Forms and functions: assessing housing need in the community care context

The National Health Service and Community Care Act of 1990 has been criticized for its marginalization of housing issues. This marginalization, although corrected in part by subsequent guidance and research (for example Department of the Environment/Department of Health 1992, Department of Health 1993, Arnold & Page 1992) has perpetuated a lack of understanding about housing issues amongst those involved in community care assessments. The initial failure to involve housing organizations has had unfortunate results in terms of integrated approaches to community care issues. There has been a situation of poor communication and lack of comprehension of different working practices and priorities which is only now beginning to be overcome. Little is known about the assessment of housing need in the community care context, although it seems likely that it is driven by the perceptions and values of organizations, rather than any real understanding of individual need. In order to understand these issues more fully a research project was set up to investigate the assessment of housing need by both housing organizations and social work teams located in community and hospital settings. Interviews were conducted with a wide range of professionals; generalist and specialist housing workers, care managers, social workers, occupational therapists and health professionals. In addition observations were made of the assessment process, and users and user groups were consulted. The results suggest that professionals have different approaches to housing need, driven by procedures, practices and professional grounding in place before the implementation of the community care legislation, but that awareness is growing about the limitations of these existing approaches, and the need to develop greater insight. The most holistic approach to housing needs assessment was evidenced in planned discharge from long stay hospitals, where there was evidence of an integrated approach, examining all aspects of the significance to individuals of house as home.