9. Statement by the Minister for Housing and Regeneration: Integrating Housing, Health and Social Care

– in the Senedd at 6:28 pm on 26 June 2018.

Alert me about debates like this

Photo of Elin Jones Elin Jones Plaid Cymru 6:28, 26 June 2018

(Translated)

The final item on the agenda this afternoon is a statement by the Minister for Housing and Regeneration on integrating housing, health and social care, and I call on the Minister to make her statement—Rebecca Evans. 

Photo of Rebecca Evans Rebecca Evans Labour

Diolch. The Welsh Government knows just how important secure, good quality housing is to the health and well-being of the communities we serve. We understand the considerable pressures on both health and social services, and we know that housing organisations and housing services have a vital contribution to make in responding to those pressures. Whilst housing and social care are both key priorities in our programme for government and our national strategy, 'Prosperity for All', we recognise that we are not going to respond to the needs of people in Wales if the housing and social care agendas are pursued separately. 

The parliamentary review of health and social care recognised the role that housing can play in promoting and sustaining good health and well-being. Similarly, poor or inappropriate housing can have a detrimental effect. 'A Healthier Wales', our plan in response to the parliamentary review, provides us with an important opportunity to take further strides along the integration agenda. It provides us with an opportunity for a step change in how we deliver health and social care in Wales, including through new models of seamless local health and social care. We are committed to responding to the challenge. We are committed to doing so across Government. And we recognise the need for housing to be at the heart of this work.

Our integration agenda is supported by the integrated care fund. The fund comprises both revenue and capital funds and aims to improve public services by making collaborative working an explicit requirement for local authorities and local health boards, whilst allowing a space for innovation. The fund is a key component in reducing unnecessary hospital admissions, inappropriate admissions to residential care, and delayed transfers of care. We have seen a marked decrease in delayed transfers of care since the fund was introduced, but I know there is more we can do. The fund supports a number of objectives, including developing homes much more suited for older people, people with dementia or learning disabilities, or young people with complex needs, alongside care and support.

Photo of Rebecca Evans Rebecca Evans Labour 6:30, 26 June 2018

Whilst the fund is already beginning to support accommodation-led solutions to social care, alongside both housing and health capital programmes, I want to move towards developing a more scalable, strategic programme of capital investment, which has housing at its core. I want us to up our game with this fund and move away from delivering just smaller—but important—localised projects to a much more innovative and truly integrated approach, prioritising accommodation-led solutions that are explicitly designed to lessen the demands on social care budgets. I am very pleased to be working closely with the Minister for Children, Older People and Social Care to better align what we do in housing and social care. The Minister for Children, Older People and Social Care and I visited an extra-care housing and care scheme under construction in Maesteg yesterday, which has care and support at its heart. Its development is informed by an assessment of local population need and local housing need and it's the kind of project we want to see more of.

I am pleased, therefore, to announce a new three-year capital programme of £105 million to support a move to a more strategic and scalable approach to accommodation-led solutions to health and social care needs. I want to see this accommodation-led approach embedded in the models of care we develop for older people and other vulnerable groups. We know the role that housing plays in people’s health and wellbeing. Housing is the platform to prevention and early intervention for social care, and it's also the key to helping make services more sustainable. The new £105 million integrated care fund capital programme aims to maximise the contribution housing interventions can make to improve service delivery, whilst also alleviating the pressures on the NHS and the delivery of social care.

Additionally, this programme responds to a number of recommendations in the report, ‘Our Housing AGEnda: meeting the aspirations of older people in Wales’, which set out a wide-ranging programme of change when it was published last year. It highlighted the need for concerted action at a variety of levels. The report was a call for action, not only by Welsh Government, but by a wide range of other stakeholders across the public, private and third sectors. The expert group behind the report recognised the importance of action at a variety of levels to bring about transformational change. The report will continue to provide a road map of the further changes still required if we are to respond adequately to the housing, health and social care challenges we face in Wales.

We are driving the integration agenda by supporting the health, social care and housing sectors to work much more collaboratively through regional partnership boards. These boards are provided for by the Social Services and Well-being (Wales) Act 2014 and are the responsible for making the strategic investment decisions for the integrated care fund. They bring together health, social services, the third sector, citizens, and other partners. They have integration at their very core. I am determined to see the voice of housing coming through even more strongly in the work of regional partnership boards. The housing contribution to more effective care and support can’t simply be an optional extra; it needs to be at the core of our efforts to integrate services so as to achieve the greatest impact. So, I am pleased to be able to tell Members that we will be making housing a statutory member of regional partnership boards, and officials are exploring how this can be most effectively implemented.

