Welcome words – now the action?

Sometimes it can feel as if all of the effort that we put into raising the profile of the wider housing and ageing issues is getting us nowhere, as we hear of yet another great local Care & Repair or similar service closing down.

However, as I read the conclusions in the Communities and Local Government Select Committee Inquiry into Older People’s Housing Report, the work that we put into making representations to this all felt worthwhile.

The list of recommendations are all ones that Care & Repair England had either put forward or endorsed, particularly the critical role of home improvement agencies, handyperson services, information and advice about housing options plus home adaptations, all of which are relevant to the vast majority of older people living in ordinary housing.

We also support building better new homes for future generations of older people, making new homes more accessible and flexible across the life-course, as well as building specialist and innovative new homes to meet specific needs.

The Committee’s recommendation to develop a new national strategy for older people’s housing is also timely, given the current high level policy interest in housing.

Best not to reinvent the wheel, so any new strategy really should build on the excellent work which resulted in the last comprehensive strategy on this subject, Lifetime Homes, Lifetime Neighbourhoods. Whilst I would say that, wouldn’t I (as the Chair of the government’s advisory committee on the subject at the time), this Strategy did receive cross government and multi- party support, as well as attracting international interest and approval.

But let us not get carried away quite yet. A Select Committee report is great – but what really matters is the extent to which the recommended actions are taken up by the Government of the day.

At the front line we are seeing decommissioning of preventative services such as impartial info and advice, independent HIAs and handyperson services at an unprecedented rate, with the resulting loss of skills and knowledge built up over decades.

Rapid action is needed to ‘stop the rot’  now – it will be so much harder to rebuild from scratch.

Perfect Storm?

Some years ago Care & Repair England published the report ‘A Perfect Storm: An ageing population, low income home ownership, and decay of older housing’ to draw attention to the potential implications of the radical shift from renting to owning amongst lower income groups, particularly when those lower income people retired on small pensions.

The report analysed housing stock condition, demographic and tenure trends alongside housing related policy response.

A similar conclusion was reached to that of the House of Lords Inquiry Ready for Ageing? i.e. that the policy response was woefully inadequate.

Last week’s publication of the latest English Housing Survey Headline report 2016-17 data, revealed that for the first time in more than a decade the number of non-decent homes in the owner occupied sector has increased, rising from 2,694,000 in 2015 to 2,912,000 in 2016, nearly a fifth of the private sector stock.

As our report demonstrated (Off the Radar), the majority of those living in non-decent owner occupied homes are older people, particularly those with disability or long term health conditions.

Whilst one has to be cautious about drawing conclusions from a relatively small change, taken with other emerging data about indications of falling life expectancy in poor areas and low income pensioners, this does accord with the difficulties of finding the money for essential home repairs reported by home improvement agencies and others.

The current housing media focus is understandably on the dire situation of homeless people, families living in temporary accommodation and the scandal of a whole generation locked into expensive, poor standard private sector rented property.

However, this is not a good reason to totally ignore the housing and financial difficulties faced by low income older people.

Not everyone over retirement age is living on a high pension in a house in the south east worth millions. We must not lose sight of those who are ‘just about managing’ – or close to not managing.

Failure to make the connection between housing disrepair and health is not only costly to the NHS, but has potentially dire consequences for individual older people.

We have to somehow make the case afresh for the practical, preventative housing help that home improvement agencies and handyperson services can offer, but which seem to be disappearing at a rate of knots [January 2018]

Adaptations work

Crawling up the stairs, being unable to wash properly, not being able to sleep in your bedroom – these are the real life impacts of not having home adaptations done when you need them.

Whilst there is often a response along the lines of ‘isn’t it obvious’ when it comes to measuring the health impacts of such situations, lack of quantified, academic evidence, and particularly of the cost benefits of home adaptations, has been an issue for some time.

This is why the new international review of evidence concerning older people and home adaptations is so welcome.

Commissioned by the Centre for Ageing Better and carried out by the University of the West of England, this is a long overdue and important addition to the armoury of those of us passionate about making older people’s homes good places to age well.

Whilst this review won’t answer all of the questions (and one of the findings is that there really does need to be much more research in this field as all of the key evidence was from non-UK studies), this overview provides some much needed data to help us make the case for adaptations.

The review was preceded by last week’s surprise (and very welcome) budget announcement of additional national government funding for disabled facilities grants this year. What we now need is to see that national money added to by local health, housing and social care inputs (however modest) as well as steps taken to innovate/deliver integration to produce even better results for individuals.

We are delighted to be taking the next steps with Centre for Ageing Better and gathering local examples of the elements of innovation and good practice, particularly features identified as important in the evidence review, such as speed of provision and tailored solutions that listen to the priorities of the individual older, disabled person.

 

The Importance of Satisfactory Housing for Older People

There is a consensus that older people ideally want to remain in their own homes, with support if necessary, for as long as possible. As the majority housing tenure for older people is owner occupation the “stay put” ambition involves responsibilities for repair, maintenance and, for many, modifications in response to disability.

For those living alone on limited incomes and not able to undertake necessary works themselves these forms of investment are a source of genuine worry and anxiety. If not addressed unsatisfactory housing conditions present risks to the health and wellbeing of older people. Access to low or no cost independent and trustworthy advice/information and assistance services provided through home improvement agencies has been highly valued by this client group.

However due to continuing austerity affecting the public sector local home improvement agency services, particularly those that receive local authority funding, have experienced a reduced level of financial support or had funding removed. Care & Repair England argue that

  • the demise of such prevention and response services really is storing up problems for the future especially to the health and social care sectors and
  • investment in services providing housing interventions for older people constitutes a sound business case for those sectors

The challenge for housing providers is to convince health and care commissioners that investment in housing led interventions can contribute to meeting their outcomes. This is why, with the support of the British Society of Gerontology (BSG) and the University of Manchester’s Institute for Collaborative Research on Ageing (MICRA), Care & Repair England in July 2017 organised a national conference examining the policy and practice framework for this issue. The title of the event was Small but Significant – Innovation, Impact and Evidence: Practical housing interventions to improve older people’s health and wellbeing. It included speakers who have been involved in service innovations that have already been evaluated including handyperson services linked in with ambulance service responses, to hospital discharge systems and pro-active home safety interventions.

What is striking in the majority of cutting edge practice is its fragility. It is often based on small scale, fixed term pilots, short term contracts, stop-start funding, with constant uncertainty for providers and practitioners.

Care & Repair England are firmly of the view that a coherent new national initiative is urgently needed that will once and for all firmly embed handyperson services into preventative, integrated health, care & housing systems.

Please click here for the Speakers presentations