Steve Beyer S Presentation Supported Employment 20 Oct 09

Why Supported Employment?

Stephen Beyer

Welsh Centre for Learning Disabilities

Cardiff University

Wales, UK

Percentage of people with a learning disability in paid work Estimates of people in paid work

Scotland- 12.1% 2007 17% - English National Survey 2003/04 7.5% - English Local Authorities, Commission for

Social Care Inspection 2007/08 WORKSTEP - about a third of people placed 2008 Pathway to Work pilots- about 2% New Deal- about 3% Access to Work- about 4%

We do not know what hours people are working

Percentage of people with a learning disability in paid work

3% 3%

20%

13%

35%

24%

0%

5%

10%

15%

20%

25%

30%

35%

High Support MediumSupport

Low Support

MaleFemale

• Biased towards people with a mild learning disability

National Survey 2003/04

Mean17%

Percentage of people working 16+ hours per week

2% 1%

12%13%

28%

15%

0%

5%

10%

15%

20%

25%

30%

High Support MediumSupport

Low Support

MaleFemale

• Overall, biased towards small hours from PSA group• WORKSTEP primarily over 16 hours

National Survey 2003/04

Problems of awareness and definition There is little shared definition across social

care and employment services of: Learning disabilities “Mild, moderate or severe”

Awareness of their work potential, and support needs, is low among: Families People with learning disabilities DEAs Some employment providers Social workers and social care staff

Key problems of moderate and severe learning disabilities Majority of people will have problems with:

speech and language memory cognitive processing

More people with severe learning disabilities are are likely to experience additional: sensory and physical impairments poor vision measurable hearing loss epilepsy

Key problems of moderate and severe learning disabilities Ability to understand verbal instruction and to

provide information Cue dependency creates difficulty transferring

tasks learned here (training) to there (job) Small changes can lead to the person being

unable to do a well known task : Changes in task sequence Changes in work machinery Changes in work materials Changes in a co-worker role Changes in workplace environment

All this weakens the relevance of pre-training

Why supported employment for people with learning disabilities? Effective task training research going back into 1970s

Complex & dangerous tasks Matching “ecology” of workplace to person’s wishes,

talents and specific strengths researched in 1980/90s “Zero reject” vocational profiling in use since the mid

1980s instead of “work/can’t work” testing Training in a specific workplace crucial to this client

group Put together, these techniques were called “supported

employment” and success with people with learning disabilities demonstrated in US University evaluations in 1980 and 90s

What works for people with a learning disability learning jobs?

Training on the job- Systematic Instruction Job coach support on-site Breaking tasks into steps “Chaining” tasks together Hierarchy of cues

Physical guidance Gestures Verbal prompts

Job adaptation if needed Managing praise and

reinforcement more closely Specific social training strategies Work-based accreditation of skills

demonstrated

Pre-employment training is possible Verbal instruction & demonstration Simple language Greater time to learn Use of naturally occurring praise and

re-inforcement through: Supervisors, work-mates Ordinary pay incentives

Managing work pressure/ productivity demands

Shaping social contact through co-workers

Qualifications for job and career development

Severe Moderate Mild

What works in finding jobs?

Greater use of support to find & plan Families Job coaches

Extended Vocational Profiling/ Discovery

20+ hours in various environs? Interests and what good at Relevant experiences Work types and environments Days and schedules Welfare benefit planning

Use of practical job tryouts to aid decision-making

Aided CV and support planning Proactive and specific job finding and

matching jobs to people Employer presentation and negotiation Adaptation of interview and induction

Greater independent action More use of generic help to

identifying strengths, interests and experience

Use of more generic sources for vacancies

Greater use of courses, “job clubs” CV development Job search Writing applications

More use of mainstream job application & interviewing and induction processes

Severe Moderate Mild

Outcomes from supported employment Shafer et al. (1990)

27 states- 1,400 SE programs People with a learning disability most frequent participants 157% increased participating individuals during the study period Individual placement superior to other models

West et al. (1992) 42 states- 74,960 individuals in SE People with a learning disability 62.8% of all participants 30.4% classified moderate, 8.7% as severe or profound

