Solving Housing Problems For The Elderly And Seniors

Transcription

1 OLDER PERSONS ACCOMMODATION STRATEGY

2 OLDER PERSONS ACCOMMODATION STRATEGY LIST OF CONTENTS SUMMARY OF RECOMMENDATIONS CHAPTER 1 INTRODUCTION Aims and objectives Background Process National context Local context CHAPTER 2 - ENGAGEMENT AND PARTNERSHIP WITH OLDER PEOPLE CHAPTER 3 - NEEDS AND DEMANDS Population growth and profile Disability and illness Support needs Adaptations Demand for accommodation CHAPTER 4 - SUPPLY MAPPING Spatial distribution of older people and sheltered housing Condition of accommodation Decent Homes Standard CHAPTER 5 - PROMOTING INDEPENDENCE Adapting homes Repair and renovation Creating warm homes Safety in the home Maintaining the garden Help with shopping, cleaning and meals Dealing with isolation Assistive technology Flexible care and support CHAPTER 6 ENABLING CHOICE IN HOUSING The extent of choice The Homechoice lettings system Downsizing Page 1

3 Needs assessment and help with moving Standards and design Security issues CHAPTER 7 RECONFIGURING SHELTERED AND DESIGNATED HOUSING Demand and perceptions Dealing with existing social housing stock Management issues Continuity of care within schemes Extra care schemes Intermediate care CHAPTER 8 RESOURCE IMPLICATIONS Capital funding Revenue funding APPENDIX 1 STRATEGY ACTION PLAN APPENDIX 2 MEMBERSHIP OF DIF OLDER PERSONS SUB-GROUP APPENDIX 3 ORGANISATIONS CONSULTED ON THIS STRATEGY Produced and adopted by Eastleigh Borough Council Author: Tony Hall - Head of Housing Services

4 SUMMARY OF RECOMMENDATIONS Engagement and partnership with older people Key actions should include: Pull together existing information held by agencies on the views of older people Ensure that where general consultations are being undertaken the needs of older people are a focus Look to work with existing networks and groups that represent older people Research housing and service needs of black and minority ethnic groups and work with partners on provision. Needs and demands Key actions should include: Carry out research on why people move into sheltered housing and where they move from plus why people move on from sheltered housing and where they move to. Promoting independence Key actions should include: The total amount spent on disabled adaptation works from the Council s capital resources should be increased as necessary to cope with demand A specialist housing occupational therapist (OT) should be employed on a joint basis with Social Services Methods of reducing the waiting time for Disabled Facilities Grants to be explored The PART initiative to be supported and that loan and equity release options be publicised and explained to residents to encourage take up Re-assessing measures to assist with repairs and refurbishment once findings of the Borough s stock condition survey are known Further work to be undertaken to promote heating and energy conservation measures to the elderly and that for homeowners, loan or equity release measures be encouraged to pay for these works as appropriate. A review to be carried out to establish the effectiveness of the gardening service in allowing elderly people to remain at home and to ensure that it is being properly targeted at those identified by health and social services as being most at risk Consider ways of expanding the gardening service in view of the level of demand. As part of an integrated approach with Health and Social Services, assistance be given with research and the development of new services as appropriate The benefits of sheltered housing schemes in preventing social isolation to be promoted work to be undertaken with housing association landlords to Page 3

5 encourage greater use of their communal facilities by residents in the wider community. Assistance should be given to assistive technology projects where practical. Enabling choice in housing Key actions should include: Research to be undertaken to ensure older applicants are not missing housing opportunities through difficulties in using the Homechoice system. An equity share scheme model to be investigated for Eastleigh Review the policy that removed the equity limit for homeowners applying for sheltered housing to ensure those with other options are not housed before those with more limited choice Research to be undertaken into under-occupation incentives and attempts made to quantify the cost of the incentive compared to the provision of a new home for a homeless family. Sheltered housing information pack be reviewed and some parts combined to produce a more manageable and comprehensive product Advice literature to be regularly updated and corporate identity and quality improved Future production of advice literature to be considered jointly with Social Services, Health and other agencies, ensuring consistency and an integrated approach to advice. Improve the provision of targeted benefits advice to older people Reconfiguring sheltered and designated housing Key actions should include: Clear information about sheltered housing to be provided and schemes further promoted. Aim to eliminate bedsit flats in sheltered schemes by 2010 When modernising sheltered schemes, especially where bedsit flats are involved, consideration to be given to creating some two bedroom flats To meet the needs of existing as well as future tenants it is recommended that a number of quality two bedroom bungalows and flats be provided for older residents to move on to Support for funding to improve the quality of sheltered housing to be considered where an association faces major difficulty due to the scale of the task, where investment would produce extra social housing on a site or where a major benefit might be gained in terms of the health agenda. Formation of an asset management project team to assist in the task of reconfiguring sheltered and designated older persons housing Ensuring that a review is carried out of the operation of the new Elderly Mental health scheme at Rowan Court. Page 4

