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Purpose -In December 2010, the Ministry of Justice published Breaking the Cycle: Effective Punishment, Rehabilitation and Sentencing of Offenders, the Government's Green Paper on criminal justice reform. This paper seeks to discuss the implications of this Green Paper on housing for offenders.Design/methodology/approach - This paper examines the proposals set out in the Green Paper, and in particular the intention to deliver rehabilitative services on a payment-by-results basis, and discusses its implications for housing for offenders.Findings - The paper argues that the Green Paper is primarily focused on improving rehabilitation and reducing re-offending, and that improved access for offenders to housing is essential if this is to be successful. However, it demonstrates that there are significant barriers to be overcome in achieving this and argues that criminal justice service providers and housing providers will need to work together to ensure that these issues are addressed.Originality/value - The governments proposals to reform the criminal justice system, contained in the Green Paper Breaking the Cycle, are focused primarily on rehabilitation. Improved access for offenders to appropriate and sustainable housing is essential if this is to be successful, as the Green Paper recognises, and a combination of some specific measures and a general move to payment-by-results for rehabilitation services is intended to deliver this. However, there are significant barriers to overcome in achieving this and further challenges are presented by cuts in services and changes to housing and welfare policy. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the lived experiences of key stakeholders working with homeless people during the implementation of universal credit during the austerity years. Design/methodology/approach: The literature on austerity reveals welfare reforms' impact on support services staff. Service providers' perceptions of the impact of austerity-led policies and welfare reform via nine interviews with people working in homelessness organisations in Brighton and Hove in the UK. Service providers see the situation for their service users has gotten worse and that the policies make it more difficult to extricate themselves from their current situation. Three central themes relating to the impact of austerity-led welfare reforms were, namely, Universal Credit: the imposition of a precarious livelihood on welfare claimants; a double-edged sword: "If people are sanctioned: people can't pay"; and "Hard to maintain my own mental equilibrium". Findings: More precisely, this paper captures service providers' perceptions and experiences of the impact of austerity-led policies on their services and how they believe this, in turn, impacts their clients and their own lives. Research limitations/implications: The dimension cuts across service provision to vulnerable people and is intertwined with health and well-being outcomes. Austerity is detrimental to the health of service users and their clients. It is known that when it comes to the health and well-being of the most vulnerable, who have suffered most from the impacts of austerity policies. However, in times of open austerity, it falls also on those trying to ease their suffering. Originality/value: The data suggest that policies were developed and accentuated by austerity, which led to the stripping of welfare support from vulnerable people. This process has impacted the people who rely on welfare and service providers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to consider how a South East project approached systems change to improve unsupported temporary accommodation (UTA) and the changes made for people experiencing multiple disadvantage ("multiple and complex needs"). This paper also covers some matters that are hard to change or uncertain, such as housing shortages and financial constraints. The paper focuses on a case study of the East Sussex Temporary Accommodation Action Group (TAAG) – a multi-agency action group. Design/methodology/approach: A qualitative case study involving a thematic analysis of seven semi-structured interviews, with a review of published literature and internal documentation. Findings: This example of setting up a TAAG shows us the value of having a dedicated forum to look at a part of the system that requires changing and to identify what works well. Creating a collaborative and democratic space with a common purpose brings different stakeholders and perspectives together and opens discussions to new ways of working. Equalising partners creates an opportunity to create change from the bottom-up within a system traditionally governed by statutory bodies. This study found that the TAAG has facilitated learning around trauma-informed practice and nurtured more sustainable changes towards a Standards Charter and women-only safe UTA. Originality/value: This is one of the first qualitative case studies of a local systems change approach to improving UTA for people experiencing multiple disadvantage in East Sussex. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to remove the self-evidence of the concept of severe and multiple disadvantage (SMD) by drawing upon a historical as well as a critical perspective to show its contingency. Design/methodology/approach: This paper will introduce the concept of SMD by examining how it has come to be understood in the way that it has. This paper does so by exploring key texts which have informed the development of the concept as well as its conceptual near neighbours such as "multiple needs". This paper traces some advancements of the concept within practice and further research with a focus on the Fulfilling Lives programme and the Lankelly Chase Foundation. Finally, the author reflects critically upon the concept and the manner in which the concept has become operationalised. Findings: This analysis demonstrates how a particular definition of SMD has come to dominate over the past few years because of the research and practice of key organisations. On the one hand, this has further marginalised alternative definitions and ways of working, but on the other hand these stakeholders have been able to influence the way in which UK policy has taken up the concept within its governmental priorities. Originality/value: To date, research has taken the term SMD for granted which limits the ability to critique its definitions and applications. This is an important and timely contribution because concepts are all-too-often taken for granted and at a pivotal moment when SMD has become nationalised through policy, critique is a political, potentially transformative, act. [ABSTRACT FROM AUTHOR]

