Report of Strategic Director, Care, Wellbeing and Learning.
The Committee had agreed that the focus for its review in 2018-19 would be “Helping People to Stay at Home Safely” and would consider how health, social care and voluntary services support people’s confidence and independence to live safely in their own homes. The review would centre on the following six core themes:-
· Assistive technology and digital information
· Enablement services
· Housing options to support independent living
· Commissioning for enablement outcomes
· Emergency and community services
· Personalisation and choice
This evidence session examined the housing options to support independent living and focused on the following two areas:-
The Committee was informed that the Strategic Housing Market Assessment for Newcastle Gateshead (SHMA) identifies 2,619 specialist older person housing units and the Gateshead Housing Company total owned older persons housing stock is 3,623.
It was noted that in terms of sheltered housing there are 2,050 bungalows appointed for older persons in Gateshead distributed amongst the general housing stock and managed by the local housing office teams. Additionally, 1,573 properties are managed by The Gateshead Housing Company Older Persons Team. These include 315 flats, 219 sheltered flats and 1,039 bungalows that are grouped in recognised sheltered schemes. These schemes offer customers an independent living environment with small, easy managed self-contained services. Access to support and advice with health and housing care needs is available on site.
The Committee received evidence that work is ongoing to protect this offer of choice and independence for older people. This has been achieved by refocusing the Neighbourhood Services Team in 2017 into four neighbourhood housing teams but retaining a specialist Older Persons Housing Team to deliver a boroughwide tenancy and estate management service. In addition, following the transfer of the Sheltered Scheme Officer Service to The Gateshead Housing Company in April 2016 there has been a restructure of the service to deliver more efficient ways of working and a more customer focused service. As a result, four Older Persons Housing Officers have been introduced who deal with estate management issues and cover a patch of approximately 400 properties respectively which means they can offer more intensive to customers who have higher support needs. These officers directly manage onsite Sheltered Scheme Officers and Mobile Scheme Officers.
As more people in Gateshead aged over 65 are living with selected conditions and or care and support needs the Sheltered Scheme officers are able to ensure that customers living in sheltered housing feel safe and secure in their homes and they manage a support planning process for these customers.
A support plan is agreed for each customer within a week of moving into the scheme which sets out how their care and support needs will be met and determines if they are eligible for a care package of extra support and their eligibility for any benefits. The plans aim to maximise individuals’ independence and consider social activities each customer might participate in. The plans are monitored closely and reviewed every year and take account of changes in circumstance, such as a customer coming back home after a period in hospital, leading to a need for a change in the levels of support provided.
The sheltered team gives priority to needs and risk assessment delivered in a way that suits the needs of individuals living in the scheme with monthly visual inspections to identify issues such as repairs, cleanliness and tripping hazards. Customers are also provided with support on personal safety around the home.
As residents with care and support need are a higher risk in terms of fire safety partnership work continues with Tyne and Wear Fire and Rescue Service to achieve its vision of “creating the safest community”. Annual home safety visits reduce the risk of fire in domestic premises in sheltered housing. Home Safety checks are conducted within every sheltered home annually and every sheltered scheme has a fire risk assessment and a building specific fire management plan both of which are reviewed annually. Water hygiene checks have also commenced from this year.
The Committee also noted that the service plays a vital role in helping older people to stay healthy, reducing hospital admissions and delayed transfers of care and falls, thereby generating savings to health and social care budgets.
The Committee was informed that nationally each year one in three people over 65 and almost one in two people over 80 experiences one or more falls, many of which are preventable. A fall at home that leads to a hip fracture costs the state £28,665 on average. Short and long term outlooks for patients are generally poor following a hip fracture and are a major cause of people moving from their own home to long – term residential or nursing care. Gateshead has a significantly higher rate of admissions to hospital as a result of falls than other parts of the country.
Home safety visits therefore look at ways to help reduce having a fall, including simple changes to the home and doing exercises to improve strength and balance. The Older Persons team work in close partnership with Adult Social Care and local GPs to report concerns about people who are not managing independently at home.
The Committee was also advised that in Gateshead in 2011 a total of 12,138 (34.4%) of people aged 65 years or older were identified as living alone. Sheltered housing can therefore help tackle social isolation by providing a range of social activities and support networks. The Hen Power project, run by North East Charity Equal Arts sees older people keeping hens to reduce depression, loneliness and improve well-being and the project at Wood Green in Gateshead has attracted press and television coverage from all around the world.