6 CHAPTER 1 INTRODUCTION Aims and objectives As people live longer, the number of older people as a proportion of the population increases and this in turn needs consideration in terms of housing options and services. This strategy is not, however, just about the needs of vulnerable older people. It is as much about the majority of older people who live in ordinary housing without accessing services as it is about those with explicit health and care needs. For this reason the strategy looks at the role of accommodation for older people in a broader fashion, looking at the contribution it makes to the promotion of inclusion, active ageing and independence. The specific aims of the strategy are to: Highlight investment requirements to ensure existing social housing stock continues to meet the needs of older people. Inform investment decisions in new housing provision, services or assistive technology. Promote choices in accommodation and services for older people Develop methods of joint working between agencies to ensure effective and timely intervention aimed at maintaining independence as long as possible. Background The need for an older persons accommodation strategy was recognised as a priority within the Housing Strategy in This followed work 1 that had been carried out around the provision of social housing for older people and the challenges that were being faced as a result of the changing demands and aspirations of older people themselves. Within this wider context this strategy seeks to consider the role of housing and in particular the impact of the Council s core objectives around the promotion of well being linked to health, economy and environment. The absence of appropriate housing at any time in life severely inhibits well-being, but never more so than in older age. For this reason the aim of the strategy is to ensure that older people have access and choice to appropriate housing and that where it is needed they are given support and care to continue living independently. This not only promotes community cohesion, but also prevents isolation and exclusion. In short the document should provide a framework for the future planning of accommodation and related services for older people. Process Supporting People prompted a reconsideration of the local arrangements for planning and commissioning services. This took place in tandem with changes to the health agenda and the local structures supporting development of services in that area. As a result it was decided to establish a local structure pulling together lead agencies and providers to look at the implications of Supporting People and ways of 1 Older persons registered social landlords housing stock statement Page 5

7 maximising Transitional Housing Benefit. The outcome of this was the setting up of a District Inclusive Forum (DIF) which in turn feeds up priorities to a District Core Group and beyond to the Supporting People County Core Group. Helping to shape local policies and priorities are a range of sub groups focused on specific client groups. One of which is older people. The DIF Older Persons Sub-group is set to look more widely than the confines of Supporting People. Nonetheless the work of the group does need to bear in mind the county direction stemming from the Supporting People reviews and especially the work that is intended in 2006 around the development of key standards for sheltered housing. It may well be that this strategy will need to be revised in the light of that work. Membership of the DIF Older Persons Sub-group is set out in Appendix 2 In terms of wider engagement the document was circulated as part of the consultation process to those set out in Appendix 3. National context There have been a number of significant national policies issued over the last few years, which recognise the needs of this group. They include: National Service Framework (NSF) for older People 2, which sets out governmental initiatives, legislation and guidance. A number of sections of the NSF - intermediate care, stroke, falls, mental health in older people, and the promotion of health and active life in older age - have significant housing components. The NSF, together with earlier initiatives around partnership and funding flexibilities, open the way to stronger joint working and the possibility of developing and implementing integrated strategies. Sustainable communities 3 - Published in February 2003 this set out targets for the housing sector in terms of new housing delivery and regeneration and renewal especially around the achievement of the Decent Homes Standard. With the policy has come a change to the allocation of resources, with a single pot being created for allocation by a new regional structure called the Regional Housing Board. The Board has been required to devise, with partners, in each region a strategy that will direct investment. In the South East an initial strategy has been completed. Only passing reference is made to the needs of older people however, a new strategy document is currently being prepared and is due to take effect from April Quality and Choice for Older People s Housing: A Strategic Framework 4 seeks to address the many problems and opportunities for older people in securing decent, affordable and suitable housing and adequate and appropriate care and support for the 21 st Century. It sets out five key areas for policy and service development: Diversity and choice Information and advice Flexible housing provision 2 National Service Framework for older people DoH 3 Sustainable communities Building for the Future ODPM DETR and DoH, January 2001 Page 6

