Supported Housing for HWB

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

The future of Supported Housing:Integration – if this is the answer, what is the question? Domini GunnDirector of Health and Wellbeing

Learn with us. Improve with us. Influence with us | www.cih.org 2

Supported Housing for HWB

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Service models that

are fit for purpose

Meeting changing needs

of partners & customers

Ensuring strategic fit with

future social care and health

priorities

VFM & social value of current

provisionUnderstanding

current & future demand

Making the best use of

community based assets


But..• “The burning platform facing public services

means that business as usual is just not possible” King’s Fund

• The Graph of Doom• The Tsunami of Ageing• The rising cost of housing• Cuts in Supporting People• Increasing levels of homelessness• Crisis in mental health services..


Family Mosaic – Health begins at home

• Assessments with 600 tenants over 65:– 92% of participants reported at least

one long-term health condition– a third suffered from depression– 40% have back pain and – 44% arthritis– half of participants felt lonely all or

some of the time.


The impact …

• The first 445 people surveyed had made:– 1,719 planned GP visits – 159 emergency GP visits– 1,124 planned hospital appointments– 156 visits to A&E and– spent 455 nights in hospital.

Potential saving of £4.7 million per year


Impact narrative• Achieving integration for Housing needs to be

about building an ‘impact narrative’, across a number of different outcomes or domains, drawing on a number of different evidence sources, including:

Case studiesEvaluation findingsDistance travelledCustomer feedback Inputs, outputs & outcomes


CIH Outcomes

What & how do we deliver

A framework – using information as evidence

What does it cost?

Who is our target population?

What difference do we make?

Inputs Activities Outcomes

What can/should we say to commissioners?

Benefits

Nat

iona

l out

com

es re

leva

nt to

offe

r 1. Enhancing quality of life & recovery

2. Improving health

3. Delaying & preventing need for care

4. Safeguarding vulnerable people

5. Positive experience of care & supportA po

ssib

le li

brar

y of

rele

vant

evi

denc

e SP / contract outcomes

Improving lives

Ways to well-being

Evaluation findings

Use of resources

Customer satisfaction

-Assessment-Support & safety planning-User led-Supported housing-Floating support-Integrated health-End of life care-Specialist services -Review-Move on

Value

Case studies

Standards compliance


Case studies-Individuals’ journeys

A framework – using information as evidence

National outcomes and local commissioning priorities

A possible library of relevant evidence

SP / contract outcomes-Economic well-being-Enjoy & achieve-Be healthy-Stay safe-Make a positive contribution-Positive move-on

Improving lives-Comfortable & secure homes-Adequate income-Safe neighbourhoods-Getting out and about-Friendships & learning-Keeping active & healthy-Relevant information

Ways to well-being (mental well-being)-Connect with others-Be active-Engage with things around you-Keep learning-Give 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


Key challenges• Finding a balance between retrospective analysis, and what

will support your offer in the future

• There is plenty of research about what improves the lives of people – what is your role in this and what impact does your work have on national outcomes?

• Contacts & relationships – key success indicator

• Providers or commissioners?

• What are the local commissioning and health priorities? This will help to shape your offer in different areas

• Very little of the data collected now through monitoring tells health and care providers or commissioners about your expertise in relation to the national outcomes, so…


How might we do it?• Constructing a narrative from different perspectives• Looking at costs AND benefits• Different measures require a different approach –

need to reflect local commissioning priorities• Critical analysis of your evidence base – where are

the gaps?• Focusing just on the national outcomes is likely to

limit what you can say• Coherent, evidenced, outcome focused, costed

case that can deliver high quality services



The service Quality Tool – provider side


SQT assessor side



Linking ‘distance travelled’ to the calculation of social value


The system will have a menu of person centred needs assessments and support plans already in place, but providers can also use their own, provided they read across to the outcomes framework applicable to the service.


If there is evidence to demonstrate that the service provided more input than the service user recognises, there is an option to modify the service input score, with agreement from the commissioning authority.


The Care Bill

A Bill to reform the law relating to:• Care and support for adults and the law relating to

support for carers• To make provision about safeguarding adults from

abuse or neglect• To make provision about care standards• To establish and make provision about Health

Education England• To establish and make provision about the Health

Research Authority, and for connected purposes.


Radical change• Pulls together over 12 existing Acts into a

single modern framework • Fundamentally reforms how the law works

placing people’s wellbeing , needs and goals at the centre of decision making

• Individuals will no longer feel that they are battling to get the care and support they need

• Puts carers on a par with those for whom they care

• Better Care Fund etc – new money?


Sharing resources


CIH resources & tools• Service Quality Tool – SQT – DCLG sponsored• Social Value – housing related support• Working Together: older people’s service

remodelling• Working Together:

Safe at Home• Corporate partnership • Policy & practice

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Rhetoric to Reality

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

What you need to know about the care bill - CIH briefing 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 packwww.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/CIH_briefing_on_the_Care_Bill

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



Documents

Supported Housing for HWB