sitra bulletin 2014 04 final

www.sitra.org

bulletinTHE MAGAZINE FOR HOUSING WITH HEALTH, CARE AND SUPPORT 2014 – NO.4

SportingMemories Proactive

approach totelecare

HomelessHealthcare

Communityentrepreneurs

Closingthe dooron homelessness

Illuminatingideas onlocalism

Money Matters

expertise, training & consultancy inhousing with health, care & support

02 bulletin 2014 No.4 www.sitra.org

Contents03 CEO’s Comment

04 Opening doors to healthAndrew Casey, Director of Homeless Healthcare, explains how the London HomelessHospital Discharge Network is a new set of services aiming to open doors to health forpeople who are homeless.

06 Community entrepreneurs – enterprise and innovation in Notts and HertsCommunity Catalysts, Director of Operations, Angela Cately, tells us about2 of the (micro) community groups they have been working with.

08 Closing the door on the homelessness Jo Driscoll from Warrington Borough Council explains the innovative approach tohomelessness taken in Warrington.

10 Sporting MemoriesTony Jameson-Allen Director of Sporting Memories Network shows the role sport canplay in improving the lives of people living with Dementia.

12 Illuminating ideas on localism in Blackpool Paul Greenwood, Chief Executive of Bay Housing Association looks at how local connectionscan help the integration of health and housing.

14 One Page Profiles for HousingWe reflect on some key points from our One Page Profile Campaign.

15 Money matters Sitra’s Policy Officer Roselee Molloy describes what providers and users of housingsupport services should know about the new standards for National Minimum Wage.

16 Taking a proactive approach to telecare Sue Yeandle Director of Circle at the University of Leeds, discusses the importance oftaking a proactive approach to telecare.

18 Life After Housing BenefitThe National Housing Federations Patrick Murray reveals the key issues raised in theirconsultation looking at how housing costs for people in supported housing might befunded in the future.

20 Sitra Training

Cover Story

SportingMemories

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Sitra StaffChief ExecutiveVic RaynerDeputy Chief ExecutiveLisa HarrisonPolicy OfficersGeoffrey FerresRoselee MolloyLauren SadlerTim Parkin (interim)Policy and Research Co-ordinatorsDani CohenBurcu Borysik

Training and Events Manager Stephanie HillContracts OfficersAnna RobertsonWendy GreenBusiness SupportLana LewisSarah Pink (Maternity leave)Georgina Gorton Head of Finance & Central ServicesBerihu Mohammed

EU Funding and Finance OfficerRay NaickerFinance AssistantAlison QuinnOffice Co-ordinatorGill CottonCentral SupportMonica AntolinSharelle HunteInternsGeni JohnsonLuke Smith

expertise, training & consultancy inhousing with health, care & support

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03THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

CEO’s Comment

Giving housing a sporting chance…….

Vic RaynerChief ExecutiveEmail: [email protected]

Keep up to date with our BlogKeep up with developments and add to the debate at Sitra CEO’s blog at www.sitraceo.wordpress.com

About SitraSitra is a membership organisation championing excellence in housing with health, care and support.

Membership benefits include discounts on all services and events, access to free advice, an annual subscription to the bulletinand regular briefings on key policy developments in the sector. Sitra works with local and central government to ensure thatthe needs of its members are recognised, understood and met by resource providers. If you would like to join Sitra pleasecontact the Membership Administrator on 020 7793 4710 and ask for an application form, or download one fromwww.sitra.orgContent ©2014 SITRA (Services) Ltd except where stated, All right reserved. All images © individual photographers & illustrators. Opinions expressed by individuals writers are notnecessarily those of Sitra or the magazine’s Editorial Team. E&OE. Design: Aquatint BSC 020 8947 8571 www.aquatint.co.uk

Here we are in another ‘summer of sport’ – and love it or hate it – there is certainly noescape! Our headline story ‘plays’ to this theme, and we have a great feature on the

award winning Sporting Memories Network – a reminiscence dementia project – talkingabout how the arrival of the Commonwealth Games in Glasgow has triggered their new

partnership work with a number of Housing Associations in Scotland.Sporting mavericks have dominated the headlines and this edition reports from Blackpool

on the role of the small housing provider as a maverick to watch out for – one with astrong bite! Bay Housing Association showcases the ability of a small organisation to

both engage with and drive the integration agenda. The ‘small is beautiful’ themecontinues with Community Catalysts focusing on the importance of micro providers in

developing a broader market to meet the needs of individual service users. Someexcellent case studies showcase what a difference tailored services can make.

Levelling out the playing field for access to healthcare has been an ambition of HomelessHealthcare, and the London Homeless Hospital Discharge Network is a vital response to

ending the cycle of treatment, deterioration and readmission. This article is a helpfulconnection to the current policy agenda showcasing the importance of bringing together

housing and health to identify integrated solutions to long established design flaws in thecurrent system.

An article focussing on getting AKTIVE might not be all that it seems in this sportingedition! However, it provides an excellent overview of the findings from the AKTIVE

(Advancing Knowledge of Telecare for Independence and Vitality in later life) project. Theproject encourages a proactive approach to telecare, identifying it as a key resource forsupporting the growing ageing population. This is a theme that has certainly dominated

many discussions – at both national and local level and undoubtedly access to, andappropriateness of, telecare is part of an ongoing exploration of options to support

independent living for the older population.

So, to one of the ultimate challenges, the prevention of homelessness. WarringtonBorough Council share their thinking on the key steps they need to take, and how their

focus on prevention and integrated partnership will enable them to achieve their vision ofpreventing homelessness by 2018. Sitra has also included an update on our own

challenge around getting housing to take a collective step towards personalisation. Ourcampaign to encourage the adoption of One Page Profiles across the sector has

succeeded, and we are now planning the next phase of supporting clients and staff toensure the practice continues to spread.

No recent edition of the Bulletin would be complete without a look at what is happeningaround supported housing costs. The National Housing Federation, Sitra, Homeless Link

and Women’s Aid ran together a series of events, webinars and briefings on this issueand views about the longer term position for supported housing costs have been brought

together by the NHF. As this goes to press, it remains unclear what the timeline orprocess for the longer term solution is, but getting the arguments rehearsed is an

important step in the journey.


In 2012 St Mungo’s research1, withHomeless Link, showed only a thirdof homeless hospital patients hadreceived any support around theirhomelessness while being treated.

