WANDSWORTH COUNCIL. Older people Housing Policy Statement and Strategy

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1 WANDSWORTH COUNCIL Older people Housing Policy Statement and Strategy October 2008

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3 CONTENTS 1.0 Introduction Older people: the strategic framework nationally and London-wide National strategy Lifetime homes, lifetime neighbourhoods: a national strategy for housing in an ageing society London strategy Older people in Wandsworth Wandsworth: the younger borough Tenure of older residents in Wandsworth Wandsworth s older residents: health and disability Wandsworth s older residents: increasing ethnic diversity Wandsworth s older residents: future projections Older people s housing: the effects Older people housing policy statement Aim of the policy Implementing the policy The older people housing strategy Aims and objectives of the strategy The housing service: older people Policies and service statements Service Delivery Providing accommodation Temporary accommodation for homeless households Non-sheltered housing including housing suitable for wheelchair users Underoccupation: the room to move scheme The physical disability queue Sheltered housing Resident participation and community involvement in sheltered housing Extra care housing Care homes, care homes with nursing and specialist accommodation for older people with mental health needs Adaptations to current property continued

4 Providing information, advice and support Supporting people WATCH Lifeline and Telecare Tenancy support service Concessionary decorations assistance scheme Housing webpages Private sector housing and the home improvement agency Age Concern: Wandsworth practical help at home service Creating a safe environment Improving safety, security and access on estates FLaSH: the fires, locks and safer homes scheme Hate crime and harassment Overcoming barriers to communication People with hearing or speech impairments People with visual impairments Service standards in relation to older people Statutory powers and legislation Links with other strategies Multi-agency work Training and support Monitoring and service development Older people housing action plan Equality impact assessment APPENDIX 1: Council-owned sheltered housing APPENDIX 2: RSL (registered social landlord) owned sheltered housing APPENDIX 3: Care homes APPENDIX 4: Care homes with nursing APPENDIX 5: Statutory responsibilities in relation to older people APPENDIX 6: Equality impact assessment: summary APPENDIX 7: Map of sheltered housing, extra care housing and care. homes

5 Older People Page Introduction 1.1 The council has a key role to play in ensuring that the departments within the council work closely with each other, the NHS and other local partners to ensure that older people are enabled to make active and informed choices about their accommodation and to sustain their independence and well-being in their own home for as long as possible. 1.2 This document sets out the council s housing policy and strategy for older people who require housing and housing-related support services in their own right or as part of a household. It will form an element of the future updated Housing Strategy and Business Plan, which will be prepared in line with the revised strategic housing objectives approved by the council in November It will also support the new five-year ( ) strategy for older people, which has been developed by the council in partnership with Wandsworth Teaching Primary Care Trust and other stakeholders It has been developed by the interdepartmental and inter-agency Older Persons Accommodation Review Working Group, which is chaired by the deputy director of housing and includes representatives from the council (housing department, adult social services department, home improvement agency and policy unit) and the primary care trust (PCT). A three month consultation on the first draft of this policy statement and strategy and the accompanying action plan was launched on 15 November 2007 at an event organised by Wandsworth Older People s Forum to aid consultation by the council on an overarching strategy for older people in Wandsworth. 1.4 Following this event, the documents were sent out to residents associations (including sheltered housing residents associations) of council tenants and leaseholders, Resident Management Organisations who manage between them about ten per cent of the council s housing stock, Registered Social Landlords who operate in Wandsworth, members of the Wandsworth Strategy Group for Older People (WSGOP) and community groups (including Wandsworth Older People s Forum and Age Concern Wandsworth) on the housing department s database who had expressed an interest in being consulted on one or more of the following: older people, housing strategy and accessing housing services. 1.5 The documents were also published in the housing section of the council s website 3 with feedback invited and an article was included in the January 2008 edition of the council s sheltered housing newsletter advising tenants that they could obtain a copy from their sheltered housing officer and encouraging them to tell us what they think. Only three responses were received to the consultation and all were supportive of the approach taken. In addition, Wandsworth Older People s Forum provided more general feedback, based on their own consultation (including the event held on 15 November 2007) on the council s overall strategy for older people