8 Quality Joint working National Strategy for Neighbourhood Renewal Action Plans 5 - promotes neighbourhood management supported with multi agency working to secure regeneration of both the physical and the social fabric of communities. The social aspects of regeneration are now seen to be as significant as the economic aspects, and there is a growing understanding that they are closely inter-related. The impact of poor housing is often felt disproportionately by older people as a result of other factors such as poverty, crime and disrepair and needs to be addressed in the round. Funding Government has been keen to increase the financial freedoms available to authorities, especially where it has been linked to performance through Public Service Agreements. At the same time it has been encouraging agencies to address organisational barriers and cost shunting, by placing an expectation that services will become more customer focused. Arrangements for Supporting People reflect this, although in reality there is still some distance to go. Decent Homes Standard a target set by Government and amended in 2002: by 2010 to bring all social housing into decent condition, with most of the improvement taking place in deprived areas, and increase the proportion of private housing in decent condition occupied by vulnerable groups. A decent home must meet the following four criteria: a) It must meet the current statutory minimum standard for housing b) It must be in a reasonable state of repair c) It must have reasonably modern facilities and services d) It must provide a reasonable degree of thermal comfort Much older sheltered housing was built to what would now be considered low space standards and which is inadequate when wheelchair or other mobility issues arise. The Government is also looking to empower citizens, including vulnerable people, both individually, for example through extending Direct Payments to Older People, and collectively, for example through the Better Government for Older People. Regulatory Reform Order 6 this enables local authorities to develop wider polices and tools aimed at vulnerable households where disrepair or unfitness exists. In part this is about ensuring that people who are capital rich but income poor are encouraged to tap into resources locked up in property as a first step before loans or grants are offered. In this way more people should be able to access help who otherwise would have been ineligible due to the means test but it effectively ends the availability of grant assistance except in exceptional cases. 5 ODPM 6 EBC s Private Sector Renewal Policy Page 7

9 The duties on local authorities to produce a Community Plan, to promote the economic and social well being of their population, and to establish a Local Strategic Partnership Structure with a range of stakeholders, are opening up new models of partnership and relationships between local authorities and their citizens. Local context A number of local factors have a bearing on the strategy. They are: Locally the needs of older people have been identified as a priority through the Community Plan 7 consultation and the work of the emerging Local Strategic Partnership. This is mirrored within the council with older people being identified as a discrete area within the Social Policy Portfolio. Budgetary provision has been made to assist with developing this agenda (for example introducing the gardening service), albeit at a low level. Establishment of a single PCT covering the whole of the borough plus southern Test Valley. This has meant a stronger focus on local issues. Reorganisation within Social Services with dedicated service managers for client specific groups. This is supported further through a joint health and Social Services partnership managers post and a jointly funded housing and Social Services post looking at the housing and health needs of residents including the assessments for extra care accommodation. Establishment of local Supporting People structures initially aimed at maximising transitional funding but post implementation these can now focus on longer term planning issues. Initially for older people this will include 8 : establishing and agreeing minimum standards for all sheltered housing, reviewing all sheltered housing against agreed criteria and aligning services better with hospital discharge and intermediate care. It is expected that the latter will also take account of the role of Home Improvement Agencies, which will also be subject to review. Changes to the capital-funding regime for housing now means that there is less certainty about funding particularly for remodelling sheltered housing. The Council s investment will continue around Disabled Facilities Grants and the new private sector renewal policy. Due to changes in the funding regime however, funding for DFG s will reduce from 600,000 in 2003/04 to 450,000, which had previously been the programme prior to 2002/03. Hampshire County Council is currently reviewing the provision of nursing care homes. Within Eastleigh work has already commenced on the refurbishment and extension of Fleming House. Options also are being considered for the facilities at The Mount. Re-organisation of Primary Care Trust services may lead to the provision of new intermediate care facilities in the Borough. 7 Draft Eastleigh Community Plan Summer Hampshire Supporting People Strategy June 2003 Page 8

10 CHAPTER 2 - ENGAGEMENT AND PARTNERSHIP WITH OLDER PEOPLE The views of older people are not well documented in Eastleigh although individual pieces of research help to build a picture. Although the Housing Needs Survey helps with detailed points there is less of a steer about more general priorities. Nationally research suggests that common themes include poverty, environment, community safety, active ageing, health and care; the need to maintain independence however features most significantly. Research of a more general nature is of critical importance. Older people are not a homogenous group but have very differing needs ranging from the active to the highly dependent. For this reason planning and commissioning needs to be well informed and to produce flexible solutions. Increasingly older people are demanding to be seen as active citizens as well as consumers of services. This is manifesting itself in higher expectations about the standard and range of services provided and with self-funding becoming an increasing feature of service provision, user demands will be all the more important. Funding whether through direct payments or through resources such as equity or pension/savings will become more commonplace and will drive change. A number of mechanisms currently exist in the borough for consultation. These include: Citizens Panel, Borough News, Southern Parishes Older Persons Forum, RSL sheltered housing liaison mechanisms and customer panels, the Homechoice newsletter, Supporting People mechanisms, the Asian Elders Group and Age Concern. Although useful in their own right they do not represent a cross cutting view of need or ensure a formal means for engaging older people themselves. Existing information held by agencies on the views of older people should be coordinated by the Borough Council. Traditional means for consulting are not necessarily appropriate and will not ensure that hard to reach groups are engaged. This factor needs to be considered. The Local Strategic Partnership could assist with a general survey of needs. When general consultations are carried out, there should be a focus on the needs of older people. It is important that the needs of black and minority ethnic (BME) groups should not be overlooked. Care needs to be taken not to make cultural assumptions that older people in these groups will be looked after by family. Engagement with BME groups locally should aim to determine the level of unmet housing and service needs among older people and the Council should then work with our partners on provision. It is generally accepted that BME groups are under-represented in sheltered housing schemes as cultural and language difficulties can make them seem a less attractive option. As part of the strategy implementation we will look to work with existing networks and groups that represent older people. There will also be a need to explain aspects of the strategy, especially where changes to existing housing provision are planned. Page 9