Many people were dischargedstraight back to the streets withouttheir housing or health problemsbeing resolved. Others dischargedthemselves early because they werenot getting support around theirother needs, (such as alcoholmisuse) while in hospital making itdifficult to engage with them.

The net result? That the healthcondition of homeless peopleleaving hospital rapidly deteriorates,and many are readmitted soonafter – distressing for the individualinvolved, and costly to the NHS.

The London HomelessHospital DischargeNetwork

The London Homeless HospitalDischarge Network, managed byHomeless Healthcare, was createdto end this cycle of treatment,deterioration and readmission.Along with ‘Hospital to Home’projects in Charing Cross andSt Thomas’s hospitals to supportand secure accommodation for

homeless patients, the network isfunded as part of the Department ofHealth’s £10 million HospitalDischarge Fund2.

The Discharge Network offers ‘stepup, step down’ care for homelesspeople who are not ill enough torequire hospital care, but who stillrequire some ongoing care. It isavailable to those who are leavinghospital after a period of treatment,or to prevent admission to hospitalin the first place. This may be seenas equivalent to the care provided byGP, nurse and family members forgeneral population in their homes.Without a home and network ofsupport, it can be more difficult toregain your health.

The Network will initially consistof 34 specifically designed bedspaces, within four existingSt Mungo’s Broadway hostels.Clients are provided with singlerooms, and supported by a nursingteam available during daytime hours,five days a week. This team iscomplemented by a visiting GPservice. Clients can remain in theservice for as little as a few days upto approximately 12 weeks.

As psychological issues are also acommon reason why peoplebecome and stay homeless, these

Andrew Casey, Director of Homeless Healthcare, explainshow the London Homeless Hospital Discharge Network willopen doors to health for people who are homeless.

OpeningDoors toHealth


can act as an obstacle to recovery.The Hospital Discharge Networkteam also includes a part timeclinical psychologist and two parttime psychotherapists.

More broadly, we know that healthcare is only part of the problem:recovery depends on ensuring thatclients have somewhere safe to gowhen they leave. Hospital DischargeNetwork staff will work alongsidehousing support staff within thehostels to ensure that clients are notonly helped to recover their health,but also to move on as theirtreatment comes to a close.

Evaluation of the pilot project thatinformed the design of theNetwork, based in one hostel,showed that providing this type ofhealth supported hostel places ishighly effective: over the pilot yearthere was a 77% fall in hospitaladmissions, A&E visits fell by 52%and ambulance call outs droppedby 67%3.

The first patients were admitted inJune 2014 and we’ll be keepingpeople up to date with progress.

Making the linksbetween homelessnessand health

The Hospital Discharge Network isan important part of HomelessHealthcare and St Mungo’sBroadway’s wider health work,which recognises homelessness asa health issue. Poor health is asignificant cause of homelessness– 36% of St Mungo’s clients in2013 said that a mental healthproblem had contributed to theirhomelessness. Homelessness,particularly rough sleeping, can ofcourse have a detrimental effect onhealth. 67% of their clients report aphysical health need, and 45%have a significant medical problem.Homelessness is oftenaccompanied by multiple andsevere health needs: A quarter ofour clients have a combination ofmental, physical and substance useneeds, and many more acombination of two of these. A keypart of the service is to undertake a

holistic health needs assessmentby a GP or nurse.

Homelessness can make it moredifficult to access health services.Homeless people face a wide arrayof barriers to care, includinginflexible services; single diagnosisled pathways which are unable tosupport their full range of needs;lack of flexible mental healthsupport for people with complextrauma; and a lack of understandingof the impact of homelessnessamong health staff. An importantaspect of the project is helpingclients to engage and stay engagedin health services.

StreetMed is another HomelessHealthcare innovative project – asmall nursing team that combinesthe skills of nursing and homelessoutreach to help bridge the gap inhealthcare provision. Nurses carryout holistic assessments of theperson and then take steps toaddress their identified needs in allaspects of healthcare.

StreetMed take referrals from otheragencies, including outreach teamsand staff within hospitals, toidentify clients in need of theservice. A key component of thesuccess of StreetMed has been theability to follow patients acrossborough boundaries, providingintegrated case management byadvocating across housing andhealth services.

Improving access tohomeless health care

Improving the health of homelesspeople and making health care moreaccessible is vital if progress is to bemade towards the Government’saim of reducing health inequalities4.Critical to addressing the health ofpeople who are homeless is a better

understanding among health staff ofthe impact of homelessness onhealth, and efforts to remove thebarriers to health care.

But tackling poor health amongpeople who are homeless alsorequires efforts to address theirhousing needs. Health andhomelessness are so intertwined,it is difficult to overcome either inisolation.

Both homeless and health servicesmust recognise this and find waysto provide integrated housing andhealth support. This depends onbuilding strong relationshipsbetween health providers andhomelessness services, so that theycan share information and expertise,and offer training to staff andsupport each others’ clients.

The sector should be proud.The London Homeless HospitalDischarge Network is the latest ofmany innovative projects integratingthe work of health and homelessservices. These include the“Pathway” projects that facilitateeffective and safe discharge forhomeless people. Another exampleis tailored psychotherapy such asthe St Mungo’s Broadway Lifeworksservice that provides psychotherapyto people who may be still usingdrugs or alcohol.

This autumn, St Mungo’s Broadwaywill be launching its healthcampaign, A Future: Now. This aimsto raise awareness of the healthneeds of homeless people, andissue a call to action to Health andWellbeing Boards.

St Mungo’s Broadway andHomeless Healthcare, as acommunity interest company, willbe working to ensure that no-one isexcluded from health care becausethey do not have a home.

1 Homeless Link and St Mungo’s (2012) Improving hospital admission and discharge forpeople who are homeless http://homeless.org.uk/sites/default/files/HOSPITAL_ADMISSION_AND_DISCHARGE._REPORTdoc.pdf

2 https://www.gov.uk/government/news/ten-million-pound-cash-boost-to-improve-the-health-of-homeless-people

3 http://www.mungosbroadway.org.uk/services/recovery_from_homelessness/homeless_intermediate_care_pilot_project

4 The Mandate. A mandate from the Government to the NHS Commissioning Board: April2013- March 2015 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/256497/13-15_mandate.pdf


developed and tested an approachthat supports people runningestablished community groups andenterprises to deliver a great servicewhilst also supporting people with agood idea to turn it into reality.