Purpose: The Inspiring Change Manchester (ICM) programme has aimed to improve outcomes, including employability, for people experiencing multiple disadvantage in Manchester. This paper aims to compare learning from the ICM partnership with wider literature to demonstrate what helps people with experience of multiple disadvantage to achieve training, volunteering or work outcomes and what may prevent this. Design/methodology/approach: Semi-structured interviews with people with experience of multiple disadvantage and employers in Manchester working with this group were thematically analysed, and the findings were compared to wider literature, previous ICM research and programme data. The primary research took a peer research approach. Peer researchers co-designed the topic guides, co-facilitated interviews where possible and helped to identify key themes. Findings: Entering and succeeding in training, volunteering and/ or paid work has many positive impacts for people experiencing multiple disadvantage. Ongoing and better awareness raising will be key for more individuals to benefit from such pathways, alongside accessible recruitment processes. Continuous personal and professional development opportunities are important to positive experiences, as is organisational culture. Short-term contracts arose as an issue in the research, more needs to be done to support people with experience of multiple disadvantage into secure work. Originality/value: Although there is a range of literature on good practice and challenges to enable people to engage in training or employment, this often focuses on a particular characteristic or need, rather than experiences of people facing a combination of interrelated needs. This paper also includes first-person lived experience voice, rather than this perspective being interpreted through a particular lens. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present insights into the way in which system change can be activated around the provision of services and support for people experiencing multiple disadvantages in an urban setting. Design/methodology/approach: This paper is informed by a thematic analysis of reflections, reports, learning logs, interviews and experiences of those "activating" system change in the Golden Key partnership in Bristol between 2014 and 2021. Findings: Four themes are identified, including "creating the conditions for change", "framing your involvement", "investing in relationships" and "reflective practice and learning". For each of these, an illustrative vignette is provided. Practical implications: Practical recommendations and reflective questions are provided with suggestions of further considerations for applying this approach in different contexts. Originality/value: This paper describes an original approach of activating and supporting people to do system change to improve the lives of people facing multiple disadvantages. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to review the history and current state of provision of homeless medical respite services in the UK, drawing first on the international context. The paper then articulates the need for medical respite services in the UK, and profiles some success stories. The paper then outlines the considerable challenges that currently exist in the UK, considers why some other services have failed and proffers some solutions.Design/methodology/approach The paper is primarily a literature review, but also offers original analysis of data and interviews, and presents new ideas from the authors. All authors have considerable experience of assessing the need for and delivering homeless medical respite services.Findings The paper builds on previous published information regarding need, and articulates the human rights argument for commissioning care. The paper also discusses the current complex commissioning arena, and suggests solutions.Research limitations/implications The literature review was not a systematic review, but was conducted by authors with considerable experience in the field. Patient data quoted are on two limited cohorts of patients, but broadly relevant. Interviews with stakeholders regarding medical respite challenges have been fairly extensive, but may not be comprehensive.Practical implications This paper will support those who are thinking of undertaking a needs assessment for medical respite, or commissioning a new medical respite service, to understand the key issues involved.Social implications This paper challenges the existing status quo regarding the need for a "cost-saving" rationale to set up these services.Originality/value This paper aims to be the definitive paper for anyone wishing to get an overview of this topic. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report on a scoping review of the advantages and challenges of extra care housing (ECH) provision in the UK for people living with dementia. Access to suitable housing is a fundamental right for people living with dementia and can enable people to live as well as possible (Twyford and Porteus, 2021). Understanding the advantages and disadvantages of different models of housing with care has been identified as a research priority by people living with dementia (Barrett et al., 2016) but "there is no current consensus on the best model of specialist housing for people with dementia" (Twyford and Porteus, 2021, p. 29). Design/methodology/approach: This scoping review identifies the advantages and disadvantages of living in ECH for people with dementia. It is the preliminary stage of a study that seeks to develop knowledge about different models of ECH for people living with dementia (Atkinson et al., 2021). Findings: Advantages include the promotion of independence, flexible staffing, safety and security, social inclusion, physical design and integrated service provision. Disadvantages include barriers to entry, tensions between independence and support, managing advanced dementia, resourcing flexible care, managing social exclusion, loneliness and stigma and a disabling environment. Research limitations/implications: The scoping review reinforces the need for further research into different models of ECH provision in the UK for people living with dementia. The review provides insight that is of benefit to all stakeholders involved in ECH and contributes to the development of evidence-based provision called for in the recent All Party Parliamentary Group inquiry (Twyford and Porteus, 2021). Originality/value: This scoping review summarises the current position for people living with dementia in ECH. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide a supply-side review of policies and practices that impact on the shortage of supply in the contemporary specialist housing market for older people in the UK.Design/methodology/approach The review is based on a review of academic literature, policy documents, reports and other sources.Findings There is a critical conflict between the key social purpose of specialist housing (i.e. living independent of socially provided care) and the values that underpin and ultimately limit the quantity of units in both the social and private sector. In the social sector, government policies prohibit rather than encourage local authorities and housing associations from increasing specialist housing stock. The nature of leasehold tenures in the private sector tends to commodify not only housing stock but also those who use it and therefore acts to instrumentalise housing supply in favour of the profit motive and the focus on the person and her or his needs is largely ignored.Originality/value While the shortage of specialist housing is well known, this paper is unique in that it provides a comprehensive and critical supply-side review of the factors that have created such conditions. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to present a case study about the Team Around Me (TAM) model of case coordination which was developed by Fulfilling Lives Islington and Camden (FLIC) as an action experiment. The model is a standardised tool for running case conferences for clients experiencing multiple disadvantage (MD). Design/methodology/approach: Deploying a case study approach, this study explores why a TAM-coordinated approach is beneficial for people experiencing MD. Findings: The authors explore why the need for effective case coordination is integral for clients experiencing MD, and how current structures fail to facilitate effective case management. The authors put forward an argument for the four core principles underpinning the TAM model: strengths-based, action-focussed, systems thinking and client involvement. The barriers to embedding and upscaling this approach are discussed, alongside the obstacles presented by the wider system that prevent wider implementation. Originality/value: The TAM model is a new approach to case conferences, designed and upscaled by FLIC, and has since been adopted across two London boroughs, and training has reached services across the UK. This paper highlights the need for innovative approaches to case coordination that centre client involvement, promote a strengths-based approach and recognise system blockages as a key barrier to client progress. [ABSTRACT FROM AUTHOR]

The Government's 2005 Green Paper on Adult Social Care put forward a vision of 'independence, well-being and choice'. While the notion of independent living was central to the vision and to the substantive policy proposals presented in the Green Paper, there was no definition of what 'independent living' actually means. The British Council of Disabled People supports many of the ideas in the Green Paper, such as the proposed introduction of individualised budgets. It also has concerns about the continuing lack of basic rights to receive support and to live independently in one's own home, and about the way in which the new vision will be financed and implemented. [ABSTRACT FROM AUTHOR]