11 CHAPTER 3 - NEEDS AND DEMANDS Population growth and profile Nationally the growth of older people as a proportion of the population is likely to create new challenges in terms of the range of services needed and the relationship between the working and the non-working population. Based on 2001 figures 8.2% of the population is thought to be over 65 years. By 2031 this is set to rise to 25% of the population. In housing terms this creates a number of issues. Although the majority of older people will continue to live in their own homes the need for supported, sheltered and care environments is likely to increase. The current national provision of 1 million bedspaces is thought to be woefully inadequate. The population of the Borough was 116,177 at 2001, compared to 105,999 at 1991, an increase of 10%. Table 1 Population by age and gender in Eastleigh and surrounding area Eastleigh Southampton Test Valley Winchester BC CC BC CC Total People Males Females Source: 2001 census When Eastleigh Borough s population is disaggregated into age bands and projected changes shown to 2011 a number of factors that have a housing impact become more obvious. Table 2 shows Housing Needs Survey population projections. Census data is also shown for 2001 and indicates a higher actual population than that previously projected. Table 2 - Population growth by age group census Change Total Change Source: Census 2001/ Housing Needs Survey 2002 Page 10

12 The over 65-age group shows a steady rise in numbers over the period. The greatest rise is due during This accounts for a 9.6% increase. Proportionally, a large increase of 32.3% (1,293 people) is expected in the 80+ age group between 1996 and This group will then total some 5,293 people. Given the resource demands associated with this group, this constitutes a large increase in terms of service planning and commissioning, although in actual numbers it may be numerically small. Disability and illness With an ageing population comes issues related to mobility, with long term limiting illnesses becoming more prevalent. The housing needs survey looked to identify the number of households affected by mobility problems or long term limiting illnesses and found that 16.3% of households were affected, suggesting 9,236 households in the Borough overall. Of those, the survey established a strong link between illness and age, the details of which are set out in the table below. Table 3 Disability and long term limiting illness by age Age % No.s implied Total Detail is also available about the nature of illness and disability with a high incidence of conditions that are often attributed to ageing. Table 4 sets this out in more detail although it should be noted that the data relates to all households with a disability not just those of older people. Table 4 Nature of disability Disability % responses % households No.s implied Mobility problems 30.9 (25.3) 50.5 (35.8) 3916 (530) Limiting long term illness 15.7 (17.6) 25.6 (24.9) 1982 (368) Visual/hearing Impairment 12.8 (11.3) 21.0 (16.0) 1630 (236) Heart/asthma/respiratory problems 13.5 (18.9) 22.1 (26.6) 1716 (394) Page 11

13 Other physical disabilities 10.3 (12.6) 16.8 (17.8) 1302 (264) Wheelchair users 6.4 (5.3) 10.6 (7.5) 818 (111) Mental health problem 6.8 (5.6) 11.2 (8.0) 868 (118) Learning difficulty 3.6 (3.4) 6.0 (4.8) 462 (72) TOTAL 12,694 (2,093) * Bracketed figures relate to households where more than one member is affected by a disability. Although this establishes a clear pattern of disability amongst older people it does not suggest that housing is necessarily inadequate for their needs. The data therefore does need to be treated with some caution. What the report does identify is that the number of wheelchair-adapted properties does not automatically correlate with those who are wheelchair dependant. In fact only 35% of wheel chair users had adapted properties. Support Needs Within the Housing Needs Survey respondents were asked to identify services, which they currently needed but were not receiving. A total of 8,936 answered this question with 3,955 households in need of additional support. Diagram 1 Unmet support needs Finance Health and well being Emotional/ behaviour Social/activities Safety/security Advice/advocacy Looking after the home Training/employment Source: Housing Needs Survey 2002 The top two areas of unmet need are in the area of finance and benefit advice along with assistance in looking after the home. Although the survey does not differentiate it is assumed that by this people mean assistance with daily domestic activities rather than help with repairs etc. Cross tabulation further highlighted that wheel chair users need help most with money and benefits advice whilst those with mobility and respiratory diseases needed help looking after the home. Of those already in receipt of support, 35% received assistance from Social Services or a voluntary body, whilst friends, family or neighbours supported the remainder. Page 12