Of course, providing new accommodation shouldn't be seen as the only solution. It's essential we support people to continue to live independently in their own homes as their needs change. We know that aids and adaptations are often a lifeline to people who experience a disabling environment. A suitable, well-adapted home can make the difference to someone’s ability to live independently and receive health and social care close to home, avoiding admission to hospital, or having to move to long-term residential care. We have already introduced important improvements to the system of providing small-scale aids and adaptations to help people do this. The new approach, called Enable, is focused on greater efficiency by simplifying and speeding up the process of getting an adaptation. It does this by determining the most efficient way to deliver an aid or adaptation to meet someone’s need, as there a number of funding sources available depending on a person’s circumstances and tenure. The new system also collects data to help us understand how we can improve this process still further. However, we recognise our current improved system can still be complex and needs streamlining, and a recent report by the Wales Audit Office supports that view. So, I have announced that we will be taking forward a further change programme in this area and we will be consulting on these changes in due course. We must streamline the funding and provision of services to make it more citizen focused, transparent and consistent in its delivery.

These important areas of work, alongside the new programme of capital investment, are all aimed at helping people who need support to receive the right support, whether they are older people with complex needs and long-term conditions, people with learning disabilities, children with complex health needs, or carers. Our plan for health and social care recognises the significant role appropriate housing can play in moving health and social services closer to communities in a year when we are celebrating the seventieth anniversary of the NHS, which was of course born here in Wales. What's not always appreciated is that Nye Bevan was Minister for health and housing, and his contribution to improving the quality and volume of available housing was significant. He understood that for people to live long and healthy lives they needed access to appropriate housing, and it is in that spirit that I make this statement today.

Photo of Angela Burns Angela Burns Conservative 6:36, 26 June 2018

I'd like to thank the Minister for bringing forward this statement today, the content of which is very welcome to us, because you have pinpointed with accuracy that lifestyle, transport, housing and design are vital elements of how we're going to be able to move forward in a more integrated way and to have a healthier Wales. It's very vital because home is going to be increasingly the place where our health and our social care needs are delivered, and of course, no single part of the system can possibly hope to answer all of our needs. Michael Marmot's 'Fair Society, Healthy Lives' really highlighted the significance of the wider issues that impact on health. In fact, they say often, don't they, that housing, employment and education are the causes of the causes of ill health. So, I think anything that Welsh Government, with the support of the Assembly, can do to tackle some of these issues is incredibly important. 

Having said all the nice words—and you'd be disappointed by anything else—I just want to challenge you on a couple of points and ask for some explanations in a couple of other areas. The parliamentary review of social care did indeed recognise the role that housing can play, however, your response, or the Government's response—'A Healthier Wales'—your plan in response to that parliamentary review, had very, very little on housing. You talked about new partnerships between health and housing, you talked about area plans that would provide a robust platform, but perhaps you can give us a little bit more information about how crucial a role housing will be enabled to play in delivering this vision of a healthier Wales. You do make a very strong assertion that there's been a marked decrease in delayed transfers of care and I'd be really interested to know where those statistics have come, from because I've yet to be able to put my hand on my heart to say that that is there, because of course it's been one of the key components of our winter pressures and all the rest of it. We don't see it out there on the street and I'd like to know how you have that. 

You talk about upping the game with the fund and delivering larger projects and you talked about going out with the Minister for Children, Older People and Social Care and seeing new plans. Can you please tell us how you're going to ensure that local authority planning departments come on board with this? Time and time again in my area, I know of great initiatives that bring together housing and care that are being turned down by local planning authorities because they don't meet some criteria in the planning documentation. We've got to get over this and start building the houses that people really need. I absolutely welcome the £105 million of extra money to support this more scalable approach and it's really good to see that it's tying in across the whole of the United Kingdom, isn't it, because the UK Government have also announced this better care fund with a significantly larger sum of money, but they're a slightly larger country. So, it's good to see that everyone's going down—this is a good direction of travel.

I would ask you to perhaps cast your eyes over David Melding's White Paper 'Liveable Cities', because it's from the Welsh Conservative think tank and it does, very much, focus on socially inclusive and environmentally sustainable homes and cities and environments that can be built on the principles of the health and well-being of the citizens. Going back to what are the causes of the causes of ill health—it is your home, it is your environment, your education and your employment prospects. Also, could you please, actually, just give us a quick bit of an overview on the adaptation side? You talk about the new fund, but we do, very often, have this scenario where a house is very expensively adapted for somebody who has needs, and when they move out, those adaptations are then ripped out, at great cost to us all, and then somebody else moves in to get a sort of baseline home. This is nonsense; surely we should just be making sure the appropriate person moves into that.

