Evidencing the value of housing advice and information

Evidencing the value of housing advice and information for older people May 2011 Dr Gemma Burgess

Aims and objectives • The purpose of the evaluation, which is funded by DCLG, is three-fold: 1. To assess value for money, in terms of costs, benefits and savings to the public purse. 2. To evaluate the service in terms of how far it is meeting its objectives of: Empowering older people to make informed decisions Give them full knowledge of all the options available Support them in appraising these options effectively 3. To deliver the objectives of the funders and other stakeholders.

Key research questions 1. 2. 3. 4. Is the initiative meeting its own, its funders’ and broader policy -based governmental aims and objectives? How has the national-local model developed and what does it add? How can the value for money of the First. Stop initiative best be measured in relation to the objectives? And what is the evidence on value for money so far? How can this assessment contribute to the development of the commercial potential of the initiative?

Methodology • Phase 1 – available on our website. • Phase 2: – – – – Literature/policy update Data analysis from CRM – progress against targets Postal survey Client interviews Local pilot case studies Local pilot case study typology Training programme evaluation VFM

Local pilot case studies • • Summary of all pilots. Five case studies: 1. 2. 3. 4. 5. • • • Oxfordshire West Somerset Nottinghamshire Newcastle Warwickshire Interviews with all pilots and caseworkers. CRM and web data analysis. Progress against targets. Client case files. Analysis – successes/challenges.

Postal survey • 38% not sought help from other agency. For significant proportion of clients, First. Stop is first point of assistance. • Most common agencies contacted before First. Stop were local council and charitable organisations – but issues not resolved. • Enquiries about sheltered or more suitable accommodation were most common, followed by enquiries about care. • General measures of satisfaction met for nearly all respondents: for example, whether they would recommend the service, and the quality and means of information provision. • A smaller but very considerable proportion of clients – perhaps around half – for whom the service is more decisively important: it helped solve their specific problem (55%), provided help they couldn't have got elsewhere (48%) or without which they wouldn't have known what to do next (41%).

Client interviews • • Complexity of issues. Difficulty of knowing where to get I&A. First. Stop are helpful, knowledgeable. Increased confidence, more able to appraise their options, make informed decisions. • 30% respondents interviewed did not remember calling FS. • A sub-group who would have liked ongoing, face to face, local support.

Client interview quote • “Every aspect I asked I got a clear answer. It was very impressive to get all the advice from one person; it took away being passed from pillar to post and was very reassuring. The tone of the person on the phone was business like but very sympathetic. She fully understood the minefield I was in and took me through every aspect. She also gave me her name so if I needed to call back I could ask for her. It was nice to be reassured I was doing the right thing. On the money side she worked through everything with me, benefits, pension, house, she did a calculation and told me I didn’t have to worry. I needed someone cold blooded to work it out and she gave me the courage to stick up for myself with social services. I needed proper advice rather than advice from well intentioned people. I came off the phone feeling stronger”.

Local pilot projects • • All slightly different. Some strategic, some case work/a mix. Broad/narrow client groups. Different relationships with national First. Stop.

Local pilot projects – successes • Met targets – clear demand for services. – “There is a need, a lot of people are not able to access information or don’t know where to go. Even within the local authority they might say they can’t help or are passed to two or three different people and then the client gives up”. • Positive client outcomes whether supported to move or supported to stay put include older people having better knowledge of options, being informed to make appropriate choices, reduced anxiety, improved quality of life. – “It is a very needy client group and without the service I do not know who would have helped them. They do not fall into the remit of social services who, if they did anything, would probably only suggest care. Without the service they would have had no help and would have reached crisis point. Most clients we are reaching before they get to crisis point so we are preventing it”.

Local pilot projects – successes • Worked successfully across different agencies and departments to resolve client issues. • Freed up social worker and OT time. – “It has been really well received; the occupational therapists are really pleased that someone is doing the work to fill in the gap”. • Case workers used national First. Stop resources. • Greater awareness of housing options for older people. The strategic work encouraged more joined-up working between organisations and professionals.

Local pilot projects – challenges • Time taken to set up. • ‘Marketing’ skills for housing options case workers. • Continuous promotion to get First. Stop brand recognised locally, but balanced against capacity to deliver face to face case work so tended to step back from promotion when case numbers increased for fear of too much demand. • This meant less time and resources for promoting the national First. Stop helpline and website. • The national/local model is still developing. • Achieving the strategic aims was challenging in some areas, even where the case work service was successful. • Monitoring and data collection – the need to evidence success but relatively short time frame of projects reduces chance of ‘outcomes’.

Local pilot projects – value for money • For the VFM analysis: – – – – – Client profile Presenting issue Actions taken Outcomes The ‘what ifs’ Simplify/categorise Quantify in monetary terms VFM Broader costs/benefits – case studies to exemplify

Case work outcomes • Outcomes include: – – – – Signposting Information and advice provided Support in decision making Benefits checks Care changes Supported to move to alternative accommodation Supported to stay e. g. adaptations • Benefits? • Savings? • What can be given a monetary value?

Examples of potential benefits • To individuals: – Supported to stay in/move to the accommodation of their choice – wider choices. – Financially better off (average income increase of £ 50 per week after benefits checks). – Reduced anxiety. – Improved well being and quality of life.

Examples of potential benefits • To the public purse: – Prevention of falls (around £ 3000 per fall). – Free up social worker and OT time (community OT case work £ 80+ per hr). – Prevention of hospital admissions. – Prevent premature moves to care homes (LA residential care for older people £ 1, 017 care package costs permanent resident week – LA sheltered housing £ 312 comprehensive package costs).

Challenges of ‘proving’ VFM • • Time frame – need outcomes. Lack of monitoring information. Data collection can be simple but built in from the start. Value of prevention with potential upstream benefits – hard to quantify. • Value of crisis management. • Local priorities – e. g. downsizing where pressure on family sized homes.

Reporting • Still TBC. • Likely to be a July report.