Modernising Community Care - The Housing Contribution: Page 7

Modernising Community Care - The Housing Contribution

7.0 THE HOME BASED APPROACH: - RE-HOUSING AND STAYING PUT

Introduction

7.1 Achieving integration of people with support needs into the community involves ensuring that they have access to the full range of housing options, which would allow them to remain at home wherever this is their choice. This means providing opportunities for staying put in their existing homes or re-housing into more suitable housing.

Re-housing through allocations

Allocation routes

7.2 There are in effect two parallel systems for those with support needs who are seeking re-housing in the social rented sector: -

through the housing providers' allocations systems, usually into independent tenancies including supported housing;
through social work departments' placements into supported housing accommodation (not all registered with social work).

Housing providers' allocations policies should recognise both of these routes.

Allocation policies

7.3 Most allocations policies have been developed to respond to "traditional" definitions of housing need and tend to give greatest emphasis to substandard housing conditions, homelessness and insecure tenancies, overcrowding and medical priority.

7.4 While these needs should continue to be recognised, allocations policies should now recognise the particular needs of community care users and carers requiring support by: -

ensuring that needs categories respond to community care needs;
recognising that re-housing may increase the ability of an individual to live independently, or at least with less support;
ensuring that medical priority recognises the needs of those with, for example, mental health problems, learning disabilities and sensory impairment as well as those with mobility difficulties;
responding to the needs of those living in shared housing who may wish to move on, perhaps because their sharing arrangements have broken down or because they wish to live independently and in self contained accommodation;
recognising the needs of owner occupiers who can no longer remain within their own home and for whom other ownership options are not available;
recognising the statutory requirements of the Disability Discrimination Act 1995, including the provisions relating to the Disability Rights Commission, the homelessness provisions of the Housing (Scotland) Act 1987 and the Children (Scotland) Act 1995.

7.5 The policy should be developed so as to respond both to planned re-housing (for example from the long stay sector or non-urgent transfers) and to urgent re-housing (acute hospital discharges, breakdowns in existing housing arrangements). More generally, arrangements should be in place to respond to significant improvement or deterioration in a resident's condition that suggests a move to other housing is required. Such changes may be detected as a result of a care management review or from routine contact with wardens or housing management staff. The possibility of allowing the person concerned to stay in their own home by making changes in the support provided, or the supply of appropriate aids and adaptations, should always be considered before re-housing is contemplated (see Staying Put below).

Allocation Policies

Kingdom Housing Association includes a range of different re-housing opportunities for those with support needs.

applicants for the general housing list are eligible for social needs points where there is a need to move in order to give or receive support from a close relative or a friend;
a separate waiting list for those requiring barrier free housing or with some special design features. applicant's needs are assessed by an occupational therapist;
in all new developments, the aim is to design 10% of all properties for applicants who are waiting for special needs housing;
a range of independent living, shared housing, care and cluster provision and small group homes have been developed for those with housing and community care needs. The applications are all subject to a points system and pointed and offers are made to those in greatest need i.e. those with the highest level of points.

Each of these routes to re-housing is described in Kingdom's published allocations policy.

Contact: Helen Eagle, Kingdom Housing Association, 01383 515388

Co-operation among housing providers

7.6 Access to re-housing has become more complex for applicants as the number of housing providers has increased. Co-operation between local housing providers is therefore increasingly important. The 1999 Scottish Office Practice Note on Housing Allocations in Scotland recommends a number of approaches including: -

sharing information so that each provider knows about other local providers, their stock and their allocations policies;
the use of common housing registers, so that applicants can have access to the full range of local provision without having to apply separately to each provider.

Co-operation Between Housing Providers

The Hamish Allan Centre in Glasgow acts as a clearing-house between those seeking housing and agencies controlling access. The network focuses on those who are homeless and have community care needs. It provides services specifically for single adults.

The Network acts as the broker between agencies by nominating individuals for accommodation and liaising with support groups to provide services. Key features include controlling nomination rights for single homeless lets and maintaining a property profile on database.

