Dimensions is a specialist provider of a wide range of services for people with learning disabilities and autism. As a not-for-profit organisation it supports around 3,500 people and their families throughout England and Wales. The organisation enables people to be part of their community and make their own choices and decisions about their lives.
It has recently entered into an exclusive contract with Essex County Council (ECC) to provide housing brokerage to people with a wide range of needs. The process started in 2011 when the council decided to pilot a Housing Brokerage Service to test out a new way of supporting people with learning disabilities to access a range of housing options and increase the number of people moving onto independent living. The aim was to identify different housing options, have someone dedicated to sourcing the available options for individuals based on their needs and preferences and then support individuals to see plans through to reality.
ECC, sponsored by the National Development Team for Inclusion (NDTi) and the Department of Health, set out to pilot the Housing Brokerage Service in 2011. This was to address significant issues the county had in identifying and securing suitable properties for people with disabilities – the county has a deficit of social rented housing along with a very competitive private rental market.
It was felt that the best approach to supporting people with disabilities to find suitable housing would be through using specialist brokers (rather than social workers) who understood how local authority housing worked and who could also develop relationships with estate agents and private landlords.
It was at this stage that discussions started with Dimensions. They hadn’t undertaken housing brokerage, however they were well-versed in personalised approaches to housing and services for people with learning disabilities. Dimensions already operated in Essex but did not hold significant amounts of housing stock so there were no conflicts in the working partnership.
Making it work
There were many aspects to consider in making the brokerage work, including the organisation of housing and support delivery in the county. The pilot stage helped to identify and solve issues as they arose.
Social care support is arranged by ECC, however housing responsibility lies with the district and borough councils. This means that there are different departments, teams and budgets to consider when supporting people to move. There needs to be a high level of communication and efficiency to ensure all aspects come together to meet an individual’s needs within the timescales required by landlords – housing vacancies can move very quickly.
The service acts as an intermediary, offering a named person who supports individuals, landlords, social workers and commissioners through the entire process. The housing brokers identify requirements, find suitable properties and bring all parties together offering expert guidance and reassurance at every stage, including ongoing support.
Although the brokers work to a contract, they are independent of the council, meaning that they are not bound by local authority rules and regulations. They have flexibility in the way they operate, so they can bring together private landlords, social landlords, housing associations, the county and borough councils and estate agents. The brokers work to ensure they are the first point of contact for any opportunities to ensure there is a steady stream of housing available for people when they may need it. The brokers give landlords and estate agents advice and guidance on letting to people with disabilities including resolving any issues or concerns around tenants with housing benefit. They also support the individuals by helping them to complete the necessary paperwork or ensuring that their support is set up for when they move in.
When the pilot was evaluated, the report by the NDTi stated that there was an ‘impressive’ range of housing options made available to people looking for housing. These include shared supported living, private rented, local authority, shared ownership, choice based lettings, management transfers, extra care and shared lives.
In its first year, the service paid for itself seven times over before considering ongoing lifetime cost savings. For example, one young couple, who formed a relationship while in residential care costing £4,000 per week, wanted to move in together. The broker identified a private landlord, negotiated the rent to an affordable level, worked with the social worker to identify a support provider and liaised with all of them to support a successful move. The saving to ECC is over £150,000 per year.
‘Part of the problem is that whilst ECC has the duty of care, it is the twelve borough councils in Essex that have the duty of housing,’ explained Sanna Westwood, the former commissioner who launched the pilot, ‘and although the young couple’s housing costs were significant, from the borough council’s perspective they were suitably housed. By introducing a range of housing options our housing brokers are basically the oil that makes the system work more efficiently.’
Once the pilot was evaluated it could be seen that the new approach offered great financial and social outcomes. This led to the mental health and substance misuse teams in the county deciding to pilot similar services. ECC then contracted with Dimensions to take on all three services from April 2015, offering a single brokerage service to support vulnerable people to build their independence and live in their own homes. Dimensions feels that it could easily be replicated in other areas and for other vulnerable groups with housing needs. It just needs local authorities to fund a post that isn’t traditionally funded by social care, however Dimensions believe the results speak for themselves.
