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Into Perspective: LGBT+ social care provision
Are we getting it right?

In a recent report from Tonic, Stonewall Housing and Opening Doors London, older lesbian, gay, bisexual and transgender (LGBT+) people were asked for their thoughts on moving into social care housing. Following the results, we’re asking, do we need more specialist provision for LGBT+ people, or are other changes required?

The joint report from Tonic, Stonewall Housing and Opening Doors London, Building Safe Choices 2020 – Our voices: LGBT+ later life housing demand in London has shed a light on how people want to live as they age. It looked largely at housing with care and people’s preferences around this provision.

Key findings indicate that older LGBT+ people want:

  • Housing, care and support services that are safe, to be treated with dignity and respect and to stay where they live.
  • Policy makers and providers to recognise their specific needs as part of the LGBT+ community.
  • Advice and support around housing and services, both for current and future needs.

Should we focus on inclusive or general support?

The Building Safe Choices 2020 report also found that most LGBT+ people surveyed would prefer to live in LGBT+ affirming or accredited housing.

Respondents (58% of whom were over 60 and 82% of whom do not have children) stated that they wanted to stay in London, with three quarters voting for this option.

56% stated that they would feel happiest in LGBT+ specific housing and 64% would prefer an LGBT+ accredited provider, while just 1% would be happy to live in a general retirement community and only 2% would prefer a non-specific care provider.

What do the findings tell us?

The results of the survey, which took views from 624 participants and hosted focus groups with LGBT+ people, overwhelmingly show that the current offering is not up to standard.

People reported feeling discriminated against, feeling they had to hide their true identity, and wanting to feel safe and secure. They were unsure where to go for advice and information around planning ahead and particularly in a crisis.

What’s more, there are few options for those seeking care that is LBGT+ specific or affirming, despite the vast majority of people in this community wanting this type of support.

A call to action

Tonic, Stonewall Housing and Opening Doors London conclude with five calls to action. Despite being aimed exclusively at the London care market and authorities, these have wider-reaching implications, with many being applicable to areas across the UK.

The first call to action is to ‘formally recognise the needs of older LGBT+ people in policy and practice’. The organisations want to see the specific and unique needs of the LGBT+ population reflected in care and support offerings, as well as policies.

Other calls to action include the promotion of LBGT+ accredited housing and services, saying that accreditation should be promoted to all providers and services to that options are available to older LGBT+ people. Again, this could be applied across the country to encourage more people to feel safe and happy with their support.

The report gives detailed information on what older LGBT+ people want. So what are we getting wrong and what needs to change?

These themes are not new

This timely joint report from Tonic, Stonewall Housing and Opening Doors London, has messages that have relevance well beyond the capital. Drawn from a survey and a series of focus groups there are powerful (and sometimes harrowing) accounts in this report of the additional challenges that are often faced in later life by people from LGBT+ communities.

The report concludes with three key messages:
1. Housing, care and support for older LGBT+ people should be safe, recognise people’s life experiences and treat them with dignity and respect. People want to stay living where they have lived and to receive services from organisations that are LGBT+ affirming or accredited.
2. There is currently insufficient provision which recognises diversity and differences.
3. There is a need for more advice and support as well as more housing and services.

Sadly, these themes are not new. The findings of this survey echo many previous reports (including work by the National Care Forum in partnership with providers) that highlight the changing demographics of later life and an older generation that is becoming more diverse. As a consequence, family structures that are also changing. Added to which, older people from LGBT+ communities may experience long-standing attitudinal issues on top of ageism. Discrimination and prejudice associated with gender and sexual identity can therefore result in multiple stigmatisation. Barriers faced by family and community relationships can all too easily contribute to feelings of social isolation.

Ensuring that services for older people from LGBT+ communities are affirmative requires an equality and rights-based approach which promotes diversity and person-centredness. There are important workforce and training issues to address. There may be a need for additional support as well as an appreciation of the importance of peer-led networks and partnership working.

The question that arises time and again is whether to develop more specialist housing and services for older LGBT+ people or make some fundamental changes to existing housing and support services to enable people to feel safer in mixed communities. The answer to that is simple – we urgently need to do both!

I sincerely hope that this report helps to shine a light on an area of provision neglected for too long.

Des Kelly OBE, Chair, Centre for Policy on Ageing

Relatability is a standard of value

The recent report by Stonewall Housing, Tonic and Opening Doors London echoes previous research and studies on this subject; namely that LGBT+ people do not feel safe with current health and social care service provisions.

The question is, should we be building more services for adults who are LGBT+? The short answer is yes. Since we opened our doors, we have received calls from LGBT+ people from as far north as Scotland and as far south as Cornwall and not just people who are over 50.

As the only specialist provider for the LGBT+ community, we have sadly encountered many obstacles from organisations, local authorities and individual representatives who do not see a need for an LGBT+ service like ours.

Health care systems are working hard, but are over-stretched and heteronormative. Additionally, directors have to manage ever-shrinking budgets; LGBT+ clients would have to present in significant numbers before it would be a priority for a local authority.

For years, we have been campaigning for the Care Quality Commission (CQC) to create an option where clients can identify service providers who support the LGBT+ community. We were told to change our name to include ‘LGBT+’ and that there was ‘no need to provide more targeted signposting’.

Bespoke care services are not new, there many religious and cultural-specific care providers who have been operating for years. These services are successful because they target a specific, often local community. However, this type of localisation cannot apply to the LGBT+ population, who live throughout the country.

Four years ago, we believed there was a need for a variety of services for our community, to support the growing demand for social care. Now, after providing years of support to the LGBT+ community, we absolutely know there is a need for services like ours around the UK.

Relatability is a standard of value, as we all wish to see ourselves reflected in the things and services we use every day. Therefore diversity, understanding and representation of our various identities certainly matters. It matters to our clients and our staff and it should matter to organisations who are tasked with helping people.

We would like to see reflective services like ours around the country, and support given to small, grassroots providers who are working hard and tackling these issues every day.

Ramses Underhill-Smith, Director, Alternative Care Services

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