An Age of Uncertainty? T he future of home adaptations in a changing world

1. An Age of Uncertainty?The future of home adaptations in a changing world Sue Adams Care & Repair England

2. Presentation • Emerging policy context with regard to state assistance with home adaptations • Ideas being explored by the National Home Adaptations Consortium • Practice connections

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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…….]

9. 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

10. Time lag…….. • Between ideological shift and law • Between policy & implementation This can be problematic for practitioners

11. Long term view….. • How we got to where we are today – a reminder of the foundations of the system that you are dealing with

12. 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’

13. 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

14. Future influences • Personalisation and Individual Budgets • Equalities Act 2010

15. Taking the long view…… System over past 40 years moved to a rights based model with mandatory entitlement but: • Mismatchof need and resources allocated for such a system • Even less money: Survival of adaptations help may depend upon benefits to health/ social care costs

16. 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’

17. Medium Term Prospects

18. Off the agenda……. • DFG Formal ‘Guidance’ • Social Housing ‘Guidance’ • Audit Commission Inspection • Lifetime Homes Standards

19. 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 forhealthy communities, inclusive design

20. 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????

21. 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

22. 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

23. 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

24. Where next?

25. 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

26. 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

27. 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

28. 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

29. 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

30. Contact Details • info@careandrepair-england.org.uk • Weblink to Time to AdaptReport www.careandrepair-england.org.uk/timetoadapt.htm