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Who is responsible for housing with care schemes?

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Imogen Blood.JPG
This is a guest post from Imogen Blood, who is carrying out research for the Joseph Rowntree Foundation into housing with care.

'Whose responsibility?' is an 18-month research project which considers the roles and responsibilities of different organisations involved in housing with care (HWC) schemes and their impact on the quality of life of older people. It is one of three studies into HWC that are being funded by JRF as part of their Better Life programme. This month, JRF is publishing a Viewpoint that introduces and explores some of the initial findings from this work.


HWC promises older people the privacy and independence of their own front door in a secure community setting. They can also take advantage of a range of facilities and activities, and have the option of flexible in-house care and support.

In order to deliver this range of services in an increasingly diverse market, different organisations (or different parts of the same organisation) need to work alongside each other. A number of not-for-profit organisations and businesses are often involved in providing a wide range of services to a scheme, from housing maintenance to personal care, hairdressing and/or occupational therapy. External agencies - such as local authority social care, housing and other departments; health services; and other regulatory authorities - may also be involved in commissioning, safeguarding or inspecting. The roles and responsibilities of these key players can sometimes be unclear or even contested.

If a scheme is designed with insufficient car parking spaces, whose responsibility is it to resolve matters? What impact - both directly and indirectly - does this have on residents in the meantime? Where a local authority has nomination rights to a scheme, whose responsibility is it to ensure a mixed community in the scheme? What is the impact on more active residents, if the majority of newer residents are too frail to participate in activities?

Input from lots of different organisations need not spell disaster in the same way that a single organisation providing all of these services might not ensure coordination. However, it is vital that we understand the impact that blurred boundaries (and good partnership working) can have on older people and their quality of life, especially where they have high or increasing support needs. It is also important that providers and commissioners identify and share what works and what doesn't in making sure that responsibilities are clear between themselves, tenants and their families.

We began the fieldwork stage of the project in September and will be interviewing older people, their families and a wide range of professionals over the coming months. There will also be an online survey of housing with care providers.  The final report and a guide with examples to inform providers and others will be published in late 2012.

The research is being conducted by Jenny Pannell, Ian Copeman and Imogen Blood from the Housing & Support Partnership. If you would like to contribute your views and experiences, or find out more, please get in touch: 

Tel: 07894 904 355    email: enquiries@housingandsupport.co.uk

Housing benefit changes for supported housing - it's not about cuts

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The words housing benefit have become so associated with cuts that it's almost a surprise when the coalition proposes a policy that seems to have another intention.

That is the apparent truth behind proposed changes to housing benefit for people in supported housing mean?
They are designed to revise how additional housing benefit payments are made to supported housing tenants. Such payments are designed to take account of how their additional needs impacts on their housing costs (i.e. the need for people with multiple or complex disabilities to have specially designed or adapted housing, for instance).

However, the government argues, the current system is out of date, because it denies support to some people in need (people in private, as opposed to social housing, or those whose landlords do not provide care or support) and provides almost unlimited help to others.

The key proposals are to split these clients into two groups:-
  • People with lower-level needs, who often receive support through hostels or foyers. This group would receive the standard rate of housing benefit for their area plus a top-up to acknowledge the extra costs of their housing.
  • People with higher-level needs who would receive a special rate, decided by local authority care and support staff (rather than housing benefit staff, as at present).
In the consultation document, it insists that any changes will be cost neutral overall.

Interestingly, sector bodies appear to be taking this message on board. Here is a statement from Mencap, the National Housing Federation (which represents social landlords), the Association for Real Change (which represents learning disability providers), the Association for Supported Living and housing advisory service Housing Options:

"We are reassured that the DWP says this is not a cost cutting exercise and that the consultation does not seem propose major changes for people living in local authority or housing association supported and sheltered housing. We agree that there is a need for reform of the system to ensure that it is more transparent and open. However, we must ensure that the vulnerable, disabled and older people have somewhere to live that suits their needs and enables them to live more independently in their communities in the long term."

