1. Housing-related services and the DH preventative agenda Clare Skidmore, DH Care Networks

2. Some Facts and Figures...

3. Prevention in Housing, Health and Care “Lifetime Homes, Lifetime Neighbourhoods: a national strategy for housing in an ageing society, 2008 Putting People First, 2007 Next Stage Review, Darzi, 2008 Care and Support Green Paper ‘Shaping the Future of Care Together’ Ageing Strategy, ‘Building a Society for All Ages’ National Dementia Strategy End of Life Care Strategy

4. Enablement Assistive Technologies Personal budgets Person-centred support plans Neighbours Community Networks Volunteers Information advice and advocacy ULOs Leisure, transport etc Better housing options Responsive, flexible services

5. Housing and Prevention – Examples Primary Prevention - Universal information and advice services Secondary Prevention - Integrated housing, health and social care interventions - Handypersons’ services offering ‘that bit of help’ Tertiary Prevention - Home Improvement Agencies providing large scale adaptations Extra Care Housing - for rent and / or sale

6. Building an Evidence-Base ‘Low level support’ highly valued by older people. Proving benefits and cost-efficiencies requires establishment of a causal link between a specific service and its outcomes This is complex because: –costs and savings often fall to different sectors and organisations; –it is difficult to predict what would have happened had a particular intervention not been available; and –many quality of life measures are perceived as subjective

7. Housing and Prevention - the Evidence DH Partnerships for Older People’s Projects DH Predicting Social Care Costs Project building on the PARR tool LinkAge Plus led by DWP Supporting People Benefits Realisation Local Model led by CLG Foundations Future HIA Project Health and Safety Rating System

8. POPP: 2008 Findings 99,988 individuals received a service within the POPP across 470 projects including housing-based services Demonstrable effect on reducing hospital emergency bed-day use For every £1 spent on POPP, average of £0.73 saved on the per month cost of emergency hospital bed-days Positive effect on self-reported quality of life and health POPP programmes associated with wider culture change Health /social care partnerships and joint commissioning strengthened Almost half the staff in the projects were older volunteers

9. Predicting Future Social Care Costs Project led by Nuffield Trust, builds on PARR tool and combined model Using anonymised health and social care data to forecast which individuals in a population are at greatest risk of incurring social care costs through loss of independence due to age- related conditions and ill health If more effective investment is to be made in prevention, councils need ways of identifying individual risk accurately across their population so they can target effective interventions Strong interest in continuing to explore ways of exploiting health and social care information in the common aim of maintaining individuals’ independence and developing more cost-effective approaches

10. LinkAge Plus: 2009 Evaluation LinkAge Plus (LAP) - comprehensive approach for accessible joined-up services for older people Services include housing choices advice; home safety checks; and other housing-related interventions Benefits included: promoting older people’s independence; acting as a catalyst for the increased join-up of services across public services, and the community and voluntary sector Older people stress that it is the small things that make the difference Final evaluation demonstrates cost-effectiveness, including savings to the public purse

11. Useful References Clark,. H, Dyer, S. and Horwood, J. (1998) ‘That bit of help’ The high value of low level preventative services for older people, JRF Curry, N. (2006). ‘Preventive Social Care: Is it Cost Effective?’ Kings Fund Publication ODI’s ‘Better outcomes, lower costs’ report, Heywood and Turner, 2007 http://www.kingsfund.org.uk/publications/kings_fund_publications/appendices_to.html http://www.dwp.gov.uk/ageing-society/linkage/evaluation.asp http://www.dhcarenetworks.org.uk/prevention/ http://www.dhcarenetworks.org.uk/independentLivingChoices/housing/ http://www.careandrepair-england.org.uk/pdf/healthyhomes.pdf http://www.viewcare.co.uk/Publications/fallsint.pdf Supporting People Benefits Realisation Local Model on the SPK website - http://www.spkweb.org.uk/ http://www.spkweb.org.uk/

12. Conclusion Evidence of the cost-benefits Proof is difficult in such a complex area Difficult economic times Wider transformation agenda Can commissioners afford not to invest in an integrated approach which includes housing-based solutions? Hand over to Steve Malone from Foundations, for interactive session focusing on the contribution of Home Improvement Agencies to prevention and early- intervention

13. info.housing@dh.gsi.gov.uk http://www.dhcarenetworks.org.uk/IndependentLivingChoices/Housing/ Thank you