1. Does your home suit you? Making the housing link to long term health conditions in later life Sue Adams Care & Repair England

2. Remit of presentation  Brief overview of emerging policies  Policy message: Make your own provision/ plans for later life care  What can people do to prepare their homes, particularly if they have a long term health condition?  How can OTs contribute?

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. Age of Uncertainty……..

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 being questioned

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  Eg. Housing world argued for universal Lifetime Homes design principles – lost?

7. Age of Uncertainty: Social Care  State is re-negotiating its ‘contract’ with citizens and their care & support, particularly in later life  Dilnot reviewed adult social care funding and Law Commission reviewed legislative framework  White paper & Bill - now progressing through Parliament

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  Welfare reform  Localism, deregulation: Planning reform/ Building Regs reform [DFG survived last CSR…….]

9. Time lag……..  Between ideological shift and law  Between policy & implementation This can be problematic for practitioners, but we can expect…

10. Where will this take us?…..  Enable individual choice  Promote self help  Closer ties between health & care

11. Do we have the right homes to enable self help? Making the health connection

12. Suitable stock now?  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

13. Suitable stock in the future?  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

14. Building for the Future?  Low rate of new build and less adaptable than much of the older stock (all tenures)  Majority will still wish (or have to) live in mainstream housing, hence rising need for adaptations  Issues: security of tenure/ welfare reform

15. The housing and health link

16. Integration Agenda  Health and Social Care integration- theme in DH policy  Need to put housing into the frame  LTCs and demographic trends set to transform approach to health care – housing key to many strategies

17. Long Term Health Conditions  There are 15.4 million people in England with at least one long-term condition  Three out of every five people aged over 60 in England suffer from a long-term condition  Major challenge in health care is treatment of multiple LTCs

18. Long Term Health Conditions Housing link to:  Arthritis  Stroke  Heart Disease  Macular Disease  Dementia  COPD/ Respiratory

19. Housing links to health issues Physical  Respiratory conditions  Arthritis  Cardiovascular conditions  Falls  Accidents  General increased risk of infections Emotional  Stress  Depression  Social Isolation

20. LTC & housing self help guides  Ran housing options workshops with people with range of conditions  Limited information about housing options on main health condition sites  Barriers to accessing help and information unless in crisis  Stories and feedback from local Care & Repair services

21. Filling an information gap  Ideas for making adjustments to existing home in advance of crisis  Thinking about longer term suitability and alternative options  Recognise limitations for individual actions in some cases – not a solution for everyone but a start

22. Limits  Can only go so far with poorly designed property  Limits to individuals’ resources

23. Self help guides useful for…..  ‘Younger old’ individuals esp. for early stage diagnosis  Carers and families of people with higher level needs  Professionals – key role in passing on information & could locally tailor

24. Example of self help guide content  Making your home easier to live in when you have a xxx condition design and layout ventilation and heating safety and security going out and about gadgets and equipment  Thinking about moving home – www.firststopcareadvice.org www.firststopcareadvice.org  Sources of related advice and information

25. Illustration of topics covered  Ventilation and air quality (furnishings, moisture level control etc)  Room layout, storage, positioning of frequently used items  Viability of adaptations, equipment and assistive technology potential

26. Occupational Therapy  Key to the self help and prevention agenda  Integration in action  Shift to enabling role?

27. Looking ahead

28. Opportunities?  Rhetoric of health, care and housing working together – maybe trial projects around self help as part of Health and Well-Being Strategies?  Clinical Commissioning Groups?  Hospitals??

29. Opportunities  Pass on information via self help groups – maybe develop locally tailored supplements  Lessons from our ‘If only I had known’ housing help in hospitals projects – integration in action

30. Look out for  DH Strategy on Long Term Conditions  DH funding for information provision (in White paper)  Integration and prevention initiatives  Have a look now at new Hospital2Home Package

31. Contact Details info@careandrepair-england.org.uk  Weblink to six Housing and Health Condition practical guides plus ‘If only I had known..’ reports www.careandrepair-england.org.uk Click on Home from Hospital Hospital2Home pack - http://housinglin.org.uk/hospital2ho me_pack/ http://housinglin.org.uk/hospital2ho me_pack/