Manchester City Council Report for Resolution Report to: Communities Scrutiny Committee 19 June 2013 Subject: Report of: Support available to LGBT Older People Geoff Little, Deputy Chief Executive Liz Bruce, Strategic Director Families, Health and Wellbeing Summary This report provides an overview of the support available to LGBT older people in the city and what we know about this population through national and local research and intelligence. Recommendations Members of the Committee are requested to note and comment on the key matters for consideration. Wards Affected: All Contact Officers: Name: Adam Farricker Position: Senior Equalities Officer Telephone: 0161 234 4615 E-mail: a.farricker@manchester.gov.uk Name: Paul McGarry Position: Senior Strategy Manager, Public Health Manchester Telephone: 0161 234 3503 E-mail: p.mcgarry@manchester.gov.uk Background documents (available for public inspection): Manchester: A Great Place To Grow Older 2010-2020 LGBT Public Health Outcomes Framework Companion LGBT Question Time: Have your say in the city March 2013 7
1. Introduction 1.1 Manchester City Council has a long history of promoting equality and diversity across all equality groups. This report focuses on the support the council gives to LGBT older people. It sets this specific support in context of the mainstream and commissioned services for all older people, which are available to LGBT older people. The report also summarises the research and intelligence at both a national and local level. 2. Background and National Context 2.1 Recent figures show that there are roughly one million lesbian, gay and bisexual people in Britain who are over 55 years of age. It is estimated that LGBT people are nearly twice as likely as their heterosexual peers to expect to rely on a range of external services as they get older, including GPs, health and social care services and paid help. 2.2 One of the main reasons for this is that older LGBT older people are likely to have diminished personal support networks. This is highlighted in a recent research paper published by Stonewall which found that LGBT people over 55 are more likely to be single; more likely to live alone; less likely to have children; and less likely to see biological family members on a regular basis. 2.3 The Stonewall research finds that half of all LGBT older people over 55 feel that their sexual orientation has, or will have, a negative impact on getting older. Around 60% of LGBT older people are not confident that social care and support services, like paid carers, or housing services would be able to understand and meet their needs. Almost 50% of older LGBT people would be uncomfortable being out to home care staff for fear of prejudice and discrimination, and more than 60% would be concerned that their sexuality will not be respected if they go into care. 2.4 Many of Manchester s older LGBT community will have lived through homosexuality as an illegal act and faced historical exposure to severe stigma and discrimination throughout their lives. This leads to a fear that they may be met with prejudice or hate and it is recognised that prolonged exposure to discrimination and stigma may have a detrimental impact upon their physical and mental health. 2.5 According to a 2008 study by the Commission for Social Care Inspection only seven per cent of older people s care homes had worked specifically on equality around sexual orientation. However, a 2009 study conducted by the University of Brighton found that 85% of older LGB people say that they would give information regarding their sexual and/or gender identities if they believe the service is LGBT friendly and the data is kept confidential and anonymous. 60% of LGBT respondents to a separate study said they would move out of their current home and into accommodation for older lesbians and gay men given the choice. 8
3. Local Context 3.1 Outcomes from a focus group hosted by the Lesbian and Gay Foundation (LGF) for the Equalities and Human Rights Commission found that many of these national issues concerning LGBT older people are also real issues in Manchester. The LGF report that many LGBT older people still have huge fears about accessing mainstream social care services because they fear that they will be outed and do not believe the services will meet their needs. With many of these people having diminished personal support networks they are turning to other forms of support such as the LGF s Befriending Service. 3.2 One of the key issues highlighted by the LGF is that LGBT older people do not have enough confidence in mainstream support and care services in terms of meeting their specific needs, making them feel included and welcome or in protecting them from prejudice and discrimination. As a result many LGBT older people either do not come out or they do not access support services at all. Both of which can cause both physical and mental health issues. 4. Understanding the Local Population 4.1 Owing to the absence of a sexuality question in the national 2011 Census, LGB population figures (national or local) are not accessible. Current statistics estimate the UK s LGBT population as between five and seven per cent. With Manchester being one of the nodal points in the UK for LGBT communities the higher estimate of seven per cent is applied to the North West and Greater Manchester. With the 2011 Census showing a Manchester population of 501,000, by applying the higher end LGBT population rate of seven % it can be estimated that the LGBT population of Manchester is 35,070 4.2 It is not clear what the age breakdown of this group is, however, as reported in the most recent State of The City: Communities of Interest report there is evidence to suggest that some same-sex couple move to more rural areas as they get older which may indicate a move outside of Manchester. 