Specialist Housing and Support for Older and Vulnerable People

Background

By 2030, there are projected to be around 70,000 people over 65 living alone in Somerset, most of whom will be aged 75 or older. The 90+ population is also projected to rise from 5,100 in 2008 to 18,700 in 2033.

As people get older, their housing needs often change. The ‘Housing and Older People Study, Taunton and South Somerset Housing Market Areas' (Fordham Research, 2010) reported that few older people (aged 55 and over) planned for future housing needs and it is only unexpected events or sudden deterioration in health that necessitates moving to specialist accommodation. However, when asked why they didn’t plan ahead, a major factor was a lack of awareness of the options open to them and the precautions they should take to prepare. 

Some people need support to be able to continue living in their own homes. Some people, of all ages, have disabilities that mean their homes need to be adapted. Other people need help if they become homeless. They often need advice and access to services to stop them from going back onto the street. Some of these people have mental health problems that mean they need extra support.

Specialist Housing

Sheltered Housing is a relatively low level preventative service that effectively stops the escalation of problems to more severe and expensive solutions. There is support within these schemes for both mental health and physical needs, allowing them to maintain their independence, which is a key priority of the Health and Wellbeing Strategy. Without this, greater intervention would be needed from social services, with additional relocation to higher cost residential care schemes. Sheltered Housing prevents, or at least delays, reliance on more care based services.

Sheltered Housing is also complemented by a response to alarm calls service that aims to prevent the involvement of emergency services and admissions to A&E that often results in ‘bed blocking’ caused in hospitals. Just as importantly, regular Health and Safety checks and support provided by staff prevents the likelihood of slips, trips and falls in the first place and therefore the need for any intervention.

Sheltered Housing staff also manage neighbour issues, preventing these from escalating into disputes and maintaining community cohesion. They also signpost other public sector services and support (such as benefits advice), providing a more joined up and efficient public sector response to this vulnerable sector of our society. 

Extra Care housing, sometimes called 'very sheltered housing' or assisted living apartments, is a growing and popular part of the 'housing with care' market. Most ‘extra care’ consumers are older people and they often find it attractive because it offers them independent living in a home of their own with other services on hand if they need or want them.

Extra care is gaining a reputation for being able to accommodate people who would otherwise be frequent users of acute services, largely because their housing is unsuitable for them to self-care. It is also arguably a better accommodation option than long-term care for older people unable to return home after a period in hospital because their housing is unsuitable.

Supply of Specialist Housing

The Somerset Strategic Housing Market Assessment (SHMA), published in October 2016, estimated that there are just over 7,600 units of specialist accommodation across the county (approximately 7,000 Sheltered and 600 Extra Care); this is equivalent to 132 units per 1,000 people aged 75 and over (ranging from 112 per 1,000 in Sedgemoor up to 151 per 1,000 in Mendip).

Demand for Specialist Housing

The Somerset Strategic Housing Market Assessment (SHMA) identified a potential future need for 9,879 specialist housing units - 395 per annum in the 2014-39 period. This was based on national analysis by Housing LIN, suggesting that that there should be around 170 units of specialised accommodation per 1,000 people aged over 75 years.

At 31st March 2017, more than a thousand households on the Homefinder Somerset (the choice-based letting scheme) expressed interest in sheltered housing (see below)

At 31st March 2017, 199 households on the Homefinder Somerset were interested in Extra Care housing (see below)

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Housing Support for Vulnerable Individuals

A range of organisations in Somerset provide support to vulnerable people with housing needs. Analysis of the varying needs and size of this group has been captured in a series of research reports, summarised below.

Housing Support for Vulnerable Single People Needs Analysis (2015)

A Needs Analysis in 2015 sought to build an overall picture of vulnerable people requiring housing support. Data was requested from a number of services, including Pathways to Independence (P2I) and Pathways for Adults (P4A) housing support services, IMPACT, Somerset Drug and Alcohol Service (SDAS) and Somerset County Council’s Leaving Care service.

The analysis identified that between January and December 2014, a total of 1,570 people were identified who had contact with P2I/P4A providers or who were on the caseload of SDAS, IMPACT or Leaving Care and had some level of accommodation support need identified by that service.

The analysis identified that all services had a high proportion of clients with a housing support need who also had a substance misuse issue. Additionally, a high proportion of individuals with P2I, P4A and SDAS services had a recorded co-existing mental health issue of some degree. Where the information was provided, the picture suggested that more males than females were accessing or requiring housing support.

P2i (Pathways to Independence) Needs Analysis (2015)

A P2i Needs Analysis, published in 2015 (downloadable here) provided detailed quantitative and qualitative data about young people with housing needs. Key facts and figures included:

• Between April 2013 and March 2015, 717 people received support from P2i services, which could include one or more of the following:-
  • Supported accommodation;
  • Temporary emergency accommodation;
  • Flexible floating support (help to support people maintain their own independent accommodation or remain at home with friends and family)
• Almost half of those supported by P2i in this period were aged 17 to 19. The most common age is 18, after which numbers decline with age.
• At 31st March 2015, there were with P2i: 204 people in supported accommodation; 125 receiving flexible or floating support; and 6 in emergency accommodation.
• 61% of young people accessing P2i services (excluding Care Leavers) received support for homelessness, but other issues included mental health (10%), substance misuse (8%) and rough sleeping (5%).
• Care Leavers constitute a major group of vulnerable young people with specific needs around housing. 519 young people aged 16 to 25 were supported by the Leaving Care team in Somerset between April 2013 and March 2015.

Details of the P2i service currently provided are on the P2i website. 

Socially Excluded Needs Analysis for Somerset (2011)

A report commissioned by Somerset Drug & Alcohol Partnership (SDAP) in 2011 estimated that there were approximately 1,862 ‘socially excluded’ people in Somerset, representing 0.36% of the county’s population. A total of 1,149 people in the socially excluded client group passed through supported housing services commissioned by Somerset County Council, of which;

• 497 were single homeless with support needs,
• 202 were rough sleepers/people with substance misuse problems,
• 373 were people with mental health problems,
• 77 people were offenders or those at risk of offending.

One of the major needs identified by the socially excluded cohort in supported housing was help in securing move-on accommodation. This confirmed findings within the 2008-11 Homelessness Strategy for Somerset Making Homes, Helping People, Changing Lives.

Customer Insight Research: Obtaining and Maintaining a Secure Home (2015)

A 2015 research report from Mendip District Council explored the factors that influenced individuals’ abilities to obtain and maintain a secure home. More specifically the research explored the needs of those in non-secure accommodation, how these needs were currently being met and the barriers these people faced and the support/services that could enable better alternatives to the current provision.

An overarching theme of the report was that many of the barriers to progression lay within the behaviours, perceptions and lifestyles of the customers themselves. The following ‘opportunity areas’ were identified:

• Addressing both the harmful and beneficial influence of entrenched social networks, and to capitalise on the strength of family relationships.
• Empowering individuals with the knowledge and understanding of a full range of options and actions that can help them progress and achieve goals.
• Distinguishing between potential cohorts of individuals and their varying support needs, and minimising the negative influence of harmful behaviours and lifestyles within temporary accommodation.
• Supporting customers to work towards realistic ambitions – based both on their capabilities and available housing options.

Further reference:

• Somerset Extra Care Housing Strategic Review 2008
• Dementia in Somerset