Purpose: Social impact bonds (SIBs) have become a favoured way to fund public services, including housing, prison and homelessness projects, in an era of austerity. In a growing critical literature on SIBs, a largely absent voice is that of the link worker. This paper aims to focus on the views of link workers in a SIB funded project which works with long-term entrenched rough sleepers in the East of England. Design/methodology/approach: Interviews with link workers were conducted with a thematic analysis echoing many of the views expressed in the critical literature not only about the problems but also some of the advantages that SIBs offer to this type of project. Findings: Three key themes were discomfort with the funding mechanism; flexible and innovative interventions that SIBs make possible; and problems with the outcome measures that trigger payments. This study concludes that if SIBs are to achieve their promise of providing funding which leads to effective solutions to deeply ingrained social problems, there needs to be more careful evaluation of their true benefits in comparison to publicly funded projects, adoption of more appropriate and project-specific outcome measures and a much clearer explanation and justification of the way in which SIB funding works. Originality/value: Few studies have specifically explored the perceptions of front-line link workers in the homelessness sector. This study highlights not only the concerns but also the benefits associated with the use of SIB as a funding mechanism within the homelessness sector. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine the recent evidence relating to green (nature-based) dementia care for people living with dementia in long-term accommodation and care settings (housing for older people that provides both accommodation and care, such as residential care homes, nursing homes and extra care housing schemes). The review formed part of a pilot study exploring interaction with nature for people living with dementia in care homes and extra care housing schemes in the UK. Rather than a comprehensive systematic or critical literature review, the intention was to increase understanding of green dementia care to support the pilot study. Design/methodology/approach: The review draws together the published and grey literature on the impacts of green (nature-based) dementia care, the barriers and enablers and good practice in provision. People living with dementia in accommodation and care settings are the focus of this review, due to the research study of which the review is part. Evidence relating to the impacts of engaging with nature on people in general, older people and residents in accommodation and care is also briefly examined as it has a bearing on people living with dementia. Findings: Although interaction with the natural environment may not guarantee sustained wellbeing for all people living with dementia, there is some compelling evidence for a number of health and wellbeing benefits for many. However, there is a clear need for more large-scale rigorous research in this area, particularly with reference to health and wellbeing outcomes for people living with dementia in accommodation and care settings for which the evidence is limited. There is a stronger evidence base on barriers and enablers to accessing nature for people living with dementia in such settings. Research limitations/implications: The literature review was conducted to support a pilot study exploring green (nature-based) dementia care in care homes and extra care housing schemes in the UK. Consequently, the focus of the review was on green dementia care in accommodation and care settings. The study, and thus the review, also focussed on direct contact with nature (whether that occurs outdoors or indoors) rather than indirect contact (e.g. viewing nature in a photograph, on a TV screen or through a window) or simulated nature (e.g. robot pets). Therefore, this paper is not a full review of all aspects of green dementia care. Originality/value: This paper presents an up-to-date review of literature relating to green dementia care in accommodation and care settings. It was successful in increasing understanding to support a pilot study exploring opportunities, benefits, barriers and enablers to interaction with nature for people living with dementia in care homes and extra care housing schemes in the UK. It demonstrated the impacts, value and accessibility of nature engagement in these settings and identified gaps in the evidence base. This review and subsequent pilot study provide a strong platform from which to conduct future research exploring green dementia care in accommodation and care settings. [ABSTRACT FROM AUTHOR]

Purpose -- Changes in the UK social care sector over the past 20 years have effected a fundamental shift in commissioning and delivery relationships. This "quasi-market" challenges existing theory and models around competitive advantage. This study, as outlined in two earlier articles, addressed weaknesses in the defining framework for analysis and business planning in this new environment; the purpose of this concluding paper is to propose a new perspective for those interested in entering this market. Design/methodology/approach -- The original research comprised a constructive research approach through a single holistic case study, using qualitative research methods including document analysis, interviews, secondary data, observations and facilitated meetings. Findings -- This final paper offers a structured framework of analysis and response: the External DriversModel. Research limitations/implications -- The model was developed for a scenario impacting upon a social housing agency, with ambitions to enter this market as a new provider; it may require further research to establish its generalisability to other organisations and other sectors. Originality/value -- This series of three papers adds to existing knowledge by critiquing current business models, and positing a potential development to existing contingency theory: the External Drivers Model. The study has resulted in a number of outputs including an outline of tools to assist in using the model. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to review the management of the (accessible) social housing stock as a means to achieve a cost effective solution to meeting the needs of an ageing population. The paper examines the costs and effectiveness of an accessible housing register (AHR) as the primary means social landlords have to utilise accessible housing stock efficiently. Design/methodology/approach – The paper examines the cost effectiveness of the most advanced AHR in the UK. The data for the study was collected in 2009 (costs/expenditure quoted relate to that year) and is derived from a combination of interrogating computerised allocation records and the collection of information on costs through interviews with local authority staff. Findings – The concept of an AHR can involve substantial set up costs. The financial analysis to assess their cost effectiveness proves complex but suggests that an efficient full register could be more than justified in these terms if it led to a reduction in costs, through the removal of the need for a relatively small number of adaptations in the first years of a tenancy. Originality/value – This is the first study that assesses the financial case for AHRs. [ABSTRACT FROM AUTHOR]

Purpose This paper is a conceptual discussion of the marginalisation of the voices of older lesbians, gay and bisexual (LGB) women, within the collective discourse of “older LGBT* housing”. The purpose of this paper is to critically interrogate its (in)equality implications and to consider ways in which they might be overcome.Design/methodology/approach This is a conceptual discussion that draws on the social justice model of equality developed by Nancy Fraser, specifically the domains of resources, recognition and representation.Findings The housing needs, wishes and concerns of older LGB women are often marginalised while at the same time those of older gay men are privileged. Older LGB women’s preferences for gender- and/or sexuality- specific housing are silenced within collective homogenising discourse – by researchers and activists alike – which mobilises a “mainstream” or “LGBT*-specific” binary about housing options.Research limitations/implications Research findings which do not include the voices of older lesbian, gay and bisexual women are inherently flawed. There is a need to ensure their voices – across the older age spectrum – are included.Practical implications The voices of older LGB women in relation to older age housing need to be better heard so that they can be better resourced.Social implications The marginalisation of older lesbian, gay and bisexual women’s voices in relation to older age housing has profound equality and human rights implications.Originality/value Critical discussions about the gendering of older LGBT* housing discourse are long overdue. This paper seeks to open a dialogue about these important issues. [ABSTRACT FROM AUTHOR]

Purpose - Changes in the social care sector over the past 20 years have effected a fundamental shift in commissioning and delivery relationships, creating new markets for social housing services. This paper aims to examine how far existing theories around competitive advantage in markets are compatible with the new public management (NPM) approach to the market, or whether there is a need for a new approach to business planning for agencies that addresses the particular characteristics of this specific quasi-market. Design/methodology/approach - This paper draws upon original research developed through a single holistic case study of a UK social housing service, using qualitative research methods including document analysis, interviews, secondary data, observations and facilitated meetings. Findings - Existing business theory and models around competitive advantage do not suit this "contrived" NPM market. A new framework or model will be needed for analysis and business planning in this new environment. Originality/value - This paper adds to existing knowledge by critiquing current business models, and positing a potential development to existing contingency theory: the external drivers model The study has resulted in a number of outputs including an outline of a toolkit to assist in using the model. The model requires further research to establish its generalisability to other organisations and other sectors. [ABSTRACT FROM AUTHOR]

