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Adding housing to the care equation

Housing has long been held as an important factor in the health and well being of a population.Indeed, as the Chartered Institute of Housing (CIH) says, “Public health interventions in the late 19th and early 20th centuries began by improving housing. Philanthropists including Octavia Hill, Joseph Rowntree and Titus Salt all recognised the impact of providing good quality housing in sustainable communities as a prerequisite for the health and wellbeing of people in their localities.”So why, in discussions about integrating health and care services, has housing so often been overlooked?Proper integration of services is vital to meet the challenges of major changes to the welfare system as well as a rapidly changing demographic – the impact of an aging population is only now beginning to be realised.But focus has been firmly fixed on the causal link between health and social care. In fact, in June last year, the Government announced £3.8bn Better Care Fund to integrate the two services, reducing pressure on the NHS and keeping people in their own homes.The Better Care project was postponed this May, with implementation now due to start in April 2015 – though commentators doubt this will happen, just a month before the general election. But, if nothing else, the big money project highlights how important the integration of health and social care services is considered.In the past, housing professionals have complained about not being included by local health and wellbeing boards. As the CIH says in Delivering housing, health and care outcomes: “Experience across the housing sector is that some GPs, nurses and hospital staff understand the importance of good housing, but not all. For some, the focus is on ensuring clients have a ‘place of safety’ which can lead to a default on residential care as a health and care solution, rather than consideration of the ‘home’. Many do not involve housing officers, support offices or others in decisions about shared clients.”Clinical Commissioning Groups (CCGs) are designed to help change this and are seen as important in the lead to integrate local services. A recent report by the NHS Clinical Commissioners – Taking the lead: How Clinical Commissioning Groups are changing the face of the NHS – included the case study of Oldham CCG working with the local council and a housing association to lift 1,000 households out of fuel poverty. The CCG is spending £200,000 on a Warm Homes initiative– providing new boilers, insulation and, in some cases helping with debt reduction ¬– but expects to save £300,000 a year in reduced hospital admissions and social care costs. The households themselves are expected to save £450 a year each.Unfortunately, such examples seem to be rare – not one of the other case studies in the report included housing.But, with the passing of the Care Act 2014, is this all about to change?The Act puts integrated services – including housing – at the heart of social care. For the first time, housing – referred to in the Act as the suitability of living accommodation – is included in the Government’s definition of ‘well-being’.As the National Housing Federation notes in its briefing on the Care Act, “The challenges inherent in providing social care to a growing number of people mean that the social care system will need to change to provide more services in the community and in people’s homes where this will maximise people’s well-being, alongside residential care homes.“The fact that for the first time the suitability of someone’s living accommodation is a key consideration within the social care system means that housing providers are potentially well placed to help improve the well-being of more people through their services.”The Act also places a duty on local authorities to include housing to promote the integration of health and care. Local authorities will also be required to include providers of social housing as one of the key partners in planning a person’s need for care services.At Mears, we are leading the way in integrating housing and care services. We are committed to working with partners to improve the lives of those most in need. We understand through first hand experience the positive impact on service users and providers of offering a holistic, person-centred approach which includes housing and care.The new legislation comes into force in April next year – perhaps not a moment too soon. Finally, decades after realising its importance to public health, has housing finally been given its rightful place in the delivery of effective, integrated services?


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