Care and Support for Residents with Different Levels of Need in Housing with Care Schemes in England

Transcription

1 Care and Support for Residents with Different Levels of Need in Housing with Care Schemes in England Robin Darton British Society of Gerontology Annual Conference, Oxford, 12 September 2013, 10:15 This presentation reports on independent research funded by the NIHR School for Social Care Research. The views expressed in this presentation are those of the authors and not necessarily those of the NIHR School for Social Care Research or the Department of Health/NIHR.

2 ASSET is an independent research project commissioned and funded by the National Institute for Health Research s School for Social Care Research Adult Social Services Environments and Settings

3 ASSET: Project Team Simon Evans, Association for Dementia Studies, Worcester Robin Darton, PSSRU, Kent Jeremy Porteus, Housing LIN Sarah Vallelly, Housing 21 Randall Smith, School for Policy Studies, Bristol Ailsa Cameron, School for Policy Studies, Bristol Ann Netten, PSSRU, Kent Theresia Bäumker, PSSRU, Kent Teresa Atkinson, Assoc for Dementia Studies, Worcester Clare Gardiner, Assoc for Dementia Studies, Worcester Adult Social Services Environments and Settings 3

4 Context Development of housing alternatives to ordinary housing and care homes Wide variety of provision: Sheltered housing Retirement housing Extra care housing Retirement villages Little information on social care Forward planning (Dilnot, 2011; Cm 8378, 2012) and downsizing (HMG, 2011) Adult Social Services Environments and Settings 4

5 Key Features of Extra Care Housing (Laing & Buisson, 2011) Primarily for older people Accommodation is (almost always) self-contained Care can be delivered flexibly, by staff based on the premises, at least during the day Support staff are available on the premises for 24 hours a day Domestic care is available Communal facilities and services are available Meals are usually available, and charged for when taken Aims to be a home for life Offers security of tenure Adult Social Services Environments and Settings 5

6 Percent Entrants to Extra Care ( ) & Care Homes (2005): Barthel Index of ADL Extra care 20 Care homes Barthel score (grouped) Adult Social Services Environments and Settings 6

7 Percent Entrants to Extra Care ( ) & Care Homes (2005): MDS CPS Extra care Care homes MDS CPS score Adult Social Services Environments and Settings 7

8 ASSET: Stages of Project Phase 1: Literature review Phase 2: Scoping survey (56 LAs; 99 providers) Phase 3: Case studies (5 LAs; 9 schemes) Phase 4: Analysis & reporting Adult Social Services Environments and Settings 8

9 ASSET: Literature Review Focus of peer-reviewed literature on residents, wellbeing, environment Focus of grey literature on systems, providers, funding Most studies focus on single schemes, single providers, single local authorities So challenge is to identify broader models, specifically of care and support arrangements Adult Social Services Environments and Settings 9

10 ASSET: Scoping Surveys 24 hour waking cover (n=72): 59 by 1 organisation 8 by >1 organisation 5 by no organisations Restaurant /café: 54 of 66 extra care schemes (79%) 4 of 5 very sheltered schemes (80%) 15 of 15 retirement villages (100%) 4 of 11 other schemes (36%) Adult Social Services Environments and Settings 10

11 ASSET Scoping Surveys: Specific Needs Catered for by Schemes After moving in On moving in Physical Impairment Mild Cognitive Impairment 59 Medium Cognitive Impairment Advanced Cognitive Impairment Mental Health Issues Learning Disabilities Adult Social Services Environments and Settings 11

12 ASSET: Commissioners FACS: Usually Substantial/Critical Balance (H/M/L): ⅓, ⅓, ⅓ High needs usually 10 hours pw Difficulty maintaining balance in highlypressured areas Greater flexibility to accommodate low/no care needs in counties, and in larger schemes Adult Social Services Environments and Settings 12

13 Discussion Alternative to residential care? Different profile on admission long-term support Facilities to support high needs, e.g. meals Variation between areas in ability to maintain balance within schemes: Pressure on resources Infrastructure and history Adult Social Services Environments and Settings 13

14 Contacts Robin Darton Senior Research Fellow PSSRU University of Kent Adult Social Services Environments and Settings 14