Two more questions. What measurements do you have in place to measure the success of this extra funding? How will you know if it's hitting the nail on the head and doing what it should be doing and how are you going to apportion it across the areas of greatest needs or across the areas of Wales? And, finally, I come back to that planning authority and planning permission again. We do need different types of houses and we should be building homes that already have—either bungalows, or, if we're tight on space, we should have extra wide stairs going up so that you can put a stairlift in if you need to, because people want to stay in their home and they want to remain in that home. We're trying to encourage them to do that. We need to build homes where it is easier to put in hoists. We need to build homes where it is easier to adapt a kitchen. And those are the things that we need to start looking at in the design principles for our housing stock going forward if we truly want to buy in to the fact that people are going to stay in their home, they're going to receive their healthcare in their home, they're going to receive their social care in their home, hopefully until the end of their days. This is a great direction of travel, it's a good initiative, but I'd really like to see some teeth put into this, because it's a lot of money and I'm worried that we won't achieve what we need to achieve.

Photo of Rebecca Evans Rebecca Evans Labour 6:42, 26 June 2018

I thank you very much for those questions and for the warm welcome that you gave at the start of the contribution, and for your recognition about the importance of housing in the wider health and social care agenda. And we're not just talking about housing; you made the point that, actually, we're talking about homes, and when we listen to people, they generally tell us that home is where they want to be. I think that social care and provision of care closer to home and, ideally, at home, is certainly the way forward in supporting people to have that aspiration realised.

You referred to the parliamentary review; well, our statement today is very much part of our response to that parliamentary review from the housing perspective and it's done very much in association with health and social care as well. You referred to the fact that the parliamentary review called for a new partnership between health and social services and housing. I think what we're setting out today, through the integrated care fund, is very much that new partnership and we're making sure that that has housing at its heart by ensuring that regional partnership boards will, in future, have housing as statutory members of those boards. When I was Minister for social services, I recognised then the important role that housing could make and I encouraged regional partnership boards to include housing on those boards. And, I think it's fair to say, it was done with varying degrees of success across the different regional partnership boards in Wales. In recognition of that now, we realised that now is the time to consider how we can put that on a legislative footing, so, we intend to bring forward regulations to give housing that status and focus that it really needs on those regional partnership boards.

You referred to delayed transfers of care. I'll ask the Minister to write to you with the very latest statistics, but they are published monthly, I believe, by the Welsh Government. Some of those figures that we are seeing are amongst the lowest that we've ever seen in Wales since the records began, 13 or 14, I think, years ago, and that is quite extraordinary, given the fact that we are in a position now where demands on hospitals, especially in that kind of setting, are increasing. So, I recognise that we are making improvements in this area, but as I said in my statement, there is much more that we can do and that we need to do. This announcement I'm making today is part of our response to that challenge as well.

You quite rightly mentioned the issue of local authorities and planning and how they can enable this kind of agenda. This was very much recognised by Professor Phillips's 'Our Housing AGEnda' report, which is referred to in the statement, and the expert group that informed that statement focused on how the planning system can better support an aging population. The revised 'Planning Policy Wales' requires planning authorities to identify where interventions may be required to deliver older people's housing when there has been a need for that locally, and this may include the identification of specific sites and policies in local development plans. Consultation on a revised draft of 'Planning Policy Wales' has recently closed, and I'm sure the Cabinet Secretary will be making an update on that very shortly.

I was aware of the 'Liveable Cities' document. I was really pleased to respond to that debate just a couple of weeks ago, and it really was an excellent debate, and I think recognition from all sides about the important role of how we design our cities in terms of the benefits, or otherwise, it can bring to our health. I'm keen to see accommodation-led regeneration in our towns and cities as well, because we had questions to the First Minister today that focused on the impact that the downturn in retail and the changing patterns of consumer spend are having on the high street, and there's certainly opportunity, I think, to ensure that our high streets become places where people want to live, because there are lots of benefits there in terms of being in the middle of all of the action, and also having larger numbers of people living in our town centres is obviously good for those retail businesses that remain.

In terms of adaptations, we're very focused within our new fund to ensure that adaptations do continue to be resourced as they should be. So, within that £105 million, there is a main capital programme, which would be a minimum of 75 per cent of the spend, and a discretionary capital programme, which would be a maximum of 25 per cent of the spend. Within that discretionary capital programme, we would expect regional partnership boards to consider aids and adaptations that are not supported by existing programmes and that are in support of those specific objectives of the ICF, which are older people, people with learning disabilities, children with complex needs, and carers. They could look at equipment projects, which support people to live independently in their own home and to reduce hospital admissions or speed up that hospital discharge, or other smaller scale projects in support of the ICF objectives. So, those projects could be community-led or third sector-led, because the social services and well-being Act also is very focused on ensuring that we do support those third sector organisations and co-operatives and so on to be able to deliver services within the community as well.

