157. The Supporting People Strategy notes that

local authorities will […] play an increasingly important role in planning for the major demographic challenge of our time, an ageing society. The preventative services delivered by Supporting People are pivotal in addressing the needs of these groups before crisis point and managing wider local authority pressures, such as social care costs.[190]

158. Much of the evidence we received commended the Supporting People programme's role in helping older people live independently at home. Services such as Handyperson[191] were singled out for particular praise and many witnesses believed that advice and information services to help older people understand their care and housing options had been improved. However—along with the burden of the competitive tendering regime for Supporting People contracts—the issue of sheltered housing being part of the Supporting People regime was the most hotly disputed issue within the evidence submitted to our inquiry.

159. Age Concern and Help the Aged outlined the background to this contentious issue in their written evidence:

When SP funding was introduced in 2003 there was a debate about whether sheltered housing should be included under this funding regime. There was an early recognition that the inclusion of sheltered housing, under SP, could prove problematic and assurances were given in guidelines designed to protect sheltered residents. […] Prior to 2003, sheltered housing was delivered as a complete package, with the funding of housing support via Housing Benefit payment for those unable to pay service charges.[192]

Following a change in the Housing Benefit system in 2003, only 'bricks and mortar' could be paid for with Housing Benefit. The 'support' aspect of sheltered accommodation had to be paid with Supporting People funds. Age Concern and Help the Aged believe that the change in the funding regime from 2003 "is at the core of ongoing problems and complexities for many existing and prospective residents." [193]

160. In oral evidence, Mr Oldman of Age Concern and Help the Aged explained that the separation of housing and support costs was leading to "a fragmentation of services and confusion amongst residents about what the services are and how they are provided."[194] He went on to add that this fragmentation demonstrated a "failure to recognise that in relation to specialist housing and sheltered housing the reason it works is because it is an integrated package which brings together housing management and housing support. If you take that apart, you are creating inherent instability, financial instability within those schemes."[195]

161. Many witnesses, including the Anchor Trust, believe there are compelling reasons to remove sheltered housing as a low-level preventative service from the Supporting People regime, arguing that "the Supporting People structure is designed for higher-level interventions."[196] As we have already seen, evidence to our inquiry highlights widespread concern that pressure on local authority budgets will lead to funding being focused on services to support the most critical and acute needs, with the benefits of preventative, lower-level interventions consequently being lost.

162. The Anchor Trust also pointed out that "Older people in receipt of Supporting People funds receive a relatively small amount per person meaning that the administering of these funds is relatively expensive."[197] This view was supported in oral evidence by Louis Loizou of Brighton and Hove Sheltered Housing Action Group:

[…] all Supporting People does is deliver money […] it could quite easily, more cheaply and more efficiently be paid through the benefits system.[198]

The loss of wardens in favour of floating support

163. The focus of many witnesses' submissions regarding services for older people was the growing trend for local authorities to withdraw onsite wardens from sheltered housing schemes and replace them with generic or floating support teams which are able to deliver services to a larger number of older people in the community, rather than being attached to a single scheme. Age Concern and Help the Aged stated that "in three years time 38% of sheltered housing will have floating support (as opposed to warden services) from a base of 5% five years ago."[199] Whilst the organisation accepted that "There is certainly a strong argument that basic housing support services should be available to all groups of older people regardless of tenure—which was the stated objective of SP"[200], it remained "unconvinced that SP has achieved this objective."[201] Whilst floating support was acknowledged as being effective in expanding the client base being served by Supporting People services, Age Concern and Help the Aged referenced their 2009 report Nobody's Listening[202], in which they showed that older owners in sheltered and extra-care housing (many of whom are very vulnerable and not well-off) are sometimes denied Supporting People services as Administering Authorities have discretion to decide how support for older people in leasehold and privately rented accommodation should be funded. There was therefore a strong sense amongst many witnesses that Supporting People was neither delivering to some of the most vulnerable older people in society in a tenure-neutral way, nor managing to retain residential wardens in sheltered accommodation as a valid choice of housing-related support. On this latter point, given that service user choice is a mainstay of the Supporting People strategy, the removal of residential wardens as a 'choice' in some local authority areas is seen by many witnesses as a significant failure of the programme.

THE CASE FOR WARDENS

164. An argument against replacing wardens with floating support was raised by John Belcher of the Anchor Trust, who told us

People move into sheltered housing to seek security. They look to the scheme manager to provide that and suddenly they are finding that the scheme manager service in some parts of the country is being withdrawn, it is moving to floating support. [203]

This failure to manage the expectations of older people who have moved into sheltered accommodation on the understanding that there would be a residential warden has led to numerous legal challenges against decisions by providers or commissioners to replace wardens with floating support. At the time of our inquiry, the outcomes of these challenges were unknown.

