It seems obvious that having a warm, safe home has a profound effect to our physical and mental heath yet we still talk about housing, health and social care as three very separate but infrequently overlapping sectors.  

In the complex organisational landscape, Housing Associations are uniquely positioned to understand the social, economic and financial challenges of their tenants and some of the pressures they face as a direct result of the lack of capacity and / or collaboration elsewhere in the housing, health and social care systems. 

The scale of the challenge 

  • We have an ageing population with younger adults with disabilities living longer. The anticipated UK funding gap is £18 billion by 2030/31.
  • The National Audit Office calculates that local authorities have seen a 49.1% real-terms reduction in government funding between 2010/11 and 2017/18, resulting in a 28% reduction in their spending power. Adult social care spending in the UK has fallen by 9.9% between 2009/10 and 2016/2017.
  • According to the Competition and Markets Authority (CMA), care homes that have more than 75% of local authority funded residents are most at risk of failure and a quarter of UK-wide care homes fall into this category. In addition, there are particularly high turnover rates for care workers. Some reports indicate an annual rate of 38% (which could be further exacerbated by Brexit).
  • Cuts in local authority social care spending have led to increased use of A&E services by people aged 65 and over
  • Home care agencies are also struggling with hourly rates in some areas falling considerably short of the minimum that businesses need to cover their costs.

The size of the opportunity 

In the continued absence of the Social Care Green Paper (the 12th such paper in 20 years) the ever increasing demand on local authority social services means that bespoke locally driven solutions rather than significant system wide changes in response to these issues are demanded. 

It’s very positive that Julie Ogley, the President of the Association of Directors of Adult Social Services, has just confirmed that her mission is to develop connections between housing and social services professionals. She says she will “encourage colleagues nationally and locally to focus on housing and accommodation – lifetime homes, homes for people with care and support needs and their carers or PAs, a safe home for people who have been in an abusive relationship, or just a roof over their head for some people”.

Breaking down the current silos is key to adopting an approach which really delivers integration and innovation. In our view, it appears likely that real progress will only be achievable in practice if designated resource is made available to design, deliver and commission a coordinated local approach within an agreed framework of shared budgetary accountability. 

This pressure is particularly acute in the South West with an ageing rural population and seasonal economy. The recruitment challenge for care providers is significant particularly as staff often live considerable distances from those they support. 

Local Plans that deliver development which is sensitive to and helps to shape the delivery of an integrated health, housing and social care system would be very welcome. This might involve developing multi-disciplinary cross sector service design and delivery teams, place-based approaches to the use of technology to improve lifestyles and connectivity and effective projects with the voluntary and community sector to create greater social impact. It would be interesting to see how a more integrated approach could target the economically inactive groups within communities, strengthen relationships with schools, colleges and universities and establish new working practices that seek to minimise the environmental impact of housing and social care for the future. Initiatives such as the Welcome Home Scheme with the Red Cross to assist those who need reassurance about going home after several weeks or months in hospital is just one good example of an integrated approach that works to support and re-establish independent living within communities.