housing: why it matters for our health & wellbeing.. … pdfs/presentations/ne...eg care act...

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Housing: why it matters for our Health & Wellbeing.. & the art of the possible for integration

Domini Gunn, Director of Health & Wellbeing

Chartered Institute of Housing

Learn with us. Improve with us. Influence with us | www.cih.org

Housing’s virtuous circle

Housing supply

Housing conditions

Affordability & flexibility

Place & community

Health and Wellbeing

‘The right home, in the right place, at the right time, at the right cost’

• Affordable

• Connected

• Accessible

• Supported


NHS Constitution 2012

‘[The NHS] is there to improve our health and well-being, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives.’

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Housing Constitution 2013?

“the right to housing should not be interpreted in a narrow or restricted sense which equates it with, for example, the shelter provided by merely having a roof over one’s head or views shelter exclusively as a commodity. Rather it should be seen as the right to live somewhere in security, peace and dignity.”

V. Annex 1, General Comment No. 4 on the right to adequate housing (Article 11, § 1), § 7, adopted 13 December 1991.

Committee on Economic, Social and Cultural Rights, the principal U.N. body responsible for housing

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Homes fit for growing & thriving?


Housing as a solution ….?

“Our vision is simple. Firstly, for those

people with urgent, but non-life

threatening needs, we must provide

highly responsive, effective and

personalised services outside of hospital.

These services should deliver care in or

as close to people’s homes as possible,

minimising disruption and inconvenience

for patients and their families.”

Sir Bruce Keogh


Homes fit for ageing?


Global Ageing

0 5 10 15 20 25 30 35 40

USA

Russian Fed

Ireland

UK

Sweden

France

Canada

Germany

Switzerland

Spain

Italy

Japan


Where’s the tipping point?

“If nothing is done to change the current housing

situation, occupied places in care homes and hospitals would need to rise by 151%, from around 450,000 to around 1,130,000 by 2051, and some estimates project long-term care expenditure as

rising by around 325% in real terms between 2002 and 2041.”

‘Lifetime Homes, Lifetime Neighbourhoods: A National

Strategy for Housing in an Ageing Society’ 2008


40,000+ needless hospital days = £11.2m

A few numbers …..

23% non decent housing


Housing, Health & Social Care Remit

• What role can housing play in the drive to integrate health and care?

• The Care Act's core aim of promoting 'well-being‘

• Understanding the key 'levers' for housing inclusion in Better Care Fund Plans

• Making 'living safely & well at home' a reality for more people


Integration is everywhere…

• Every report, think tank, public policy statement, manifesto……..

• Primarily health and social care focus– have to put the case all the time for housing

• Who pays issue unresolved [NHS free vs Care costs]


Where does housing come in?

• Some references in new legislation/ frameworks eg Care Act

• Better Care Fund includes housing money [DFG £220m, + capital specialist -neither ring-fenced]

• No targets or outcomes for housing – so can it help to achieve health and care targets/ outcomes?

• Bottom line – cannot achieve the improvements (fiscal / social) without safe, decent homes for people to live in


Is Housing in there?

• Survey this Spring (using FOI) by Leonard Cheshire found that around a third reported that housing was not mentioned in their Better Care Fund Plan

• DFG inclusion in Plans still unclear, as is funding

mechanism (DFG money now comes from DH) • More to do …………. Will the Care Act help?


Hospital use

• C. 66% of general and acute hospital beds are occupied by people 65yrs +

• 70%+ of hospital bed days = emergency admissions

• 80% of emergency admissions for 2 weeks or more = over 65yr olds

Housing hazards/ poor/ unsuitable homes can contribute to all of above – need to quantify more


Care Act & Guidance

• INDEPENDENCE – ‘Supporting people to live as independently as possible, for as long as possible, is a guiding principle of the Care Act’

• CHOICE – ‘[LA must] put in place a system where people have the information they need to take control of their care and support and choose the options that are right for them’

• CONTROL – ‘the local authority should assume that the

person themselves knows best their own outcomes, goals and wellbeing’


Care Act Guidance

• A local authority must provide or arrange for the provision of services that contribute towards preventing, reducing or delaying the needs for care and support.

• The provision of suitable living accommodation can be a way to prevent needs for care and support, or to delay deterioration over time.

• Getting housing right and helping people to choose the right housing options for them can help to prevent falls, prevent hospital admissions and readmissions, reduce the need for care and support, improve wellbeing, and help maintain independence at home.


Building Housing Pathways


Case studies

-Individuals’ journeys

Housing framework – using information as evidence

National outcomes and local commissioning priorities

Support contract

outcomes

-Economic well-being

-Enjoy & achieve

-Be healthy

-Stay safe

- Positive contribution

-Positive move-on

Improving lives

-Comfortable &

secure homes

-Adequate income

-Safe neighbourhoods

-Getting out and about

-Friendships &

learning

-Keeping active &

healthy

Ways to well-

being (mental

well-being)

-Connect

-Be active

-Engage

-Keep learning

-Give time

Resources consumed

-Primary/secondary

health

-Social care Satisfaction with services

-Client satisfaction survey

Evaluation findings

-e.g. Discharge project

Organisation Metrics

-Finances

-Meaningful use of time

-Support networks

-Physical health and well-being

-Housing

-Offending behaviour

-Safety

-Positive contribution

Enhancing QOL Improving health Delay / prevention Safeguarding Experience of care

Compliance –

reg. standards


Making the case for Housing


Rhetoric to Reality

Chartered Institute of Housing: www.cih.org source of information, support and professional membership

Creating housing choices for life – CIH briefing CIH Tools: Service Quality (2014), VFM(2013) & Social Value (2014) Developing your local housing offer for health and care - targeting outcomes – CIH framework doc Hospital 2 Home resource pack www.dh.gov.uk/health/2012/10/hospital-2-home/

http://www.cih.org/

http://www.cih.org/

http://www.cih.org/

http://www.cih.org/publication-free/display/vpathDCR/templatedata/cih/publication-free/data/What_you_need_to_know_about_the_Care_Bill

http://www.cih.org/publication-free/display/vpathDCR/templatedata/cih/publication-free/data/Creating_housing_choices_for_life



http://www.cih.org/publication-free/display/vpathDCR/templatedata/cih/publication-free/data/Developing_your_local_housing_offer_for_health_and_care





http://www.dh.gov.uk/health/2012/10/hospital-2-home/








Thank you for listening ..

Domini Gunn, Director Health & Wellbeing

Chartered Institute of Housing

[email protected]

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mailto:[email protected]

housing: why it matters for our health & wellbeing.. … pdfs/presentations/ne...eg care act...

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