Right Housing Right Support
for Older People
Review of Housing Support Services for Older
People
undertaken by
Lancashire Supporting People Partnership
Current Provision
Total
Capacity
Number of Self
Funders
Voids
Annual Spend
Sheltered
housing units
Approx
13,000
Approx 3,500
Between
2% and 5%
£4.5 million
Alarm only
(no regular
visiting
support)
Approx
4,500
Approx 1,400
Floating
support (long
term)
Approx
26o
£450k
Budget Context/Procurement
• £29 million in 2010/11 reducing to £26 million
by 2013/14
• Establishment of framework agreement
• Introduction of maximum hourly rate for
sheltered housing of £14.92 in July 2011
• Maximum rate for community alarm
monitoring only service – £1.50 per week
• Maximum rate for community alarm with
emergency response – £4 per week
Key Aims of the Review
• Define outcomes
• Determine most appropriate service model at a
local level
• Reflect and respond to wider social care, health
and housing agendas
Can be a variety of service models but must
deliver outcomes
Scope
• Extra care and other housing with care models
• Sheltered/supported housing where support is
attached to the building
• Floating/visiting support
• Community alarms
• Telecare – separate review
• HIAs – separate review
Review Process
• Common process , common outcomes but local
models
• Three project groups covering different parts of the
County – commissioners, providers, service user reps.
• Information Pack – aims, scope, policy context,
population, good practice
• Mapped need – further discussions
• Mapped supply – North West Asset Survey
• Cross referencing sheltered housing tenants with
database showing people receiving care
Review Process Contd.
• Approx 13,000 questionnaires sent to people
who use services (4,518 returned)
• 116 resident focus group held by scheme
mangers using standard set of questions
• Provider questionnaires-27 responses (out of
33)covering 98% of service users
• 11 stakeholder questionnaires
• 3 commissioner and provider events
Service User Consultation - Findings
• Main reasons for moving to sheltered accommodation –
illness/disability(51%), safety and security (45%), support of
scheme manager(34%)
• Help which would have enabled people to stay in previous
home – decorating (37%), community alarm(33%) repairs
(32%) aids and adaptations(32%)
• After having experienced living in sheltered housing, 85% of
older people would not have stayed in their home even if
support had been available
• 88% of service users were very satisfied or fairly satisfied
with the support service that they receive
• 92% of people were satisfied with the housing that they
receive
Service User Consultation - Findings
• 11% of people don’t receive visits or calls
• 37% of residents felt that the support from a scheme
manager was amongst the three most important
factors in making their home a good place to live.
Safety and security had the highest response rate
(46%).
• 37% wanted to be able to choose the type of support
from list, 35% wanted to choose between visits and
calls and 49% didn’t want any choice, 19% no response
• Over half residents didn’t have a preference for how
support costs were calculated, remaining half were
evenly split between support received (22%) and
standard charge (24%)
Frequency of Support
Flexible frequency of visits, Daily Call
242
Flexible frequency of visits, No Call
180
A visit every few months, Daily Call
42
A visit every few months, No Call
49
Monthly Visit, Weekly Call
22
Monthly Visit, Daily Call
50
Monthly Visit, No Call
170
Weekly Visit, Weekly Call
89
Weekly Visit, No Call
671
Daily Visit, Daily Call
204
Daily Visit, No Call
458
Flexible frequency of calls, No Visit
68
Weekly Call, No Visit
131
Daily Call, No Visit
717
0
100
200
300
400
Total
500
600
700
800
Consultation with Older People (not receiving
sheltered housing services) – Distributed via
HIAs and Meetings Organised by Districts
• Only 58% of people said that they would know where
to go for information
• 83% of respondents would prefer to stay in own home
• Broad agreement with the principle of choosing the
type and frequency of support
• 58% of people want to charge based on support
received and 25% wanted standard charge
Provider/Stakeholder Consultation
• Support from stakeholders and providers to
offer support to people living in private sector
• Providers and stakeholders expressed concern
about how well the sector meets the diverse
needs of older people
• Support for offering a menu of support options
• General support for strategic outcomes,
however concerns about the impact of
implementation: admin costs; risk; staff
contracts
Key Issues
• Increasing number of older people and the pressure on
public funding means that services must be targeted at
those people in greatest need
• Currently appear to be funding some people who don’t
need or want support, whilst provide limited
opportunities for home owners and private sector
tenants
• There is the need to identify the most appropriate
method of targeting services whilst not losing the
preventative focus
Strategic Outcomes/Criteria for
Assessment
• Established strategic outcomes
– Lancashire Strategy for an Ageing Population
– Research for this review
– Value for money
• Strategic outcomes formed the basis for the
assessment of options
Strategic Outcomes
Access
• Information regarding Housing Support Services for
older people must be freely available.
