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Emerald Group Publishing Limited
Copyright © 2012, Emerald Group Publishing Limited
Article Type: Editorial From: Housing, Care and Support, Volume 15, Issue 4
After an excursion, in our last issue, into papers from across the globe – a development that we will continue in future issues – we return to the UK for this last issue of 2012, with four papers that between them illustrate much of the range of activities that lie in the links between housing, care and support.
Many of the constant themes of this journal over the years are present here. We have a historical perspective on the role and potential in ordinary (or “general needs”) social housing to support communities and develop frameworks for a sense of belonging. This is followed by two papers on the particular scope in housing associations, as agencies with strong engagement with tenants, to find new ways, in a climate of austerity, to offer support to the more vulnerable. Finally a paper on the need to respond more constructively to the many difficulties often underlying the plight of homeless people, through addressing the training needs of staff.
“Doing more with less”
We are seeing the continuance of austerity driving social policy, throughout the West. As the time shortens towards the full enactment of welfare reform in the UK, it is not surprising that there is a renewed interest here both in getting – and demonstrating – value for money and in doing “more with less” in all aspects of housing management and support in the community.
Whilst there are clever financial models that should enable new housing to be built, the means by which individuals can pay to live in that housing, across all tenures, i.e. employment or welfare benefits, still leaves the gap of un-affordability for many – a gap that has to be bridged if the home, as the bedrock of support, is secured. Meanwhile, if other supports to vulnerable individuals – welfare benefits and services – are eroded or withdrawn, then there are further risks for housing providers in housing vulnerable tenants.
If care and support is to continue to be delivered “at home” – and if costs to the already beleaguered health and social care services are to be kept at bay – then housing practitioners have to think in detail about the way they are able to tap into wider, informal supports. Social housing is especially well placed to enable access to family and social (people) networks, links with voluntary support organisations and social enterprise projects to support the growing number of people struggling to make ends meet. But, as we shall see, social housing can also play a role in encouraging active participation, co-production, and so help us to see vulnerable people also as active citizens.
In such straitened times it is useful to remind ourselves of the “giants” of social reform in the past, and the contexts in which their reforms emerged. In this, the centenary year of her birth, there has been some discussion on the legacy of Octavia Hill, one of the early pioneers of what we now call “social housing”. But this discussion has included some criticisms of what some have seen as a paternalistic streak, which runs through so much of philanthropy in that era. In their paper, Hindes and Chung defend the reputation of Hill – and point to the many ways in which her work and thinking anticipated the lessons still being learned today in the management of social housing.
Especially interesting, in current circumstances, is Hill’s insistence on empathy between tenant and agent; and her stress on face-to-face interactions in small scale operations; against the facelessness of distant bureaucracy. This is a challenge for the management of contemporary housing associations, faced with the pressures to grow larger, in order both to maintain robust finances, and to cope with the demands of increasing regulation, and of the commissioning of their services. Perhaps we must start to see this as also a challenge for the regulators, and the commissioners.
Such concerns for human engagement between landlord and tenant are alive and well – but seen now, as Hindes and Chung observe, more in the context of special needs housing. Yet Hill’s comments are also strikingly reminiscent of more recent developments in community ownership – as we have seen, for example, in West London, and only a few miles away from Hill’s first homes, as described in Jonathan Rosenberg’s earlier duo of papers in this journal (Rosenberg, 2011, 2012).
Hill’s use of private housing for social purpose is a reminder that it is not something in the original building or ownership that gives the social character to social housing, but the way the housing stock is managed – the social purpose. Finally, it is also worth noting that Hill’s Victorian England was a world which was very rapidly urbanising, more comparable in many ways to the situation in developing nations today.
Back to the future
Octavia Hill’s legacy is therefore very much with us – including the importance of working with tenants, especially more vulnerable tenants, and not just providing services to them, as passive recipients. But there are still new and creative techniques being developed, to respond to the particular needs of the 21st century. Gary Lashko’s article gives an account of a very contemporary approach to the same issues – of treating people not just as needy, or as merely consumers of services.
Time banks have been described as a form of Asset-based Community Development by which service users’ strengths and creativity can be encouraged, bringing the best out of people and communities – even the most vulnerable of people (Gardiner, 2012). As is shown in Gary Lashko’s paper on the thinking of CHS (whose initials stand for Cambridge Housing Services, a name which underlines their local roots), this is far more than just volunteering, not just a different way of delivering, in cost-constrained times, the same services that that used to be delivered by properly paid.
Lashko’s paper is also bold in describing the thinking behind what was initially a failed bid for funding. In that way, it is a glimpse into the reality of service-led development work, with its constant opportunities and frustrations. This is an example of a paper describing the realities of front-line services development, and part of an occasional series in which we invite staff to describe the work that they are doing.