Other response are less charitable, however. We've also seen this from housing benefits consultant Chris Smith of Housing Benefit Help

"These proposals by the Department for Work and Pensions are intended only to cut its own budget and make its own benefit administration simpler.  They take no account of the knock on costs of the hardship caused some of the most vulnerable members of society. There are problems with the existing system but these proposals are not the answer."

This should be one to watch.

Wirral Council to publish review into care charging scandal

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Wirral Council is set to publish a review into a long running care charging scandal, the Liverpool Daily Post reports.

The council overcharged people with learning disabilities for supported living services between 2000 and 2006. It then forced Martin Morton, the social worker who blew the whistle on the abuse, to resign.

However, another independent review into how the council had handled the case of Morton, the whistleblower, which was handed to the council in April, resulted in him being offered his job back. The current council leader said he had been "treated disgracefully".

That review was not published at the time to avoid biasing any disciplinary action against those concerned with the case.

The second review, which is due for publication later this month, is thought to be even more critical of the actions of the council towards Morton.

So, I assume that any disciplinary action has now concluded. What the result of that has been is not clear from the Liverpool Daily Post's report, but rest assured I'm just off to find out.

Are my council's cuts to services illegal?

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Question by Horia Varlan.jpgLast week a court found that Birmingham councils decision to restrict its eligibility criteria for adult social care to 'supercritical' was illegal because it breached the Disability Discrimination Act.

In the wake of that decision, today, the president of the Association of Directors of Adult Social Services and director at Birmingham, Peter Hay has warned many more councils could face a similar fate.

But how do you know if what your council has done is against the law? Community Care legal columnist and editor of Social Care Law Today, Ed Mitchell, gives his handy guide below.


When making policy decisions councils were required under the DDA to to give "due regard" to these needs: promoting disability equality eliminating discrimination, promoting equality of opportunity, eliminating harassment, treating disabled people more favourably if necessary, promoting positive attitudes on disability and encouraging participation of disabled people.

The duty has been reformulated by the Equality Act 2010 but the DDA case law remains valid.

In effect this means:

The council should be able to show genuine consideration has taken place. Supporting paperwork should record this. Just saying that the matters were considered is unlikely to be enough.

Disabled people will need to be given adequate notice to participate in any consultation on decision which effect them. This may be longer than for non-disabled people.

It is often necessary to keep the adverse impact, under review. This is a good way of demonstrating that 'due regard' has been given.

A council can still make a decision which has an adverse impact on disabled people. The duty to have 'due regard' does not require a particular result but councils should be upfront about the effects of what they are doing and explain why, despite adverse impacts, they are going ahead anyway.

Image courtesy of Horia Varlan on Flickr

Southern Cross crisis hits frontline social workers

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Blogger Fighting Monsters has a good piece this morning detailing how families are already refusing to go to Southern Cross care homes for fear of them going bust.

Care home inspector: 'Less visits puts lives at risk'

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200px-Silhouette.jpgThe number of on-site inspections of adult care services being conducted by the Care Quality Commission fell 70% in the first six months of the new regulatory regime, we report today. Here an anonamous CQC inspector explains the turmoil at the regulator which underpins the falling inspection rates and why it's something government, service users and policy makers should all be afraid of.

Mounting concerns over the new CQC inspection regime will only be fuelled by these falling figures. If this trend remains unchanged, problems could go under the radar, putting lives at risk.

The Commission argues that regulation, not inspection, is the way forward, but we fear this will result in rising caseloads at a time of huge cutbacks.

At the moment inspectors are struggling under the weight of their workloads, as many are forced to cover more than double the number of services compared with last year. Some inspectors have seen their caseloads rise from 26 to 70 services.

An inspector who may have covered only nursing homes in the past, is now expected to examine hospitals, healthcare practices and dentist services. After next April GP services will also be added to the list - there is no way the current number of inspectors can check all these services are safe. Many inspectors don't feel they yet have the training and back-up to cover these new services.

As huge cuts hit the public sector, it is more important than ever that services are inspected.  Pressure will be piled on those staff left over from the massive job losses and employers will attempt to cut corners to save funds.

