Timetable and Budget
| Description | Deadline/Limit |
|---|---|
| Deadline for Stage 1 applications | 14 February 2023, 1pm |
| Notification of outcome of Stage 1 application | April 2023 |
| Project start | May - July 2023 |
| Project duration | 12 - 24 months |
| Budget | £200,000 to £250,000 per project |
Due to the urgency of this research call, applications will be assessed through a fast-track single stage Committee assessment process, based on information provided in the outline stage 1 application form. Successful applicants will be invited to respond to Committee feedback in an expanded form and will directly proceed to contracting and project start-up.
Introduction
The National Institute for Health and Care Research (NIHR) Policy Research Programme (PRP) invites proposals for a single research project to undertake an evaluation of the Care and Support Specialised Housing (CASSH) Fund. This evaluation will support policymakers in the Department of Health and Social Care (DHSC) to shape policies on housing-related care and support, in the context of wider adult social care policy. This research project has the following aims:
- To understand whether the CASSH Fund meets its policy objective, i.e. to incentivise more supply, hence mitigating unmet demand, of supported housing for older people and disabled adults in England.
- To understand whether the current scope and parameters of the CASSH programme, and the way in which it is administered effectively attracts and enables providers to deliver CASSH units, and what the facilitators and barriers are for housing providers to access the Fund and implement CASSH schemes.
Note - it is not a primary research objective to examine the impact on residents’ health & care outcomes of living in the units delivered with support from CASSH.
Background
The CASSH Fund aims to incentivise the building of long-term supported housing for older people, as well as adults with physical disability, learning disability, autism, or mental ill-health in England, so that unmet demand for these housing units can be mitigated. The CASSH Fund provides such incentive by way of capital funding that partly subsidises the capital costs of construction (or renovation as the case may be) thus making the overall investment more viable for providers. More information is available within The Mayor’s Care and Support Specialised Housing Fund.
The policy rationale is that by increasing the supply of CASSH units, more older people and disabled adults can live independently and healthily at home whilst receiving care and support as and when needed, rather than residing in institutional settings (e.g. hospitals or care homes) which may not be optimal to their needs.
The CASSH Fund was first announced in 2012 and commenced in 2013. In 2021, the Adult Social Care reform white paper, ‘People at the heart of care’ announced a continuation of the CASSH Fund for 2022-25.
Housing providers can bid for CASSH funding. As delivery agencies, the Greater London Authority (GLA) administer Funding for supported and specialist housing on behalf of DHSC in London, and Homes England (HE) for the rest of England (not yet commenced in 2022/23). The agencies promote and encourage the take-up of the CASSH Fund, as well as approve bids, allocate CASSH funding to them and programme manage these approved schemes until their completion. The agencies regularly report delivery progress of the Fund to DHSC.
There has not been an evaluation specifically on the CASSH Fund. The most relevant research in this field is the evaluation of the Department of Health and Social Care’s Extra Care Housing Fund (which preceded CASSH in terms of incentivising the provision of housing with care and support for older people). Some other relevant studies include ‘Financial benefits of investment in specialist housing for older and vulnerable people’ commissioned by the Homes and Communities Agency (now Homes England), and ‘INTEGRATED HOMES, CARE AND SUPPORT - Measurable Outcomes for Healthy Ageing’ commissioned by the Extra Care Charitable Trust.
DHSC wants to understand whether the CASSH Fund helps incentivise more supply of long-term supported housing units for older people and disabled adults, thereby mitigating the unmet demand for these housing units. DHSC also wishes to understand whether the scope and parameters of the Fund and its practical implementation is effective in attracting providers to deliver CASSH schemes.
Evidence about the effectiveness of the CASSH Fund (as a public intervention) will help DHSC understand if and where changes to the Fund might be needed in future to ensure the intended policy aim is realised.
DHSC, through the NIHR, commissioned the King’s Fund to conduct an evaluation scoping exercise for the CASSH Fund. This report identified that there were both policy and implementation questions that an evaluation could focus on. We are looking to commission an evaluation focusing on the implementation questions identified, rather than evaluating the impact of the CASSH units on their residents’ health outcomes.
