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Care Where We Live: Local government's role in adult social care reform

Care Where We Live: Local government's role in adult social care reform

Housing is featured prominently in this new LGA report (theme 6). Against the backdrop of the Casey Commission, it makes the connection that housing is key to independence, prevention and wellbeing, recognising that housing-with-care options, accessible housing, home adaptations and lifetime adaptable design should all be viewed as core components of adult social care rather than separate policy issues.

The report makes a number of housing-related recommendations, including:

  • A focus on prevention. A future adult social care system should be built far more around preventing, delaying and reducing the escalation of need. Achieving this will require prevention and housing to move from the periphery of reform discussions to the centre, supported by dedicated investment, stronger accountability and a much closer alignment between care, housing, communities, public health and wider public services.
  • Government should recognise housing as a core component of care, prevention and independence, not simply as a related policy issue, and work with local government, housing, health and care partners to develop a National Care, Wellbeing and Housing Plan for England.
  • Every decision about care made by an individual and family includes a decision about where to live. This can include adapting homes to make them best able to use latest technology, optimised for safely moving and getting around, and making sure that specialist equipment to support disabilities can be used. It can also include moving to a shared setting where isolation can be combatted and where onsite care can be delivered.
  • We need housing to be considered and treated as an equal partner to care and health, in line with people’s preferences and in recognition of housing being a key wider determinant of health. This means housing options being planned for and developed in a way that is inextricable from the strategic planning and commissioning of health, care and support. It could include state support and incentives to downsize, such as grants to help people clear their homes, or even consideration of the role of property taxes. Councils would be willing partners in housing and care development as part of social care reform, particularly if they had better and easier access to capital funding.
  • The recent Social and Affordable Homes Programme 2026-2036 provides the framework for housing development for older people and people with care needs. This will only work if housing associations, Mayors, strategic councils, and councils with social care responsibilities work together on local plans, and, 
  • The expansion of housing related care settings since the late 1960s has grown significantly but has stalled in the past 10 years. Many councils have, for financial reasons, had to abandon ‘warden’ supported housing and the development of extra care, and supported housing settings – which include affordable rent, private sale and shared ownership – has been sporadic and not well planned. In total, there are approximately 74,000 housing with care units in the UK  (where people live in a home), compared with around 530,000 residential care beds (where people live in one room). This situation should be reversed. 

On the latter, the Housing LIN was originally established in 2002 by the Department of Health as an in-house team to support the deployment of the then housing with care capital programme. Over the next decade until its government funding was withdrawn, the Housing LIN was directly responsible for funding the development of over 90 new schemes - the largest period of growth for the sector ever. It is therefore not surprising to note that LGA state that supply subsequently stalled.

Commenting on the LGA report, our CEO Jeremy Porteus said:

We are immensely proud of our achievements whilst in the Department of Health and since becoming independent of government have continued to build on our ethos of shared sector learning and improvement to further stimulate the market for more age-friendly and technology-enabled mainstream and specialist/supported housing. This aligns closely with the HAPPI and TAPPI principles and is core to our major upcoming SHAPE Exchange programme. We look forward to working closely with the LGA to integrate housing in local health and care localities and on how housing can shape the care where we live.

Click on the following links for more about HAPPI and further information on TAPPI. And register for SHAPE so you can keep updated on our forthcoming funding call with Vivensa Foundation.