Dementia Awareness – Housing takes a lead………..

The word is spreading fast about Living Well with Dementia – there are a plethora of initiatives going on across the country as part of Dementia Awareness Week (#DAW2014) and a strong focus on the Alzheimers Society Dementia Friends initiative – particularly through their media campaign.

So how is housing taking up the challenge? There has been some excellent work over recent years developing an understanding and implementation of the impact of the built environment on those living with and caring for those with dementia. A great starting point is the excellent resources developed and disseminated by the Housing LIN on this area. In addition, the role of supporting those with dementia to continue to live independently in the community presents a strong opportunity for housing related support services to take a lead in developing and adapting their services to meet this need.

However, research just launched this week by the Dementia and Housing group shows that much of the training available to support the sector in taking a proactive role in this field is not tailored enough to the needs of housing.

Sitra have been concerned about this for some time, and to that end have formed a unique partnership to support change. The learning partnership combines the strength, knowledge and networks of three organisations. Association for Dementia Studies, a national and international centre of excellence in training, education and research in dementia studies; Sitra with its expertise in housing related support; together with the Housing LIN, the knowledge hub for housing, health and social care professionals in England involved in housing with care for older people. The two programmes we have developed are ‘The Strategic Leaders Programme’ and ‘The Scheme Managers Programme’. These are fantastic action learning based opportunities to equip participants with a sound understanding of dementia and person centred practice; access to the latest best practice in housing and dementia support; together with practical tools and resources with which to lead and influence change within your organisation.

The development of these courses have been supported by DCLG, and this first set of events are part of a pilot in the West Midlands, enabling us to keep costs as low as possible. For full details and booking you can go to http://www.sitra.org/training/dementia-leaders-programme-for-the-housing-sector/

Finally, another great opportunity for housing to take the lead in Living Well with Dementia is to get on board with the Dementia 4 Schools programme. Anyone attending our #changemakers conference will have heard the challenge to housing from Angela Rippon, the champion of Dementia 4 Schools. There are great opportunities for housing associations and support providers to take a lead in connecting with schools and for accommodation based services to think about the potential to join in with the National Care Home Open Day on 20th June 2014.

We would love to showcase more of the sectors work on dementia – so do keep in touch and let us know what you are doing.to take the lead…..

For info……

Dementia Leaders Programme for the Housing Sector

The Bare Essentials

The Strategic Leaders Programme will run for two days with a half day follow up and is aimed at senior leaders working within the housing sector. The dates are Tuesday 22nd July and Wednesday 23rd July 2014 with the follow up half day on Thursday 18th September (9-45am to 1-00pm).  The venue will be Birmingham (location to be confirmed).

The Scheme Managers Programme will run for four days as an action learning set with a break for reflection to complete a course assignment. The course is aimed at managers with responsibility for running housing services for older people, including general needs housing. The dates are Tuesday 16th and Wednesday 17th September and Tuesday 21st and Wednesday 22nd October 2014. The venue will be Birmingham Voluntary Services Centre in central Birmingham.

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Integration – Starting small…..

Last week I attended the launch of Surrey Care Association – a county wide association establishing itself as an independent membership body. There were a small number of our members at the event – those who cross over between care and support – but predominantly they were private organisations who running one or more residential care homes or domicillary care operations.

The agenda varied little from any meeting of supported housing providers I have attended in recent years – funding, regulation, impending legislative changes and commissioning practice. There were some things that were not discussed with as much vigour as I might expect from a supported housing crowd – less focus on coproduction, less talk of assets and strengths – but the same commitment to provide care and support with the individual at the centre of that agenda.

So – why are we sitting in different rooms? Why when we are so keen to promote to policy makers the value of housing being a critical part of the integration agenda – the much exalted triumvirate of health, housing and social care – are we not modelling that behaviour at a local level?

In an effort to address some of that challenge in a small way, I was really pleased that at the launch Sitra and the Surrey Care Association are working together to bring housing and social care closer together in the locality. We are going to look actively at opportunities to provide training that will appeal across the sectors, share information and advice and work at opportunities to bring providers of housing support and care together.

These are small steps, I recognise – but important ones to begin to build up the narrative of integration from the grass roots upwards. Our shared purpose was evident from the event – and was reminded when watching the voting for #ukhousing #powerplayers2014 unfurl – I was struck by the very timely comment of Paul Taylor at the end of his recent blog…..

