Appendix 1 Housing Contribution Statement
Argyll and Bute Council · 25 May 2022
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 25 May 2022 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 Argyll & Bute Health and Social Care Partnership Strategic Plan 2022/23 – 2024/25 LOCAL HOUSING CONTRIBUTION STATEMENT Prepared by Argyll & Bute Council Housing Services and approved by Argyll & Bute Strategic Housing Forum, March 2022 1.0 Introduction This is the third Argyll and Bute Housing Contribution Statement (HCS) which builds on the positive joint working that has been established across the housing, health and care sectors since the inception of the HSCP’s Strategic Plan in 2016. It provides the focus for strategic coordination between the council’s housing service, local housing associations (Registered Social Landlords or RSLs), other housing agencies, and the HSCP; and will ensure that the Local Housing Strategy (LHS) and Strategic Commissioning Plan are aligned when they relate to health and housing. This strategic coordination requires: Involvement of housing representatives in the integration authority’s strategic planning group and localities; Shared work on the needs assessments underpinning the SCP and LHS; and Production of a Housing Contribution Statement as an integral part of the SCP to explain how services have been aligned. Following current guidance, the Housing Contribution Statement is required to: • Briefly articulate the role of the local housing sector in the governance arrangements for the integration of health & social care; Provide a short overview of the shared evidence base and key issues identified in relation to housing needs and the link to health/social care; Set out the shared outcomes and service priorities linking the Strategic Plan and Local Housing Strategy; Set out the current and future resources and investment required to meet these shared outcomes and priorities, and identify where these will be funded from the integrated budget and where they will be funded by other (housing) resources; Provide an overview of the housing-related challenges going forward and improvements required. Cover key areas such as adaptations, housing support and homelessness. It will also aim to articulate the housing contribution across a wide range of groups including older people and those with disabilities, mental health and addictions.
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2 2.0 Background and progress, 2019/20 – 2021/22 As the previous HCS stated, the local housing system encompasses the following: As strategic housing authority for Argyll and Bute, the council has legal responsibility, for: In summary, the housing system comprises: The wide range of housing services available in Argyll and Bute include: Strategic planning, new build development and empty homes; Homelessness, housing options and information and advice; Tenancy support, mediation, money skills; Welfare Rights, income maximisation, and benefits; Private sector property repairs and improvements; Aids and adaptations, and Care & Repair; Home energy efficiency, fuel poverty and climate change initiatives; Factoring, estate management. All of these, and other particular functions, have a positive impact on the health and well- being of the local population; and will continue to make a real and significant contribution to the outcomes of the HSCP’s strategic plan. Housing supply across all tenures & the functioning of all aspects of the housing market Government spend directed at housing & housing services The quality, standards & safety of existing stock Planning & Infrastructure delivery, insofar as it directly relates to housing Housing Services The interface with other policy areas e.g. economy, health, social care & environment The Housing Need & Demand Assessment The Local Housing Strategy The Strategic Housing Investment Plan • Argyll & Bute Council The Statutory Strategic Housing Authority • HOMEArgyll - ACHA, Dunbritton, Fyne Homes, Link Group, West Highland • Specialist RSLs - Bield, Trust, Key Housing, Blackwood, Cairn, Cube/Enable The Social Rented Sector • Private Landlords & tenants; Letting agents; • Community Groups, Development Trusts The Private Rented Sector The Owner Occupied Sector Home Owners
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3 Table 1: HCS Progress/Outputs 2019/20 – 2021/22 Action Milestone/Output Using evidenced based need and demand to identify specialist housing requirements early in the development of the SHIP and SLP. The new Argyll & Bute Housing Need & Demand Assessment (HNDA) was approved as “robust and credible” by the CHMA in 2021, with specific positive commendation for the section on Specialist Provision & particular needs. Early engagement with health and social care partners (e.g. OTs, learning disabled team) in the planning for the SHIP, help inform practical design issues Following an initial fixed-term appointment, the dedicated post of Housing OT was confirmed as permanent and fully funded by Housing Services in 2021; and has continued to enhance planning processes and engagement across the sectors. A more co-ordinated approach across housing, health and social care to address homelessness A key outcome of the Argyll & Bute Rapid Rehousing Plan was the appointment of a Mental Health & Addictions Officer, with funding from the Council Housing Services, to ensure closer engagement for homeless cases, particularly those with complex and/or multiple health issues. 110 homeless cases with health related issues (i.e. physical or mental health; drugs/alcohol; or unmet need for support/care) received a positive outcome during 2019/20 and 2021/22. Ensuring housing improvements and home energy efficiency programmes are targeted at the most vulnerable and fuel poor households. The Home Energy Efficiency Programme Scotland: Area Based Scheme delivered 547 improvement measures to 428 homes with total grant aid of £2.571m (2019/20 & 2020/21 only). Ensuring allocation policies and access to social rented housing does not present barriers to those with particular needs Despite covid restrictions, approx.1,675 households secured RSL tenancies (years 1&2 only) of which 20% (340) were to specialist housing/ households with disabilities or health conditions. Increasing the supply of suitable affordable housing across an appropriate range of models and types and tenure, as appropriate, to meet local need and reverse population decline. The SHIP delivered c. 225 affordable new build homes, including around 20 specialist units (wheelchair, amenity, specially adapted) in years 1& 2 and first 3 quarters of year 3. In addition 66 empty homes were brought back into effective use in years 1&2. Around 16% of RSL stock is designated as specialist provision (and a significant proportion of the ground floor, mainstream stock would also be accessible and suitable for future adaptation) Ensuring housing services help to tackle & eradicate health inequalities; and address disadvantaged individuals and communities. In 2021, Health Impact Assessment completed for new LHS along with positive assessments for Equalities & Socio-Economic impact, Child Rights & Well-being, and Islands Communities. In 2019/20, 135 private homes & 237 RSL homes were adapted with grant aid; and in 2020/21, under covid, 63 private homes & at least 112 RSL homes also received adaptations.
