1. Extracare Housing Seminar The Watershed, Bristol 5 June 2008

2. n Ld – help families to let go; 24 hour residential to extracare housing and holding a tenancy; size of scheme eg 130 at St Monicas – impact on pwld or dementia ie economies of scale – how does this relate to ld models for community living; eco credentials; flexibility of personal care and personalisation; getting OTs and designers in early n Name a champion in housing dept n Involve the OT at design stage n Provide transitional support worker n Information for future planning

3. Pennine Court: Sharing the Experience Lessons in developing extra care for people with learning disabilities and remodelling sheltered housing Shena Latto - Consultant in Housing, Care and Support

4. The Project n Remodelling of small conventional bedsit sheltered scheme to provide:- ~Sheltered accommodation to modern standards ~Extra care facilities/services for people with learning disabilities as they age - 4 units n Funded by:- ~DoH Extra Care Housing Fund (one of 10 projects funded by the Learning Disabilities element of the programme) - £225,000 ~English Churches Housing Group - £760,000 (inc £100,000 toward Extra Care units)

5. Moving On – Making Space Drivers n belief that choices available to people with learning difficulties as they age should link more closely to the broad range of housing and support services for older people n recognition that existing older people’s services need support in developing their services to cater appropriately for the learning disabled older population n recognition that existing services have difficulty appropriately meeting the needs of people with learning difficulties who develop early onset dementia - identified as a particular pressure by the learning difficulty service n recognition that, like other people, as they grow older people with a learning difficulty may find that their existing homes do not meet their needs – for instance for ground floor, accessible accommodation

6. Other Drivers n Integration n Partnership ~Between commissioners, housing providers and support agencies - to provide a more flexible range of housing and housing with support options, which in turn allows better use to be made of other health, care and support provision, for people with learning difficulties as they grow older ~Between commissioners and the providers of services for both older people and people with learning difficulties – to ensure that the needs of people with a learning difficulty are acknowledged within wider services for older people

7. Original Configuration n 21 bedsits + 2 x1 bed flats n Integrated scheme manager’s house n Small common room/lounge n Kitchen n Lift n Laundry

8. Planned New Configuration n 15 x 1 bed flats n 2 x 2 bed flats n Improved facilities and communal areas n Frail Elderly and wheelchair standards throughout n Redecoration and rewiring – inc assistive technology platform - throughout

9. Managing the Process n Two phase approach plus some relocation - decanting unnecessary n Resistance – working at tenants’ pace n Consultation n Disperse or Cluster

10. Design Issues n Design Working Group n Use of existing standards n Experience elsewhere n Advice from a range of professionals n Consultation

11. Commissioning the Extra Care Service n 24 hour care and support n Working in partnership with scheme manager n Joint – SSD and SP – specification, tender and contract monitoring

12. Outputs and Targets n Integration within the scheme itself n Developing community links n Developing and encouraging relationships and friendships n Increasing take-up of education and leisure activities n Reducing social isolation n Improving the quality of life and self-esteem of service users

13. Extra Care Tenants n Identifying tenants n Moving In n Integration n Impact

14. Key Lessons n About developing Extra Care for people with learning disabilities n About developing integrated schemes n About remodelling sheltered housing n About partnership working

15. Exercise n Introduce yourselves to the rest of the group – and identify someone to feedback n Building on what you have heard today and on your own individual experiences, what do you think are the key challenges in developing extracare provision n How would you meet these challenges – at strategic, operational front-line n Three practical tips to feedback

16. n Support pwd for life if can establish structured day n Allocations panel which allocates dom care, care homes and extracare/housing – joint philosophy n Making happen – land, capital – extracare expensive in terms facilities – role of social grant if to be affordable – champion who make case in terms long term outcomes

17. n The rural group… rural issues – implications of moving from small rural area; can 24 hour support – mobile home care n Need for good risk assessments – commonly agreed across different professions n Need to get all sectors on board – particularly health – away from ’prescription’ of residential care n Need for project manager to lead