Third sector telephone housing options service for older people: a realist evaluation.

Abstract

The intended outcome of a third sector telephone housing options service focusing on specialist housing is to empower older people to reassess their home environment. However, there is no existing academic research in this area. In an original contribution to knowledge, this study addresses the question: How, why, for whom and in what context is a third sector telephone I&A service efficacious in relation to instilling empowerment in older people considering specialist housing? This thesis takes a realist philosophical perspective and realist evaluation approach (context-mechanism-outcome configuration - CMOc). Key methods include a focus group with service advisors (to develop programme theory), access to the service setting, analysis of imparted information and realist/semi-structured interviews (n=31) with older information-seekers (n=16) one month (n=16) and four months (n=15) after engaging with the service. Tenure and access to deliberative networks are key areas of context. Against a backdrop of a shortage of specialist housing and subsequent complex conditions, those in private housing (mostly owner-occupiers) tend to seek empowerment. Social tenants, limited to a system where a low priority, already have experiential knowledge and seek accessible alternatives. It was common for participants to trust the service relative to negative prior experiences. Yet, in the majority of CMOc (n=8) outcomes tend to reflect an inability to act (social tenants) or uncertainty (mainstream residents) – the latter triggered by mechanisms such as apprehension. A key finding was that many information-seekers sought, desired or used the interviews for more substantive discussion. The current UK market and structure of I&A provision, both hampered by neo-liberal influences, are not conducive to older people reassessing their home. Firstly, this research further underlines the need to increase the supply of specialist housing. Secondly, this study challenges established thinking where information, and not the relational elements of substantive deliberation, is assumed to empower.