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4 Overall, progress against the key aspects of the HCS are positive (coded green below) despite the significant impact of the pandemic on delivery of services in years 2 & 3 of the previous strategic plan. While certain issues require further work (coded amber below) there are no areas which have failed to progress to at least some extent. Senior Council Housing Officers and representative RSL CEOs continue to participate in the HSCP Strategic Planning Group; and senior management from the HSCP attend the Argyll & Bute Strategic Housing Forum. During the pandemic, regular cross-sectoral meetings were established including virtual “huddles” which have led to greater engagement & synergies. Shared Evidence Base Following the 2018 Joint Housing, Health & Care Needs Assessment, the revised HNDA 2021 includes dedicated research on and engagement with wheelchair users, Gypsy/Travellers; Armed Forces veterans; Learning Disabled and others with particular housing & support needs. Joint working with the new Housing OT has also improved data analysis for these groups. Shared Outcomes & Priorities A full review of the Health Impact Assessment for the new LHS in 2021 helped to identify a number of service priorities across the partnership. The Housing OT work plan was developed from the previous HCS action plan and feeds into the shared LHS outcomes & targets which were agreed through a series of option appraisal workshops & strategic conferences over last 3 years. Future challenges & improvements required Key issues previously identified remain priorities: delivering appropriate services & solutions in the remote rural & island context; agreeing specific project objectives, such as joint responsibilities/opportunities for re- provisioning of care homes and delivering effective range of housing/ care models in local areas; tackling health-related issues for key clients such as homeless; and improving adaptations services across all tenures. This was highlighted at national level as the main area of weakness in the first round of HCS; and while significant progress has been made over last 3 years, with Housing investment in support of HSCP plans being clearly identified, further work remains to be progressed in respect of specifying where investment will come from Integrated HSCP budgets or other sources. Positive progress has again been made, and the SMART action plan for this HCS has been developed as part of the HNDA/LHS planning process with HSCP colleagues and following wide consultation with stakeholders over the last 3 years. Progress will continue to be reported on a quarterly and/or annual basis to the Strategic Housing Forum and to the HSCP’s Strategic Planning Group. Governance Monitoring & Evaluation Resources/ Investment
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5 Each of these HCS elements are further outlined in the following sections. 3.0 Governance Arrangements: Partnership Working and the Strategic Housing Framework The Strategic Housing Forum In Argyll and Bute, the overarching body with responsibility for overseeing the delivery of the LHS and the Strategic Housing Investment Plan (SHIP) is the Argyll and Bute Strategic Housing Forum which comprises a range of key community planning partners and meets quarterly. It is chaired by the Council Housing Spokesperson and administered by the Council’s Housing Service but also involves other council services such as Planning and Economic Development; and external partners such as the Scottish Government, local and national RSLs, Highlands & Islands Enterprise, the Loch Lomond & Trossachs National Park, Argyll & Bute Care & Repair, ALIenergy, Home Energy Scotland, Communities Housing Trust and others. Health and Social Care representation on the Forum has been consolidated in recent years with senior management from the Integrated Authority now established on the core membership of the Forum. Housing Sector involvement in HSCP Policy and Decision Making Planning Structure What we Intend to do Integrated Joint Board While the Housing Sector is still not represented directly on this first tier governance body of the HSCP, the intention remains that all relevant housing issues considered by the board should be fed back to the Strategic Housing Forum by the appropriate senior HSCP delegate as required. Strategic Planning Group At this level, the Council’s Team Lead for Housing Strategy continues to ensure that necessary linkages are maintained between the LHS and the SCP and that further opportunities for joint working are identified. The RSL sector is also represented on an ad hoc basis, with individual landlords from the HOMEArgyll partnership sharing responsibility to attend and to articulate the views of the social rented sector and provide a practitioner perspective. However, ensuring appropriate feedback is provided, primarily via the Strategic Housing Forum, remains critically important. Care Homes & Housing Working Group This work strand was resumed in 2021, after a hiatus, and the working group provides an overview of the project work, direction, authorisation, accountability and support for the delivery of strategic change projects for care homes and housing. Senior managers from the Council Housing Services liaise with Lead Allied Health Professional, Housing OT, and Service Improvement Officer from HSCP.
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6 Over the life of the previous Strategic Plan and HCS, from 2019/20 to 2021/22, a network of cross-sectoral arrangements has been established to facilitate effective strategic and operational engagement between Housing, Health and Social Care, including inter alia:- SHIP Operational Group – Council Housing Services, RSL Development Officers, Scottish Government Area Team, Housing OT, and on an ad hoc basis associated HSCP staff monitor, review and prepare updates of the Strategic Housing Investment Plan on a quarterly schedule. Local Area Operational Groups – a network of local operational groups comprising key area Housing officers from council and HOMEArgyll partners, the Housing OT and local OTs, focusing on specific casework and local issues/priorities, including assessment reviews of waiting list applicants with medical needs points and effective matching of RSL allocations HOMEArgyll Steering Group – Housing OT & Mental Health & Addictions Officers now attend these sessions Learning Disability Steering Group – Housing Strategy Manager attends this group on a regular basis. Alcohol & Drugs Partnership - Housing Strategy Manager attends this group on a regular basis, with Housing OT. Adult Protection Committee – Housing Strategy Manager attends this group on a regular basis. In general, therefore as recorded in the previous HCS, the higher level, strategic co- ordination across housing, health and social care continues to be reasonably well- established and strong connections remain in place. Over the next 3 year phase of the SCP and HCS, it is our intention to engage the wider housing sector as far as possible, and continue to enhance community consultation at a locality level. Locality Planning Groups Following a hiatus, Area Locality Groups are due to be revised and reconvened, and area housing managers and other officers will participate in these meetings as appropriate. TEC Hub / TEC Digital Steering Group The TEC Digital Steering Group explores all opportunities for technological support & improvements to HSCP clients within their homes; and housing has been established as a key work strand in relation to this objective. The Group proposed to establish a TEC Housing & Health Forum, following joint events held over the last 3 years.