Managed by the City Housing Department, the activities of the Network are overseen and supported by a multi-agency steering group.

Contact: Maureen McKinnon, Accommodation Development Network, 0141 287 1854

Staying Put

General Approach

7.7 Enabling an individual to remain within their own home and delivering the care package to their home is one of the principal objectives of the community care policy. It is one of the key themes in "Modernising Community Care". Recent research for The Scottish Office on medical priority has confirmed the importance of staying put to users. It has also indicated that housing authorities currently give limited advice on the opportunities to enable a person to remain in their own home when first approached by a person with a housing need. Further guidance to local authorities entitled "Good Practice in Housing Management-Medical priority in Housing Allocations (Note 7) was issued by The Scottish Office in February 1999.

7.8 All housing bodies are encouraged to develop staying put options. They will not only better meet users' preferences but also have the potential for reducing the pressure on the social rented housing stock. Options available in the local area should include: -

information and advice;
aids and adaptations;
care and repair;
community alarms;
appropriate housing management support services;
combined or joint waiting lists by housing providers.

Information and Advice

7.9 Good quality information and advice about available options is essential if people are to be helped to remain within their own homes or move to more suitable, alternative, accommodation. HomePoint, the Scottish Homes housing information and advice service, has now published a number of information booklets for people with disabilities. In addition, local information needs to be prepared, explaining the opportunities available locally.

7.10 Advice services for people with all kinds of disabilities and other community care needs are beginning to develop, including advice on opportunities for owner occupation.

Advice Services

The Disabled Persons Housing Service (DPHS) was set up in April 1996 to provide a one-stop shop where disabled people could find all the answers to the questions they have, as well as help to enable them being able to ask the questions they did not know they could ask.

From its base in Edinburgh, the DPHS helps disabled people obtain housing more suitable to their needs and thus enable a greater independence in how they live at home and in their community. This is achieved through:

assessment of needs and production of a range of options for meeting these through Personal Housing Plans (PHPs);
operating a register of disabled people seeking housing and using this to better match vacant property with the needs and preferences of disabled people;
constructing computer-based information systems on all available and planned barrier-free and wheelchair housing in Lothian;
general advice services on all aspects of housing services and across all service providers;
provision of architectural services.

The DPHS has been awarded Scottish Office grant funding to establish a network of similar services in other parts of Scotland.

Contact; Jillian Flye, Information Officer, 0131 225 7788

Ownership Options in Scotland aims to enable disabled people, or households, including someone with a disability, to overcome barriers to home ownership. The service seeks to: -

provide support and advice on home ownership options and feasibility;
act as a vehicle for Scottish Homes' and other grants aimed at increasing the supply of special needs housing for owner occupation;
offer a consultancy service to individuals and organisations concerned with the housing and support of people with disabilities;
increase awareness of home ownership alternatives and how these may be accessed;
increase the supply of low cost and other homes suitable for disabled people;
identify and overcome the financial, legal and technical barriers to home ownership developing models,information resources, and streamlining procedures to achieve this.

Contact: Julia Fitzpatrick, Ownership Options in Scotland, 0131 556 6099

Both the DPHS and Ownership Options in Scotland are voluntary organisations.

Aids and Adaptations

7.11 Aids and adaptations remain the main service through which people with restricted mobility are enabled to remain in their own homes. Delays in obtaining adaptations, either because of late assessments or in providing aids or adaptations recommended by assessments has to be avoided. Many agencies have had to resort to emergency measures to deal with backlogs. In part, the problem has developed because agencies use ad hoc approaches rather than developing a clear policy. Shared assessments should stress new ways of improving matters. Scottish Homes is convening a multi-agency working group on adaptations with the aim of producing good practice guidance across all tenants by July 1999.

7.12 The eligibility criteria and procedures for obtaining aids and adaptations should complement the arrangements in place for the allocation of houses by local authorities and other housing providers.