Small-scale voluntary andindependent sector “microproviders” and social enterprises

Community Catalysts supports the development ofsustainable local groups and enterprises that help peopleto live their lives. Angela Catley, Director of Operations,tells us about 2 of the micro community groups theyhave been working with.

At Community Catalysts we believethat small (micro) community groupsand enterprises are essential to thesuccess of personalisation, forminga vital part of a diverse andimaginative local market. There arehowever many barriers to setting upsomething new in any sector and inthe care and support sector thereare more barriers than most! We’ve

can offer community-based,affordable and niche support toindividuals or small groups.” ThinkLocal Act Personal

From 2010 until 2014 CommunityCatalysts worked in partnershipwith Nottinghamshire CountyCouncil (NCC) to stimulate andsupport micro community basedenterprises and organisations. NCCrecognised that if people who needcare or support are to have realchoice and control over their livesthere needs to be a choice of highquality, local and imaginativesupports and services available.

Key outcomesl 275 enquires received from

members of the public inNottinghamshire

l 190 people received active helpfrom the Coordinator RebeccaStanley

l 64 micro-enterprises nowoffering support and serviceswithin their community

l 60 of these are new and wereestablished over the life of theproject

l 900 people who need care andsupport to live their life are usingthese services

l Between them they havecreated 112 jobs and 84volunteering opportunities

l A large number of creative andinnovative services and supportsare now available

The Hertfordshire Micro MarketProject was a partnership betweenCommunity Catalysts andHertfordshire County Council (HCC)running from 2012 until 2014. Theaim was to deliver a wider andmore diverse range of services forindividuals looking for personalisedand individually tailored support.

Key outcomesl Contact made with 157 existing

and emerging enterprisesl 45 people received active help

from the Coordinator TracyAhern.

l 23 of these were alreadyestablished but have beenhelped to develop, diversify orbecome more sustainable.

COMMUNITYENTREPRENEURSenterprise and innovationin Notts and Herts

The Nottinghamshire project to increase the number of micro providers exceededinitial expectations. The partnership with Community Catalysts and having adedicated coordinator in post with the right knowledge and skills has been key toestablishing the work and designing a model for the future…. NottinghamshireCounty Councils commitment to facilitating a diverse local market continues and thelearning from this project is now embedded in the way it works on a day to daybasis. The focus of work with micro providers will continue through a lead role for amember of the Strategic Commissioning Unit who will continue to link into theknowledge and expertise of Community Catalysts…

Sue Batty Group Manager – Strategic Commissioning


l 22 were local people with ideasfor new micro-enterprises, 14 ofwhich were up and running atthe end of the project and 4 ofwhich were very close

l They are used by 476 peoplewho need care and support tolive their life

l Between them they havecreated or sustained 98 jobs and59 volunteering opportunities

l People are funding their supportin a number of different waysincluding self-funders and thoseusing a personal budget.

Sam Niven set up Senior Momentsin 2011 to make a difference to thelives of older people; her serviceoffers a range of support inStevenage, to help people tocontinue doing the things they liketo do. This can include practicalhelp such as assisting withcorrespondence, form filling, over-seeing deliveries and springcleaning, to learning to use the

internet, research family historyand take trips out. Sam’s storyhighlights the difference a micro-

“

”

Hope Springs Horticulture CIC is a user ledorganisation that supports people with enduringmental health difficulties across NorthNottinghamshire. The company is run by HelenPower and Anita Burnett who have thirty years’experience between them of mental health andrunning horticultural therapy projects including 3projects that had been running for many years.Cheapside Allotment Project which grows fruit andvegetables which are then sold locally. ClumberPark Project where volunteers work alongsideNational Trust staff in the nursery in order to gainpractical skills, invaluable for those moving on intoeducation or employment and Sutton LawnsProject based in the old greenhouse complex andspecializing in starting plants from seed.

provider can have on the quality ofa person’s life, particularly whenthey are living with dementia.

‘I started working with Irene about a year ago, she is 104 and has dementia.She has outlived all her family, so only has a very good neighbour that hastaken care of all her affairs as her power of attorney. She has always beenfiercely independent never wanting to go into a care home and has a rangeof services at home to provide the necessary help. I was contacted toprovide some extra support and I now regularly visit Irene …

Through time spent with her I learnt she missed her dogs, so last year Itook my friend's dog to see her, she lit up. On a lovely sunny day wewalked around the block and I was amazed that it sparked her dog walkingmemories and she knew exactly where she was, something that hasbeen rare over the time I've spent with her, when she often thinks she isback where she grew up in Yorkshire. This Christmas we accompaniedIrene to a community Christmas day dinner, not only did this ease theworry of her neighbour who was going to be away, but also took somepressure off the care agencies over a time when they have skeleton staff.More importantly, Irene enjoyed herself. She sang her way out of thehouse and into the car and was clearly lifted by the occasion.

From my perspective, the benefits have been bringing some consistencyand joy to Irene’s life her and from her guardian’s point of view, she valuesthe fact that she is only ever dealing with one person (me!) that she canrely on and trust.’ - Sam Niven.

Following funding cuts these 3 projects were facedwith closure and the team got together to find a wayto save them. Helen and Anita met with RebeccaStanley from Community Catalysts who helpedthem to set up a Community Interest Company andHope Springs Horticulture was formed.

The project has been a godsend to me, it gives mea reason to get out of bed in the morning and isgood therapy’ Service User.

Helen Power says ‘Rebecca and the micro-providernetwork gave us the initial encouragement andbelief that we could successfully set up on ourown. Her on-going support has helped us achieveour aims and led to us now running a well-regardedand thriving enterprise’


Jo Driscoll from Warrington Borough Councilexplains the innovative approach to homelessnesstaken in Warrington.

How do we prevent homelessness,especially during a time whenaccess to both rented and owneroccupation homes is so difficult formany people?

This is a question many localauthorities have been askingthemselves, especially ashomelessness has been on the risenationally, coupled with changes toboth the economic and policyenvironment over the last fewyears. Warrington Borough Councilhas recently adopted an innovativeand fresh perspective to tackle thischallenge.

The Warrington HomelessnessCommission was established withthe aim of objectively leading apublic debate focussed onhomelessness in Warrington,involving key partners from thepublic, voluntary and businesssectors and those citizens of theborough who have directlyexperienced homelessness.