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7 4.0 Shared Evidence and key issues 4.1 The Health, Care & Housing Needs Assessment produced jointly by NHS Highland and the Council in 2018, helped to inform a comprehensive revision of the Argyll & Bute Housing Need and Demand Assessment (HNDA) which also involved a range of primary research, secondary data analysis and stakeholder engagement, and was completed in 2021. HNDA Technical Supporting Paper 08: Specialist Provision in Argyll & Bute, 2021 HNDA Technical Supporting Paper 09: Veterans & Armed Forces, Argyll & Bute Council, 2021 HNDA Technical Supporting Paper 10: Gypsy/Travellers, Argyll & Bute Council, 2021 HNDA Technical Supporting Paper 11: Wheelchair Users, Argyll & Bute Council, 2021 Helensburgh & Lomond Housing Market Study, North Star/Argyll & Bute Council, 2018 Argyll & Bute HNDA Household Survey, Research Resource/Argyll & Bute Council, 2019
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8 Simultaneously, the HSCP was developing a refreshed Joint Strategic Needs Assessment (JSNA) to underpin their new Strategic Plan. 4.2 The HNDA is a statutory duty for local authorities, and as a key requirement it must identify the need for “specialist provision” for persons with particular needs to enable independent living. This refers to both “bricks and mortar” accommodation and support services, under 6 specific categories: Accessible and adapted housing; Wheelchair housing; Non-permanent housing e.g. for students, migrant workers, refugees; Supported provision e.g. care homes, sheltered housing, hostels/refuges; Care/support services for independent living; Site provision e.g. pitches for Gypsy/Travellers or Travelling Showpeople Council officers responsible for developing the HNDA have consulted with their counterparts in the HSCP, in particular the Senior Information Analyst, Public Health, and liaised on the shared evidence base. There is a strong commitment to ensure this process is further developed and a key action for both the new LHS and the HSCP Strategic Plan is to continue to promote closer alignment of the HNDA and JSNA processes, with a view to sharing evidence, identifying needs and planning for solutions across health, social care and housing. As far as possible, the HNDA aims to analyse data at a sub-authority level based on 9 housing market areas (HMAs) which have been identified within the local authority boundaries. These HMAs should allow for data to be further aggregated or disaggregated as required. The HMAs in relation to the revised structure of four HSCP localities are summarised in the following table. Housing Market Area HSCP Locality Bute Bute & Cowal Cowal Helensburgh & Lomond Helensburgh & Lomond Mid Argyll Mid Argyll, Kintyre, Islay (excludes Colonsay) Islay, Jura & Colonsay Kintyre (plus Gigha) Lorn Oban, Lorn & the Isles (includes Colonsay) Mull & Iona Coll & Tiree
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9 4.3 The Argyll and Bute housing profile, updated as of 2020/21, is summarised below. ARGYLL & BUTE HOUSING MARKET PROFILE 2020 Population 85,320 Households 41,723 Dwellings 48,285 Ineffective Stock (Empty Properties & Second/Holiday Homes) 11% Average House Price £173,280 Average Household Income £37,091 Affordability Ratio 4.7 RSL Stock (Social Rented Housing) 18% (8,629) HOMEArgyll Waiting List (Active Applications) 2,469 RSL Stock Turnover (Annual Lets) 810 Pressure Ratio (Nos of applicants per available let) 3:1 Private Rented Sector 12% (5,822) Household Type, Principal Projection, Argyll & Bute, 2021-2031 Household Types 2021 2026 2031 % change 2021-2026 % change 2021-2031 Single Person 15,996 16,061 16,021 0.4% 0.2% 1 adult & 1+ children 2,153 2,011 1,919 -6.6% -10.9% 2 adults 14,426 14,664 14,423 1.6% 0.0% 2+ adults & 1+ children 6,101 5,618 5,318 -7.9% -12.8% 3+ adults 2,959 2,816 2,611 -4.8% -11.8% Source: Household Projections for Scotland (2018-based), NRS, 2020 Total Housing Stock (all tenures) by HMA, 2020 HMA Stock % of A&B Total Ineffective Stock Bute 4,247 8.8% 19% Coll & Tiree 680 1.4% 32% Cowal 8,722 18.1% 11% Helensburgh & Lomond 12,171 25.2% 5% Islay, Jura & Colonsay 2,180 4.5% 16% Kintyre 4,171 8.6% 11% Lorn 8,604 17.8% 8% Mid Argyll 5,659 11.7% 13% Mull & Iona 1,851 3.8% 15% Argyll & Bute 48,285 100.0% 11% Source: Argyll & Bute Council Tax Register, 2020
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10 Estimated Total RSL Stock by Property Type, March 2021 RSL Total Stock Mainstream Stock Specialist Stock Specialist Stock as % of Total ACHA 5221 4855 366 7% DHA 466 371 95 20% Fyne* 1617 1185 432* 27% WHHA 790 758 32 4% HOMEArgyll 8094 7169 925 11.4% Other RSLs** 585 132 453 77.4% A&B TOTAL 8679 7301 1378 16% * Fyne Homes’ specialist stock total includes 127 properties defined as “Other Specially Adapted”. Figures for general, mainstream adapted properties are not included in the other RSL totals. **Other non-HOMEArgyll RSLs include: Bield, Trust, Key Housing, Blackwood and Cairn HOMEArgyll RSLs Specialist Stock by Type ACHA Amenity Disabled Amenity Elderly Sheltered SELG Elderly Specialist Stock 7 40 200 119 DHA Special Adapted Ambulant Disabled Amenity Wheelchair Specialist Stock 3 16 69 7 FYNE Homes Ambulant Disabled Amenity Extra Care Medium Dependency Wheelchair Other Adapted Specialist Stock 34 192 24 21 34 127 West Highland Ambulant Disabled Other Special Adapted Medium Dependency Wheelchair Specialist Stock 14 1 1 16 Around 5% of the affordable housing supply available for allocation each year is specialist housing. This amounts to approximately 130 homes p.a. (N.B. 2020/21 is excluded from calculations given the anomalous circumstances and constraints on allocation during the lockdown period) HOMEArgyll Lets by Property Type, 2016/17 – 2019/20 House Type 2016/17 2017/18 2018/19 2019/20 4 Year Totals All Types 1,019 884 928 849 3,680 Amenity for elderly 32 30 30 37 129 Housing with Support 3 3 2 2 10 Sheltered Housing 32 38 43 22 135 Wheelchair 14 5 3 2 24
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11 General Needs 919 806 847 786 3,358 Gypsy/Traveller Site 4 2 2 0 8 Other (mainstream) 15 0 1 0 16 4.4 The social rented sector (RSL provision) in Argyll and Bute includes the following specialist accommodation suitable for persons with particular health or care needs. Accessible and Adapted Housing: includes - Amenity Housing for older or disabled persons – design is based on the standards of general needs housing with some additional features shared with sheltered housing but there is no warden and a community alarm may or may not be fitted. Ambulant Disabled Housing – consists of dwellings for people with disabilities who are not confined to wheelchairs. Built or adapted to general needs housing standards but has level or ramped approach, WC and bathroom at entrance level and other special features Medium Dependency accommodation Mainstream/General Needs accommodation which may have been adapted Other Specially Adapted Housing – homes with other adaptations, such as renal dialysis equipment, and bespoke designs for those with complex needs. Wheelchair Housing This consists of dwellings for people confined to wheelchairs. It is built or adapted to give extra floor space, whole house heating, and special bathroom, kitchen and other features. Sheltered wheelchair housing – design is adapted to wheelchair standards but also has the features listed below for sheltered housing. It is for elderly people confined to wheelchairs, rather than for other such disabled people. Supported Provision: includes- Sheltered Housing. The design is based on the standards for general needs housing with all the additional features of amenity housing (eg space standards, handrails, bathroom features, heating system standards, accessible light switches and socket outlets, etc.) PLUS a warden service may be provided and an emergency call service should be provided. Very Sheltered Housing. This form of housing (sometimes known as “care” and “extra care” housing) generally has all the features listed for sheltered housing, but will usually have special bathroom facilities. In addition, a greater level of care and support is offered through the service of extra wardens, full- time carers or domiciliary assistance and the provision of meals. Retirement Housing. Home Care and Assistive/Smart Technology – This has an important role in supporting independent living, and is usually associated with the occupant rather than the property. This can be provided in existing homes or in new build
