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Housing and Environment

Housing and Environment. Contribution to the Prevention Agenda Sue Adams (Director of Care & Repair England). Workshop Agenda. Look at how housing and related measures are linked to the prevention and wider health and social care agendas

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Housing and Environment

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  1. Housing and Environment Contribution to the Prevention Agenda Sue Adams (Director of Care & Repair England)

  2. Workshop Agenda • Look at how housing and related measures are linked to the prevention and wider health and social care agendas • Highlight practical initiatives through looking briefly at two projects • Healthy Homes, Healthier Lives • Handyperson services

  3. Starting Point Key Policy: “Enable older people to live independently in their own homes” Key Policy: Prevention and reduced need for hospital and residential care To achieve these housing provision and housing related services are fundamental to health and social care agendas

  4. The Interconnections • Housing quality, suitability and availability impacts upon: • General health and well-being • Health inequalities • Health and safety risk factors (eg. falls) • Ability to live independently in community Hence links to demands on health and social care services

  5. The Prevention Agenda • White Paper – limited specific reference to housing but critical by implication (ie importance of care & support at home) • Social Exclusion Unit – explicit reference to housing, including handyperson services:

  6. Health Policy Drivers • Prevention of health problemseg.Choosing Health; focus on changing people’s behaviour (smoking, obesity, drinking and sexual health) but environment relevant too • More efficient use of resources, eg. better hospital discharge, reduced readmission, better use of GP / professional time • Tackling health inequalities eg. ‘spearhead’ PCTs for 88 most deprived areas

  7. Health Policy Drivers • Older People’s NSF - Falls reduction and other targets • Other specific NSFs – eg. Long Term Conditions, related community matrons initiative

  8. Social Care Policy Drivers • Prevention agenda – White Paper • Enableindependent living in own homes (older, disabled, learning difficulties) • Stronger link to health agenda? • Self help culture? • Greater use of assistive technology

  9. Health/ housing linked initiatives • Prevention technologies grant (£80m, 06-08) • Community matrons (3,000 new posts) • Health trainers (initially 12 areas, £2.4m 06-07 then national from 07) • Partnerships for Older People Projects (£60m, 06-08) • Warm Front (£450m, 06-08)

  10. Housing Policy Drivers • Main impetus: • Number of new units, especially for key workers/ homeless/ families/ first time buyers/ regeneration of areas • Improve standard of social rented housing: target of meeting Decent Homes Standard by 2010 (lesser private sector target) • Improve neighbourhoods (Sustainable Communities)

  11. Decent Homes “The Government has set a target that by 2010 all social housing will be brought up to a 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.” (2002 Government Spending Review).

  12. End of Unfitness Standard • Housing Health and Safety Rating System (HHSRS) • Comes into force in April 06 • Housing sector - create private sector housing renewal policy in consultation with health • Introduces concept of assessment of hazards – 29 hazards defined [Self training toolkit – I&DeA)

  13. Quick Quiz • X% of homes are owner occupied • X % of all people on low incomes are owner occupiers • X % older people live in the general housing stock, X % in sheltered housing, X % in residential or nursing home care • List any health conditions that may be caused/ exacerbated by poor housing

  14. Quick Quiz • How many non-decent homes are there in England? 2.7 million 4.7 million 6.7 million 8.7 million • How many of these non decent homes are in the private sector? 32% 48% 61% 79% • What % of vulnerable private sector households live in non decent homes? 12% 24% 37% 54%

  15. Answers • 71% of homes are owner occupied • 50 % of all people on low incomes are owner occupiers • 90 % older people live in the general housing stock, 5% in sheltered housing, 5% in residential or nursing home care

  16. Answers • How many non-decent homes are there in England? 6.7 million • How many of these non decent homes are in the private sector? 79% • What % of vulnerable private sector households live in non decent homes? 37%

  17. Implications of the figures • Growing numbers of poorer owner occupiers who are finding it difficult to afford to maintain or adapt their homes • Policy agenda to help and support older and disabled people to live in their own homes, but often those homes need repair/ adaptation Impacts on delivering health objectives…………

  18. Physical Respiratory Problems (Bronchitis, Asthma etc) Arthritis Cardiovascular conditions Hypothermia Falls Accidents (electrocution, CO poisoning etc) General increased risk of infection Emotional Stress Depression Social Isolation Main Health & Housing Links

  19. Accidents and Falls • Every day 8 people over 65 die from a fall • 2.8 million falls a year by people over 65 • 67% of falls happen in the home • Hip fractures cost the NHS £1.7billion a year • Falls cost NHS £570m pa • Target in the National Service Framework for Older People : “ by 2010 the number of serious injuries from accidents will have reduced by at least one tenth”

  20. Cold Homes – Fuel Poverty • 45,000 extra deaths occur during winter months compared to the rest of the year. • Est. 60% of elderly households experience fuel poverty ie. they need to spend more than 10% of their income to heat their home to an adequate standard (moving target).

  21. Housing and Disability • There were 1.4 million individuals with a medical condition or disability requiring specially adapted accommodation in 02-3. • 26% of these people were living in accommodation which was not suited to their needs (351,000 people) (SEH 2003/4) • Strong link between social class and disability, esp. early onset (ELSA)

  22. A Decent Home – at the Centre Safe, suitable, adapted home Maintaining independence Health and wellbeing Prevention

  23. Resources Health Risks and Health Inequalities in Housing: an Assessment Tool Prof. Tim Blackman, University of Durham, 2005 www.changeagentteam.org.uk/housing [Healthy Homes, Healthier Lives, C&RE]

  24. Healthy Homes, Healthier Lives • Training initiative, primarily for health sector but also involving social care and voluntary sector • Aims to raise awareness of housing/ health links and the practical actions that can be taken to improve housing conditions

  25. Handyperson Services • Highly valued by older people • Key role in prevention • National survey and report • National Promotion

  26. Handyperson Services • Repairs & odd jobs • Minor Adaptations • Safety checks/ falls prevention/ fire safety • Home Security • Home from hospital • Telecare link • Thermal comfort

  27. Linking Housing and Health • Practical example: • Bristol Care & Repair Healthy Homes - training backed up by handyperson team, home from hospital and move on services

  28. Linking Housing and Health • Blackpool Care & Repair Seashore project - connecting policy, targeted funding and practice

  29. Healthy Homes, Healthier Lives Task • Look at each of the photographs • Together identify the building faults/ problems that you can see and note down the impact that each of these could have on a person’s health and well being.

  30. Health and Housing Action • Housing initiatives to meet prevention agenda Possible Policy Areas • Tailor private sector housing renewal, decent homes and HHSRS policy and expenditure to compliment/ meet health and social care prevention agenda • Single Assessment - address housing

  31. Health and Housing Action Possible Prevention Related Action • Joint working to fast track adaptations • Combine data to target action • Include housing in JD of community matrons and health trainers • Train front line health and social care staff in Healthy Homes Awareness

  32. Health and housing action • Joint planning and commissioning of preventative services eg. Joint commissioning of full range of home improvement agencies services including: Repairs/ Adaptations/ Handyperson/ Home from Hospital/ Safe and Sound/ Fast Track and ‘Housing Options’ support services

  33. Housing Priorities • Key Messages from older people • Choice and control over home • Adequate space/ designed for life • Help with small repairs and adaptations – fast and accessible • Location/ transport critical • Practical support to live independently

  34. Care & Repair England Email info@careandrepair-england.org.uk Website: www.careandrepair-england.org.uk

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