“As I’ve said – in an online super-connected world – sectors only exist in our imagination anyway….”

and to remember – that whilst we might not all be ‘super-connected’ yet – the people that we work with will get so much more from any small steps we take…..

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Change is coming – are you ready! #changemakers

Update!!! Thanks to everyone involved for a fantastic #changemakers conference on 20th March 2014. Much more to come – but for a quick preview – see  http://storify.com/burcuborysik/a-story-of-changemakers-in-housing-with-support-an?utm_content=storify-pingback&utm_medium=sfy.co-twitter&utm_campaign=&utm_source=t.co&awesm=sfy.co_jeZB&dm_i=F3O,2AUYW,2EG23F,8CDOM,1

We are in serious countdown mode at Sitra – with less than 24 hours to go before our annual conference. http://www.sitra.org/training/free-sitra-annual-conference-2014-change-makers/

The theme of the event is #changemakers – and I am excited that we have gathered together a programme representing some of the most exciting thinkers and doers – not just on the podium – but in the audience too.

However, this blog is not intended as a spoiler! I have seen enough of the coverage of George Osborne’s budget to not wish the #notnewnews tag to be applied to our conference programme!

However, there is a real challenge to understand how positive change continues to happen within a sector significantly impacted by austerity, welfare reform and a shifting commissioning base.

I have been looking with great interest at the work being carried out within the NHS – particularly around #nhschangeday. We could do a lot worse than look at the leadership approach being advocated by Helen Bevan – and I am very interested in her perspective around how change happens, and how we need to build up our sector ‘rebels’ and ‘boatrockers’. (http://www.slideshare.net/NHSIQ/better-care-fund-helen-bevan)

I really like her graphic as to how we plan for change ……. and how change happens.

change

I know that the conference will inspire me as we clamber up the hills of change to ‘keep on trucking’. The sector has a long tradition of innovation and change, and I hope that the day will recharge, inspire, delight and create change in equal measures. I look forward to seeing you tomorrow – or to you joining us throughout the day under the umbrella of #changemakers.

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Pulling Together – Coproduction in Action

At the end of January we brought together a fantastic group of clients, front line workers and organisation leaders to celebrate the launch of Pulling Together. If you haven’t had a chance to check out this great resource – then visit www.pullingtogether.org.uk

The Pulling Together website provides you with up to date materials on the following areas of welfare reform:-

The Work Programme

Personal Independence Payments

Resettlement for Under 35’s

Universal Credit

The site also includes FREE training resources including lesson plans, presentations, exercises, links to broader resources and a guide to the co production and co delivery of courses.

Critically all the training resources were co produced in a unique partnership between Sitra and SHP– working with Sitra coproduction experts, and our welfare benefits trainers – and SHP frontline staff and clients. This means that what you get in the training is not just what the ‘experts’ say – but rather – what the clients and front line staff think is essential that you know – and using their experiences and voices throughout the training.

This exciting collaboration really comes to life if you take a look at this clip about what it felt like to be involved in the co production process.

SHP  have been enthusiastically putting the resources to use – working on sessions for front line staff, for clients as part of internal meetings and training sessions and on a one to one basis using exercises or information from the training to support key working session.

The project was supported by the London Housing Foundation – who are self declared funders of ‘great ideas’. We are delighted that they took this initiative on board and help us bring it into focus.

I really hope that you find the materials useful – and we are keen to get your feedback on what works for you – and how you have used them. We are committed to keeping the resources and the wider web upto date – so let us know if you develop anything that you would like us to share.

In the face of all the changes going on – we hope that this ‘pulls together’ much of what you will need!

DSC_1020 DSC_1015 DSC_1005 DSC_0982

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Still time to make some noise…….

It will be no news to those of you in the housing sector how critical housing related support services are being cut in some areas of the country. It is something we have been covering at Sitra through our work with individual members, commissioners and central government. Whilst it is well known that housing related support, alongside a wide range of public services, has experienced cuts at a local level over recent years – the scale and breadth of recently proposed cuts to services is of great significance. There are a large numbers of authorities who are out to consultation on their budgets and will be voting on decisions this week. Here is snapshot of what is happening out there:

Nottinghamshire County Council – Services in Nottinghamshire have already been significantly cut since 2011, and the latest budget proposal presents an additional 35% cut of the remaining funding. If the budget goes through, the remaining services will only be able to focus on the narrowest set of clients that may include some services for  people with mental health problems, vulnerable younger adults, women escaping domestic violence and short term support for older people to tackle isolation. However to continue to fund these services, they are proposing a cut to all drug and alcohol accommodation services, offender accommodation services, homelessness preventative floating support and move on. Framework provides detailed information about these proposed cuts and a call for support through their Think Again campaign.

