Joint strategic planning is a key element of delivering community care. A study of the housing strategies and the linked community care plans of 120 local authorities, by Brian Lund and Mark Foord of The Manchester Metropolitan University, found:
-- New forms of collaboration are emerging, often with a specific housing dimension; however, in county areas, the absence of a clear structure to link housing and community care at county level can jeopardise local planning, restrict access to county resources for supported housing and undermine the operations of the emerging Special Needs Housing Groups/Forums.
-- Most local authorities have commissioned housing needs surveys but with special needs added on to general needs surveys focusing on affordability. Surveys of special needs are developing but as they are not being carried out within a standard framework, findings are difficult to compare and collate nationally.
-- There is concern amongst general needs housing associations and local authorities about unmet support needs. Housing authorities are responding by establishing special support teams and increasingly linking offers of accommodation to guarantees of care/support packages.
-- Social housing is geographically concentrated and the location of people with specific needs is strongly associated with indicators of deprivation. Whereas planning procedures are sometimes used to restrict the housing opportunities of people with specific needs, the limited positive powers available to promote 'balanced' communities are rarely used.
-- In the 1990s the debate on housing and community care has centred on the process of joint working rather than its outcomes. Performance indicators related to the objectives of independent and integrated living are absent from housing strategies and community care plans. The researchers conclude that such indicators can be developed but only by the systematic recording of the accommodation requirements of people with specific needs.
Despite the declaration that 'housing is a vital component of community care and is often the key to independent living' made in Caring For People: Community Care in the next decade and beyond (1989), many housing departments expressed concern about the extent of their involvement in community care planning during the early stages of its implementation. Central guidance on the issue was sparse and rarefied, a reflection of tensions between the Department of Health and the Department of the Environment concerning 'cost-shunting' and the potential use of social housing for community care leading to the creation of unbalanced communities.
In 1992 the Department of the Environment strengthened the position of housing in community care planning by linking the Housing Corporation's Approved Development Programme to the local government housing investment process, but the integration of the housing and community care agendas to produce a 'seamless service' was placed firmly in the domain of local government and health commissioners. Through analysis of local authorities' overall housing strategies and linked community care plans, this study set out to examine how effective joint planning is proving.
Movements towards joint planning
Since 1993 new methods for joint planning for those purchasing services and for involving housing in community care have evolved. The study found four main forms of collaboration developing: joint commissioning/purchasing; locality planning; special needs housing groups/forums and, in counties, county housing groups. This has enhanced the role of housing authorities in community care planning but there are still some gaps in the links between the different elements of the local planning system which may hinder its successful operation:
-- In county areas, the absence of a clear strategic framework to integrate housing and community care at County Joint Consultative Committee level can prejudice the operations of locality planning and Special Needs Housing Groups/Forums and separates the provision of accommodation from potential sources of capital and revenue.
-- Some Special Needs Housing Groups/Forums formed by housing authorities lack connections to any client-based planning groups in their area.
-- As the purchaser/provider division hardens, purchasers are becoming removed from the information generated by the routine activities of service providers, making it more difficult to assess the local implications of policy.
-- Community care plans do not contain information on revenue contributions to housing with support.
Although local authorities recognise the necessity for 'bottom-up' need assessment, reliance on 'top-down' data (Census information and prevalence rates) remains dominant in both the housing and social service sectors. The information available varies according to the client group under examination; the absence of information on the requirements of a particular group can influence the way in which priorities are determined.
Despite the emphasis placed on the role of individual need assessment in the countdown to the implementation of community care, 'bottom-up' information relating to individual preferences and professional assessments of need - either from housing register or community care assessments - is not being used to estimate aggregate need. The complexities of housing for people with a specific need make it difficult to estimate aggregate need without the accumulation of information from detailed individual assessments.
