Funding Alarms & Proactive Communication Systems for Vulnerable People
In sheltered/supported housing & in dispersed tenancies
Providers and Commissioners involved in the provision of emergency alarm services to vulnerable people have a problem; they are increasingly experiencing funding restrictions, which inevitably means that the provider will need to subsidise or entirely fund the service unless they ask the residents themselves to pay
This mostly affects services for older people, but by no means always. If we think laterally and innovatively we might just be able to reframe our thinking on the provision of what might be better seen as proactive communications systems not just alarms which reactively respond to emergencies, some of which may have been avoidable had there been a higher level of routine proactive communication. Sometimes emergency alarms are used for non-emergency communication as well, despite the fact that they're routinely unfunded.
We could widen the scope of what these communications systems do and go beyond older people in sheltered and extracare schemes. How about older people in dispersed accommodation like general needs? How about other vulnerable people, whether in supported housing or general needs accommodation?
It is important, however, that in reimagining this issue we keep some key objectives in mind and stick to them:
- The service provided to older and other vulnerable people should be improved, not diminished
- Costs to the landlord and to the tenants should not increase: instead they should reduce or be eliminated
- Staff resources should be freed up so they can be targeted more effectively to people with the greatest need
- The service should be preventative in nature with the intention of keeping the accommodation adequate to the residents' needs. It should be safe and take pressure off statutory services
- The service should apply to accommodation-based services and to vulnerable people living in what are otherwise general needs tenancies.
It is especially important in these harsh times for the public purse that we are able to work innovatively to find new ways of making things better and more cost-effective. Support Solutions has thought much about how we should collectively respond to the needs of vulnerable people in an increasingly fraught public funding climate and the challenges of welfare reform: what follows is one response and there will be others. Watch this space!
There is a problem: no one feels able to fund alarms any more, be that the whole "alarm" system or just parts of it. Traditionally one or a combination of the following funding streams has funded alarm services:
- Housing Benefit
- Supporting People
- Social Care/NHS funding
The fact that there are a number of historical funding streams shows that there are a number of different components to what we call an "alarm" service. For example, there is the hardware/equipment (hard-wired systems with pull cords, dispersed pendant alarms). These components are increasingly hard to fund other than by recovering the costs directly from the people who use them, and some don't use them, they just happen to be provided as part as the accommodation.
Some providers subsidise the service as the hardware components and the servicing, maintenance and upgrading of those components are increasingly difficult to fund as a service charge.
Housing Benefit departments are seeing the servicing and maintenance of alarms as ineligible as it is part of the "provision of an alarm" which is ineligible under Schedule 1 of the Housing Benefit Regulations 2006. The service charge guidance connected to the Universal Credit Regulations 2013 also establishes that all elements of a personal emergency alarm are ineligible for funding.
Then there's the human response (the call centre, scheme-based and/or floating support staff). This has historically been funded through Supporting People and sometimes it still is, but that's now the exception not the rule. Supporting People sometimes used to meet the hardware costs of some alarm systems as well. Providers have, often with Support Solutions' assistance, successfully allocated some of the costs into the Housing Benefit service charge to reflect the response to calls related to the door entry intercom system, the fire alarm or other property-related functions. This is still remotely possible albeit very short term as the majority of Housing Benefit departments are determining that the entirety of the emergency alarm response is ineligible for Housing Benefit.
Another potential funding route is the NHS/Adult Social Care department (or Social Work department if you're in Scotland). This can be argued on the basis that the funding of preventative services reduces demand and associated costs on statutory sector health and social care services. However, alarm systems are primarily reactive not preventative. Statutory sector commissioners are going to want to understand your "value proposition" - or how much you are going to save them, not cost them. Reactive alarms, which can sometimes be expensive, don't provide the outcomes for that.
If we change our thinking and forget about the "alarm" label for a moment and focus on the idea of a proactive communication system then we might be able to reimagine how we provide services to older and other vulnerable people in accommodation-based and dispersed tenancies and how we get them funded.
One Size Doesn't Fit All
A constant concern on the part of anyone involved in sheltered housing, as an example, is the sometimes "one size fits all" approach to the provision of "alarms" and associated communication systems, especially with "hardwired" systems. Some people benefit from this provision, albeit to varying degrees, and some don't but it's often there anyway. Sometimes people don't need it, don't want it but they, or their landlord, have to cover the costs of it anyway. What is needed are services and associated equipment that are targeted to needs and costed and funded accordingly.
What is also needed is choice. We're in the age of personalised services now so it's important that people can be in control of how such services are deployed to meet their needs.
Any reimagination of the old "alarm" systems shouldn't always mean that they disappear, just that they are not the default position. Most of the components of a traditional "alarm" system are important, but as part of a wider and more functionally preventative system rather than being the centrepiece of a reactive "alarm" system. Given the problems with funding it would seem like a good idea to create service delivery models that reduce the cost of the provision of the alarm
Housing Proactive can sit at the heart of any proactive communication system for vulnerable people; it reduces and sometimes eliminates the need for alarms in the traditional sense (and at the very least can reduce the unfundable elements of an alarm to a few pence a week). In addition to improving services to vulnerable people it costs tenants and providers nothing at all to install, run and maintain provided tenants are HB eligible and very little if they're not.
