FirstStop advice for older people

1. Description of the programme
2. The study
3. What are the outcomes?
4. Key findings
5. Points to consider

Description of the programme

FirstStop is a partnership led by the Elderly Accommodation Counsel (EAC) that offers information and advice on housing, care and support, and related financial matters to older people.

The FirstStop advice service is delivered via a website, a national advice line, a network of 28 local partners and peer support services. The service supports 4 million website users per year plus 18,000 advice line clients and 20,000 local clients. The Department for Communities and Local Government (DCLG) funded the service in 16 local areas at the time of the evaluation. Working in partnership with the EAC and Care & Repair England (C&RE), local partners aim to:

• Ensure that more older people can live independently and with dignity in their own homes for as long as they wish.
• Connect housing, health and social care in ways that improve older people’s overall  quality of life.
• Work with older people to influence decisions about housing and the related services which affect their lives.

The study

EAC and C&RE commissioned an external evaluation to assess the value of an integrated  service to older people  and  current  and  potential funders. The aim of the evaluation is to explore how far:

• Local housing and care options advice services directly facilitate the achievement of specified health and adult social care outcomes.
• The provision of tailored information and advice by local housing and care options advice services results in behaviour change by older people (and the associated impact).
• Such services deliver savings, particularly to health and social care budgets and the indicative levels of savings across the programme.

Completed by KHC Consultancy, the evaluation provides an overview of the service offered by local partners (including 1,268 people who benefited from a casework service from April to September 2015), before focusing on four specific areas (West Cumbria, Northumberland, York and Middlesbrough).

Evidence is drawn from national data, output and outcome data returns, interviews with service users, staff and stakeholders, 16 case studies and a desktop and literature review, including the identification of unit cost and social value information.

What are the outcomes?

• Financial wellbeing: subjective assessment of personal wellbeing and quality of life, including: safety, anxiety, social isolation and financial wellbeing.
• Financial capability (ability): review of welfare benefits resulting in increased income for older people, contributing to improved health and wellbeing. 
• Other: savings to providers resulting from changes in the use of health and social care services. Changes to the living situation of older people following the support.

Key findings

• Local FirstStop services identify and secure aids, adaptations, assistive technology, improved heating, and, where appropriate, alternative housing solutions. This has been vital in supporting successful hospital discharges and reablement for people with complex health conditions.
• Wellbeing was improved for 59% of older people and health outcomes for 43%. The flexible, personalised service supports older people to take better decisions (a core principle of the Care Act 2014) and helps them to  continue to live safely, independently and well at home. Service users commented on the quality of the support received and of feeling in control of the decisions that they made.
• A further £942,300 in welfare benefits was secured for older people, equating to £1.88m in a full year. This increased income was enabling older people to purchase practical help and pay for essential services such as heating, which can, in turn, improve health and wellbeing.
• DCLG’s investment of just under £500,000 in the brokerage delivered by the 16 FirstStop local partners has delivered approximately £11.5m in annual savings for the NHS and social care system from the avoidance of falls, unplanned hospital admissions and GP appointments. This was estimated using information from in-depth interviews alongside analysis of the overall data returns from all local services to examine and model impacts and the resultant savings.

Points to consider

• Methodological limitations: Analysis of the cost benefit impact of the local FirstStop service does not include cost inputs from other agencies which work collaboratively with the service. Benefits may continue for a number of years but any future savings have not been quantified.
• Relevance: The evaluation concerns a package of integrated support to older people on housing, social care and related financial advice. The extent to which outcomes can be attributed specifically to the financial advice was not an objective of the evaluation and is thus not evidenced.

Full report

FirstStop advice for older people - full report