Demographic Changes – future models of provision for older people Jeremy Porteus Housing Learning & Improvement Network 2 December 2005, Sheffield

Independence, well-being and choice “Housing provision and independent living are the key life chances but the quality of provision and support is often unacceptable” (Source: Improving the Life Chances of Disabled People, Prime Minister’s Strategy Unit, 2005) “Increasingly public policy has been moving from focussing on those with the highest level of complex needs, to an approach that seeks to maintain and promote people’s independence, health and social inclusion” (Source: Green Paper on Adult Social Care, DH 2005)

From welfare to well-being Integrated health, housing and social care systems Multi-agency approach that fits into local delivery plans and commissioning arrangements Focus on needs and aspirations of users of services Range of home care and support services, including better use of sheltered housing, Home Improvement Agencies, handyperson services etc It is part of the growing spectrum of housing, care and support services that reflect choice, community, and citizenship

Strategies for an ageing population 16% of the population not in “good health” or with a limiting long-term illness People aged over 60 take up 40% of the NHS budget Around 40% of people in community hospitals could be cared for at home Around 30% of older people in residential care are inappropriately placed

Knowing the market in the region Significant age shift Changing users’ aspirations Diverse range of needs

Housing with care for older people 90% of older people live in their own home Majority of older people live alone 70% are homeowners 500,000 occupy sheltered housing 500,000 live in residential/nursing care 600,000 receive home support/care 1.4m people linked to a community alarm

Funding frameworks Access and Systems Capacity Grant Extra Care Housing Grant Partnerships for Older People Pilots Supporting People & DFG arrangements Direct Payments and individualised budgets Preventative Technology Grant But In England during 2004/05, approximately £14.4 billion of public funds will be invested in social care. Of which £10.6 billion is for services for adults.

What are the issues for the region? Maintaining status quo is not an option – changing markets including a wider range of housing with care choices Need for adaptability - closer integration of home improvement agencies and “staying put” services with care, support and neighbourhood agendas to support users of services in their homes locally/regionally Funding – time limited statutory income sources/grants, use of equity release, PFI?, making use of Health Act flexibilities to deliver community equipment services and DFGs New technology - introduction of telecare and e-health services (NHS Direct). How can you get Smart? Improved coordination of advice, advocacy and information to help users of services to make informed decisions eg CILs Influence strategic commissioning and resultant new patterns of home care, floating support, day centre and primary care/nursing services to maintain health and well-being

The challenge for existing services Move away from a silo approach Not linked to wider housing for older people strategies Fragmented service – services tied to locations Process – different professionals / different systems Different funding streams We have not yet got a person based solutions joined up across health, social care, housing and the many provider services.

The challenge for the region Planning for an ageing population: sheltered housing is a valuable resource to those people who need it, growing use of mixed tenure schemes and retirement housing for sale Health dividend: making links in local neighbourhoods with primary and community care, and other services Design Age: opportunities to future proof design and innovate eg, the use of technology – create virtual communities

The challenge for the region Lifestyle choices: Changing need and aspirations Funding issues: Supporting People, Direct payments, private finance & venture capital Outcome focussed: Improve the quality of life and well-being of older and vulnerable adults, aid the effective delivery of housing, care and support, and support self-care and mutuality

Some final thoughts Are existing services fit for purpose? What is the impact of Supporting People reviews and other Govt policies/ targets? Be ready for a changing landscape of housing, primary and social care!

Tackling age discrimination

Contact details Thank you! For further information on the Housing LIN: Email – housinglin@eac.org.uk or visit Web – www.changeagentteam.org.uk/housing Thank you!