The council appointed anindependent chair – Nick Atkin,

In Warrington levels ofhomelessness are highcompared to other similar andneighbouring areas, with anincreasing number of peopleaccessing services who havecomplex or multiple needs.The establishment of theCommission provided a uniqueopportunity to lead afundamental review andrethink homelessness inWarrington.

DomesticviolenceLack of

welfaresupport

Housingshortage

Lowincomes

Migration

High accommodation

costs

Unemployment

PovertyVictimof crimeOffending

behaviour Poorhealth

and disability

Drug or alcohol

problemsBereavement

Losinga job

Sexualor

physicalabuse

Familybreakdown

Mentalhealth

problems

Experienceof being in

care, prison orthe armed

forcesDebt

Havingparents

with drugor alcoholproblems

Childhoodexperience of homelessness

Relationshipbreakdown

HOMELESSNESS

CLOSINGCLOSINGthe door on

homelessnessthe door on

homelessness


Chief Executive of Halton HousingTrust and Vice Chair of the town’sclinical commissioning group, totake the helm and lead theCommission on this excitingjourney.

Nick said: “Wherever you are inthe country homelessness is acontentious issue. It is one subjectwhere most people have anopinion. Some of these opinionsare based on perception ratherthan reality. The Commissionprovided us with the opportunity tocut through the anecdotes and getto the facts”.

Deputy Leader of WarringtonBorough Council Councillor MikeHannon is chair of the WarringtonPartnership which commissionedthe Homelessness Commission.He said: “There was a strong beliefthat we needed to put this issue onpeople’s agenda and get peopleand agencies talking so that wecan develop new ways of workingtowards preventing homelessness.The creation of the commissionreflects Warrington’s commitmentand dedication to tackling theissues in a positive way andcreating innovative solutions thatwill meet people’s needs. We arelooking forward to seeing how thecommission and its solutionsdevelop and support some of ourmore vulnerable residents”.

Prior to the launch an in-depthdesktop review was carried out topull together the information andevidence. For the first time thisbrought together all the data at anational, regional and local level toinform the next steps for theCommission.

The emerging issues werepresented at the inaugural meetingof the Commission on Monday 7October 2013. Whilst agreeing theaims for the Commission’s work itwas apparent that that whilst muchhas been achieved in Warrington toaddress the aims, much more

remained to be done.

A widespread consultation andengagement programme wasundertaken to understand in detailthe views and perceptions ofstakeholders. It also captured theviews of those people who hadexperienced homelessnessservices, offering the opportunity toexpress their views and concernsdirectly to the WarringtonHomelessness Commission. Aseries of focus groups and one toone meetings took placethroughout October to December2013.

During this time additional activityincluded: benchmarking with otherCheshire Local Authorities, aprocess mapping exercise with thein-house Housing Options Teamand work to gather additionalintelligence and information on thecosts of homelessness, hiddenhomeless, mental health issues,domestic violence and ex armedforces personnel.

To conclude the engagementphase, the Commission held a fullday meeting in December. Thismeeting was held in public, withwide range of stakeholderspresenting, including nationalhomelessness experts andpractitioners, serviceproviders, the Mental HealthOutreach Team, a localadvocacy group and anoutreach worker from theBasement Advisory Centre(a support centre for thehomeless in Liverpool).

A comprehensive approachwas adopted throughoutensuring that theCommission’s work wasdelivered in several stages.Each stage informed the next,resulting in a comprehensivebody of evidence and themesto enable the Commission toidentify key issues andformed the basis of their

resulting recommendations.

During their final meeting, inJanuary 2014, the WarringtonHomelessness Commissionreviewed all findings, identifiedareas for improvement, andpotential solutions. From this theywere then able to agree the tenrecommendations as outlined intheir final report. Our focus onprevention and integratedpartnership working will enable usto achieve this vision by 2018.

Our recommendations include:l Developing a single gateway

approach, with all agenciesinvolved working togetherclosely

l Undertake a strategic review ofcommissioning, managementand delivery of homelessnessservices

l Adopt a preventative approach torough sleeping in the town

l Establish a multi-agencygovernance group lead thedelivery of the recommendationsand future homelessness workin Warrington. This group will besupported by a task and finishoperational delivery group

A full copy of the report and a summary of the Commission’s workcan be found at http://bit.ly/Tzw667


once again evaluated the training,resources and learning of staff andvolunteers involved. There are nowcity and county-wide sports focusedreminiscence activities taking placeacross England and Scotland, withprojects commissioned by CCG’s,Public Health teams or local Healthand Wellbeing Boards.

Sporting Memories Network usesarchive images of sporting heroes,old grounds and teams to helptrigger memories of older sportsfans attending weekly groups. Thesubject matter of sport offers acommon currency and natural topicfor conversations, promotingcommunication and interaction,particularly (though not exclusively)for older men. Some remarkablestories have emerged from sportsreminiscence, including one

Tony Jameson-Allen Director of Sporting Memories Network shows the role sport canplay in improving the lives of people living with Dementia

Recalling great moments of sportcan prove beneficial in promotingcognitive functioning, triggering longheld memories and providing socialactivities that can play their part intherapeutic interventions andactivities offered to people livingwith dementia. Singing, dance, craftand arts all offer stimulating topicsand hobbies that engage andpromote socialisation. Following aWorkforce Development InnovationFund Grant from Skills for Care, theSporting Memories Network pilotedusing sport as a focus for activitiesacross fifteen care homes in Leeds.

The pilot was evaluated by thePersonal Social Services ResearchUnit, London School of Economicsand a wider roll out ensued whichincluded over 60 health, social careand leisure organisations, PSSRU

gentleman who it transpired hadplayed at Wembley alongside BillShankly and Matt Busby. Whilst noteveryone has maybe had such agrand sporting career, most peopledo have a story to tell and focussingon sport can tap into a subject thatis held dear by many and connectscommunities and generations.

In Scotland, a focus on thissummer’s Commonwealth Gamesthat are taking place in Glasgow hasresulted in sporting memorieshooking up with two housingassociations. In Edinburgh a projectis about to commence establishingSporting Memories groups acrossthe City in partnership with TrustHousing Association, LifeCare andDeaf Action and working withDrummond Community School andschools in the Stockbridge area.