14 Adaptations Currently around 9% of all dwellings in the borough are adapted with just under a third of these found in the social rented sector Diagram 2 Types of adaptations needed bathroom adaptations hand/grabrails stair/vertical lift ground floor wc extension wheelchair adaptations access to property other Demand for adaptations remains high. Over the last couple of years the programme has grown from 450,000 in 2001/02 to 600,000 in 2002/03 and 2003/04. Becoming debt free removed the Right to Buy set aside requirements enabling more money to be used for adaptations, making the funding increase possible. That funding route has now ceased and the budget is likely to return to around 450,000 for the 2004/5 year. Demand for Accommodation From the 2002 Housing Needs Survey it can be seen that 2,821 households identified the need to move older relatives into the Borough over the next 5 years and into a range of accommodation types, including staying with relatives, accessing residential /nursing care, securing sheltered housing or non specialised housing. The greatest demand was for residential/nursing care with 873 households identifying a need for it. This level of demand (29.8%), was identified by the children of older people rather than older people themselves (5.6%). When looking at older persons expressed needs, the pattern is strikingly different with only 156 older people identifying the need to move within the next 5 years. Of that number the demand was more or less evenly split between private and social rented sheltered housing. This relatively low level of demand for sheltered housing is borne out by activity on the Homechoice Register. As at 31 st March 2004, 551 households out of a total of 4,055 on the register were over 60 years of age, some 13.6%. Within the last twelve months there have been advertised vacancies for 142 units of accommodation designated for older people of which 77 were sheltered flats. The average number of applicants for each vacant property was as follows: sheltered flat 10 one bed bungalow 21 Page 13

15 two bed bungalow 24 This compares with an average of 80 applications for each two-bed house advertised and 84 applications for each one bed flat where no age restrictions apply. It should also be borne in mind that applicants for designated elderly housing are usually in lower priority bands on the register, indicating a less urgent need to move. There is also a higher refusal rate (1.6 refusals per property) than for general needs properties offered. In 2003/4, while 64% of general needs one bed flats were let to people with an urgent priority and the remaining 36% to people in the needing band, 53% of one bed flats for the over 55 s were let to the needing band with 38% being let to those in the wanting band. Average numbers tend to mask the fact that some sheltered housing schemes remain popular, generally the ones with good space standards, modern facilities and in a good location, while others are hard to let. To assist with marketing and investment decisions it is proposed that research be undertaken to find out why people move to the individual sheltered housing schemes, why they move out and where they move to. Tracking people moving on might also provide useful information in terms of planning care needs as people become more frail Page 14

16 CHAPTER 4 - SUPPLY MAPPING Spatial distribution of older people and sheltered housing The distribution of older people is not even across the borough. The table below sets out the distribution of sheltered housing across areas linked to the older persons population profile. Figures in brackets include private sheltered housing. Table 5 Population and sheltered housing provision by area. Area Total Sheltered units Botley (+32) Bursledon Hamble (+33) Fair Oak (+38) Netley/Hound Bishopstoke West End (+61) Chandler s Ford/ Hiltingbury Hedge End (+35) Eastleigh (+32) TOTAL 1418 (+231) Source: Hampshire Small Area Population Forecasts 1999 Condition of Accommodation Although a stock condition survey is expected later in the year basic information on the adequacy of current accommodation is already known from the housing needs survey. From the responses it is possible to imply that 17,502 households experience some incidence of concern about aspects of their homes recognising the need to undertake a range of repairs or improvements. Diagram 3 Types of improvement identified in Needs Survey additional security window repairs insulation improved heating re-wiring roof repairs damp proofing Of those recognising the need to undertake work in the next three years, work to windows, additional security and insulation were seen as priorities. Structural repairs featured lower down the list possibly reflecting either a reluctance to undertake major repairs, lack of financial provision to cover the costs of the work or ignorance about Page 15

