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Chapter seven Findings from Local Authorities

7.1. This chapter draws on evidence from available literature on the research and strategies that have been developed by local authorities in Scotland. To supplement this, and to ensure that all the most recent research and 'grey literature' were being captured, a selection of local authorities were contacted directly to identify any un-published or on-going research.

Issues Identified in Strategies

7.2. The community care plans developed in the mid to late 1990s by Scottish local authorities provided the first means of bringing together representatives from health, housing and social care to set joint priorities. These early plans have been updated at regular intervals, and provide information on the needs of a range of groups, including older people.

7.3. The kinds of issues that have been identified for attention in relation to housing services for older people in these strategic documents include ¹¹:

• Development of mechanisms to deal with delayed discharge concerns; some are specifically aimed at seasonal pressures, and others focus on the development of rapid response teams in general;
• Work with care home providers to support this form of provision;
• Review of capacity in the varying forms of accommodation with care;
• Best value reviews of home care services, assessment and care management;
• Improved range and capacity of home care services, sometimes specifically focusing on intensive care at home;
• Improved joint assessment procedures;
• Improvements in the provision of care alarms.

7.4. The main focus of these documents relates to the care services provided for older people, and only considers housing in relation to the provision of housing with care (through sheltered/ extra-care and residential homes). Housing departments are involved in the development of these strategies, but to varying degrees.

7.5. Strategic developments from a housing perspective are contained in the local housing strategies. The kinds of issues relating to older people in these strategies include ¹²:

• Increased funding for equipment and adaptations;
• Improved matching of people with particular needs to housing available through the development of Common Housing Registers;
• Improvements to joint working with health, housing and social work;
• Finding housing solutions to issues of delayed discharge;
• Increased provision of sheltered and extra-care accommodation, and additional support available in existing sheltered housing schemes;
• Improved assessment of support service needs through increased availability of single assessments for older people;
• Expansion of care and repair services;
• Amendments to allocations procedures to encourage older people to move to barrier-free housing.

7.6. As would be anticipated, these strategies focus on the physical housing requirements of housing for older people. In identifying the need for housing for older people, some local authorities rely on housing needs assessments which generally do not identify the housing needs of individual groups, including older people. Quantifying housing needs of older people at a local authority level is an area which could benefit from strategic attention.

7.7. In addition to these strategies, Aberdeenshire Council (2001) has developed a joint strategy for older people, which was developed following wide-spread consultation with older people. It covers the themes of information and communication, involvement in the community, transport, older people's finances and 'help when you need it'. However, it does not provide a strategic focus on the housing needs of older people.

7.8. This review indicates the need to join up the development of strategies for older people, so that housing, health and social services can agree a strategic direction for meeting the overall housing and support needs of older people. This has been taken forward in England through the requirement for local authorities there to develop Older People's Strategies (Department of Health, 2003). A review of progress with these strategies may be instructive for strategic development at local authority level in Scotland. There is progress in achieving this at a national level through its consultation document Age and Experience: developing an older people's strategy for a Scotland with an Ageing Population, which is working towards the development of an integrated strategy for older people.

Research by Local Authorities

7.9. There has been a limited amount of research into housing and services for older people by local authorities in Scotland over the last decade. Our search identified the following reports:

• Tayside - Community care services for older people (Social Work Inspectorate for Scotland, 1996);
• City of Edinburgh - Housing needs assessment for older people ( DTZ Pieda/ System 3, 2000);
• Tayside - evaluation of very sheltered housing provision (Williams, 2001);
• Renfrewshire - older person's housing needs and services (Craigforth Consultancy, 2001);
• Aberdeenshire - older people's housing and support needs (Craigforth Consultancy, 2004);
• City of Edinburgh - survey of current and potential occupants of sheltered housing ( MRUK Research, 2005a and 2005b).

7.10. These pieces of research have fed into policy development at local authority level, but there was no information available about what policy or service changes were made as a result of the research.

7.11. There is also a considerable amount of research work which has been recently commissioned by local authorities across Scotland. Consultations indicate that the majority of this research considers the existing provision of specialist housing for older people, and how these are perceived by their residents. These have generally been commissioned under the Supporting People programme, and therefore may not cover all the issues related to maintaining older people in their own homes, including the requirements for repairs and improvements, equipment and adaptations. Distinctive pieces of research that have been identified through consultation with local authorities include:

• Survey of black and ethnic minority older people in Edinburgh
• Survey of older home owners in Edinburgh
• Review of those on sheltered housing waiting lists in Perth and Kinross
• Comprehensive review of service provision for older people, including care home beds, geographical distribution and waiting lists for all services including home care - in South Ayrshire

7.12. The focus of research to date has been on the provision of sheltered and extra-care schemes, and the future need for these facilities. Stock condition surveys go some way in identifying the needs for physical improvements in housing stock, though these are not sufficiently focused on the needs of older people to be able to quantify older people's housing needs, the best way of facilitating these improvements and set strategic goals (Craigforth Consultancy, 2001).

7.13. Reviews of Supporting People strategies in England (Brown et al, 2005) suggest there is still a lack of evidence of strong partnership working and policy co-ordination. In particular they suggest an increased use of mapping systems such as Geographic Information Systems, or pathways approaches to older people's lives. These strategies lack a focus on housing that should be an important component of older people's strategies. Other researchers have identified the whole systems perspective as a useful means of conducting strategic reviews, as they bring together preventative services, primary care, specialist housing and residential care, intermediate services and resource centres (Fletcher et al, 1999). They also note a lack of inclusion of providers in strategic planning, which is considered vital for the future implementation of strategies.

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