SportingMemories


Groups will be established in daycentres and shelteredaccommodation settings, engagingwith residents and older peoplefrom across the communities,assisted by NHS mental healthcoordinators and other projects andinitiatives established in Edinburghsuch as Deaf Action. StirlingUniversity who will be providingobjects to help trigger conversationsfrom their Commonwealth Gamesarchive and Glasgow CaledonianUniversity whose students will helpcapture stories from participants.

Meanwhile the network has alsoteamed up with Glasgow HousingAssociation and Glasgow Life increating a sporting reminiscenceproject which has been grantedofficial XX Commonwealth GamesLegacy 2014 status. The project willinclude an exercise to identify thelegends of sport across the yearsand of course, lots of sportingreminiscence groups and activities.Staff from Glasgow HousingAssociation have been trained assporting memories facilitators andsupplied with the resources to workwith older tenants across the city.

Talking sport also often leadsparticipants to either revisit sportsonce played, or gives an opportunityfor facilitators to offer new games orexercises to engage in. Projects inNorth East Lincolnshire, Wigan &Leigh and York include partnershipswith local sport and leisure servicesand personal trainers. Whilst weeklygroups in Bristol and SouthGloucestershire are facilitated byformer professional footballers andcounty cricketers at the groundsthey once played at.

Professional Sportsupporting sportingmemories

Professional sport has embraced thework and worked in partnership withthe network to engage fans in thewider projects and to raiseawareness of The Prime Minister’sDementia Challenge and theDementia Friends initiative acrossgenerations. Grimsby Town FootballClub enlisted the help of National

Citizen Service students whovolunteered at their MemoriesGame in December 2013. Morememories games are planned withGloucestershire County CricketClub, who held the first cricketmemories match on Friday 23rdMay, when pupils fromBedminsterdown School andvolunteers interviewed supporters attheir T20 game v Middlesex.

To support the work, fans, stars,celebrities and journalists have beensharing their own favouritememories online, which are thenused in the groups to trigger yetmore lively discussion and debates.The Prime Minister, David Cameron

shared two personal memories,London 2012 featuring in his first,his second is below

“An early memory I have is being atthe Canal Turn when Red Rum wonthe Grand National in 1977 – it wasa complete thrill to see such historybeing made!”

The Sporting Memories Networkwas awarded Best National Initiativeat Alzheimer’s Society NationalDementia Friends Awards and arechairing a new task and finish groupwith Alzheimer’s Society as part ofthe Prime Minister’s Challenge onDementia. The group met for thefirst time in June.

The group of men gathered round the table and quicklystarted examining the old photos. Names of players wereenthusiastically shouted out and soon the stories aboutgames, players, goals and incidents were told with greatfondness. The recall was impressive, by any standards.All of these men had dementia.

One well-dressed man sat contentedly reading his paper.“Come on, Bill” said one of the helpers, “you like football,don’t you?” Somewhat reluctantly, Bill joined the group.Using the photos to trigger long held memories, Bill took usback to the 1930s and 1940s as if it was yesterday. Alongwith his boyhood pal, Jimmy, they rattled off scores, line-ups and goals and spoke of legendary figures. As thesession was ending, Jimmy leaned across and whispered,”Bill was a grand player, I saw him play for Celtic.”

Bill was in fact William Corbett, formerly of Celtic, Preston,Leicester, Dunfermline and Scotland. October 1942.England 0 Scotland 0, at Wembley. The match reports allsaid that Bill was the man of the match. “I have neverseen a Scottish centre-half play Tommy Lawton as well asyoung Corbett did this afternoon” said one. All of themsang the praises of the 20 year-old and predicted a brightfuture for him in the navy blue of Scotland.

This young man had faced the might of English football:Hapgood, Britton, Cullis, Mercer, Matthews, Lawton andCompton, all in their prime. A crowd of 75,000 had seen atremendous struggle and young Corbett wasthe star man. Bill was ever so proud pointingto the Scotland line-up on the back of theprogramme. Shankly, Corbett and Busby.“Not a bad half-back line, eh son?”

www.sportingmemoriesnetwork.com

Bill’s Story


I do like to be beside theseaside

There’s a seaside place calledBlackpool, noted for fresh air andfun…. So it was and still is. Sadlythese days it is also known for itspoor rankings in most tables ofdeprivation and health. Lifeexpectancy in Blackpool,particularly for males, is not whatyou would expect with all thatozone knocking about. BayHousing runs schemes for 16-25year olds, three of which aresituated about 500 yards fromthe Golden Mile, midwaybetween the Tower and thePleasure Beach. Wards in thatarea are among the mostdeprived in the country.

Small is beautiful

In Housing Association termsBay is a minnow. We act asManaging Agents for twoRegistered Social Landlords andhave a grand total of 30 bedspaces. To our advantage weonly work in one local authorityarea, Blackpool is a unitaryauthority with a population ofaround 150,000 so is alsorelatively small. However, it isone of the most densely

populated areas in the country,with large numbers of HMOswhich bring many problems oftheir own. It also has a verytransient population, both fromout of area and within the town.This means that, even with only30 beds, we are a significantplayer in the town and we haveworked hard to be on the frontrow with everything. We have areputation for accommodatingpeople when others are unable toand for achieving good results.

Mavericks Rule OK

When I arrived at Bay Housing,over 18 years ago, I had nevereven heard of SupportedHousing. I was drafted in with atrack record of sorting outfinancial and governance issuesin a variety of Church and ThirdSector organisations and sowhile sorting the financial issueswas something I could easilyresolve, improving myknowledge of the sector wasurgently required. So we joinedNHF and Sitra and I set aboutattending meetings and pickingpeople’s brains.

One of the great things about theorganisation is our ManagementCommittee. We still have threemembers who were involved insetting up the organisation, in

Paul Greenwood, Chief Executive of Bay Housing Associationlooks at how local connections can help the integration of health

and housing.

Illuminatingideas on localismin Blackpool


the days long beforecommissioning. They identified aneed and set about doingsomething about it. For manyyears we had a Chair who waswell known for her activities bothlocally and nationally – she tookthe Archbishop of Canterbury forlunch down the local chippy! Sheencouraged me to get involved inthe wider third sector andthereafter served on the localCouncil for Voluntary Service(CVS) Board for almost 10 years.I also chaired the NHF NorthWest Care and Support Group for3 years and have chaired theBlackpool Supporting PeopleForum for 6 years. Additionally,I pursued social activities. As atheatre organist I regularlyperform at prestige venues forcivic events, conferences andeven a royal visit. This gives methe opportunity to meetcouncillors and officials anddiscuss local issues with them.

