Written evidence submitted by Shared Health Foundation [HCE 014]

Housing, Communities and Local Government Select Committee

Inquiry: Housing conditions in England.

Shared Health Foundation is a not-for-profit organisation based in Greater Manchester that aims to alleviate the impacts that poverty has on health. Through this, our largest project has been to tackle the effects that living in temporary accommodation has on children and families. As co-secretariat to the All Party Parliamentary Group for Households in Temporary Accommodation, we are able to provide substantive evidence to the committee that offers local and national perspectives. Our work is grounded in the voices of those with lived experience.

1. Child mortality.

Between 2019-2024, seventy-four children died with their temporary accommodation listed as a contributing factor to their death[1]. Fifty-eight of them were below the age of one. Their deaths were caused by a combination of the chaos of homelessness and environmental factors with their accommodation, such as mould, overcrowding and a lack of safer sleeping options.

Additionally, new data highlights that between October 2023 and September 2024, eighty children died with their usual residence being temporary accommodation. While their accommodation has not yet been linked as a contributing factor to their death, they are disproportionately at risk of mortality compared to non-homeless children.

B. Mould.

B. 1. The prevalence of mould.

A consistent issue raised by residents in temporary accommodation across the country is mould. The call for evidence on temporary accommodation launched by the APPG for Households in Temporary Accommodation found that out of forty-one respondents, eighteen mentioned mould in their accommodation[2]. Other reports from families have highlighted the extent of mould in their temporary accommodation so much they have to sleep on a mattress on the kitchen floor, as the bedrooms are covered.

Damp and mould in temporary accommodation can be caused by poor ventilation, a lack of working central heating, leaks, and an absence of laundry facilities leading to families washing and drying clothes in their rooms. Residents have reported personal belongings and clothes becoming covered in mould. Without access to cleaning and laundry facilities, it is difficult to restore these items and to ensure that mould is prevented from spreading further within properties.

B.2. The consequences for children.

The Committee will be aware of the detrimental impact that mould has on a child’s health, following the tragic death of Awaab Ishak in 2020. Children in temporary accommodation can be exposed to high levels of mould that pose serious risks to their respiratory system. Families have reported children experiencing difficulties with their breathing and contributed to the development of or exacerbation of asthma, as well as bronchitis, which can be exacerbated by the presence of vermin[3].

Shared Health have also been made aware of the case of a neurodivergent child with sensory needs peeling mould from a wall and eating it. Fortunately, the child had only ingested a small amount so there were no significant repercussions. Yet, the consequences of this could have been severe for the child as it could have been detrimental.

C. Lack of facilities.

Some properties used for temporary accommodation may have kitchen, bathroom and laundry facilities, but a consistent issue is disrepair to these facilities. Additionally, some properties are lacking facilities at all. The latter relates to emergency accommodation used that do not have kitchens or washing machines. It is also common for temporary accommodation providers to require a service charge from residents for the running of and cleaning of facilities. Based on the experiences of families supported by Shared Health who are required to pay this service charge, facilities are often out of use for prolonged periods of time.

C.1. Kitchens.

As stated, it is common for properties used as emergency accommodation, such as B&Bs and hotels, to not have kitchen facilities. Legally, children can only be placed into this type of accommodation for a maximum of six-weeks. However, this limit is often overlooked as the housing and temporary accommodation crises worsens. This is exemplified by the fact that 2,300 households with children across England have been living in a B&B for longer than the limit, according to the most recent data gathered by MHCLG[4]. The result is that families are reliant on takeaway and dried/tinned foods that lack nutritional value, increasing the risk of children developing health conditions, such as scurvy and gastrointestinal problems.

Families supported by Shared Health living in mixed accommodation often report poor hygiene in shared kitchen facilities. As this type of accommodation can be mixed with single adults, families are also reluctant to use the kitchen space as they cannot store food without concerns that it may be taken by other residents, or that the utensils and equipment will be dirty. Furthermore, for families that have fled domestic abuse, it can be traumatic to share a space with other adults. Therefore, they may be reliant on takeaways and tinned/dried foods that can be prepared and eaten in their rooms.

C.2. Bathrooms.

