What’s my line?

Remember this? Back in the archives of BBC, you can find old episodes of this cult game show where members of the audience were invited onto the stage by the inimitable Eammon Andrews and invited to ply their trade, moving themselves into ever exaggerated contortions to relay the essentials of their daily job to a relatively clueless guest panel! Oh how we laughed!

Roll forward 40 years – and meet the housing with care and support sector – acting out ever more complicated descriptions of what it is that we do. With a flurry of hands and exaggerated actions, we bend and shape our workforce to sound like the kinds of roles that we think the commissioners of the future will want. I completely understand this, and indeed have been advocating for housing to be recognised for the contribution that it makes to the health and social care sector – but there is a need for the sector to take a breath – and work out what it wants to be in this changing world.

The good news is that we are part of the way there. Sitra and Skills for Care have been working on identifying and scoping out the range of roles within the sector for the last 18 months. The product of this work is some excellent resources outlining how this plethora of person specs and job roles can be brought together into a smaller subset of definable roles, which have then been mapped onto the existing qualifications developed by Skills for Care.

This provides a real possibility for us to reframe what we do into identifiable/portable/transferrable roles – that we can then start to champion and promote to our future partners, commissioners and clients. It would also be enormously valuable in scoping out the role for the future workforce, giving a clearer message to recruiters, colleges and apprentices – about what it is that they can find if they join the housing with care sector.

The four roles that have been developed through the mapping and stakeholder engagement are Co-ordinator, Navigator, Independent Living Advisor and Support officer. Does this sound right to you – could you envisage your role, or members of your team, or services you commission fitting into those job roles? Can you see your offer to CCG’s, Public Health or adult social care being framed in the context of providing – for example – ‘navigators’?

Want to find out more and get your hands on these excellent resources – then join Sitra and Skills for Care on our roadshow of free events. Dates still available in Taunton, Cambridge, Birmingham and Preston. Full details of the events can be found here. http://www.sitra.org/free-skills-for-care-events-workforce-issues-for-those-working/

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Health and Housing: Back to the Future Day!

It is the 21st October 2015 – a day that many Back to the Future fans have been waiting for! Amidst the flurry of excitement about what gadgets and gizmos will mirror the films future sight – I have been left wondering what Doc and Marty would have to say about the health and housing sector 30 years on in their travels. Would they take one look at the landscape and leap back in their DeLorean – or would they recognise that there has been progress, and the appetite for change is very present?
Today, coincidentally (if you believe in such things!) is also the Kings Fund and Public Health England joint conference on Health and Housing – and this to me is a marker of a significant and potentially sustainable shift in the relationship between these two sectors.

This is also the day where Sitra and partners launch three separate reports which show just what progress has been made – and provide evidence and ideas for how to take things further.

The first of these is a report sponsored by PHE, and delivered in partnership with the Royal Society for Public Health which recognises the innovative offering of the housing workforce to deliver public health messages. The report, Public Health: Housing workforce holds the key, is accompanied by a series of free to use learning resources to develop the skills and knowledge of the workforce, supporting research and case studies.
The second report, Housing: Just what the doctor ordered, addresses the ongoing challenge of housing providers engaging with Clinical Commissioning Groups – and vice versa. It is a real ‘how to’ guide written in partnership with the NHS Alliance, who speak with great confidence and authority from the health perspective.
The final offering recognises that housing can’t deliver the best services to meet tenant need on it’s own. A home is much more than a house: Integrated approaches for the housing, health and care needs of vulnerable adults has been produced with the Local Government Association and showcases excellent examples of where housing, health and social care have come together to meet the needs of the most vulnerable people.

So stick with us Doc and Marty – the future is looking bright (er!)

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Sheltered from the storm…….?

There is a maelstrom going on out there! Well the world of professional housing staff are certainly in a whilrling dervish – although when I take the temperature outside of the bubble – we do seem to be operating in a micro climate – and this is concerning.

I am, of course, talking about the looming Right to Buy deadline – and my number one concern is its impact both on those current tenants of sheltered and supported housing, and those who may need to access the stock in the future. The big news in the voluntary deal is the portable discount, and how this provides an opportunity for housing associations to still meet their obligation to all tenants to have access to right to buy, but at the same time use their board’s discretion to retain supported and sheltered housing stock.

However, this is all presupposing they feel able to in the light of the challenges they face.

Sitra and others have been continuing our discussions with our members about the impact of the 1% rent reduction, and how this will affect both future developments, and current provision (please see previous blog for details). The message has been that supported housing, whether or not the service charge is included in the -1%, will be significantly hit by the rent reduction, and this will raise questions about long term viability on a scheme by scheme basis. We also know that there is currently no exemption from the rent reduction (or for that matter for the right to buy) for supported housing (unless you fall into the very narrow definition of specialist supported housing) and therefore as things stand, the provision of supported housing is already precarious. My worry is that there will be housing associations out there who have to make some very difficult decisions, when the right to buy is requested, to let go of some of their precious sheltered and supported stock.