Photo of David Lloyd David Lloyd Plaid Cymru 6:48, 26 June 2018

Can I welcome this statement from the Minister for Housing and Regeneration? I very much welcome it, and welcome the direction of travel as well. Naturally, we would welcome £105 million capital spend as well. In terms of the background, obviously there's mention of Aneurin Bevan. There will be a lot of mention of Aneurin Bevan over the next couple of weeks, I suggest, and, yes, he was the Minister of housing as well as health, and up to 1951 housing was part of the department of health at Westminster level. Then, for some reason, it got split off, but that link between housing and health is absolutely that intimate, and we should be reinstituting that link, frankly, because bad housing equals bad health. We have homeless people on the streets of Wales today, and their life expectancy is 47 years, while the rest of us are going to live to beyond 80. So, bad housing indeed equals bad health.

In terms of the other situation in terms of people always asking me, 'How are we going to deal with this huge expansion in the number of elderly people and their care requirements and their health requirements?' And I always say, actually, we need to start with their housing. We need a huge expansion of the sheltered accommodation principle, whereby this requires a culture shift amongst our people as well, in terms of planning ahead and thinking, 'How am I going to spend my latter years?' I would suggest in some sort of sheltered accommodation. There are excellent projects dotted around Wales and the United Kingdom—yes, it's a housing solution and people have wardens there looking after them. In the same complex, Scandinavian village-type model, it can get more intensive, then, in terms of—. There's a sort of nurse equivalent—there's a nursing-home-type situation in the same complex, and there are also advanced dementia care beds, again in the same complex, so that people move in, and then if their health deteriorates, they just move to a different part of the same complex—they don't have to leave, so, hence, couples who have been married for 50 to 60 years are not split up like we do now, callously and sometimes without warning. They remain in the same complex, only in a different bit of it. Throw in a bit of a restaurant, hairdressing, bit of bingo—everybody's happy. You know, that's how we should be treating our elderly, not jamming people in residential homes, I would say, or in less-than-adequate private nursing homes, quite often—and I could provide names of less-than-adequate private nursing homes if the Minister insists. But there are some excellent examples. I would mention Cylch Caron, Tregaron—integrated housing, health and social care project. There are still technical issues to overcome, though. I mean, people have been working in their separate little silos for too long, and even when you have some wonderful, innovative thinking, 'Let's start with the housing and build the health and the social care on to it', you still have issues with regard to how that's going to run.

I'm pleased to note that you've mentioned the integrated care fund here as a flagship, and I don't want to embarrass the Llywydd over much, but it's only fair to note that this brilliant idea of the intermediate care fund, as it was then, came as a germ from the brain there of Elin Jones, Assembly Member for Ceredigion, at the time in 2013, which was part of a budget deal between Labour, Plaid, and the Liberal Democrats we had then, in 2014, I think. So, that was the germ of this excellent idea, which has been built upon today. I congratulate Elin all the time, actually, about this innovative thinking, because that's what it's about: it's about breaking out of silos and breaking out of individual portfolios and thinking, 'We have an elderly person here. How are we going to deal with this situation?' We start with, 'Where are they going to live? Can they stay where they are with all the support, or, actually, are we going to have to think a bit broader about this? And let's have these integrated projects.'

So, yes, there's a £105 million. There's a lot of mention about capital funding: capital this, capital that. Lots of projects need revenue support as well. Can I just ask the Minister: is there any revenue funding as part of any of this—not to discount the very considerable sum that you've just announced now—and in terms, obviously, of—? I mean, it is a complex field—that's sometimes why it's difficult to integrate things. There are various other pots of money and lots of other people doing excellent work elsewhere, particularly with certain vulnerable groups. The Supporting People funding, which is continuously under threat of being integrated somewhere else—and lots of people would want to see Supporting People funding safeguarded, maintained, even, developed—how would that work together with this agenda? Because, as you mentioned in your statement, it's not just about elderly people, it's also about people with complex needs as well. Diolch yn fawr.

Photo of Rebecca Evans Rebecca Evans Labour 6:53, 26 June 2018

I thank you very much for those comments, and before I address those points, I realise I had neglected to answer the point that Angela Burns raised in terms of how we're going to be monitoring and overseeing what is very significant spend. Effective monitoring and evaluation arrangements are important in order to provide us with those assurances that ICF capital funding is being fully utilised in the support of effective integrated and preventative services, and, of course, when we see the projects coming forward, it will also help us be informed about where we're going to in terms of future spend through the ICF capital investment as well. So, regional partnership boards must ensure that they have robust monitoring arrangements in place to ensure that schemes funded via the ICF capital deliver those intended outcomes on time and within budget. Evaluation arrangements must also be established to identify and evidence the impact as well as the general appropriate use of funds, and reports must be made on a quarterly basis, as detailed in the guidance that is presented to regional partnership boards. In terms of overseeing the main capital programme, well, projects should be agreed at regional partnership board level, but then submitted to the Welsh Government. We recognise that as an appropriate level of oversight there. However, there must also be robust internal processes for scrutiny and sign-off for regional partnership boards with regard to the discretionary capital programme, but that would need to be proportionate to the kind of level of projects that we're talking about there. So, discretionary projects are anything under £100,000, and main projects are anything over £100,000. 

