handled appropriately as it is a most sensitive issue; consultation with tenants is key (King et al, 2009). The issue is sensitive as it involves changing the nature of sheltered housing as an option for older people, guaranteed onsite support may be the reason

169 that tenants chose to move in. In a study on supporting older people in rural communities, "on-site wardens with a generic support role were seen by some respondents as a pull factor, making sheltered accommodation an attractive option for them" (Bevan et al, 2006:17).

With regards to the ongoing services, onsite wardens are dependable in the sense that they are consistently around from 9-5, Monday to Friday. For an offsite service to be effective, effort must be made to ensure that clients can be given a workable time slot for their support. This type of scheduling is complex because the amount of support a client will need when the warden arrives my vary; the demand is unpredictable. Travel costs need to be kept to a minimum for this service to operate efficiently.

Cost

The main threat to the onsite model is reduced state funding. Wardens providing onsite support develop support plans with their tenants to ensure that they all receive the level of support that they require. However, all tenants pay the same for this service, regardless of the level of support they receive. Supporting People guidelines are changing, so support will have to be provided on a needs basis, instead of a tenure basis (Welsh Government, 2013a). Not everyone living in sheltered housing will need support under the new definitions, despite the fact that they may want it. This will reduce the number of people in sheltered housing that can access the support service, so onsite wardens will become underutilised and uneconomical. One solution, as discussed already, is to use offsite wardens so that capacity is spread across sites ensuring much higher levels of utilisation and therefore lower costs per client.

"Budget and other pressures have increasingly led local authorities to re-tender support contracts... many replacing them with peripatetic, shared or ‘floating’ support services" (Pannell and Blood, 2012:17). The reason that offsite support costs less is that it is more efficient, with wardens focusing solely on support provision and only visiting clients with an assessed need for support. Onsite wardens are commonly not fully utilised as the number of people requiring support in their schemes is not high enough, whereas offsite wardens cover multiple schemes. When Derby moved to

170 offsite support provision, they were able to cut their warden team from fifty to twenty, resulting in a significantly lower cost service. It is estimated that around 25% of sheltered housing schemes no longer have an onsite warden, following significant cuts in Supporting People funding; pushing local authorities to reassess their services (Age UK, 2014a). Those in favour of offsite wardens would argue that if this alarm service is appropriate for managing scheme support during the night, it is also appropriate during the day, so the cost of a onsite warden does not represent best value. However, this view does not account for the additional costs elsewhere that are caused by the loss of onsite wardens, for example, the cost of someone else checking the building, the cost of community development officers etc.