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Supporting people with social care needs on release from prison

A scoping review of literature on identifying and meeting social care needs of people released from prison.

Key messages

  • data on the number of people released from prison with social care needs is extremely limited, with almost no quantified information available
  • most literature is descriptive rather than evaluative, with relatively few studies focusing directly on social care following release
  • several promising initiatives exist, including pre-release training and buddy or self-referral schemes, but long-term evidence on effectiveness is lacking
  • barriers remain around continuity of care, screening and information-sharing between prison and community settings
  • policy and research should prioritise evaluation of interventions to improve social care outcomes after release.

Policy implications

  • more consistent approaches may be needed to identifying and assessing social care needs before and after release
  • stronger continuity of care and information-sharing could reduce gaps during transition
  • promising interventions may warrant further development and evaluation before wider adoption.

Gaps

  • absence of population-level data on social care needs following prison release
  • lack of robust evaluation of interventions and pathways
  • limited evidence on specific subgroups, including disabled people, older people and those with complex needs.

Commentary
This review highlights persistent gaps in understanding social care needs among people leaving prison. The lack of reliable data on how many individuals require support, and what that support looks like, limits the ability of systems to plan and commission services equitably at a critical transition point.

The available evidence is largely descriptive, offering limited insight into whether existing approaches improve outcomes. From an equity perspective, this makes it difficult to know which interventions reduce disadvantage and which risk reproducing gaps in access and experience.

Several initiatives, including pre-release skills training and buddy schemes, suggest potential for more person-centred and continuity-focused models of care. These approaches aim to bridge the divide between custodial and community settings, but their long-term impact remains unclear.

Barriers around continuity of care and information-sharing reflect wider structural challenges. These disproportionately affect people with overlapping needs, including physical disabilities or long-term conditions, increasing the risk of unmet need after release.

Improving equity in this area will require stronger evidence on need, outcomes and effectiveness. This includes better data collection, evaluation of interventions and research that reflects the experiences of people leaving prison, to support more responsive and equitable social care pathways.

Housing conditions and ageing in England

A report examining how housing quality affects the health, wellbeing and care needs of older people, particularly during the COVID-19 pandemic.

Key statistics 

  • around 2 million non-decent homes in England are occupied by older people 
  • non-decent homes make up 17% of the housing stock in England 
  • the number of people aged 75+ living in non-decent homes increased from 533,000 in 2012 to 701,000 in 2017, a rise of 31% in five years 
  • older properties are significantly more likely to fail housing quality standards, with 42% of homes built before 1919 failing the Decent Homes Standard 
  • over 4.5 million people aged 50 and over provide unpaid care in England, with caring responsibilities increasing during the pandemic 

Key messages 

  • housing conditions are closely linked to the health and wellbeing of older people 
  • poor housing can contribute to respiratory illness, heart disease, mental health problems and increased risk of falls 
  • the COVID-19 pandemic highlighted the central role of the home in protecting health, particularly during periods of lockdown 
  • many older people live in homes that are unsuitable for ageing, including homes with hazards, poor heating or accessibility barriers 
  • housing improvements and adaptations can support independence and reduce demand for health and social care services 
  • unpaid carers play a critical role in supporting older people, but many experienced increased pressure during the pandemic 
  • integrated policy approaches linking housing, health and social care are needed to support healthy ageing 

Policy implications 

  • invest in large-scale programmes to improve housing quality and remove hazards in homes occupied by older people 
  • expand funding for home adaptations and preventative housing improvements 
  • integrate housing considerations into health and social care planning and policy frameworks 
  • support services that help older people remain living safely in their homes 
  • strengthen support for unpaid carers, particularly those providing care in unsuitable housing environments 
  • use housing interventions as part of strategies to reduce health and social care demand 

Gaps 

  • the report relies largely on existing evidence and policy analysis rather than new empirical research 
  • limited analysis is provided on regional variation in housing conditions affecting older people 
  • there is limited exploration of how housing inequities affect different socioeconomic or ethnic groups 
  • more research is needed on the long-term health and social care outcomes of housing improvements 

Commentary 
This report examines how housing conditions affect the health, wellbeing and care needs of older people in England, particularly in the context of the COVID-19 pandemic. It highlights the central role that the home plays in supporting health and independence later in life. 

A key finding is that a large number of older people live in homes that do not meet acceptable housing standards. Around two million non-decent homes are occupied by older people, often containing hazards such as excess cold, poor repair or risks of falls. These housing conditions can contribute to a range of health problems including respiratory illness, heart disease and injury from accidents. 

The pandemic reinforced the importance of housing quality. During lockdowns, many older people spent almost all of their time at home, which intensified the effects of living in unsuitable or unhealthy housing. Poor housing conditions were associated with worsening physical health, mental health challenges and greater social isolation. 

Housing conditions also affect how health and social care systems function. For example, unsafe or inaccessible homes can delay hospital discharge, increase the risk of hospital readmission and make it more difficult for people to receive care at home. The report highlights the importance of home adaptations, such as grab rails, stair lifts and accessible bathrooms, which can help older people remain independent and reduce demand on health and social care services. 

Unpaid carers are another important part of this picture. Many carers experienced increased responsibilities during the pandemic as formal services were disrupted. Providing care in homes that are cold, unsafe or unsuitable can create additional strain for carers and increase risks for both carers and those receiving care. 

From a care equity perspective, housing conditions are unevenly distributed across society. Poor housing is more common among people with lower incomes and in disadvantaged areas. These housing inequities contribute to wider health inequities by increasing the risk of illness and reducing the ability of people to remain independent in later life. 

Overall, the report argues that improving housing conditions should be considered a core component of health and social care policy. Targeted investment in housing improvements and adaptations could support healthy ageing, reduce pressure on health and social care services and address wider inequities in health outcomes.