Housing, Wellbeing & the Care Act Integrated approaches to prevention Liz Greer

1. Housing, Wellbeing & the Care Act Integrated approaches to prevention Liz Greer North East ADASS Care Act Programme Manager liz.greer@northeastcouncils.gov.uk 07557 759770

2. Overview-the Care Act • Modernising legislation replacing patchwork of law developed since 1948 • Reforms the way care and support is provided (April 15) • Financial reforms postponed until 2020 • Wellbeing & personalised care at the heart of the reforms • Aims to make care and support clearer and fairer for all • New national eligibility threshold • New duties on Councils & their partners • New entitlements for people who use services & their carers

3. …around 400,000 people in residential care, 56% of whom are state-supported …around 1.1 million people receiving care at home, 80% of whom are state-supported …and around 6 million people caring for a friend or family member. Demands on the system Three-quarters of people aged 65 will need care and support in their later years Older people are the main users of acute hospital care - 60% of admissions, 65% of bed days and 70% of emergency readmissions. 72% of recipients of social care services are older people, accounting for 56% of expenditure on adult social care.

4. Cuts in Council spending Adult social care spending has fallen by @8.5% in real terms from 2011/12 to end of 2013/14

5. New ‘universal’ duties on Councils • Promote wellbeing • Prevent, reduce or delay development of care needs • Provide information and advice about care and support • Shape and commission care markets to meet current and future need • Limit impacts of provider failure or service interruption These duties apply to all people in the local population, irrespective of current or future needs for care and support

6. Prevention Services, resources & facilities which prevent the development of care and support needs could include: • universal access to good quality information • support to create safer neighbourhoods • Promotion of healthy and active lifestyles via eg exercise classes • Reducing loneliness or isolation through befriending schemes or community activities • Encouraging early discussions with families about potential care arrangements or suitable accommodation should a family member become ill or disabled

7. Reduction Services, resources & facilities to reduce the development of care and support needs eg • targeted interventions aimed at those with an increased risk of developing needs (eg stroke;falls) • Fall prevention programmes • Adaptations to housing eg to improve accessibility • Equipment loans • Telecare services • Handyperson services • Early identification of carers & support to help them care effectively and look after their own health and wellbeing.

8. Delay Minimising the effect of a disability or deterioration for people with complex needs and promoting independence through : • rehabilitation/reablement services • equipment services and adaptations • Carer support eg respite care, peer support ,adaptations, IT and assistive technology, access to advice and information about carer benefits and financial advice

9. And the winners are..? • Substantially lower threshold for assessment and care and support- lower even than service users • Can get help even if the cared-for person is not eligible • Usually no charge or financial assessment for care and support • Rights to personal budgets & direct payments …and around 6 million people caring for a friend or family member.

10. Information and advice Councils must set up and maintain an information and advice service distinct fromthe duty to meet eligible needs • Councils (working with partners) must provide targeted information and advice at key ‘trigger points’ in people’s lives • Early identification of people who will benefit from financial advice or information including how care and support can be funded • Must be offered in a variety of media, formats, languages & face to face • Independent advocacy must be offered where people will experience substantial difficulty in understanding, retaining or using information (where there is no-one else to fulfil this role) • People can readily access regulated and unregulated financial advice at different points in their care journey

11. Trigger points • Bereavement • Hospital entry and/or discharge • Diagnosis of health condition • Consideration or review of Continuing Healthcare arrangements • Take-up of power of attorney or applications to Court of Protection • Application/review of disability benefits • Access to work interviews • Contact with/use of private care services, including home care • Change/loss of housing • Contact with the criminal justice system/release from prison • Retirement

12. New duty on Councils-cooperation & integration • Councils must cooperate with named public bodies including Housing, Public Health, Benefits, Employment & Training Agencies, Probation Services, NHS England, CCGs, NHS and Foundation provider Trusts • Duty to co-operate is reciprocal ie named partners must also cooperate with Councils • Duty to co-operate is extended where possible to other partners eg private housing providers • Integration between care and support provision, health and health related services (including housing) must be promoted

13. Integration, cooperation and partnerships “Councils should consider how they can work with partners to identify unmet needs and coordinate shared approaches to preventing or reducing such needs...including housing providers ...who can provide local insight into changing or emerging needs” “Councils must ensure the integration of care and support provision...with health and health-related services, which include housing. This responsibility includes a focus on integrating with partners to prevent, reduce or delay needs for care and support.”

14. Approaches to integration Examples of integration include:  • Sharing population data to better understand/profile local needs • Joint commissioningof services to deliver better outcomes in a local area • Integrated approaches to provision of advice and information which may reduce, delay or prevent the development of care needs • Integrating assessments to cover health, care and housing needs • integrated provision of care and support services

15. Discussion