Local authority cuts will mean that there is less information available on how services are performing - we will be relying on providers to tell us what is happening. Providers will not want to flag up problems and those using the services often feel intimidated into staying quiet. When we do site visits we feel under pressure and pushed for time. It is also worrying that we don't yet have a proper system for gathering feedback from those using the services.

There is a strong chance that inspectors may only visit a site every three years, or even longer. The new paper reviews mean that a report on a care home that is having problems may not be flagged up as high priority, so could be stashed at the bottom of the pile. All risks are assessed differently now, so priorities can fall by the wayside.

Inspection used to be about change - talking to people and advising them. It would lead to improvements in practices and the quality of services. Regulation is now a hands-off approach that could increase risk and see providers escape blame.

We worry that if things go wrong inspectors will be blamed instead, when we have no realistic chance of keeping tabs on services. The Commission and the government must listen to the concerns of inspectors and recognise that 'light touch' regulation will play havoc with the care system. 

Some things you may have missed: Prisoners' families and extra care

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We've been failing a bit in our duties to inform, educate and entertain, well, to inform at least, so here are a couple of things of note that you may have missed:

  • Helping prisoners stay in touch with their families is well-known to improve their prospects after release, but charities in this field are struggling to demonstrate their effectiveness, found a report last week by voluntary sector think-tank New Philanthropy Capital. NPC has developed a measurement tool to help charities in this area, but it also has some tough messages for government and commissioners - apparently there is much confusion among charities about what commissioners are looking for, so it calls on government to be clear about the outcomes it is after and to improve access to data.
  • Anyone remember extra care housing? I remember when i started reporting on adult social care in 2003 it was all the rage but it has less of a national profile these days. Anyway a recent report commissioned by social housing builder and maintenance firm Keepmoat has attempted to set out the core role of extra care in responding to the housing needs of an ageing society. It predicts an increasing role for extra care in future, both in supporting vulnerable groups, such as people with dementia, and meeting the needs of the wider community.
Sixty percent of the public say government spending cuts have left the county ill prepared to deal with an aging population, a poll finds.

The poll of 2,000 people by Age UK also showed over a third thought that services for older people should be protected from cuts.

Michelle Mitchell, director of Age UK, said: "If responding to demographic change is filed away as 'too difficult' then our current leaders will fail future generations of both young and old as the demographic changes begin to take effect."

"We want to see the government now start to address these issues in an intelligent, holistic way that encourages departments to work together to come up with different and better ways of working that will prepare us better for an ageing society," she added.

The survey also found that 84% of people feel the government is not prepared to meet the needs of an aging population. Plus, 79% said their local council was in the same position.

The poll was commissioned to inform the development of Age UK's Agenda for Later Life report, which calls on the government to meet 12 challenges to deal with the ageing population.

Read Age UK's twelve challenges after the jump...

Campaign makes case for sheltered housing

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A campaign has been launched to make the case for sheltered housing - it comes from the trade body for the sector, ERoSH (the Essential Role of Sheltered Housing).
As befits the times, ERoSH is arguing that sheltered housing ticks both the Big Society box (as a community facility that can be used for a wide range of purposes) and the public sector efficiencies box (as a preventive service for older people that reduces pressures on the health and social care budgets).

Campaigning against cuts is the new black

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Black shoe by Nothampton Museum.jpgWe've had campaigns against disability benefit reform, campaigns against redundancies and various national groups speaking out for their own section of the sector or clients.

Now, a group of charities, baronesses and academics have launched a consorted campaign against public sector funding cuts.

The Campaign for a Fairer Society says it "wants power and control to shift from government to citizens, families and communities. But we don't want the government's 'Big Society' if that means a loss of basic human rights and unfair cuts focused on the most vulnerable".

It has even got a list of seven principles for a fairer society.

Supporters include Alzheimer's Scotland, Baroness Campbell (herself a well known disability right campaigner) and Jim Mansell (an expert in learning disabilities).

Image by Northampton Museum on Flickr

About the Adult Care blog

   
 

The Adult Care blog looks behind the policies, practices and personalities involved in the care of older and disabled people for any hidden truths, helpful tips or humour.

It is written by Community Care’s adults’ services beat editor Mithran Samuel.

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