Housing LIN Conference February 17 th 2015 Housing for Independent Living

Imogen Blood Dan Gaul

Housing LIN Case Study Bolton Council Qualitative or Quantitative Approach?

O Aspirations O Demographic and Financial Pressures O Strategic review with partners O Inclusive Approach, what do older people want O Governance Project Overview

O Older People’s Housing Needs and Aspirations O Access to Housing O Maintaining Independence Themes

O Community Engagement O Stakeholder Partnerships O Data Analysis O Literature Review Workstreams

Community Engagement strand  Produced and distributed a flyer  Ran 9 focus groups through ‘gatekeepers’  Outreach: market and lunch clubs  Stalls: e.g., sheltered scheme open day  Home visits/ phone calls with individuals

We heard from 170 people.. O Age range from 50s to 90s; half were in 70s; O 30% were men; O 20% were BME; O A third had a disability or long-term condition; O Two-thirds were owner occupiers

Information & Advice “There needs to be more done to promote what’s available – it needs really spelling out for owner occupiers, who will often assume they are not eligible – then people can pass it on to others” “I think there is a tendency for people working in services/ policy to assume that the general public know where this help is” “It is really difficult to speak to an actual person anymore…you keep getting signposted on. The information is not in one place anymore” “I’m looking at places online and I’m not sure if they are private or council or what… you need a list of what‘s actually available at the present time”

Uncertainties about moving O Financial risks/ uncertainty O Health – prognosis – care? O Couples – family O Changes to policies/ services O Understanding/ trusting the system O Timing a move What can be done to inform, reassure and support decision making?

Location, quality, access, affordability

What are the housing options for lower income owner occupiers? “I think it’s fair to say that everyone here is happy in their own homes and wants to stay in them as long as possible but, for many of us, we are also effectively prisoners in our homes because none of the other systems for housing are really affordable or accessible to us”. PRS? Equity release? Shared ownership?

O 17 interviews O Challenges and pressures O Willingness to work together O Forward planning Stakeholder Partnerships

How many older people do we serve?

Over 75 population (000s) AREA Bolton Bolton Bolton Bolton Pop Source ONS National Pop 2012 table2_tcm

What level of service do we need?

Prevalence Rate Pop 75+(000s) MCGV Extra Care 25 Sheltered Housing 125 Enhanced Sheltered 20 Residential 65 Nursing 45 MCGV More Choice Greater Voice Report Prevalence rate per 1,000 people over 75

Prevalence Rate Pop 75+ MCGV Extra Care Sheltered Housing Enhanced Sheltered Residential Nursing Prevalence Rate per 1000 people over 75

What services are currently provided?

Prev Rate Pop 75+(000s) MCGV Extra Care Current Provision 340 Shortfall Current provision taken from Elderly Accommodation Counsel data base

Have we got the right commissioning strategy?

Prev Rate Pop 75+ National Average Extra Care

Prevelance Rate Pop 75+MCGV National Average Bolton National Ranking Extra Care Sheltered Housing Enhanced Sheltered205 0n/a Residential Nursing

Prevalence Pop 75+MCGV National Average Bolton PresentBolton Extra Care Sheltered Housing Enhanced Sheltered Residential Nursing

What is needed at community level?

Current Need Depr MSOA Provision 2035 Variance E Bolton E Bolton E Bolton E Bolton E Bolton E Bolton E Bolton MSOA Middle Super Output Area

OPDI Extra Care Capacity Centre East Horwich Kearsley North South Westhoughton OPDI Older People’s Deprivation Index

O The high level of housing stock for older people in the centre and east of the borough O The lack of Extra Care in Horwich and South Bolton. The lack of care services in Westhoughton O The relative lack of care services in the North of the authority’ O The limited opportunities for leasehold extra care development in the authority with the north of the borough and Horwich offering the best sites for development. Summary

Project Outcomes

Short term Opportunities O Develop community partnerships -UCANs -Staying well -HIA -Think Positive - Health Trainers - Dementia Friendly Communities O Advice and Guidance O Dementia Support and service development O GT Manchester Big Lottery Fund

O Improvement and coordination of information, advice and access to housing support services. O Increase the capacity of preventative services and the role of the community O Develop a wider choice of housing options that will support improved health and well being O Build on the strength of existing partnership arrangements to ensure housing’s role is one of leadership and influence Housing Strategy Priorities

Group Discussion O How can we accurately estimate future demand for older people’s housing ? O How have you used research findings to influence your service development ? O How should commissioning strategies influence future prevalence rates

Imogen Blood Dan Gaul Jean Bray Contacts

What is happening nationally?

National Questionnaire (1) O The 27 authorities have 129 extra care schemes with an average of 44 units per scheme O 22 authorities still provide 24/7 care across their provision O Main change is the move away from block contracts to a more flexible commissioning arrangement. One authority has a reablement package as an admission requirement. O The average allocations based on care needs are 30% low 32% medium and 38% high need. O Most schemes and in particular new schemes support people with dementia

National Questionnaire (2) O Most schemes remain popular and have waiting lists with few voids O Key barrier for development was getting the correct assessment processes and tenants in the extra care homes(8) followed by getting land in the right location(6) and then affordability, poor marketing and communication (all 5) O 67 schemes are currently in development at an average of 50 units per scheme

National Questionnaire (3) O The greatest incentives to attract developers are public land offered at attractive rates (9), support from the Homes and Communities Agency’s Affordable Homes Fund (5), and support from the Department of Health Care & Support Specialised Housing Fund, Only 2 authorities offered revenue funding as an incentive. O The main alternative to standard extra care provision is more flexible care provision including support for outreach hubs and specific services in rural localities (9 in total) and remodelling sheltered schemes ( 5) followed by reablement services and dementia (both 4). Downsizing was only mentioned by 2 authorities.

Group Discussion O How can we anticipate future demand for older people’s housing ? O How have you used research findings to influence your service development ? O Future prevalence rates