Akin to kitchens in mixed accommodation, families may also have to share bathrooms with single homeless adults. This is a safeguarding risk, as both homeless families and homeless single adults are vulnerable but these groups have different needs. As domestic abuse is one of the leading causes of family homelessness that disproportionately affects women and children, it is inappropriate to require them to share bathroom facilities with individuals that may resemble their abuser. Shared Health have been made aware of examples of children being sexually harassed and assaulted by other single adults in their temporary accommodation. Therefore, requiring them to share a bathroom is inappropriate and should be a never event. Families have also reported having to spend large sums of money on cleaning supplies due to the poor hygiene standards in shared bathrooms.

It is common for facilities to be out of use due to disrepair, leaving families without use of bathroom facilities. As highlighted by campaigner Kwajo Tweneboa, the lack of repairs to properties is meaning that families are being required to defecate in bags[5]. This erodes any sense of dignity for a family and should not be allowed to happen under any circumstances.

C.3. Laundry facilities.

Some temporary accommodation properties do not have access to free washing machines, meaning that families are required to pay for external washing facilities or wash their clothes in the sink. The former option is expensive, especially when paired with the cost of eating without kitchen facilities and cleaning supplies for unhygienic bathrooms. The latter option means that it is much more difficult to clean clothes fully, as well as having to dry the clothes in their room and increasing the risk of mould growing.

D. Disrepair of properties.

D.1. Poor maintenance.

Families have reported living in accommodation that remains in disrepair for prolonged periods of time. Broken facilities, exposed electrical wiring, leaks, plumbing issues, infestations, and structural damage are all common issues that we have heard about from residents. Many have reported that they have raised disrepair issues to their temporary accommodation provider or local authority, yet the problems have not been fixed. The risk of serious accidents and illnesses to be caused to children in properties that are poorly maintained is increased.

D.2. Accidents and illnesses caused by disrepair.

The NHS does not code for temporary accommodation, therefore, we do not know how many accidents and illnesses are caused by disrepair. However, there is an abundance of anecdotal evidence that outlines the increased risk of negative health outcomes experienced by families living in temporary accommodation caused by poor maintenance. Some examples include:

-        Burns caused by radiators that are too hot and respiratory illnesses caused when heating does not work;

-        Gastrointestinal issues and infections caused by sewage in the toilet, shower, and sink;

-        Sleep deprivation caused to a child who would wake up during the night covered in ants due to an infestation;

-        And a pregnant mum falling down the stairs in her accommodation because the lift was broken and remained unfixed. Luckily the baby was unharmed but the mum suffered a dislocated knee.

D.3. Safeguarding.

In mixed temporary accommodation, in which families and single adults are required to share facilities, safeguarding concerns may arise when there is disrepair. The APPG’s call for evidence highlighted the concerns of residents who had broken or missing locks on their doors, allowing other residents to enter their rooms. Respondents stated response times to addressing this lack of security were too slow, if they were responded to at all. This leaves residents vulnerable to burglary and assault, leading to increased feelings of anxiety and insecurity for children, that could contribute to further traumatisation and impact their wellbeing.

E. Lack of space.

E.1. Badger or Baby?

The Housing Act 1985 sets out the legal standards for spacing in occupied premises, licenses and tenancies[6]. A child aged over 10 is classed a 1 person, 1-10 years is ½ a person and notably no space for a baby under 1 is required. In regards to overcrowding it is not a criminal offence if the property is temporary or licensed to a local authority[7].  The lack of space standards for babies limits local authorities and developers to provide suitable temporary accommodation to a family's needs and increases the risk of child mortality. There are 20,000 babies living in Temporary Accommodation but no overcrowding law protects them - in short, babies do not count[8].

However, in stark contrast, the protection of badgers, specifically those expecting cubs, have laws around their health and wellbeing with it being illegal to move a badger from their set if they are pregnant, birthing or raising cubs[9]. The consequence of breaking these laws can consist of 6 months imprisonment or an unlimited fine. Whereas there are no repercussions for not providing adequate spacing for a baby in temporary accommodation or moving the mother whilst pregnant, despite the risk of mortality.

Shared Health have worked with families who are moved frequently from hotels to HMOs and other Temporary Accommodation properties, one family with a young baby was moved 7 times in 7 months. The disruption that this causes is detrimental to the safety and development of babies and infants, that would otherwise be deemed unacceptable for badgers.

E.2. Overcrowding.

The lack of regulation and clarity on space standards in temporary accommodation means that overcrowding is common. Families are often placed into emergency accommodation and required to share rooms and beds. An example of a family that Shared Health have worked with consisted of six family members living in one room with a double bed and a set of bunk beds. The small kitchenette was also in this space, as well as the family sharing a small en suite bathroom.

