ANNEX 6

Circular SWSG7/94 5458 - Community Care - The Housing Dimention

ANNEX 6

EXAMPLES OF EXISTING PRACTICE

INTRODUCTION

This Annex summarises examples of existing practice in housing and community care, covering

1. Housing Forums - looking separately at those involving:-

(A) strategic and enabling bodies only;

(B) strategic and enabling bodies, and housing providers;

2. Aggregate Needs Assessment

3. Individual Needs Assessment

These examples are set out in summary form, and cover the main parts only. However, it is hoped that these examples may be helpful to housing, health and social work bodies in setting up local arrangements for co-operation on housing and community care. This annex should be regarded as an interim document, to be superseded in due course by the database of information on good practice in community care, which The Scottish Office and Scottish Homes have commissioned from the Nuffield Centre for Community Care Studies at the University of Glasgow.

1A HOUSING FORUMS - involving strategic and enabling bodies only:

Ayrshire and Arran

Comprises Local Housing Authorities - Cumnock and Doon Valley; Cunninghame; Kilmarnock and Loudoun, Kyle and Carrick, Irvine New Town, Scottish Homes, Strathclyde Regional Council Social Work Authority, Ayrshire and Arran Health Board.

* The forum remit is:

- strategic needs based approach to the planning of Community Care;

- inform the allocation of capital and revenue by individual authorities and agencies;

- ensure capital investment based on agreed priorities is matched by the necessary revenue support;

- harmonise different timescales for capital and revenue funding;

- agree common definitions and approaches to measuring housing need;

- establish levels of shortfalls, and agree principles which will govern meeting assessed housing and related support needs of individuals as identified in agreed care plans;

- agreed protocols for joint assessments involving housing at the operational level.

* Geography - Forum boundaries coincide with health board boundaries.

Central Housing Forum

Comprises local housing authorities - Stirling, Falkirk and Clackmannan District Council; Central Regional Social Work Authority; and Forth Valley Health Board.

Remit

- To plan and prioritise the provision of appropriate special needs housing within the Region.

- Ensure that all agencies develop their role in community care as set out in the Circular 'Housing and Community Care' (now replaced by this circular).

- To develop systems for ensuring each agency is fully informed of proposed developments of special needs housing.

- To ensure all agencies have a common understanding of needs within the District.

- To co-ordinate all proposals for special needs housing within the Region, ensure that they are meeting priority needs, ensure that all other parties in the forum have given consideration to proposals and ensure that funding where required is agreed.

The chair and lead responsibility was recently changed from social work to housing in order to move the agenda forward and start to develop a housing strategy for the area.

Geography - Boundaries coincide with Central Region and Forth Valley Health Board.

1B HOUSING FORUMS also involving housing providers.

This type of forum allows housing associations and voluntary housing providers to comment upon and discuss strategic housing issues, and will also allow local housing authorities and Scottish Homes as housing providers to contribute to the debate and discuss the implications of the strategy for themselves as housing managers e.g. implications for allocation policies, repairs etc.

This type of forum can also be used to discuss with health and social work operational issues that concern housing providers e.g. assessment procedures, discharge protocols, inter-agency working. It is helpful for the chair of this type of forum to have an understanding of the strategic and operational issues, so that he or she can structure agendas accordingly.

Fife

The Forum began to meet in April 1991 and adopted a 2 tier structure in February 1993. The core group, which meets every 6-8 weeks, consists of representatives of Scottish Homes, the Social Work Department, Fife Health Board, the 3 District Councils and Glenrothes Development Corporation. This group is joined twice a year, in May and October, by representatives of all interested Housing Associations. Where appropriate Housing Association representatives are invited to contribute to short life working groups on specific issues. Membership of the Forum therefore consists entirely of people with a professional contribution to make to the planning and provision of housing for those with community care.