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12 provision; and as far as possible the Housing Sector will explore and support assistive/smart technology capabilities, ensuring flexibility to tailor the provision to individual needs. 4.5 Key findings of the Housing Need & Demand Assessment, 2021 In summary, the HNDA identified:- Increasing demand for 1/2 bedroom properties with population aged 75+ increasing by nearly 3,000 people over the next decade; and potential additional demand if Council targets are achieved for increasing the younger economically active population. Continuing demand for aids and adaptations across all tenures, with resource pressure and waiting list evidenced from an average annual spend of £1.3m across all tenures and an anticipated 250 persons or more per annum requiring adaptations to RSL homes over the next three years. With more people managing long term health conditions living in their own homes with increasingly complex health and social care needs, the need for aids, adaptations and support at home is likely to increase. Changing care home use means that new care home placements are for people with greater dependency and there are higher turnover rates. Challenges to the provision of Home Care (particularly in some local areas) leading to delayed discharges in hospital. Falling demand for sheltered/warden housing models, with empty properties/voids in some areas. An ongoing need for closer working between services at a local level to identify individuals and families in need of specialist housing provision and match them to current and future housing. The HOMEArgyll waiting list identifies applicants with particular needs and health-related conditions which can be adversely affected by their housing circumstances. As of January 2022, over 95% of the registered applicants either required or would accept mainstream, general needs accommodation. Only 69 applicants (or 139 including those with nil points and those on the internal transfer list) stated that they specifically required specialist provision and would not accept mainstream housing. HOMEArgyll Waiting List Applicants by House Type, 2022 House Type % of Total Waiting List, 2022 General Needs 95.2% Specialist Provision ONLY 4.8% Housing with Support 6.5% Wheelchair 4.6% Amenity for Older Persons 10.6% Sheltered for Older Persons 7.4% NB. Applicants can select multiple options therefore %s do not sum to 100. As part of the Housing Need & Demand Household Survey, local households were asked a range of questions on need for specialist forms of housing across Argyll & Bute. 4% of households with a life limiting illness or disability stated they do require specialist housing. This equates to 334 households
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13 across Argyll & Bute. Based on evidence from the HOMEArgyll Common Housing Register and the 2019 HNDA Survey, it is estimated that approximately 200-300 households may require specialist forms of housing across Argyll & Bute. Homelessness In terms of other particular needs categories, a key area for further exploration will be health and care related needs of the Homeless. While homeless presentations have reduced significantly in Argyll & Bute in recent years, due primarily to the effective delivery of the Housing Options information & advice service, evidence suggests that people who are homeless can experience some of the worst health problems in society and are more likely to have unhealthy lifestyles and complex needs which lead to long-term health issues or exacerbate existing problems in a self-perpetuating spiral. In January 2022, there were 224 live homeless cases recorded in Argyll and Bute (marginally higher than in 2019), of which 6 had a self- defined physical health issue; 9 had mental health issues; 6 had drug or alcohol issues; and only 1 expressed an unmet need for support from health/care providers (all incidences of health, addictions and support needs are notably lower than was recorded in the previous HCS in 2019). Over the last three years the average length of time to close all homeless cases was 30 weeks, however the average time for those with drugs or alcohol related issues was double this, at 53 weeks. The incidence of physical ill-health, depression and substance misuse issues is significantly higher amongst homeless people and those living in poor housing conditions; and, at a national level, hospital admissions for this group are far in excess of the population living in settled accommodation. Those at risk of homelessness and people living in unstable or vulnerable housing, including non- permanent accommodation, overcrowding and homes in poor condition also must be considered in relation to the impacts on health and can benefit from some form of housing contribution. Young single males are particularly affected in this group, but children in homeless families and women subject to domestic abuse are also client groups with particular housing and health or social care needs. There is an ongoing requirement to maintain an adequate supply of suitable temporary accommodation, with local-authority leased properties being preferred (RSL accommodation in general is most effectively utilised as long-term, permanent accommodation) and a primary focus on smaller units, mainly for single persons.
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14 4.6 Priority: Shared evidence Outcome: Ensure that planning for services is based on robust data and information Aim: Continue to enhance the connections between the HNDA and JSNA processes What we said we would do What we did Improve comprehensiveness and consistency of OT caseload data. Review protocols for data capture to enable reporting of OT caseload data that includes a breakdown by type of service provision, household type and long-term conditions, by local area Due to staff turnover and the constraints on HSCP & OTs since March 2020, as a result of the Covid pandemic, this action has not progressed. Further work and a possible pilot exercise will be explored early in the life of this new Plan, co-ordinated by the Housing OT Management Group. Continue to work in collaboration to develop strategic documents. Argyll and Bute Council Housing and Argyll and Bute HSCP Public Health will continue to work in collaboration to further understand housing needs, particularly recognising a current gap for those with Mental Illness, people with autism and for those who experience homelessness. Collaborative working on the “specialist provision” section of the revised HNDA helped to enhance the existing evidence base and built on previous analysis, with a particular focus on the requirement for wheelchair accommodation. The health and care needs of key groups such as Gypsy/Travellers and veterans were also targeted. However, while some progress was made regarding older people and those with dementia further consideration will be required over the next 3-5 years.
