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Demographic Changes – future
models of provision for older people
Jeremy Porteus
Housing Learning & Improvement Network
2 December 2005, Sheffield
Independence, well-being and choice
“Housing provision and independent living are the key
life chances but the quality of provision and support is
often unacceptable”
(Source: Improving the Life Chances of Disabled People,
Prime Minister’s Strategy Unit, 2005)
“Increasingly public policy has been moving from
focussing on those with the highest level of complex
needs, to an approach that seeks to maintain and promote
people’s independence, health and social inclusion”
(Source: Green Paper on Adult Social Care, DH 2005)
From welfare to well-being
• Integrated health, housing and social care systems
• Multi-agency approach that fits into local delivery plans
and commissioning arrangements
• Focus on needs and aspirations of users of services
• Range of home care and support services, including
better use of sheltered housing, Home Improvement
Agencies, handyperson services etc
• It is part of the growing spectrum of housing, care and
support services that reflect choice, community, and
citizenship
Strategies for an ageing population
•16% of the population not in
“good health” or with a limiting
long-term illness
• People aged over 60 take up
40% of the NHS budget
• Around 40% of people in
community hospitals could be
cared for at home
• Around 30% of older people
in residential care are
inappropriately placed
Knowing the market in the region
• Significant age shift
• Changing users’ aspirations
• Diverse range of needs
Housing with care for older people
• 90% of older people live in their
own home
• Majority of older people live alone
• 70% are homeowners
• 500,000 occupy sheltered housing
• 500,000 live in residential/nursing
care
• 600,000 receive home support/care
• 1.4m people linked to a community
alarm
Funding frameworks
•Access and Systems Capacity Grant
• Extra Care Housing Grant
• Partnerships for Older People Pilots
• Supporting People & DFG arrangements
• Direct Payments and individualised budgets
• Preventative Technology Grant
But
In England during 2004/05, approximately £14.4 billion of
public funds will be invested in social care. Of which
£10.6 billion is for services for adults.
What are the issues for the region?
• Maintaining status quo is not an option – changing markets including a
wider range of housing with care choices
• Need for adaptability - closer integration of home improvement agencies
and “staying put” services with care, support and neighbourhood agendas to
support users of services in their homes locally/regionally
• Funding – time limited statutory income sources/grants, use of equity
release, PFI?, making use of Health Act flexibilities to deliver community
equipment services and DFGs
• New technology - introduction of telecare and e-health services (NHS
Direct). How can you get Smart?
• Improved coordination of advice, advocacy and information to help users of
services to make informed decisions eg CILs
• Influence strategic commissioning and resultant new patterns of home care,
floating support, day centre and primary care/nursing services to maintain
health and well-being
The challenge for existing services
• Move away from a silo approach
• Not linked to wider housing for
older people strategies
• Fragmented service – services
tied to locations
• Process – different professionals
/ different systems
• Different funding streams
We have not yet got a person based solutions joined up
across health, social care, housing and the many
provider services.
The challenge for the region
Planning for an ageing population: sheltered housing is a
valuable resource to those people who need it, growing use of
mixed tenure schemes and retirement housing for sale
• Health dividend: making links in local neighbourhoods with
primary and community care, and other services
• Design Age: opportunities to future proof design and innovate
eg, the use of technology – create virtual communities
The challenge for the region
• Lifestyle choices:
Changing need and aspirations
• Funding issues:
Supporting People, Direct
payments, private finance
& venture capital
• Outcome focussed:
Improve the quality of life and well-being of older and
vulnerable adults, aid the effective delivery of housing,
care and support, and support self-care and mutuality
Some final thoughts
• Are existing services fit
for purpose?
• What is the impact of
Supporting People reviews
and other Govt policies/ targets?
• Be ready for a changing
landscape of housing,
primary and social care!
Tackling age discrimination
Contact details
For further information on the Housing LIN:
Email – [email protected] or visit
Web – www.changeagentteam.org.uk/housing
Thank you!