Purpose – Using some case examples from Care & Repair England in the UK, this paper aims to focus on the integration of housing help in a hospital setting. Design/methodology/approach – The paper gives some background on Care & Repair and the development of local housing and hospital linked projects. The broader debate about the role of housing is then considered. Findings – Key recommendations from the case studies are discussed and the wider debate on improving integration is considered in relation to the UK Government's recent Care and Support White Paper. Originality/value – The paper considers the role that housing plays in health and social care provision and why people engaged in the sector should continue to work towards better integration of housing, health and social care. [ABSTRACT FROM AUTHOR]

Purpose - This paper aims to illustrate realities of homeless people's lives during a time of significant change in UK public sector funding and welfare policy. Design/methodology/approach - A participatory research approach was used including working with two co-researchers; two people who have direct experience of homelessness. A sustainable livelihoods approach was adapted to provide a framework for analysis. The research was undertaken during May to October 2011. Findings - The paper interrogates five areas of assets held by people themselves that support sustainable livelihoods, an existing approach used in other research. Life journey narratives show that a connected range of services, operating through an empowerment model, promote human dignity. Research limitations/implications - Findings resonate with issues identified in larger studies; however, as the funding and policy context is rapidly changing it is recommended that additional local qualitative studies could be conducted during the next three years to illustrate impacts in people's lives. Practical implications - The paper suggests front-line services must include resettlement as well as crisis and stabilising services in order to ensure homeless people can successfully move from home to home. Social implications - The research identified negative attitudes towards homeless people. By illustrating homeless people's achievements the study provides evidence of the impact of, and the value of continuing to fund, homeless services. Originality/value - The paper suggests that people who have experienced homelessness achieve a successful life with support by drawing on their considerable life experience and personal talents. This message is important for practitioners, commissioners and policy makers working through a period of change for homeless services. [ABSTRACT FROM AUTHOR]

Purpose Professional partnerships between housing and health are not impossible, but they take time, commitment and dedicated strategic leadership. The language and culture of the two sectors are sometimes complex and do not always match. There can be issues understanding each other's motivation, ethics and terminology which can cause a barrier when working together. The purpose of this paper is to share the journey of how Wakefield District Housing (WDH) is working with the care and health sector to create sustainable partnerships that benefit both parties, getting to a stage where they could successfully integrate with healthcare providers in the Wakefield district.Design/methodology/approach The paper offers the reader an overview of how WDH's membership of the Wakefield Health and Wellbeing Board enabled improved partnership working with NHS and other members, including the establishment of a Housing, Health and Social Care Partnership, the employment of dedicated senior staff, co-located multi-disciplinary teams and joint design of new services.Findings WDH has demonstrated that the organisation understands the challenges facing NHS colleagues, has acknowledged the complexities of the system that their partners work in and looked for solutions alongside them. The opportunities within partnership working are boundless and, if successful, the outcomes for tenants and the wider Wakefield population could be in excess of those envisaged in planning the project. Partnerships will almost inevitably encounter challenges along the way but if all partners keep their own and shared visions in mind, further success is within reach and all parties will get there faster by not going alone.Practical implications The paper offers useful guidance and ideas for other housing organisations aiming to improve their contribution to local integrated healthcare.Originality/value This paper provides an original perspective from inside the programme, offering practical, comprehensive and deliverable initiatives to improve health outcomes for local communities. [ABSTRACT FROM AUTHOR]

Purpose The 2017 Naylor Review has been the subject of some controversy, with some of the press, social media and other critics portraying its recommendations as a "fire sale" or privatisation of the NHS. The purpose of this paper is to examine preceding reports into efficiency and best value of the NHS, the evidence behind the review recommendations, and analyse data into housing affordability for the capital's NHS staff. It concludes by advocating for partnerships with housing associations to deliver social and financial value by utilising redundant NHS land to deliver the affordable housing that London and the rest of the UK so urgently needs.Design/methodology/approach The paper was developed using the content analysis of preceding independent reviews of NHS efficiency, published critiques of the Naylor Review and analysis of NHS produced data to consider the potential savings and opportunities for reinvestment in capital projects.Findings The paper identifies existing partnership models and examples of good practice and advocates the adoption of joint ventures and other forms of partnership to ensure that both best value is achieved from the sale of NHS assets, and publicly owned assets are reused for social purpose.Originality/value The paper uses existing data, analysis and context to map a route for achieving best value in managing the publicly owned asset base and reinvesting the proceeds of the sale of redundant properties into UK public services. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to explore the operationalizing of a philosophy of humanization of hostel care and the challenge to such development presented by the proposed adoption of the "housing first" approach ("Chez Soi D'Abord") in Paris. Design/methodology/approach -- The paper is a translation of the transcript of an address given by the author to a symposium of psycho-analytic therapists working with the homelessness resettlement services in their quarter of Paris. It is a narrative of service development, described in some practical detail, with philosophical and psycho-analytic depths. Findings -- A philosophy of care and social education is replacing the philosophy of surveillance that had characterized earlier development of hostels. Psycho-analytic concepts, based on the writings of Lacan, help to understand the importance of addressing the profound psycho-social dislocation of individuals subject to the implicit violence of their situation. Originality/value -- This is the first known paper in print and in English to describe the development of a psychologically informed environment in homelessness resettlement in France. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to give an account by a rehabilitation psychiatrist of many years of involvement in shared housing for former long-stay hospital residents and other long-term mental health service users. Design/methodology/approach -- The paper offers a personal view based on developments in one locality of East London, blending case study narrative with cited earlier published papers that confirm and/or give greater detail on specific aspects of the experience gained. Findings -- Long-term mental health service users, given the opportunity via shared housing to develop more lasting and natural relationships, proved to have social and interactive capacity that was obscured by both the conditions of hospital wards and by isolating accommodation "in the community". The experience provides lessons for a better understanding of patients' problems. Practical implications -- Shared housing is often seen as simply a poor substitute for independent living; but the experience recounted here suggests that shared living may have particular value for some client groups. Originality/value -- The housing developments and the associated research remain unusual and of potential value for planners of long-term services. [ABSTRACT FROM AUTHOR]

