MD3167 Mayor’s Care and Support Specialised Housing Programme – Revenue funding: Commissioning activity for underserved needs

1.1. Since 2013-14, the GLA has been administering London's share of the Department of Health and Social Care's (DHSC's) Care and Support Specialised Housing (CASSH) programme to deliver homes for older and disabled Londoners (approved by MD1073, MD1476, MD2256, MD2672, MD2877 and MD3027). To date, £140m has been spent on CASSH schemes in the capital.
1.2. A further £193m was committed nationally for CASSH for schemes starting between 1 April 2022 and 31 March 2025; MD3027 approved London's share of capital funding for the period. This included £48.5m capital funding for 2022-23, and a commitment to further capital allocations in 2023-24 and 2024-25 to be agreed annually with the DHSC. MD3027 also approved up to £150,000 revenue funding per annum to administer the programme.
1.3. As of 2 October 2023, the GLA and the DHSC have entered into a memorandum of understanding (MoU) that sets out the terms of the 2023-24 funding allocation and the responsibilities of each party. The MoU allocates £180,000 of revenue funding (additional to the usual administration budget for the programme) for a project to understand underserved needs; and enhance market and bid development for the programme to meet these needs. It is expected that the project will help identify new partners and stakeholders; and develop the future pipeline for the programme, particularly in relation to meeting underserved needs. The £180,000 revenue funding is in addition to the £150,000 allocated for 2023-24 to administer the programme (as previously approved via MD3027). All capital and revenue funding is expected to be received in arrears.

2.1. The Mayor's CASSH programme aims to boost delivery of a range of specialist housing provision, with an element of care and support for older and disabled adults in London. Experience of delivering the CASSH fund to date suggests there is value in a project to develop the market delivering CASSH in London to ensure the programme is meeting the needs of target client groups, for whom less provision has been delivered through CASSH to date, particularly Londoners experiencing housing barriers related to mental health.
2.2. The additional £180,000 revenue funding committed by the DHSC for 2023-24 aims to build an understanding of the needs and gaps in provision for specialist and supported housing (SSH) among Londoners with mental ill health, as well as enhancing market and bid development for underserved needs in the CASSH programme.
2.3. The GLA will project manage the activity; this will involve a combination of in-house and commissioned work, particularly seeking to procure an expert provider, in line with GLA procurement policies, where this will add value to the activity over internal delivery, for example where it makes use of specialist technical skills such as to undertake the modelling, or where there is a need for enhanced resourcing. The project will establish what the appropriate balance of insourced and commissioned activity is for each element of the work with input from colleagues across the GLA Group.
2.4. Expected key outcomes include a final evaluation report; opportunities to convene relevant partners; and funding opportunities to develop the future bid pipeline for the programme, particularly in relation to meeting underserved needs amongst adults with mental ill health. Through wider stakeholder activity and consolidation of existing data, the work is expected to build an understanding of needs, barriers, gaps, and relevant funding opportunities at local, sub-regional and regional levels, to enable delivery of housing for mental health client groups across London.

3.1. Under section 149 of the Equality Act 2010, public authorities - of which the Mayor is one - are subject to a public sector equality duty, and must have 'due regard' to the need to:
• eliminate unlawful discrimination, harassment and victimisation
• advance equality of opportunity between people who share a relevant protected characteristic and those who do not
• foster good relations between people who share a relevant protected characteristic and for those who do not.
3.2. Protected characteristics under section 149 of the Equality Act are age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex, sexual orientation, and marriage or civil partnership status (all except the last being "relevant" protected characteristics).
3.3. The funding is targeted to understand the needs, barriers and gaps in housing provision for adults living with a mental disability, specifically mental ill health. Figures published by Healthy London Partnership show up to 8 per cent of adults in London reported having a long-term mental health problem. Whilst housing needs among mental health population groups will vary, types of SSH, such as sheltered housing, may be appropriate in some cases, particularly where individuals are finding it difficult to manage in their own home and need more support.
3.4. Research has shown that those who are homeless, or at risk of homelessness, are more likely to experience mental distress. As of quarter four, 2021-22, 4,720 London households assessed as being owed a homelessness duty (from a total of 13,060) had one or more support needs.
3.5. Mental illness is also prevalent among older people. In 2022, 10-16 per cent of Londoners over 65 had depression; and an estimated 2-4 per cent had severe depression. Older people living alone or in residential care, and those with physical illness or who are disabled, are more at risk, with some 40 per cent affected by depression.
3.6. The Royal College of Psychiatrists commissioned a review of supported housing provision for people with mental health conditions. This found evidence that such provision reduces hospital admissions; risks associated with tenancy breakdown; costs related to out-of-area placements; and delayed transfers of care.
3.7. The funding not only seeks to understand the housing needs of a specific population group that may experience inequality and exclusion. It also aims to convene stakeholders to enhance the delivery of homes for Londoners with mental ill health through the programme.

