How can housing associations support independent living
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Roy McNallyFoundations
How can housing associations support
independent living?
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Foundations
National body for home improvement agencies
Department for communities and local government
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older / vulnerable client group
Interventions in the home
what’s a home improvement agency?
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Why home improvement agencies?
Design their services around the needs of the client
Project manage works in the home
Protection from rogue traders
Casework to bring in other assistance measures
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HIA Coverage
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Housing Association HIAs
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Interesting facts………..
65 + age group will make up 28% of population by 2028 (England)
People born today can expect to live to 100 years
Living longer but with multiple health conditions
In UK 80 % of over 65s live in own home
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NHS
PUBLIC HEALTHSOCIAL CARE
HOUSING
primary and secondary care service
health improvement
Essential………often overlooked!
community care
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• Deliver substantial benefits
• To the client – wellbeing
• To the public purse – independence away from statutory services
• Outcomes that cut across statutory frameworks
• Better Care Fund – forcing integration
Why are housing interventions so important?
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• 20th Century drop in Infant Mortality related to house building not just health innovations
• 19th & 20th Century rises in life expectancy overwhelmingly associated with environmental factors
• Where you live matters • Hilary Thomson’s review of 39 studies
1887-2012 confirms health improvements from housing
Longitudinal impact studies
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Non-integration – A long history
operating in silos
siege mentality
poor data-sharing
sovereignty
Acute
Care
Primary Care
Children’s
Services
ASC
OT
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A common scenario
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Woof Woof !!
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I’m cold and can’t afford to heat the
house?I can’t get
upstairs to the bathroom?
They’ll want me to go in a home?
I’m feeling depressed!Money problems
I don’t want to be a burden to my kids!
Where do I go? What do I
do?
I can’t cope
If anything happens to me
who’ll look after my little dog?
I miss doing the garden
Home security
Respiratory problems
Fear of crime / social isolation
Slips trips & falls
Mental Health issues
Financial abuse / Rogue Traders
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DFG Assessment
of Need
Universal Credit Application
This is the plan This is the plan This is the plan This is the plan
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DFG Assessment
of Need
Universal Credit Application
Integrated Care
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Forcing integration
Planned at CCG / H&WBB
Supports Prevention
Expects Innovation
Better Care Fund – Turning it inside-out?
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BCF – A mechanism to force integration
New Care Bill emphasises ‘duty’ to integrate
Driven by austerity – no new money
Seeks reduction in duplication and cost
Designed to protect Social Care budget
Reduce expenditure in ‘acute’ to invest in prevention
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Social Care
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B
A
D
C
Source PSSEX1 England, 2011-12 Final Release
A – Older people (65 and over) £8.79 bn
B – Adults with physical disabilities (18-64) £1.58bn
C – Adults with learning disabilities (18 – 64) £5.19 billion
D – Adults with mental health needs (18-64) £1.15 billion
Social care expenditure by user 2011/12
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• Funding pressures – doing nothing no longer an option
But……• A opportunity to leverage other non-public purse
funding.• An opportunity to develop more creative partnerships
which are both more cost-effective and cause-effective
Austerity – Cost & Cause effective solutions
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The Liverpool Healthy Homes Example
Reducing health inequalities
Focus on environmental / lifestyle
Focus on most deprived SOA
BRE estimate save £50M
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The Bolton Example
Self–assessment of well-being
Common assessment framework
Predictive modelling software
HIA / Housing integral to plan
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