Integration Inaction

The gap between day to day reality compared with Law and Guidance is nowhere more stark than in relation to the Care Act 2016.

This well received legislation and the associated Guidance was significantly influenced by practitioners working across the social care, health and even housing sectors. Wellbeing was defined to include considerations of housing, prevention was high on the agenda, as was more integrated working.

What do we see happening to care in reality, from our particular housing perspective which concerns older people living in mainstream housing?


We are seeing service contracts ‘salami slicing’ the elements of our longstanding integrated vision, which was the very foundation of the idea of ‘Care & Repair’.

We see separate contracts (and hence different providers) for DFG/non DFG adaptations/help with home repairs (with these disappearing entirely in many places)/ handyperson services (now often grab rail installers rather than rounded enablers of independent living)/information and advice about later life options/casework/financial advice/ wider issues support/ trusted trader listings.

The poor service user instead of having a single point of contact can be faced with dealing with a plethora of non-specialists, where once the Care & Repair agency was their one-stop-shop.

From the perspective of an outsider, the integration of care and health is a very long way from reality, whilst the inclusion of housing is patchy at best.

Our new survey of Sustainability and Transformation Plans is hardly a cause for celebration, with housing, let alone ageing, hardly getting a mention in all but a few areas.

We clearly have a long road to travel before the vision of integration is anything like reality. [July 2017]

The Thirst for Knowledge

At just about every event for older people that Care & Repair England has been involved with about housing decisions in later life, impartial information and advice (I&A) come out as key issues.

This priority is reflected in the titles of our I&A projects, such as ‘If only I had known’,

It underpins our Silverlinks initiative, which aims to ‘spread the word’ about later life housing and care options through older people talking to each other (‘peer to peer information transfer’, to give it a technical description).

It is therefore worrying to hear of the demise of so many independent voluntary sector information and advice services for older people, and to this week read about the poor quality of online advice and information being provided by nearly half of local councils.

In their national survey, ‘Better Connected’ (which regularly assesses local authorities online performance) found that 49% of councils provided an unsatisfactory or poor service in terms of information for the public about finding local care and support for older people.

It is worth noting that when Care & Repair England worked with older people in the North West of England to undertake a mystery shopping exercise, looking both at online materials and phoning up to seek practical housing help, results in the majority of places were also disappointing.

The Care Act 2016 and associated Guidance include specific requirements concerning information and advice to enable self help/ prevention. Clearly not all authorities are taking this on board.

We all realise how tough the financial situation is for local councils, but when you consider the benefits that result from enabling self help and informed decision making, this does seem short-sighted.

The cost benefit ratio in the independent evaluation of the EAC FirstStop ‘Housing & Care Options Info and Advice’ programme was 1:23. In the recent in depth evaluation that we carried out of one of the local First Stop I&A projects run by Age UK Warwickshire, our even more cautious methodology found an £8 pay back for every £1 spent – the savings for just one of the older people interviewed would have more than covered the annual cost of the adviser.

We urgently need a new national initiative to crack this info and advice issue once and for all. Let us hope that when it finally emerges the Government’s Social Care Consultation will come up with great new proposals. [July 2017]