Purpose -- Appropriate housing for the growing population of older adults is becoming an international concern. The purpose of this paper is to report on a review of UK and international literature carried out as part of a project exploring the commissioning and delivery of social care in housing with care settings. The paper also considers housing with care in the context of UK policy and practice. Design/methodology/approach -- The peer literature review process used a range of academic databases as well as government and third sector web sites, drawing on relevant material in English published from 1990 to 2012. Findings -- Findings are presented within three main themes: how care and support is provided; the role of the built environment; and the benefits for resident well-being. The review found a paucity of literature focusing specifically on care and support in housing with care settings, particularly in terms of how social care is delivered, but the evidence base suggests that housing with care is in a strong position to deliver on most if not all UK government aspirations. Practical implications -- Despite a growing literature both in the UK and internationally exploring the characteristics and benefits of housing with care for older people, substantial gaps remain in the research evidence. Originality/value -- This paper presents an up to date review of the housing with care literature in the context of current UK policy. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore whether handyperson services are able to meet the needs of diverse groups of older people, specifically in the UK policy context, to meet the requirements of the Equality Act (2010). Design/methodology/approach – The scoping review of the literature was conducted in 2012 using a wide range of literature from the UK. Findings – In an under-researched field it is difficult for policy makers to determine whether handyperson schemes and their associated services are accessible to and being used by all sections of the older population. Schemes do not generally collect and report data about their users. Research limitations/implications – The scoping review concentrates on UK literature. There are a variety of handyperson schemes and they operate in different ways with different criteria and priorities. Some of the accounts of handyperson schemes provide little data about user characteristics. Practical implications – The paper suggests how handyperson schemes may be able to meet the requirements of the Equality Act (2010) by outlining what data are needed and approaches to gathering it sensitively and proportionally. Originality/value – The paper is the first to consider the implications of the Equality Act for handyperson schemes, which may be relevant to other housing and care services. [ABSTRACT FROM AUTHOR]

Purpose This paper considers the challenges and solutions in relation to older lesbian, gay, bisexual and trans (LGB&T) housing in the UK. The purpose of this paper is to identify the key housing issues and concerns affecting older LGB&T people in the UK, and ways in which these might be addressed.Design/methodology/approach This is a practical discussion which focusses on the issues of policies and provision in relation to older LGB&T housing in the UK, both specialist and mainstream housing.Findings There is a growing body of literature from both the voluntary sector and academic researchers highlighting the housing issues affecting older LGB&T people. There is a need for both specialist and appropriate mainstream housing provision. However, policy and funding issues constrain the creation and/or development of such provision.Practical implications Policy makers and housing providers in the UK need to address, and meet, the diverse housing needs of older LGB&T people.Social implications Until their housing needs are met, many older LGB&T people remain concerned about their housing futures, and may end up living in housing which is not their preference and which is not suitable for them.Originality/value This paper is the first to provide a comprehensive overview of the work of Stonewall Housing’s network for older LGB&T people, and the challenges and solutions which have been identified in relation to their housing issues and concerns. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to consider the legacy of Octavia Hill in the UK, one of the early pioneers of what is now called social housing. Design/methodology/approach – The paper sets out the background of Octavia Hill, and the context in which she operated before moving on to a discussion about the current relevance of her work. Findings – In the centenary year (2012) of the death of Octavia Hill her work has come under some criticism. The authors consider this and seek to defend her reputation, pointing to the many ways in which her work and thinking anticipated the lessons still being learned today in the management of social housing. Originality/value – The paper gives an account of the achievements of Octavia Hill and evidences their relevance to modern social housing. [ABSTRACT FROM AUTHOR]

Purpose -- This paper aims to offer a commentary on Psychologically Informed Services: A Good Practice Guide, a recently published operational guidance document on developing psychologically informed environments (PiEs) in services for homeless people. Design/methodology/approach -- The paper is an invited opinion piece and comment based on the author's specialist knowledge gained from undertaking research addressing the experiences and needs of young runaways. Findings -- The new operational guidance is welcomed but should be extended so that psychologically informed environments are provided in services for young runaways under the age of 16, who often encounter abuse, mental health issues and problematic substance misuse and experience homelessness post 16 and into adulthood. Originality/value -- Commissioners and practitioners should encourage the development of psychologically informed environments for young runaways to meet their needs, aid recovery and reduce the likelihood of experiencing homelessness as they move into adulthood. [ABSTRACT FROM AUTHOR]

Purpose -- This paper aims to offer a commentary on Psychologically Informed Services: A Good Practice Guide, a recently published operational guidance document on developing psychologically informed environments in services for homeless people. Design/methodology/approach -- The paper is an invited opinion piece and comment based on the specialist experience and viewpoint of the author as a clinical psychologist working in a primary care mental health service for homeless people, The Wellbeing Service in Bristol. Findings -- The paper is an account of the Wellbeing Service with a mixture of paid staff and volunteers, some of whom are experts by experience. The approach is outlined, with a description of a number of individual, group work and other engagement opportunities offered at various potential entry points. The pathway is then illustrated through the example of one individual, told largely in his own words. Originality/value -- The journeys of recovery are not straightforward and are rarely linear and services need to work hard to ensure that we engage people at the point where they currently are, allowing for them to drop out but, crucially, enabling them to return. Keywords Psychologically informed environments, Pathways, Entry points, United Kingdom, Homelessness, Public health [ABSTRACT FROM AUTHOR]

