How can social care contribute to building healthy places?
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Speaker 5: Mr Neil Revely, Director of Social Care, Sunderland City Council
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How can social care contribute to building healthy places?
- 1. Health Housing & Social Care - Building Health into Homes FUSE QRM 20 October 2015 – Teesside University Neil Revely Executive Director People Services, Sunderland City Council Chair, Association of Directors of Adult Social Services, Housing Policy Network
- 2. Housing – not new in supporting Health & Care! • Public health in the mid-19th century established to tackle the cause of infectious diseases – poor housing & sanitation • Much of what the social housing sector does was born out of the public health movement • Better designed and better housing standards fundamental to improvements in health and daily living since early 20th century • Modern planning and design fundamental in supporting independent living • Home adaptations and disabled facilities grants long established • Innovative new models of housing supporting current and future generations to live independently
- 3. Setting the Policy Context • Marmot Review - to improve Health and Wellbeing, need to improve the social determinants of health • Health and Social Care Act - Reforming health services and creating Health & Well Being Boards • Care Act - An overarching vision for adult social care including an emphasis on housing solutions • Better Care Fund – requires integration and needs to drive significant efficiencies • Five Year Forward View – Healthy New Towns • Memorandum of Understanding – Improving Health through the home • Devolution – opportunity or threat?
- 4. The Challenges – Growing Demand • Life expectancy is rising • Over 65s - 11.4% increase between 2010 and 2014 • Over 65s in need of care will increase by 40% between 2005 and 2020 • Pupils with a Learning Disability will increase by 26% between 2014 to 2023 (2x the overall pupil increase) • Without changes this equates to a 150% increase in care costs • 95% older households want to live at home
- 5. The Challenges • The Economy • Reductions in public resources • Increasing demand and expectations • Strategic shift to personalisation, early intervention, prevention, re-enablement, care at home • Welfare reforms • Changing the way agencies work with residents and communities • Unlocking untapped assets and potential within communities
- 6. The Challenges – Housing • Housing supply (all tenures) • Provision of affordable homes (all tenures) • Registered Providers – rent reductions, right to buy, and housing related care costs • Improving the housing offer for older households (all tenures) including supporting downsizing through attractive accommodation options • Enabling people with housing and care needs to live at home independently – including new developments, links with welfare reform and capital
- 7. Making Housing Count – the opportunities • Provide a real choice for independent living – bungalows, extra care apartments, downsizer homes and retirement housing • Older households in future proofed modern housing – choice of tenure, affordable to heat, level access • Well designed to maximise ‘home for life’ aspiration • Evolve the housing offer to meet new and emerging demand and aspirations • Keeping people central to their communities • Improved outcome for people, carers, families • Improved property conditions • Willing partner supporting integrated working and substantial health and social care efficiencies
- 8. Specialist Housing – example Seafarers Way Extra Care Development • Extra care housing designed for dementia – new build • Grade 2 listed ‘Old Orphanage’ - refurbishment • Informal Partnership – Investor, LA, RP, HLF • Private investment linked to Pension Funds
- 9. Specialist Housing – example Dovecote Meadow Extra Care ‘village’ • 175 units including 17 for people with dementia • Avoiding Public Subsidy • Partnership Funding/Shared Risk • Flexible rental/purchase
- 10. Why Integration Matters & Making Housing Count Reduce Demand & Avoid Cost • Prevent or reduce levels of demand; acute (inpatient, A&E and outpatient care), primary (community health) and social care (residential, intensive home care) Reduce Costs • Reduce unit costs e.g., tariffs for condition specific interventions • Reduce costs of pathways • Reduce staffing costs/overheads Outcomes for People • Most importantly much better for people and families
- 11. Final Thoughts • The legislation and policy helps – but locally its about people and whether we want to do it! • We need to use the burning platform of rising demand and reducing resources • The Sectors need to act more coherently • Government needs to join up better • A better evidence base is required • Relationships are the key • The MoU is a real opportunity – let’s use it!
- 12. Contact Details Neil Revely Executive Director People Services Sunderland City Council Civic Centre Burdon Road Sunderland SR2 7DN Tel: 0191 5618953 E-mail: neil.revely@sunderland.gov.uk
Editor's Notes
- Create and develop healthy and sustainable places and communities. Duties on the local authorities to Set up Health and Wellbeing Boards Establish and have authorised our Clinical Commissioning Group(s) Put in place a Joint Strategic Needs Assessment Establish HealthWatch Transfer Public Health including the Director of Public Health Develop a Health and Wellbeing Strategy BUILD AND STRENGTHEN RELATIONSHIPS ACROSS THE WHOLE SYSTEM Caring for our Future White Paper and the Care & Support Bill Housing Strategy – not specific enough about specialist housing Cross Government – not joined up enough DH (Health/Social Care)/DCLG/DWP etc DFGs/Telecare/adaptations/equipment etc
- Life expectancy is rising, as is the absolute size of the older population, and the size in proportion to the population as a whole, will grow An aging population both in absolute terms and relative to country-wide trends and left unchecked will see decreasing numbers in the family forming age groups In Sunderland, it is forecast that by 2030 the number of older people above 65 years of age will rise by 46%, with those over 85 increasing by 50%. In 2010 the numbers of people with Dementia are estimated at 3100, by 2025 we are likely to have 4600 people aged 65 years and over with a diagnosis 37% of older people in Sunderland have problems with some aspects of daily living which is projected to increase by 28% between 2008 and 2025 Even if no improvements to public health, this would increase care costs by 150% by 2025 Over 95% of vulnerable residents told the City they wanted help to live in their own homes currently and/or in the future
- - A consortia of housing providers have been meeting with the NHS Commissioning Board to formulate a Partnership Agreement that recognises the role of housing - Joint select committee report on Care and Support Bill recommended extending the scope of what constitutes wellbeing to include, safe and settled accommodation - Department of Health £300m Care and Support Specialised Housing Fund higher quality thresholds to deliver care ready housing for disabled and older people that can improve health and wellbeing - Forthcoming government statement on integration, will include reference to housing NHS Confederation briefing, Stronger Together, HWBs need closer engagement with providers, including housing Reduce costs of pathways – eg S’land Drug & Alcohol services
- - A consortia of housing providers have been meeting with the NHS Commissioning Board to formulate a Partnership Agreement that recognises the role of housing - Joint select committee report on Care and Support Bill recommended extending the scope of what constitutes wellbeing to include, safe and settled accommodation - Department of Health £300m Care and Support Specialised Housing Fund higher quality thresholds to deliver care ready housing for disabled and older people that can improve health and wellbeing - Forthcoming government statement on integration, will include reference to housing NHS Confederation briefing, Stronger Together, HWBs need closer engagement with providers, including housing Reduce costs of pathways – eg S’land Drug & Alcohol services
- legislation and policy helps – it supports joined up working We need to use the burning platform of rising demand and reducing resources – necessity the mother of invention The Sector needs to get its act together – easier to be understood and its offer simply expressed Government needs to join up better – too silo’d in its approcah A better evidence base is required – it will convince the NHS Relationships are the key – its all about the people