• Arrangements for accessing services must be easy to
understand and use
Support
• Housing Support Services for older people must
promote the wellbeing and independence of
individuals and be preventative in nature
Strategic Outcomes
Personalisation
Individuals must have choice and control over
their support
Accommodation
Older people living in social rented accommodation must
have access to decent homes that provide the safety and
security they need
Older people who own their homes or live in private
rented accommodation must be supported to access
appropriate advice and assistance in connection with the
condition, safety and security of their housing
Strategic Outcomes
Tenure
• Support must be available to older people living in all
tenures
VFM
• Housing Support Services for older people must
deliver value for money
Meeting the diverse needs of the Community
• Housing Support Services for older people must meet
the diverse needs of the community (in terms of the
equality act; issues for people living in rural
communities and the level of dependency of those
people needing services)
Three Key Decisions
• Service model
• Number of providers
• Procurement of community alarms
Service Models: Options
Option 1 - status Quo (accommodation based
support i.e. support fixed to specific
accommodation, apart from 3 small pilots)
Option 2 - flexible contracts issued enabling
providers to offer support to people living in
specialist accommodation for older
people/sheltered housing and to general needs
tenants, private sector tenants or owner
occupiers
Service Models: Options
Option 3: a mixture of contracts would be issued
including:
– Accommodation based - support fixed to specific
specialist/sheltered accommodation
– Non accommodation based support
Decision – Option 2
SP CB and all the project groups (commissioners,
providers and service user reps on some groups)
Providers: Options
Option 1: One provider per geographical area
Option 2: Multiple providers
Decision: multiple providers
Community Alarms - Issues
• Maintenance and call monitoring – further work required
regarding the most appropriate approach to
procurement
• Out of hours response service – options:
– Continue to procure as part of SP contract for housing
support
– Utilise existing social care crisis/rapid response service
– SP procures a small number of services by
geographical area
Reason for Choice
•
•
•
Findings of option appraisal- assessment of
options against strategic outcome
Provides the time and flexibility to enable a
local solution to be found (acknowledges the
different position of providers currently)
Able to monitor the take up from people in the
private sector – demand still unclear.
Implementation – Delivering the
Strategic Outcomes
• Meetings held with most providers – development of
individual action plans showing how provider contributes
towards achievement of strategic outcomes
• Develop principles of eligibility/assessment for services
based on need, whilst maintaining a focus on prevention
• Develop principles in relation to a menu(s) of options – and
link a person’s assessed needs / support plan to one of the
options whilst maintaining personalised service
1. Free up capacity by ceasing to offer support to people who
don’t require it
Still Investigating
• Explore variable charging linked to menu
• Individual budgets for people who are also in
receipt of social care (further investigation
required)
• Explore block gross chargeable contracts to
enable flexibility/contracts will need to be
capped at level of spend
Further information
Information analysed on three different footprints
• District reports
• Locality report (e.g. North: Fylde, Lancaster,
Wyre)
• Lancashire report
Sarah McCarthy, Head of Supporting People,
07917521919