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15 5.0 Shared Outcomes and service priorities 5.1 Following extensive stakeholder engagement over the last three years, the fully revised and updated Local Housing Strategy for Argyll & Bute, 2022 – 2027, sets out the agreed joint vision and high level aims which also underpin this latest iteration of the Housing Contribution Statement. While Priority 3 clearly has the most explicit relevance in the context of the HSCP’s Strategic Plan, each of these four outcomes will make a strong contribution to the integration agenda and to local health and social care objectives. The LHS vision and outcomes will support the overarching objectives of both the HSCP Strategic Plan and the Argyll and Bute Outcome Improvement Plan, as well as helping to address the national housing, health and well-being outcomes for Scotland. The housing sector, via the LHS, has an important and direct contribution to make to these national health and well-being outcomes as well as the local service priorities identified in the HSCP Strategic Plan. The housing contribution is particularly relevant to national LHS Vision “Everyone in Argyll & Bute has access to a suitable, high quality home which is affordable and located within a vibrant, sustainable and connected community” Four key LHS Outcomes/Priorities 1. HOUSING SUPPLY & PLACEMAKIN G 2. HOUSE CONDITION, ENERGY EFFICIENCY & POVERTY 3. SPECIALIST PROVISION & INDEPENDENT LIVING 4. HOUSING OPTIONS, INFORMATION & SUPPORT To facilitate access to sufficient, suitable and affordable housing across all tenures To regenerate communities by improving the quality, condition and energy efficiency of housing and by tackling fuel poverty To enable people with particular needs to live independently in their own homes and to remain in their communities To promote individual housing options to meet housing need and ensure everyone has access to appropriate, accurate and timeous information, advice and assistance
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16 Outcome 2: “People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community”. This will involve the provision of good quality, suitable housing to support a range of needs; as well as housing support services to sustain homes and tenancies; other forms of specialist provision such as aids, adaptations, smart technology and other equipment; and preventative measures including timeous information, advice and assistance in tackling fuel poverty, improving energy efficiency, or maximising income through welfare rights assistance. Housing can also contribute to other national health outcomes such as Outcome 9: “Resources are used effectively in the provision of health and social care” where effective housing solutions and policy interventions can prevent crises arising and obviate costly health and social care responses. The Social Return on Investment, and financial benefits of preventative spend, from Housing sector investment have been well documented in recent years, particularly in respect of significant savings to the health and social care budget from early investment in adaptations, specialist accommodation, and services tackling fuel poverty and homelessness. It should also be recognised that Housing staff provide key local connectivity through regular contact with, and visits to, service users, tenants and estates. Improving/enhancing linkages between housing and HSCP staff will ensure early interventions as required to prevent, where possible, the need for more expensive care or hospitalisation at a later stage. Frontline housing staff can identify vulnerable tenants or prospective tenants. Knowing who to contact to ensure these people are getting the services they require is a valuable link in the HSCP Integration agenda. RSLs have a track record in partnership working, involving delivery of a range of services and projects that go beyond the ‘bricks & mortar’ of housing provision. Such ‘wider-role’ activities include welfare advice services, social, community, environmental and employment initiatives, many of which have direct or indirect links to improving the sustainment of peoples’ lives in town and rural communities.
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17 5.2 LHS Outcome 3: Specialist Provision & Independent Living: Key Actions & Targets The requirement for specialist provision will be met by: Delivering the vision and objectives set out in the Argyll & Bute Housing Contribution Statement; and fully implementing the jointly agreed Housing OT Action Plan Ensuring effective provision of sufficient and appropriate aids and adaptions to meet identified needs across all tenures; Maximising the use of assistive technology to allow people to continue to live independently in their own communities and working with partners to deliver the TEC in Housing charter; Continuing to work with Care & Repair and other partner agencies to deliver effective services that support independent living; Delivering SHIP targets for new build specialist housing, including wheelchair targets; and ensuring early engagement with HSCP in the design process; Monitoring and encouraging regular engagement with equalities groups, including Gypsy/Travelers, to inform service improvement In addition, partners will focus on early engagement and intervention to meet need for specialist provision by: coordinating intelligence sharing, improving awareness of support services; and having forward planning conversations with individuals and their families. LHS Outcome 3: Key Targets 2022-2027 At least 10% of affordable new builds should comprise some form of specialist provision, including 5% specifically for wheelchair accommodation The overall stock of specialist housing in the RSL sector will be increased Identified needs for adaptations to existing homes will be addressed within the life of the strategy The proportion of households who are elderly, contain vulnerable children, or have a disability, achieve at least similar rates of positive outcomes via PREVENT1 assistance as the general population. Official Gypsy/Traveler sites meet the recommended national standards Levels of Gypsy/Traveler satisfaction with sites & services will be sustained or increased Further research will be undertaken on specific equalities groups as required, including any particular needs of disabled children and younger adults, to enhance the evidence base and inform future updates of the HNDA The detailed Action Plan for LHS Outcome Three is set out in the annex to the strategy, available on the council website via the following link: https://www.argyll-bute.gov.uk/housing/housing-strategies-consultations-and- research-0
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18 6.0 Housing-related challenges and service improvements required. In delivering an effective, balanced housing system in Argyll and Bute there are a number of remaining and emerging challenges which impact on the housing contribution to health and well-being objectives. 6.1 Improving strategic and operational structures and partnerships While some progress has been made over the last three years towards a more streamlined and efficient approach to service planning and delivery, further focused improvement in respect of effective linkages and joint working processes across the housing health and social work sectors remains critical. There is also still a need to improve understanding and share greater awareness of the different sectors throughout and across all agencies and at all levels. What we said we would do: What we did Complete an initial mapping exercise of engagement structures and existing networks across housing, health & care services; and thereafter ensure this is maintained on an annual basis. The aim of this exercise was to reduce duplication of meetings, to improve awareness of appropriate communication channels, and to ensure appropriate decision- making structures are in place. Further work is required to progress this action. A training programme is to be delivered by the Housing OT and Council Housing Officers, which will aim to engage local staff in joint learning and raise mutual awareness. The iHub training was launched in 2019/20, as a joint initiative, and a first round successfully completed for a range of staff across Argyll & Bute. A refresh or second round of targeted training will be reviewed. A review of common terminology remains an important requirement (e.g. in relation to housing models, there is a need to establish clear, definitions of “amenity”, “ambulant disabled”, “sheltered”, “very sheltered”, “extra care” and “progressive care” housing, as well as clarifying distinctions in terminology regarding housing support etc. A general understanding of, and adherence to, Scottish Government definitions would be a fundamental step towards consistency). Through the stakeholder engagement & consultation processes for both the HNDA and LHS, improvements have been made in respect of awareness, understanding & consistency of terminology. Further improvements on joint understanding of particular housing & care models will be helpful to inform and enhance the Care Homes & Housing work strand for example and other aspects of joint planning and service delivery. Housing services will collate a briefing paper on this.