Apart from the CASSH Fund, there are other ways of public intervention to incentivise the building of supported housing for older people and disabled adults, such as capital subsidy under other housing programmes (e.g. Affordable Homes Programme) and revenue subsidy through exemptions to rent regulations. These are out of scope of this evaluation.
Research priorities
An evaluation of the CASSH Fund is required, covering schemes commencing during the period 2022-25. It will address evidence gaps and generate new evidence to support efforts to understand how the CASSH Fund is being implemented and received and what it means for the supply of supported housing units for older people and disabled adults.
DHSC expects the evaluation to focus on the implementation of the CASSH Fund within the context of wider policy goals, specifically answering the following primary research questions:
- To what extent does the implementation of the CASSH Fund enable it to meet its policy objective, i.e. to incentivise more supply of supported housing for older people and disabled adults in England
- Is there geographical variation across England in how the CASSH Fund is accessed by housing providers across England? If so, what might be driving this variation?
- Is there any variation among the number of CASSH units / schemes delivered for older people, people with physical disabilities, mental ill health and people with a learning disability / autistic people? If so, what might be driving this variation?
- To what extent are the scope, parameters and operational arrangements of CASSH effective in attracting and enabling developers to make use of the fund to provide units, compared to the alternative available to developers who have made use of CASSH?
- Are the scope, parameters and operational arrangements of CASSH more effective in attracting and enabling developers to deliver supported housing for older people, than to deliver those for adults with physical disabilities, mental ill health or adults with a learning disability/ autistic people?
- What are the facilitators and barriers for housing providers to access the Fund and implement CASSH schemes?
The list of research questions above is not fully extensive and we welcome applicants’ suggestions.
We are open to applicants’ suggestions on methodological approaches to address the questions above. Potential methodologies and approaches could include:
- analysis of administrative data – focused on the take-up of the CASSH Fund, geographic variation and changes over time in the supply of CASSH units.
- and primary data collection – including a survey and/or interviews with housing providers exploring barriers or factors affecting delivery and providers’ views on whether the CASSH Fund’s delivery approach supports it in achieving its policy objective.
Data collected by both agencies relating to the implementation of the CASSH Fund and the schemes it funds (up to completion only) can be made available to the research team, for example:
- Scheme location
- Number of units in a scheme
- CASSH funding allocated to a scheme
- Delivery milestone dates, e.g. start on site and completion
- A scheme’s target client group
- Tenure, e.g. social/affordable rent or affordable ownership.
The King’s Fund scoping work identified areas for an evaluation and sources where evidence may be drawn from.
The Department for Levelling Up, Housing, and Communities (DLUHC) have commissioned a separate research project on the size, cost and demand of the supported housing sector. It is important that the contracted party undertaking this proposed evaluation consider the research commissioned by DLUHC to ensure that they offer complementary evidence on supported housing.
Expertise required
Applicants should be able to demonstrate the following:
- Expertise in evaluation of national policy programmes
- Expertise in conducting quantitative and qualitative research and analysis
Ideally applicants will have experience of conducting research and / or evaluation on topics related to either housing or social care policy, but this is not essential.
We appreciate applicants may not have experience conducting research and/or evaluation projects that cover both housing and social care policy areas simultaneously. We welcome bids from those who may have more experience in one of the two specific policy areas.
We welcome bids from applicants from a wide range of different host organisations, including consultancies, research agencies or higher education institutions (HEIs), and encourage applications from those who may not have applied for NIHR funding before. The NIHR also welcomes bids from consortiums.
Applicants may wish to engage with the NIHR Research Design Service (RDS). The RDS provides free and confidential advice on research design, writing funding applications and public involvement, to health and social care researchers across England.
Outputs
Outputs should include:
- periodic updates as agreed at project scoping;
- draft final publishable report and final publishable report, with executive and lay summary in a form suitable for policy colleagues in a 1:3:25 format;
- presentations of interim and final findings from the evaluation, to DHSC colleagues;
- code and anonymized datasets from analysis conducted to allow quality assurance by DHSC if needed;
- applicants may also want to consider academic publications and/or conference presentations as applicable.
