Identifying the health care system benefits of housing with care

“The obvious is that which is never seen until someone expresses it” Khalil Gibran

These words sprang to mind as soon as I read the recently published evidence in the report from the Housing LIN. It clearly demonstrates the link between housing with care and a positive impact on NHS resources.

For us at Whiteley Homes Trust (WHT) this was not revelatory. We simply sighed with relief that such an important and obvious connection has finally been demonstrated and quantified. This comes after many years of observation and feedback from residents, families and staff in our own extra care facility at Whiteley Village, an older people’s community of 262 alms-houses, 51 extra care apartments, residential and nursing facilities, which has been providing accommodation and care for over 100 years. Indeed, the first trustees had enough common-sense to know that in planning a village for older people of limited means, the provision of accommodation for a nurse to live in every quarter was a sensible thing to do.  

care and support, has had a massive impact on the older people who live here. Our experience over the last 15 years of running the first extra care scheme in Surrey within this community has given us many anecdotal examples of where just a little bit of care and support, has had a massive impact on the older people who live here. As a result, this has also changed the dynamic between the NHS and our residents.

“I probably would have died if I’d gone to a flat in a street. I wouldn’t have been able to cope. Here it is easier” – WHT Resident

Our own data showed that in July this year our housing support workers, financed by the charity after the demise of the Supporting People Fund, escorted 9 residents from our extra care scheme to the local surgery. The truth is that had they lived in unsupported accommodation, it is unlikely they would have asked for help and probably wouldn’t have gone. The financial consequences of a missed opportunity for early intervention by the NHS are incalculable, the cost to the individual could be their life.   

What we have also observed as a benefit of living in “community” is that the natural systems of support between neighbours mean that a person is “known”. Indeed, when we asked residents in 2017 what makes living at Whiteley different from anywhere else, they said the 3 most important things were (1) they felt safe (2) they were known, and (3) they were proud (of living here).

The expression of these basic needs provides a clear insight into where the benefits of housing with care can positively impact the health and social care system in a way that could provide modern- day solutions to the crisis in care for older people. The new Housing LIN report shines a light on the need for the re-allocation of public funding to reflect older peoples own aspirations.

It is wise to remember that however housing is configured it is relationships that enable people to maintain independence and health, yet the stark facts according to Age UK are that more than 2 million people in England over the age of 75 live alone, and more than a million older people say they go for over a month without speaking to a friend, neighbour or family member. No wonder then that there is an inevitable reliance on the NHS as the “go to” provider of support and information. Some key facts about the effects of loneliness on health can be found here (opens new window). For me this simply underpins the need for more creative community housing with care solutions.

As an optimistic junior Occupational Therapist, I remember the great hurrah when the NHS and Community Care Act was published 30 years ago, emphasising the virtues of the prevention agenda and the consequent need to redistribute funds from the Acute to the Community Sector. The research of the Housing LIN today alongside examples (opens new window) like the Wigan Deal (their strategic approach was recently covered in the Housing LIN’s NW regional meeting), which builds on local community assets should therefore underpin the long awaited Social Care Green paper.  One can only hope that it does reflect the important role that Housing providers play in supporting ageing well, whilst promoting the benefit of a relatively small investment from the NHS.

None of this is rocket science, but the will to flexibly and creatively move resources to make it happen still feels as remote as the moon. What we do know however, is that people today living in extra care facilities are not afraid of expressing the obvious……………. It is for us to listen and act.
 

“ I see a carer here every Monday morning. She comes and checks – any problems? I tell them about my neighbours……I have a neighbour with breathing difficulties and if I call the carers they do come. I like it because it is reflecting what is happening nationally, helping people stay in their own homes.” WHT Resident