The Committee also noted that the Older Persons Housing Team are working in partnership with Gateshead Council to develop intergenerational get together sessions with local schools to promote greater understanding and respect between generations and contribute to a more cohesive community. One of these sessions will involve pupils learning about the lives of residents living in sheltered accommodation. The Committee was informed that there are plans to further develop links with schools to deliver joint work around technology, arts crafts, gardening and performing arts.
Bensham Court is also now part of the national safe places scheme which aims to support vulnerable people who find themselves scared or at risk while out and about in the local community. Difficulties experienced by individuals could include feeling unwell, having an accident, becoming lost, being bullied or having something stolen. Individuals who come to the Court for help will receive support from the Mobile Sheltered Scheme and the residents until contact can be made with a family member or support agencies.
The Gateshead Housing Company are also holding free courses to help customers avoid falling prey to scams. Moving Forward is the housing company’s training programme that gives local residents the opportunity to learn new skills, meet new people and help to improve services and provides information and advice on wide ranging topics which can help support their day to day lives.
Future plans include improving opportunities for social activities in communal lounges; working with customers to improve outside communal spaces more welcoming and secure with communal gardens and patio spaces and embedding the system of health and safety checks and improving system monitoring.
Extra Care Housing
The Committee was informed that Extra Care Housing allows someone to live independently with support on site 24 hours per day and has been in place in Gateshead for twenty years. The Committee noted that currently there are six extra care schemes in Gateshead with a total capacity of 240 apartments and the eligible age to access the schemes in Gateshead is 55 although there may be exceptions in special circumstances and the average age across all the schemes is 83. However, just under a quarter (24%) of people living in extra care housing in Gateshead are aged 90+.
The Committee was informed that the cost to provide care and support within an extra care housing setting is significantly cheaper than residential care and a for a package for someone living in their own home in the community. The average cost per person in extra care housing is £9,800 per annum which is less than a like for like package for home care services. The cost of a residential care placement in Gateshead averages £32,000.
The Committee was advised that a full review had been carried out of the existing delivery model for extra care housing over a six - month period which had included a full consultation programme with all the tenants, their families and the staff who work within the extra care housing schemes.
Overall feedback from the review had been positive but areas for improvement had been highlighted in relation to lack of activities across some schemes; not enough staff to support people in communal areas and some schemes not having the right balance of tenants.
The Committee was informed that the new model would be based on an outcomes approach which would allow the contracted provider to move away from a time and task model and focus on delivery of care and support in a more personalised and flexible way to meet the needs of each tenant. Following a tender exercise the contract for the schemes at Angel Court and Callender Court had been awarded to Human Support Group Ltd (HSG) and a transition period is underway with the transfer to take place on 19 November 2018.
The Committee was advised that the demand for extra care housing in Gateshead has increased over the last few years and there is now a need for further schemes to be built over the next five years to meet both current and future demand. A mixture of specialist provision is required along with larger developments across the borough. Dementia is a significant challenge for Gateshead so the development of specialist dementia care units along with investment in technology will allow people to live independently for longer without the need to move into long term residential care.
The Committee received information regarding potential development opportunities going forwards over the next five years to meet current and future need.
The Committee indicated that they had received information that there were plans to merge Shadon House with other care schemes and asked for clarification around this.
The Committee was informed that Shadon House was part of the Promoting Independence Centre and was dementia specific. There were also two other centres, Eastwood and Southernwood which provide intermediate care.
The Committee was advised that due to the fact that the buildings for the centres providing intermediate care were well past their prime and the estimated running and repair costs, consideration was being given to provide a new offer for intermediate care on a single site, in conjunction with Newcastle Gateshead CCG. The Committee was informed that as intermediate care is only provided for short periods (ie a maximum of six weeks) for families this would be similar to visiting a relative in hospital.
The Committee was advised that consideration had started to be given to Eastwood as an option for the single site as it was closest to the hospital and to Heworth Metro and there was potential scope for the site to have a bigger building. The Committee was informed that there was a need for approximately 60 intermediate care beds. The Committee was informed that discussions were still ongoing with the CCG regarding the options and there was still much work to be done but this was the medium - term vision.
RESOLVED - i) That the Committee considers that the support
being provided to people within sheltered
accomodation and extra care housing in
Gateshead is supporting people to maintain living
ii) That the Committee supports the requirement for
additional extra care housing to be developed in
the next five years to meet current and future