Lewis Macdonald



Housing through the lens of ageing: Integration, communication and community

 

Speech in the Scottish Parliament

 

29 January 2019



I congratulate Graham Simpson on securing today’s debate.

We do indeed need to adjust our focus and to look again at housing policies and priorities in the context of an older population that is growing in size.

Much of our existing housing stock in both the public and private sectors has been built with young people and families in mind, but we know that future demand for older people’s housing will only go up.

Existing models such as sheltered and very sheltered housing remain valuable, as we have heard, but new models will also be required in the age of health and social care integration.

I want to focus my lens on one particular new model that has been developed in my home city—indeed, the minister’s home city—of Aberdeen, and which has been showcased by Age Scotland and the University of Stirling in the report that we are debating.

When I took on the role of convener of the Health and Sport Committee a year ago, I soon discovered that the integration of national health service provision and local authority social care was moving at very different speeds in different parts of the country.

I had ministerial responsibility for that process of integration between 2005 and 2007, but despite continuing commitment to it from successive Governments, there is clearly still some way to go.

I discovered last year that Aberdeen City health and social care partnership is held up as an exemplar for others to follow, and it is good to be able to highlight a specific aspect of the partnership’s work in this debate.

Delayed discharge can happen for a variety of reasons, but the most common is that there is no suitable accommodation or care package available that would allow a person who is no longer in need of continuous healthcare to leave hospital.

Aberdeen City Council has converted what was sheltered housing at Clashieknowe in Bridge of Don to provide interim housing and support for people who are either due to leave hospital or struggling to cope in the community.

Clashieknowe has 19 interim housing units catering for adults over the age of 18.

Although many residents are older people, this is one of the few services that supports people with complex social care needs who are under 65. Intermediate care and support are provided onsite by the council’s social care provider, Bon Accord Care.

Residents are enabled to learn or relearn skills necessary for daily living, from cooking and cleaning to independent mobility and medication.

Key to the success of Clashieknowe is the mutual trust among housing, social work and NHS staff, with effective partnerships among Aberdeen City Council, Bon Accord Care and the health and social care partnership.

Another partner is the Disabled Persons Housing Service, a local charity based in Aberdeen; the delayed discharge housing liaison group, the housing needs assessment team and the adapting for change project group have also played important roles.

Aberdeen City Council has also launched interim housing for people with low-level support needs in Cove and in Mastrick in the city, recognising that future provision must span a broad spectrum of needs, abilities and disabilities.

Intermediate care and support cost money, of course, but they cost a good deal less than delayed discharge.

Initial findings from the Aberdeen project suggest that interim care costs around half the cost of a hospital stay.

Delayed discharge is a challenge not just for the NHS but for housing and social services and I commend the good example of Aberdeen.

A person-centred approach, open lines of communication and regular meetings of all concerned are key to success, as is a health and social care partnership with the vision to know what needs to be done and the clout to get on and do it.