Kieran Findlay

Welcome to the Scottish Housing News Podcast and the third episode highlighting the pressing issues surrounding accessible housing ahead of our Housing and Social Care Accessibility Summit later in September. I’m Kieran Findlay and so far in the series, Jimmy Black and I have heard about the political challenge of tackling the shortage of accessible homes and the need for social housing providers to forge relationships across many sectors to effectively meet the needs of Scotland’s ageing population.

Jimmy Black

Some of the most important stakeholders in this equation are those working in health and social care services and that’s where our focus lies today.

With us are Jacquie Pepper, chief officer/director at the Perth and Kinross Health and Social Care Partnership and Elaine Ritchie, strategic lead for housing and communities at Perth and Kinross Council.

Kieran Findlay

Hello Jacquie, welcome to the podcast. Describe your role to those who come from primarily a social housing background and may not perhaps have experience in the social care side of things.

Jacquie Pepper

Okay, thanks very much, Kieran. It sounds like a really simple question, but it’s actually going to have a complicated answer to it because if you are a chief officer for a Health and Social Care Partnership, you wear a number of different hats and the reasons for that is to try and integrate and bring together the provision of community health and care services for the people within a geographical area. So the geographical area for me is Perth and Kinross. And what that means is that as chief officer, I’m both a director of the council, as in terms of Perth and Kinross council and NHS Tayside for local health and community care services within what is a very large rural geographical patch.

I also am the chief officer for the Integration Joint Board, which is delegated with the strategic planning function for those services. So they have a strategic role. So the budgets are delegated to the IJB and it allows us to bring those budgets together and meet the needs of our population. And so I wear lots of different hats. So sorry if it’s a complicated answer to what might seem like a simple question.

Jimmy Black

I was going through the agreement that set up the IJB. I think the latest version is 2022. I was puzzled because it didn’t seem that the IJB or the Health and Social Care Partnership had any direct role in housing, it seemed to be specifically reserved and the only things that you would be doing would be support in some cases in aids and adaptations and that surprised me because actually, homelessness for example in other authorities might well be an IJB responsibility.

Jacquie Pepper

Yeah that’s a really interesting observation and poses quite a number of questions Kieran because in Perth and Kinross and indeed across Tayside those services that are delegated to the IJB pertain only to the adult population. So if we are providing for young fit adults or families, that’s not something that we have responsibility for either for providing operationally or for strategically planning. So you’ve picked up on something that means that we are actually focused on part of the equation and not the whole of the picture.

And that presents challenges, but what it does mean is that we have to work very closely with our colleagues such as Elaine and others, both in terms of that work as a council and that whole system, whole age and community focus, but also with our community planning partnership. So we need to have very strong links there. We’re not responsible for the delivery of that, but we need to work very much hand in glove so that our needs and requirements and our strategic needs assessment is fully understood across those different areas of responsibility.

Kieran Findlay

So Elaine, where are the areas that your role and that with Jackie and the partnership do overlap?

Elaine Ritchie

So as the strategic lead for housing and communities, I’ve got lead responsibility for our council housing service. So that’s our 8,000 properties throughout Perth and Kinross, our sheltered housing and our homelessness service. So in terms of the areas that we meet, we’ve got really good collaboration, particularly in the subject of accessibility housing. We’ve got an independent living panel, which is chaired jointly between housing and health and social care. And that’s for people that have got complex needs or people that need support to live independently in the community.

So those Jackie has just alluded to that shows no responsibility, there is a lot of partnership working and that’s kind of like enshrined within our housing contribution statement. So we’ve got a statement of our intent of how we’ll work together. So we might not have it through the legislation but we’ve got it as a partnership approach. So we’ve got some really good examples where we come together, that hand in glove in terms of getting the right outcomes for people. And it’s been a key driver for us in Perth and Kinross because we identified particularly within the accommodation area that we didn’t have appropriate accommodation for people that wanted to live independently or needed to be discharged from hospital.

And over time, since Covid, over the couple of years, we’ve built quite a lot of projects, core and cluster models. So what I mean by that is just mainstream housing that we’ve actually enhanced our specification in terms of making it more accessible for people to live in the community. So there’s lots of kind of like areas of commonality where we’ve come together but it’s that partnership work and its relationships, it’s knowing people, it’s understanding each of got roles and responsibilities but keeping in mind what we’re all trying to achieve at the end of the day and that’s the outcomes for people that live in our communities to allow them to thrive and survive in communities with the right support, with tech, with care and things like that. So they’re not in hospital and they’re not being disadvantaged as a result of a disability that they may have.

