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Emerald Group Publishing Limited
Copyright © 2011, Emerald Group Publishing Limited
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Article Type: Editorial From: Housing, Care and Support, Volume 14, Issue 3
This journal aims to promote a better understanding and constructive practice in the role and potential of housing in community care, social exclusion and public health. We aim to promote and publish research to develop the evidence base, and also to showcase here examples of effective emerging practice – action learning that has yet to receive detailed and thorough formal evaluation.
Many of our papers focus on the efforts and role of social housing services – that is, those providing housing built and managed primarily for social purpose. This is where we can see the most obvious imprint of other, wider social concerns, for example in public health, in area regeneration, and in housing-based work with those individuals and groups who are more vulnerable and/or most at risk of marginalisation.
The four articles in the current issue amply illustrate the breadth of this field. Three articles concern new initiatives specifically in housing for older persons, each tackling an aspect of the interface between care and housing. They are all different; but they are consistent and complementary with each other; and the underlying themes have clear resonances with other clients groups.
Our first paper is an evaluation by the Personal Social Services Research Unit, of the development in the UK of extra-care housing (ECH), currently promoted as an alternative to full residential care for older persons with growing care needs, through enhanced and flexible service integration. This paper is published to coincide with the launch of a tool kit for the development of ECH, which has been produced by the UK Housing Learning and Improvement Network – the Housing LIN – formerly a part of the Dept of Health, and now supported by the Elderly Accommodation Council (EAC).
For those who may be unfamiliar with the Housing LIN, we thoroughly recommend the collection of reports and “think pieces” that they have published over a number of years. This has become an exceptionally useful repository of innovative thinking and practice, especially in relation to housing for older persons. But there are many useful papers there on wider research and policy frameworks, and other needs such as the healthcare of those homeless. The Housing LIN web site is: www.housinglin.org.uk/
Much research in recent years has indicated that – just as with other vulnerable groups – the more choice and the more say that older persons can have in the running of their own services, the more positive the outcomes; not just in the tailoring of services to meet needs, but also in the empowerment of individual and groups, which has positive spin-offs in its own right. This approach is further illustrated here by an account from EAC itself of their work in promoting and developing tenant/user consultation.
Current government policy guidance encourages the use of informal means of consultation; and in the approach adopted by EAC, a card game has been developed to create relaxed social spaces in which tenants are comfortable talking with each other about the services they receive. This valuable feedback – obtained without the need for staff intervention – can then be used by providers to improve and target the services they provide. In the EAC approach, this is then further developed into an awards ceremony – an enjoyable opportunity to celebrate success – and an approach to benchmarking good practice which is grounded in the views and experience of service users themselves.
Extracare is a model of flexible service integration largely in specialist accommodation (though possibly with the specialist unit being used as a “hub” for other local residents); and the PSSRU report findings suggest that it can be only one part of a wider strategy for maintaining the more frail elderly in maximum independence. Our third paper is an account of a different approach, outlining current developments in environmental design, known as retro-fitting, for those with dementia to help maintain their cognitive and emotional orientation.
Here, the physical design of fittings and furnishings is used to complement psychological reminiscence therapy approaches, helping to sustain the tenant, resident or home owner’ in their own homes, and amongst their own memories. Early results suggest that this can reduced reliance on medication, for example, in a care home. But this approach can equally well be applied in ordinary homes (in what is known as “general needs” housing), anywhere a housing provider – such as a social landlord – seeks to encourage adaptations to meet the needs of older persons.
The final article in this issue takes the same issues of engagement and empowerment, applied now in retain to the monitoring of success of services for all the more vulnerable client groups. The Outcome Star has become very popular in the UK and further afield, as a creative way to engage service users in specifying the outcomes they wish for from services. In so doing, it aids the monitoring of the effectiveness of those services in a way that is rooted in the experience of service users. This paper – by the Star’s development team – gets beneath the surface, to explore the values base and philosophical grounding for more service user-friendly monitoring and evaluation.
All four articles here describe initiatives developing in the UK context. But they are surely international in range; and the ingenuity, creativity and commitment they demonstrate is reflected in action in state, voluntary and private sector initiatives across the globe. Furthermore, the concerns that they address – vulnerability, engagement, empowerment, service design – raise issues which we will encounter with all the client groups with whom social housing works.