6 Page 2 Older People 1.6 As highlighted by Wandsworth Older People s Forum 4, by the time most people reach pensionable age, they have managed to achieve secure housing and created a home so, while it is important to meet the needs of people rendered homeless in old age, most older people are no different to others in respect of housing needs and therefore need three elements to enable them to have a secure base from which to lead a social life: a) adequate income to be able to cover the essential outgoings of the home b) personal control over their tenure every effort should be made to enable people to live at home c) space to lead their desired lifestyle 1.7 As also highlighted by Wandsworth Older People s Forum, the objective of any strategy for older people is centred on independence and self-sufficiency and enabling older people to lead safe and happy independent lives in their own homes is crucially dependent on a comprehensive support structure being in place to overcome the everyday practicalities. Access to handyman services, as provided through Age Concern Wandsworth (see page 49), was emphasised as vital to enabling people to continue to live at home. In addition, the services of the Home Improvement Agency and Houseproud loans (see page 48) were identified as an important part of the support network for older homeowners. 1.8 They emphasised the prospect of facing a move from one s long-term home to a smaller one as being one of a number of life events which can precipitate problems and advised us of the need for an advocacy service which can support older people without relatives, or any living nearby, at such times. They also advised us that older people who are under-occupying their homes may be more willing to downsize if they are able to keep a spare room as, if they have children, a key part of their sense of independence might be the ability to have the children stay with them on a visit, something which becomes more relevant as families are dispersed geographically. For information about the council s Room to Move scheme, please see page They told us that good information should be available about the options for alternative accommodation and that the extra care housing project (see page 38) is good and needs to be replicated so that it is an option available in each part of the borough as people should only have to move away from their familiar district if they wish. The provision of information and advice about housing options will be considered as part of a wider review of the provision of information and advice for older people through the council s overarching strategy for older people. 4. Wandsworth Older People s Forum (January 2008) Second Thoughts on an Older People s Strategy for Wandsworth

7 Older People Page Older People: the strategic framework nationally and london-wide National strategy 2.1 In January 2001, the then Department of the Environment, Transport and the Regions (DETR) and Department of Health (DH) jointly issued the document Quality and Choice for Older People s Housing: A Strategic Framework 5, which set out for the first time the Government s vision for older people s housing and housing-related support. Through the ongoing development and improvement of this strategic framework, the Government s aim was to explore the key housing issues that affect older people and to ensure that policies and actions are put in place to address them, including specific concerns of older people from black and minority ethnic (BME) communities, older people with dementia and others with specific needs and requirements. 2.2 The framework made it clear that local authorities have a key role to play in taking the lead locally, working with the NHS and other local partners, to take stock and identify any gaps or weaknesses in their local strategies. It recognised that housing policy has a major role to play in ensuring that older people are able to realise their potential. It acknowledged that effective housing, allied to the right care, support and wider services, such as good transport and community safety, can be the springboard that enables older people to remain involved and live their lives to the full whereas poor housing can be a fetter to older people, contributing to immobility and social exclusion, ill health and depression. 2.3 The framework identified two major objectives: a) to ensure older people are able to secure and sustain their independence in a home appropriate to their circumstances; and b) to support older people to make active and informed choices about their accommodation by providing advice on suitable services and options to ensure access to appropriate housing and services 2.4 It suggested that service approaches should be integrated, holistic, inclusive, involving and preventative and identified the following priority areas for new policy and service developments: a) diversity and choice: ensuring services promote independence and are responsive to all older people s needs and preferences b) information and advice: ensuring that information and advice are accessible both to professionals and older people themselves on the variety of housing and support options / solutions available c) flexible service provision: assisting local authorities and service providers to review housing and service models in order to improve flexibility to meet changing needs, taking into account the views of older people d) quality: emphasising the importance of the quality of housing and support services, both in terms of ensuring homes are warm, safe and secure and in monitoring the services provided e) joint working: improving the integration of services delivered at the local level by housing, social services and health authorities and nationally through Government departments. 5.