Jimmy Black

We had Angela Currie from Hanover on recently and she was saying that one of the difficulties for her, she wants to build a supported housing development. She wants to provide the houses but she also wants to provide the support and quite frequently procurement issues get in the way. How do you cope with that kind of thing with your IJB and with your housing department?

Jacquie Pepper

Well, we have a commissioning team and one of the things I think, when we’re talking about some of the particular needs of these individuals, they can be very complex and we work very closely with a number of providers to be as creative as possible. I can’t really go into the individual specifics about that because it begins to move into issues of confidentiality. But we’ve got a number of really, really positive examples where you have adults with very complex needs, both in terms of learning disabilities, but also in terms of living with neurodivergent conditions that makes it difficult for them to live independently or in locations that are pretty busy or they’ve got specific requirements around that.

So we’ve been very, very creative around it. And we’ve been working with a particular organisation who I think are quite skilled at developing a staff team to support those individuals because some of them require quite a considerable staff team to enable them to live independently. That is assets-based, if you like, and is around the particular interests of those individuals. And I’m thinking of one young man, for example, who likes to be very active, climb, run, kayaking, so his team are actually recruited for their interests so they’re matched very closely with the needs of the individual. So it’s those kind of things.

I think we’ve got lots of examples of where we’ve managed to do that quite well. So the housing is only one aspect of it as you describe. It’s the adequacy and the actually individualised nature of the support for each individual that sits alongside that that will make that a success. And we’re currently also working pretty hard on ensuring that those people who’ve spent perhaps too long in hospital are able to move into their own independent accommodation. Exactly as Elaine was describing there, that core and cluster model where there might be a small number of people who can come together, but there’s a staff team who can support that in a way that gives a bit more resilience to making that work because it can be quite difficult.

And I think the challenges for us in Perth and Kinross and Elaine will know this more than I do is the rural nature of it. Because we’ve probably about two-thirds of our population or more than two-thirds of our population live in what would be classed as rural and remote locations. And I was just looking at some data where we’ve got people who are, or 57% of our homes are off gas grid, for example. So that gives you an indication of the geography that we’re trying to serve here. And it’s not everybody’s choice to live in an urban area. So it’s about getting that balance right as well.

Kieran Findlay

This individualised nature of finding a solution that’s right for the person is an interesting one because another challenge that Angela Currie brought up was them having such a geographically wide remit as well brings them into contact with different health and social care partnerships and that’s different relationships that you have to forge and different people that you have to speak to. Would it be helpful if there was some legal enshrinement of partnership working or some basis to kind of route these discussions on?

Elaine Ritchie

I don’t think so because I think we’re looking at that through the homelessness legislation in terms of a prevention duty and there’s been a wee bit of concerns raised from that from quite a lot of local authority workers that we’re already working to prevent homelessness and adding legislation into it sometimes complicates the matter and takes away that partnership. I think here in Perth and Kinross in terms of what Jackie’s described there, we’ve got the council, but we’ve also got housing association partners that just don’t provide in Perth and Kinross, they also provide in Glasgow and Edinburgh. And that’s some of the common, that’s the frequent thing that I get from them is, ‘Goodness, Elaine, it’s different here than what it is in other local authorities’. And that’s where we come together as a strategic oversight to say, tell us what are the challenges that you’re facing and we provide the support and we try to simplify that as much as possible.

And as a local authority, we’ve set up hubs. They’re called housing option hubs and we’re trying to use those hubs to get a bit of simplification to help our health and social care partners. And I know that we’re a long way off from that, but I think we’re starting to recognise as local authorities, we’re big organisations and we think we’re working quite effectively but also when you stand back and think ‘Goodness, is that how you apply for things?’

So we are aware of that process and we do need to make that simplified and we are working with our housing association partners through all our development boards and whatnot to try and simplify that as possible because at the end of the day we’re working with individuals and we need to make sure we get the right outcomes for those individuals and make it as easy as possible given all the challenges we’re facing in terms of lack of accommodation, financial issues, we need to be much more streamlined and much more effective and get rid of the bureaucracy that sometimes holds us back.