Bad housing leads to bad health. That's well recognised, I think, and that's something that came forward very strongly in Dai Lloyd's contribution. The kind of project he was describing early on in his contribution, about a project which demonstrated good practice, was very much what we consider in terms of extra care. Welsh Government has got a long history of supporting extra care since 2002. With the support of £197 million of Welsh Government funding, we've seen 49 extra-care schemes funded across Wales, providing over 2,000 homes for older people, where they can maintain their independence and avoid the need for unnecessary hospital admissions. But I think that the ICF capital funding, which we've announced today, really does take that commitment now to a new level, and certainly, I would imagine that extra-care projects might be some of those coming forward via regional partnership boards, because I think extra care has gone much further on from sheltered accommodation because there can be on-site care for people, so that means that people's health and social care needs can be responded to quickly and responsibly and can help them cope better with crises. Also, we can't forget the important role that care technology plays in supporting people to better manage their risks, and also some monitoring of people's vital signs, which assists proactive healthcare, and extended clinical supervision, and that reduces admissions and enables earlier discharge, again, from hospital. So, I think we'll certainly see some of those step-up, step-down projects coming forward from regional partnership boards, and I'm sure that would be very welcome as well. 

In terms of integrated health and social care settings, this is another part of the response that Vaughan Gething has outlined in terms of the parliamentary review, and a pipeline of 19 projects was identified in December as part of £68 million of investment in a new generation of integrated health and care centres. A theme of the pipeline is integration, and health boards are looking to work with a range of delivery partners, including local authorities, housing associations and the third sector. The model of care for each of those will differ. Business cases, I understand, are currently being developed, and there is engagement with a wide range of stakeholders to identify the opportunities to promote integration. This really is the biggest targeted investment in primary and community care infrastructure by the Welsh Government, and I very much look forward to those projects moving forward. 

There was a question regarding how we are funding this, because, obviously, these projects also need revenue funding. So, in this financial year, the Minister for social care has announced that there will be £50 million of revenue funding in the integrated care fund as well. And, obviously, there are opportunities to marry up this funding with regeneration funding, for example, and other funding from health. So, this potentially could have the opportunity to look elsewhere for funding for projects that meet other wider objectives as well. But there is certainly that revenue funding to support what's needed. 

Photo of Gareth Bennett Gareth Bennett UKIP 6:58, 26 June 2018

Thanks to the Minister for her statement and for the announcement of the new funding. I appreciate that, to a large extent, housing, health and social care are all interconnected and they need to be considered together, which is the basic thrust of today's statement. So, we do appreciate that sentiment, and we acknowledge the need for different departments to work together to achieve these aims that you've set out and not to work in silos. So, I think that applies both at Government level, where you have to work alongside possibly two other Ministers to achieve these aims, and also at more regional level. So, I think it's a good move to have housing needs included in the regional partnership boards as a statutory obligation. 

One basic issue regarding these three integrated areas is: are we building enough bungalows in Wales? Angela Burns touched on that. She raised the issue of bungalows, but Angela raised a number of valid points and I wasn't sure that this basic fundamental question was actually answered by you. You answered a lot of points, but I'm interested in what you think about this simple issue of the number of bungalows that are being built. 

There are a variety of home adaptations that can be carried out to make homes more habitable for residents who have developed physical or mental issues, or who have simply got older. Of course, there is a question of priority. You mentioned different groups, but you didn't mention veterans, so are they part of the integrated care fund programme, or are they coming under another scheme? I would like some enlightenment on that issue. But obviously, there is going to be this problem of priority. There are lots of different groups. You did state that there are certain percentages of funding that will be allocated in different ways. I suppose one basic issue is: will there be a coherent system of priorities that is easily understandable to the applicants who are applying for grants for things like home adaptations?

New technology can sometimes be used to benefit the lives of fairly housebound people. For instance, a lot of day centres have closed in recent years. People living in rural areas may not be living close to a day centre in any event, so loneliness and isolation have become a major problem. Can we investigate home adaptations that encompass older people accessing facilities like Skype or something similar, or even in training those who are interested in accessing the internet? Could that form a cost-effective part of home adaptation? Obviously, we need to have broadband in those areas first.

I was intrigued by Dai Lloyd's vision, which I think is a good one—this idea that older people can sometimes live in semi-communal forms of living that will often be more beneficial for many of them. There's also something called reminiscence therapy, which can benefit people who are experiencing difficulties with their memories. This can be incorporated into the kind of village complex that Dai was referring to at one point. So, I wonder if this can be incorporated in some way into the Government's programme. Thank you.

