1. Shaping the Housing and Care Markets for All Older People
Julie Ogley
Director of Social Care, Health and Housing
Central Bedfordshire Council

2. The Housing and Social Care Dimensions – the similarities
Different origins but converging missions…
A focus of resources on those most in need
Neither system exists in isolation
Public sector housing operates alongside the open market for housing
Social care is delivered in a market that has a significant element of private provision
Benefits of a joined-up approach (especially if Health can be included as well) are better outcomes for customers and greater efficiency for organisations

3. The Housing and Social Care Dimensions – the differences
Buildings will be around for a long time and can be difficult and costly to adapt to changing requirements and expectations
Social Care services can be scaled up and down and adapted to changing requirements relatively quickly and cheaply
As with the Health dimension there are legal and cultural barriers to be overcome.

4. Central Bedfordshire – Challenges and Opportunities
An ageing population
Mainly small/medium size towns plus rural area
Budgetary pressures

5. What does ‘market-shaping’ mean in practice?
Two dimensions:
First - knowing what we want to achieve:
What our customers need and want
What delivers best outcomes
What delivers most effectively
Second – the delivery mechanisms – knowing how we intend to achieve it

6. How can we shape the market?
There is a continuum of delivery mechanisms
Direct provision of services
Contracting for service provision
Joint ventures and partnership working
Grant-funding
Benefit in kind
Generating opportunities
Statements of intent
All mechanisms have their place – choose the most effective solution to the circumstances.

7. What tools have we got? Reshaping of direct services
Using our commissioning and purchasing power
Actively managing existing contracts.
Using the Council’s powers to create innovative solutions, develop ventures and partnerships.
Using the Council’s land-holdings
Whole council solutions – regeneration, assets, housing, planning, economic development all working together
Use of the Planning System:
Market Position Statements / Investment Prospectus / Design Guides

8. Who are our customers?
Housing needs and social care needs overlap but are not the same thing
Our responses to housing need and social care need is different and affected by a number of factors:
Legal duties: housing and social care eligibility
Council policies: preferences for one policy solution over another
Intrinsic factors: it takes longer to scale up and down housing responses to need than social care responses
Housing need is multi-dimensional, social care need less so.
Care Act makes clear that that we have a duty to all vulnerable adults – not just those in need of public subsidy. That duty is across the whole council and beyond – not just social care directorate.

9. Our responses to customers’ needs
Stay independent in own home if possible
Choice of accommodation and care options for those who can’t
Choice not limited to those who have the ability to pay
It should not be assumed that older people staying in their own home means that they will be more independent than other housing solutions. A person living in extra care or a care home may have more independence, choice and control over their day-to-day lives than someone living in their own home. A home which may not be suitable for their needs and where they are reliant on inflexible domiciliary care visits for basic care.

10. What does this look like in practice – what’s happening now
Services to allow people to remain independent in their own homes: domiciliary care, reablement, assistive technology, respite care, aids and adaptations, tenancy sustainment
New affordable extra care schemes across Central Bedfordshire – delivered by the Council’s HRA and Housing Associations
Replacement of outdated facilities – care homes and sheltered schemes

11. Priory View, Dunstable

12. Croft Green, Dunstable

13. What does this look like in practice – what’s still to be done
More affordable extra care schemes
More care home provision in key areas
Open market housing with care for older people
New mainstream housing suitable for older people

14. Some examples Direct investment: Priory View
Market-led approach to care home reprovision
Make this someone’s job – MANOP Team
Regional modelling of impact of Care Act on care home fees

15. A suggested process What have you got and what do you want
Describe the gap between the two.
Identify what you need to fill those gaps.
Think about which organisations could be part of a solution.
Work your way up the options sequentially – starting with the lowest cost option.
Keep reviewing progress and be prepared to change and take opportunities when they arise.
Don’t forget the outcomes you are trying to achieve.

16. Finally… This isn’t easy We are working within complex systems
The historic, cultural and legal barriers are real but can be overcome
We need to be adaptable to circumstances
We should support each other to shape the market and look for commonality of interests and economies of scale
Sharing success stories is important but we can also learn from ‘what went wrong’