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TX: 10.03.08 - Sheltered Housing Wardens

PRESENTER: WINIFRED ROBINSON

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ROBINSON
Last year we reported on the loss of the residential wardens in a private housing development run by Peverel Homes. Since then we've discovered that the loss of live-in wardens in sheltered housing is something of a trend. Nick Lawrence has been looking into it, Nick what have you found?

LAWRENCE
Well since we first broadcast that original report, which, as you said, was about one private scheme we found there are many, many more developments losing live-in wardens or losing their warden service altogether. According to figures compiled by a body called The Elderly Accommodation Council, whose statistics are also used by government, they show that over the past five years 50,000 sheltered accommodation places have been lost and that represents 1 in 10 of the total places available in the UK. So there are now 470,000 sheltered places, compared with 520,000 places five years ago. Now the Elderly Accommodation Council says this loss is not due to sheltered flats being demolished, it's housing schemes which had both residential and non-residential wardens when they were set up but now have no warden service at all. As you'd expect these services are sorely missed. Vera Holbert is 95, she lives in Hammersmith and she explained how the loss of a warden had affected her.

HOLBERT
Say for instance you had a letter in the post and you didn't quite understand it, right you would go down and ask Karen if you could have a word with her, yes she'll call in the office and have a talk with you and help you to discuss things. I've only just got my thing from Sarah, my brochure, got in this post now. But if you have a very early post right you could pop downstairs - can you help me. Now I have to wait. If there was any query on that post I would have to wait till tomorrow.

ROBINSON
Vera Holbert. So why have the wardens gone?

LAWRENCE
Well there are a number of reasons not least of which is the changing role of sheltered accommodation. Imogen Parry is the director of research at EROSH, that's the National Consortium for Sheltered Housing and Retirement Homes, she says that the residents coming in these days typically need more support than they once did and that 24 hour help lines linked to individual flats and highly trained wardens serving more than one development can work better.

PARRY
The role of the warden was originally intended to be a good neighbour, this was some sort of 30 years ago. And they were intended to keep an eye out for the people living in the sheltered scheme. The role has changed dramatically because the people living in sheltered housing now are much frailer than they were originally, either because they've aged in place or because people coming in to sheltered housing now are much older than they originally were or they originally used to or was intended. So that the wardens or scheme managers or supported housing officers now have much frailer people to look after and the good neighbour role isn't sufficient anymore. The staff have to be better trained, better managed, better supervised and they also have to keep better records of what they're doing.

ROBINSON
Well you said there are a number of reasons Nick, what other factors are at play?

LAWRENCE
Well councils can no longer rely on recruiting people willing to be on call 24 hours a day, seven days a week for relatively low pay. There was a court ruling back in 2003 that established that the contracts of 20 wardens working for Harrow Council were in breach of the European Working Time Directive, which limits the number of hours that we can be called on to work. The wardens brought the case because they were contracted to work 37 hours a week but in fact when you took their on call time into account they worked over 100 hours. The wardens brought this case and they won considerable sums in compensation. Obviously this has made local authorities and other employers nervous about recruiting live-in wardens under the old terms.

ROBINSON
So councils simply can't afford then to pay to cover a 100 plus hours a week?

LAWRENCE
Absolutely not. I have been scouring the minutes of council meetings up and down the country, wherever you see care lines and mobile wardens being mentioned you also see cost reductions.

ROBINSON
And what's wrong with replacing a live-in warden with a highly trained specialist, perhaps acting as a warden to more than one sheltered block or even having access to a skilled team answering a distress call at the end of a 24 hour helpline instead of a live-in warden?

LAWRENCE
Obviously nothing at all but for many residents I've spoken to what's wrong with it is that they have moved into developments with wardens on site, got used to that, only to find that the service has been withdrawn. And now people complain too that mobile wardens spent a lot of time at the computers and that organising social activities - outings, gatherings, etc. - had gone by the board. Imogen Parry from the National Consortium for Sheltered Housing says that these changes are inevitable because services must be accountable.