17 the need for work. The factors identified clearly are linked to amenity value and feelings of well-being. Decent Homes Standard Information is still being collected from housing providers concerning works that might be needed to ensure the Borough s existing social housing stock for older people meets the Decent Homes Standard by Although many of the sheltered schemes already meet this standard, there are concerns that some of the bedsit flats could fail. This is because one of the criteria to meet the standard is that kitchens should have adequate space and layout to contain the required items appropriate to the dwelling. This also applies to many of the one-bedroom bungalows designated for older people. Failing this kitchen criteria alone however would not mean the Standard has been failed. The Decent Homes Standard comprises a range of criteria and a home is likely to fail if it lacks three or more modern facilities and services. As well as space standards in the kitchen these include reasonably modern bathrooms and kitchens, appropriately located bathroom and WC, adequate sound insulation and adequate size and layout of common areas for blocks of flats. Alternatively, the Standard could be failed if a key building component is old and because of its condition needs replacing or major repair. Key components include roofs, windows, doors, central heating boilers, gas fires, storage heaters and electrics among others. There are criteria relating to other building components and the thermal comfort provided by the home. Dwellings must also meet the fitness standard under S604 of the Housing Act 1985 (as amended by the 1989 Local Government and Housing Act). Even where the Standard is met as a property meets sufficient of the individual criteria, that property may not be sustainable in the longer term if it fails to meet customer expectations. A review of existing supply therefore needs to look at but also beyond, the Decent Homes Standard. Page 16

18 CHAPTER 5 PROMOTING INDEPENDENCE Key factors exist in the planning of accommodation services, which affect the ability of older people to support themselves in a community setting. Push factors that may result in a breakdown in independence include: Unsuitable or unadapted housing Unresolved crises such as ill health, bereavement, family support Fear of crime Social isolation Dementia or extreme confusion Service planning needs to take account of all these factors and to provide a range of services that mitigate against them. These can take a number of forms but as a minimum the strategy should seek to see the development of supportive and enabling environments. The decision to move can be overwhelming and a new environment can in turn trigger confusion, depression and dependency. Because of this efforts should be made to support people who wish to stay in their own home for as long as possible. Set out below is a range of services that can help older people to maintain independence at home. Adapting homes Help by adapting homes to meet the needs of those with physical disabilities is channelled through a Home Improvement Agency. Southern Focus Trust have been contracted by the Council to provide this service, liaising with the client, occupational therapist, landlord (if applicable) and the Council s Private Sector Housing team who administer Disabled Facilities Grants (DFG s). This service is available for all tenures. Eligibility for a grant to cover the cost of the works is strictly means tested. The Home Improvement Agency are usually contacted by the client, their occupational therapist or their landlord and will ensure a specification for works is produced, the client can meet the cost or a grant is applied for, obtain quotes and select a contractor and ensure the works are completed satisfactorily. The service will provide advice on issues such as benefit entitlement while carrying out a financial assessment of the clients ability to pay and can help with maintenance and safety works. The Council uses part of the Right to Buy receipt from Eastleigh Housing Association each year to provide 40% match funding to a 60% government grant to pay for DFG s. During 2004/5 it is budgeted that 450,000 will be spent providing DFG s, 180,000 of which will be from the Council s Right to Buy receipts. During the past two financial years regulations had allowed a higher amount to be spent but changes to these mean the current year s budget has been reduced to the levels for the years preceding 2001/2. It should be noted that some housing association landlords also provide funding for small-scale adaptations to their tenants homes. In particular, Eastleigh Housing Association spends some 80,000 per annum on works costing under 500 each. In addition, the Housing Corporation provides a small amount of funding for housing associations to carry out works. For Eastleigh HA this amounted to around 22,000 during 2003/4. In some cases, contributions will be made to the cost of major adaptations from an association s own reserves. Page 17

