Delivering supported accommodation Challenges ... · Me Email [email protected]...
Transcript of Delivering supported accommodation Challenges ... · Me Email [email protected]...
Delivering supported accommodationChallenges, considerations and cuts
Angie Boyle, Policy AdviserMental Health Providers Forum
Me
Email [email protected] [email protected]
• Policy Advisor MHPF
• Head of ProgrammesCoalition for Collaborative Care NHSE
• TLAP
• Associate In Control
We lead a strategic
collaboration of “not for
profit Mental Health
organisations”
Linking strategically with
the Department of Health,
NHS England and Public
Health England aimed at
benefiting the strategic
development of the “not
for profit mental health
sector”.
“Minister I want a life, not a service….”
Gavin Croft 2014 to Norman Lamb Minister of State for Care Services
People with disability and long term conditions:Cuts to Personal income to support independenceCuts to housing benefitsCuts to social care
“Angie…what is social care?” “It’s the front line prevention service of the welfare state”
Localism?
•Hooray
•Boo
•Social care is the main activity of local government
Complex system?
•What actually is social care? – the best kept secret?
•Time for a new narrative - ??
•It’s the NHS who provide my care isn’t it?
Social Justice diminishing by the day?
•People in need just feel ‘lucky’ to have anything
•Most people pay for their own social care
•We are not a poor country, we choose to spend our money on other things.
Social services leaders commit to four-year campaign to secure funding Association of Directors of Adult Social Services calls for social movement to build public support for a better deal
social care as a social movement
Harold BodmerFormer President ADASS
Care Act 2014
Parity of access.
Suitability of accommodation central to wellbeing
5YFV 2014
5YFV mental Health 2016
10 year journey
Among other things decent place to live, job
and relationships
Integrated
Personalised
Commissioning
18 sites
2015-
Housing White Paper
2017
Transforming Care including
housing programme
Sustainability and
Transformation Plans
44 STPs main vehicle for transforming health and
care services
Public Health
Framework
Positive ……………….Policy framework
Resourced, Appropriate Accommodation
Quality – investment in both Psychologically Informed environments
Co-production – adoption of co-production with people and other expert advisors
Staff recruitment and training – investment in the recruitment and development of staff
Policy Informed Practice
Basic Ingredients for successful supported accommodation
Mental health and Housing report 2016
Although residential and nursing care may be coming back, the reality is it’s never really gone away.
Cost and savings
“Very broadly, the evidence for people with mental health problems indicates that either individual or shared supported housing options are lower cost than residential care homes (Jarbrink et al, 2001; Beecham et al, 2004; Priebe et al, 2009; Knapp et al, 2014; Killaspy et al, 2016). For people with a learning disability, the picture is less clear; some studies have suggested that individual or shared supported housing options can be higher cost than residential or nursing homes (Hallam et al, 2006; Roe, 2011a; Roe, 2011b) while others provide examples of supported housing options costing less than residential care (Department of Health, 2009; Association for Supported Living, 2011, McConkey et al, 2016).”
NDTI Housing Discussion Paper 1 2017
Between the rhetoric and what our members and overall sector are telling us and experiencing….
Reduced stock
• Social housing Right to Buy
• Housing subsidy grant disappearing
Income challenges
• Introduction of Universal Credit
• 1% rent reduction
Impact on vulnerable people and
prevention services
• Paralysis in development
• Local Housing Allowance Cap
And a key enabler to sustained wellbeing .... Social Housing
Impact for people in need of social housing…
LHA issues are resolved via a
ring fenced fund
We think it’s problematic since no agreements about how this will pan out locally
and impact on particular groups.
HCA ramping up focus on VFM
No issue in principle but
must bust the myth of great
affluence
Universal Credit having negative
impact on people
Less Hostile -Opportunities to
build more houses and
increase borrowing BUT 1% rent cut still
in place until 2020 when new rent decisions will be made
People with mental health problems - most live in private sector provision with little protection. And also live in their own homes
National living wage
Sleep in payments
Increased
Regulation fees
Apprenticeship levy
Reduction of fees from statutory
funders – less than care costs
People:Reduction in supportIncreased threshold
for eligibilityReduced income Reduction in life
chances
And the current approach to dealing with all this …
Radical change needed
Entrenched paternalism
Rationing
We cannotAfford the currentWay of being so a 21st century approachneeded
The state isResistant to Choice and Control and Letting go
Rationing is the primaryApproach in most areasAnd increased control
Health and social care integration at a system level…
Another form of structural or financial re
engineering?
The key to greater efficiency?
Improved system for people? Less handoffs, less complex funding,
easier to navigate?Service providers given
greater flexibility?
Integrated Personal Commissioning• Sites so far……Stockton, Luton, Cheshire, Gloucester, Hampshire, Lincolnshire, NEW Devon, Portsmouth,
Somerset, Torbay, Tower Hamlets, Birmingham, Herfordshire, Islington, Notts City, Sheffield.
Integrated Personal Commissioning will be the main model of care for 5% of a local system’s population, including people with multiple long term conditions, people with severe and enduring mental health problems, and children and adults with complex learning disabilities and autism (NHSE IPC)
‘No society has the money to buy, at market prices, what it takes toraise children, make a neighbourhood safe……The only way the world is going to address social issues is by enlisting the very people who are now classified as ‘clients’...and converting them into co-workers, partners and rebuilders of the core economy.’ Edgar Cahn
“The introduction of new models of care that deliver better health and wellbeing outcomes for people and a better experience when they access services, depends significantly on the commitment, understanding and ambition of local leaders, all health and care providers, the voluntary and charitable sector and communities themselves. “ Personalised health and care 2020 – a framework for action. Gov.uk
Woodsend Court IAS Trafford Housing12 Apartments – 6 for people with additional Needs6 for good neighbours
Accommodation centred support for Improved mental health
Organisation Timebank
New technologies the new frontier and the panacea?
Will transform tasks, enhance lives…. But not at the cost of human interaction...