As a supplement to information derived from the Census many local authorities have undertaken needs surveys. These surveys have been directed primarily towards justifying the need for social housing, as required by planning guidance (PPG3), with special needs questions often appended to a general needs survey. As the limitations of such surveys have been recognised, surveys directed specifically towards identifying special needs are developing. However, there is no standard framework for these surveys and therefore no mechanism for estimating the national accommodation requirement arising from community care, which is virtually ignored in national estimates of future housing requirements.
Although some authorities have established priorities based on a systematic appraisal of need, the distribution of resources is influenced by a variety of factors including:
-- the division of central resources into separate streams; * statutory responsibility under the homelessness provisions of the 1985 Housing Act; * the assumption that a particular need is absent simply because it hasn't been quantified; * consultation with housing forums, which is often used to reach a consensus on priorities; *the availability of supplementary resources, such as redundant buildings and revenue derived from the operations of the social security system; *the dominance of urban regeneration in many authorities, which tends to concentrate resources for special needs provision in particular areas.
Access to general needs housing
Priorities for additional accommodation are influenced by access to the existing housing stock. There is disquiet amongst general needs housing associations and local authorities concerning the unmet support requirements of their tenants - a reflection of the concentration of people with specific needs in the social housing sector and uncertainty about the multitude of possible funding sources available for support. Housing authorities are responding to this issue in two ways:
-- establishing special support teams; a development with implications for the legitimacy of the 'welfare' elements in the local authority housing revenue account - a contentious issue in some areas; and * linking offers of accommodation to guarantees of care/support packages from social services and the voluntary sector - a practice that will be facilitated by the 1996 Housing Act.
The location of special needs housing
Social housing is spatially concentrated and the location of people with specific needs is strongly associated with indicators of deprivation. This distribution is due to a number of compounding factors and has implications both for people with a specific need and for others living in a neighbourhood. The geographical concentration of people with specific needs has already become an issue in a few authorities and is likely to be identified as a problem elsewhere. Whereas planning procedures are sometimes used to restrict the provision of new housing for people with specific needs, it is rarer for the limited positive powers available to promote 'balanced communities' (under planning guidance PPG3) to be used.
Process and performance
In the 1990s the debate on housing and community care has centred on the process of joint working rather than the outcomes of collaboration. However, indicators of performance by which to assess progress towards the objectives of independent and integrated living are sparse. The outputs most frequently quoted in housing strategies and community care plans are the number of dwellings with on-site support completed and the number of dwellings with specific design features built or adapted. At national level, the National Housing Federation has measured progress by the percentage of Housing Corporation resources allocated to special needs accommodation, but this is becoming difficult to compile as the distinction between special needs and ordinary housing has started to dissolve.
Other potential performance indicators include:
-- The homelessness statistics generated by the 1996 Housing Act. * The reduction in local housing need as measured by the housing register, mandatory under the 1996 Housing Act. * The number of 'bedspaces' in each unit of special needs accommodation. * The proportion of people with specific needs living in self-contained accommodation. * The monitoring of the housing opportunities of people with specific needs in terms of location, waiting time, the quality of the dwelling offered and the 'failure' rate of tenancies.
Housing and community care is now an issue for local government and there are sufficient examples of good practice to justify the establishment of a centre in England to collect and disseminate information (along the lines of a centre already established in Scotland).
About the study
The research was undertaken by Brian Lund and Mark Foord at The Manchester Metropolitan University. It draws upon an analysis of 120 housing strategies, produced each year between 1993 and 1995, selected to be representative of local housing authorities in England. This information was supplemented by an analysis of the community care plans associated with the strategies and an examination of the processes involved in the preparation of housing strategies in five housing authorities.
The full report, Towards integrated living? Housing strategies and community care by Brian Lund and Mark Foord, is published by The Policy Press in association with the Joseph Rowntree Foundation (ISBN 1 86134 049 4, price£11.95).
For further information on the research, contact Brian Lund, Social Policy Section, Humanities Building, Rosamond Street West, Off Oxford Rd, Manchester M15 6LL, Tel. 0161 247 3456, Fax: 0161 247 6361.