Housing and Health –Towards the Holy Grail –via Local StrategicEngagement

Where does all this take us youmay be asking? What is thebenefit of all this involvement inthe wider world? You may recallthe Sitra Local StrategicEngagement project led by SueBaxter, the underlying conceptsof which have becomeincreasingly more importantunder the Government's localismagenda. How it helps is wellillustrated by the part I haveplayed recently in a pilot projecton linking Housing and Healthwhich has been going on theBlackpool, run by NationalHousing Federation (NHF),details can be found on the NHFwebsite. We were able to uselocal connections to get theproject up and running. The NHFofficer leading the pilot came toBlackpool on her first visit todiscuss how we might proceed.Her objective was to makecontact with the Council, Healthand the Third SectorInfrastructure body. Using my

contacts, I made a few phonecalls and before she caught thetrain home at teatime we hadseen the Leader of the Council,the Chief Officer of the CVS andthe Director of Public Health.Local connections wereinvaluable.

An important strand in relation tothe health agenda is a connectionwith the local Third SectorInfrastructure Organisation.Many Third Sector organisationshave a long track record ofworking with health. Co-operation and understanding ofwhat they are doing is importantin deciding what and wherehousing can sit and what it has tooffer towards achieving healthobjectives. The Chief Officer ofan infrastructure organisation isfrequently a member ofimportant bodies such as theHealth and Wellbeing Board andis an important link. There arealso regional bodies. In the NorthWest, the Voluntary Sector NorthWest (VSNW) has an officerresponsible for Health issues andtheir knowledge and contacts areinvaluable. As part of the pilot weworked with VSNW to bringtogether representatives fromHousing Associations andorganisation from the widerThird Sector. Both sides found

this a useful experience and wereable to identify possible areas forfuture co-operation.

Lessons in Localism andthe Wider Third Sector

Get involved with local ThirdSector InfrastructureOrganisations. Not an easy taskfor larger Association who maywork across dozens of localauthorities. It is a new departureto deal with someone other thanthe Housing Department in anauthority. The question you willneed to answer is who does thattask and how do they fit into yourstructure and feed inintelligence?

Do not forget the smallorganisations. They are oftenquite near the coalface in termsof Local Strategic Involvement.Large Associations will oftenhave Managing Agents who havea good deal of local knowledgeand connections. Make use ofthem.

Identify and use the mavericks inthe world. They often succeedbecause of who they are andwhere they are.

Making the ConnectionSitra is pleased to announce its new Making theConnection programme designed to help housingorganisations navigate their way through thechanging landscape of health & social care. Housinghas an important contribution to make in achieving aperson-centred health and social care system, butwithout conscious effort it can all too easily find itselfleft on the margins.The programme is still evolvingbut includes hot topics, briefings on specific areas ofinterest, training courses and tailored consultancyand is designed to help organisations identify boththe challenges and opportunities available.

Forthcoming Hot Topic include:4 September: Health and Wellbeing Boards: Hearing the housing voice18 September: Making partnerships work

Find out more about Making the Connection on the Sitra website –

bit.ly/SitraMtC

One-Page Profiles for

HousingWhat peoplesay about One-Page Profiles

What’s important forOne-Page Profiles

How tosupport thecampaign

We are currently aware of 10,000 One-Page Profiles that are in use in the UK housing with support and care sector. The numbers are gradually increasing, as organisations are learning how a simple tool can help enhance conversations between clients and staff and enable effective support.l ‘A Powerful tool in changing how people are perceived and supported’ – Michael Smull, TLC-PCPl ‘It's about helping to improve services and human beings relating to each other’– Ceri Shephard, Transformation Manager, Look Aheadl ‘They enabled us to link people with similar interests and provide truly person-centred support’ – Steve Scown, Chief Executive, Dimensionsl ‘An easy reminder of how we must treat each service user as an individual’– Lisa Rogers, Quality and Performance Manager, Andover Mencapl ‘We support people with learning difficulties into open employment, and One-Page Profiles have been really useful in allowing us to share information about our people with their employers in a positive way.’ – Hadassa Kessler (Supported Living Development Manager, Kisharen)

l Simplicity is key to One-Page Profiles, as they give individuals a way to communicate important information as succinctly as possible. l One-Page Profiles need to be evaluated as part of the broader personalisation and coproduction agenda- how could a personalised service be delivered without knowing what is important to the person and how they wish to be supported? l One-Page Profiles are about starting conversations, true and honest ones between individuals. The mutual sharing of information breaks down the barriers between clients and staff that prevent them from forming equal and reciprocal relationships. l Finally, As Smull says ‘they are a means to an end, not an end - It is about how the profiles are used and NOT just that they exist.

l Visit our website to find out about how One-Page Profiles help promote effective and personalised housing with support and care services. l View our One-Page Profile gallery and read stories of Sitra staff and members. l Share your stories of implementation and inspire othersl Keep the discussion going on Twitter by using the hashtag #onepp

One-Page Profiles have been established in social care for some time and were adopted by the health sector during the inaugural NHS Change Day in 2013. Since Sitra’s annual conference ‘Change Makers’, we, along with our colleagues in Helen Sanderson Associates have been striving hard to promote the use of One-Page Profiles for housing with support and care in England.


A Fond FarewellMany of you will have worked with SueBaxter our Policy and Practice Office over thelast 13 years. Last month Sue left Sitra for anew challenge and we would like to take thisopportunity to thank Sue for her invaluablecontribution over the years and wish her thevery best for the future.

An Honourable MentionWe were delighted to hear that SitraAssociate Clenton Farquharson was awardedan MBE in the recent Queen’s BirthdayHonours. Clenton is co-chair of Think LocalAct Personal and was recognised for hisservices to disabled people and the WestMidlands Community.


Whittlestone v BJP Home Support (July. 2013)Employment Appeal TribunalThis case involved a floating support worker who wasrequired to stay overnight with service-users in theirhomes. She was paid a flat rate of £40 for a shift from11pm to 7am and given a camp bed. The carer claimedshe was entitled to NMW even when she was asleep asit was work. She lost at the employment tribunal butwon on appeal. The judge agreed that it was work. Hewrote, ‘she would have been disciplined if she had notbeen present throughout the period of time; she couldnot for instance slip out for a late night movie or for fishand chips. The fact that her physical services were notcalled upon during the night were… irrelevant since herjob was to be there.’