Budget and duration
A total of £200,000 to £250,000 is available for this research call. Costings can include up to 100% full economic costing (FEC) but should exclude output VAT. Applicants are advised that value for money is one of the key criteria that peer reviewers and commissioning panel members will assess applications against.
The evaluation should commence in Summer 2023, and the project should complete within 12-24 months. The duration of the proposed study should be as short as is consistent with a high-quality study.
Management arrangements
A research advisory group including representatives of DHSC and DLUHC, and other stakeholders as appropriate should be established. The advisory group will provide guidance, meeting regularly over the lifetime of the research. The successful applicants should be prepared to review research objectives with the advisory group, and to share emerging findings on an ongoing basis. They will be expected to:
- Provide regular feedback on progress;
- Produce timely reports to the advisory group;
- Provide comment to all final reports.
The research team will be expected to work closely with nominated officials in DHSC, its partners and the NIHR Policy Research Programme. Key documents including, for example, research protocols, research instruments, reports and publications must be provided to DHSC in draft form allowing sufficient time for review.
Application
New Guidance on Inequalities and Inequalities data collection within NIHR PRP Research:
Inequities and inequalities in the provision, access to and experience of health and care services is a high priority area within the Department of Health and Social Care and the NIHR and is present in the majority of funded projects. We will now assess all NIHR research proposals in relation to health and care inequalities. NIHR asks researchers to explore issues of inequality and inequity in the research being proposed.
Our goal is also to facilitate more widespread and consistent reporting of data on health and care inequalities relating to the primary outcomes of NIHR funded research. Applicants should, if feasible, collect or analyse data related to health and/or care inequalities, we request that this stated in the proposal. This is a new request from the NIHR PRP and we will be continuing to monitor queries and make any necessary clarifications, as needed.
We understand that research projects may employ different methodologies, and focus on different populations. We ask that you please clearly identify in the research plan section of the application whether your application has a health and care inequalities component. If the project uses quantitative methods, please include detail of the core set of data that will be collected or analysed. Submission of the data collection will be a condition of final reporting that will need to be submitted to NIHR PRP when the grant has finished. If a health and/or care inequalities component is not included, please explain clearly why this does not fit within your research.
When exploring inequalities, we would like researchers to focus on collecting responses from or about individuals with a range of characteristics. Characteristics to consider are: sex and/or gender, region, 5 ONS Ethnic groups, and the 5 IMD quintile groups. These characteristics are considered an ideal, but we understand that these are subject to change depending on the sample population and research design. Given the nature of this project, looking at inequalities related to region or geography may be most appropriate. DHSC is open to applicants’ suggestions on how to approach inequalities for this project.
A recording of the Health Inequalities in NIHR PRP Research Q&A Event which was held on 19 September 2022 is available to view on Youtube, this may be useful to refer to as it provides additional information.
Further details about this new request can be found in Appendix A.
References and key documents
- Mayor of London (2018) The Mayor’s Care and Support Specialised Housing Fund [Accessed November 2022]
- DHSC (2022) People at the Heart of Care: adult social care reform white paper [Accessed November 2022]
- Mayor of London (2022) Funding for supported and specialist housing [Accessed November 2022]
- PSSRU (2011) Evaluation of the extra care housing initiative: PSSRU technical report [Accessed November 2022]
- Homes & Communities Agency (2010) Homes & CommunFinancial benefits of investment in specialist housing for older and vulnerable people [Accessed November 2022]
- Extra Care Charitable Trust (2019) INTEGRATED HOMES, CARE AND SUPPORT - Measurable Outcomes for Healthy Ageing [Accessed November 2022]
- The King’s Fund (2020) Evaluating the Care and Support Specialised Housing (CASSH) programme: results of a scoping exercise [Accessed November 2022]
- NIHR Research Design Service [Accessed November 2022]
Appendix A: Further Detail on the New Guidance on Health Inequalities data collection within NIHR PRP Research:
Health Inequalities is a high priority area within the Department of Health and Social Care and the NIHR and is often present in a majority of funded projects. We are now assessing all NIHR research proposals in relation to health inequalities. We are asking applicants to identify in their application whether or not there is a health inequalities component or theme and how this research hopes to impact health inequalities. We are also asking researchers to collect relevant data related to health inequalities, if appropriate for the research. Collecting specific information about health inequalities in research submitted to the programme will allow for categorisation of health inequalities research, curation of data to aid future health inequalities research and enable policymakers to better understand the implications of health inequalities within their policy areas. This is a new request from the NIHR PRP and we will be continuing to monitor queries and adapt the process as needed. If you have any feedback on this new request, please contact us at prp@nihr.ac.uk.
