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Draft Extra Care Housing Strategy

Draft Extra Care Housing Strategy. Older Peoples Housing Strategy Group 23 rd June 2014. Consultation.

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Draft Extra Care Housing Strategy

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  1. DraftExtra Care Housing Strategy Older Peoples Housing Strategy Group 23rd June 2014

  2. Consultation • A provider engagement morning was held on 9th July 2013. The outcomes of the ‘World Café’ session held at that event form Appendix 1 to this strategy. They have informed the development of this strategy. • A further provider engagement event was held on 14th January 2014 specifically to discuss a possible development in Bridport. • The first draft of the strategy was produced in January 2014. Formal consultation took place between February and April 2014 when the draft was widely circulated, including on the Dorset for you Consultation Tracker. In addition it was considered at the winter 2013/14 series of Dorset Age Partnership Meetings. The outcome of this consultation forms appendix 2. Draft Extra Care Housing Strategy

  3. 1. Overview • Introduction • National Context • Local Context • Diversity • Demographics • The value of extra care housing • Current Extra Care housing in Dorset • Demand in Dorset • Funding • Development of new extra care schemes • Service Delivery • Consultation Draft Extra Care Housing Strategy

  4. 2. Aims (1.2) • To facilitate the development of appropriate new extra care housing schemes • To facilitate and in many cases fund support and unplanned care services in extra care schemes • To work in partnership with communities, housing authorities, housing associations and the private sector to achieve these aims. Draft Extra Care Housing Strategy

  5. 3. Care Act 2014 (2.5) • Duty to provide preventative services • The duty to prevent need for care and support is set out in Clause 2 of the Care Act, which identifies three main strands of prevention – preventing the need for care and support, delaying needs for care and support, and reducing the needs for care and support. Draft Extra Care Housing Strategy

  6. 4. Pathways to Independence (3.5) Like all DCC directorates, Adult and Community Services faces major financial pressures over the next few years. The budget needs to be reduced by £16 million by March 2016, with further savings of at least £3-4million likely to be needed to cope with rising costs and public demand. It is planned to fundamentally change the way things are done - maintaining high quality services for the public, but delivering them in different, more cost-effective ways. Draft Extra Care Housing Strategy

  7. 5. Pathways to Independence (3.5) • Pathways to Independence is a new programme which will review, reform and redesign adult social care services. • The programme will achieve this through a variety of means, including: • more use of assistive technology, such as telecare • move older people and people with learning disabilities away from residential placements to community supported living accommodation, where appropriate • Extending the use of direct payments and personal budgets Draft Extra Care Housing Strategy

  8. 6. Population aged 75+ across the County(5.2.3) Source: 2012-based trend projections, district level, DCC 2013 Draft Extra Care Housing Strategy

  9. 7. Population aged 85+ across the County(5.2.3) Source: 2012-based trend projections, district level, DCC 2013 Draft Extra Care Housing Strategy

  10. 8. The value of Extra Care housing (6.1) It is characterised by: • Self contained accommodation incorporating design features to facilitate independence and safety • 24 hour care and domestic support available in the individuals own home if required and an alarm system • Meals available • Communal facilities Plus • Staff offices and facilities • Specialist equipment to help meet needs of more frail or disabled residents such as assisted bathing • Social activities on site and/ or arranged. Draft Extra Care Housing Strategy

  11. 9. The value of Extra Care housing (6.1) Key features that distinguish extra care from residential care homes are: • Self contained accommodation not simply a room (including en-suite rooms) • Provision of care can be separated from provision of housing • Care can be more easily be based and delivered on an individual basis • Occupiers can be assured tenants or owners with degree of security not licensees. Draft Extra Care Housing Strategy

  12. 10. East Sussex Evaluation (6.4) Key findings: • When assessing where residents in the schemes would live if they were not living in extra care housing, 63% were judged as needing residential/EMI/nursing care; • the enabling design and accessible environment of extra care housing supported self care and informal family care, thus increasing independence; • The evaluation outcomes strongly support the preventative nature of extra care housing; • The cost of extra care housing was on average half the gross cost of the alternative placements. • The best impact and financial returns were delivered by clients at the high end of the medium dependency care band, i.e. between 10 to 14 hours per week of care at the point of entry. Draft Extra Care Housing Strategy