Today, I head off to speak to a conference about how the Care Act 2014 applies to sheltered housing. I will be taking the temperature of the housing association members there to see how they feel it is likely to affect their stock. The current Right to Buy scheme, as it applies to local authority stock, is clear the exceptions a landlord is likely to consider (https://righttobuy.communities.gov.uk/wp-content/uploads/2015/02/Your-Right-to-Buy-Your-Home-A-Guide-July-2014.pdf), and sheltered and purpose built supported is part of that. However, my reading of the voluntary offer is that any exceptions will be at the discretion of each and every board, and whilst directed to this exemption, there is no requirement for them to apply it.  It is imperative on housing associations board members that when they are making the decision about how to vote on Right to Buy, they consider and discuss how they might structure any future decision making around discretions in a way that explicitly protects the long term future of supported and sheltered housing. Without this discussion, the very stock that we are reliant on to meet future requirements might be under threat.

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The devil IS in the detail…..

As things stand, the 1% rent reduction does apply to supported housing and it is our understanding that the term rent, under the relevant legislation does include service charges.

Over recent weeks we have been working hard with partners and members to unpick a terminological turmoil – made ever more complicated by increasing use of different descriptors to define the world of supported housing.

Unravelling the terminology

Specialised Supported Housing – This is the group of accommodation that has been suggested might be exempt from the rent reduction. The reasoning behind this is that it is already exempt from the Rent Standard. Our understanding is that this definition applies to a very small section of the supported housing sector, and amounts to not much more than 10,000 units. The full definition of Specialised Supported Housing can be found in our web briefing. This is the exemption that recent housing press articles have been talking about. It in no way exempts the rest of the sector.

Specified accommodationSeeking an exemption – Sitra has been working with a broad range of partners, led by Homeless Link. We are asking for an amendment to the legislation seeking exemption to the rent reduction for all accommodation that meets the definition of specified accommodation. This definition was developed and enshrined in legislation under the Housing Benefit and Universal Credit (Supported Accommodation)(Amendment) Regulations 2014 A detailed briefing has been produced and a full copy of this can be found here. Please read it and take any local action you can to raise this issue with your own MP.

Service Charges – In or Out? There is significant confusion around this issue, and the ultimate answer is that no one can definitely say they are not included in the rent reduction. Our interpretation of the legislation would suggest that services charges are a constituent part of 2008 definition of rent. (the reference point incorporated in the Welfare Reform and Work Bill). Therefore we have been asking our membership to provide detailed understanding of how the inclusion of service charges within the rent reduction will affect costs. Please ensure that the modelling you are doing internally recognises the potential for service charges to be included in the reduction. If, of course, there is further clarity and cast iron assurance that it is not in there, then we will share that, but right now we are urging consideration of this issue in your preparations. We have drawn out this issue in more detail in our recent briefing which can be found here.


We have been gathering views from members, and it is clear that there are huge ramifications for the sector as a whole. This impacts on existing schemes and plans for the future development of supported housing. If you have been thinking through what this means for your service(s), we have a brief questionnaire for you to complete, contact vicr@sitra.org for details.

Act Now

If you are happy to share your thinking process with Sitra, we will ensure that it is included in our analysis, and will continue to update and alert government of the implications. Please also ensure that you use opportunities to influence at a local level.

There is a very short time frame for any amendments to the Welfare Reform and Work Bill and we know that without an exemption for specified accommodation, the impact on future provision of supported housing will be huge.

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Come in! The door is open…….#widerworkforce

Two reports out today show how the housing workforce can and does play a significant role in supporting people’s effective discharge from hospital, and their ability to live independently and healthily at home.

The Royal Society of Public Health have produced a new report on how the #widerworkforce can play a part in the delivery of public health messages. Once you get behind todays media fascination with getting your barber or your barmaid to tip you a wink about health checks – there is a critical message about how to engage the wider workforce.

I was delighted to see the leadership role of housing recognised within the report, and Sitra’s recent research on behalf of Public Health England showed that the housing sector was already contributing to the delivery of healthy conversations, supporting positive behaviour change and increased partnership working across health and housing. Clearly, the housing workforce has huge amounts to contribute to the promotion of better health in communities as one of the key trusted professionals crossing the threshold. In addition, housing provides a critical piece of the healthy living jigsaw, contributing invaluable expertise on the impact of the built environment on an individual’s ability to enjoy healthy independent lives at home.

Today, Healthwatch England also published their report ‘Safely Home’, bringing evidence from the experiences of over 3000 people leaving hospitals and care settings. This report particularly hones in on the experience of older people, homeless people and people with mental health problems. The report has five key messages about what people were experiencing when leaving hospital – poor co-ordination between services, not being involved in decision making , not having their full set of needs met, experiencing stigmatisation for their condition and feeling left alone without the services they need. On reading the report, I was heartened to see a number of good practice examples highlighting the effectiveness of an integrated approach between health and housing. However, despite having the term ‘home’ in the title there is clearly much to be done at both a strategic and operational level to securely bring housing and housing into the frame in order to improve the experience of those coming ‘home’ from acute care.