Jimmy Black

There’s a new bureaucracy coming of course because the Scottish Accessibility Standard is under preparation. It’s out for consultation. I’m sure something will be coming soon. Does that worry you? I mean, one of the things that you’ve pledged, point three of your local housing strategy is about delivering more homes for people with varying needs. Will a new accessibility standard make that easier or harder? And why is it that you only want to have 10% of new houses designed to be accessible? And why not have 50%?

Elaine Ritchie

Yeah, so it won’t make it harder. We already design our new builds to that very neat standard. So we were already, we saw that coming on the horizon. So we’ve got our design specification. So it shouldn’t really have any impact. So no challenges there. And the reason that we’ve got 10%, that’s a minimum amount that we will build to. And we’ll try and achieve that a bit harder but the reason we’ve done that is just to give that flexibility with our builders and also our housing association partners, to say that is the minimum, but we will try to exceed that where possible.

We have done that this year alone. We’ve got roughly about 40% of our new builds that have come through that’s got those accessible standards and some have went a bit higher in terms of specification for fully accessible. So it could be wheelchair accessible, but what I’m seeing is a wee bit higher and that’s for not people that have just got a physical disability, but in terms of what we’re seeing in Perth and Kinross is the groups are neurodiverse in terms of your autism and whatnot in terms of just the layout, soundproofing, just even the landscaping of some of our builds as well. So we’ve not just focused on the interior of the house, we’ve tried to get to think of a house that’s a lifetime home as well for those individuals.

So yeah, there will be challenges, but in terms of the standard, we’ve already got that. Our challenge is making sure that we continually have that supply coming through and we’ve got the finance and the budget to able to support that given the current challenges that we’re facing there.

Jimmy Black

Now one of the things you mentioned a minute ago and something I’m very interested in is the use of technology to help people live independently. Yeah. And I used to work in that field and I worked with some of the people in Perth and it was very clear that you were quite well ahead of some other authorities in terms of your use of technology.

You produced a very snazzy smart flat and you also have been involved in a pilot for the digital telecare systems that coming in. Do you feel that you’re getting there with the new digital switch over because that is crucially important for keeping the systems running. And what else would you like to do with technology in terms of keeping people in their homes?

Jacquie Pepper

Well, I’ll start off. That’s okay, Elaine, just to say that it’s a very timely question because we’re just about to take a report to our Audit and Performance Committee about that switch from analogue to digital. So that’s gone extremely well and we’ve just been given an award for the progress that we’ve made. So we’ve actually reached the standard required ahead of time. So that’s great.

I think one of the things, just thinking Elaine, we’ve been doing quite a bit of work as a council’s leadership team around technology and the use of AI. And I mean, it’s quite interesting for me because I feel I’m behind the curve on some of that as an individual because I’m not a gadget person. I’ll put that on the table. However, I think the opportunities that come from, particularly for people who are living with memory difficulties or onset of dementia, that kind of prompting and being able to help people decide whether it’s time to shut the curtains and whether it’s day or night and all of those kind of things. I don’t think we’re harnessing that to the best of our abilities. And I’m not sure that anybody is, but I think there’s something that we really need to do there.

But not just been thinking about our population just now, it’s us as we’re growing older. Our ability to use technology will be entirely different from the current population. So we need to be planning now, I think, for the future. And how families keep in touch with each other, it’s completely different to what we’ve done in the last five, 10 years. So I think we need to embrace that and be thinking and trying to get ahead of that curve. It’s going to require a bit of investment and doing so in the current financial climate is difficult, but it certainly has to be a priority.

Kieran Findlay

Elaine, in the spirit of coming together at the Summit later this month to encourage change, where are you seeing examples of good practice that people should be paying attention to? What’s working really well in Perth and Kinross?

Elaine Ritchie

I think it was what I started with in terms of our independent living panel. It started off by a couple of colleagues coming together and now we’ve got a joint assessment. don’t, if housing are out doing an assessment or meet a family, we then share that with social work. So we’ve reduced duplication and people not having to tell their story three or four times. So we’ve evolved from having a small couple of people coming together to having a panel where now we’re actually prioritising and using that to fit into our strategic housing investment programme in terms of future needs.

