Health and housing roundtable write-up

Yvonne Castle, Chief Executive, Johnnie Johnson talks through the organisation’s approach to supporting older and vulnerable residents through the coronavirus crisis.

Is our sheltered stock fit for purpose. Are we meeting the needs of an ageing population? What are the implications that the current climate has placed upon caring for vulnerable residents? What are the opportunities?

The NHC hosted our virtual Health and Housing Roundtable last week, we heard from Trish Grierson, Head of Independent Living, Johnnie Johnson and Marie Smith, Housing Manager, Durham CC on their approaches to supporting older people.

Trish Grierson, Head of Independent Living, Johnnie Johnson was invited to join us to talk through the Johnnie Johnson approach to supporting older people. Johnnie Johnson has 2080 residents in sheltered housing schemes, mainly in the North West and North East. Over 900 residents are aged over-70 and they have a social monitoring scheme which has over 50,000 call-monitoring connections. Technology-enabled care is vital to them.

Trish set the scene with the aim of the roundtable – to examine whether sheltered housing is a thing of the past or a model for the future. She talked about one of their largest schemes in Stockport which they have been upgrading, taking a lot of resident engagement into account. This has involved improving bathrooms and making it ‘age-friendly’, not ‘dementia-friendly’ as many residents are not tolerant of residents with dementia. They are also remodelling bedsits; of which they have 770 out of 5000 stock, refurbishing buildings to combine units into one-bed flats. Trish also talked about an interior design pilot which they have carried out, seeking to implement a 7-8 year period to renovate whole homes at a time.

She also talked through the disadvantages of sheltered schemes. The unit sizes are small and whilst they do have communal spaces, residents currently cannot utilise them due to social distancing, there have been some challenges with some residents grouping together and not adhering to social distancing. Trish then opened up discussions for participants


Summary of comments, questions and answers

Participant question: When refurbishing outdated sheltered schemes we have had difficulty letting some units, choosing to hold some of voids to temporarily house residents whilst we renovate. How can you best manage this sort of arrangements?

When carrying out bathroom renovations we consulted the LA. We opted not to move people out at all. We carried out a lot of consultation with residents and carers. We also seek to modernise when each property becomes void. If we want to work on a long-standing property we will have to look at relocations. It can be a controversial approach but avoids inconveniences with moving residents. We have been surprised in the past at how quickly this can come together.  


Participant question: Sheltered housing is still having the same issues as 20 years ago in many ways. Can you talk about the expectations and aspirations of the new older residents coming through? It has clearly changed and is changing dramatically since the post war days (when older people reached that age for sheltered housing having been ‘young’ in the post war era) when Johnnie Johnson got in to this. Can the buildings and service keep pace with expectations? Many older people choose this route as they have too much equity in their homes, though it is not ideally what they would like.

Buildings are becoming tired and dated. Many organisations are converting buildings into extra-care schemes though this is not an option for all. Renovating is great at changing the experience of sheltered living but it doesn’t always get people through the door to see it in the first place. Many people don’t want to move of course, though often it is a desire to remain in the community, not in their current home as such. The location is key, so we should seek to develop within communities. 

 Rural housing presents challenges for extra care schemes. Residents want something within the village that they live, not 30 miles away in Alnwick or Berwick. In the long run it can mean bigger centralised schemes can be more expensive as residents cannot get support from family members.  

We find that at the moment we are communicating with residents far more than previously.  Independent living coordinators have largely raised not only our call volume but also the length of the calls, receiving feedback that residents feel they are receiving a better service. Single residents have reported that they appreciated extra calls, though all groups have seen an increase to a certain extent. Feedback has been surprising, we thought many would not want extra contact. Some are engaging in extra contact with relatives through iPads etc. Independent living coordinators have a daily check in with line managers and have reported enjoying the calls. We’ve looked at key roles, many of which of course aren’t paid well, looking at refuse collection, cleaning etc. Relationships with landlords have also been considered, people are quite critical of being told what to do. Its very important to communicate that these are not our rules but those of the Government.


Participant comment: Bellview Scheme in Belford has been a very successful extra scheme. We cannot build our way out of situation with bungalows, they cannot be delivered in big enough numbers. A Manhattan loft-style living situation would be the ideal way to sell sheltered living, though of course unlikely. With the right location I believe that uptake will be far greater.

In GM, with devolved powers, we have seen that housing providers are working closely and providing good support.

Satty Rai asked: does anyone have anything to add on remote working/takeaways form the current situation? 

Participant comment: we have the majority of our schemed staff home working, with a small remote team going round the schemes. We also carry out daily welfare calls which have been positively received. Over the last week or two we have received ASB calls. We need to start implementing procedures to counteract build-up of social-distancing related issues.

Participant comment: Yes, we’ve had complaints from residents of others using communal gardens. People complain where they see others behaving in a way they wouldn’t, though not necessarily against guidelines.

Marie Smith, Housing Manager, Durham CC 

Marie provided some context about Durham County Council which is classed as a rural authority. Tenure make-up is 20% social and they are tasked to deliver with 31 housing providers. Firstly, they want to ensure that vulnerable residents have all the support they need, around new homes, they want to ensure that older peoples’ needs are met, they want to increase access to housing and they want to examine their social stock across the board.

Marie went on to say they wanted to do something specifically on housing for vulnerable groups. Internally conversations can be difficult due to their size. They looked at four groups: single homeless, learning difficulties, mental health and older people. The council are looking at wrap-around support, with many of their providers having their own support schemes. In the private rented sector there are a lot of people who don’t come to them and they feel they could be more proactive.

Within their housing provision team the council are offering a project management service. Some older people may have too much equity to qualify for a sheltered scheme but have no family to look after them. With Durham County Council’s 20-year plan they have a target for 10% affordable housing for older people, a minimum of 600 units – they plan to work closely with providers on this. Often owner occupiers are stuck in properties and older people struggle to access the scheme as it’s internet based.

The council are also looking to set up a local lettings agency, seeking to help those with low-medium complex needs. Marie felt it could be extended to help older people too. Their final aim is to examine outdated stock. They have targeted delivery plans looking at  a number of indicators across communities to warrant interventions to reverse decline.


Summary of comments, questions and answers

Participant question: Really good to hear that you are proactively seeking to understand and then communicate what you need accommodation/support wise to partners Marie. Will you look at all tenures as a lot of people do have some equity and the private side of things can get forgotten in policy? Many are sitting on equity and the affordable approach often excludes them.

In housing solutions, we are looking at the private side; this is where a lot of challenges for older people are. Yes, those who you identify can be forgotten about. This certainly aims to includes them. 

Participant comment: You made a key point on local plans being fit for purpose. In LAs structures planning sometimes colleagues in housing don’t see much of what goes in; funding teams are situated separately from housing and often it feels like there isn’t enough consultation with housing before funding decisions are made. It is key to have a housing person embedded within planning on a day-to-day basis.

Within my organisation, restructuring meant that housing, ASC and childhood services have been integrated. There have been great benefits because of this.

Participant question: could you expand on your housing project management service?

Our home improvement agency carries out home adaptations, surveyors are checking whether changes can be made to properties. Some older people have come to the service but failed the means test as they have too much cash. The service is seeking to develop to help these people at a low cost.  

A representative from YHN said they carried out a full external review last year, the report has been used to develop a housing offer for older people – this was shared after the event.