Worcestershire County Council – Their current consultation proposes cutting spend on preventative services from over £15m to £6.5m. It includes proposals to cut substance misuse services by 75%, older peoples support services by 50%, over 70% cuts to services for people with learning disabilities and the complete removal of housing related support funding for services for ex offenders.

Derby City Council – Proposing a cut of £2m, having cut by over £2m last year. This will reduce their overall spend on Supporting People by over 70% in a two year period. Details of proposals are outlined here.

Torbay Council – Proposing a cut of £3.2m to housing related support services. Including 100% cut to services which include Integrated families, Criminal Justice Accommodation Services and sheltered housing. In addition there is a proposal to cut 100% of the funding to the Employment Support service for people with disabilities. Information about the Torbay proposals can be found here.

London and the South East – In a recent survey of commissioning priorities across this area carried out by Sitra, we identified further evidence of trends in commissioning where ongoing cuts serve to undermine large swathes of the positive focus on preventative services delivered through the vision of the Supporting People programme, and underpinning the future visions for a preventative focus within communities inherent in the Care Bill. A summary of this research can be found here.

Local members are busy on the ground campaigning against the cuts, whilst some authorities are busy continuing to champion the cause of preventative services.

If you are part of that group making the case – then we hope that a reminder of some of these resources might be helpful:-

Outcomes – Housing related support has a detailed and robust outcomes framework, which measures the outcomes as defined by the individual service user. The outcomes have been collected since 2007 by St Andrews University, and approximately two thirds of local authorities continue to collect this information and submit it to St Andrews. The outcomes have also been mapped across to a range of other public outcomes frameworks – as shown for example in this Sitra factsheet on Older People.

Data – In summer 2013 Sitra gathered together data from a range of authorities across England. This data brings together performance data around cost of services, alongside performance indicators and housing related support data. The data is combined in a tool which enables the benchmarking of authority spend against different client groups, types of provision and outcomes collected by St Andrews. The full set of data can be found here.

Cost Benefit Analysis – although the bulk of this research was carried out in 2009, this continues to be used to provide a robust argument at a local level. This research provides a detailed set of counterfactuals which support the argument for investing in preventative support.

 Case studies and influencing votes – Organisations have many fantastic case studies, and this is an opportunity to ensure that those voting on the decisions at a local level are fully aware of what the services they are considering deliver the individuals and the wider community. Some example case studies can be found here and a useful way to argue the case with councillors can be found here. 

This is a critical decision week for many services around the country.

 It is very important that everyone with an opportunity to add their voice to secure preventative housing related support services does so now.

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What difference does a name make…….#support #resilience #prevention??

Have spent a great morning with members in the South West today – talking about key policy areas for the sector and continuing our focus on the health and social care. I was delighted to be joined by Robin Johnson, who I left this afternoon leading members through a masterclass in Psychologically Informed Environments. 

However, and I need to choose my words carefully here, members of ‘the sector’ were raising the challenge of what we now call the ‘sector’. I was seeking to explain to University colleagues and health commissioners present in the audience what we understood to be housing related support. I was firmly told by some members that this is no longer how they refer to their services, and actively discourage staff from ‘looking back’ to the old SP definitions and descriptions of the work that they do.

So – what do they now call their services – and how do they differ from what they were offering 4-5 years ago. It does seem that some of the key is in the name – services now being described in terms of their role in the community, their focus on wellbeing, their contribution to resilience and their success around prevention. Some even went as far as to say that they were discouraging the connection with housing – not wanting to make the link explicit.

So where does this leave the services they offer – and how do they distinguish themselves from other community based services offering similar resilience based approaches. How does a support worker offering advice around financial management differentiate themselves from an outreach Money Advice worker? How does a support worker offering support to engage with community activities differ from a befriending service? Surely the key difference is that these activities are being carried out with the sole purpose of ensuring the client has sufficient support to enable them to remain in their home?

I think that members are probably in tune with raising the question of how we brand the work that we do – and that this may be yet another nod to the pervasive influence of localism. What floats the boat of resilience in the SW, may be staunchly anchored to the post of housing related support in the WM. However, I think breaking the link between the work we do and ensuring client stay housed will serve us badly. If we are to continue to push for housing to be recognised as having a central role in the health and wellbeing of individuals, in the prevention of entry into more acute services and the key to remaining independent and being able to contribute actively to the community then we need to shout out about our connection with housing. If local authorities will no longer pay for housing support, then we may need to convince health commissioners to pay for wellbeing support – but they need to understand that the wellbeing comes from being supported to remain independent and critically ‘at home’ (wherever that may be).

