1. Housing with Care and Support.
Workforce challenges and solutions.

2. Aims of this workshop.
To outline SfC’s and Sitra’s work to date in this field
To demonstrate the range of possible solutions to developing employees in housing with care roles
To share and discuss specifically developed learning profiles for this sector – and to check them for the future.
To explore what more can be done to help this sector develop and retain highly skilled employees.
To give an opportunity for local networking between Housing with care and support employers and employees
Work carried out across 1.5 years. Emerging results.
Now we understand some of the challenges, we can offer possible solutions, both from existing resources and by creating new ones.
From research, we have have pulled together common job roles in the main parts of the sector and will share with you how these can be mapped to qualifications.
Also looking for your input. What else is needed?
Plenty of chance for networking.

3. Who are Skills for Care?
Skills for Care is the employer-led workforce development body for adult social care in England. 
We represent a growing sector that currently has around 17,000 employers and a workforce of around 1.5 million workers . Many of these are employed within Housing with Care and Support services.
 We work with employers across England to make sure their people have the right skills and values to deliver high quality care.
Recognise that who delivers care and support is changing…roles are changing and services are too to make the most of resources and provide innovative solutions. Must not overlook the role of HWC&S in this workforce. Current NMDS data holds information about 172 sheltered housing services, 144 extra care housing services and 502 supported living services. We know there are many more. Need this info to complete the picture.

4. What do Skills for Care do?
Our work covers four main areas;
Understanding the bigger picture; via the development and management of the NMDS-Sc
Finding and keeping the right people; recruitment and retention resources, guides and programmes
Setting the standards for quality care; Care certificate, qualifications and apprenticeships.
Looking ahead; meeting the workforce challenges of integration, personalisation and innovation.
NMDS-Sc – data for planning and evidence of need. Eg sheltered housing, average age 49years (c/w 43 years in adult sc sector) = future workforce planning need.
R and R; getting more people into a growing sector.
Standards; improving quality of care via quals and standards.
Looking ahead; what do integrated roles need in the way of L and D, how do you transform cultures, how do we make services more personalised?

5. Skills for Care often works in partnership with other bodies to share learning.
In the field of Housing with care and Support, we work with a range of partners, including;
Sitra
The Housing LIN
Chartered Institute of Housing
EROSH

6. About Sitra
Sitra is a national membership organisation with 30 years of experience in
Providing leadership,
Influencing policy through expertise,
Promoting best practice
Providing consultancy, training and advice

7. Context of this work.
Emerging understanding of the role and importance of housing services
End of Supporting People ring fenced funding
Tightening of eligibility criteria
Fewer resources
Changing roles (responding to need and policy drivers)
Integration
Personalisation
Prevention.
Housing now acknowledged to be a ‘health related service’ Care Act, preventative, a valued partner.
SP funding has meant that preserved monies have now been absorbed into ASC budgets..and squeezed.
Fewer resources…fewer people getting services
Response from some has been to merge roles..see this in our research.
Better Care fund important here with discharge from hospital/housing . Pioneer sites also.
Personal budgets ; less impact within housing than ASC in general at present but will change
Prevention seen as key area with CA..advice and guidance also. Housing seen in this context.

8. Spectrum of Provision
Credits for slide to ARCO (ass of Retirement Community Operators)

9. Who lives where?

10. Work so far.. Short films to highlight types of services
Research on emerging roles in the extra care sector.
Signatory to the Memorandum of Understanding on Health and Housing
The Care Act and Housing workshops
Research (on line and interview based) this summer
Resources produced (as of today!)
3 films; extra care, supported housing, integrated roles
Sitra and SFC research
MoU has action plan.
CA has potential for housing services.
Latest research to understand the needs better.

11. Research
Skills for Care commissioned Sitra to undertake research into the workforce needs of new, emerging and changing job roles that have a housing and social care overlap.
This research surveyed over 100 organisations within extra care housing, along with 13 interviews with strategic thinkers across the housing sector during the summer of 2014.
Research can be viewed at;

12. What sort of emerging roles did we find?
There is a move towards a culture of enabling independence and also towards a more outcomes based approach which is being driven by commissioning and contracts. Areas that have emerged and created new roles include those focused on:
Health and wellbeing
Welfare and benefits advice
Independent living
Activity co-ordination
Reablement/rehabilitation
These are all fairly new roles and are sometimes a singular role but sometimes elements that are being absorbed into people’s existing roles. They are ‘demand led’ both by the changing expectations of the tenants but also due to the changing demands of local commissioners for a more integrated, enabling service. More to be said by Anisha later.

13. 5 key messages from the research
1. The skills and knowledge needed for ‘cross over’ roles are wide and diverse – providers acknowledged a need for guided support to identify the appropriate skills and knowledge to match these roles.
2. Guidance is needed for employers to be able to use learning that is currently available to meet the needs of this workforce– there is a need to map current and future workforce needs to current learning provision and explore new technologies to enhance training and development
Emerging roles are hard to ‘fit’ with familiar quals and learning. Has the market place kept up with what is needed?
Some of this challenge is about the time to analise what is needed; what fits and where can I get it?