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19 What we will do: i. Complete an initial mapping exercise of engagement structures and existing networks across housing, health & care services; and thereafter ensure this is maintained on an annual basis. The aim of this exercise is to reduce duplication of meetings, to improve awareness of appropriate communication channels, and to ensure appropriate decision-making What we said we would do: What we did Local group structures will be developed or enhanced to facilitate effective and efficient joint working at an operational level. While there is a need to avoid duplication of structures, it is also important not to add to the complexity of the often unwieldy locality planning groups. Established an operational focus on local area officer groups (RSLs, OTs & Council Housing Services), with Oban recognised as an effective exemplar model. HOMEArgyll Steering Group; SHIP Officers Group; and the Care Homes & Housing Steering Group also key. In moving forward with the integration agenda, Housing will continue to remain focused on the strategic outcomes and seek to ensure that all partners are involved in decision-making, and that there is cohesion and coordination between individual housing organisations themselves in order to present a unified contribution to the health and social care partnership. Ongoing partnership working, particularly via the Strategic Housing Forum has helped consolidate the housing partners approach to engagement with HSCP. RSLs’ SHIP submissions for Council Funding for instance must now evidence liaison with HSCP/OTs and show that any particular needs have been considered in project proposals. Following the appointment of a dedicated Housing OT, Housing Services will aim to extend and sustain this post in the future to facilitate cross-sectoral planning for the delivery of appropriate Specialist Provision, by securing complementary funding where possible. The Housing OT post was made permanent in 2021 with the Council Housing Service providing full funding. The HSCP provides administration and line management for the post, liaising with Housing Services Management. Housing Services will ensure regular (quarterly and annual) reports on the LHS and SHIP, amongst other performance updates, are submitted to the local and central groups within the HSCP hierarchy. LHS/SHIP progress reports are disseminated via members of the Strategic Housing Forum, and published on the council website for general access.
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20 6.2 Addressing the key drivers of the local housing system The wider environmental factors that define and drive the local housing market are well evidenced and remain unchanged since the launch of the previous Housing Contribution Statements; and these also reflect the main challenges for health and social care as outlined in current strategic plans i.e. the continuing demographic trends leading to a significant decline in the local population combined with a significant growth in older persons; a fragile economic structure exacerbating affordability issues; and the dispersed rural geography which impedes service coordination and delivery. All of these factors have been exacerbated inevitably by the unprecedented impact of the coronavirus pandemic over the last two years, and the ongoing consequences are likely to have long term effects. In light of all these factors, it is worth reiterating the reciprocal and mutual benefits of joint working i.e. the important contribution that health and social care can make in turn to housing. What we said we would do: What we did Housing services and associated agencies will aim to maximise the impact of available resources and tackle deprivation amongst the most vulnerable, through a range of co- ordinated activities and functions; early interventions; and supporting the retention of key workers for health and care services across all communities, by improving access to, and supply of, suitable affordable accommodation (both mainstream and specialist properties). The Council successfully negotiated a Rural Growth Deal for Argyll & Bute which includes up to £3m investment for specific housing projects to be targeted at key & incoming workers, including HSCP staff. The HOMEArgyll partnership will be encouraged to review the Common Allocation Policy in respect of priority points awarded for appropriate “key” workers. The SHIP programme will aim to deliver sufficient new build affordable homes to meet identified specialist needs, with a benchmark target of 10% of all completions being wheelchair accessible or alternative/bespoke models of provision. As a minimum, all new build projects should comply with Housing for Varying Needs Standards, to ensure flexibility and maximise potential adaptability within the stock, including capability for smart/assistive technology as required. Around 225 affordable new homes were delivered via the SHIP across Argyll & Bute, including approx. 20 specialist units (wheelchair, amenity, specially adapted) since 2019/20 up to December 2021 (i.e. 9% of total completions). In addition 66 long term empty homes were brought back into effective use during 2019/20 & 2020/21.
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21 6.3 Aligning and synchronising service delivery and needs assessments Problems continue to arise at an operational level within both housing and health and social care when trying to co-ordinate access to suitable accommodation with the provision of appropriate support packages. Delays can occur during either part of the process, and a concerted effort to promote early intervention and better understanding of the relevant allocation and needs assessment processes is required. What we said we would do What we did Establish or enhance local operational groups, with multi- agency, cross-sectoral membership, to co-ordinate responses to individual clients and shared casework on a regular basis. Housing OT coordinates individual case reviews with area officer groups from Council and RSLs. Positive approach being replicated across all areas. Co-ordinate awareness-raising seminars and deliver the national iHub Housing Solutions training programme to local staff across the housing, health & care sectors. Initial round of training delivered in 2019/20 jointly by Housing OT and Council Housing Officer for range of staff throughout Argyll & Bute. Complete an audit of existing particular needs information and advice materials and revise/update provision/services as required for targeted client groups. This action was not progressed as scheduled, due to staff turnover constrained in-house capacity, and ongoing workloads. Housing Services to explore potential for commissioning external audit e.g. from Housing Options Scotland. Develop and implement formal partnership agreements between individual Housing Providers/RSLs and HSCP services. Informal partnerships have been improved, resulting in better & earlier identification of housing opportunities for HSCP clients. Ensure HSCP engagement in the review of the common allocation policy; and in the ongoing review of waiting list applicants. Housing OT involved in case reviews and assessment of applicants with 200 medical points; and attends HOMEArgyll Steering Group meetings.
