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| Nearly a third of Scotland's population lives in rural areas, and policy guidance about integrating housing and community care needs to make explicit reference to sparsely populated areas. In the past this dimension has tended to he neglected. This study was commissioned (i) to examine the particular problems associated with service delivery of the housing component of community care in rural areas, arid (ii) to identify and describe case studies which demonstrate how these problems can be addressed. |
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| Main findings |
- Providers of rural housing and community care services have to overcome several difficulties: many users have low incomes and live in poor quality housing: travelling is difficult; the rural areas contain a range of needs but each in small quantities and a particular type of provision may fail for lack of local support services; most respondents in the study argued there was a shortage of affordable housing for community care groups.
- Despite the problems, there are opportunities in rural areas for developing service initiatives which might be harder to achieve in the urban context. Firstly some rural communities are more close knit and supportive, and such communities are an important resource. Secondly, joint working between different agencies can be easier because organisations are small scale and individuals within them can more readily make connections with professionals from other disciplines. Thirdly, it appears easier in the rural context to adopt a flexible approach to policies and procedures.
- The study found that more progress was being made in rural areas at the planning level than at service delivery level. Nevertheless there were interesting, albeit limited, projects which were overcoming the special problems of rural areas. These included the extension of the Personal Housing Plan concept to community care, imaginative use of the Care and Repair model and dispersed ('floating") housing support, multi agency supported housing projects, and small scale, locally based needs surveys.
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| About the Study |
| The study used 3 main methods: |
| 1. A review of the literature on housing and community care delivery in rural areas; |
| 2. A short survey of 18 rural councils seeking examples of innovative practice in their areas; |
| 3. Telephone interviews and visits to investigate selected case studies in more detail. In selecting case studies, the emphasis was placed on examples that were in sparsely populated areas, that demonstrated tripartite working between social work, housing, and health boards, and that covered different user groups. |
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| Enabling people to remain in their own homes |
| With a shortage of suitable accommodation, it is particularly important in rural areas to ensure that the existing accommodation of community care clients is suitable for their occupation, to avoid their having to make a disruptive move to alternative accommodation possibly some distance from local support networks. There were a number of interesting Care and Repair projects, all of which have made a contribution to helping people remain in their own homes. In the Orkney Islands Care and Repair project all the main elements were in place for a co-ordinated provision of a comprehensive housing service for community care: |
| it had earmarked funding, worked closely with local authority housing, finance, and occupational therapist services, and responded in a very focused and flexible way to each request. Other Care and Repair projects were increasingly working within a community care framework through addressing the need for adaptations on an inter agency basis. They all reported, however, that progress in addressing poor housing conditions was being adversely affected by funding gaps. |
| Several authorities felt that dispersed alarm services had greater community care potential in rural areas, particularly for younger disabled people, although these services need to be better linked to other provision and services. |
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| Housing Design |
| Services like those described above are reactive. They attempt to make housing less disabling. It is especially important in areas with a dispersed or sparse population that new housing is built to high standards of accessibility and adaptability, so that the maximum potential for meeting the changing needs of local populations can be met. Two case studies (in Coldstream and Orkney) demonstrated the importance of user involvement in housing design, and how it affects the likely take up in any rural area of well designed units for people with disabilities. |
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| Housing and Support |
| There is a shortage of supported accommodation in many rural areas. The study, however, found a number of developments, such as the Strathcarron Project, which aim to keep dependent people out of distant and expensive residential care by offering integrated housing and support locally. Joint working can help overcome some of the problems of developing supported housing projects in rural areas, which include high land prices, high travel costs and local opposition. Multi purpose centres serving the wider community can make the most cost effective use of resources. Lessons learnt from pioneer rural supported housing projects include: |
- the need to appoint a manager at the earliest moment to bring and keep all parties together;
- the need to conduct a broad based initial needs analysis;
- all partners must be prepared at an early stage to set out clearly the sources of funding which are potentially available.
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| The relatively recent development of floating or dispersed support is of particular importance in the rural context: people are enabled to remain in ordinary, non stigmatising accommodation through the provision of such support. Dispersed housing support can only work well if local agreements have been made about the relative responsibilities of health, housing and social work departments. The report describes the Eildon Housing Association's dispersed supported housing service in the Borders. |
| At the time of the study there were uncertainties about the revenue funding of housing and support. |
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| Assessing Needs |
| A common criticism is that there is very little knowledge about the housing and care needs of rural community care clients. Needs may be more hidden than in urban areas, because of a greater tolerance of poor housing conditions, and because local choice of provision is restricted. Recent developments in housing needs assessment methodology as applied to community care are of limited value in sparsely populated areas. However, the study identified a number of small scale, locally based, surveys in Sutherland and Dumfries and Galloway which have adopted a comprehensive approach to community care needs. |
| Arguably, rather more progress has been made in identifying housing need through individual community care assessments in rural areas than in urban areas. The Personal Housing Plan, originally developed in Skye, has been extended to carry out holistic assessments of people with physical disabilities in the Borders. Instead of slotting people into existing housing services, the Personal Housing Plan starts with a comprehensive look at their housing, health and social care needs, and only then looks at how these needs can be met. |
| Experience in these areas shows that: |
- for personal housing plans to be carried out there needs to be one professional at the heart of the assessment conversant with multi-agency services and resources;
- adequate funding needs to be made available to allow local organisations to continue to play a critical role in exerting pressure for local housing and community care services in rural areas;
- many of the locally based surveys have shown the need for small, easy to manage units of accommodation, with readily available support, as an alternative to residential care provision.
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| Housing information and advice |
| Rural areas are relatively disadvantaged in terms of the provision of housing advice and information. Yet cost effective use of resources can only be achieved if there are local networks which provide good quality information on the available housing and services, which connect up well with systems for assessing people for these services. Inter agency collaboration between purchasers and providers and, most importantly, with the local community is essential so that an information strategy can be formulated, and duplication of effort avoided. Outreach services and other face to face methods must be flexible, so that one organisation can act as a conduit for delivering the services of another. |
| Highland Council's LAMBDA project is an interesting use of information technology in rural areas; although the take up of the pilot project was not very high, it was considered a success principally because of the capacity of the system's technology to transcend organisational boundaries, thus making the achievement of the delivery of a seamless service more achievable. |
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| Key Recommendations from the Research |
- There are strong arguments for continuing the established policy of positive discrimination in housing resource allocations in favour of rural areas. Good quality, affordable housing is essential to successful implementation of community care policies.
- The Care and Repair model is well established in rural areas. It could be expanded to a range of user groups and go beyond its home improvement role by acting as a base for other services.
- Many of the examples of good practice in the study were for older people. Other user groups should be the beneficiaries of imaginative inter agency provision.
- Assessment of the housing needs of community care users should be carried out at local level, since authority-wide surveys do not uncover local and diverse rural need. A bottom up approach (local small scale surveys) needs encouraging.
- Intensive housing management services, particularly dispersed or floating housing support, should be expanded in rural areas as they have a key role to play in keeping different categories of users in their own homes or at least in mainstream housing, and out of specialist provision.
- The Personal Housing Plan methodology pioneered on the Isle of Skye should be replicated. It has great potential for community care.
- Information technology, despite its high costs, has a key role in the provision of information and advice to dispersed communities.
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| " The Provision of Housing and Community Care in Rural Scotland ", the research report summarised in this Research Findings, may be purchased (price £5 per copy). |
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| This Research Findings may be photocopied, or further copies may be obtained from: |
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