19 Requests for DFG s outstrip the finance currently available for them. The grant is a mandatory one and so the demand has to be managed by prioritising cases, leading to a waiting period of many months for non-urgent works. Even with extra finance, occupational therapist resources have been stretched and clients may have to wait 5 to 6 months for an assessment of their needs to be carried out. It is recommended that methods of reducing this waiting time be explored. Some of the most expensive DFG cases involve requests for extensions to homes or the provision of through-floor lifts. An extension can cost 25,000-30,000 while provision of a through floor lift with associated adaptations for a wheelchair can cost around 16,000. A small number of these cases can use a significant proportion of the available budget. The most expensive adaptations are often for families rather than older people but funding is from the same budget. Attempts are therefore now being made to encourage clients requiring major adaptation works, whether young or older, to seek alternative, suitable accommodation. We have set in place mechanisms whereby such cases are identified early enough to plan a home in a new development designed for the needs of a specific wheelchair user at a reasonable cost on the building contract. In order to provide a more pro-active approach to meeting the needs of those requiring adaptations it is proposed that a specialist housing occupational therapist (OT) be employed. This person can carry out prompt assessments of the works needed, advise on alternative housing options where appropriate, assess the suitability of any property vacancy advertised and fast track adaptation works. This can prevent the loss of an accommodation offer due to the extensive void period on a property that might otherwise be required before a client is able to move in. Social Services have already agreed to fund 50% of the cost of the post and attempts are currently being made to find the remaining costs from within the Council s Housing Services budgets. It is intended that this specialist OT will facilitate some savings within the DFG budget by seeking more cost effective housing options as well as providing a speedier service for clients. Despite attempts to improve the cost effectiveness of the DFG budget, demand is likely to continue to outstrip resources and as can be seen from chapter 3, demographic changes are likely to worsen the situation. It is therefore recommended that the total amount spent on adaptation works from the Council s capital resources be increased when necessary to prevent unacceptable waiting times for works. Details of costs to be notified and permissions sought as required. Changes to regulations on the provision of improvement and repair loans discussed under the next subheading have lead to a smaller spend in this area and so resources are likely to be available for re-direction. It should be borne in mind though that there is a choice to be made between spending the Council s capital monies on adaptation works or on using it to provide new homes as stated in the Housing Strategy. Repair and renovation For many older homeowners the maintenance of their home can become a major burden. For some, vulnerability can lead to an inability to select or supervise contractors allowing them to be taken advantage of through poor quality or expensive work. For others, a fixed income does not leave money for work to be undertaken. With a near 85% owner occupation rate in the Borough, many older owners are living in a valuable capital asset unencumbered by mortgage debt. Indeed, the housing needs survey found that 42% of all households in the Borough owned their homes outright. Most of these will be older people having paid off mortgages. Although the Page 18

20 survey shows that most homes in the Borough are in a good state of repair assistance in this area will help some to retain independence. Changes arising from the Regulatory Reform Order 2002 lead to the decision that from July 2003 home repair, minor repair and renovation grants should no longer be widely available. Instead options that utilise any equity in the dwelling will be looked at first, followed by loans. This may have a number of consequences including a higher incidence of disrepair amongst older people unwilling to release equity and less equity available to contribute towards care costs. Although many older people have substantial capital tied up in their homes there is often a reluctance to use money that may be seen as their childrens inheritance. Where grants are not available to homeowners for repairs, to maintain a warm, comfortable, safe and secure lifestyle the asset rich but cash poor will need to be persuaded to consider equity release or other options. When the new regulations came into effect it was found that the market in reliable loan and equity release products for older people was underdeveloped. In the past year therefore, assistance by the council in this area has virtually ground to a halt while new products are developed. To overcome these problems the Council is seeking to join with 5 other local authorities in the South Hampshire area to set up a loan facility with the Portsmouth Area Regeneration Trust (PART). PART will administer loans to elderly homeowners for repair works and although the local authorities will initially provide the funding for these loans it is hoped to raise commercial funds once a lending record has been established. It is also intended to apply for grant funding for the scheme from the Government Office South East. It is proposed that the PART initiative be supported and that loan and equity release options be publicised and explained to residents to encourage take up. It is further suggested that measures to assist with repairs and refurbishment be re-assessed once the findings of the Borough s stock condition survey are known. To help with more minor repairs the Council has been funding a handyperson service through the Home Improvement Agency since This provides reliable workmen to carry out repairs for the customer at a subsidised hourly rate. This is designed to take the worry away from people concerned about finding an honest and reliable contractor. Rates charged for work during the 2004/5 year are 5 to 8 per hour depending on ability to pay. Creating warm homes The Council employs a part-time officer to carry out its duties under the Home Energy Conservation Act. Measures to improve energy conservation in the housing stock are promoted, as are grants available through the government s Warm Homes campaign. Ensuring that as many homes as possible have double-glazing, loft and cavity wall insulation and a good central heating system can help prevent hypothermia and other illnesses in the elderly that can lead to hospital admission or a loss of independence. It is proposed that more work be undertaken to promote heating and energy conservation measures to older people. Where possible practical activities are undertaken such as distributing energy efficient light bulbs, tank jackets and radiator panels. For homeowners, loan or equity release measures will be encouraged, as set out in the HECA strategy, to pay for these works as appropriate. Page 19