Furthermore, Housing Proactive is an additional housing management service, the provision of which is sufficient in its own right to create an Exempt Accommodation scenario for Housing Benefit purposes in both accommodation-based and dispersed tenancies. This is hugely beneficial to tenants and providers in the context of welfare reform: it protects both against welfare reform restrictions and allows prevention to be properly resourced and funded.
So what does it do and how?
- It's a telephone-based housing management system based around proactive communication with tenants: it works over landlines or supplied mobile units.
- Tenants tell you that everything is ok with and at their property each day by simply pressing a button before a time you've agreed with them. They can then get on with their day without having to wait for a call or a visit, thus the system promotes independence not dependence.
- If they don't press the button, they get a call, if they don't answer; they get a visit to confirm everything is in order.
- Staff time and resources can be redeployed to tenants who really do need staff input.
- It augments existing alarm systems, reduces the need for them and associated costs.
- It acts as a 2 way messaging and communication system between provider staff and all tenants, a group of tenants or an individual tenants. For example your staff can broadcast an important message to multiple schemes in minutes.
- It provides useful housing management information for example detailed occupancy data.
- It is an additional housing management service that enables providers to legitimately define accommodation as Exempt Accommodation
- You can incorporate door entry and fire system monitoring so you don't need to pay to have this functionality included within a traditional alarm system: within a "traditional" alarm system this functionality is unfundable, within Housing Proactive it's completely fundable through housing benefit
- It eliminates the inappropriate use of alarm systems as a communication system for repairs and housing issues and therefore should reduce alarm-monitoring costs.
- It is operational 365 days a year
Staff will want to be sure that the full range of tenant needs can be covered by any proactive communication system, from additional housing management services like Housing Proactive (funded through Housing Benefit) through to an emergency alarm.
There must be a more productive and targeted way to deliver services to those who need them the most. Rather than knocking on doors or telephoning every tenant every day to ask "is everything okay?" wouldn't it be better if the default position was that the tenants let you know that everything was okay? If they didn't let you know that by a prearranged time then you'd contact them immediately. How much resource does a traditional daily check take especially in large schemes, half a day and more than 1 member of staff? And what about vulnerable tenants in general needs stock? It's hardly practical to visit, or contact them all but sometimes they may have equal or greater needs than some people in sheltered or supported housing. What if this time could be spent focusing on and making a real difference to those people who need you most?
Of course direct and easy communication with all tenants should be part of any proactive communication system. Tenants can proactively contact scheme/floating support staff, repairs, customer services. Staff should also easily be able to contact all of the tenants group: tell some of them about a facilities issue, a meeting that's happening, all of them about a security concern or just one of them about a meeting or appointment.
A proactive communication system, including Housing Proactive, shouldn't replace face-to-face contact with people, it should augment it in the same way that it augments the use of emergency alarms and combines all those components into a single proactive system.
It should also be able to provide you with meaningful and useful management information but fundamentally it should cost nothing at all (it's fundable through the rent and/or service charges and will remain so irrespective of the implications of the Welfare Reform Act), reduce the costs of unfunded elements, enable better staff deployment and enhance services to tenants.
The Way Forward
So the answer to questions over how we fund alarms is to reframe the question. If an "alarm" system is comprised just of emergency reactive components it's not fundable. If the default service is Housing Proactive, it's fundable. If people need additional components such as a dispersed alarm then they should have that too but the point is that it's based on need - it's not a "one size fits all" approach that is both inappropriate and unfundable as well as being expensive to maintain. Housing Proactive can also include door entry and fire system monitoring, which are unfundable as part as an emergency alarm system but entirely fundable if they're part of a housing management system. Housing Proactive is also based on a telephone line, which the vast majority of your residents already have or supplied a mobile (GSM) unit, reducing the need for hard-wired infrastructure. Why not use that as a means of enabling proactive communication and provide dispersed alarms where need and choice really demands it?
Please contact firstname.lastname@example.org or email@example.com. This is about reimagining the idea of "alarms" to improve services to vulnerable people whether they're older people in sheltered accommodation or extracare, or vulnerable tenants in accommodation-based or dispersed "general needs" tenants. We know it'll be a game changer in the reimagining and funding of what we used to call "alarms"
(Added to site Tuesday, May 14th, 2013)
Other Articles In This Issue
DWP Consultation Proposals: Support Solutions Response
The Silver Surge: wellbeing & prevention services for older people
A 1% Rent Cut, the Privatisation of Social Housing & a Redefinition of Supported Housing: Challenges & Opportunities
The Future Funding of Supported Housing: Responding to the Consultation
What is Supported Housing?
Funding Supported Housing
funding supported housing consultation
funding for supported housing
Supported Housing Funding
Supported Housing Manifesto
Social Return On Investment (SROI) for organisations that support people with additional needs
The LHA Cap & the Future Funding of Housing, Support & Social Care
Issue 12 Home
Funding for Housing Support and Social Care Services in a Time of Change
Intensive Housing Management & the DWP HB Consultation Proposals
Welfare Reform Bill 2011
Universal Credit & Supported Housing
Exempt Supported Housing, Universal Credit & Intensive Housing Management
Welfare Reform, Universal Credit & Exempt Accommodation
Exempt Accommodation & Welfare Reform Act Update
Exempt & Specified Accommodation & Intensive Housing Management
SROI: the cost of everything & the value of nothing
Housing proactive and value generation
Support Solutions 5th National Housing Support & Social Care Conference 2014 The conference tackled todays issues at provider level, and provided knowledgeable people to present the workshops. A.L - Caraston Hall