165. Proof that warden services are still wanted by residents was provided by Housing21, which gave an example of how a reduction in the number of older people receiving Supporting People funding has not necessarily reflect a decreased demand for service:

In one area where the local council stopped paying the Supporting People funds (of £3.75 pw) for the resident manager service and developed a mobile or floating service of £5 per week our residents chose to continue our service losing the Supporting People funding support.[204]

The Anchor Trust described a similar outcome in three of its own schemes:

where the local authority has withdrawn Supporting People funding from within a scheme and we have taken that back to our tenants, the tenants themselves have actually voted to pay for the additional cost of retaining the scheme manager service. We have had that in three individual local authorities where that has occurred.[205]

166. When we asked John Belcher of the Anchor Trust why he thought local authorities were taking money away from warden schemes, he replied that he believed that the floating support option provided local authorities with the opportunity to remove support from residents with low-level needs in order to focus on those requiring a higher intensity service. Referring to some recent incidences of local authorities taking such decisions, Mr. Belcher felt that this represented a "[withdrawal] from providing what I consider to be a preventative service for the entire scheme."[206]

THE LOCAL AUTHORITY VIEW

167. When we asked local authority witnesses for their views about floating support in sheltered housing settings, we were—perhaps unsurprisingly—given some rather different perspectives. Andrew Meakin of Stoke-on-Trent told us that "some customers in sheltered housing qualified for Supporting People because they were in receipt of housing benefit, and others did not, and had to pay the Supporting People charges as a condition of their tenancy out of their own resources. We receive a lot of complaints from those customers who feel that they are having to pay for a service that they do not need."[207] Rod Craig of Cambridgeshire's view was that resident wardens were "very expensive"[208] and that "people are looking to stay within their own homes and receive the sort of services that they could do through sheltered housing on a supported outreach basis rather than on a building basis."[209]

168. The views of Stoke and Cambridgeshire were echoed in evidence from the Minister:

There will be people living in sheltered accommodation who qualify on the basis of their age and perhaps not on the basis of necessarily needing the support that a warden can offer. If there are people living nearby in a community who could benefit from the support that a warden can offer and are able to remain in their homes longer and live independently that is not a bad thing.[210]

We were interested to note that several witnesses saw there to be a compromise between accommodation-based and floating support in the 'hub and spoke' model of service delivery, as Housing21 outlined in their evidence:

A more favourable change highlighted by the research [by Help the Aged and Age Concern] is the development of floating support services from existing sheltered housing—often referred to as the hub and spoke model—where the onsite service is used as the basis for services to the wider community and to the scheme—something that we welcome since it protects the service for existing residents and develops new services for people in the surrounding community.[211]

KEEPING USERS AT THE HEART OF SHELTERED HOUSING

Engagement and involvement of service users with Supporting People services is not seen by many to have been a strength. For residents of sheltered housing, communication, consultation and complaints handling mechanisms were viewed as having been very poor indeed. Louis Loizou, Vice-Chairman of the Brighton and Hove Sheltered Housing Action Group, told us that "[…] it took me six months as Vice-Chair of Sheltered Housing Action Group to even know that there was a Supporting People action team meeting that I could attend. They did not come to me, they did not talk to me. […] To us, Supporting People has been a distant funding body, arrogant, not willing to talk to us."[212]

169. Joe Oldman of Age Concern and Help the Aged supported this statement, telling us

In terms of the research we did with 25 sheltered schemes, the majority of those said that the consultation was terrible or there was no consultation. The other thing they discovered was that there was no complaints procedure because housing support was seen to be a grey area so people could not deal with problems through the provider, the commissioner, the local housing ombudsman […] [Residents are fearful of] reprisals and problems if they do complain […] The other thing that worries me is that there have been letters from residents going to the (as it was) housing corporation and also CLG, so people knew then this was a problem and it has been a problem for years and years and nothing has been done about it. I think that reflects very badly on the attitude towards residents.[213]

170. An example of consultation which led to a change in the original proposals was described in relation to Kent County Council:

Kent County Council took a decision to withdraw scheme manager funding from all of its sheltered housing schemes and move to floating support across the county. They engaged in a wide consultation with the tenants living in the sheltered housing schemes and the reaction from the tenants was that they actually did not want to see a change in the funding arrangements and the support arrangements which operated for sheltered housing. They lobbied and campaigned their county councillors and as a consequence of that Kent changed its decision and maintained an in-house scheme manager service.[214]

171. When we asked the Minister about his views about the replacement of wardens with floating support, he replied, "If the point you make is that people have moved into sheltered housing on the basis that they receive particular services and then those services are changed without consultation and it causes difficulties I do not believe that should happen."[215]