Travel time

Whittleston (as cited above) also ruled on the issue oftravel time between floating support clients. Carers areentitled to be paid the NMW for the time spent travellingbetween service-users when there is insufficient timebetween visits to go to one’s own home.

A bit of history

The Government has been looking closely at the issue ofNMW in the care sector for some time. In 2012 theWhite Paper ‘Caring for our Future ’ promised to look atthe issue of travel time. The HMRC carried out aninvestigation into the NMW compliance of care providersand released their report in November 2013 stating ‘Thisreview has identified higher and increasing levels of non-compliance with NMW legislation than has beenpreviously found in the sector indicating that employersneed to be much more diligent in ensuring workers’ payis compliant with NMW legislation’. Travel time wascited as a major reason for non-compliance.

The National Minimum Wage (NMW) is going up inOctober 2014. The NMW will be £6.50 per hour foradults and the Government has hinted that a largerincrease could be on the way. This represents a 3%increase, compared to a rate of inflation forecasted at2.3%, and is in line with the Low Pay Commission’srecommendations1.

Further, employers who fail to pay the NMW will nowbe subject to fines of up to £20,000, an increase of£15,000.

Overnight Workers

There are several factors to consider in determiningif an overnight worker is entitled to NMW. The firstis whether they are salaried or hourly workers.When an employee is salaried and sleep-ins aredefined as part of a worker’s ‘core-duty’, then it isexpected the worker must be paid NMW for everyhour of the sleep-in.

In contrast, for hourly workers, two recent legal caseshave found the worker was due the NMW regardlessof the definition of duties.

Esparon t/a Middle West residential Care home vSlavikovska (May.2014) Employment AppealTribunalThis case involved a worker at a care home who waspaid a flat rate for sleep-ins. She contended that herduties through the night required her to be up andtherefore entitled to the NMW. Her employer deniedthis. The EAT looked at the fact that the employerwas statutorily obliged to have a staff memberavailable on site all night, regardless of whether theyare awake or asleep. Based on this duty, the workerwas entitled to NMW.

Sitra’s Practice and Policy Officer Roselee Molloy describeswhat providers and users of housing support services should know

about the new standards for National Minimum Wage.

Moneymatters

1 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/288841/The_National_Minimum_Wage_LPC_Report_2014.pdf


can better benefit those caring forolder individuals, both paid andunpaid carers.

The methodology

Our innovative mixed methodsapproach differed from manyapproaches to telecare research.Key to our methodology wassomething we call ‘Everyday LifeAnalysis’. This involved a rich mixof discussions and observations,and included 60 older telecareusers in a longitudinal study. Italso took a holistic approach byintegrating views from carers, thesector, market and industry, aswell as focusing upon the usersthemselves. Through EverydayLife Analysis, we gained anincredible amount of insight intohow telecare is embedded intopeople’s everyday lives byexploring options, opportunities,potential and barriers.

AKTIVE launched in May 2011 andconcluded at the end of May2014, making a wealth of socialresearch publicly available.Lessons from this research arerelevant to anyone who isinterested in improving the qualityof life of our older population,ageing in place, supported self-help and making the best use ofresources.

The challenges

Through AKTIVE we wanted toaddress the challenges arisingfrom our ageing population andexplore and understand theopportunities for telecare inrelation to these challenges. Wewere particularly interested inaddressing how telecare can helpindividuals who are prone to fallsor who have dementia. We alsowanted to examine how telecare

The findings

Findings from the AKTIVE projectwere revealed in April at ourdissemination conference, and theinitial five working papers havenow been published, furtherpapers will be published shortly Allthe papers can be found athttp://circle.leeds.ac.uk/projects/current/aktive/

Five Initial Working Papers1. Researching telecare use using

everyday life analysis:Introducing the AKTIVE workingpapers (Sue Yeandle)

2. Frail older people and theirnetwork of support: How doestelecare fit in? (Sue Yeandle)

3. Telecare and older people'ssocial relations (Emma-ReetaKoivunen)

4. Coping with change: Frailbodies and daily activities inlater life (Gary Fry)

Sue Yeandle, Professor of Sociology and Director of the Centre for InternationalResearch on Care Labour and Equalities (CIRCLE) at the University of Leeds discussesthe importance of taking a proactive approach to telecare in light of recent findingsfrom the AKTIVE (Advancing Knowledge of Telecare for Independence and Vitality inlater life) project.

Taking a proactiveapproach to telecare


5. Lifestyles in later life: Identity,choice and stigma

The learning

Through AKTIVE we have learnedthat telecare is not a simpleintervention but a varied mix of‘tools for living’. We know thattelecare can help form a supportsystem that connects people toone other, and to timelyassistance. These tools for livingcan help people living with frailtiesto exercise choice and retaindignity. They can help people todo what they want, where theywant to be, and in their own way.These tools for living can evensave lives. However, we alsofound that some older peopleresist telecare because they find itstigmatising, awkward ortroublesome to use. Theseresponses gave us indicators towhat needs to change, and howwe can make changes.

Telecare systems can indeed helpus rise to the challenges of ourageing population. However, thismeans stakeholders, includingpolicy makers, industry, thehousing, health and social caresectors and users themselves,working more closely together toadopt more proactive and

preventative approaches. Theknowledge obtained from theAKTIVE project can now beaccessed via our websites andused to make a real and lastingdifference to people’s lives.

Better care for our ageingpopulation is of interest to us all,because it will impact us all.Therefore, I strongly urge anyonewith an interest in this field,particularly policy makers,commissioners and assessors, toread our research and, even moreimportantly, to use and apply the

research so that we can all bemore proactive in addressing thechallenges of our ageingpopulation.

The AKTIVE project was fundedby the Technology Strategy Boardand Economic and SocialResearch Council and led byCIRCLE, with partners at theUniversity of Oxford, TunstallHealthcare and Inventya Ltd, theAKTIVE research project exploredhow telecare can be developed tohelp older people live full andindependent lives.

Find out more about the AKTIVE projecthttp://circle.leeds.ac.uk/projects/current/aktive/

Access presentations and video from the final AKTIVE conferencehttp://www.aktive.org.uk/2014_presentations.html

Housing Benefit will be abolished in2018, so a new system for fundinghousing costs in supported housingwill need to be designed soon.DWP had said little since theirpoorly received consultation in2011, other than they wanted alocalised system with costscontrolled going forwards. They arecurrently considering how theywant to devise a new system.

