I’ve noticed that, at the upcoming National Children and Adult Services (NCASC) Conference, there’s a session on ‘The future of adult social care and support: the change we seek’. I hope that the panel at this and other NCASC sessions include the issue of housing with care and support for older people. Housing – and care and support - are intrinsically linked. No decision about care and support should be made without considering where people live.
It’s time to be ambitious about this issue. The Commission on the Role of Housing in the Future of Care and Support, which we at SCIE have helped to support, published its final report this week. Our report has recommendations; and offers a vision and a roadmap for the future but we want to make a compelling case for investing in innovative housing with care and raising public awareness of their later life housing options. Called A place we can call home, the report argues that it’s time for a radical plan for housing with care which dramatically increases the availability, quality and choice of housing with care for people who choose to or have to move from their original homes.
Here are some facts which should worry us:
- The supply of new housing with care and support homes is far outstripped by demand, with the South East for instance far better served for extra care than the North.
- The public we surveyed have huge concerns about the affordability of housing with care options
- Only 37% of people told us they would consider living in a care home
- COVID-19 has exacerbated the situation, with many people unsupported or with reduced support at an already very challenging time
All while the population of older people with care and support needs will continue to rise.
We have a number of recommendations for central government, as well as for the range of other stakeholders in this complex system; for local authorities and local partners and developers and providers. A collaborative approach is needed to address the issues.
Housing with care: The idea of Place
Local partnerships need to be formed to produce a single plan for improving housing for older people within a locality; aligning with the place-based approach which is being rigorously pursued across local government. This needs to be co-produced with people who draw on support. These plans should be developed jointly with the NHS and others, with budgets pooled to leverage larger capital funding and other inward investments into new developments, and their strategic requirements should be explicitly based on a thorough analysis of needs. The plans should include a long-term strategy for shifting investment into innovative, preventative models of housing with care and support, such as extra care. They should include the HAPPI design principles, which are based on ten key design criteria such as space and flexibility, and daylight in the home and in shared spaces.
But they must include local people if Place is really to succeed. Local areas need to develop comprehensive arrangements for co-producing plans for housing with care and support with local people. This includes establishing local co-production forums made up of, and speaking for, older people from all kinds of backgrounds, to influence planning, commissioning and design of housing.
It’s also important to expand the use of Individual Service Funds, a form of personal budget for people who draw on support, to help many more people to access innovative forms of supported living. And it’s key to develop local information, advice and advocacy hubs to give older people better access to information on housing with care and support. Local authorities have the knowledge, skills and, importantly, the democratic mandate to drive these changes.
Spectrum of housing with care
We conclude that an overhaul is needed on how housing with care and support is planned, commissioned, designed and delivered. We also set out a ten-year strategy for housing with care and support. We want ambitious plans for housing with care and support to be at the heart of the White Paper for social care. The Commission, which we at SCIE host, has looked at the spectrum of housing options that provide care and support. The Commission believes that as much as is feasible, people should be supported to live in their own homes if they choose to, but there will always be some people who need or want to move from their original home and they should have a range of suitable choices available to them, locally.
There are seven principles of excellence identified in the report, which we say are key to delivering the vision we share with Social Care Future: for everyone to be able to live in a place we call home with the people and things we love, in communities where we look out for one another, doing the things that matter to us most.
Housing with care and support is so key to the success of care and support. Let’s hope our report, with its roadmap to achieving practical change, puts it higher on the agenda than it currently appears to be.
Ewan King is deputy chief executive of the Social Care Institute for Excellence (SCIE)