Over to the experts…
As personalisation is integral to care and support services, is it logical to personalise housing too? Is this individualised approach replicable? Will other local authorities follow suit? What opportunities does it offer traditional providers? How will it shape the market?
Provides an added dimension to housing choices
Why personalise care if we don’t also personalise housing? Everyone’s housing choices are constrained by personal circumstances; age, financial and physical factors, geography, family circumstances and availability of affordable housing choices. Even with these constraints, they should not stop us exercising choice in where and how we live and with whom.
A fundamental component of the Care Act is the ‘suitability of accommodation’ in meeting people’s at-home care and support needs. This article gives an excellent overview of the innovative new housing brokerage service. It demonstrates that access to such a service provides an added dimension to the way information and advice is delivered, and offers people more voice and greater housing choices.
There are a number of ingredients that need to be in place to make housing choice tangible and deliverable. These include individuals being supported by family, Mental Capacity Act and Court of Protection activity; timely social care or other input as people transition from thinking about moving to actually moving; understanding what can be afforded and then having affordable housing available at the right time; support agencies, social care and local housing authorities understanding the available housing and how to access it; everything to make the move; and ensuring that the property is part of a person constructing a meaningful life and relationships, rather than an end in itself.
All these ingredients flow from effective commissioning practice, focused on outcomes with people at the heart whilst ensuring that decisions are based on good information. As such, this new service has real potential.
Jeremy Porteus Secretariat, ADASS Housing Policy Network, Director, Housing LIN
Housing should be tailored to individual need
Housing is a fundamental need for all. Access to secure and appropriate housing contributes significantly to health and wellbeing. The fabric of a building, alongside personalised care and support, is essential for better, recovery-focused pathways. Suitable housing can prevent inappropriate placements and admissions. Within self-directed services, choice, control, ownership and accountability are central; they are tailored to the individual and housing should be too.
The voluntary sector has a role in providing brokerage services and facilitating the relationships required to secure individualised housing. Brokerage across a range of services is being explored elsewhere and providers, on the whole, are welcoming it as long as processes are transparent and meet individuals’ needs. Delegating brokerage can enhance the function of local authorities and offer more bespoke choices and long-term sustainability. This, alongside the financial case made in Essex, should encourage local authorities to consider how to support people to access suitable housing.
There can, however, be barriers. Understanding personalisation depends on individuals, and requires willingness from local authorities to learn and change. There are issues around choice, social rented housing and the private rental market. Effective communication is key, plus time to build relationships. Partnerships may initially work best where the brokering organisation has a strong relationship with the local authority.
Brokerage offers innovative partnership working between housing and related services. It offers a valuable, informed level of support to self-directed services, facilitating integrated services and identification of the best solution. It also ensures that needs are discussed earlier and aid a cohesive, comprehensive recovery pathway.
Kathy Roberts Chief Executive, Mental Health Providers Forum
This is a great example
Personalisation should mean a system that is flexible and responsive to people’s whole life needs, which enables people to make choices and take control and which works to enhance wellbeing as well as physical health. Housing services can play a vital role in this, providing and maintaining secure accommodation for people of all ages to live full and active lives. But while personalisation is well-established in social care and gathering momentum in health, housing has less often been the focus of innovation in this area. This is set to change.
The Care Act embeds many of the principles of personalisation in statute and is explicit about the importance of suitable accommodation in meeting people’s needs and promoting wellbeing. Delivering on this ambition will take a coordinated approach to shape future housing services and different thinking about how people can be empowered to make choices about the housing and support that is right for them. Dimensions and Essex’s work is a great example of this.
Identifying housing to meet the needs and preferences of people with disabilities can be challenging, but the service shows that by combining expertise of working with people with disabilities alongside the ability to build relationships and navigate the system from outside statutory services, much can be achieved to build the right support.
TLAP is working with housing partners to develop and share our understanding of how personalisation fits with housing and support, in particular how we make Individual Service Funds work in this context. This is another innovation that Dimensions (and other providers) know plenty about and whose time has come with the prominence it is given in the statutory guidance for the Act.
Sam Bennett Director, Think Local Act Personal
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