The Future of Housing with Care in the South West Region 13 June 2016 Engaging with housing to deliver better services for older people Denise Porter Assistant Director, Adult Social Care, Housing and 0-25 DIsability

So …. What is an older person?

living with very complex needs possibly living with dementia Typically…. over 80 years old, living with very complex needs possibly living with dementia receiving care visits 4 x day probably with no, or little, family support isolated from their community.

Personalisation and the Care Act 2014 The intended effect of the Care Act is: to improve the outcomes and experience of care secure a more effective use of public and community resources by improving the personalisation of services giving people more choice and control over how their desired outcomes are achieved. To put the right to a personal budget and self-directed support into primary legislation for the first time. personalisation and self-directed support is now the expected norm of the care and support system in England

Person-centred approach Care and support Community Home Individual

Peer Review - “Being brave” - a case study of how an innovative peer review approach led to service improvement Decisions made in the acute hospital setting were not always in the best long-term interest of the individual. The level of influence of professionals based in an acute hospital setting, with a limited knowledge of community-based opportunities, on outcomes was significant. The decision-making process is owned by single-organisation (council) and does not encourage wider system ownership of final decisions and consideration of alternative options.

Peer Review - “Being brave” - a case study of how an innovative peer review approach led to service improvement The decision-making process is not providing appropriate challenge to decisions made in an acute hospital setting. Decisions and culture were extremely risk averse, demonstrated a lack of understanding of community assets and services and failed to consider alternative options. Individuals and their families were rarely engaged and their wishes were not considered

ECH provider wouldn’t accept back due to level of care Barriers to going home ECH provider wouldn’t accept back due to level of care Home environment no longer appropriate and couldn’t be adapted Level of dementia provided a significant risk to safety

Organisational structures LA Social care CCG Board LA Commissioning LA Housing Health and Wellbeing Board Housing Providers ECH LA Committee/cabinet CCG Community Health Services Care providers

The future “If you always do what you’ve always done: you will always get what you always got!”

E: denise.porter@Southglos.gov.uk Thank you Denise Porter E: denise.porter@Southglos.gov.uk T: 01454 865903