27Mar14 - Community Matters Semiar Series - At Home - ppt presentation


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The slides from the second in a series of three seminars from ILC-UK and Age UK on Community Matters - are our communities ready for ageing?

Full details here: http://www.ilcuk.org.uk/index.php/events/community_matters_are_our_communities_ready_for_ageing._at_home

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  • Thank you for inviting me to contribute to this discussion today. You will see something of my background from the biographical notes and see that I have been involved in a wide range of research on aspects of this topic over a number of years. I was asked to put up three slides making a number of points that can add to the discussion concerning whether our communities are ready for ageing - centring on the ‘home’. You will have already had the very useful briefing paper and I don’t want to repeat some of those issues – though I am bound to. In looking at the evidence I decided to start with the population.........
  • When to start thinking about the non-familial extended family – is this possible? There are areas that are discussed and where there are limited examples but to date they are not mass solutions. So some of my gaps are issues discussed but where it would be useful to know more.
  • Just a tiny fraction of older and/or disabled people live in specialist accommodation of one kind or another: most older or disabled people want to and will continue to live in mainstream housing.Accessible housing is not niche housing – it has to be mainstream to meet the scale of need. 
  • DCLG research from 2012 showed that building to Lifetime Home Standards would save society significant amounts over a lifespan compared to Building Standards. (‘A home built to current building regulations could save £83,000 during a 60-year lifespan, compared to the average for the current stock. Building to the Lifetime Homes Standard could provide a further £1,600 savings or £8,600 if the potential adaptations were made.’Assessing the health benefits of Lifetime Homes, DCLG, July 2012)Government research from 2007 showed that health care costs due to falls leading to hip fractures was £726 million a year in 2000 figures. The general costs to the NHS from poor housing was estimated at more than £600 million a year. Accessible housing would reduce these costs. Ref: Better Outcomes, Lower Costs – Implications for health and social care budgets of investment in housing adaptations, improvements and equipment: a review of the evidence. ODI, 2007 
  • http://www.mirror.co.uk/news/uk-news/hospital-bed-blocking-hits-record-2840400Tens of thousands of patients who were well enough to leave hospital were forced to stay overnight because of problems elsewhere in the system.Overall, the number of bed days lost to people trapped on wards unnecessarily hit 78,424 last month.The alarming figure means bed blocking now costs the NHS more than £20million a MONTH - with every bed filled unnecessarily setting taxpayers back £260 a night. 
  • Government’s housing strategy – Laying the Foundations – noted the relationship between the increased need for support at home in later life and inaccessible housing.
  • We have been and remain worried by the emphasis given to the mistaken notion that higher access standards increase costs unreasonably and are therefore barrier to development. Within the impact assessment published as part of the review of housing standards, up-front building costs are the main focus. Costs in themselves are relatively modest:Cost of incorporating LTH standards in figures published by DCLG in 2007 = £547 (The future of the Code for Sustainable Homes – Making a rating mandatory. CLG, 2007)In the consultation itself we see figures for proposed level 2, in the region of £400 for a 2 bed house, £500 for a 3 bed house. (see Housing Standards Review Impact assessment).However the profit ‘Cake’ for developers is driving the concept of viability assessment – the long term financial and physical health and wellbeing of communities is given far less weight.At the moment the socio-economic benefits of accessible housing is missing from the review analysis. Also the financial calculations made in the review so far take no account of how costs would fall as new standards get established and become the new norm.