The principles underpinning the present 2 tier structure were agreed in February 1993 and are as follows:

a) The Forum's primary purpose is to identify needs and discuss (and where possible agree) priorities for the provision of special needs housing in Fife, thereby helping to ensure that best use is made of limited capital and revenue.

b) It is recognised that District Councils are independent elected authorities, who may from time to time pursue policies different from those of the Forum.

c) The Social Work Department will, on the basis of information gathered by and for the Forum, and on the basis of Forum discussions, draw up Housing Needs Reports for the main client groups and publish annual statements of priorities for different groups. Decisions on the investment of Social Work Department revenue money for the care element will be guided by these annual statements of priorities.

d) The Forum's central focus will be on strategic matters:

i) gathering information;

ii) aggregating need;

iii) discussing priorities;

iv) sharing information on developments;

v) discussing alternative strategies;

vi) publishing strategic information;

vii) processing feedback from stakeholders.

e) The Forum does not concern itself with specific operational matters;

f) individual Housing Associations will negotiate directly with Scottish Homes and District Councils about the strategic/planning element of proposals.

g) following such agreement, individual Housing Associations will enter into further detailed discussions with District Councils, Scottish Homes, the Social Work Department etc to secure the necessary planning, capital and revenue consents or allocations.

i) to keep the Forum informed, Scottish Homes and the Social Work Department will report back to the Forum at the cost plan stage on developments agreed.

j) all main providers (of capital and revenue) will, in June each year, provide details of capital or revenue commitments for the current year and following years, for inclusion in a published report.

1C HOUSING FORUMS: also involving providers, users and carers.

It is important that the views of users and carers are taken into account in the planing process. Relying on the assimilation of information from the needs assessment or waiting lists gives insufficient coverage of the views of users and carers. Possible approaches are:-

1. A formal consultation process inviting users, carers and their representative bodies to respond to a draft document either in writing, or through a series of seminar/meetings. However if this course is to be pursued particular attention must be given to the needs of the audience in terms of the information supplied, the way in which responses are gleaned, and the time that people have to respond.

2. Regular attendance of representatives of users and carers at meetings/involvement in the drafting process etc. Care should be taken to ensure as far as possible that representatives are reflecting consensus views of their "constituents".

3. Involvement of users and carers in planning of particular projects, including the scenario or options stages.

Dumbarton

Dumbarton District Council established it own housing forum 3 years ago to address the implications of community care within its district. Dumbarton Housing Department has also a good track record of participation in housing policy by tenants and consults widely on its housing plan. This has influenced the model established in this area. Dumbarton District together with the other 3 local housing authorities and Scottish Homes, Strathclyde Region Social Work Department and Argyll and Clyde Health Board, Greater Glasgow Health Board, have formed a strategic housing forum similar to that of Ayrshire and Arran, with boundaries coinciding with the Health Boards.

2. AGGREGATE NEEDS ASSESSMENT

Aggregate needs assessment for housing is essential for planning purposes, but indicators or measures of need are difficult to produce.

Scottish Homes in their working paper 'Housing for Community Care Needs' drew upon various studies carried out across Britain to assess housing need. However, it should be recognised that the information held in this paper can only be a rough indicator of need, and must be complemented by local fundings.

Several areas in Scotland have or are in the process of tackling the issue of housing needs for community care.

Central

Central Housing Forum completed a detailed analysis of provision of housing for community care within their Region. This combined with national guidance figures and local needs analysis for elderly, physically disabled and those with learning disabilities to give the overall shortfalls in housing provision within the area.

Lothian

Within Lothian Region the four local housing authorities, Livingston Development Corporation and Scottish Homes have funded a 3 year research associateship with the following work programme:-

(a) A continuous watching brief on the implementation of the NHS and Community Care Act 1990 and associated legislation, together with an assessment of the strategic impact. This will include scrutiny of the media, professional trade journals and magazines; parliamentary reports, local authority and building society reports, housing association annual plans, Regional Care Plans, together with publications by consultants and other relevant organisations.

(b) Desk research on published and unpublished government statistics, CIPFA statistics and other quantitative data available from key housing institutions. This work will use and build on the housing database developed at Edinburgh College of Art/Heriot-Watt. The housing indicators will be set in an appropriate context of demographic change, employment and unemployment factors, medical and social trends etc.

