Robert Cornwall
Carlisle City Council

25
20
15
10
5
-10
-15
0
-5
Proportional Change in No. Persons: 2001-2011
Source: Office for National Statistics, Census
Cumbria Rural LSOAs Cumbria Urban LSOAs
0 - 14 15 - 64
Age Group (Years)
65+
ONS, Cumbria Intelligence
Observatory

20
10
40
30
0
-10
-20
Census 2001-2011 – Population change
Cumbria (Rural /Urban)
Proportional Change in No. Persons: 2001-2011
Source: Office for National Statistics, Census
Cumbria Rural LSOAs Cumbria Urban LSOAs
0 - 14 15 - 29 30 - 44 45 - 59
Age Group (Years)
60 - 74 75 - 84 85+
ONS, Cumbria Intelligence
Observatory

• Strong correlation between poor housing and ill health
• People are affected by poor lighting and excess cold – excess winter deaths
• Falls on stairs after warmth are 2 nd most common hazard
• Social isolation – more harmful than being a smoker
• Reductions in income – annuity rates, pensions, benefits
• Living a long way from relatives
• Resilience in overcoming a crisis – partner/carer dying
• Not feeling safe at home

• In Cumbria – 45% of the Over 85s use Social Care today
• This population is set to double and change – men are living longer
• A&E experienced winter demand level in April/May this year
• Social Care funding has a shortfall and Health spending is flatlining.
• Evidence emerging nationally that authorities which did not invest in prevention are feeling the pain most

• Fundamental aim to reduce pressure on Health and
Social Care
• Section 28a funding goes to the Upper Tier authority
– DFG additional funding has been provided to Districts
• District Councils in Cumbria got £500k in 11-12 and 12-13
• Integration in New Care Bill
• “safe and settled accommodation” is a fundamental principle
• duties on prevention (preventing, reducing, delaying care needs), and
• duties to ensure integration between care and support, health, and ‘health related’ provision including housing.

• New Guidance on DFG Good Practice due soon
• Difficulties have arisen in getting agreement around expectations on Housing associations
• Riverside in Carlisle has taken full responsibility for adaptations to their properties
– Strong emphasis on management of stock
– Void adapted properties are let if possible to suitable tenants only
– Avoid putting in Level access showers to 1 st floor of houses
– Offering packages to help with moving costs

• Project a year old - led by the GPs
• Housing the No. 1 issue
• ‘Virtual Ward’ to be established in June
• Health and Social Care Coordinators
• Targeted at the frail elderly – over 75
• Low support needs
• Reducing Social Isolation
• Risk stratification tool being developed
• Community Assets Based Development Approach

• Home Improvement Agency – July 2012
– Accredited with Foundations
• Additional services to the DFG work
• Providing the Housing Support to keep people as independent as possible for as long as possible
• Housing Caseworker – discharge service
• Community Neighbour programme
• All funded by Health and Social Care

• It’s all about the ability to respond – speed is key
• GPs need service specs and outcomes – not a policy
• It can take a long time (GP time) to set up a new service
• New services can generate income or be cost neutral
• Equity release and small affordable loans for house renovation and repair
• Making best use of ECO

• Waiting times are key – GP wants the risk of falling removed now not in a year’s time
• Deterioration in Private Sector Stock condition
• Financial pressures on everyone’s budgets
• Cultural integration – Health
• Demographic pressure on the whole system
• Obesity
• Closer to Home and even Closer to Home