Staffordshire Housing with Care Strategy 2024-2029

‘Making It Real’ is a set of nationally co-produced statements which set out what personalisation
of care services should look like from the perspective of the people who use them. These
include the following, which are important in relation to Housing with Care

Wellbeing and independence

• “I have a place I can call home, not just a ‘bed’ or somewhere that provides me with care.”
• “I live in a home which is accessible and designed so that I can be as independent as possible.”

Information and advice

• “I know what my rights are and can get information and advice on all the options for my health, care and housing”

Active and supportive communities:

• “I feel welcome and safe in my local community and can join in community life and activities that are important to me."

Flexible, integrated care and support

• “I have care and support that is co-ordinated and everyone works well together and with me.”

When things need to change

• “If I move from my home to another place, the people who are important to me are respected, listened to, supported and involved in decisions”

Workforce

• “I am supported by people who listen carefully so they know what matters to me and how to support me to live the life I want.”

The Care Act 2014 emphasises that housing is key to meeting people’s needs and places duties on local authorities to:

• Promote well-being including through considering suitability of people’s accommodation.
• Treat housing not just as 'bricks and mortar' but include the support that is needed to access housing (such as housing related support).
• Consider housing access as part of an assessment process to prevent, reduce or delay in adult social care need
• Include information and advice about housing options as part of a universal service offer (including for self-funders).
• Ensure that care and support is delivered in an integrated way with cooperation with partner bodies, including health and housing. 

The County Council’s vision is for “an innovative, ambitious and sustainable county, where everyone can prosper, be healthy and happy; and a priority is to encourage good health and wellbeing, resilience and independence to keep people healthier and independent for longer.”

This Strategy compliments the commissioning intentions set out in Staffordshire County Council’s Market Position Statements.

Staffordshire already has some excellent examples of Housing with Care. The table below shows a summary of Housing with Care currently available in Staffordshire, which includes services where people receive care and support funded by the County Council.

The County Council wishes to continue to reduce the number of people in residential and nursing care home placements by an increased use of ‘support at home’ services for older people and people with a disability with lower-level eligible needs. This will include an increase in the use of provision including Extra Care Housing, Supported Living, Shared Lives care, and other initiatives as well as domiciliary care.

Supported Living Developments being created to support people with mental health needs to live independently in Staffordshire.

What’s been happening, and what is the impact?

Staffordshire County Council and Care providers working with Registered Social Landlords have come together to understand the needs of the County for any additional Supported Living provision. The decision on additional needs have been based on data analysis of current capacity and future demand. From this joint approach the County has upcoming additional capacity of supported living intended for to support people to manage their mental health needs.

Extra Care Housing

Our population is ageing. Between 2012 and 2021 the population grew by 70,000 and by 2041 we can expect it to grow by another 80,000. Almost all of this growth is people aged 65 and over, and especially people aged 85 and over. The proportion of the population aged 65 and over will almost double from 15.6% in 2001 to 27.0% in 2041. The proportion of the population aged 85 and over will almost triple from 1.7% in 2001 to 4.5% by 2041.

This will mean more people with health conditions that will result in care needs, and a growing
demand for Housing with Care.

The current provision of Extra Care

within Staffordshire, and schemes which are in development and or approved for development, are detailed in the table below.

The growth in Adult Social Care demand
Within Staffordshire, and schemes which are in development and or approved for development, are detailed in the table below

Extra Care

SPOTLIGHT ON GOOD PRACTICE
Developing a Joint Allocation
Process to increase the
number of people with care
needs living independently
at Daisy Haye Extra Care
Scheme.

What’s been happening and what is the impact:

Daisy Haye is an Extra Care scheme in Staffordshire Moorlands. It provides older people with a housing option to live independently within the scheme. The scheme has an onsite care team and a timetable of monthly social activities. Staffordshire County Council in partnership with Your Housing Group (the scheme housing provider), Nexxus (the care provider) and colleagues from the Midlands Partnership Trust (the county’s social work teams) meet monthly to discuss upcoming vacancies at the scheme and develop a waiting of list of people with care needs identified to the social work teams that would benefit from the support available from Daisy Haye. People living at the scheme are supported with their care needs to remain living independently and the joint process has increased the number of people at Daisy Haye who have care and support needs. 

