30/03/2023
Hear from Sir David Pearson and Professor Roy Sandbach on the two of DMT’s largest funded programmes exploring why – and how – more housing choices need to be available for older people and about the challenges and opportunities.
Read a summary of the session below, and scroll down to watch the event recording.
The Commission on the Role of Housing in the Future of Care and Support was established in October 2020. Composed of a group of leaders of care and support organisations, academics, experts and practitioners related to housing with care and support, and advised by a co-production collective of people who draw on care and support services, it was co-chaired by the Rt Hon Paul Burstow, Professor Julienne Meyer CBE and Sir David Pearson CBE.
The Commission was tasked with developing a vision and roadmap for providing more options for housing with care and support. You can read the report that was published in 2021 as well as find the key recommendations, roadmap and other resources on the Social Care Institute for Excellence’s website.
One of the key themes of the report was the need to strive for greater integration across housing, health and care, putting the real needs of older adults and disabled people at the heart. David Pearson, one of the Commission’s co-Chairs joins us to tell us more and discuss what’s happened since.
A key aspect that has long-needed attention is how services might achieve better integration through use of technology – and how technology can put more control and independence in the hands of people who draw on health and care services. We’ve seen a ‘revolution’ in the way digital and online technologies, communications and media influence our daily lives but the same cannot be said for the role of digital and technology in care, health and housing – especially in relation to older adults and people with disabilities. Often siloed, there is now an urgent need to adopt more joined-up approaches across local services and systems, enabled by technology and while COVID-19 has helped embed the use of technology into the lives of many, it has also exacerbated the digital divide.
Supported by the Dunhill Medical Trust, and Chaired by Professor Roy Sandbach OBE, the TAPPI Inquiry set about listening, gaining insights and creating a set of overarching principles to inform a new framework for all stakeholders to refer to in the context of how technology can transform the landscape of everyday living environments for older and disabled people. You can read the report from the first phase here. TAPPI has now moved into its second phase.
Launched at the TSA Conference in March 2022, the second phase ‘From Principles to Implementation’ lasting 12-15 months, will assess digital services and solutions using the original TAPPI principles in six demonstrator sites to ensure they are: Adaptable, Co-produced, Cost-effective, Choice-led, Interoperable, Inclusive, Outcome-focused, Person-Centred, Preventative and Quality-focused.
This phase will gather evidence of what is possible and challenge what is perceived to be impossible, building on learning gathered during the pandemic. The goal is to create new, scalable housing service models using technology-enabled care which support personalisation and, simply, deliver better outcomes for people. Professor Roy Sandbach joins us in the session to tell us more – and to compare notes with David Pearson on the challenges and future priorities.
If you cannot see the embedded video below, then you can watch the recording on YouTube at this link.
David is the Chair of TEC Quality, the sister organisation to TSA, that has the only externally validated Quality Service Framework in the UK for Technology Enabled Care. He is passionate about choice and control for people who need social care and health and the quality and effectiveness of services. He co- Chaired with Rt Hon Paul Burstow and Professor Julienne Meyer MBE, the DMT-funded Commission on the future of housing with care and support conducted by the Social Care Institute for Excellence. The report was published in November 2021.
A former Director of Adult Social Care and Health and the Deputy Chief Executive for Nottinghamshire County Council, David chaired the Nottingham and Nottinghamshire Integrated Health and Care System and in 2017 was appointed as an independent advisor to the Government on the Social Care Green Paper in England. Taking up the role of senior lead on all social care-related matters in the NHS for the Covid-19 response from the end of March 2020, he was subsequently asked to lead the Government Taskforce on COVID 19 in the social care sector.
David was awarded a CBE in 2016 for services to adult social care and a Knighthood in the 2021 New Year’s Honours for services to health and social care integration.
Roy chairs the Dunhill Medical funded TAPPI programme… Technology for our Ageing Population: Panel for Innovation (TAPPI). It is developing a practical framework for what ‘good’ looks like in technology for housing and care. Until September 2018, Roy was Director of the National Innovation Centre for Ageing at Newcastle University and remains a visit-ing Professor at the university. He sits on the Advisory Board for the APPG for Longevity and is a Board Member for the Technology Services Association, the trade association for technology applications in the care sector. He is vice-Chair of Sunderland Ageing Well Board.
Roy is immediate past-president of the Royal Society of Chemistry Industry Council and a Fellow of the Society. He chairs Northern Accelerator, the research commercialisation programme of the five North East Universities. He led the development of the regional innovation strategy for North East England and was founding chair of the NELEP Innovation Board. He holds visiting Professorships at Cranfield University and Central St. Martin’s College of Art & Design, London.