Purpose – This paper gives an account of the development and pioneering management practices of a community-owned and managed agency, Walterton and Elgin Community Homes (WECH), locating these in the context of continuing concerns and emerging aspirations over the role of social housing, with developing UK national policy and a proposed statutory "Right to Transfer" for tenants. Design/methodology/approach – This report provides a narrative of the recent development of social housing policy development and the evolving practice of WECH. This is the essential historical and social policy background to a recent study into the health and well-being benefits of empowerment through community ownership of social housing. This first paper refers to and discusses the wider implications of the data collected during the well-being research and literature review, indicating that the population of the WECH estates experience a sense of belonging, and of being involved, which contrasts markedly with statistics for comparable populations in comparable areas of deprivation. Further analysis of the key findings of the original study will be published in Part two. Findings – The benefits of more community-owned services include the more efficient and holistic management of properties. Community-based, resident-controlled housing associations offer a secure foundation for building in additional services as part of the continued drive to devolve public services to the local level, including hosting of a substantial range of community services, for example the reintegration of the Police into the community. The principle of community ownership of council estates is also valuable in its own right for informing the direction of housing management and policy and where to target effort. The experience and practice of WECH supports the proposition that community ownership of social housing may be an exceptionally effective means for improving and sustaining wellbeing in poor neighbourhoods. Research limitations/implications – This paper argues that Government policy should actively support mass mutualisation as a means for improving wellbeing on council/social housing estates and for empowering poorer communities to take greater responsibility for their welfare. Regardless of the extent of mutualisation, many of the practices involved are transferable to non-mutual social landlords, and may be seen as markers of good practice for agencies intending to taken on social housing via transfer. Originality/value – There is continued interest in the transfer of social housing stock to new provider agencies. WECH has been the only large-scale statutory transfer until now of council housing in England and Wales to a mutual, community-owned housing association. WECH's experience is especially relevant for evidencing the significant advantages governments could obtain through encouraging many more transfers of council estates to community housing associations. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to describe a novel collaboration between a worker and a former service user in developing two support groups – an art group and an "alcoholics anonymous group" self help group – at a central London "Wet" hostel for the homeless. The paper seeks to explore the issues raised for both workers in this experience. Design/methodology/approach – The paper is a jointly written case study of innovative and reflective practice. It begins with an overview of policy frameworks and research that promote and advocate inclusion practice; then gives an account of the origins and development of the collaboration initiative; and concludes with reflections from each of the participants on what they have gained from the experience. Findings – The main challenge for professionals lies in the need for "self-reflective" practice and to challenge their own personal investments in the maintenance of their professional role and status. For ex-service users, the challenge is to overcome low self-confidence, the safety of the all-too-familiar "service user" role, and to realise that, despite real obstacles, a productive, useful contribution can be made to society. This can therefore be seen as a journey for both parties. Social implications – Working with multiple exclusion homelessness can leave professionals feeling isolated and deskilled, leading people with complex needs to be further excluded from services that feel that they do not fit their criteria. Tackling these issues requires time for reflection on the personal issues raised. Originality/value – The paper provides unique learning and insight into the development and running of support groups, resulting from the novel collaboration between a worker and a former service user. [ABSTRACT FROM AUTHOR]

Purpose - This paper aims to outline the development of a new approach, using environmental design and non-drug-based interventions to support individuals with dementia to live independently and safely in their own homes. Although in its infancy, this approach is beginning to show how it can help to improve the mood, socialisation, and short-term memory of people with dementia and reduce the need for residential care or hospital admission.Design/methodology/approach - As a case study, this paper is based upon the development teams' observations, complemented by those of other key stakeholders. It first reviews the policy context and evidence for the scale of the problem and some psychological approaches such as reminiscence work, which can alleviate the symptoms. It then outlines the potential in home improvement work in "dementia-proofing" and "retro-fitting", to enhance reminiscence-based "life experience" work. Finally, the approach is illustrated via an individual example.Findings - The results so far - though not formally evaluated - suggest that design-based approaches may add significantly to the effectiveness of psychological management of dementia via reminiscence work; early results suggest a reduction in the "chemical cosh" of medication.Practical implications - This paper describes early developments in a new approach with great potential. In the long-term, it is hoped that this dementia care model can be rolled out for replication in any home improvement agency or social care setting.Originality/value - The impact of dementia is of increasing concern both for individuals and for public budgets. The potential in dementia-friendly environmental design to complement other psychological approaches is an example of the search for more holistic approaches that respect and work with the strengths of the individual, in contrast to purely medical approaches relying on medication and/or institutional care. [ABSTRACT FROM AUTHOR]

Purpose - This paper seeks to describe the development process for the Outcomes Stars as a suite of tools which are designed to simultaneously measure and support change when working with vulnerable people as service users. It describes the original process of development of the first Star, in homelessness services in the UK, and subsequent roll out to other client groups and in other countries. The paper indicates the theoretical and philosophical under-pinning of an approach which aims to embody both research and values-based practice in empowerment and respect for the individual.Design/methodology/approach - As a case study of development by the development team, the paper is based on first-hand knowledge but builds upon extensive consultations with practitioners and users and relates these to the needs and strengths of service users, the contemporary policy framework, and wider research in the field.Findings - The Outcomes Star draws on the core principles of Action Research and Participatory Action Research and extends them beyond research into assessment and outcome measurement. As yet there has been no formal research on the usefulness of the Star approach; but, there is a rapid take up of this approach within the UK and further a field. The paper argues that the approach has proved popular, because the Outcomes Star is rooted in a philosophy that is more in tune with that of people delivering services and more closely reflects the reality of those receiving services, compared to traditional measurement techniques.Practical implications - The paper aims to stimulate further thought and effective practice in measuring outcomes for vulnerable people, and on the most useful means to engage and support people in the co-production of their own futures.Originality/value - Although the development and take-up of the Outcomes Star approach has been rapid in practice, this is the first paper in which these more theoretical and philosophical roots have been outlined and explored in such depth. It will be of use to service providers, to deepen their awareness, and to commissioners, policy makers and regulatory bodies wishing to promote practical approaches to quality assurance of evidence-based and evidence-generating practice. It will also be of interest to moral philosophers and others wishing to understand the translation of values into social practice. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to describe an example of a practical evidence-based approach to improvement in the current climate of funding cuts.Design/methodology/approach - The paper describes synthesizing insights from leadership, change management and psychodynamic theory to inform a practical change programme to develop services that meet the needs of clients more efficiently.Findings - The paper finds that rather than simply doing less - cutting staff or reducing services to meet the constraints of funding cuts - it is worth taking a long term and strategic review approach and doing something quite differently.Practical implications - New ways of working can improve client outcomes and deliver better services and the funding cuts can provide an opportunity to thoroughly re-examine existing provision; but, significant changes will only be accomplished by change processes that pervade the whole organisation - they cannot just be add-ons/afterthoughts. The implications of the new way of working are that: even when funding increases, old ways of practice will not be restored; that the use of theoretical approaches from a variety of disciplines can deliver innovative responses that are likely to be sustainable in the medium term; and to improve service standards and outcomes into the future.Originality/value - This paper finds value by looking to neurobiology, clinical psychotherapy, recovery-oriented practice, change management theory and practice, and client involvement to try to resolve the current housing crisis. [ABSTRACT FROM AUTHOR]