8 Page 4 Older People 2.5 The publication of the National Service Framework (NSF) for Older People s Services 6 by the Department of Health in March 2001 highlighted the importance of links being made across strategies and policies, particularly between housing, social care and health. The NSF set new national standards and service models of care across health and social services for all older people, whether they live at home, in residential care or are being looked after in hospital. It set out eight standards for improving the health and social care of older people in relation to: a) Rooting out age discrimination b) Person-centred care c) Intermediate care d) General hospital care e) Stroke f) Falls g) Mental health in older people h) The promotion of health and active life in older age 2.6 All of the standards have implications for housing. For example, standards six (prevention of falls) and eight (promoting an active, healthy life in older age) can only be addressed effectively if the housing dimension for older people is addressed. This means asking how suitable their housing is and considering what adaptations, equipment and repairs can help to maintain their independence and well-being. 2.7 As one of a number of follow-up actions to Quality and Choice for Older People s Housing, the then Office of the Deputy Prime Minister (ODPM), the Department of Health and the Housing Corporation commissioned the guidance document Preparing Older People s Strategies linking housing to health, social care and other local strategies, which was published in February to ensure that the diverse needs of older people are considered and reflected in the wide range of strategy documents and guidance local authorities are required to produce. The document emphasises the importance of links being made across strategies and policies, particularly between housing, social care and health. It highlights the need for particular emphasis to be given to the needs and requirements of the growing numbers of frail older people and older people from black and minority ethnic communities. It also encourages local authorities and their health partners to make the strategic shift away from residential care and towards a broader range of supported housing models, including extra care housing in order to provide greater choice, independence and control for older people in line with changing aspirations. 2.8 The importance of the links between housing, social care and health were further highlighted with the implementation of the Supporting People programme. Launched in April 2003, the programme provides housing related support to various client groups, including older people (the largest client group for services provided under the programme), to prevent problems that can often lead to hospitalisation, institutional care or homelessness and can help the smooth transition to independent living for those leaving an institutional environment

9 Older People Page In March 2005, the Department for Work and Pensions (DWP) published Opportunity Age: Meeting the Challenges of Ageing in the 21st Century. 9 The strategy is set in the context that over the next 50 years the UK and the rest of the developed world will experience an unprecedented change in the fabric of society. As life expectancy increases and the birth rate remains low, the proportion of the population aged over 50, over 65 and over 80 will increase dramatically. The aim of the strategy is to end the perception of older people as dependent and ensure that longer life is healthy and fulfilling and that older people are full participants in society. The strategy recognises that income is not the only factor and often not the main factor in ensuring a happy and fulfilling later life: housing, health, care, transport and social contacts all play a crucial part in enabling older people to live life to the full Coordinated and led by the Secretary of State for Work and Pensions (in the role as Champion for Older People), the strategy focuses on three key areas: 10 a) work and income to achieve higher employment rates overall and greater flexibility for over 50s in continuing careers, managing any health conditions and combining work with family (and other) commitments b) active ageing to enable older people to play a full and active role in society c) services that allow us all to keep independence and control over our lives as we grow older, even if we are constrained by the health problems which can occur in older age 2.11 The strategy recognises that living in a decent, warm and comfortable home is central to maintaining independence and well-being, that older people generally want to remain living in their own home for as long as possible and that, sometimes, this means providing adaptations or other support. Therefore, it aims to give older people the support they need to remain in their own home for as long as possible, in warmth and comfort In addition, in March 2005 the Department of Health published the social care green paper Independence, Well-being and Choice 11, which sets out a vision for adult social care over the next five to ten years. The key proposals for improving choice and control are: a) wider use of direct payments and the piloting of individual budgets b) greater focus on preventative services c) a strong strategic and leadership role for local government, working in partnership with other agencies, particularly the NHS and d) encouraging the development of new models of service delivery and harnessing technology 2.13 The White Paper Our Health, Our Care, Our Say: A New Direction for Community Services 12, published by the Department of Health in January 2006, confirms the vision set out in Independence, Well-being and Choice, sets a new, more integrated direction for the health and social care system and outlines a new role for directors of adult social services to tackle disadvantages encountered by older people. The focus for social services will be to help people continue to live at home and to en?content_id= &chk=qpboyy 12.

10 Page 6 Older People give them greater choice about the help and support available. Housing and housing-related care and support services are expected to contribute to this agenda In January 2006, the former ODPM (Office of the Deputy Prime Minister) published A Sure Start to Later Life: Ending Inequalities for Older People 13 which uses the same methods as the children s Sure Start model to improve access to services, bringing together services around older people in line with the Sure Start principles of independence, choice, prevention and well-being. It promotes more efficient, joined-up working by the key partners of health, social services, housing and benefits, as well as often overlooked links such as transport, leisure, community safety and learning A Sure Start to Later Life outlines how a Sure Start approach to housing can help older people to remain independent and live their lives to the full through better integration between housing and other services (particularly health and social care), a preventative focus and giving people the information they need to make informed decisions. It considers the needs of older people as they remain in their own home and the importance of low-level services, such as home safety and security, which prevent older people reaching crisis point The report identified a number of issues that may prevent many older people enjoying the standard of housing they deserve. These are grouped under five headings: Access to information 2.17 Older people need: a) information to enable them to maintain their homes and have repairs carried out b) information on housing options to enable them to move if they wish Maintenance and repair of existing housing 2.18 Older people can face a number of problems in trying to ensure that their home is adequately adapted and refurbished to meet basic standards and to allow them to maintain a decent quality of life, including: a) knowing what they are entitled to b) the length of time to get adaptation work done c) financing home adaptations d) lack of access to suitable contractors Housing options 2.19 While not every older person will want to move to specialist retirement housing, those who do want a good range of local choices in types of housing (for example sheltered and extra care housing) in both the social rented and private sectors. Housing options can be particularly important for older people from black and minority ethnic communities and older homeless people. 13.

