An Age of Uncertainty?

The future of home adaptations in a changing world

Sue AdamsCare & Repair England

Presentation

Emerging policy context with regard to state assistance with home adaptations

Ideas being explored by the National Home Adaptations Consortium

Practice connections

Who?

Care & Repair England; national housing charity aims to address poor and unsuitable housing conditions amongst older population, particularly low income home owners (since 1986)

Pioneered; local Care & Repair services, Minor works grants, Handyperson, Housing Options, Healthy Homes, Older People & “Housing Activism” plus related policies esp. adaptations and PSHR

Home Adaptations Consortium

Single aim: ‘To champion quality provision of home adaptations for disabled people’ - since 2008

Broad alliance includes: COT, CIEH, CIH, NHF, Hanover, Habinteg, Foundations, AgeUK, ADASS, Mencap, MS Society, RL Glasspool, ACO, Royal British Legion

Think tank discussions - published ‘Is it so much to ask?’ www.careandrepair-england.org.uk/pdf/dfgc_broc.pdf , and CSR Submission

Age of Uncertainty………….

Fundamental shift in thinking

Revision of ideas around role of the state vs the individual including disability and later life (OP=half+ of all disabled)

Social model of disability and responsibility of society in enabling independence and inclusion

Social Model of Disability

Disability arises from the barriers presented by society and the built environment rather than being inherent in the person themselves

Society should make adjustments to ensure the inclusion of the individual, regardless of their differences

Lifetime Homes founded on this vision

Age of Uncertainty: Social Care

State is re-negotiating its ‘contract’ with citizens and their care & support, particularly in later life

Dilnot review of adult social care funding and Law Commission review of legislative framework

DH White Paper - soon

Age of Uncertainty: Housing

State’s role in housing – massive change

100% cut in private housing funding

73% cut to DCLG Capital funding, end of social housing grant

Localism

[And yet, DFG survived…….]

Age of Uncertainty…..

There is also a more subtle undercurrent of debate resulting in a shift in public attitudes – deserving vs undeserving, use of assets

Not just theoretical– will impact on front line thinking and day to day practice

Implications for home adaptations help

Time lag……..

Between ideological shift and law

Between policy & implementation

This can be problematic for practitioners

Long term view…..

How we got to where we are today

– a reminder of the foundations

of the system that you are dealing with

Adaptations: Social Legislation

Chronically Sick and Disabled Person’s Act 1970 – duty to arrange practical assistance in the home and any works of adaptation

NHS and Community Care Act 1990 – assessment rights (introduced FACS)

[Children’s Act 1989/ Carers and Disabled Children’s Act 2000]

New law will ‘wipe slate clean’

Adaptations: Housing Legislation

1985 Housing Act

1990 Local Government and Housing Act - Mandatory DFGs introduced

Housing Grants, Construction and Regeneration Act 1996 - current

RRO (Housing Assistance) 2002 – broad power to provide assistance

Future influences

Personalisation and Individual Budgets

Equalities Act 2010

Taking the long view……

System over past 40 years moved to a rights based model with mandatory entitlement but:

Mismatch of need and resources allocated for such a system

Even less money: Survival of adaptations help may depend upon benefits to health/ social care costs

Emerging Factors

Take personal responsibility (plan ahead/ insurance?) to make provision for your own care and changes of circumstances

Fragmentation (whilst voicing integration) in the face of funding pressures and reform

Localism – vs public dislike of ‘postcode lottery’

Medium Term Prospects

Off the agenda…….

DFG Formal ‘Guidance’

Social Housing ‘Guidance’

Audit Commission Inspection

Lifetime Homes Standards

On the Horizon

DFG ‘industry led’ good practice guide with DCLG sign up

Health and Well-being Boards charged with ‘addressing the wider social determinants of health’

New health service funding systems

Planning reform; drivers for healthy communities, inclusive design

Last CSR - Against the Odds

DCLG – 7% rise in DFG allocation No cuts to any LA A few large

increases (c.30%)

Big issues LAs not matching

allocation Rising need

NEXT CSR????

Rising need for adaptations

Factors impacting on growing need Demography

Health and Disability

Housing – tenure shift, condition, suitability

Individual resources- income and savings

Data: Time to Adapt –Care & Repair England

Driver: Demography

The number of older disabled people is expected to double from 2.3 million in 2002 to 4.6 million by 2041

On current projections in 2036, 810,000 people aged 75 or more would be living in properties that they consider unsuitable for their needs.

The vast majority (c 70 per cent) 567,000 will be owner occupiers

Driver: Lack of suitable stock

1.4 million individuals reported having a medical condition or disability that resulted in them requiring specially adapted accommodation

22% said they lived in unsuitable homes

Survey of English Housing – Annual, CLG

Where next?

Thinking ahead

Consortium Think Tank days in preparation for CSR submission concluded:

Retain broad Statutory/ National framework

There is scope of system improvement and local innovation but alongside adequate budget setting

Adaptations falls between the cracks - investment by one sector (housing) results in gains by others (social care, health) – needs champion

Thinking ahead

Make best use of scarce resources - radical system reform, proportionate administration (small, medium, large adaptations), break down professional barriers, best use of stock, cross tenure

Enable self help – holistic, independent, impartial information for self funders too

Single body responsible for all aspects

Thinking ahead

Health link key - but conundrum of medical vs social model of disability

Localism –making the case for funding, better ‘PR’, tell stories

Role for Health and Well-being Boards to drive improvement - data, planning & prevention, include adaptations in national outcomes framework

Consortium members will……

Continue national efforts to gain recognition of their value Social care funding debate Public health ie. PHWB outcomes Welfare reform/ HB/ tenancy lobby Media stories

Self help and sharing good practice Design better homes for all (LTH, LTNs) Guides

Other useful information

Living Well at Home – APPG (Housing and Care) Inquiry report www.housinglin.org.uk/Topics/type/resource/?cid=8167

Coming soon? Good Practice Guide to DFG

Chance to contribute to: Adaptations Good Practice Case Studies

Contact Details

info@careandrepair-england.org.uk

Weblink to Time to Adapt Report

www.careandrepair-england.org.uk/timetoadapt.htm