  13. 11. SHOP: Strategic Housing for Older People (8.3) The toolkit suggests per thousand people over 75 years there should be: • 125 conventional sheltered housing properties • 20 ‘enhanced’ sheltered housing properties • 25 extra care properties Draft Extra Care Housing Strategy

  14. 12. Need in Dorset (8.3) The figures in the next slide are based on: • 186 units of extra care housing managed by housing associations in Dorset, of these 11 are let on a shared ownership basis with the remainder rented. Otherwise, current provision based on information from the SHOP database. • The need for 20 ‘enhanced’ sheltered housing properties and 25 extra care properties per thousand people aged over 75 • Tenure split equally between rent/shared ownership and owner occupied • A population of 52,410 people aged 75 and over in 2011 with a projected population of 65,930 by 2021 and 85,480 by 2031 • The use of the ratio of the number of units per thousand of the population aged over 75 years is due to this being widely accepted as a ‘threshold age’ for entry to specialised housing. Draft Extra Care Housing Strategy

  15. 13. Need in Dorset (8.3) Draft Extra Care Housing Strategy

  16. 14. Need in Dorset – Rent / Shared Ownership (8.3) (*) Equates to 10 units of enhanced sheltered housing and 12.5 units of extra care housing per 1000 population over 75. Draft Extra Care Housing Strategy

  17. 15. Funding (9.2-5) NOT YET AGREED - The Council will work with partners to develop funding models which make the development of extra care housing possible. It will consider both making land available for such schemes and providing capital funding NOT YET AGREED - The Council is committed to providing funding to enable the development and operation of appropriate extra care housing schemes. NOT YET AGREED - Subject to continuous review, it will continue to commission a core support and unplanned care service for existing schemes. It will look constructively at funding a similar service at planned extra care schemes. As a condition of occupation, all occupiers are obliged to receive, and if appropriate fund, this service in order to sustain an on-site care team and guarantee an emergency response. Draft Extra Care Housing Strategy

  18. 16. Development Priorities (10.1) NOT YET AGREED - Dorset County Council and its health partners need to proactively address this shortfall in provision as part of the strategy to reduce hospital bed based care and the use of residential care. In developing schemes consideration needs to be taken of the following factors. Draft Extra Care Housing Strategy

  19. 17. Development Priorities (10.1) . Draft Extra Care Housing Strategy

  20. 18. Development Priorities (10.3) New or remodel Research has indicated that the costs can be similar. However, some schemes could be remodelled relatively inexpensively. For instance, Synergy Housing has schemes at Turbary Court, Ferndown and Meadows Court, Verwood, which were developed to extra care standards but not commissioned as such. Draft Extra Care Housing Strategy

  21. 19. Development Priorities (10.4) Location - Proposals: NOT YET AGREED • Take account of the relative need in each district and focus on areas with greatest need • Consider development in the settlements in the table on earlier slide • Keep under review the possibility of use of County land for extra care housing on terms to be agreed at the time • Work with public sector bodies to identify potential public sector or Section 106 land suitable for extra care housing. • Work with housing associations to identify sheltered housing schemes suitable for conversion to extra care schemes Draft Extra Care Housing Strategy

  22. 20. Development Priorities (10.5) Tenure It is anticipated that many future extra care housing developments will be mixed tenure. If this is the case care will need to be taken to ensure that charges are reasonable and well publicised. Draft Extra Care Housing Strategy

  23. 21. Development Priorities (10.6) Scheme Size and Layout It is generally considered that the minimum economic size of extra care developments is now around 50-60 dwellings. Smaller developments can have unaffordable service and care & support charges. Draft Extra Care Housing Strategy

  24. 22.Development Priorities (10.8) Facilities - Essential: • Communal lounge(s) • Dining area • Residents tea kitchen • Communal WCs • Assisted bathroom • Scooter store • Car parking • Lift • Manager’s office • Laundry (if no washing machines in apartments) Draft Extra Care Housing Strategy

  25. 23.Development Priorities (10.8) Consideration should be given to increasing viability of facilities by opening them to the wider community. However, this must be set against maintaining service users’ privacy. Draft Extra Care Housing Strategy