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22 6.4 Addressing inequalities in the delivery of adaptations The provision of private sector adaptations is a housing function that should be delegated to the Integrated Authority while adaptations for the RSL sector currently remains separate and continues to be funded from a discrete Scottish Government fund. This can lead to inequality and result in operational confusion; and also means that funding can be constrained dependent on a household’s tenure. Budget constraints for RSL adaptations remain a persistent issue, and is being closely monitored. Early notification of requirements will help to improve and streamline the process; but a national policy for a tenure-blind approach still needs to be implemented. What we said we would do What we did Establish/consolidate a monitoring framework for RSL adaptations with quarterly and annual reports submitted to the Strategic Housing Forum; including a summary of Stage 3 funding allocations from the Scottish Government to individual landlords; actual spend; over/under spend at year end; and estimate of outstanding works/backlog. The Housing OT has made initial progress in developing a framework for adaptations, and Housing Services is working to improve data collation and monitoring on Stage 3 RSL activity, investment, & waiting lists. Explore the establishment of a joint adaptations panel for high cost/complex cases; and develop a protocol/policy for assessment and delivery of minor adaptations in the RSL sector. Complete a review of the prioritisation process for all adaptations. Some initial work was progressed over the last 3 years via the Housing OT post, and this will be pursued over the course of this new Plan Establish a monitoring framework for waiting times for all adaptations, and a post-completion evaluation/satisfaction protocol As above, to be progressed & coordinated via the Housing OT Collate data and produce a GIS map of adapted properties; and thereafter maintain this database/mapping on an annual basis Due to staffing constraints this action has not been progressed to date. GIS mapping will be pursued over the life of the new Plan and LHS. .
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23 6.5 Tackling poor stock condition, fuel poverty and energy efficiency Apart from the basic imbalances in housing supply and demand in Argyll and Bute, a key challenge for the future is to address the significant levels of disrepair and inefficient housing stock that have a major, negative impact on the health and well-being of individuals and the wider community. In general, this authority has higher than average incidence of poor condition homes and fuel poverty and this is a key priority for the new LHS and will also be an important consideration for the HSCP. Continuing to support the local Care and Repair service; providing advice and assistance to home owners, landlords and tenants; and targeting home energy programmes effectively will help to alleviate this problem. Other identified challenges include: meeting need in the private sector, particularly in the owner-occupied sector; the need to explore and expand current models of provision with more flexibility; establishing detailed assessments of need for certain vulnerable groups beyond the elderly, where data and evidence are less readily available; and meeting rural demand, for example the needs of carers supporting vulnerable people in remote locations, and ensuring sufficient support staff are available. What we said we would do What we did Monitor HEEPSABS programme by household characteristics Council Housing Services will implement a monitoring framework for Energy Efficiency measures by household attribute (age, disability etc, as far as possible). This will allow assessment and evaluation of the impact of these measures specifically on those with health issues/equality groups. Reporting will be submitted to the Strategic Housing Forum. This is currently under review and Housing Services are developing a framework for collating more detailed equalities & health related information on clients in receipt of, or applying for, grant funding for energy efficiency measures to be installed in their homes. This will be implemented early in the new Plan. Introduce similar monitoring framework for Welfare Rights casework, in respect of age/health condition of clients who receive positive support/interventions to maximise income and tackle financial disadvantage. Council’s Welfare Rights Team are involved in the Financial Inclusion & Advice Group and currently monitor the age of clients (with particular reference to child poverty and vulnerable elderly) are aiming to enhance their monitoring framework in respect of client equalities characteristics during the life of this Plan.
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24 7.0 Resourcing the housing contribution. 7.1 Adaptations. The provision of private sector adaptations makes a direct financial contribution to the outcomes of the health and social care partnership. Mandatory and discretionary disabled grants are funded from the council’s Private Sector Housing Grant (PSHG) and administered by the Council in partnership with the Occupational Therapist Service, Third Sector, and Argyll & Bute Care & Repair. The PSHG budget for private sector adaptations (disabled grants) amounted to £764k in 2019/20; and due to the constraints on property visits by contractors and delays in the supply chain the outturn for 2020/21 was reduced to £332k. Applying one standard SROI multiplier effect per £ invested in adaptations1 (which suggests £5.50-£6 is generated for every £1 invested) this could equate to actual investment benefits for Health & Social Care of circa £6.6m over these two years alone. On average there are around 140 private sector properties adapted annually (this average is based on pre-covid data, the figure clearly reduced over the last two years due to the constraints of the pandemic on service delivery). Future levels of PSHG are unconfirmed at this point, but the council is cautiously working on the assumption that annual budget allocations will be roughly similar to the current figure. Adaptations for housing association properties are funded separately by the Scottish Government (known as Stage 3 funding for existing properties) and in 2019/20-2020/21 investment from this source amounted to over £1.5m, which enabled around 390 RSL homes to be adapted over that period. Based on historical allocations, it is estimated that approximately £750k will be allocated per annum over the next three years; however the Strategic Housing Forum, and the RSL sector, will continue to lobby Scottish Government for increased investment to meet the existing backlog and the projected increasing demand.. 7.2 Affordable new build housing supply The delivery of new build affordable housing is directed via the Strategic Housing Investment Plan (SHIP) and funded primarily from Scottish Government’s Affordable Housing Supply Programme (AHSP) Argyll & Bute Council’s Strategic Housing Fund (SHF) RSL private borrowing The minimum resource planning assumptions for the AHSP in Argyll & Bute were confirmed in July 2021 as:- Argyll & Bute 2022/23 2023/24 2024/25 3 Year Total RPA £18.317m £18.264m £18.328m £54.909m 1 Measuring the Social Return on Investment of Stage 3 Adaptations and Very Sheltered Housing in Scotland, Envoy Partnership (commissioned by Bield, Hanover & Trust), 2011
