1. Delivering DFGs – Future Challenges Robert Cornwall Carlisle City Council

3. Census 2001-2011 – Population change Cumbria (Rural /Urban) ONS, Cumbria Intelligence Observatory

4. Census 2001-2011 – Population change Cumbria (Rural /Urban) ONS, Cumbria Intelligence Observatory

6. People Strong correlation between poor housing and ill health People are affected by poor lighting and excess cold – excess winter deaths Falls on stairs after warmth are 2 nd most common hazard Social isolation – more harmful than being a smoker Reductions in income – annuity rates, pensions, benefits Living a long way from relatives Resilience in overcoming a crisis – partner/carer dying Not feeling safe at home

7. Context – Social Care/Health In Cumbria – 45% of the Over 85s use Social Care today This population is set to double and change – men are living longer A&E experienced winter demand level in April/May this year Social Care funding has a shortfall and Health spending is flatlining. Evidence emerging nationally that authorities which did not invest in prevention are feeling the pain most

8. Housing integration – two tier challenge Fundamental aim to reduce pressure on Health and Social Care Section 28a funding goes to the Upper Tier authority – DFG additional funding has been provided to Districts District Councils in Cumbria got £500k in 11-12 and 12-13 Integration in New Care Bill “safe and settled accommodation” is a fundamental principle duties on prevention (preventing, reducing, delaying care needs), and duties to ensure integration between care and support, health, and ‘health related’ provision including housing.

9. Housing Associations New Guidance on DFG Good Practice due soon Difficulties have arisen in getting agreement around expectations on Housing associations Riverside in Carlisle has taken full responsibility for adaptations to their properties – Strong emphasis on management of stock – Void adapted properties are let if possible to suitable tenants only – Avoid putting in Level access showers to 1 st floor of houses – Offering packages to help with moving costs

11. Mrs Carlisle Project a year old - led by the GPs Housing the No. 1 issue ‘Virtual Ward’ to be established in June Health and Social Care Coordinators Targeted at the frail elderly – over 75 Low support needs Reducing Social Isolation Risk stratification tool being developed Community Assets Based Development Approach

12. Housing response to Mrs Carlisle Home Improvement Agency – July 2012 – Accredited with Foundations Additional services to the DFG work Providing the Housing Support to keep people as independent as possible for as long as possible Housing Caseworker – discharge service Community Neighbour programme All funded by Health and Social Care

13. Developing Products not Policies It’s all about the ability to respond – speed is key GPs need service specs and outcomes – not a policy It can take a long time (GP time) to set up a new service New services can generate income or be cost neutral Equity release and small affordable loans for house renovation and repair Making best use of ECO

14. Current and Future Challenges Waiting times are key – GP wants the risk of falling removed now not in a year’s time Deterioration in Private Sector Stock condition Financial pressures on everyone’s budgets Cultural integration – Health Demographic pressure on the whole system Obesity Closer to Home and even Closer to Home