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?

Fragmentation.

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]