This journal is focussed upon the evidence for impact; and we hope that the evidence of the indomitable spirit of those who are sure they have a good idea, even if one first wave of funding bodies did not see it, will be just as valid as any statistical analysis of carefully validated findings. Nevertheless, it is still important to notice the emphasis that the CHS group had put in their initial, unsuccessful proposal an emphasis, on evidence-generating practice, and dissemination of action learning.
New people-centred processes
Jane Minter’s description of the work of Care & Repair England then shows another aspect of efforts at meeting complex needs more effectively, through closer co-operation between healthcare and housing services. Minter’s paper is illustrated with examples, to make the human side more concrete; especially where savings.
Minter ends with observations on the broader debate on improving integration in the UK Government’s recent Care and Support White Paper (a proposal published prior to debates in parliament), which proposes creating a duty to co-operate; and on health to release spare land needed for accommodation for vulnerable tenants – all practical means to cope with what has been described (Morrison, 2012) as the impending tsunami of care needs, in an ageing society.
It is worth pausing to note that in UK technical parlance, “care” and “support” are often seen as different, though complementary, activities. But “support” has become the term more commonly used in relation to housing-related problems, and the funding to meet those needs; so the use of the term what will be, in a major piece of legislation, can be seen as a real step forward in recognition of the need for better integration.
Any technical distinction between what are “care” and what are “support” services also serves to obscure the complexity of inter-related needs which individuals present. Nick Maguire’s earlier work on recognition of the many mental health difficulties faced by those who are homeless, and especially those in entrenched homelessness, did much to stimulate the UK Department of Communities and Local Government’s thinking on what work is really being done by homelessness resettlement services. Nick was one of the principal authors of the original guidance (NMHDU/CLG, 2010) on meeting the psychological and emotional needs of people who are homeless; and of the more recent follow-up “operational guidance” on psychologically informed services for those stranded in entrenched homelessness (Keats et al., 2012), which was the focus of the special issue of the journal, earlier this year.
In this new paper, Maguire turns his attention to more ethical questions underlying front-line homelessness service staff’s work in addressing such needs. As he points out, with such high levels of distress and frank disorder amongst their clientele, it is inevitable that front-line staff will encounter these problems; such issues “come with the territory”. In the words of one senior housing support manager, this is not extra; this is the day job.
“Meeting” these needs therefore means at the very least encountering them; and preferably helpfully. But at best it means managing these complexities well. We know that such personal encounters between staff and service users are often the key to helping someone find the strength and support to turn their life around. As we have seen, where such support comes from peers – former homeless people themselves – there is added benefit all round (reference 15.2).
At a time when welfare services fear being swamped by rising demand and shrinking resources, we continue, in this journal, to explore the opportunities for partnership, and the capacity for active engagement and co-production, that social housing offers.
Yet these papers are a reminder that the health gain benefits of progressive practice in social housing services are wider still. With growing recognition of the value of peer support, and with the scope for participation in tenancy engagement and the broader healthcare gain from empowerment, housing services will also go into areas where health and social care services do not go, in addressing social exclusion, and tackling the social determinants of health.
But the particular capacity of social housing agencies to treat tenants as rounded full citizens, and not merely as customers, taps into a still deeper need. At a time when governments are struggling to maintain their legitimacy, faced with economic forces and pressures beyond the scope of the nation state, the benefits in local engagement add a new dimension to participation. The scope for housing to sustain, build and even re-build communities, much as Octavia Hill had first suggested, is as important as ever. It is our housing and our neighbourhoods our civic engagement, rather than our voting, that best conveys a sense of belonging, of having a stake, in democratic societies.
Gardiner, G. (2012), “Banking on time”, in Johnson, R. and Haigh, R. (Eds), Complex Trauma and Its Effects: Perspectives on Creating an Environment for Recovery, Pavilion, Brighton
Keats, H., Maguire, N., Johnson, R. and Cockersall, P. (2012), “Psychologically informed services for homeless people”, available at: www.southampton.ac.uk/assets/imported/transforms/peripheral-block/UsefulDownloads_Download/A6FD3BB1EB2A449987C12DFF91EF3F73/Good%20practice%20guide%20-%20%20Psychologically%20informed%20services%20for%20homeless%20people%20.pdf
Morrison, S. (2012), “Britain unprepared for tsunami of dementia patients”, The Independent, September 16, available at: www.independent.co.uk/life-style/health-and-families/health-news/britain-unprepared-for-tsunami-of-dementia-patients-8142462.html?goback=.gde_3127218_member_164347004
NMHDU/CLG (2010), Guidance on Meting the Psychological and Emotional Needs of People Who are Homeless, NMHDU, London, available at: www.nmhdu.org.uk/complextrauma
Rosenberg, J. (2011), “Social housing, community empowerment and well-being, Part One: empowerment practice in social housing”, Housing Care and Support, Vol. 14 No. 4
Rosenberg, J. (2012), “Social housing, community empowerment and well-being, Part Two: measuring the benefits of empowerment through social housing”, Housing Care and Support, Vol. 15 No. 1