Purpose - The aim of this paper is to comment on current evolving UK policy in public health and social housing; and especially to outline 'blind spots' in conventional health research approaches that have tended to obscure the evidence and potential in collaborative working.Design/methodology/approach - The paper summarises policy developments, in the light of recent relevant research. Mental health is used as an example.Findings - Public health policy in the UK is new and rapidly developing; but the evidence base remains scattered across different disciplines and their various disparate communication channels. Any new public health strategy focussed on health inequalities needs to recognise the role that social housing already plays in supporting concentrations of the more vulnerable. Better recognition of the everyday social and especially mental health problems that social housing staff deal with illustrates the central role of housing management as the defining factor in social housing, and the potential for partnerships with public health.Originality/value - This paper offers a contemporary overview and comment; but it also introduces to the readership recent research findings that shed new light upon the potential in closer alignment of public health and social housing management practice. [ABSTRACT FROM AUTHOR]

Purpose - This paper aims to give insight into the role of a liaison worker.Design/methodology/approach - This paper presents a first person account of someone in the role of Mental Health and Housing Liaison Officer.Findings - The paper offers insight into a day in the life of a liaison worker, including information about how they work and communicate with clients and their various different situations.Originality/value - The paper demonstrates that communication is central to delivering good and appropriate services for clients. Joint working between housing and mental health needs to become the norm, and a role such as this is the fore-runner to what the author hopes will become part of every mental health service in the country. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to take a look at the growth and development of Depaul International, the parent company of a group of charities that work to tackle homelessness around the world, as an international homelessness charity.Design/methodology/approach - The paper looks at the approach of Depaul International and the key role that community networks and local start-ups have to bear on the company's expansion into becoming a global organisation.Findings - This paper shows how the ability to work within a broad network of governments and an international community with grass roots impact has been vital to Depaul International's expansion.Originality/value - Homelessness is an issue that affects people across the world in a variety of ways and it means different things in different cultures. This paper demonstrates Depaul International's response to this issue: not to offer a top down response, but to help local people set up their own independent charities that are governed locally but have the guidance and expertise of the Depaul group, so that together a global response can be offered to homelessness. [ABSTRACT FROM AUTHOR]

This paper builds on previous work applying the concept of well-being to the field of housing. It uses the concepts of self-esteem, efficacy and social identity to explore the situations of a group of young homeless mothers. In particular, it focuses on the impact of well-being factors, among others, in understanding the uptake of education and training services. The paper concludes by arguing that well-being issues are crucial for housing agencies and others who want to engage with young homeless people. [ABSTRACT FROM AUTHOR]

This paper analyses the value of information and advice for older people in making decisions about housing and care, drawing on an evaluation of FirstStop, a new national information and advice service. The paper discusses the housing problems often faced in older age, and the pressures on public finances of housing an ageing population. The Government is trying to engender a shift to early preparation, prevention and self-help, so that older people make changes to their housing and care arrangements before encountering a crisis. The paper considers how older people can resolve their housing issues in more satisfactory and empowering ways, and at lower cost to the state, after receiving appropriate and timely information and advice. It also discusses the problems of funding this type of initiative, given the need to ‘prove’ the value for money of publicly funded services in quantitative terms, when the benefits of information and advice are difficult to monetarise. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive geriatric assessment (CGA) and draw comparisons with general population survey data. Design/methodology/approach: Cross-sectional observational study conducted in a London-based hostel for single PEH over 30 years old in March–April 2019. The participants and key workers completed health-related questionnaires, and geriatric conditions were identified using standardised assessments. Frailty was defined according to five criteria in Fried's phenotype model and multimorbidity as the presence of two or more long-term conditions (LTCs). Comparisons with the general population were made using data from the English Longitudinal Study of Ageing and the Health Survey for England. Findings: A total of 33 people participated with a mean age of 55.7 years (range 38–74). Frailty was identified in 55% and pre-frailty in 39%. Participants met an average of 2.6/5 frailty criteria, comparable to 89-year-olds in the general population. The most common geriatric conditions were: falls (in 61%), visual impairment (61%), low grip strength (61%), mobility impairment (52%) and cognitive impairment (45%). All participants had multimorbidity. The average of 7.2 LTCs (range 2–14) per study participant far exceeds the average for even the oldest people in the general population. Originality/value: To the best of authors' knowledge, this is the first UK-based study measuring frailty and geriatric conditions in PEH and the first anywhere to do so within a CGA-type evaluation. It also demonstrates the feasibility of conducting holistic evaluations in this setting, which may be used clinically to improve the health outcomes for PEH. [ABSTRACT FROM AUTHOR]

Purpose: The purpose this paper is to explore walking with purpose in extra care, retirement and domestic housing settings to better understand and support people living with dementia in these settings, develop recommendations and inform practice. Design/methodology/approach: A mixed-methods study was used: scoping literature review; online survey of extra care and retirement housing managers in the UK; case studies involving interviews with staff and family carers (n = 14) of ten individuals who engaged in walking with purpose in the different housing settings. Findings: Although residents who walk with purpose constitute a minority (0–2 residents), managing walking with purpose can be challenging and time consuming. Distraction or redirection was the most common response. Other strategies included identifying the resident's motivations and accommodating their wishes or walking with them. Culture of care, staff training and dementia-friendly design are keys to effective support for safe walking with purpose. Responses to walking with purpose in the domestic housing settings have raised serious deprivation of liberty issues. Research limitations/implications: This study had a number of limitations. The completed survey questionnaires represent a self-selected sample of extra care and retirement housing settings, and responses are based on the perceptions of the staff members completing the survey. There were a relatively small number of case study sites (three extra care housing and three retirement housing), and it was not possible to interview family members for all of the residents who walked with purpose. Originality/value: This study provides unique data on walking with purpose in extra care and retirement housing setting in the UK. [ABSTRACT FROM AUTHOR]