To help inform future consultations,the National Housing Federationlaunched our own consultation inJanuary looking at the keyprinciples on which any futuresystem should be based. After aseries of events across the countrywe produced a summary paper,which has been submitted to DWP. So what were the key principleswe identified, and why did peoplefeel strongly about them?

“The system needs to be basedon individual entitlement”

The principle of individualentitlement was consideredfundamental. The current systemmeans that if you need supportedhousing, you can claim for thecosts of providing that housing. Ifthat link is broken vulnerablepeople will be left unable to access

18

Life AfterHousingBenefit

The National Housing FederationsPatrick Murray reveals the key issuesraised following the NHF consultationin January looking at how housing costs

for people in supported housing mightbe funded in the future.

bulletin 2014 No.4 www.sitra.org

schemes and the whole system isput in jeopardy. The DWP’s originalproposal of an Local HousingAllowance (LHA) plus fixed top-upsystem would mean that claimantswould potentially not be able toclaim the full amount of theirhousing costs and would have tofind extra money which manywould struggle to do.

“The system for funding housingcosts must reflect the actualhousing costs incurred in theprovision of supported housing,but should remain treatedseparately from funding forsupport or care”

Another key principle is the need ofthe future system to accuratelyreflect legitimate housing costs sothat continued investment in newprovision could be maintained.However, given the context ofreducing funding for support, it isimportant to keep the housing costsseparate from funding for supportand care. That way there would be asecure source of income to keep abuilding running. The separation isalso necessary as in so many casescare, support and housing areprovided by different organisationsand it would very difficult to rolleverything into one single fund.

“DWP should examine otheroptions than devolving anyfunding pot to local authorities,such as examining alternativesolutions delivered throughnational bodies such as theHomes and CommunitiesAgency (HCA), or theDepartment of Health, deliveredthrough Health and Well-beingBoards (HWBs)”

Unsurprisingly, in the context ofwhat has happened to SP budgetsacross the country, the option of alocalised system was not popular.There were a number of alternativesuggestions put forwards. One wasto deliver supported housing costsnationally through the HCA. Thiswould provide a link with capitalfunding, and ensure that revenuesupport was run by a body with agood knowledge of the supportedhousing world.

Another option was to hold thefunding in the Department ofHealth, and deliver it locally throughHealth and Wellbeing Boards(HWB). Again this would provide alink with capital funding, and ring-fencing in health is still commonpractice. At a local level HWBsoffer a strategic oversight bringingtogether health and localgovernment, and the incentive to


continue investment in supportedhousing should be as strong as thepreventative role many schemesplay offer savings for the NHS.However this model would requirefurther examination – including howto ensure it was not restricted toonly those meeting social carestatutory eligibility, how the moneywould avoid being swallowed updue to NHS pressures, and howthe level of expertise needed todeliver this system at HWB levelwould be developed.

“If any localised system were tobe devised it would be criticalto ring-fence funding or at thevery least develop a verystrong incentive for the moneyto be used as intended, and notsiphoned off to meet otherpressures”

If the DWP do indeed decide todevolve the money to localauthorities the need for a ring-fenceis clear – the result of removing thering-fence from SP budgets hasbeen catastrophic. Without a verystrong incentive, the financialpressures that local authorities areunder would mean the fund wouldcome under strong pressure.

“Any proposed solution must beflexible enough to deal with thewide variety of client groups”

One of the issues identified fromthe DWP’s 2011 consultation wasthe inability of a system with fixedtop-up costs to be flexible enoughto reflect the wide variety ofschemes serving different clientgroups that make up the supportedhousing sector. No scheme willwork, and ensure a thrivingsupported housing sector, unless it

allows sufficient flexibility forwhoever is managing it torecognise and fund the legitimatehousing costs for such a variety ofschemes and client groups.

“Transitional arrangements arehugely important in order tosafeguard historic investment”

This was a really important point.Current capital funding streams aresimply unable to replicate theamount of historic investment putin to supported housing schemesacross the country over manyyears. Moving to a new systemwhich could put at risk the onereliable revenue funding stream forsupported housing meansproviders may decide it is too riskyto operate existing schemes andeither sell them or turn theproperties into general needs. Itwould be highly unlikely provisionwould be replaced on the samescale.

“Any solution should givecertainty for the longer term inorder to ensure continuedviability of existing schemesand investment in newschemes”

The current approach for investingin new schemes relies in large parton providers raising significantprivate capital, often throughlending, as capital grant does notcover the full build costs. Thereforeany new system must allow for thefull recovery of build costs and loanrepayments within the rent,otherwise providers will not investin new supported housing. Thefunding stream must also be robustand certain enough to satisfylenders requirements in order to

access private funding.

“The rents charged byregistered providers arealready regulated via the HCA”

Supported housing providers werekeen to point out that many arealready regulated by the HCA,meaning that they cannot chargeexcessive rents and this acts as acontrol on the overall cost of thesystem, as well as the quality ofprovision.

There were a number of otherissues raised throughout theconsultation, including two otherimportant principles.

Firstly there was a strong steerthat sheltered housing should betreated separately as a differentproduct serving a different clientgroup. This fits well with thedifferent timetable for pensioncredit and the possibility formeeting housing costs through thatsystem, although thought will haveto be given to those in shelteredhousing of working age.

Secondly the thorny issue of sizingany localised pot will proveextremely difficult. This doesprovide some incentive to devise anational system, despite DWP’spreference for a localised system.It will be critical to identify allsupported housing, which localauthorities have so far not done.Often housing benefit departmentshave been reluctant to acceptexempt status for properties or havenot been particularly concerned withidentifying registered providersstock. There is also a real challengeto ensure that future demand isreflected in however a fundingstream may be split up.

You can read the full paper on the NHF websitehttp://www.housing.org.uk/publications/browse/future-funding-of-housing-costs-in-supported-accommodation

Confused about recent announcements on exempt accommodation? Or need personalisedadvice specific to your projects? Sitra consultancy can offer bespoke packages of advicefrom our in-house specialist Geoffrey Ferres, starting at just half a day. Contact WendyGreen on [email protected] or ring 020 7793 4715

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