Our goal is to facilitate more widespread and consistent reporting of health inequality breakdown data relating to the primary outcomes of NIHR funded research. We would ideally like researchers to focus on the following equity-relevant variables: age, sex, gender, disability, region*, 5 ONS Ethnic groups**, and the 5 IMD quintile groups. These variables are considered an ideal, but we understand that these are subject to change depending on the sample population and specific research question.
For qualitative research projects, this can be purely baseline characteristics of the participants, for example, the number of participants in each ethnic group.
For quantitative research projects, if there are multiple outcomes/effects with your stakeholders, select a small number of main outcomes as appropriate to report equity breakdowns. We will not be prescriptive about the number of the outcomes, as it will depend on the number of study design types and the nature of the project aims. We are asking for one way cross tabulations of each primary outcome by these equity-relevant variables, if appropriate for your research, together with the number of observations in each cell. If more detailed cross tabulations are appropriate for your proposed research, please include these as well. This request applies to both primary data collection studies and secondary analysis of routine data, and to causal inference studies as well as descriptive studies; however, if this is not possible due to data limitations then please explain. Due to sample size and other data limitations there may be difficult scientific and/or data security*** judgement calls to make about which breakdowns to report and whether to merge categories to increase counts in particular cells; we ask you to make these judgments yourself, bearing in mind our data curation aim of enabling future evidence synthesis work in pooling results from different studies. We also ask that researchers report breakdowns for the unadjusted as well as adjusted outcomes/effects, as appropriate.
We understand that research projects may employ different methodologies, and focus on different populations. Please explain how the variables and data collection methods chosen are appropriate to the methodologies used.
We ask that you please clearly identify in the research plan section of the application whether your application has a health inequalities component or not and detail the core set of health inequality breakdown data that will be collected, if applicable. Submission of the data collection will be a condition of the final report for all research with relevant methodologies regardless of whether the research has a health inequalities component that will need to be submitted to NIHR PRP when the grant has finished. This should only take a few sentences within the research plan section.
* Table below uses the nine regions in England, further regions can be used if using the UK as the study population. Please report region breakdown for large samples in nationally representative descriptive studies. There is no need to report this for small sample studies, for sub-national studies, or for quasi-experimental studies where it would require time-consuming re-estimation.
** White, Mixed/ Multiple ethnic groups, Asian/ Asian British, Black/ African/ Caribbean/ Black British, Other ethnic group. If the sample size is small then it is fine to report only some of the requested equity breakdowns and to merge some of the sub-groups as appropriate.
*** For guidance on how to handle data security concerns in reporting of sensitive data please see ONS guidance.
Example data table for submission at the end of the funded research project
(N.B. If there is more than one main outcome then you will require more tables and if you adjust your outcome then you will need two tables for the adjusted outcome and unadjusted outcome. For other methodologies, variable vs number of observations may be more appropriate to record participant data). This table is for an example only. It does not contain sub variables and does not illustrate any preference for certain variables, as these will be dependent on the proposed research.
| Variable | Outcome (an appropriate average for this subgroup, usually the mean) | Number of observations | Additional information about variation if appropriate, e.g. range, standard deviation |
|---|---|---|---|
| Age | - | - | - |
| Sex | - | - | - |
| Gender | - | - | - |
| Disability | - | - | - |
| Ethnic Group | - | - | - |
| IMD Group | - | - | - |
| Region | - | - | - |