Housing Integration for Older People: Meeting Housing Needs

1. Planning for Older People’s Housing Needs – The Role of Housing in Integration 8 December 2014 Jeremy Porteus Director Housing LIN

2. About the Housing LIN Previously responsible for managing the DH’s £227m Extra Care Housing Fund and £80m Telecare in England grant 48,000 members across housing, health and social services to help improve partnership working and integration on housing and care Essential online resources on housing with care for older people to support commissioners, funders and providers in market development, innovation and investment Publish papers to brief on latest innovative policy, research and practice developments in housing, care and support for older people 9 regional ‘learning labs’ in England & Wales supporting local information exchange, peer-to-peer shared learning and improvement activities, and exemplar study visits

3. Putting older people’s housing on the map “Care minister warns of sheltered housing market failure” (Norman Lamb, Care Services Minister, Inside Housing, September 2013) “A new generation of retirement housing could set off a property chain reaction...” (Top of the Ladder, Demos, September 2013) “Older people, use homes as ‘cash machines’” (The Daily Telegraph, October 2014)

4. Ready for Ageing? “The housing market is delivering much less specialist housing for older people than is needed. Central and local government, housing associations and house builders need urgently to plan how to ensure that the housing needs of the older population are better addressed and to give as much priority to promoting an adequate market and social housing for older people as is given to housing for younger people.” Select Committee on Public Service and Demographic Change, Lord Filkin (2013)

5. What’s happening at a national level? APPG - HAPPI2 inquiry report DCLG contestable policy fund – Demos/URS research DCLG - Review of Building Regulations – streamlined building standards. Very little specific information on housing design for older people beyond broader accessibility issues such as Part M and Lifetime Homes Better Care Fund – supporting system transformation (includes DFGs = £220m per annum) Care Act guidance (April 2015) DH CASSHF Phase2 with HAPPI criteria compliance Health and Housing Memorandum of Understanding

6. Care Act 2014 - a caring act? A general duty to promote wellbeing makes reference to ‘suitable accommodation’ Housing not just the ‘bricks and mortar’, also includes housing related support or services such as Home Improvement Agencies Housing must be considered as part of an assessment process that may prevent, reduce or delay an adult social care need Information and advice should reflect housing options, as part of a universal service offer Care and support delivered in an integrated way with cooperation with partner bodies, including housing

7. Housing our ageing population 90% of older people live in ordinary housing Nearly 70% are home owners, the remainder are predominantly in social housing Supported housing for older people accounts for less than 5% of the market (729,818 units) 1.5m individuals report having a medical condition or disability that requires specially adapted accommodation Shortfall of supply in specialist housing with care to keep pace with demand, including housing for people with dementia ranges from 164,000 to 240,000 by 2032

8. Housing - task orientated: outcome focussed Specialist housing - delay moves to residential and nursing care Housing support - deliver interventions to prevent homelessness Mainstream housing – design quality and accessibility (such as HAPPI) to offset future health and social care costs Home improvement agencies and handyperson services - deliver aids and adaptations that can reduce hazards, fuel poverty Environmental health - tackle chronic disrepair and environmental conditions that can lead to a long term condition, disease or increased health inequality Regeneration and renewal – promote sustainable health outcomes via health neighbourhoods/age-friendly communities Spatial planning - support growth and links to strategic needs eg JSNA

9. What triggers a move in later life?

10. But its difficult to get away from the numbers! SHOP@ Understanding demand & capacity Housing LIN / ADASS SHOP analysis tool Draws on the IPC POPPI data from ONS, plus the EAC care & housing data

11. Delivering outcomes that older people want • Less dependency on high cost care • Developing intermediate care and re-ablement services • Make best use of technology and equipment – internet, telecare • End of Life Care – avoid hospital admission • Preventing costly health interventions eg, as a result of a fall • Providing meaningful choices and lifestyle aspirations to meet personalisation objectives • Building effective social capital to enable greater community engagement/informal or family care/volunteering

12. What’s the evidence?

13. Building Homes, Shaping communities Co-production • Community-led housing • Self-build housing • Co-operatives • Co-housing • Leasehold schemes for older people Other housing choices for older people • Extra care housing/very sheltered housing • Sheltered/retirement housing/senior living • Retirement Villages • Almshouses • Homesharing • Park homes • Mainstream housing!

14. Product development and service innovations Tenure diversity: from tenant management organisations to leasehold schemes for older people with shared freehold Localism and community engagement: Easily understood by older people and local communities Building design and delivery: More efficient procurement, planning and construction Knowledge and information sharing: access to independent information and advice ie FirstStop

15. Opportunities or Challenge? • What scope is there for better planning, commissioning and/or access capital funding with health to promote innovation in lifestyle choices for older people or stimulate a housing with care market as an alternative to institutional provision? • Making better use of sheltered housing as a community asset? • Are there the case for new forms of co-housing housing for maximising independence or is the future more specialist housing and home based care and support? • Are there other market opportunities to link with wider inward investment eg LEPS, make best use of NHS estate? • What strategies and policies are in place to engage, involve and listen to the housing with care needs of people to address wider health and wellbeing outcomes eg WAMCCG housing review?

16. A new ‘offer’ that…. • Reflects diverse preferences and needs amongst growing population of older people • Recognizes that the majority of people will continue to live in mainstream housing • Promotes Health and wellbeing – but, public purse savings and individual wellbeing benefits • Major shift to services within communities rather than hospital inpatient (planned)/ emergency (unplanned) settings • Explores future considerations for housing options • Future generations will be more demanding than post-war generation • Reduced pension provision • Growing prevalence rates of diabetes, dementia, obesity

17. Useful Housing LIN resources CIH/Housing LIN briefing: • New approaches to delivering better housing for older people Housing LIN viewpoints: • Growing Older Together: The case for housing that is shaped and controlled by older people • What about the other 95% • Lifelong neighbourhoods: how older people can add value • How can local planning authorities engage better with the housing needs of an ageing society • Senior momentum: what have planners ever done for us? • Getting off the ground: Bungalow living

19. Thank you www.housinglin.org.uk/SHOPAT/ c/o EAC 3rd Floor, 89 Albert Embankment London SE1 7TP email:info@housinglin.org.uk tel: 020 7820 8077 website:www.housinglin.org.uk Twitter: @HousingLIN