11 Older People Page 7 Joining up 2.20 Services should work to enable older people to remain independent in their own homes and should be effectively joined up to ensure that older people have one point of access to a simple and efficient service Supporting older people to remain independent in their own homes involves: a) Home Improvement Agencies b) The Decent Homes programme c) Aids and adaptations d) Integrated Community Equipment Services e) Disabled Facilities Grants f) Community alarms g) Social care services h) The Supporting People programme i) Voluntary sector handyperson schemes j) Fire safety k) Warm front l) Telecare Prevention 2.22 For many older people, a range of low-level support will be critical to ensuring independence. Such support can include services such as the provision of smoke alarms and sprinkler systems, improvements to the warmth and energy efficiency of the home, community alarms and Telecare, practical support around the home and garden, and equipment and adaptations The pilot project Link-Age-Plus 14 is testing the Sure Start approach in eight local authority areas in England, including Tower Hamlets (the only London borough in the pilot). Link-Age Plus aims to provide a single gateway (or one-stop shop ) for older people to access services provided in the community, ranging from housing, social care and financial benefits to transport, health and volunteering opportunities and a final evaluation report is due to be published in March Following the commitment given in Opportunity Age, Independence, Well-being and Choice and Our Health, Our Care, Our Say that Individual Budgets would be piloted for older people, a pilot programme was launched on 21 November 2005 and a series of 13 pilot programmes (including two in London boroughs: Barking and Dagenham and Kensington and Chelsea) to develop Individual Budgets for older and disabled people were established throughout England. The aim of Individual Budgets is to develop a more integrated approach to the provision of care and support, putting the person who receives support services in control of deciding what support they require. 14.

12 Page 8 Older People 2.25 Six funding streams were included in the pilots: equipment and minor adaptations, disabled facilities grant (DFG), community care services, independent living fund, supporting people and access to work. The pilot programme finished on 31 December 2007 and an evaluation report is due to be published in Autum Following the publication on 10 December 2007 of Putting People First: a shared vision and commitment to the transformation of adult social care 15, Individual Budgets remain an important part of the Government s agenda to give people who use public services more choice and control. Further information can be found on the Individual Budgets Pilot Programme website. 16 Lifetime homes, lifetime neighbourhoods: a national strategy for housing in an ageing society 2.26 In May 2007, the Communities and Local Government Department (CLG) published a pre-strategy document 17, which provided a short overview of work on the National Strategy for Housing in an Ageing Society and sought views from local authorities, housing associations, the voluntary/independent sector and any interested person/individual on the following questions with responses requested by 11th June 2007: a) What should be the vision for the national strategy? b) What evidence best explains the issues and trends? c) What aims and outcomes should we have for the strategy? d) What should be the priority areas for action in the strategy to achieve our aims? 2.27 Following this consultation, Lifetime Homes, Lifetime Neighbourhoods: A National Strategy for Housing in an Ageing Society 18 was published by the CLG on 25 February The strategy is presented as a living document, which sets out the Government s priorities plus actions which have been agreed to meet them and states that a delivery plan will be developed over the six -month period following publication. It recognises that good housing is critical if mounting pressures on care and support expenditure are to be managed and the best possible help and support are to be provided. It recognises that non-decent or hazardous housing brings about many costs which could be significantly reduced (for example, if we could prevent older people from falling and being hospitalised or institutionalised too early) and that future health and care will be increasingly inter-dependent. Therefore, the strategy makes housing and ageing a cross-government priority It starts from the position that we all want to ensure that we can stay independent in our own homes for as long as possible but that age brings with it a greater acknowledgement of interdependence with family, community, services and neighbourhood. It proposes that achieving the right balance means looking at planning for new homes and neighbourhoods which can sustain the changes of a lifetime; providing impartial information at an earlier stage so that people can make better and more confident decisions; greater choice of quality housing options; increased support to enable people to stay in their own homes or to move on, and better, more integrated housing support services to help people maintain their independence in their own home, CLG (May 2007) National Strategy for Housing in an Ageing Society a pre-strategy document seeking your views : 18.