Individual placement model dominant model

Outcomes from supported employment Schalock, Mcgaughey and Kiernan (1989)

1629 vocational services wages per hour in SE double those in sheltered work average full-time hours higher in SE

Confirmed by Lewis et al. 1992; Noble et al, 1991

Beyer et al. (1996) UK less positive wage outcomes over half of workers increasing income by less than

60% only 2% of workers more than doubled their income 17% experienced no change in income

North Lanarkshire Generated significant interest because of reported high levels of

employment of people with learning disabilities for 16 hours per week or more

Significant financial benefits to the people reported Noted for challenging the view that the 'benefits trap' is the biggest

problem restricting movement into employment An opportunity arose to examine in detail the North Lanarkshire

experience and to analyse their data.

North Lanarkshire North Lanarkshire Supported Employment (NLSE)

operates within a framework of a Supported Employment Partnership from 1999

By 2007: Two bases- Motherwell & Aidrie- one more planned One service co-ordinator Two senior support officers 16 job coach posts (often not all filled) 2 care and support workers

LD clients mainly, but people with mental health issues and acquired brain injury also served since 2005

NLSE Process Referral visit (7 days)

An assessment to ensure that the agency’s criteria are met Home visit (within 6 weeks)

Explain the service Check on Welfare Benefits with Welfare Rights Officer if needed

Vocational profiling (8-12 weeks) Agree person’s preferences and conditions the person wants, jobs and specific

employers Twice per week for 2-3 hours per session Meeting 1:1 in a variety of settings, at different times, and involving different

activities, including social outings Information also sought from family, professionals and relevant others Period includes 2 short job tasters, supported by a job coach

NLSE Process Job finding (Meet 1-2 hours per week)

Registering person with Job Centre Plus Pursuing employers Assisting person in job search Interview preparation Further work placements as needed

Job coaching (as long as needed) Providing training at work and fading support

Mentoring and evaluation (agreed with person/employer) Agreeing criteria and monitoring success of placement from employer and

employee perspectives Career development (No timescale)

Updating Vocational Profile Taking action to improve current, or change, job

NLSE Process Validation

0 2 4 6 8 10 12 14 16

Referral

Leavers review at school/college

VP Meeting/Home Visit

VP Social Visit

Visit JCP+, Professionals etc.

Visit Employers

Induction

Job taster

Progress review

Stag

e in

SE

pro

cess

Mean hours of input per person

Average hours provided to a sample of young people with learning disabilities in transition

North Lanarkshire Day Services 2005/06 Day Services in North Lanarkshire

composed of 5 Day Centres Registered populations for these 5 day centres

was higher at 332 places/264 people By 2007/08 a system of 5 community-based

locality day services had been developed to replace traditional day centres (+ 1 opening)

Registered population 334 places/295 people

Jobs 2007-143 jobs (138 people, 5 with 2 jobs)- 114 people

with learning disabilities; 21 with mental health issues; and 3 with brain injury

All people with a learning disability “either came from day centres or had an eligibility to attend the same”

QuickTime™ and a decompressor

are needed to see this picture.

Jobs Unemployment was 6.9% in the area compared with 4.7% for

Scotland and 5.4% for the UK (ILO definition) Full data existed for 104 people in work at 2007 (96%), of which:

88 were people with learning disabilities 15 mental health issues 1 person with brain injury

Data presented relates to these 104 people for whom we have data, with sub-analysis for 88 people with learning disabilities

Hours

Hours All workers

% Workers with LD

%

6.5-15 9 8.7% 9 10.2%

16-25 65 62.5% 56 63.6%

26-35 12 11.5% 9 10.2%

Above 35 18 17.3% 14 15.9%

Total 104 100.0% 88 100.0%

Mean Hours= 24.2 hours per week>16 hours= 91.3% all (89.8% LD)

Welfare Benefit Before (LD)

The mean total income from Welfare Benefits before people entered employment was £137.60 per person (£139.51 for LD)

Source of income

Prior to

employment (% of all workers)

After Ņincome maximisationÓ

and prior to employment

(% of all workers)

