Sep 17

Housing with care

Posted: 18 September 2017

Today is National Housing Day. Our CEO Sharon Allen reflects on the need for good quality, affordable housing.

Sharon AllenIntegration is a word that is used multiple times in policy conversations across social care and health architecture.  Yet many people struggle to articulate what integration really means – what I think it means is starting with the citizen and their aspirations and needs and providing support services to meet these. 

One of the most fundamental provisions for any of us is good quality, affordable housing, yet housing seems often to be forgotten in all these high level policy conversations.

In my experience it cannot be possible to talk about well-being if people do not have somewhere, safe, secure and affordable to live, which makes housing an equal imperative in collaboration for citizen focused provision.

A home is, of course, so much more than just the building we live in, it’s about community, it’s about feeling safe and about having the right level of support when we need it and this last point requires skilled, knowledgeable and confident staff in exactly the same way as social care requires a skilled and competent workforce.  Thinking about this some more, we recognise that the skills and knowledge required by people working in housing and social care may be similar if not the same.

Our latest report ‘Housing with Care and Support; Challenges and Opportunities for Workforce Development’ looked at these issues through a number of case studies.  Four key themes emerge from these case studies; that disaggregation of services and functions leads to people falling down the gaps; that whilst integration may be happening in some areas at a strategic level, none of the organisations contributing to this report felt fully engaged at a scheme level; recruitment and retention is a substantial challenge and that the Extra Care model is under threat as people’s levels of need increases.

Let’s look briefly at each of these in a little more detail.  Housing with care and support, like social care and health has been through many changes during the 30 years that I have worked in both sectors. This is reflected in the range of structures described in the case studies, whether the provider is both landlord and support provider, whether it is a partnership between a landlord and a support provider. 

This can lead to tension between the landlord function with a focus on collection of rent, upkeep of the property, tenant responsibilities and the support function where workers understand that for example, someone with mental health issues may need additional support to keep to all their tenant responsibilities.

Despite much effort going in to joining service provision up at a local level, the challenge of achieving integration remains.  As with social care, supported housing providers recognise the importance of developing and sustaining effective relationships between commissioners and providers.  Yet a lack of understanding of different roles, and the contribution that housing with support can bring to well-being remains a key issue. 

We are starting to see examples of joint learning and development across some aspects of social care and health – the Care Certificate as an integrated induction framework for all new starters in health or the first cohort of our integrated Graduate Management Training scheme with our colleagues in NHS Leadership Academy. 

But what about the opportunities for joint learning and development for housing, social care and health? Stronger Partnerships for Better Outcomes from TLAP is also an extremely useful framework for co-produced commissioning work.

Investing in learning and development opportunities and supporting colleagues to achieve qualifications is a key component of effective recruitment and retention strategies.  Supported housing faces similar issues to social care with the challenge of finding and keeping values led and committed staff.  There are lessons to share from social care, most notably Skills for Care’s recent Secrets of Success report that shares learning from those providers who have turnover rates of 10% or less. 

Extra care housing has been a positive development to increase the range of options for older people who need care and support to enable them to retain their independence.  Yet this model is now perceived to be under threat as people’s needs increase once they have moved in, or at the point people are referred the level of need is higher than was originally anticipated for these schemes.

Uncertainty for supported housing is exacerbated over ongoing uncertainty about planned introduction of the Local Housing Allowance cap announced as part of the last Spending Review.  Yet as the case studies show in this report, housing with care and support has a significant and positive impact for people in communities and a key part of this is having a skilled, confident and competent values led work-force.

The last word about the importance of housing with care and support should be Josh, filmed as part of the 90th birthday celebrations of CHS Group, who are a local housing association that I am a board member of.  Josh lives in a supported housing project for young people and simply says “Whenever I think of CHS, I think home” https://youtu.be/FP_XXxPQBi4?t=190