PARRY
There's different ways of looking at bureaucracy, I know everyone complains about it - teachers, nurses, doctors, social workers and staff in sheltered housing - but my response to this is that how can you improve quality and consistency without bringing in more forms to fill in, I mean you would expect your doctor to fill in forms or keep records on you, you'd expect children at school to have forms kept and so on, so that we can track improvements and it's exactly the same in sheltered housing. The old style of record keeping in sheltered housing was a diary in which everything was jumbled in in this daily diary. Staff now have - do have to keep more records and I know some residents really do resent this and some staff do. But I think it's an inevitable part of a service that has to be more accountable and professional and track improvements and benefits, so that you can demonstrate value for money.

LAWRENCE
Of course some residents will want the security of knowing if something goes wrong that help in the shape of a real person and a live-in warden is just moments away. Also they may value the friendship of that person as Vera Holbert did with her old warden Karen.

HOLBERT
It makes one feel more lonely. When somebody's here permanently and on the premises, I mean you wouldn't go up to Karen and just disturb her at weekends, after all she's got to have her private life. But she would have done. But there it is - that's how it is now. It's certainly not a happy situation.

LAWRENCE
But senior figures involved in sheltered housing counter that for some people a live-in warden is no longer a top priority for many people who are frail. John Galvin, the chief executive of the Elderly Accommodation Council, says that many people are happy to share a better trained specialist warden or wardens with other blocks. Twenty four hour helplines can also serve people who stay in their own homes, although yet most of the speed of change and the way in which it's handled makes a huge difference to vulnerable people.

GALVIN
I think many of them have had quite a difficult time in recent years and quite justifiably some of them have complained about this change in the services that are provided to them. They've moved into sheltered housing expecting that traditional residential warden service, that was part of the service offering, if you like. I think the problem for landlords and we are talking here primarily about the social rented sector, the local authorities and to some extent the housing associations, the problems they've faced is as the world changes they look a head and they say this model is not going to suit as many people in the future, it's already - many schemes are finding it difficult to attract residents who want precisely that model. So you add to that to the fact that because of the Working Time Directives and the expectations of people who do this kind of work not to be on site, not to be on call 24 hours a day and you have a situation in which things have to move.

ROBINSON
So it's not a trend then Nick that's likely to be reversed?

LAWRENCE
Well no, if you consider all the factors that play probably not.

ROBINSON
Nick Lawrence thank you.

Well Mervyn Kohler is from Help the Aged and Bill Hodson is director of housing and adult services at York, he also speaks about sheltered housing for the Association of Directors of Social Services.

Bill Hodson, 1 in 10 sheltered housing places we've just heard have been lost, will more follow do you think?

HODSON
Well I think it's important that we see sheltered housing in context, it's part of the housing market in the sense that it provides accommodation primarily for older people but increasingly it's really part of the care and support systems that we have older people. And I agree with Imogen's analysis things have changed over the last 30 years and increasingly sheltered housing or housing with extra care has been an alternative to going into residential care rather than an alternative to independent living. Most older people live in their own homes are supported by a team of people and that's increasingly true for sheltered housing. So in my area, and it's true in many other areas, we'll have a team of home care workers and out of hours workers, mobile wardens, who'll support people, rather than it all being invested on one individual. So whilst we're talking about one service changing, that's not to say investments are not going in on other ways to support people.

ROBINSON
So more will follow, the short answer is yes?

HODSON
Well we're all - we need to face up to the fact that there are going to be more of us who are older in the future and the costs of that care and support will rise. Sheltered housing will have an important part to play but it isn't going to be the whole picture and I think residential wardens, as a model, is probably a model that's past its sell by date, yes.

ROBINSON
Well some councils, it is alleged, have gone about making this change very quickly and in some instances almost at a stroke, that can't be best practice can it?

HODSON
No I think the issue of people who have gone into a development with a residential warden, as it were, on a contracting basis, that needs to be handled very sensitively and I do have a lot of sympathy for the lady who was on the programme. If you have an expectation of a service then we need to try and honour that. But we do know that in terms of the future there are fewer people who are looking for that type of service, so we do need to manage that sensitively.

