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Supported Housing for HWB

The future of Supported Housing: Integration – if this is the answer, what is the question? Domini Gunn Director of Health and Wellbeing. Supported Housing for HWB. But. “The burning platform facing public services means that business as usual is just not possible” King’s Fund

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Supported Housing for HWB

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

  2. Supported Housing for HWB

  3. 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..

  4. 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.

  5. 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

  6. 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 studies • Evaluation findings • Distance travelled • Customer feedback • Inputs, outputs & outcomes

  7. A framework – using information as evidence Inputs Activities Outcomes Benefits Value Who is our target population? What & how do we deliver What difference do we make? What can/should we say to commissioners? What does it cost? -Assessment -Support & safety planning -User led • Supported housing • Floating support • Integrated health • End of life care • Specialist services -Review -Move on A possible library of relevant evidence SP / contract outcomes National outcomes relevant to offer 1. Enhancing quality of life & recovery Improving lives Ways to well-being 2. Improving health CIH Outcomes Case studies 3. Delaying & preventing need for care Standards compliance Evaluation findings 4. Safeguarding vulnerable people Use of resources 5. Positive experience of care & support Customer satisfaction

  8. A possible library of relevant evidence A framework – using information as evidence National outcomes and local commissioning priorities 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 Organisation Metrics -Finances -Meaningful use of time -Support networks -Physical health and well-being -Housing -Offending behaviour -Safety -Positive contribution Case studies -Individuals’ journeys Resources consumed -Primary/secondary health -Social care Compliance – reg. standards Satisfaction with services -Client satisfaction survey Evaluation findings -e.g. Discharge project Enhancing QOL Improving health Delay / prevention Safeguarding Experience of care

  9. 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…

  10. 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

  11. The service Quality Tool – provider side

  12. SQT assessor side

  13. Linking ‘distance travelled’ to the calculation of social value

  14. 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.

  15. 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.

  16. 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.

  17. 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?

  18. Sharing resources

  19. 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

  20. Rhetoric to Reality Chartered Institute of Housing: www.cih.orgsource 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 pack www.dh.gov.uk/health/2012/10/hospital-2-home/

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