14. 5 key messages from the research
3. Promotion of careers in the sector needs to be undertaken, as well as improvement with recruitment and retention by employers – staff recruitment into ‘cross over’ roles should be considered as part of the wider recruitment ‘challenge’ that social care experiences. Once recruited, employers face a challenge in retaining their employees.
4. The sector are not fully aware of the impact of policy changes – the extra care housing sector needs information and advice on where policy changes such as the Care Act (2014) impacts their sector.
Found that recruitment was more of an issue than retention. Do people understand HwC? Is there a career pathway that encourages people to stay?
Policy changing rapidly; challenge to keep up but lost opportunities if not.

15. 5 key messages form the research
5. The sector does not utilise Health and Social Care apprenticeships in a comprehensive way – there is work to be done to understand how this situation could be improved.
Anisha to add comment.

16. Meanwhile, housing was beginning to go up the agenda…
Whilst this work was being undertaken, housing was beginning to gain more recognition.

17. Memorandum of Understanding.
Health, Housing and social care bodies coming together to offer practical help that promotes ;
The right home environment is essential to health and wellbeing, throughout life.
Amongst it’s aims, is to;
Develop the workforce across sectors so that they are confident and skilled in understanding the relationship between where people live and their health and wellbeing and are able to identify suitable solutions to improve outcomes.
Example of this is MoU. Large list of signatories ( ADASS, CIH, NHF, Sitra, HEE etc..) all coming together to promote the importance of home..all with actions to undertake to get this message understood etc.
Workforce a key element of this; ASC and Housing understanding each others roles is key.

18. Legislation is beginning to reinforce this link..
The Care Act (2014) recognises that;
Housing is fundamental to the general duty to promote wellbeing and to a preventative approach.
Housing is defined as a health related service
Local Authorities are duty bound to co-operate with housing in the planning and delivery of services as part of a move towards integrated services.
CA is biggest change in ASC law for many decades. Housing represented and mentioned as a partner for co-operation, partnership. Well being is a key driver and housing seen as at the heart of this. all reasons why it’s workforce needs to be knowledgable and skilled in taking advantage of these new opportunities.

19. These new duties and opportunities call for the Housing with Care and Support workforce at all levels to be ;
Informed
And
Ready for the challenge

20. Care Act and Housing workshops.
Main messages included;
Culture; housing feeling like the junior partner to health and Social Care
Poor information sharing; practical and cultural issues
The need for a holistic view of what is available by all.
Reduced budgets leads to protectionist practice rather than integrated practice.
Lack of understanding of each other’s roles causes duplication and missed opportunities.
Culture; different languages, systems and levels of understanding/respect for the role.
Info sharing; systems that don’t talk to one another, colleagues who refuse to !
Holistic ; working with people in a holistic way means that each person has to understand the wider offer, at a moment that makes sense to the person. Currently don’t.
Reduced budgets; don’t encourage new ways of working but encourage meeting minimum contractual needs/silo working.
Roles; missed opportunities through a lack of understanding. Safeguarding seen as an example (lack of clarity of how to respond, not being seen as a trusted partner).

21. Meeting other identified needs..
Recent research; widening the brief
Reaching out to all housing with Care and support services
On line survey
20 plus individual interviews covering a wide range of services
Where are the gaps with L and D, how do you use qualifications, do you use apprenticeships, are you aware of our products, what else could we do to help you?
Sitra resaech, MoU, Care Act all prompted us to think about the Sitra research…needed to reach wider to those in support services too.
Wide discussions with range of HWC&S employers from homeless hostels to extra care.

22. Care and support… Many were clear they were not providing care
Many were providing support and saw this as a potential block to engagement with SfC.
Huge diversity of the sector is a challenge.
Some services are required to register and be regulated by CQC, others are not. This also made a difference to the types and content of conversations we had regarding learning and development.
Care was a word not associated with many of the services we spoke to; they saw their role as support (specific housing tennacy support and more general support in most cases).
The sector is so diverse (see Sitra’s own attempt to define SLS’s..) and therefore no one qual or approach will work. Different funding, size, service user group, governance etc all add to the complexity.
Where CQC registered, the employers we spoke to were very clear about the quals they invested in etc…far less clear were un regulated services. Some asking for guidance and much more ‘opportunistic’ picture (though some were excellent!)

23. Findings. High awareness of Skills for Care Low awareness of products
Profile of learning very different in CQC registered services compared with un registered supported Living services.
Mix and match of qualifications (care/housing) and many seeing the need for a hybrid.
Many emerging roles that could be grouped to provide learning profiles.
Clear gaps around some areas of learning.
It seems you know about us but don’t use us…why?
We will see that many of the challenges across the whole sector are similar (r and R, dementia..) so could we have some of the help you need?
There was a mix and match of quals in housing and care..not one or the other seemed to fit many of the roles described.
However, job roles did emerge that could be mapped to show ‘learning profiles’ that may fit.
Gaps around MH, MCAct (DoLs), substance misuse.

24. Guide and associated resources.
Guide sets out findings and supplies links to useful resources
Learning profiles for common new or emerging roles.
NMDS-Sc report outlines current data on this part of the sector and identifies some key strategic challenges.
Guide sets out the picture so far, suggested solutions and some of the issues as we move forward.
Handy link to other resources.
Learning profiles to use
NMDS sc available for a strategic overview of the issues and challenges (but can also use as an employer).