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 £450k Floating support (long term) Approx 26o

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

Can be a variety of service models but must deliver outcomes 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

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 Accommodation 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 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