This paper argues that there is a need for a healthy independent specialist women's refuge sector to address the housing needs of black minority ethnic and refugee (BMER) women. It will consider barriers to equal access that BMER women have and how they could be addressed by specialist services. The paper examines how housing inequality creates additional barriers for BMER women fleeing domestic violence, and provides arguments for the way in which specialist services address inequality from the perspective of race, class and gender. The primary research provides a snapshot of the impact that the lack of access to provision has for BMER women. A case is made for a strengthened independent specialist sector as a way to address the housing needs of women who flee domestic violence. Key recommendations are identified on how housing policies, practices and service provision can be strengthened. [ABSTRACT FROM AUTHOR]

This paper presents the findings of recent research exploring how local authorities are delivering affordable housing through the planning system, focusing on their use of Section 106 (S106) of the Town and Country Planning Act (1990). Policy and practice vary between local authorities. While the amount of affordable housing delivered through S106 has increased, there is pressure on local authorities to improve performance further as affordability has worsened across the country. This paper highlights the issues that local authorities face, and makes some recommendations for good practice. [ABSTRACT FROM AUTHOR]

Purpose -- This paper seeks to offer a commentary on Psychologically Informed Services: A Good Practice Guide, a recently published operational guidance document on developing psychologically informed environments (PIEs) in services for homeless people. Design/methodology/approach -- The paper is an invited opinion piece and comment based on the specialist experience and viewpoint of the author in working with advocacy services in the UK and in the USA. Findings -- The new operational guidance is welcomed, with some provisos. Specifically, any emphasis on training for staff should certainly include an equal weighting on training for service users themselves in order to support positive self-direction and development. Originality/value -- Services that wish to develop as PIEs will need to ensure that service users are fully engaged and enabled through the process to identify their own needs. [ABSTRACT FROM AUTHOR]

Purpose A policy insiders view on the implications of Brexit for housing and welfare in England and Scotland. Why did voters choose to reject the Eu and what happens next as the government prepares for Brexit with no clear route map and growing uncertainty. Will the housing market shrink and what changes lie ahead for housing professionals. The paper aims to discuss this issue.Design/methodology/approach The author provides their viewpoint on Brexit and what is next for Britain.Findings This viewpoint discusses the potential effects of Brexit on the economy, housing, local authorities and so on.Originality/value This paper contains the viewpoint of the author. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide an exploratory account of the links between devolution, homelessness and health in the UK. Specifically, it focusses on the policy context and governance structures that shape the systems of healthcare for homeless people in London, Scotland, Wales and Northern Ireland.Design/methodology/approach Empirically the paper draws on semi-structured interviews with a small sample of policy and practice actors from the devolved territories. Qualitative interviews were supplemented by a comparative policy analysis of the homelessness and health agenda within the devolved regions. Theoretically, it takes inspiration from Chaney’s concept of the “issue salience of homelessness” and explores the comparative character of healthcare as pertains to homeless people across the devolved territories.Findings The paper provides clear evidence of areas of divergence and convergence in policy and practice between the devolved regions. These features are shown to be strongly mediated by the interplay of two factors: first, the scope and scale of national and local homelessness prevention strategies; and second, intra-national variation in public health responses to homelessness.Originality/value The paper offers considerable insight from a comparative policy perspective into the nature of healthcare provision for homeless people in the devolved regions. [ABSTRACT FROM AUTHOR]

Purpose: Trusting and empathic relationships between project workers and people experiencing homelessness (PEH) form the cornerstone for their needs to be met. However, under the UK austerity agenda project workers practice in a context of increasing pressure and limited resources; with relationships often characterised by conditionality and disconnection. The purpose of this paper is to report on a study investigating project workers' experiences of building relationships with PEH living in supported housing projects. Design/methodology/approach: A qualitative design was employed in which focus groups were carried out in six projects, using an opportunity sample of 22 project workers. Data were analysed using thematic analysis, within a social constructionist epistemology. Findings: Three main themes were identified: "Working hard to build connection", "Supporting each other within an unsupportive context" and "Draining but sustaining". Project workers acted out of strong value systems in building relationships with residents against a backdrop of systemic disconnection. Originality/value: Clear clinical implications are put forward with in a Psychologically Informed Environment framework. Services supporting PEH need to be psychologically informed and organisations need to embed reflection within their policies and every day practice. In developing services for PEH interdependence not in/dependence needs to be the aim. Finally, the responsibility for improving the lives of PEH should be placed back on society to provide a context in which PEH can thrive. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to provide an overview of the impact of the arrival of the motor car on streets, communities, life styles and health. It documents the environmental, economic and social sacrifices that societies have made, in order to accommodate car traffic; and suggests some of the early signs of the dynamics of resistance. Design/methodology/approach – In style this is an opinion piece, although based upon and backed by extensive research, some of it cited here. Historical and cultural changes are mapped out with ironic references also to architectural fashions, and contemporary film culture in the sub-headings. Findings – Prioritising pedestrians in urban areas and encouraging walking would have beneficial impacts in terms of public health and environmental quality and deliver economic savings. Originality/value – With increasing focus on public and preventive health, and concerns to develop, for example, more age- and/or "dementia-friendly" environments, the paper suggests that new-build housing, in-fill and redevelopment will need to consider the streets between our homes as a key aspect of neighbourhoods and housing policy. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to learn lessons from North America on housing an ageing population, both in terms of supporting people to "age in place", and available options for those who need/wish to move. The project, funded by the Winston Churchill Memorial Trust, comprised a six-week travel fellowship to USA and Canada to meet with housing professionals from the public and private sectors and find out about best practice initiatives and efficient models for housing older people.Design/methodology/approach – The paper is in two parts, of which this is the second. Part 2 focuses on the links between housing and health and, recognising significant differences between the countries, draws out lessons which may be applied as similar challenges of austerity, an ageing population and the increasing interest in personal budgets are faced.Findings – There is no one size fits all approach to addressing the housing needs of the older population; a continuum of options across tenures is required. There are opportunities for growth in the private and non-profit sectors in terms of the provision of services for the ageing population. Large scale social change comes from better cross-departmental coordination and cannot be achieved by the isolated intervention of a single organisation. Originality/value – This was a unique opportunity to learn lessons from North America on how to effectively meet the needs of the older population, now and in the future. The findings are based on the personal observations and conclusions of a housing practitioner. [ABSTRACT FROM AUTHOR]