13 Older People Page 9 for example through Home Improvement Agencies and adaptations services, community alarms, floating support and sheltered housing It suggests that older people want housing that meets the needs of all age groups and is well designed with growing older in mind (with a downstairs toilet and bathroom with bath and shower being particularly important), affordable to heat and with space to accommodate visiting family or friends and good storage space. It highlights that access to green, private space and a safe neighbourhood is important, as is housing that is accessible to good local transport, facilities and amenities. It also suggests the need for access to independent information and advice about housing options and support, including a reliable repairs and adaptations service for that bit of help around the home. However, it suggests that above all, people want to be listened to and be involved in the design of everything that will affect them, from planning and lifetime homes standards, to the creation of safe environments, to testing new equipment and IT devices. It also highlights that older people tend to be the most satisfied with their accommodation but for some this perception is likely to be because they have lower expectations. Research published alongside the strategy 19 can guide local decision-makers but should not substitute for local engagement with older people on the issues that matter for them The strategy is underpinned by the twin requirements of: a) economic sustainability housing must maximise public and private resources and empower older people to remain economically active; and b) social sustainability housing must promote equality, social connection and inclusion and the health and well-being of older people 2.31 It sets out the principles which will make for security and confidence that old age can be a safe, healthy and fulfilling time of life: a) to plan at all levels local, regional and national for homes and communities so that people can live out their lives, as long as possible, independently, safely and happily with their families and friends around them b) to ensure that the right choices of specialist housing are available for those who need more support, homes at the heart of the community that look and feel like home c) to ensure that the positive and right choices can be made at the right time and in a planned way, rather than as the result of a crisis; and d) to ensure that housing is seen as central to health and well-being and that services are planned and integrated to reflect that 2.32 It highlights the recognition given by the Housing Green Paper Homes for the Future: more affordable, more sustainable 20 which was published by the CLG at the end of July 2007, that local authorities and their partners are key to identifying and addressing need at the local level and that local authorities must take a strategic approach to housing as part of their place shaping role, planning and commissioning housing support services to link homes to the support and other services that people need to live in them, as well as working in partnership to ensure effective housing and neighbourhood management. It outlines the expectation that local authorities should, as part of their role in both 19. CLG (25 February 2008) Housing Choices and Aspirations of Older People: Research from the New Horizons Programme : 20.

14 Page 10 Older People planning and facilitating new housing and making best use of existing stock, refresh their housing strategies to better reflect the strategic role and their wider vision for the area. It is expected that strategies will include evidence of housing needs and housing support needs identified and plans to address these needs It is suggested that the guidance contained in Preparing Older People s Strategies can be built on through the use of new tools which have been created including: a) better data including robust and accurate analysis of demographic trends which will inform housing and planning authorities in catering for an older population with different expectations and needs; and b) new practical toolkits including a new publication to support the local strategic development of housing with care. 21 Prevention, information and choice 2.34 In terms of providing a better deal for older people today, the strategy sets out as a priority the improvement of prevention, information and choice to enable older people to make informed choices and plan ahead properly and the support of those most in need to enable people with complex needs and multiple problems to get joined-up housing and related services to enjoy the best quality of life The strategy states the Government s intention to boost preventative housing services through investing in proven approaches, such as advice and information, adaptations and repairs, which can prevent health and care crises for individuals. It also states the intention to ensure early identification of the people that most need support through piloting the use of predictive risk modelling to accurately identify which people are most at risk of a health or care crisis, such as hospital or home care admission, a year before it happens. Information and advice 2.36 The strategy identifies a critical need for more and better information about the range of housing choices available to older people and particularly for more information about the help and support that is available to older people wishing to stay in their own homes in order to ensure that those homes are safe and comfortable. It also suggests that housing advice should encompass wider issues around care and support and that one particular area where more and better information and advice is of crucial importance is in relation to options for financing home improvements, particularly through private finance and equity release It highlights that older people can find that their access to the right information and advice is poor for a range of reasons, including lack of access to the internet and that with limited access to information setting out their possible options, older people can feel that they have lost control over their future choices. It acknowledges that some groups of older people, such as disabled people with sensory impairments or mobility problems, those with learning disabilities or mental health problems and the homeless face additional barriers. Further acknowledgement is given to the fact that some older people 21. CSIP (February 2008) More Choice Greater Voice a toolkit for producing a strategy for accommodation with care for older people :