Photo of Rebecca Evans Rebecca Evans Labour 7:02, 26 June 2018

Thank you very much for those questions. I'm glad that you began by acknowledging that it's important that we don't work in silos in this regard. I think it's important that the Welsh Government shows leadership in terms of being able to work across traditional boundaries, especially when we are asking local authorities and health boards to do difficult things, including pooling budgets through the social services and well-being Act, and that's one of the key roles of the regional partnership boards, because making effective use of resources is a key priority for those boards. Those pooled funds and improved integrated commissioning will result in greater resilience in the provision of services, with a focus on improved quality and not just better value for money. 

We have been assured that all regional partnership boards are now delivering a form of pooled funds in relation to care homes for older people. We want to ensure that there are fully formed pooled funds in place that deliver effective joint commissioning by April of next year. And the Minister has made it clear that we will consider intervening directly if that's not the case. So, yes, it's important that the Welsh Government shows leadership and I think we've done that through 'Prosperity for All', which recognises housing and social care as two of our five cross-Government priorities, and we recognise that there are roles for all of us across Government to be working together on these agendas; it's certainly not one person's responsibility to be delivering.

Are we building enough bungalows? No, definitely not. I was really pleased yesterday to visit the new development in Maesteg with my colleague Huw Irranca-Davies. They are building new bungalows there and that's really exciting, because, actually, we don't have enough bungalows being built. I was talking to developers as to why, and they're often seen as being quite inefficient in terms of building them, because they are, per square metre, more expensive to build than other houses. But, equally, bungalows really do meet the needs of older people who need to be living on one floor, for example, and who need a fairly small property to be looking after. So, I would like, certainly, to see more bungalows being built, and the ones that were being built yesterday were being built through a housing association, with the specific aim of supporting people to live in those accommodations, as part of their social housing offer within the local area. So, I think that it's important that that's considered by registered social landlords, for example, as they're thinking of their forward work programme, and also by local authorities as they're considering their local housing needs analysis, for example.

In terms of priorities and how regional partnership boards will know where to be focusing their efforts, alongside a letter to regional partnership boards today as a result of this statement, we're also issuing programme guidance for this fund. So, there should be no doubt in terms of the minds of regional partnership boards as to where we would want to see that funding deployed. 

I completely agree that the use of new technologies provides us with real opportunities to support people to live at home for longer, and to monitor people's care needs, and monitor people's health, and so on. That was reflected in some of the answer that I gave to Dai Lloyd. 

Again, I think building the right homes is also about building communities, and that very much speaks to that point that you made about tackling loneliness and isolation, which we know is becoming a growing concern for many older people, but not exclusively older people, across Wales. So, building homes that are also communities, such as the one we saw yesterday, I think is a wonderful way of being able to tackle that as well. 

In terms of the groups that this funding is intended to support, those groups are set out through the social services and well-being Act, and they are: older people with complex needs and long-term conditions, including dementia; people with learning disabilities; children with complex needs due to being disabled or illness; and carers and young carers. So, those groups are specifically set out through legislation. 

We do have a very strong link between the dementia action plan and the regional partnership boards' work. The plan focuses on what service users with dementia and their family members have told us was particularly important to them, for example, timely diagnosis, and then the provision of person-centred care following that diagnosis. The implementation of that plan is being supported by £10 million of Government investment, £9 million of which has been allocated to the regional partnership boards through the integrated care fund mechanism, so aiming to drive forward and enable integrated working between social services, health, housing, the third sector and independent sectors to support people with dementia and their carers. To support this, we have issued addendum ICF guidance that was produced specifically with the dementia action plan in mind.

Photo of Jenny Rathbone Jenny Rathbone Labour 7:07, 26 June 2018

It's a pleasure to see the Government embracing the parliamentary review, and working towards how we're going to deliver person-centred care, because if we can't deliver the type of housing that people are going to need as their needs change, then it's going to be extremely difficult to do that. 

I think one of the core principles has got to be that everybody needs to be part of a community, because I don't want to see bungalows a quarter of a mile away from any services; that's not going to work. And equally, it's really important that people with dementia who may not be able to stay unsupervised on their own at home should still be part of the community. There was a lovely television programme in the last couple of days about some children visiting people with dementia, and the very, very positive impact that it had on the older people as well as the warmth that the children received from these older people, who were giving them lots of attention. So, that's a really good example of how people with dementia need to still be part of the community, whether it's restaurants where people with dementia are making the food and other people are coming in to eat it—the paying public. That's another way in which we can keep people in contact with the whole community. 