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25 The current benchmark figure for grant assistance per RSL unit in remote and rural Argyll is £95,500 (with additional benchmark allowances for quality measures such as meeting energy efficiency standards; provision of balconies in flatted properties; space for home working or study; and ensuring properties are fully digitally-enabled at point of occupancy). Currently the Council provides supplementary grant assistance of £12k per new build unit and average accruals to the Strategic Housing Fund amount to around £1.9m per annum. All new builds are currently required to meet Houses for Varying Needs standards as a minimum, and should be suitable to meet the changing needs of individuals over time. This standard is currently under review by the Scottish Government. The 2021 SHIP currently aims to deliver around 740 new affordable homes over the three-year planning period of this HCS up to 2025, of which at least 74 (10%) should be designated as specialist provision, and within that around 37 (i.e. 5% of the SHIP total for that period) should be for purpose designed wheelchair accommodation (the actual number delivered will reflect identified needs). 7.3 Investment in existing stock Investment in the existing housing stock to improve conditions, including energy efficiency measures, is substantial and has increased in recent years. The Scottish Government provides funding to local authorities to deliver the Energy Efficiency Programme Scotland (EEPS) which offers grant funding to households to install a range of energy efficiency measures including external wall insulation. Spend for 2019/20 was £847,060, and for 2020/21 it amounted to £391,882. Argyll and Bute secured £1,742,819 to deliver enabling and capital works in 2021/22, working primarily with partner agencies such as ALIenergy and Home Energy Scotland. It is anticipated that full spend will be achieved this year and that a similar or enhanced level of investment will be required in the coming years. The social rented sector are required to meet national housing quality and energy efficiency standards which entails significant programmes of work and levels of investment, all of which, again, will contribute towards overarching health and social care outcomes and objectives. Over 2019/20 and 2020/21, the main HOMEArgyll RSLs in Argyll and Bute invested £9.359m in this work, bringing the majority of their existing stock up to the Energy Efficiency Standard for Social Housing (EESSH1), and will invest further over the period of this plan to achieve EESSH2.. 7.4 Maximising household income The council’s Welfare Rights Team continues to liaise with the Housing Service, and is closely linked with the delivery of key objectives in the LHS and HCS; providing advice and support on welfare entitlements to vulnerable
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26 clients across Argyll and Bute and across all tenures (albeit ACHA also provide a similar service to their own tenants). The team also provides support and advocacy for clients, including representation at HM Courts and Tribunal appeals. The team of 9 area based staff is funded primarily by the council with additional funding from Macmillan Cancer Support for an extra dedicated post. In 2019/20 and 2020/21, the team helped to support local residents to claim over £6.35m in benefits to which they were entitled, and it is envisaged that similar income maximisation results will be generated in future years. 7.5 Other housing functions Additional financial investment from the housing sector, which contributes to the HSCP outcomes, includes Care & Repair budgets (also funded primarily within the PSHG) for discretionary repair and improvement work, tenancy support services (focusing on tenancy and home sustainment as opposed to personal care type support), homeless services and housing options/information and advice provision. These services will all provide positive returns for the health and social care partnership and have a preventative impact on their budgets further down the line. 7.6 Resources summary. The key resources outlined above are summarised in the following table: Funding Source Housing Function Total Investment 2022/23 – 2024/25 Affordable Housing Investment Programme (Scottish Government) Affordable new build homes £54.909m Strategic Housing Fund (Argyll & Bute Council) New build & empty homes £5.7m (est.) RSL Private Finance New build homes £33m (est.) Private Sector Housing Grant (Argyll & Bute Council) Private sector adaptations; Care & Repair; £2.1m (est.) HEEPSABS (Scottish Government) Home energy efficiency measures £5.2m (est.) Stage 3 Adaptations (Scottish Government) RSL adaptations £2.25m (est.) RSL EESH investment RSL stock condition / energy efficiency improvements tbc Housing OT post (Argyll & Bute Council) Permanent Post £180k Mental Health & Addictions Officer post (Argyll & Bute Council RRTP funding) Temp post until March 2024 £120k (for 2 financial years) Welfare Rights Assistance, Advice & Support Maximising household income £8m (est.)
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27 8.0 Conclusion The fundamental principles outlined in the previous Housing Contribution Statement are still valid and relevant, looking forward over the next three years. The integration agenda presents potential opportunities to maximise effective joint working particularly to apply housing resources directly and indirectly to prevent costly health and care interventions at a later date. Conversely, the cost benefits of a reciprocal Health Contribution to support housing sector activity would also be mutually beneficial for all partners. This will require focused, on- going dialogue between the Strategic Housing Forum, individual organisations and the HSCP, with a view to forging even closer linkages between the LHS, SHIP and the Strategic Commissioning Plan. As part of the formal monitoring and review process for the LHS, specific outcomes, milestones, timescales, indicators and targets in respect of housing’s contribution to health and social care will be subject to Appraisal by Scottish Government/peer review via Scottish Housing Network Scrutiny by the Scottish Housing Regulator Regular progress reporting, including annual updates, to the Strategic Housing Forum, Elected Members, individual organisation boards, community planning partners and groups, and general stakeholders Formal reports on specific outcomes to wider thematic partnerships (e.g. economic fora) including the HSCP on a regular basis. The ethos and principles of the Housing Sector are clearly already aligned with that of the HSCP, with a strong focus on preventative policies, home and person- centred services, a holistic approach to strategic planning, a fundamental commitment to reducing and eradicating inequalities, and pursuing efficiency and cost effectiveness. In summary, this contribution statement has highlighted the key role that the housing sector will have in joint planning, commissioning and delivery of services as well as influencing investment decisions to support the Strategic Plan’s outcomes and objectives. There are crucial links between: the LHS and the Strategic Plan; the HNDA and JSNA; homelessness, tenancy support, fuel poverty, energy efficiency and adaptations services and the strategic plan and HSCP services; and the Strategic Housing Forum & the HSCP/Integration Authority structures. The Housing Sector in Argyll and Bute continues to welcome this opportunity to strengthen these connections and to improve the alignment of strategic planning; focusing on common outcomes, with a view to prevention; increased supply of
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28 suitable housing options; and, in addition, to support and promote partnership and community capacity building.