We know from the 2013 DCLG English Housing survey that 3.7 million households live in social housing, and an ever growing number of these households will be populated by exactly the people that both Healthwatch and the RSPH reports highlight as critical to reach. Both reports give greater strength to the message stated in the Care Act 2014 that, ‘housing is a health related service’ and our research with Sitra members shows that there is a skilled and willing workforce who are holding the door to health wide open……

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#Integration – a three legged stool……. #health #housing #socialcare

The Care Act 2014 raises the profile of housing as a health related service. It particularly highlights the importance of it in the statutory guidance to be found in section 15. Key phrases there include:-

“Housing is therefore a crucial health related service which is to be integrated with care and support and health services to promote the wellbeing of adults and carers and improve the quality of services offered”

Section 15.48

Yet – why is it that everywhere I go, the debate about integration seems firmly fixed on how to integrate health and social care – leaving housing firmly on the shelf. We do that at our peril, it seems to me, particularly as the ambitions of health and social care are fixed firmly on a future where provision is focussed around strengths and independence and remaining at home.

Sitra and Skills for Care have started off a series of events looking at the Care Act and the Integration of the housing and care workforce. Looking particularly at the points where housing and domiciliary care intersect, and how that interface could be improved in order to achieve greater outcomes for the individual. The challenges coming out of it will not be a great surprise to anyone who has been working on the agenda of integrating health and social care and included:-

  • There is a need for central coordination, as without this integrated approaches could get very messy. This is particularly an issue when discussions around data sharing come to the fore.
  • Holistic approaches to working are not part of most workforce development approaches, so integration efforts are rowing against a tide of professional practice that focusses on boundaries, rather than connections
  • Relevant partners do not know enough about what each other are doing – key roles such as GPs and tenancy support officers need to know enough about what other partners can offer. It also needs to be clear when, and why, responsibilities end.
  • Some of the challenge of working in this way arises from different perspectives of how to work with individuals – interplay between medical and social model.
  • Funding streams do not encourage integration. Better care fund seeks to address some of this, but does not include the funding of key integration partners – reinforcing the drive to integrate – but only within the new funding regime.

The need to have housing firmly involved in integration discussions seems compelling. The challenges raised above are being replayed all over the country, and the resource and effort to enhance integrated working should focus on getting all three key partners round the table. The people that are at most risk, that need the most support to live independently, that would most benefit from early intervention and preventative services are frequently of shared interest to all three partners. If the positive support and efforts of the parties could be coordinated, with the individual at the centre, then the current challenges of integration could quickly become the benefits of holistic person centred care and support.

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From #strength2strength…….

Strength – we all have it – but sometimes it is more difficult to let it show, or to believe it will be valued, or indeed to recognise it in ourselves.

Our Sitra conference this year brings to life the many different ways in which people can and do show their strengths, and celebrates success, diversity and difference.

Delegates can expect to sing out in celebration with the Choir with No Name, challenge the stigma around mental health with Time to Change, sit in on a conversation with dementia communication activist Sarah Reed , Chris Roberts and Suzy Webster, hear how coproduction is going down with Sitra partners in Europe and understand from Martin Simon of Nurture Development how strength based working is the only way forward for communities! But that is not all! Jimmy Carlson, OBE, will be sharing how his life has changed and the importance of client led initiatives such as Groundswell. Peter Yarwood will inspire with his story of how he used his strengths to form the Lancashire User Forum, a dynamic stakeholder group for people with a commitment to recover from substance misuse. Colleagues from Change People will challenge us to think differently about how people with learning disabilities can and should be employed in the delivery of support services. We will also hear from participants from the London Housing Foundation funded programme Pulling Together who will share their experience of how a tailor made accredited training programme has brought their lived experience into the learning and development arena.

The policy agenda is shifting to sit firmly behind the strengths based agenda, and this will also be an opportunity to think about how the housing sector can show its strengths. Shirley Cramer from the Royal Society Public Health will talk about the great opportunity for the housing sector to lead the way in promoting health messages – building on our trusted connections across our tenants. Sticking with this them of building on existing relationships, Sian Lockwood from Community Catalysts will talk about how community based housing related support services have nurtured the development of new enterprises to better meet the needs of individuals within the community.

Person-centred work remains key to Sitra, and Think Local Act Personal (TLAP) will be at the conference, sharing resources and ideas for how organisations can ensure their services are focused on supporting independence and strengths. Sitra have been working with TLAP to develop ‘Making it Real’ for Housing with support, and hope to use the launch of it later in the year to boost integrated understanding of how key messages to strength based working can be used across sectors and settings.

Finally we are delighted that alongside our fantastic array of speakers, we will also be joined by a great range of exhibitors, many of whom will be showcasing the strengths and success of client led enterprise.

If you can’t join us in person – then do at least connect by following #strength2strength


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