15 Older People Page 11 from black and minority ethnic (BME) groups may also face particular difficulties in accessing information and advice, due to language or other reasons. Reference is made to a study commissioned by the Scottish Executive and published in 2007 which reflected on the lack of experience within migrant communities of ageing within the UK context, and a lack of knowledge regarding the type and availability of services for older people and the various agencies involved The strategy suggests that information, advice and support must be tailored to individual levels of need and risk so while for most people thinking about their choices, a light touch service such as web and telephone based information and advice is appropriate, a more intensive local support and advocacy service will be needed for those who are most at risk, including those who lack alternative personal and social resources The strategy sets out the Government s intention to develop a national advice and information service for older people, which will build on existing advice and information services and consist of a national webbased and telephone service which will be run by independent organisations and progressively linked in to the services of local authorities, home improvement agencies and other local voluntary and community sector front line, local organisations. The First Stop Adviceline 22, (which is initally being piloted in London and the South East) opened in July It is an independent, free service providing information and advice about care and housing in later life and is provided jointly by Counsel and Care, Elderly Accommodation Counsel, Help the Aged and NHFA Limited. It is intended that the service will develop across the sectors of social care and financial support so that, in time, it will become a one-stop shop for older people, progressively developing links to the pensions and benefits service. The strategy sets out a vision that this will be a first class information service whether at the end of a telephone line or online to be complimented by local one-stop shops where anyone can find out the full range of options available locally. As outlined on page 7, a final evaluation report of the Link-Age-Plus pilots (which aim to provide a one-stop-shop for older people to access services provided in the community, ranging from housing, social care and financial benefits to transport, health and volunteering opportunities), is also due to be published in March Low cost home ownership 2.40 The strategy proposes that low cost home ownership schemes generally have potential for the older market to help people move into better or more manageable housing and to access capital. It details the Housing Corporation s Shared Ownership for the Elderly (SHOE) product which is targeted specifically at people who are aged over 55 and allows them to move from a property they own outright to a property in which they own a share of between 25 and 75 per cent, with no rent paid on the remaining share if 75 per cent is owned. While the programme is small, the strategy states that there are 49 housing associations who, since , have offered or who are offering SHOE, and that there is coverage in all regions, with the total number of completions achieved totalling 517. The Hills Report into social housing 23 notes that some older LSE (20 February 2007) Ends and Means: The future roles of social housing in England :

16 Page 12 Older People homeowners might benefit from the ability to staircase down, to draw out part of the equity they have built up when they need it. The strategy acknowledges that, while Homes for the Future 24 identified a key role for the private sector in offering shared equity mortgages or shared ownership homes, there has been very little private sector provision of shared equity products. The Government is seeking further advice on ways to develop the private sector shared equity market. Home improvement agencies and handyperson services 2.41 The strategy sets out the Government s plans to develop new rapid repairs and adaptations services, expanding coverage of handyperson schemes across the country from 2009, with new funding being made available from 2009 to 2011 through a local and regional development bidding process. The funding will be targeted to expand coverage of handyperson services nationally, help to build capacity within the sector and develop service standards. The strategy also sets out the Government s intention to work with local authorities, health sector service commissioners and other partners, including home improvement agencies to ensure that the delivery of handyperson schemes are linked into related services such as falls and accident prevention, home security, fire safety, energy efficiency, adaptations and targeted health improvement As made clear in the strategy, the Government wants to see Home Improvement Agencies (HIAs) developing as the hub around which vulnerable clients exercise their choice about their home environment, providing older people with personal support to make informed choices about the full range of housing options so, even if it is not possible to provide a service themselves, the HIA could act as the advocate for the client whilst the service is delivered by others. Therefore, the Government commissioned Foundations, the national coordinating body for HIAs, to undertake the Future HIA Project. A report presenting an overview of the main findings was published on 9 September It states that the full report will be published in Autumn While the project recognises that the sector is extremely diverse and that no single model will be appropriate for all agencies, it suggests that all HIAs in the future should share two key facets: client-centred support provided in a person s own home and expertise in making changes to the physical fabric of the home It also highlights that due to the introduction of direct payments, personal budgets and potentially individual budgets (see page 7) HIAs will need to adapt to an environment in which older and disabled people will have greater involvement and say in the services they receive, so changes are expected in the way services are commissioned and provided. It advises that HIAs will need to promote themselves to the wider public in order to attract referrals and offer services that can be purchased direct by individuals