So we’ve got education involved in that as well. So children who being born with a disability. So our future plan in that. So that area has really grown from us and from Jackie’s side, from our health and social care colleagues have really bought into that in terms of working with us. And we’ve provided them training on housing and talking about technology. We’ve started using sensors in our properties and some of the information we’ve been using that for some of our condensation work, but we’ve used it to support some intelligence back to health and social care. And we think there’s something not right within the property with some individual, there’s been no movement and things like that.

It’s that partnership work and constantly keeping a curve of what’s on the horizon. So we just spoke about AI there, how we’re using that, but how it could potentially maybe free up some of our staff to provide that element of support where we’re really struggling. And so I think it’s just partnership working, focusing on looking at accommodation so it’s allowing people to live independently and not just providing the bog standards things that we do. I think we do think quite creatively and we’ve got a really ‘think yes’ attitude within many of our teams which really really help and that empowers staff to come up with solutions.

Sometimes they could be a bit risky. But we look at the risk and say, well, if it doesn’t, let’s do a small test of change. If it works really well, let’s implement it. If it doesn’t, we’ve tried it and we can forget about it if it doesn’t. So it’s just about having that appetite for risk as well.

Jacquie Pepper

Can I add something to that? One of the reports that we’ve taken recently to the integration joint board is an update on our complex care transformation, which we described as core and cluster developments. But in addition to that, in terms of the investment in a multidisciplinary team of providing that support to enable people to live independently, we were looking at some data and we know that we have not had a single hospital admission for someone with learning disabilities experiencing a crisis since April 21.

I think that’s outstanding. And there’s a real lesson in that, that we need to be doing a number of things to have a successful approach to retain people independently and inclusively within their communities.

Jimmy Black

One of the things that Perth has been getting a lot of praise for, Perth and Kinross I should say, is the homeless service. And we featured that on the podcast before. It seemed to be one of the leading councils in Scotland on homelessness.

How much of a part does the Health and Social Care Partnership play in that success?

Elaine Ritchie

A big part in terms of it’s not just getting a home, it’s actually sustaining somebody in that property. although our business in housing is getting people into housing, it’s getting people in, but sustaining people in that tenancy. I’m working quite closely with Health and Social Care in terms of housing support, people with complex needs, mental health has been really, really positive and had a major impact on our house, what we call it ‘Home First’ approach here, we don’t call it the homelessness service, it’s about getting a home if that’s the first priority for that individual.

So yeah, again, working with our colleagues in health and social care, doing that holistic picture in terms of what is the person’s needs. Housing support is something that we provide as a housing service, but it’s that specialist support in terms of hoarding, mental health breakdown, working with families is really really important and it’s early intervention as well is key. So although we might be psyched to lead in homelessness, we’re also trying to prevent people coming into the system in the first place and keep them in their home if it’s safe to do so. And that’s where we really call upon our colleagues in health and social care, particularly when there’s families involved or people who are just really really vulnerable. It’s about making sure we get that personalised support and sustain them in their property.

And that can be providing support to aids and adaptations. It could be a variety of things or even linking them with appropriate groups in the community to combat isolation as well.

Jacquie Pepper

And I suppose you just to support that in terms of the single point of access for health and social care comes through our access team. And within that, it’s a team of staff dedicated to a variety of needs that may present. So whether that’s adult protection, people experiencing mental health crises or drug and alcohol issues. It’s an approach that I think we’re in a good enough size and can come together well and Perth and Kinross to able to deliver that and respond more holistically.

Now we don’t always get that absolutely right. Not sure anybody does, but we’re committed to doing that. And I think we spoke about integration at the start of this podcast, which is about providing that integrated response to people. And we know we’ve got more to do on that. But we have integrated our health and council social work drug and alcohol services and relocated them to very recently and we’ll be doing more around how we combine our mental health services as well and we have a whole transformation programme around that so it’s very much about designing how we respond to people to meet their needs rather than to service our needs.

Jimmy Black

When I was doing research for this I was getting very enthusiastic about the Gannochy Trust development that was done about three or four years ago. Absolutely beautiful little houses, gardens all around them, pretty much all on one level. I know there are some that are not. And just accessible from the very start, as far as I can see. Is that something we should be aspiring to everywhere? And just what a wonderful development.

