1. Right Housing Right Support for Older People
Review of Housing Support Services for Older People
undertaken by
Lancashire Supporting People Partnership

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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%)

10. Frequency of Support

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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)

18. Three Key Decisions Service model Number of providers
Procurement of community alarms

19. 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

20. 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)

21. Providers: Options
Option 1: One provider per geographical area Option 2: Multiple providers Decision: multiple providers

22. 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

23. 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.

24. 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

25. 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

26. 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,