  26. 24. Culture (11.1) • At the heart of the development is its culture or ethos. This is evidenced in values and practices that promote independence. Key to the culture are the following desired attributes of a service: • Work to enable, maintain and where possible increase service users independence • Philosophy of ‘working with’ residents, with residents participating in running scheme and activities • Able to meet the diverse needs of residents, for instance ensuring that there is no gender bias in schemes and that same sex couples are supported to live together. • Wide range of social activities and continuing links with wider community, residents made aware of this ethos prior to moving in to avoid any tendency on behalf of residents to unreasonably exclude non-residents. However, clear distinction needed between part of scheme ‘open to the public’ and part reserved for residents. • Relatives’ active participation in provision of support and care encouraged not discouraged • Barrier free environments and design which is enabling • A home for life Draft Extra Care Housing Strategy

  27. 25. Allocation of accommodation (11.2) Some existing schemes were let on the ⅓, ⅓, ⅓ basis. However, services should be provided to people who need them. It is questionable whether this model is financially or ethically viable at a time when demand outstrips supply significantly and budgets are tightly constrained. The following proposals acknowledge that the provision of extra care housing is a partnership between DCC, the housing authority and the landlord: Draft Extra Care Housing Strategy

  28. 26. Allocation of accommodation (11.2) Proposal: The allocation of accommodation at services funded by DCC to be by an Allocation Panel, with representatives from DCC, the housing authority and the landlord. The care and support provider(s) to be non-voting member of the panel. Draft Extra Care Housing Strategy

  29. 27. Allocation of accommodation (11.2) Proposal - allocation be on the following basis: • Schemes adhere to the ethos of being a mixed community of people with differing care needs, typically divided into those requiring differing amounts of help (low, medium and high levels) with their personal care • The optimum mix to be: ⅓ low needs(1 - 5 hours per week), ⅓ medium needs (5 - 10 hours per week) and ⅓ high needs (more than 10 hours per week) Draft Extra Care Housing Strategy

  30. 28. Allocation of accommodation (11.2) Proposal - allocation be on the following basis: • All residents are normally expected to be aged 55 or over. There will be circumstances in which younger adults with disabilities would be suitable for an Extra Care scheme, but this would be the exception rather than the rule. The Allocation Panel would examine such situations case by case. Draft Extra Care Housing Strategy

  31. 29. Allocation of accommodation (11.2) Proposal: Allocation be on the following basis: • People with one or more of the following care and support needs would be eligible for consideration: • Would benefit from a safe environment and housing support to help them continue living in the community. • Are frail or physically disabled • Suffer from depression or some other mental illness which is managed through appropriate treatment and support and be likely to derive psychological benefit from living in this setting • Exhibit some cognitive dysfunction, possibly with short term memory loss and some disorientation. • Have a degree of learning disability • Couples would be eligible to apply where one or both meet the criteria set out in our eligibility criteria above. Draft Extra Care Housing Strategy

  32. 30. Service Model (11.3) The Council supports a core care and support model which provides four key components:- • an initial Settling In Support Programme; • a Health and Well-being Support Programme; • 24 hours support and unplanned care cover; and • Facilitation of a Meals Service providing at least one hot meal each day These should be complemented by a community alarm service capable of monitoring peripherals (telecare and telehealth), door entry system with CCTV. Draft Extra Care Housing Strategy

  33. 31. Service Model (11.3) It is anticipated that service users be required to receive and pay for this service as a condition of occupying a property. There will be at least three services going into an extra care scheme: • The core care and support service • Individual planned care packages • Housing Management These service elements may all be provided by one provider or they may be provided by a combination of providers. It is desirable to encourage further innovation. No one model will meet every situation. A degree of flexibility is required around acceptable models Draft Extra Care Housing Strategy

  34. 32. Charging (11.4) Arrangements for collection of charges from self funders vary between schemes. In some cases some services are provided free of charge to all service users. It is planned to review charging arrangements to ensure consistency and fairness. Draft Extra Care Housing Strategy

  35. Comments to: Robin James : Service Development Officer, Dorset County Council, County Hall, Colliton Park, Dorchester DT1 1XJ : 01305 225904 : robin.james@dorsetcc.gov.uk Draft Extra Care Housing Strategy

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