Elaine Ritchie

Yes. If budgets allow. Yeah, I think we’re all in awe of those lovely little bungalows. And I think something we are looking at with the Gannochy Trust because we’ve got an ageing population within Perth and Kinross then the next 20 years we’ll have a 30% increase in the number of people over the age of 65 so it is something and we’re consulting with people regarding what their housing aspirations are and it’s the bungalow type with two bedrooms and that’s not the cheapest things to build and you don’t maximise space as well.

So yeah the Gannochy Trust, we work really closely with them but yeah that accommodation is outstanding in terms of just the community it builds and just the wee ‘ooteries’ that they’ve got outside it’s combated social isolation and brought a community together. Yeah it’s something I would love to aspire to as the strategic lead for housing but probably not on my purse strings that I’ve currently got.

Kieran Findlay

So yeah, clearly a lot of things going well in Perth and Kinross, but on a national level, we’re in a housing emergency, a housing crisis, the Scottish Government’s looking to kind of rein back on public spending, where do you see the issues coming down the track, or where are the areas that you’d be looking to the Scottish Government for support in the future?

Jacquie Pepper

Can I come in first, Elaine? Because we’re very much focused on the housing needs of those people that we’re very much serving from a health and social care perspective or people presenting with vulnerability. But one of our biggest challenges is about affordable housing to deliver essential health and care services. So that’s a huge focus for the council and is a real concern for the integration joint board because unless we can attract people to live in the communities then we’re not going to be able to meet the needs of our population as we go forward.

It probably is something that we speak about every day, Elaine, think, with elected members. So it’s very much a huge priority for Perth and Kinross as a council. But I think that’s a national issue and goes beyond Perth and Kinross but as a tourist area, a very desirable area to come and visit and a desirable area to live in and you know the post-pandemic that’s even more so even when we’re trying to recruit quite specialist professionals including GPs, doctors, Allied Health Professionals, OTs, it’s particularly challenging for us. So housing is absolutely essential to that.

Elaine Ritchie

I don’t have anything to add in terms of, we’ve not declared a housing emergency, but we’ve got a housing crisis, even though we’ve got Home First. We’re still getting good outcomes for homeless people, but it’s hard. I have been in this business for over 25 years and I’ve never ever come across such pressure on the housing service.

Everybody’s a priority from early release of prisoners, everyone’s a priority, we just don’t know what is a priority. And we’re in meltdown a wee bit. We had a cut to, I keep on talking about money and I shouldn’t, but we’re being asked to provide more affordable housing but they cut our affordable housing grant by 25%, we don’t know if we’re going to get that back but we’re being asked to do more with less and we’ve got builders now coming out the market, we’ve just had a local housing builder today who made 66 people redundant. That’s properties that they were building for us. So it’s just dire just now.

We need more funding, but we need to be creative with that funding. We’ve got lots of public sector like NHS and whatnot. They’ve got buildings, some of them they’re looking to downsize. I think the government’s missing a trick there in terms of utilisation of these buildings even commercial property. There’s a lot. We’ve put an action plan to the government from Perth and Kinross and some good ideas. Still not had feedback on it, but there’s more to be done there. So I’m not doom and gloom. There’s lots of opportunities. think we’ve just, money’s not everything, but I think it’s about partnership and taking risks.

But yeah, we need affordable homes, not just for people with independent living needs and accessibility but it goes right around in terms of child poverty and the poverty agenda. It’s a solution that can help with those areas. The amount that we are putting plasters on areas, if we were to reinvest for affordable housing, it might help with some of those areas. But I’ll get off my soapbox now.

Kieran Findlay

Thanks, Elaine, I’m sure that those are thoughts that are shared across Perth and Kinross and across the country, to be honest.

Thanks to yourself and to Jacquie. Thanks to everyone who has reached out and shared very kind words about this accessible housing series of episodes that Jimmy and I have put together. We just hope we’ve given you a small flavour of what’s ahead at the Summit at the end of the month. I’ll be very much looking forward to handing over the reins to a range of experts, including Jacquie.

In our next episode, which will almost certainly be published after the event, Jimmy and I are hoping to visit a new fully accessible development in Dundee to see how it’s helping to transform the lives of the people that are living there. So stay tuned for that. But until then, it’s a goodbye from Jimmy Black and it’s a goodbye from me.