The impact of Supporting People on builders of supported housing

172. The splitting of 'accommodation' and 'support' under Supporting People appears to have had a particular impact on builders of supported housing. Their capital investment can be threatened by the prospect of ongoing revenue funding (from the delivery of support services) being lost through the competitive tendering process. This issue is not specific to sheltered housing for older people, but also for other forms of supported housing, such as that for people with learning disabilities. Raglan Housing Association describes the difficulties for providers in this respect:

From an RSL perspective, the lenders that finance association development programmes are becoming more aware of the […] risk to revenue funding of projects and are both trying to increase the rate of interest on finance borrowed and becoming more reluctant to do so.[216]

In February 2009, Inside Housing described how housing associations were demolishing or selling off supported housing schemes because of uncertainty around how councils commission support services.[217]

173. Sitra recognises the financial risk to providers of having split accommodation and support for supported housing schemes, and recommends

That the CLG, with the HCA, run a consultation exercise on how best to ensure the continuing link between housing and support, including the continuing provision of accommodation based services where appropriate, and ensure that capital investment in new supported housing is not threatened by the risk on ongoing revenue funding being unavailable.[218]

Sheltered housing—where next?

174. In February 2008, the Government published Lifetime Homes, Lifetime Neighbourhoods: A National Strategy for Housing in an Ageing Society[219]. This cross-Government strategy addresses older people's housing needs and aspirations and outlines the Government's plans for ensuring that there is enough appropriate housing available in future to relieve forecasted pressures on homes, health and social care. The Strategy contains a range of measures to bring about fundamental changes, such as an expansion in existing support available to older people that will help them to live safely and, where they choose, independently in their own homes. Whilst organisations such as Age Concern and Help the Aged believed this report went a long way towards addressing older people's housing needs in the general sector, they did not believe that it adequately addressed the issue of sheltered housing. Consequently, a Ministerial working group was set up to look at issues raised within the Nobody's Listening report and wider issues around Sheltered Housing.

175. As a result of issues discussed above, and in the interests of promoting user choice, several witnesses proposed that Supporting People funding should be paid directly to those eligible for socially rented sheltered housing, to enable individuals to choose whether to live in schemes with an integrated warden or to purchase housing and support separately. Providing this choice was felt to be in tune with the 'personalisation' agenda and the spirit of the Supporting People programme in giving service users control over the services they receive.

Conclusions: sheltered housing

176. It is not possible for us to draw firm conclusions on the complex area of the position of sheltered housing within the Supporting People regime on the basis of the limited evidence which we have received in the context of this inquiry. Nevertheless it is clear that the separation of funding for accommodation and support has created serious issues for providers and users of sheltered housing, and there is a strong case for reconsidering sheltered housing's place in the Supporting People regime.

177. It is also clear from the evidence which we received that service user consultation, involvement and complaints handling, which has not been perceived as a particular strength anywhere in the programme, has been particularly weak in the area of sheltered housing. The issue of the replacement of wardens with floating support is a case in point. There are pros and cons to the replacement of wardens in this way, and we do not consider that resident wardens should necessarily be retained in all circumstances. However, we are concerned that user choice is not being listened to.

178. We welcome the fact that a Ministerial Group is now considering these issues, and trust that it will take note of the volume and strength of evidence submitted to this inquiry on the topic of sheltered housing. The evidence we received suggests that this Ministerial group needs to focus on:

• Reviewing whether sheltered housing should stay within the SP regime;
• Improving needs analysis so that evidence is available of what older people want; and
• Developing a more coherent strategy for the provision and funding of housing and support services for older people, making clear the role of sheltered housing.

The Group should also consider the effect of splitting 'accommodation' and 'support' under Supporting People on builders of supported housing, and make recommendations about how to ensure that capital investment in new supported housing is not threatened by the risk of ongoing revenue funding being unavailable.

191   Handyperson services are offered by many Home Improvement Agencies to help older or disabled people with small jobs around the home, or operate specific schemes to improve home safety and security, prevent falls in the home, improve energy efficiency or make homes suitable for people to return to after a stay in hospital. Back

192   Ev 130 Back

193   Ibid. Back

194   Q 150 Back

195   Q 150 Back

196   Ev 116 Back

197   Ev 118 Back

198   Q 142 Back

199   Ev 129 Back

200   Ibid. Back

201   Ibid. Back

202   Help the Aged, Nobody's Listening (London, 2009). Back

203   Q 150 Back

204   Ev 108 Back

205   Q 151 Back

206   Q 153 Back

207   Q 215 Back

208   Q 252 Back

209   Ibid. Back

210   Q 323 Back

211   Ev 108 Back

212   Q 160 Back

213   Qq 161-62 Back

214   Q 163 Back

215   Q 322 Back

216   Ev 136 Back

217   "Uncertainty causes landlords to demolish supported schemes", Inside Housing, 27 February 2009. Back

218   Ev 193 Back

219   Communities and Local Government, Lifetime Homes, Lifetime Neighbourhoods: A National Strategy for Housing in an Ageing Society, February 2008.

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