 What do you think? What do you now call the work that you do?

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Final Chapter – Ukraine 2013

After a long and eventful night on the train – we arrived – at 8.00am precisely – in the port of Odessa. We were met by Father Jan, who was to take us out towards the Daughters house out by the Black Sea. We drove past a long boulevard of houses, all of which looked as if they had gone up in the last 5-10 years – which were the holiday homes of Russians wanting a vacation by the Black Sea.

The Daughters of St Vincent  provided the most amazing hospitality, a shower and a chance to revive after the long journey – and I began to fully understand the connection between how the DePaul services operate in partnership with the catholic community in Ukraine. The nuns that we met were to reappear later in the day, administering medication and support to the homeless men and women of Odessa. They had received full medical training as nurses or social workers, and then dedicated their life to serve under the order of St Vincent, which has charity as a calling.

We then went to visit the day centre which had been established in Odessa over the last two years. Based in a residential cul de sac, the day centre provides facilities for twelve (maximum sixteen) homeless people a day. Because of the location, it is not possible for people to come to the centre directly, and so people are identified on the basis of highest need, at the food and medical station in the heart of the city, and then driven directly to the centre.  They have one day a week which is women only, and women are able to come and get clothes, have a shower, get a haircut and have vital medical help. There are lots of medical challenges, partly because the hospital service won’t respond sometimes to medical emergencies for clients because of their inability to pay. The sisters of charity support the project, and are trained nurses and social workers, so come to the centre every day to support the staff and provide vital medical help. Many of the clients have terrible wounds, often from dog bites.  The weather conditions mean that in the summer, clients are suffering from sun burn and dehydration from heat, and in winter, the extreme cold runs risks of frost bite.

One of the key services on offer in the day centre is centred around the recurring theme of lack of ID. The centre works with the clients around the issue of document recovery – to support people to reclaim their id papers.

There is a Government shelter is in the city – and de Depaul can refer people directly to the shelter. People can stay in the shelter for one month for free, and then can stay on with 150 grevna per month. Those who stay there can take a shower, clothes etc…. The precise size of the homeless population is unknown, but the fact that DePaul has worked with over 4000 unique individuals at the feeding station over the last 2 years provides an indication of the scale. Because of this, access to the day centre, and the showers, clothing, support that it offers is rationed to once every three weeks – prioritised very much on the basis of need.

Interesting parallels with UK homeless provision emerged in discussions with the staff at the day centre. They had identified that there were two very distinct groups of homelessness, those who are long term homeless, and those who are new to the street. Much like the current UK focus on ‘No second night out’ they were seeking to work as priority and as quickly as possible with those new to the street. They recognised that this was the most effective work and have been engaged in some really successful mediation with Depaul brokering a connection and sending people home to their own city. Odessa, partly because of its geographical location, and because of port status does attract a lot of people from other cities and countries – hoping to find work

Our final destination was to the mobile feeding and medical centre. This usually took the form of a large single decker bus, providing some dry space for medical support and to talk with those new to the service. On this day, the bus was not available (a long and enlightening story!) but the service was still on offer from a much smaller van. We found the van parked up in a park very near the station and surrounded by roads leading off from the station.  60 or 70 come to this site every day. – and twice a week go to another market as well where they might see an additional 70 people. At least 30 people get medical attention at the bus.  Because the bus was unavailable – medical support was being offered next to the van – and whilst the best efforts were made to maintain some dignity, the van was parked by the roadside, on a busy thoroughfare. Critical interventions being made, but in far from ideal settings.  I spent some time talking to the guys coming to the feeding and medical centre, and it is clear that this service represents an absolute life line.

Our final discussions were around what longer term provision the city needed. There are high hopes that in the near future there will be an opportunity to develop a purpose built centre to provide the critical medical support, and those services offered by the day centre. This would be a fantastic step forward for those living on the streets in Odessa. The commitment and energy of those providing support has been quite overwhelming, and to date – there has been huge amounts of evidence to show that Depaul and those working within the community to support their services have not only a strong and clear vision – but also a very significant track record of bringing vision into reality.  The London Housing Foundation funding has played a small part in supporting this work, and I feel privileged to have been party to some of those decisions, and inspired to think – what next?

 

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