  • 27Mar14 - Community Matters Semiar Series - At Home - ppt presentation

    1. 1. Community Matters – are our communities ready for ageing? Seminar 2: ‘At home’ Thursday 27th March #communitymatters
    2. 2. Malcolm Dean #communitymatters
    3. 3. Joe Oldman Housing Policy Adviser Age UK #communitymatters
    4. 4. Jessica Watson Policy and Communications Manager ILC-UK #communitymatters
    5. 5. Professor Sheila Peace Professor of Social Gerontology Open University #communitymatters
    6. 6. Community Matters : are our communities ready for ageing: At home’ Comment from Sheila Peace Professor of Social Gerontology, The Open University ILC-UK/AgeUK Community Matters Series, Thursday March 27th
    7. 7. Key evidence points • The older population spans 40-50 years of living with different needs over time – third and fourth ages debate • Lifestyle changes – increase in older coupledom; women living alone • Home ownership currently central to discussion of financial assets in later life and within families • Maintaining the home a central concern, triggers to change • Recognise home and gender invisible in adult housing, health, social care policy
    8. 8. Gaps in research and policy • Home-sharing – intergenerational; non-familial; Home- caring – a growing industry; understanding relationships • Supported Care & Repair – impact of knowing the builders, the gardeners, decorators. • The good things about renting in all housing types • Age-segregation/age-integration – the balance between communal and individualised living • ‘Staying put’ through technological development - beyond the microwave and telecare?
    9. 9. Things to do to fix some of these issues • Re-think access to Disabled Facilities Grants if adaptations cost more than £1000 • Encourage Estate Agents through training to know about alternative housing across the life course • Lobby for better terms of employment for home carers e.g. Travel payment • Intergenerational interaction based on trust - ways to encourage more older people into schools - could lead to gardening, decoration assistance, home-sharing • Support RIBA/Design Council in discussing more inclusive design and recognition of change with age. Start up costs for more innovative housing.
    10. 10. Sue Adams Chief Executive Care and Repair #communitymatters
    11. 11. Are communities ready to enable active ageing at home? Sue Adams, CEO, Care & Repair England
    12. 12. 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)  Pioneers local initiatives; local Care & Repair services, Minor works grants, Handyperson, Housing Options, Healthy Homes, Older People’s “Housing Activism”  Policy shaping: Older people’s housing
    13. 13. Ageing well at home  Older people’s homes and neighbourhoods are a major determinant of their mental and physical health & well-being  Hence critical to enabling aspiration to age well at home
    14. 14. Heath, housing and care: ‘The triangle of independence’ 14 Enabling housing & environment Good health Social networks and care Independent older person Services in one area fail the person if other parts missing Evidence on key reasons for loss of independence are inter-action between health, social, housing Multi-disciplinary approach more successful. Housing often missing link
    15. 15. Where do older people actually live? → 7m older households (500,000 specialist units) → 30% of all homes lived in by older people → 90% live in mainstream housing stock (6% sheltered/ retirement, 4% residential/ nursing/ other) → 75% owner occupation (specialist housing = 80% social rented/20% private)
    16. 16. Where do most want to live?  Aspiration to live independently in a home of their own choosing for as long as possible  Want choice and a variety of housing options for all stages of later life  older people are all individuals at many life stages,  not a homogeneous group, span half a century 50-100+yrs  Need flexibility in homes to accommodate as much of the variation/ fluctuation of later life experience as possible
    17. 17. Research: What makes a good place to live?  Good design of the home : Adaptability, flexibility, spa ce standards  Location: Neighbourhood accessibility/ features , transport, shops, services, social opportunities, proximity to family & friends, safety, security, out door space
    18. 18. Research: What makes a good place to live?  Access to services: to practical support for daily living at home  Wider social factors: history, identity, sta tus
    19. 19. Conjecture: Older people tomorrow  Building for the future What will tomorrow’s aspirations be?  Higher? Expect more choice? Technological?  Learn from past mistakes in design of sheltered housing bedsits and small one bed flats  Even more reason to build in greater flexibility Current counter pressures: Building even smaller, un- adaptable living spaces / welfare reform & ‘under- occupation’, planning and Building Regs reform