DLA (Care)+DLA (Mob)* 1.1% - DLA (Care)+DLA (Mob)+ IS 47.7% 73.9% DLA (Care)+DLA (Mob)+ IB/SDA 30.7% 14.8% DLA (Care)+DLA (Mob)+ IS+IB/SDA

11.4% 5.7%

IB/SDA only 1.1% - DLA (Care only) 1.1% - DLA (Care)+IS - 1.1% DLA (Care)+ IB/SDA 1.1% - DLA (Mob)+IS 2.3% 3.4% IS only - 1.1% JSA 2.3% - Training Allowance 1.1% - Total 99.9%+ 100.0%

Impact of benefits advice There was a small increase in take-up of DLA at this point from 93%

to 98%. Mean total income from Welfare Benefits after maximisation was

£141.93 per person, an average increase of 3% on the pre-employment income.

Income actually increased only for 9 people (7 for LD) Average increase in income from Welfare Benefits being 91%,

or £50.03 per week (94% and £50.83 for LD) Range of individual increases being from 6% to 306% (same for

LD)

Welfare Benefit After (LD)Source of income When in

employment (% of all workers)

Tax Credit only 1.1% DLA (Care)+DLA (Mob)+ Tax Credit 83.5% DLA (Care)+ Tax Credit 3.4% DLA (Mob)+ Tax Credit 2.3% DLA (Care)+DLA (Mob)+IB/SDA 9.1% Total 99.4%+

Benefit changes Overall, Welfare Benefits represented:

99.4% of income before employment (98.7% LD) 100% after maximisation (100% LD) 48.5% when in employment (49.7% LD) Reduction in Welfare Benefits from:

a mean of £137.60 per person before (£139.51 for LD) to a mean of £122.05 per person (£122.65 for LD) a fall of 11.3% (12.1% for LD)

This represents a total saving to the taxpayer of per year £84,032 for the total group of clients (£77,168 for LD).

Wage income The average salary earned in employment was £134.29 per week

(£129.60 for LD) The average hourly rate was £6.11 per hour (£6.09 per hour for LD),

14% above the adult National Minimum Wage of £5.35 in place for 2006/07

On its own, salary was slightly lower than both the average pre-employment and the maximised Welfare Benefit incomes before employment

However, 40.4% of the workers had a higher gross income from salary alone, than their maximised Welfare Benefit income before employment (34.1% for LD)

“Better off” Overall, average total gross income from all sources

after employment was £256.34 per week per person (£252.25 for LD)

Better off by +113.2%, based on 104 people for who we have all data (+94.8% for 88 people with LD)

Most common increase 51% and 75% A slightly greater proportion of people from other client

groups (mental health, brain injury etc.) in the 200%+ better off group

People with learning disabilities showed the full range of better off outcomes

Tax? No better off data net of Tax and National Insurance, as

North Lanarkshire does not collect this data Using Tax Benefit Model Tables for 2007 (DWP 2007)

can estimate the tax paid On average people would pay £16.91 tax/NI per week

(£9.80 for LD) This would reduce income in employment to an average

net figure of £239.43 per week per person (£242.45 for LD)

Percentage better off in employment, net of tax/NI reduced slightly to +102.7% (+86.8% LD)

Costs to LA The annual costs of SE in North Lanarkshire, based on 2007/2008

budget was £4,304 per person per year, based on “actual capacity”- 202 people

Equivalent Locality Support Service, which catered for 295 people on a full- and part-time basis with an annual cost of £14,998

Using the average number of people in jobs 122 (ranging from 109 Jan. to 129 Dec. 2007) the cost per employed person of SE rises to £7,126 per job.

This still represents 47.5% of the cost of a LSS place

Full Cost:Benefit Analysis?