17 Older People Page 13 Lifetime neighbourhoods, lifetime homes and wheelchair accessible housing 2.44 In terms of ensuring that the housing needs of older people are met in the future, the strategy sets out as a priority to ensure that the homes and neighbourhoods we design and build are suitable for people at every stage of their lives and describes lifetime neighbourhoods as; neighbourhoods where transport, good shops, green spaces, decent toilets and benches are consciously planned for people of all ages and conditions in mind a simple concept but not often achieved It states the Government s intention to ensure that all public sector funded housing is built to Lifetime Homes standards 26 by Specifically, it states that Lifetime Homes standards will be made a mandatory part of the code for sustainable homes to encourage progressively increased take-up in new build projects. It is proposed that the standard will be made mandatory in the code at level six from 2008, at level four from 2010 and at level three from The strategy states the Government s aspiration that by 2013 all new homes will be being built to Lifetime Homes Standards and the intention to review take-up of the standards in 2010 with a view to bringing forward regulation in 2013 if take-up has not matched expectations While lifetime homes are designed to adapt to changing needs over time and include features helpful to wheelchair users, fully wheelchair accessible homes are purpose built to suit the needs of wheelchair users with the necessary circulation space and level access to provide full wheelchair access to all parts of the home and with adjustable fixtures and fittings to enable occupants to live more independently and enjoy a better quality of life. The strategy states that it is therefore critically important for housing needs assessments to consider and plan for appropriate levels of provision of wheelchair standard housing, which should be considered within mixed tenure residential developments in locations with good access to amenities and services The South West London Housing Partnership s Investment Framework for South West London already requires, in line with the London Plan, that all new affordable housing built in South West London (including Wandsworth) should be built to the Lifetime Homes standard and that ten per cent should be wheelchair standard. This requirement was also included in the Investment Framework In terms of adapting existing housing, the strategy sets out the Government s plans to modernise the Disabled Facilities Grant (DFG). DFGs are discussed further on pages The strategy sets out the Government s expectation that all local authorities will introduce choice-based lettings (CBL) by 2010 and its intention to encourage the adoption of accessible housing registers to ensure the best use of existing accessible housing. It also highlights that the CLG has provided 186,000 to assist London boroughs and RSLs to implement the London-wide accessible housing register. This is discussed further on page

18 Page 14 Older People Specialised housing (e.g. sheltered housing, extra care housing and care homes) 2.50 The strategy states the Government s intention to ensure that a more strategic approach is taken nationally and locally to determine what type of housing is needed in what location, supported with newly published tools for local strategic planning which will be supported by better evidence and a coordinated cross-government research approach. Reconnecting housing, health and care 2.51 The strategy acknowledges that decent housing makes a fundamental difference to mental and physical health and well-being and has a critical contribution to make to the value and effectiveness of the health and care systems but that these services do not always join up and housing can sometimes be left out of the equation. It recognises that if preventative approaches are to work, it is necessary to identify those at risk as early as possible and that the joining up of other services with housing must be seen as vital in delivering the Department of Health s agenda of care close to home, early discharge and early intervention and prevention It outlines the Government s plans to: a) pilot a new approach to transform early intervention and prevention, using predictive risk modelling to accurately identify which people will have a health or care crisis, such as hospital or care home admission, a year before it happens b) take action to further join up assessment, service delivery and commissioning to deliver better personal outcomes for older people, including the further development of the single assessment process to include health, housing, care and benefits c) deliver greater personalisation through the use of personal budgets and individual budgets, with the wider roll out of individual budgets and the form they might take being subject to the evaluation of the pilots which is currently under way (see page 7) London strategy 2.53 In July 2006, the Government announced that the Mayor of London would be responsible for the capital s Housing Strategy and for deciding the broad distribution of investment in affordable homes. Valuing Older People: The Mayor of London s Older People Strategy, which was published in September 2006 by the Greater London Authority (GLA) 28 raises a number of issues related to older people s housing and homelessness, which are also addressed in the former Mayor s Draft Housing Strategy which was published by the GLA in September 2007 and due to be formally consulted upon and finally approved during the latter part of Given the change of Mayor after 1st May 2008, it is reasonable to anticipate that the new Mayor s policies will differ from those of his predecessor. As publication of the new London Housing Strategy is awaited this section sets out the issues with relevance to older people s housing needs raised by the previous Mayor s older people strategy. 28.