Supported Living

Over the period 2020 to 2040 the total population of Staffordshire residents aged 18 to 64 is predicted to remain roughly static. The population with a moderate to severe learning disability, who are likely to require care and support, is predicted to grow slightly. The population with a moderate or severe personal care disability is predicted to fall slightly. The population of people with an autistic spectrum condition is expected to grow by 9%.

+6%

The greatest increase in the number of people with a learning disability is expected to be in the 45-54 age range which is predicted to increase by 171 people (6%) from 2,790 to 2,961.

-12%

In the same period the number of people aged 55-64 with a learning disability is expected to decrease by 304 individuals (-12%) from 2,856 to 2,552.

However, the growth in demand for Supported Living is expected to be greater than this overall demographic figure.

Over time, we anticipate that people are more likely to receive care and support in Supported Living and less likely to do so in residential or nursing care. In addition, there has been an increase in demand for Supported Living for people with mental health needs in the last two years, and it is not yet known to what extent this trend may continue. The delivery plan for Supported Living will capture a “pipeline” of future demand, linked to individuals’ care reviews and capturing their future wishes.

Rough Sleeping and Homelessness

Each Borough and District Council has their own strategies, policy and practice regarding rough sleeping and homelessness. Each strategy recognises that there will need to be a cross-sector response, to ensure the right advice and support is provided at the right time, with opportunities to intervene early and prevent homelessness in the long term.

People become homeless for a wide range of reasons which can include substance misuse and addition, mental ill health and illness, physical illness, domestic abuse, unemployment, poverty, family breakdown, lack of affordable housing, tenancy breakdown and rent areas.

An overview of housing affordability and homelessness across Staffordshire is indicated in Table 6.

Through our detailed delivery plans, we will identify where specific individuals with adult social care needs are affected by homelessness and rough sleeping. We will work collaboratively with a clear pathway to provide support to meet care needs in settings that also seek to prevent or address homelessness and rough sleeping, and to develop appropriate arrangements where care needs cannot be met in these settings.

Rough Sleeping and Homelessness

SPOTLIGHT ON GOOD PRACTICE
Stafford Borough Council have
commissioned accommodation
through a ring-fenced grant
from the Ministry of Housing,
Communities and Local
Government specifically for to
support rough sleepers in the
Borough.

What’s been happening and what is the impact:

The accommodation includes a six-bed purpose designed unit for entrenched rough sleepers with 24/7 staffing which is underpinned by a coproduction model and five units of dispersed ‘housing first’ accommodation. Both projects went through a tendering process and specialist charities, who also operate as Housing Associations, were successful in securing the contracts. The provision is reliant on rough sleeper grant funding to provide intensive wrap around support which is critical to sustaining accommodation for those who have experience of rough sleeper or homelessness and have complex needs that include mental health and social care, offending behaviour and substance misuse amongst others.

"Eagle House offers temporary
accommodation for single people
aged 18-64 who are faced with
homelessness."

We are developing strong partnerships to ensure a collective understanding of Housing with Care and supply and demand and to oversee developments, as Staffordshire is a diverse county, and we aim to have the right type of Housing with Care in the right locations for our residents.

What we will do

Work together - The County Council’s partners include the eight District and Borough Councils in Staffordshire, the County Council, the NHS, Registered Social Landlords, as well as housing developers, private landlords and care providers, and we will also work with other partners including Homes England. The County Council will work collaboratively with partners as they deliver their statutory and legislative duties that support the delivery of good quality Housing with Care provision.

Joint training - To help support our partnership working, we are together embarking on a range of joint training so that we all have a shared understanding of Housing with Care and can jointly tackle the challenges our residents sometimes have in accessing it.

Detailed delivery plans - The Strategy will be delivered through the development and implementation of detailed delivery plans for each of the key areas of work, co-produced with people with care and support needs and with our partners.