4.3 Since 2003 the Manchester Valuing Older People partnership has worked with a range of local and national agencies to improve the quality-of-life of older residents. In 2012 Age-friendly Manchester was launched to build on the VOP programme. Central to the programme has been an objective to promoting equality. This focuses on tackling age discrimination and inequalities that relate to all protected characteristics including sexual orientation. As we develop our intelligence of older people with these characteristics, we can set actions that focus on improving services for groups whose needs aren t being met. 4.4 In April 2012 when equality monitoring of the Supporting People programme was extended to include sexual orientation. As with other commissioned services, support housing services funded by the Supporting People programme is fully available to LGBT Manchester residents subject to their assessed needs. 9
4.5 A review of the 1919 Supporting People referrals received over the past 12 months, indicates that 74 people who have been referred to or who have selfreferred themselves for support are members of LGBT communities. Only two service users that recorded their sexuality as LGBT were aged over 50 years of age, however it should be noted that the referral data received in completed by providers and has yet to be validated. In addition, it should also be noted that 56% (2,438) referrals that have been received did not record sexuality, and a further 19 referrals recorded customer s' sexuality as 'other' but included no further information. 5. Support in Manchester 5.1 The vast majority of mainstream care services are commissioned to deliver care and support to Manchester residents based on care needs, irrespective of a person s sexuality. To support LGBT communities, the Directorate for Families, Health and Wellbeing also commissions two services targeting LGBT residents. 5.2 The first service commissioned by the Directorate is provided by the Lesbian & Gay Foundation through the Directorate's Wellbeing Grants, and is targeted to improve the mental wellbeing of isolated older LBGT residents. The second service is commissioned through the Supporting People programme to provide accommodation for up to three young LBGT residents aged between 16 and 21. 5.3 There are also services for those people with HIV with the George Trust, Barnardos and the Black Health Agency and whilst these are not specifically aimed at the LGBT community over 46% of the people using the service at the George House Trust are LGBT and over 17% are over 50 (although this figure also includes heterosexuals). The George House Trust (in partnership with the Council) are also providing training to Registered Care Homes for older people to raise awareness of HIV issues. 5.4 The Building Health Partnerships initiative is designed to improve collaboration between the new health structures and the local voluntary and community organisations and social enterprise sector (VCS). The programme is an NHS Commissioning Board funded programme delivered by NAVCA, Social Enterprise UK and the Institute for Voluntary Action Research (IVAR) through local Clinical Commissioning Groups (CCG s) 5.5 Manchester is one of twelve areas that were selected to build on existing good examples of engagement work and to reflect a diversity that will allow the learning to be of benefit across England. The Lesbian & Gay Foundation working in partnership with South Manchester Clinical Commissioning Group are leading on this with the local VCSE, CCG the Health and Well-being Board, the Council. 5.6 The initiative focuses on highlighting the health inequalities faced by LGBT people, exploring the issues and barriers that they encounter to develop strong and informed CCG engagement with LGTB communities. The initiative will particularly centre around three areas: capturing and exploring LGBT 10
people's experiences of GP services; sexual orientation monitoring, and; promoting the Pride in Practice benchmark. 6. Valuing Older people (VOP) 6.1 Manchester s Strategy for ageing A Great Place to Grow Older highlights that meeting the needs of older LGBT people remains a priority. The personalisation of care services and commissioning of culturally sensitive services are giving Manchester s older LGBT community greater access to support. In order to reach out and engage increasingly with the LGBT community the VOP team works with the Out in the City Group, LGF and other key partners. For a number of years, a member of the Out in the City group sat on the Valuing Older People Board. VOP has also ensured that images of older LGBT people featured in its Positive Images of Ageing programme. 6.2 The Out In The City initiative, is a social/support group for LGBT people over 50. There is a drop-in every Wednesday and Thursday at London Scottish House, Mount Street providing various activities including keep fit, bowling, day trips, visits to galleries, museums, cinemas, pubs, tea rooms as well as walks in the city and in green spaces or just relaxing and chat among friends. 