Roy spent 31 years with the Procter & Gamble Company holding global R&D positions in Europe and Asia, leading inno-vation programmes across the world. One of his patented inventions is a $150 million business in the US. Roy was awarded the OBE in the Queen’s Birthday Honours 2017 for services to science, innovation and skills.
I think we also need to think about training the trades people on the needs of older people. I had my bathroom redone just in case of ‘need’ – now I am in need of that there are absolutely no grab rails and we can’t fit any because the unit is made of reinforced glass.
You’re so right Asmina. We funded some great work in Wales by Care & Repair Cymru to develop a Builders Charter to operate across Wales in order to increase the number and accessibility of reliable contractors that older people can call upon when they need work to their homes. But this is for older people specifically. A lot more needs to be done to promulgate good design principles in building more generally which will benefit us all. There are some great examples emerging -check out Invisible Creations and Motionspot (but there are others) but, to your point, this needs to be mainstreamed and included in basic trades training.
Lifestyle behaviours (nutrition, physical activity etc.) are responsible for over half of our well-being. Can the speakers talk about innovation in housing to provide residents with the capability, opportunity and motivation to adopt more healthful behaviours?
There’s so much more to be done here Anne-Marie. The HAPPI Principles were published over a decade ago and encompassed 10 design principles, which included the provision of space and flexibility, positive use of circulation space, shared facilities and hubs ((e.g. for cooking and eating) and storage for bicycles and other equipment. These principles sought to encourage people to live more physically active and connected lives. But they are not mandatory and work continues to ensure these are built into the Building Regulations. Some local authorities have voluntarily adopted them. Some of the individual demonstrator projects within the TAPPI programme also seek to address the encouragement of healthier lifestyles through the use of technology and we’re looking forward to hearing the outcomes.
So interesting to hear these talks today – thank you! I have a question about equity and differential effectiveness – one challenge is to ensure that innovations dont benefit the ‘better-off’ most and therefore increase inequalities. Do you have scope in your pilots to test interventions for differential effectiveness across social groups?
I think Roy started to give an answer on this Joanna, but it’s such a big topic! The TAPPI testbeds are focused on older people living in supported living environments. Because there are very few options of this nature for people in the more advantaged socio-economic groups this work is almost entirely focused on the least advantaged. You raise an excellent point, though – there’s certainly scope for some work to test differential effectiveness across the range. Food for thought…
Has the Commission addressed the considerable retention and recruitment issues of care staff/the care workforce?
Hi Janet: the Commission was largely focused on the call for more housing with support options but it made a series of recommendations for government, set out in a route-map which included a requirement to publish a national workforce strategy for social care, which includes six priorities, as previously called for by the national social care leaders and applies across all housing with care and support settings. We hope to see these recommendations revisited and reflected in the soon-to-be-launched Older People’s Housing Task Force.
This conversation is a good example of “person-centred care” and is exciting in light of the potential for ICSs. From the perspective of palliative care, a holistic person-centred assessment takes account of physical, psychological, spiritual and social needs. Well thought through housing can both create the conditions for living and dying well and prevent future problems in the social domain of need. Also reduce need to transitions in later life which are distressing, costly and disruptive. Good to hear thoughts on preventive and person centred care?
We agree, Richard. In much of the work we’ve been funding recently, we have been re-iterating the need to bring housing, health and care together in strong, connected partnerships. We’re starting to see this happen, but as ever, the incentives and funding are lagging behind…to Iain’s point , there need to be innovative funding mechanisms that encourage investment in preventative models – but also to demonstrate to consumers what’s available to drive the change from the demand side too. There is potential for more to be done around social outcomes contracts and for social impact investors to be working in partnership with the public sector on this. There are some nascent examples.
One of the principles was preventive. Can you expand on this point? I’m interested to know how we incentivize in preventive services/innovations within housing and what their (housing Providers) drivers may be to invest in them – and to demonstrate what’s available to consumers?
Thank you, Iain. To an extent the most appropriate housing for our needs and choices is preventative in terms of maintaining our independence and reducing risks that come from being in housing that might be (for instance) unsuitable in lay out, facilities or hard to heat. As Professor Chris Whitty said in his recent evidence to the Health and Social Care Committee on Prevention in health and social care “For example, one of the reasons we are going to have a problem in the UK as the population gets older is that the housing stock is not designed for that. It is designed largely for a young family with two children. That is going to be very problematic. People with even a moderate disability may not find it easy to live independently. The design of the built environment, and the natural environment that we maintain within it, is absolutely critical for physical and mental health.”
The trick here is for housing health and care to have joint strategies to ensure that preventative approaches are embedded in housing solutions and people have access to the best evidence about what works and their cost effectiveness.
One of the things that we’re trying to do at DMT is to provide funding to front line organisations to help them to demonstrate what’s available for both users and policy-makers.