21 Safety in the home A Homesafe scheme is also funded by the Council and delivered using the Home Improvement Agency. The scheme provides someone to check the electrical installation and appliances in a home as well as checking the security of doors and windows and ensuring there are no obvious hazards that could lead to trips, falls or other accidents. This health and safety check on properties is provided free of charge. Trips and falls are a major cause of admissions to hospitals and A&E departments. They also contribute to loss of independence. For this reason Health Services are carrying out assessments of sheltered housing schemes, day care and other services to identify and remove the causes of falls. They are also keen to link up with other services such as occupational therapy and Homesafe to ensure homes are made safer. It is recommended that resources be directed in a collaborative approach to ensuring these services are joined up and effective. Maintaining the garden Worry about maintaining the garden as well as the fabric of the home can be a factor in pushing an older person to seek a move to sheltered housing or residential care. An overgrown garden can prove stressful and can also alert passers by to the fact that the householder is vulnerable and may be easy prey as a crime victim. To help with this problem the Council established a gardening scheme in 2002, run by the Home Improvement Agency. Gardening for up to one hour per week is provided to the elderly and disabled at a cost of 5.00 per hour for those on means tested benefits and 8.00 per hour for others. The aim is to provide a reliable helper. Funding of the scheme by the Council for 2003/4 was 21,500. The service is hugely oversubscribed however and recently a new system of prioritisation has had to be introduced to ensure the service is targeted to those in greatest need. It is proposed that ways be considered of expanding this service in view of the level of demand. It is also recommended that a review be carried out to establish the effectiveness of the service in allowing elderly people to remain at home and to ensure that it is being properly targeted at those identified by health and Social Services as being most at risk. Help with shopping, cleaning and meals These services are not primarily provided by Eastleigh Borough Council but are essential in maintaining frail residents in their own homes. Shopping and cleaning are services usually carried out by relatives, friends or other carers, or bought in through the domiciliary care system. Meals are provided through Meals on Wheels which is partly funded by the Borough Council. It is not expected that the Borough will lead on the provision of these services although it is recommended that as part of an integrated approach with Health and Social Services, assistance be given with research and the development of new services as appropriate. Dealing with isolation Research clearly indicates that isolation is a major contributory factor to the onset of depression and dependency in older age. Finding ways to enable older people to maintain an active role in the community is challenging. At one level older people are more active taking part in volunteering, local politics and community-based activities. Page 20

22 These generally require a level of fitness and mobility. However, the trend is generally towards less mobility and involvement. In an area with high levels of car ownership maintaining access to basic services without one can be difficult. Promoting transport alternatives for older people is therefore especially important and links with the local transport plan need to be made to ensure that the needs of this group are considered. One of the attractions of sheltered housing schemes is that they provide the company of people of a similar age group and opportunities to take part in social activities. It is recommended that this aspect of sheltered housing schemes be promoted to older residents as a housing option and that work be undertaken with housing association landlords to encourage greater use of their communal facilities by residents in the wider community. It should be acknowledged that this is already happening in a number of sheltered schemes in the Borough. Efforts in this direction are likely to increase demand for properties in the schemes and so should in principle be welcomed by the housing association landlords. Efforts to deal with the issue of isolation involve a range of statutory and voluntary agencies and will be covered more extensively in the Council s overarching older persons strategy. Assistive technology Emergency call systems have existed in sheltered housing schemes for several decades and the extension of these to individual homes is also well established practice. In sheltered housing schemes residents usually have pull cords fitted into each room in their homes that contact a control centre when activated. Those in greatest risk and non-sheltered housing residents connected from their own homes will often have pendants or wrist bands to wear to initiate an alarm call. The control centre receiving the call can be located anywhere but will have immediate access to a database of information about the resident, can reassure them over telephone loudspeaker and can summon named contacts of the caller or the emergency services to visit as appropriate. In Eastleigh the charity COPE was set up to provide alarm call systems to residents of any tenure not already linked to a housing association scheme. In 2004 this work was taken over by Eastleigh Community Services (ECS) and as at April 2004 the system is provided by them to some 600 homes in the Borough. Demand for this service is likely to increase with the numbers of frail elderly choosing to stay living in their existing homes. ECS are developing plans to broaden their range of provision. Technology has now advanced and systems are becoming available that can monitor movement in a home based on the occupants normal routine and provide an alert if they do not get up or go out at their normal times. Smart technology can also be used to turn off appliances when the gas to them is not lit for example or when they have not been used for a period of time. Hampshire County Council is currently investigating the use of such a system. If successful, the intention is to roll this out across the county. Again, this is not an area the Borough Council needs to lead on but it is recommended that assistance is given with such projects where practical. It should be noted that if used in new developments, there are likely to be capital cost implications. Page 21

23 Flexible care and support A hierarchy of services that are readily accessed needs to be created with clear protocols about the trigger points for stepping up or down the care and support as needed. It should include: Home Safe schemes Aids, equipment and technology Adaptations Floating Support Meals on wheels Day care services Domiciliary care Shopping services Community transport Neighbourhood watch schemes Extra care Specialist support e.g. for dementia Personal care Night visits Intermediate care and rehabilitation Respite Specialist housing including nursing and residential care Page 22