But I think one of the problems we have at the moment is that we have such a lack of choice in housing because of the acute housing crisis, so that when people's needs change it becomes really difficult to enable them to stay part of the community that they know, because we simply haven't got anything available. I've got a constituent who is, so to speak, over-occupying because of the bedroom tax. She's got an adult son with some autistic spectrum difficulties. It's very difficult for her to be in a flat because of that, but there are simply no two-bedroomed homes in the community she is a major part of as a really good community leader. Sadly, it looks like she's going to have to leave that community, which is completely tragic, in that we haven't got a range of housing types. Hefin David raised the issue of the mass house builders who all want to build the same old rabbit hutches. We don't yet have the flexibility we need in the type of housing that people are going to need and where people feel a sense of some control over it.

I was reading a fantastic article earlier this month about a project in Eindhoven called Project Milestone, where the Eindhoven university of technology have been fully involved in 3D-printed housing. They envisage that, within the next five years, people are going to be able to design their own homes on a computer to suit their particular needs, depending on how many children they've got, et cetera. But because they're using a specially formulated cement that's squirted onto the structure, a bit like whipped cream, it's miles cheaper than bricks and mortar and incorporates smart lighting, heating and security. I can see how it can be made to work.

So, I just wondered if you're thinking in your regional partnership boards about how you're going to contract with small and medium-sized local builders who are going to deliver the types of homes that people in that community are going to need. They'll be different in every community. I can't see a role for bungalows in the inner-city parts of my constituency, because the land just isn't there, but I can see a demand for people to continue to stay in the street they've lived in for 60 years, so that they're near to their children and will be able to maintain those links that are vital to keep people out of hospital.

Photo of Rebecca Evans Rebecca Evans Labour 7:11, 26 June 2018

Thank you very much for those questions. I'll begin at the end of your contribution when you were talking about innovative housing. I think that we are really on the cusp of a revolution in terms of the way that we build housing. There are so many exciting new ways of building homes. Some of those are being supported through our £90 million innovative housing programme. The current window is open for another week or so—another couple of weeks—so I'll certainly be encouraging businesses of all sizes to consider making applications to that. I think it's particularly well suited to SMEs because SMEs have a long history of embracing risk long before the volume house builders have done. I met with the Federation of Small Businesses earlier today and I was impressing upon them the need to be promoting amongst their members the opportunities under the innovative housing programme for SMEs, because they are real opportunities, I think. 

They also have access to our property development fund, which is a £30 million fund, and that will enable small and medium-sized enterprises, again, to have relatively easy access to funding in order to support some of their building projects. Again, we recently announced the stalled sites fund, which is a £40 million fund and that's to open up sites that are there and ready to go in terms of planning, but for whatever reason haven't been able to be built on—for example, remediation needs to be undertaken in order to make the land suitable for building. So, those small elements that prevent the project from being viable right now, but with this kind of support might make them viable in future. It can also be used in terms of assisting small and medium-sized enterprises with their cash flow as well.

So, I think the innovative housing programme, although we're supporting many different types of housing at the moment, it is all with the purpose of informing us where we need to go in future in terms of building houses at a much greater scale and pace. So, potentially, we could be getting to the point where we start thinking, 'Well, these are the three or four kinds of ways of building homes that really work for us here in Wales and these are the ones that we want to invest in in the future, these are the ones where we can keep the skills here in Wales, where we can build here in Wales.' We've just had the statement on woodlands, so we can be using as much Welsh timber as possible. I think that this is a very exciting agenda in terms of housing, particularly innovative housing. I would imagine that where projects do come forward under the ICF they would be certainly looking at one and two-bedroomed properties because, as Jenny says, these are the kinds of properties that are in short supply and are better suited, particularly, to older people. 

You referred to the lack of choice in housing when people's needs change. Again, this is something that's exciting about the extra-care programmes, which will be supported and which have already been supported, in terms of them being able to adapt to people's needs as their needs change. Again, Jenny referred to new technologies and the exciting opportunities they can present there. I visited Llanelli recently to look at their support for social care, and they were showing me some of the technologies that they deploy. One was a watch that supports people with dementia. So, it's got GPS on it, and the individual can agree, with their families, with their carers, the boundaries where it's safe for them to go—so, areas that they know very well—and if and when the person leaves those boundaries, then the family is informed, and it's a great way of giving families peace of mind but also giving people the independence that they deserve as well. 

The children visiting people through, for example, Dementia Friends projects, I think, is wonderful as well, and I know that it's not just the older people or the people with dementia who get a lot from that as well. I think that the children certainly get a lot from that, and that's something I would be looking to promote as well. I also just recognise the comments that you've made about the importance of the parliamentary review and the real focus that it does put on personalised and person-centred care.