19 Older People Page The strategy recognises that adequate housing is essential for an individual s health and well-being and that poor quality housing is linked to poor health whereas well designed and suitable housing allows older people to retain their independence Many older homeowners in London have difficulty maintaining their homes, usually because of their low incomes but, while they are often cash poor, many older owner-occupiers have large amounts of equity in their homes: 94 per cent of pensioner homeowners have equity of 100,000 or more tied up in their property. The strategy describes how equity release schemes such as the Houseproud scheme 29, which guarantees that no home will be repossessed while the client is living in the home, can offer older people the opportunity to mobilise some of this capital in order to carry out essential maintenance, repairs and adaptations and quality of life improvements. Older homeowners in Wandsworth can obtain advice and information about grants and loans, including Houseproud loans, through the Home Improvement Agency who actively promote such options (as outlined on page 49) The strategy highlights the requirements of the London Plan that all new housing must be built to the lifetime homes standard 30 and ten per cent must be wheelchair accessible or easily adapted to be so to ensure that London s future homes are more easily adapted to meet people s changing housing needs as they get older. As outlined on page 13, the South West London Housing Partnership s Investment Framework for South West London already requires, in line with the London Plan, that all new affordable housing built in South West London (including Wandsworth) should be built to the lifetime homes standard and that ten per cent should be wheelchair standard and this requirement was also included in the Investment Framework Unfortunately, it is not always possible to adapt existing housing to meet changing needs and, for those who need to move, the strategy outlines work under way to develop a London Accessible Housing Register to improve access to and information about available, accessible and adapted properties across London. On 27 September 2007, the GLA published Housing Choice for Disabled Londoners: Delivering the London Accessible Housing Register. 31 The strategy suggests that most social landlords do not hold accurate information about their accessible homes and as a result many accessible and adapted homes are let to people who do not need them. As outlined on page 33 of this document, this is not the case for Wandsworth Council properties as all council properties that become available for re-letting are inspected and an assessment is made as to whether they can be adapted to meet the needs of any of the households on the Physical Disability Queue

20 Page 16 Older People 2.58 Recognition is also given to the fact that older homeless people are especially vulnerable to the known triggers of homelessness and the needs of older homeless people are more likely to go unmet as services for homeless people are often more tailored to the needs of younger people while services for older people tend to assume that they are already housed. It is also acknowledged that, once housed, older people who have been homeless are more likely to have difficulty maintaining a tenancy because of their multiple physical / mental health needs, longer periods of homelessness and extreme isolation caused by a lack of support networks meaning that they often require ongoing support to sustain a tenancy. As demonstrated on page 30 of this document, the number of households in Wandsworth who are accepted as eligible, unintentionally homeless and in priority need because they or a member of their household are vulnerable as a result of old age, is extremely low (only seven households in 2007/08) and it has always been possible to accommodate these households within sheltered housing schemes where they have the support of a Sheltered Housing Officer or within general needs housing if they prefer, with support if necessary A significant number of older people are living in under-occupied properties and the strategy encourages underoccupation schemes, which help those older people who would find a smaller home easier to keep warm, cheaper and more manageable to run to move to more suitable accommodation. Details of Wandsworth Council s Room to Move underoccupation scheme are provided on page 32 of this document. The strategy highlights how housing related support services such as community alarm provision (for example, Wandsworth Council s WATCH Lifeline see page 46), floating support and wardens in sheltered and extra care housing can enable older people to remain independent in their homes for longer. It also acknowledges that appropriate, low-level services can enable older people to retain their independence and supports the call by the Association of Directors of Social Services (ADSS) and the Local Government Association (LGA) for a long-term shift in resources from acute to community-based health, social care, housing and prevention services Unfortunately, it is not always possible for older people to remain independent in their current home and it is important that other housing options are available. The strategy identifies a severe shortage of care homes in the capital, with 22 care home places per 1,000 older people in inner-london and 39 in outer-london compared to an average of 48 places per 1,000 older people in England as a whole. It also points to a lack of culturally appropriate residential services in London, where older people from BME communities form a much higher proportion of the population than elsewhere in the country.

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