These plans will cover: 

• Extra Care: The term 'extra care' housing is used to describe developments that comprise self-contained homes with design features and support services available to enable self-care and independent living for older people.
• Supported Living: Supported Living schemes support people with learning disabilities, physical disabilities, autism, or mental health conditions to live independently in the community. Schemes can be shared houses or clusters of flats or may be single households
• Shared Lives, a highly flexible form of supported living and gives individuals the opportunity to live within a family.
• Major and Minor Adaptation including Disabled Facilities Grants: These are grants provided by the local authority to help meet the cost of adapting a property for the needs of a disabled person.
• Homelessness and Rough Sleeping support for people with social care needs: Housing, care and support for people who do not have a home and who have social care needs.
• General housing needs: Housing that meets the needs for the population of people with care needs.

Structured approach - We aim to adopt a strategic and structured approach to improve the alignment of care and support needs across Housing with Care and deliver our ambitions, which will include:

• Working in partnership with providers to take a flexible approach in making Housing with Care provision available for people with a wide range of needs and consider new business models to enable this.
• Implementing innovative and technologically enhanced housing, care, and support solutions, that help people to live independently in a safe home and community environment that provides opportunities for them to participate, shape and become actively involved in their communities.
• Implementing provision where people’s capacity to age well is supported by having ready access to social and communal services, family members, neighbours, and the broader community.
• Implementing housing with care provision that is affordable to local populations and offers security of tenure and greater independence, health, and wellbeing

Maximised outcomes of those with social care needs - Our Strategy aims to maximise the outcomes of people with social care needs and provide best value for money by offering good quality and cost-effective services that support people, and those that may care for them. We want people with social care needs to live as safely, independently, and healthily as possible, with the right care, at the right time, in the communities of their choice, whenever possible. It is important that our strategic objectives for Housing with Care help us to deliver this.

Sufficient housing with care services - We will work with our strategic housing and care partners and support them to deliver sufficient housing with care services that reflect adult social care needs including:

Housing Authorities, Housing Developers, Registered Providers of Housing, Private Landlords

developing an appropriate mix of accommodation, properties, sizes, and types by working together to ensure that Local Plans reflect the requirements for our diverse communities.

• Delivering a mix of tenures including rented and social housing suitable for a range of individual circumstances.
• Schemes offering good quality housing alongside good quality care that promote independence, meet people outcomes, and offer a less restrictive environment where people can take positive risks.
• Developing models of housing management support are aspirational and promote recovery for people with mental health conditions, so that they can support people to live more independently and encourage people to move away from provision that is no longer suitable for their needs. This approach will alleviate issues such as creating dependency on care services and bottlenecks in care provision that prevents further referrals for support.

Registered Providers of Care, Community and Voluntary Sector Organisations, Public and Private Sector Institutions.

• Maximising choice of care for people in a way that does not jeopardise their tenancy and housing arrangements.
• Offering a range of care appropriate for people with a variety of needs - from intensive personal care to less intensive and non-regulated support.
• Commissioning Housing with Care schemes which offer ready access and actively seek to connect with community assets, and work with local voluntary organisations.

We will develop with our partners detailed delivery plans for each of the following areas:

Extra Care

The County Council’s aim is that Extra Care housing will become an attractive alternative to residential homes and that the supply of Extra Care will reduce demand on residential home capacity required, through:

• The provision of Extra Care Housing with people moving in before or at the point they can no longer manage in their own homes to reduce the risk that they will need.
• Pathway development and multi-agency working.
• Short-term Extra Care for reablement and respite.
• Alternative provision for younger and working age adults with learning disabilities and/or autism, physical disabilities, and mental health conditions.

