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Purpose Comment on the contribution that housing can make to delivering better health and wellbeing outcomes. More specifically, the purpose of this paper is threefold: summarise recent evidence that makes the case for housing in helping to address health and social care issues; comment on the challenges and opportunities of partnership working; and describe examples of interesting and innovative local joint provision.Design/methodology/approach Draws on the author's briefing papers on housing, health and social care for housing quality network, which is a national housing consultancy organisation as well as the author's role as Chairperson of East Midlands Housing Care and Support, which is a regional housing association.Findings Collaboration between housing, health and social care is making slow progress at the national level in England. This is despite an ever-increasing evidence base highlighting that good housing can help to address issues, such as delayed discharges. Nevertheless, there are an increasing number of interesting examples of successful local initiatives on housing, health and adult social care. The way forward is to facilitate joint working at a local level.Originality/value Focusses on the success of examples of local joint working between housing, health and social care to achieve better outcomes for vulnerable people. [ABSTRACT FROM AUTHOR]

Purpose The perspectives of people with dementia and their care partners regarding “extra care” housing are currently unknown. The purpose of this paper is to report findings of a consultation study exploring the perceived barriers and facilitators of a relocation to extra care housing, from the perspective of people living with dementia, and their care partners.Design/methodology/approach Fieldwork consisted of paired or 1-1 interviews and small focus groups with potential users of an alternative model of extra care support for people living with dementia in the South of England. The consultation took place between June and August 2013. The interviews and focus groups were audio recorded, transcribed verbatim. The transcripts were analysed thematically.Findings Benefits of extra care were identified as the opportunity for couples to remain living together for longer, creating a supportive, dementia-friendly community, and a reduction in the strain experienced by the care partners. Barriers centred on a sense of loss, stress and uncertainty. Living and caring at home was perceived as preferable to shared care.Research limitations/implications The findings presented here have limited generalisability for two reasons. First, the shared care approach consulted on was very specific. Second, the participants form a purposive sample and as such are not representative of a wider population. Despite best intentions, the voice of people with dementia, are underreported in this consultation. Only one person with early on-set dementia was interviewed and the remaining two people with dementia were interviewed alongside their care partner.Practical implications The findings cast doubt on the viability of extra care facilities, designed for couples living with dementia, if extra care continues to be conceptualised and marketed as a preventative lifestyle choice. The findings indicate the value of consulting with people with dementia, and their care partners, when designing new forms of housing with care specifically for people living with dementia.Social implications The findings of this consultation exemplify the wish of couples living with dementia to remain together, in what they perceive to be “home”, for as long as possible. Couples living with dementia are therefore unlikely to wish to move into an extra care facility as a lifestyle choice option, early into their journey with dementia. This raises questions about the suitability of extra care, as a form of housing with care, for couples living with dementia.Originality/value This paper contributes to the body of literature, exploring the feasibility of new and innovative alternative care and housing options, for people with dementia. This paper is one of the first to explore extra care as a housing and social care option for couples with dementia. [ABSTRACT FROM AUTHOR]

Purpose – The critical potential of hospital discharge policies and practices to ameliorate the health and social care needs of homeless people has become the focus of considerable interest in England. Central to this rise in policy formation and practice development is an acute understanding of the multiple exclusions homeless people face in navigating public health and social care systems. In ways small and large this nascent landscape is serving to redefine and reshape hospital arrangements for homeless people, and opening-up new ways to deliver care across clinical, social and therapeutic boundaries. The purpose of this paper is to seek to add empirical vigour and theoretical rigour to this unfolding policy and practice terrain. Design/methodology/approach – This paper draws on findings from a case study concerned with exploring and explaining how statutory and voluntary sector organisations use specialist hospital discharge policies and practices to coordinate pathways of care for homeless people. Findings – This paper illustrates how people affected by homelessness and ill-health are routinely denied access to statutory housing support, social work assessments and district nursing provision through acts of institutional gatekeeping and professional abrogation. Originality/value – This paper makes an important contribution to understandings of the connections between hospital discharge arrangements for homeless people and statutory housing, social work and district nursing provision. [ABSTRACT FROM AUTHOR]