    20. 20. Data  Projected household growth → Between 2008 and 2033 around 60% of projected household growth will be made up of households with someone aged 65 or older Projected population growth → number of 85+ doubles & 69% of this age group have disability/ long term health condition/ dementia
    21. 21. Is our housing ready for ageing?  28% of older people live in non- decent homes  1million vulnerable older people (75+) in non-decent housing, mostly in the owner occupied sector - Major inequalities
    22. 22. Is our housing ready for ageing?  1.4 million individuals have a medical condition or disability that means that they need specially adapted accommodation: 22% consider their current home unsuitable (SEH)  Based on current population projections, by 2036 around 810,000 people 75yrs + would be living in unsuitable homes (70%+ in owner-occupied properties) C&RE, Time to Adapt
    23. 23. Cold Homes The Marmot Review team special report on cold homes and health concluded that there is a strong relationship between cold temperatures and cardio- vascular and respiratory diseases. It noted that cold housing;  increases the level of minor illnesses such as colds / flu  exacerbates existing conditions such as arthritis and rheumatism  negatively affected mental health  is related to excess winter deaths
    24. 24. Practical Solutions Current housing  increased help with home adaptations  ‘handyperson’ services to do small tasks  expand home improvement agencies
    25. 25. Main Solutions Future homes -  Build all new homes to Lifetime Homes Standards*  Design Lifetime Neighbourhoods *Applied in London to all new homes but not a national requirement www.lifetimehomes.org.uk
    26. 26. Solutions  Stimulate better, more varied specialist provision – positive choice  Need independent, impartial information & advice about housing and care options /finance  Empower OP as informed consumers – FirstStop www.firststopcareadvice.org.uk
    27. 27. Better Homes = Healthier People  Examples: Philanthropic Garden Villages/ Garden Cities  Results: Healthy, sociable places to live = better health
    28. 28. Active Ageing at Home to underpin policies Need ethos, vision and shared values across government  Enable older people to live well at home  Create places which  enable older people to remain active and socially engaged  enhance independence, health and quality of life Need acknowledgement that ‘home’ is more than bricks and mortar
    29. 29. Looking forward together  Support a positive, active ageing vision and ethos to underpin planning  Share information & evidence to build the economic case It is all our futures…..
    30. 30. Contact and Links sueadams@careandrepair-england.org.uk Housing & Ageing Alliance: www.housinglin.org.uk/AboutHousingLIN/HAA/
    31. 31. Paul Gamble CEO Habinteg Housing Association #communitymatters
    32. 32. Why accessible housing counts Paul Gamble, CEO Habinteg For ILC conference: ‘Community Matters: are our communities ready for ageing: At home’.
    33. 33. What’s special about housing? 1200 year replacement cycle (based on construction rates in 2007) 2012 - @100K housing built Best estimates 230k a year needed UK demographic trend that UK set to have largest population in Europe by 2050 c.70m+ Affordability crisis 33
    34. 34. Where will they all live? 2001 census showed that specialist housing accounted for less than 3% overall Updated estimates don’t exceed 6% Most older people will remain in mainstream housing 34
    35. 35. Housing sector responses to ageing Segmentation extra care retirement villages co-housing HAPPI Inclusive design 35
    36. 36. Inclusive design Carrot and stick Helen Hamlyn Foundation Livability/Lifemark – AU and NZ Lifetime Homes Standards Regulation But clear evidence that regulation uderpins change 36
    37. 37. The benefits of accessible living #1 Reduced risk of falls and injury – Reduce NHS bill by building to LTH or similar rather than Part M. (Hip fractures alone cost £726m in 2000.) 37
    38. 38. The benefits of accessible living #2 adaptability– • more quickly • more safely • Saving NHS £260 per day. 38
    39. 39. The benefits of accessible living #3 Postpone or avoid moving to residential care - Cost saving of £700-800 per week – to family or social care budget 39
    40. 40. ‘Cost’of standards vs long term value 40
    41. 41. Finally: much potential in the review, but… • Building standards should benefit consumer, householder, community, society - will they? • We need the right standards, consistently applied with robust enforcement to make the difference • Ongoing monitoring, research and development is essential if we’re to keep pace with changing needs – especially at higher end of access. 41
    42. 42. pgamble@habinteg.org.uk www.habinteg.org.uk/responses
    43. 43. Q&A and Open Discussion #communitymatters
    44. 44. Break #communitymatters
    45. 45. Open Discussion #communitymatters