Missing: Access to Work, GrantsIncluded: Workstep payments (6 places)

Situation with NLSE

Situation without NLSE

Costs Flowbacks Costs Flowbacks LA-funding 1. NLSE

2. Access to Work funding

5. VAT on production sales (Assume equals 13).

9. Cost of Locality Day Service

12. VAT on production sales (Assume equals 6).

Disabled workers in NLSE

3. In-work Welfare Benefits/Tax Credits

6. Income Tax & National Insurance 7. Indirect tax on income

10. Welfare Benefits paid when unemployed

13. Indirect tax on income

Non-disabled workers displaced by NLSE

4. Out of work Welfare Benefits paid to displaced non-disabled workers

8. Indirect tax on income

11. In-work tax credits when people now employed

14. Income Tax & National Insurance 15. Indirect tax on income

Change in Net Saving over time

0.60

0.50

0.40

0.30

0.20

0.10

0

Savingper£1

spent

Years in operation1 2 3 4 5 5+

0.43p

Full Cost:Benefit Analysis?Situation with NLSE

Situation without NLSE

Costs (A) Flowbacks (B) Costs (C) Flowbacks (D)

LA-funding 1. NLSE&- £7,2162. £?+

5. £0 9. Cost of LSS-£14,998+

12. £0

Disabled workersin NLSE

3. In-work benefits £3,130/Tax Credits-£3,217

6.Tax NI- £567+7. Indirect tax onincome-£2,333

10. Welfare Benefits paidWhen unemployed= £7,155

13. Indirect taxon income- £1,252

Non-disabled workersdisplaced by NLSE

4. Out of work welfare benefits- £3,648

8. Indirect tax onincome- £638

11. In-work tax credits when people employed-£1,076

14. Tax NI- £373+15. Indirect tax on income- £1,038

Total £17,211 £3,538 £23,229 £2,663

Net cost*+ to government

-£6,894

Ratio of flowbacks tocosts with NLSE+

0.21

Conclusions North Lanarkshire have been successful in placing people from the general

Social Work Services population of people with learning disabilities in employment of 16 hours per week or more

This has been with relatively unfavourable unemployment levels locally. It is likely that this can only be achieved with this client group if the key

approaches used in North Lanarkshire are replicated, particularly the focus on 16+ hours per week.

Any reduction of cost:benefit ratios is cumulative and must be assessed across the body of people shifted from day service to employment

Year 1 costs are much higher than year 9 costs Any “saving” in costs related to day service can only be redeemed if there is

a strategy of shifting resources from day service to employment outcomes

Conclusions Skilled job coaching and investment in a staff group of sufficient size

is important, and it is likely that replication would require: Investment at a significant level to provide enough job coach

and Welfare Rights Advice and management resources effective training in the process

Replication of the intensive SE process, and including expert Welfare Rights Advice

Monitoring to ensure the process is delivered to an adequate level of intensity

There remain some uncertainties in the cost analysis that would benefit from a more detailed costing of the full package of support for supported employees and day service alternatives for future workers

Reference Beyer, S. (2008) An evaluation of the outcomes of supported employment North Lanarkshire

(2007). Motherwell: North Lanarkshire Council. Beyer, S. Goodere, L. and Kilsby, M. (1996) The Costs and Benefits of Supported

Employment Agencies: Findings from a National Survey. Employment Service Research Series, No. 37. London: Stationery Office.

Beyer, S., Grove, R., Schneider, J., Simons, K., Williams, V., Heyman, A., Swift, P., and Krijnen-Kemp, E. (2004) Working lives: The role of day centres in supporting people with learning disabilities into employment. London: Department of Work and Pensions.

Beyer, S., Kaehne, A., Grey, J., Sheppard, K. and Meek, A. (2008) What works?- Transition to employment for young people with learning disabilities. Chippenham: Shaw Trust.

DoH (2001) Valuing People:A New Strategy for Learning Disability for the 21st Century. London: The Stationery Office.

DWP (2005) Improving the life chances of disabled people. Sheffield: Department for Work and Pensions.

Acknowledgement We are grateful to:

Duncan Mackay and George McInally of North Lanarkshire Social Work Services for being prepared to share their time and their experiences with others

Maureen Cook, Margaret Gavan, and Margaret Wilson for background to the services

the NLSE team for producing the original updated data, to Ruby Stewart for compiling the data

Patrick McAviney for providing comparative financial data. Simon Whitehead of the Valuing People Support Team for his

support and VPST and CSIP