(c) Interviews with key agencies at local and regional level. This would include housing associations, Scottish Homes, local authorities and other key umbrella bodies in the social housing field.

Particular reference will be made to the community care legislation and the expectations arising from the assessment and care management programmes and new elements of "choice". Therefore the researcher will approach bodies involved with consumers as well as those involved in the management and supply of housing.

The bulk of this work will be carried out at the beginning of the project in order to assess expectations, investment strategies and identify other planning issues;

(d) Analysis of key data.

(e) Case study work which will ensure a balance in relation to the local housing authorities Regional Council/Health Board planning sectors.

In other areas, namely Tayside, work is underway to begin to tackle the information gap. The Tayside joint planning forum as recently as established a sub-group specifically to address the issue of housing needs for community care. Where relevant information held by all agencies is being collated and analysed along with population estimates and national guidelines.

Glasgow District Council has completed a comprehensive study of housing required for those with special needs within their District. They commissioned Smart and Titterton, consultants, to help them with the study. This extrapolates from population figures, using prevalence rates for various community care groups based on existing national and local studies, the number of people within the District with special needs for a wide range of different groups. This information also includes estimates of the numbers falling into broad subgroups defined in terms of dependency levels. This information on prevalence/dependency levels is then converted into estimates of housing requirements, and as appropriate the support which is required to enable the occupant to remain in the community. The Glasgow District Council report has shown the number and level of support required, as well as levels of specialist accommodation needed within the District.

As with all aggregate needs assessment, this information should be considered in conjunction with information on identifiable needs collected through Social Work Authorities' individual needs assessments, better housing waiting list information and research studies for particular needs within areas.

3. INDIVIDUAL NEEDS ASSESSMENT

It is essential that housing is involved in an individuals needs assessment.

Within Tayside Region, Dundee District has established a way of joint working for individual needs assessment.

DUNDEE DISTRICT COUNCIL

SPECIAL NEEDS COMMITTEE

Introduction

Dundee District Council's Special Needs Committee is an established example of joint individual needs assessment being used in the allocation of mainstream council tenancies.

Membership

The membership of the Committee is:

- Tayside Health Board's Community Medical Officer

- Tayside Regional Council's Social Work Department, Senior Community Care Manager (Learning Difficulties)

- Tayside Regional Council's Senior Community Care Manager (Mental Health)

Gowrie Housing Association, Housing Officer

- Dundee District Council's Housing Allocation Officer.

- Dundee District Council's Housing, Senior Housing Officer (Forward Planning).

History

The Committee first met in June 1987, and was modelled on the format of the Council's Committee for the Re-housing of the Physically Disabled. By using an established format initial start up difficulties were minimised.

Remit

The remit of the group is to consider the housing and support needs of people with a mental health problem or learning difficulties applying for mainstream council housing and to award appropriate priorities to facilitate their rehousing.

Responsibilities of Members

Dundee District Council's Senior Housing Officer (Forward Planning) - Chairperson.

Care Managers - Assessment of housing and support needs.

Allocations Officer - Advice on housing stock and availability etc.

Community Medical Officer - Medical assessment and confirmation of priority awards.

Outputs

(i) Award of appropriate special needs priority to secure permanent rehousing in mainstream council housing to meet individual needs.

(ii) Assessment that supported accommodation require coupled with deferral of any application for mainstream housing.

(iii) Assessment that no priority required and applicant should be re-housed through the standard Waiting List.

Frequency of Meetings

Monthly.

Client Group

People with a mental health problem or learning difficulties.

No restrictions are placed on the current accommodation circumstances of the applicant, so long as the applicant is considering mainstream accommodation. Therefore, applicants may be living in hospital or some other supported setting, living in the community or homeless.

Waiting List

Since 1987, the Committee has considered over 200 cases, 124 of which have been re-housed into mainstream Council stock. Of the remainder, some have been re-housed into supported accommodation provided by Gowrie Housing Association and S.A.M.H. (Scottish Association for Mental Health) and some into the private sector - including residential care.

Referrals

Referrals can be made by Community Medicine, Social Work, housing providers and other agencies. Community Medicine collate G.P. referrals.