Photo of Elin Jones Elin Jones Plaid Cymru 7:16, 26 June 2018

We're over time already with this statement. I have three other Members wishing to speak. Oh, I have an excellent Member at the back there, indicating that she no longer wishes to speak. I've got two other Members wishing to speak. I'll call you, but I want succinct questions and succinct answers. Jane Hutt.

Photo of Jane Hutt Jane Hutt Labour

Yes, thank you, Minister, for your statement, and can I say how pleased I am to hear about the news of this substantial investment in housing as part of the package to join up health, social care and housing? Last week, I spoke at the policy forum on older people's care, and I think Rhun was also there, chairing a session. We did draw attention to the unique opportunities we've got to drive forward policy in this area. Now, Dr Dai Lloyd has already talked about the origins of the intermediate care fund, as it was, back in 2014-15, and I would just like to have a brief moment to remember the time we spent, one hot summer, in closed rooms, with myself as finance Minister, Elin Jones as the Plaid Cymru shadow Minister, and I think it might have been Peter Black, because certainly we said, 'It should be health, social care and housing.' And I'd say that was £50 million to deliver a Welsh Government budget in 2014-15. It's now firmly embedded in policy delivery in Wales. But I think, and it's what came out of the policy forum last week, that actually housing hasn't actually been integrated—housing and social care. It's been more health and social care.

So, my two questions are, firstly: social housing partners at the forum last week had very different experiences of whether they were involved or not in the regional partnership boards. Can you confirm that they will be involved, and how that will happen, how that will progress in terms of taking forward decisions on the integrated care fund? And also, another point that was made very strongly: can we ensure that the housing element of the intermediate care fund doesn't run from one good, but time-limited, funding announcement, but is sustained for the longer term planning?

Photo of Elin Jones Elin Jones Plaid Cymru 7:18, 26 June 2018

It's a very clever trick, Jane Hutt, to name-check the Llywydd in your contribution in order to squeeze in two rather than one question. Two quick answers.

Photo of Rebecca Evans Rebecca Evans Labour

Okay, I will be brief. I just want to recognise that, as other Members have said, there is genuinely cross-party interest and support for this agenda, so I think it's only fair to recognise that.

In terms of the social housing partners and the housing sector on those regional partnership boards, it is true to say that their voice has been heard very well on some of those regional partnership boards as kind of associate members but not statutory members, but then, in other regional partnership boards, housing feels frustrated, I think, that they haven't had their voice heard. So, that's one of the reasons why we have taken the decision to put housing as statutory partners on those regional partnership boards, to make sure that they get the credit that they deserve on those boards, but also get the strong voice and are taken as seriously as they should be, given how important the capital element is to this and how important we see housing in terms of supporting people's good health and well-being.

In terms of the funding, this is a three-year funding arrangement, so it will be £30 million for this year, £35 million for the following year, and £40 million for the year after that. This should be able to give regional partnership boards the opportunity to plan forward with that. We've written to the regional partnership boards today, outlining their indicative allocations for each particular region.

Photo of Mark Isherwood Mark Isherwood Conservative 7:20, 26 June 2018

I have one comment and a straight question. I was delighted to see that the need for housing to be put at the heart of health and social care and broader community regeneration is acknowledged—a point I was banging away on back in 2003 in this place, when there were warnings that if urgent action wasn't taken, Wales would face the housing supply crisis that we now have. 

But, moving on, two weeks ago, I chaired the cross-party group on disability and I wondered how you respond to the findings presented to us by the Equality and Human Rights Commission on 'Housing and disabled people: Wales's hidden crisis'. I'll just give three of them: how do you respond to their findings that there's no target in the Welsh Government's 20,000 affordable housing target by 2021 for accessible homes, that only one out of 22 local authorities have set a percentage target for accessible and affordable homes, and that only 15 per cent of local authorities in Wales said that the information they had about disabled people's housing requirements was 'good'?

Photo of Rebecca Evans Rebecca Evans Labour 7:21, 26 June 2018

Thank you for very much for those questions and comments, and I very much recognise the report to which you referred. We have asked our officials to explore that report to see what more we can be doing to ensure that we are building housing that is accessible to people. Certainly, housing that is built, or other accommodation that is built, through our integrated care fund would be very cognisant of the fact that it's supporting older people and people with complex needs and so on, and that it will need to be tailored to the needs of those individuals. But I think we also have to remember that we do have the Welsh quality housing standard that applies to the social rented sector here in Wales. By 2020, all of our local authorities and all of our registered social landlords will have met that standard. I think that does set the bar really in terms of ensuring that housing is of a good quality here in Wales, but I do recognise the seriousness of that report and the need to ensure that we do more in terms of accessibility.

Photo of Elin Jones Elin Jones Plaid Cymru 7:22, 26 June 2018

(Translated)

Thank you, Minister, and that brings today's proceedings to a close.

(Translated)

The meeting ended at 19:22.