7.13 Approaches which local authorities and other housing providers should consider include: -

streamlining assessment and procurement processes to ensure that adaptations are undertaken as speedily as possible. This involves clearly defining responsibilities of OT staff and housing staff so that best use is made of their respective skills, and using self assessment for simple aids;
establishing clearly defined priorities for adaptations so that those with the most urgent need are dealt with immediately. Some authorities have a particular category of applicants who require adaptations before they can be discharged from hospital. These cases should receive priority;
ensuring that a database of adapted property is held and that this is readily available to staff allocating properties (Scottish Homes already has a database of its own adapted property that can be made available);
creating closer working relationships between housing staff and occupational therapists (OTs). One possibility is for an OT to work within the housing department full or part time;
developing performance targets and measurement.

Aids and Adaptations

Clackmannanshire Council has located an OT post within the housing development section of the housing arm of their joint Social Work and Housing Department. The post is funded by social work but managed by housing. The post offers the housing department speedy access to OT assessments for aids and adaptations and has led to a significant reduction in the time the whole process takes to complete. It has also been useful in providing speedy access to professional advice when they are considering the allocation of previously adapted properties and a means of speeding up their consideration of people with a physical disability who are on the waiting list. Generally the relocation of the post has resulted in an improved working relationship between housing and social work. The post holder is also used directly as a specialist advisor in some aspects of the planning process and is involved with the housing development section's care and repair projects, thereby providing a professional OT service to both the public and private sector aspects of the department's responsibilities. The section deals with the HRA capital programme, private sector housing, the housing plan and housing development. It is responsible for all aspects of process from strategy to implementation to direct service.

Contact: John McConnon, Service Manager (Housing Development), 01259 452382

Care and Repair

7.14 Care and Repair schemes can enable elderly and disabled owner occupiers and some other groups to carry out repairs, improvements, and adaptations enabling them to stay in their own homes. Care and Repair officers in local projects can help clients to decide what works are required, choose reliable tradesmen, obtain finance (mainly from improvement and repair grants from local authorities but also from private lenders such as banks and from the clients own resources) and supervise the works. Small repairs services can also be included.

Care and Repair

Western Isles Council operates a Care and Repair Project, funded from the housing Department budget and managed through the housing grants section of the Environmental Services Department. It is overseen by monthly meetings of a joint group comprising representatives from the social work department, OTs from the Health Board and the Environmental Services Department. This group considers particular issues relating to specific applications but also reviews broader aspects of need over time. The care and repair programme is based largely on OT and social work assessments and addresses client needs through work relating both to care and repair and aids and adaptations. The scheme provides a streamlined means for securing all necessary reports on the applicants, whilst the project oversees all planning and building related responsibilities. The housing grants section receive applications backed by the relevant professional reports and allocates funds on the basis of agreed criteria and general eligibility under the Housing (Scotland) Act.

Contact: Matt Bruce, Comhairle Nan Eilean Siar, 01851 703773 Ext 361

Community Alarms

7.15 Community alarms are useful tools in any community care housing provision. They can give people confidence, a feeling of security and peace of mind enabling them to remain in their own homes. They can also contribute to helping people return home from hospital earlier and offer an effective way of communicating with emergency housing, health and social work services. Community alarms also provide peace of mind for carers.

Support Services

7.16 Housing management support services play a vital part in supporting people in their own homes. Housing management staff, through direct contact with tenants (and sometimes neighbours) can alert care support providers about a person's changing needs leading to the development of care services. Housing management services eligible for Housing Benefit purposes are under review as part of the DSS/DETR led consideration of proposals for a new long term funding regime for people in supported housing. The suggestions made in "Supporting People: A New Policy and Funding Framework for Support Services" (Department of Social Security 1998) for the long term funding of support services for people in supported accommodation are being taken forward by the Government. The new arrangements are expected to come into operation in April 2003. "Modernising Community Care" stresses the need for social work, health and housing organisations to review together the support needs of their local community to provide more suitable and flexible home care services.