Key risks and issues
4.1. The key risks are set out in the table below.

Links to Mayoral strategies and priorities
4.2. Policy 5.2 of the London Housing Strategy includes the following proposals that are relevant to the CASSH programme, and to this specific project:
• Policy 5.2A: The Mayor will work with councils, housing associations, government and others to ensure that London's homes and neighbourhoods support London's diverse housing needs. This will include ensuring more of London's new and existing homes are accessible and appropriate for disabled Londoners, older Londoners and families with children, including requiring councils to provide guidance on the size mix of low-cost rented homes.
• Policy 5.2B: The Mayor will work with councils, housing associations, government and others to ensure that Londoners who need it are provided with support so that they can live independently. This will include:
o investing at least £100m in supported housing for older and disabled Londoners
o making the case to government that the new funding arrangements should meet the support and housing costs of supported housing in London.
4.3. This project also intersects with some objectives outlined in the Mayor's Health Inequalities Strategy. This includes ensuring Londoners' mental and physical health are equally valued and supported (objective 2.2); and improving housing availability, quality and affordability (objective 3.6).
4.4. Strategic objective 4 of the Mayor's Equality, Diversity and Inclusion Strategy is:
"To work with councils, housing associations, government and communities to help improve the supply of homes available to meet Londoners' diverse housing needs, including for accessible and adapted housing, specialist and supported accommodation, and Gypsy and Traveller sites."
Impact assessments and consultations
4.5. The London Housing Strategy and the London Plan set out the strategic framework underpinning the Mayor's CASSH programme, in relation to meeting the diverse housing needs of older and disabled Londoners (including those with mental ill health). Consultation on the London Housing Strategy was undertaken between September and December 2017. Consultation on the London Plan was undertaken between December 2017 and March 2018. Both have been subject to impact assessments.
4.6. Since 2013-14, the delivery of the Mayor's CASSH programme has involved extensive consultation with partners and the DHSC.
Conflicts of interest
4.7. There are no known conflicts of interest to declare for those involved in the drafting or clearance of this decision.

5.1. Mayoral approval is sought for the receipt and expenditure of up to £180,000 revenue grant funding from the DHSC as part of the CASSH programme to undertake commissioning activity in 2023-24 as detailed in section 2 of this MD. This funding is in addition to £150,000 to be received from the DHSC in 2023-24 (as previously approved via MD3027). This brings the total revenue funding for CASSH, for 2023-24, to £330,000. If any of the funding received in 2023-24 is not spent this financial year, the funding income will be moved to 2024-25 via an income in advance year-end adjustment, subject to approval from the DHSC.
5.2. The Specialist Housing and Services Unit, part of Housing and Land, will manage this funding and expenditure.

6.1. The foregoing sections of this report indicate that the decision requested of the Mayor concerns the exercise of the Authority's powers under section 30 and 34 of the Greater London Authority Act 1999 (GLA Act), falling within the Authority's statutory powers to do such things considered to further, or that are facilitative of, or conducive or incidental to, the promotion of economic development and wealth creation, social development or the promotion of the improvement of the environment, in Greater London.
6.2. As set out above, the funding will be used to commission analysis and convene relevant stakeholders, with the aim of enabling housing delivery for mental health client groups across London. It is open to the GLA to take the view that this activity will promote both social and economic development, and is therefore within its powers contained in section 30 of the GLA Act.
6.3. In implementing the proposals in respect of which a decision is sought, officers should comply with the Authority's related statutory duties to:
· pay due regard to the principle that there should be equality of opportunity for all people
· consider how the proposals will promote the improvement of health of persons, health inequalities between persons and to contribute towards the achievement of sustainable development in the United Kingdom
· consult with appropriate bodies.
6.4. In taking the decisions requested the Mayor must have due regard to the Public Sector Equality Duty under section 149 of the Equality Act 2010 - namely the need to eliminate discrimination, harassment, victimisation and any other conduct prohibited by the Equality Act 2010; and to advance equality of opportunity, and foster good relations, between persons who share a relevant protected characteristic (race, disability, age, sex, sexual orientation, religion or belief, pregnancy and maternity and gender reassignment) and persons who do not share it. To this end, the Mayor should have particular regard to section 3 (above) of this report.
Grant funding and procurement
6.5. The decision, above, requests approval of the receipt of grant funding and the expenditure of such funding for the procurement of services. Officers are reminded to ensure that the GLA comply with any conditions placed upon the use of the grant funding. Furthermore, officers must comply with the GLA's Contracts and Funding Code when undertaking the project-related procurements.

7.1. The key milestones of the project are set out below: