Research into practice

Gaynor Wingham considers a report warning that
a lack of suitablehousing is compromising the original goals of
care in the community.

How people feel about where they live can be very important to
social workers. A report by the Joseph Rowntree Foundation has
examined this. It draws on 21 funded studies to examine housing
policies and assessed their impact on communities. It found a clash
between housing policy and community care.

The report warns that lack of suitable housing in many areas has
led to disabled and vulnerable people being denied choices, forcing
them to live in the most run-down and unpopular estates.
Financially hard-pressed authorities interpreting their
responsibility to offer care and support in a narrow way intensify
this sense of insecurity and isolation. The report also suggests
that housing benefit cutbacks, which can hinder the variety of
community care services provided and service users’ choice of
accommodation, compound the disconnection of the different arms of
policy.

The report calls for a national housing initiative to ensure
that the original goals of community care – promoting independent
living and greater social integration – can be reached. It also
calls for improved resourcing of advice and advocacy, with central
involvement by service users.

The report criticises the formal needs assessments, which have
proved uncomfortable for those on the receiving end. There are
often discrepancies between the needs identified and the services
actually provided. Further needs may go completely unrecorded if
they fall outside the criteria of what the local authority is
prepared to fund.

The report highlights the vital preventive role that suitable
housing and support can play in postponing the need for expensive
residential care. It calls for national guidance on the kinds of
preventive housing and support services to be included in local
plans – and seeks to remove the anomalies that make access to
services dependent on living in particular types of
accommodation.

The report identifies five areas where housing and community
care policy is marked by major problems and contradictions: where
people live, the reality of choice, needs assessment, access to
information; and funding.

How can social workers make use of these messages now? Some
social services and housing departments are currently jointly
managed, and this should provide an ideal opportunity to examine
the issues. Others may need a closer dialogue to look at responding
to local conditions and service users’ experiences.

Individual cases could be considered. It may be seen that choice
is limited for disabled and vulnerable people, and that it is
possible to extend this choice with some planning. If there are a
number of service users who appear to have similar experiences and
feelings in an area, then case examples could be highlighted.

The report found that most users would prefer to live in a
self-contained “place of their own” rather than a group home. If
there is a policy to extend group homes for people with learning
difficulties, for example, then alternatives could be
considered.

It is important for social workers to be proactive in the
planning process, bringing their wide and valuable experience of
how a certain policy has affected their client group.

If needs assessments are used to ration scarce resources, then
how this is explained to service users should be explored. Do they
have real – or illusionary – choices?

Social workers have to work within policies that may appear
outside of their control, but they do have the direct evidence of
their impact. They also have the experiences of the service users.
These can and should be used to influence changes and planning.

– The report, High Hopes: Making Housing and Community Care
Work, by Lynn Watson, Joseph Rowntree Foundation and York
Publishing Services, 2001, is available for £13.45, telephone
(01904) 430 033.

Gaynor Wingham is director of the Professional
Independents Consultancy.