ROBINSON
That's an interesting claim isn't it that there are fewer people looking for that kind of service because you see what people on the other side of the argument to you would say is that sheltered housing has never been aspirational, if you ask me or you now do we want to go into sheltered accommodation at some stage we'll probably say no but that doesn't mean we won't need it later.

HODSON
Well there's just been a survey done of people aged between about 50 and 65 about what they think their housing needs are going to be and you're right, it won't surprise you, that sheltered housing hardly figures in people's ideas about what they would want, most people think they're going to be able to stay in their own home for most of their life. But some of us will need to move towards the end of our life and that's where I think extra care housing, which is a high quality kind of housing where care can be provided, has a very useful role. But the days of people moving in, in their early 60s, to a special place called sheltered housing and spending 30 years there, I think that's not going to be the pattern in the future.

ROBINSON
Mervyn Kohler from Help the Aged, do you accept then that for some people a live-in warden just isn't a top priority and that while the loss might be lamentable it is inevitable?

KOHLER
I accept that change is occurring all around us, I accept that the older population living independently, whether in their own homes or in sheltered housing, are living with much degrees of fraility than in the past. What I'm not sure I accept is that we can actually just watch this one sweep itself out the door. I mean yes it is important to have access to all the better qualified technicians who might be able to deal with certain emergencies but actually you need a gate keeper, you need an access point, to make that sort of thing happen.

ROBINSON
But what are you suggesting, I mean what could you do instead, you can't have both the sheltered housing person and have them on call 24 hours a day given the ruling that we've had in court, that's not affordable anymore and also put the other things in place as well can you?

KOHLER
We've got to look at the way in which these contracts are actually worked out and based. But as Bill said, in his contribution, I mean the alternative for many of these people would be moving into a care home and that of course is a cost much, much greater. So I think we've actually got to bear these sorts of things in mind in a relative context. Yes the costs of providing warden cover and other bells and whistles in sheltered housing are going up but I think we may be in danger of throwing the baby out with the bathwater here.

ROBINSON
Bill Hodson, do the maths for us, if you would. How much is saved per resident by replacing a live-in warden with a 24 hour helpline or a shared warden?

HODSON
I'm afraid if you're asking someone to do the maths you've picked the wrong person. But in terms of efficiencies what I would say about that is that we need to be thinking about a team approach, a team of people who support people and personal approach ...

ROBINSON
Is more cost effective?

HODSON
Well it's not necessarily but I'm just saying that the resident warden I don't think is a very cost effective way and we need to be thinking about the use of technology. Now that is changing dramatically. For some people they will definitely feel a resistance to a sort of remote contact but many people are now used to actually using their phone or something based on their phone to talk to someone when they need them, as opposed to having someone in the home all the time. And that technology will improve over periods of time so more people can access advise and support on a personal basis without having someone actually downstairs available to do that 24 hours a day.

ROBINSON
What would you say to those people who believe that in the rush to evaluate everything you are failing to value face-to-face contact, social events, small kindnesses that the wardens performed in the past?

HODSON
I think that's a very important factor because I think one of the things that would be a concern to me and my colleagues in social services is social isolation and potentially depression and I think where the good neighbour role was very, very positive was that it provided that link into the outside world for people often who didn't have anyone else to talk to. But there are different ways that we can befriend people, often through voluntary organisations or other schemes, so that people can keep a contact. And social outings can be organised without having a resident warden, we don't have resident wardens in York but we do have social outings for people in sheltered housing. So I think that personal touch must remain though, it's very important.

ROBINSON
Mervyn Kohler, briefly if you would?

KOHLER
I think that as we look forward obviously the internet and telephones and things like that are going to be the way more and more people get information and communicate but that is not the situation with our older population today who don't particularly like call centres and don't have access to the internet. So there may be a change being made here which is happening too quickly. I'm not against change but can we just take it more slowly.

ROBINSON
Mervyn Kohler, Bill Hodson, thank you both. And we would like to know your experiences, if you have any, of the withdrawal of wardens in sheltered accommodation. You can call us 0800 044 044 or you can e-mail bbc.co.uk/radio4/youandyours.


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