Action urged to tackle clash between housing policy and community care

A report published by the Joseph Rowntree Foundation warns that lack of suitable housing in many areas has led to vulnerable people being denied choice and forced to live in the most run-down and unpopular estates.

Their sense of insecurity and isolation is often intensified by the narrow way in which financially hard-pressed local authorities interpret their responsibility to offer care and support. Recent Housing Benefit restrictions are posing an additional threat to support services on estates while further limiting the choice of housing available.

Drawing on the findings from 21 individual JRF-funded research studies, the report calls for a national housing initiative to ensure that the original goals of community care - promoting independent living and greater social integration - can be reached.

This would apply to all types of housing tenure and be concerned with:

• the reshaping and conversion of unsuitable and outdated specialist provision:
• renovating private sector properties that have fallen into disrepair;
• developing more accessible, self-contained housing (such as 'Lifetime Homes' developed by the Joseph Rowntree Foundation)
• expanding property maintenance schemes such as 'Staying Put' and 'Care and Repair'.

The report also calls for much better resourcing of advice and advocacy services with central involvement by those using services and a specific brief to explore and explain local housing and support options. Despite official rhetoric about ïempoweringÍ community care users, the formal needs assessment required by legislation can prove an unnerving and uncomfortable experience for those on the receiving end. There are often discrepancies between the needs identified and the services actually provided. Further, needs may go completely unrecorded if they fall outside the criteria of what the local authority is prepared to fund.

The report highlights the vital preventative role that suitable housing and support can play in postponing the need for expensive residential care. It calls for national guidance on the kinds of prevantative housing and support services to be included in local plans - and measures to remove the anomalies which make access to services dependent on living in particular types of accommodation.

Research consultant Lynn Watson identifies a number of key areas where housing and community care policy is marked by major problems and contradictions:

• Where people live - the uneven distribution of specialised and supported housing for disabled and vulnerable people, together with the concentration of available council housing in unpopular, 'hard to let' neighbourhoods, undermines attempts to provide wider housing choice and less segregation.
• The reality of choice - some local plans for housing and community care depend on increasing the supply of existing specialist accommodation - such as group homes for people with learning disabilities. Surveys suggest that most users would prefer to live in a self-contained 'place of their own'.
• Needs assessment - there is a basic contradiction between the theory that needs assessment should allow users to make informed choices about available services and the reality of their use by authorities to ration scarce resources.
• Access to information - some users taking part in needs assessments are ill-equipped to influence the outcome because their rights have not been properly explained to them. Research shows that advocacy and self-advocacy groups are enabling users to influence the way that services are planned and delivered in some areas, but that these are not yet common.
• Finding and funding support - little thought has been given to ways in which care should be organised for people living in different types of housing. Housing managers are especially concerned about their capacity to cope with growing concentrations of vulnerable people in run-down estates where there are few existing support services. Housing Benefit cutbacks and other funding restrictions threaten the development of support services as well as reducing the opportunities for users to move into a flat or bedsit of their own.

The report concludes that under existing policies many disabled and vulnerable people face great difficulty in having their housing and support needs recognised. Local officials interpret their 'gatekeeping' role as one of discouraging what they see as non-priority applications.

Lynn Watson said: "In principle, community care policy supports a move away from concentrating disabled and other vulnerable people in hostels and homes and endorses independent living and individual choice. In practice, those goals depend heavily on a supply of suitable housing that is currently just not available.

"This disconnection between the different arms of policy is compounded by Housing Benefit cutbacks and failure to devise a comprehensive funding system that will help, not hinder changes in community care services and that will provide users with the types of accommodation that they really prefer."