Purpose – Homelessness often results from the loss of social networks and individuals are tested in being able to sustain or develop new positive social networks necessary to rebuild lives. The purpose of this paper is to present findings from an exploratory study which investigated how different agencies and professionals support people experiencing multiple exclusion homelessness (MEH) to develop and maintain their social networks amid other competing priorities, such as reducing substance misuse and re-offending. Design/methodology/approach – The study was undertaken in England 2010-2011 in three case study sites. Data were collected in 76 interviews with practitioners and managers, from disciplines including housing support, social work, criminal justice, mental health and substance misuse services. Totally, 56 interviews and five focus groups were also undertaken with people with experiences of MEH. Data were analysed thematically. Data from one site in particular permitted a focus on personal relationships and social networks which were seen as beneficial but also potentially problematic. These data are drawn upon to reflect on the implications for housing providers and practitioners. Findings – While multiple factors had often led to the loss of social networks among homeless people, findings revealed that practitioners working with homeless people may be able to promote existing social networks, such as partnerships, help develop new ones, and support people withdrawing from less positive relationships. The authors conclude that practitioners should be alert to structural changes that threaten social networks and may need to enhance skills in creating opportunities to foster existing positive relationships in direct work with their clients and in collaboration with other professionals. The need to be careful of blurring professional boundaries is also observed. Practical implications – This paper suggests approaches that may encourage practitioner reflection and commissioning practice in achieving good outcomes for people with experiences of MEH by highlighting the importance of social networks and the potential for practitioners to foster supportive relationships. Originality/value – This paper considers the often under-researched area of day-to-day engagement with social networks and the implications of working to support these as part of the role of homelessness services. While drawing primarily on recent research in England the themes raised will have wider relevance to housing and care services generally. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to consolidate policy, research, evidence and good practice around strategies tackling fuel poverty and affordable warmth for older people aged over 60 to support the development of more effective services for this life course stage and to tackle physical and mental health inequalities. Design/methodology/approach – The authors consolidate current policy, research, evidence and examples of good practice in exploring effective interprofessional approaches that contribute to affordable warmth for older people through “desktop analysis”. The authors support this with qualitative data from Health and Wellbeing Boards (HWBs), health inequalities and environmental health from research comprising four longitudinal case studies in the Midlands and North of England over 18 months and semi-structured interviews with members and support officers. A total of 50 interviews were undertaken and 55 hours of HWB meetings observed. Findings – There are numerous older people living in fuel poverty. The depth of fuel poverty increases with age particularly the over 75s and physical and mental ill health are affected. There are an increasing number of tools to help estimate health care costs around the cost effectiveness of interventions and there is a real need for more local evidence about what is working well, how and why. However, there is no mandatory requirement for fuel poverty strategies and more creative local strategies are required taking organisational and interprofessional relationships into account. The emphasis in integrated care provides new impetus and scope to encourage preventative services but these new partnerships need to be effective in what is a complex policy environment. There is still a long way to go in places. The challenges of ageing are numerous, complex and not fully understood and sit across multiple policy areas. Originality/value – Fuel poverty strategies tend to be delivered on a geographical or income bases rather than by life course approach and a focus on older people. We need to focus more specifically on older people, a rapidly growing population and to better understand thermal properties of our ageing housing stock and how best to intervene to protect and improve health and safety. Emerging approaches need to overcome artificial statutory and non statutory divides and move towards sustainable, evidence based affordable warmth strategies for older people to protect and improve health. [ABSTRACT FROM AUTHOR]

Purpose – Homeless populations are a politically contentious problem and researchers struggle to achieve a balanced approach. They place emphasis on sharply contrasting factors, such as; institutional structures, ideologies or individual dispositions and differences. Central questions remain unanswered, i.e., is homelessness an outcome of society’s failings related to housing shortages, or a personal choice, as in the status of “intentional homelessness?” The purpose of this paper is to set aside assumptions, to explore experiences of homelessness and psychosis. Design/methodology/approach – An existentially informed hermeneutic phenomenological analysis; exploring transcribed narratives from semi-structured interviews with three men. Findings – These participants started to wander as a spontaneous response to distressing life experiences. Without any plan they travelled to new locations living on the street. Being contained and treated against their will in the psychiatric system was another source of distress. They did not choose homelessness through a rational calculation of their best interests. They felt at odds with society, which did not protect them and failed to meet their needs. Research limitations/implications – In qualitative research, findings are not generalisable to other settings. Practical implications – Homeless services should be enhanced by psychological expertise along with more person-centred emphatic approaches; the authors of social policies should consider their philosophical assumptions. Social implications – Systemised mental healthcare does not solve complex problems; fails to meet needs. Originality/value – The analysis informs the design of further research, prompts practitioners to review their understandings and provides grounds for the rewriting of policies. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to report on a small telehealth pilot in local authority sheltered housing in NE England. This explored the training and capacity building needed to develop a workforce/older person, telehealth partnership and service that is integrated within existing health, social care and housing services. Design/methodology/approach – A qualitative case study approach on the implementation and deployment of a pilot telehealth service, supporting sheltered housing tenants with Chronic obstructive pulmonary disease (n=4). Findings – Telehealth training and capacity building, needs to develop from within the workforce/older person partnership, if a usable and acceptable telehealth service is to be developed and integrated within existing health, care and housing services. To be adaptable to changing circumstances and individual need, flexible monitoring is also required. Practical implications – Service users and workforces, need to work together to provide flexible telehealth monitoring, that in the longer term, may improve service user, quality of life. Originality/value – The pilot explored a workforce/older person partnership to consider how to add and implement telehealth services, into existing health and housing services. [ABSTRACT FROM AUTHOR]