Supported Living

Our intention is that the proportion of people in Supported Living will rise over time, with the proportion of people in residential homes gradually falling over time. We are currently developing a revised commissioning approach for Supported Living and our aims include:

• Increasing the availability of Supported Living in Staffordshire for people currently placed outside the county where appropriate, including young people placed in other local authority with disabilities and entering transition.
• Strengthened assurance for our housing arrangements including that people in Supported Living have an appropriate tenancy agreement, that there are no inappropriate links between landlords and care providers, and that those with private sector landlords are not adversely affected by more limited housing benefit available.
• Commissioning focused on outcomes and a reduction in transaction costs, with care providers managing changes in individuals’ needs, unless a significant and long-term change is confirmed through a social care led review.
• Effective and efficient processes for sourcing care that offer a good customer experience and minimise administrative costs.
• Standardised rates that are financially sustainable for care providers whilst also being cost effective for the Council.
• Strengthened quality assurance and contract management, with clear quality standards and standardised contracts in place.

Shared Lives

We have recently recommissioned this service, and our commissioning intentions for this service include:

• Increasing awareness of Shared Lives amongst residents and grow the service.
• Enabling more of our residents to benefit from Shared Lives and increase the capacity of the service.
• Developing targeted strategies designed to ensure the Shared Lives service continues to add value to the housing with care pathway.
• E-viewing options for growth and diversification of the Shared Lives scheme including expanding the scheme to more individuals so that people can achieve outcomes through Shared Lives as an alternative to other forms of support.
• Increasing the numbers of individuals supported within Shared Lives through innovative recruitment of new Providers and marketing of the scheme to communities across Staffordshire.

Major and Minor Adaptations including Disabled Facilities Grants (DFGs)

Our intention is for the County Council to work in partnership with our Borough and District Councils and with stakeholders to deliver a DFG pathway that is efficient and effective in supporting people to remain independent and safe at home in addition to:

• Increased use of Assistive Technology, equipment and adaptations Major and minor and DSG) to enable people to live independently.
• Improved and co-ordinated information and advice in relation to accessing DFG’s, to ensure effective information, step-by-step guidance and support to all applicants.
• Continually improving the customer journey and procedures between the County Council and our Borough and District Council’s that facilitates better access to suitable home adaptations that will enable people with a range of disabilities to live more independently within their homes.
• Ensuring practitioners, with the most appropriate skills and experience, are utilised for when they were needed to accurately assess the needs of individuals and they receive the appropriate adaptations to them to enable them to live more independently.
• Continued contract management and co-ordinated resource allocation to deliver the adaptations required within each Borough and District Council.
• Continued management across Staffordshire of both contractors and product suppliers (providers) within this specialist market to meet the need of eligible residents offering consumer protection and insurance backed warranty for the works, where applicable and ensure compliance with relevant regulations.

Homelessness and Rough Sleeping support for people with social care needs

Our intention is for the County Council to work in partnership with the borough and district councils to:

• Continuing to improve our prevention services that support the reduction of Homelessness and Rough Sleeping for people with social care needs.
• Providing good quality housing, care and support options, so people can resolve their problems in a way that is resilient and long lasting by accessing the appropriate adult social care support that they need.
• Identifying people who are at a greater risk of homelessness due to their social care needs and face barriers to accessing good quality affordable housing with care and support services, including people with mental and physical health issues and disabilities who are also at a greater risk of homelessness.
• Working across the Councils and housing partners to increase access to affordable, good quality temporary, move-on, and settled housing across Staffordshire for people with social care needs.
• Continuing to develop tailored accommodation and support pathways for people with complex and multiple needs.
• Strengthening our information, advice, guidance and support services to help people to make informed decisions about their settled housing options, including as they move on from temporary accommodation and ensuring that these are accessible for people with social care needs.
• Improving referral pathways between Adult Socia Care and Housing Options services within our Borough and District Council where necessary.

General housing needs

We aim to work collaboratively across the Councils in identifying the general housing needs for people with adult social care needs. This will include:

• The County Council regularly updating each borough and district with its predictions of future underlying social care need in each area
• Ensuring that borough and district councils are provided with the County Council’s Market Position Statements
• Working together so that the adult social care needs of older people, adults with a disability and adults with complex needs are integrated into each borough and district Council planning application for C2 developments and are reflected into their Local Plans.