When the wisdom of age isn't enough
Added on 13/05/2015
Written by Jeremy Porteus, Director of the Housing LIN (Learning and Improvement Network)
In most areas of life there's something comforting about the idea of information and advice. As long as they are of sufficient quality, information and advice can provide a shortcut to sensible decisions.
Given the importance of housing and care decisions older people (and those in late middle-age) face, it is surprising and frustrating that trusted services providing information and advice (I&A) on housing and care remain so fragmented. We need coordinated action and support to ensure that high quality, accessible I&A services are established and embedded in every local housing market.
We also need creativity if we are to move away from a culture where most of those contacting existing I&A services are already in a crisis - such as a stroke, a fall in the home or the death or incapacity of a carer.
I believe this cultural change will need greater sector leadership supported by national initiatives to build on the successes of the relatively small-scale operations currently in place. This central drive would shape clear terms of reference outlining the specific activities needed to develop, promote and sustain local I&A services.
The new government could stimulate that leadership - and support the development of trusted information and advice services across the country - by emulating the framework it has used in the health service, such as NHS Choices. For example, an I&A challenge fund could provide central government cash to local housing I&A providers and partnerships on a competitive basis. The money would stimulate innovative schemes that both help local people and offer potential savings across the housing, health and social care system.
To embed and sustain I&A services locally, a national taskforce could provide 'change agent' approaches that would support local providers and evidence what works.
National 'change agents' could champion innovative and holistic approaches to local I&A services. This means involving enthusiastic older people in developing and testing such services. It means promoting the services. It means ensuring they are accessible through using a range of platforms - from traditional leaflets to helplines and websites.
Local 'change agents' can also drive the much-needed cultural change that would encourage people who might be thinking about their future housing and care needs to engage with I&A services.
However, they can also transform thinking within local authorities and housing and care providers, for whom I&A services are too often an after-thought.
Given the Care Act places duties around information and advice on local authorities, they should be eager to work with their partners in the voluntary sector. Councils and their new NHS commissioning partners should be looking to the resources and services out there.
The Department of Communities and Local Government has supported local FirstStop Advice initiatives led by EAC (Elderly Accommodation Counsel). These have complemented other effective information, advice and advocacy services provided by organisations such as Care & Repair England, Age UK and local providers such as home improvement agencies.
In 2011, the All Party Parliamentary Group on Housing and Care for Older People devoted a chapter to the issue in the report that emerged from its Living Well at Home inquiry. Four years on it is hard to disagree with its recommendation that the government should provide long-term funding for the FirstStop Advice service. It also argued that local authorities should be encouraged to coordinate the provision of face-to-face housing I&A for older people.
However, as a recent joint report by major I&A providers, Making the case - for integrated, impartial information and advice about housing, care and related finance for older people , made clear, people need integrated and comprehensive information and advice services that reflect the links between housing, health and social care.
It is disappointing that the report suggests continued widespread ignorance about the range of housing and support options available for older people. It says: "Many callers to our telephone advice lines assume that if they, or a family member, cannot cope in their current home, the only alternative is to go into care. There is little awareness of the range of possible home adaptations, equipment, telecare/teleheath or floating support services...let alone knowledge of alternative housing possibilities including supported housing."
It defined an integrated or one-stop shop service as one offering advice and information on:
- Housing options involving a house move and those that allowed people to 'stay put'
- Finance options
- Care and support options.
Change is happening. FirstStop Advice, for example, is updating the popular Housing Options for Older People (HOOP) tool. It guides older people or their carers/relatives through the issues they would usefully consider when reviewing their housing needs - including possibly care and support. As a web-based resource it will not be for everyone but it is an example of a smart, complementary service to the organisation's advice line.
I would argue that the new government must not only commit to long-term funding of the existing services, such as local FirstStop Advice schemes, but expand them across England as part of the leadership role I advocated.
With the wisdom age brings, older people are often well-placed to advise the young on life's trials and tribulations. In return, society should be thinking about how we can supply the knowledge they need to make some of the most important decisions in their later lives. This is the real challenge ahead
Jeremy is Director of the Housing LIN and vice-chair of the Housing & Ageing Alliance
Published on 13 May 2015 by the Housing LIN