6.3 There is a reading group which meets on the last Thursday of the month and the annual Manchester Pride parade at August Bank Holiday provides the group members with an opportunity get involved and to promote an awareness of older LGBT people in Manchester. The group has worked in partnership with Whitworth Art Gallery, Library Theatre, Islington Mill, Manchester Art Gallery, Start Manchester as well as artists, photographers and poets and they are also represented on the VOP forum. 6.4 The VOP team in partnership with the Manchester Public Health Development Service have produced a Sexual Health and Relationships guide focusing on: Health issues related to sexual well being. People wanting, finding and starting new relationships. People moving on from relationships. People in relations. Single People. The Guide has been licensed to Public Health Wales and the Family Planning Association. 6.5 The Guide provides specific information and support for older LGBT people in relation to coming out in later life, sexually transmitted infections, living with HIV, Domestic abuse and also provides a list of useful contacts for readers to seek further information advice and guidance. In 2011 a range of resources were produced by VOP and Manchester Public Health Development Service promoting sexual health services to older LGBT people. 11
7. The Lesbian and Gay Foundation (LGF) 7.1 The LGF provides a wide range of support services to older LGBT people, including: helpline, email and pop-in service; wellbeing clinic peer support groups, including two groups specifically for older men and older women; face-to-face counselling; befriending scheme; art therapy and film therapy groups 7.2 In the financial year 2012-2013, LGF events and services were accessed 265 times by LGB people over the age of 50, where current age was recorded. Of those, over 70% were aged 50-60 years. 7.3 In the financial year 2012-2013, the LGF the helpline was accessed 68 times by LGBT people over the age of 50, where current age was recorded. Of those, nearly 70% were aged 50-60 years. 7.4 The befriending service supports LGBT people who may be feeling lonely, having mental health issues, are new to the area, are coming out of a relationship, or just coming out. It offers up to 10 sessions with a volunteer befriender, who can support and guide the service user through difficult times. In 2012-13, the befriending service was accessed by eight LGB people over the age of 50. 7.5 Older & Bolder is a peer support group aimed at older men (40 and over) who identify as gay or bisexual. The group meets monthly at the LGF and provides a safe, encouraging and non-judgemental space for men to take part in themed discussions and activities, and also to expand their social networks away from the village environment. In 2012-13, the group was accessed 110 times by gay and bisexual men over the age of 40. 7.6 Bloomers Older Women s Group will be launched in summer 2013, aimed at women who are over 50 and identify as lesbian or bisexual. The group will meet monthly at the LGF and provide a safe, friendly, welcoming and fun environment for women to meet and socialise. 8. Key matters for consideration 8.1 The monitoring of customer s sexuality is improving, however without comprehensive monitoring across mainstream, commissioned and grant funded provision, it is not possible to estimate the scale of this issue in Manchester. The Equality Team is currently working with services across the Council to improve the equality monitoring of our service provision whilst developing an E-Learning package. This will remain a priority for all adult 12
commissioned support services through the new Integrated Commissioning Hub 8.2 The Equalities Team recently facilitated a LGBT consultation event in partnership with LGF to mark LGBT history month. This took a Question Time format whereby members of the public and other key stakeholders could submit questions to a panel sparking discussion and debate. There are plans to organise a similar event later in the year with a focus on the specific needs of Older LGBT people including ways forward for the public, third and Private Sector organisations across the city with relevant partners invited as panel members. 8.3 The criteria and referral process of the Children s Commissioning and Families, Health and Wellbeing programmes will continue to be highlighted as LGBT inclusive. As the budget settlement reduces the Council s financial and resource capacity to commission specific services, it needs to ensure all support services made available are fully inclusive and this is embedded within an effective communication strategy with providers and to customers. 8.4 Equality and Diversity training is now available to all MCC staff and elected Members through the M People E-Learning Academy. All staff that engage and communicate with customers on a regular basis are encouraged to complete the training to ensure equality issues are risk assessed, mitigated and communicated confidently and with credibility. This will enhance the Council s reputation as an organisation of Equal Opportunity in both employment and service provision. 8.5 The Council continues to support the work of LGF and our partners through the South Clinical Commissioning Group to develop Building Health Partnerships pilot. As this work progresses it should be monitored and reported on, with regards to any issues realised and proposed initiatives regarding older LGBT communities across Manchester 13