As stated previously, such a lack of space leads to issues such as disturbed sleeping patterns and poor safer sleeping practices, such as not having a cot, that can increase the risk of Sudden Infant Death Syndrome. This is despite the Homelessness Code of Guidance stating that accommodation should not be deemed suitable if there is not space for a cot if the household has a child below the age of two, and that a cot should be provided if there is not already one in the property[10].

The bedroom standard is not applied to temporary accommodation, given the nature of the accommodation is ‘temporary’. Specific criteria applied within social housing to prevent overcrowding are not applied to temporary accommodation, despite some households remaining in it for years. This means that accommodation that would otherwise be deemed unsuitable for a household if they were not homeless are being allocated to families placed into temporary accommodation.

E.3. Delays to Development

Another consequence of a lack of space in accommodation is there is minimal room for children to play and explore. The first 1001 days of a child’s life are the most important for shaping their cognitive, emotional, and physical development as they learn to explore the world through play. Infants require a circle of security, in which they are able to explore the world away from their parents, after which they can return to their parents to be nurtured. Yet, for infants living in cramped accommodation, there is no space to do this. This has a significant impact on a child’s ability to form a secure attachment with their parents, as well as affecting their development of the skills needed for emotional regulation. Increasing numbers of children growing up in temporary accommodation are not school ready by the age of five and are more likely to have lower educational attainment during their school career.

F. Steps the Government can take to tackle poor quality accommodation.

It is vital that there is greater regulation and accountability for local authorities and temporary accommodation providers to maintain standards in their properties and communicate effectively with households. The following recommendations must be considered to improve the quality of temporary accommodation:

F.1. Applying the Decent Homes Standard and Awaab’s Law across all forms of temporary accommodation.

The Government’s consultation on the Decent Homes Standard and the potential application of it to temporary accommodation is welcomed but it must be applied to all forms of temporary accommodation. While some forms of emergency accommodation do not have kitchen facilities, the other elements of the standard must still be enforced in this type of accommodation.

The announcement of the extension of Awaab’s law to temporary accommodation is also welcomed, but again this must be applicable to all forms of temporary accommodation. To enforce this properly, inspections should be routinely carried out to ensure properties are up to the standard.

The proposed date for implementation of the updated Decent Homes Standard following the consultation in 2035 is too far away. It is vital these measures are introduced immediately to prevent harms to children, particularly in the case of child mortality.

F.2. Mandatory inspections of temporary accommodation properties.

Currently, local authorities are not routinely inspecting the conditions of properties they are placing homeless households in. Councils are unaware of the state of disrepair in some temporary accommodation, particularly when they are procuring from rogue landlords that do not fix issues when raised. The Committee has already brought this to the attention of the Government following its previous inquiry into children in temporary accommodation, in which the Government responded that consultations on the extension of the Decent Homes Standard to temporary accommodation would look at appropriate enforcement mechanisms.

A recent conversation held between Shared Health and a temporary accommodation officer from a local authority highlighted that the Council had to believe that a temporary accommodation provider had fixed an issue reported by a tenant, despite the tenant saying otherwise. Instead of inspecting the property to ensure the problem was resolved, the provider was trusted over the tenant, meaning the tenant is still living with the issue. If local authorities were required to carry out mandatory inspections of the properties they procure as temporary accommodation and report to MHCLG, there will be a greater chance of standards being upheld and more accountability for temporary accommodation landlords to maintain their properties.

Temporary accommodation residents are also advised to take up issues with their accommodation with the Housing Ombudsman. However, this is not always accessible for those that need to resolve an issue with their landlord. For tenants whose first language is not English, those who are not aware of the Ombudsman, or those who do not have access to WiFi, reporting their landlord this way is almost impossible. Homelessness is a chaotic and traumatic time for anyone, as they face being moved around, away from their support networks, so tackling a rogue landlord through the Ombudsman may be out of reach for them.

F.3. Tackling discrimination within the housing system.

We have witnessed the poor treatment of residents in temporary accommodation by their landlord or housing association for complaining about the appalling conditions of the property they are in. Residents are left feeling isolated and ignored, which negatively impacts upon their mental wellbeing on top of the trauma they are likely to have already experienced. Lauren’s testimony (please see this below) highlights how she felt “left to rot” by the services put in place to support her. This may be acutely felt for households from ethnic minority backgrounds, or those whose first language is not English.

An example of this is a family who had reported the extensive problem of vermin in their building, affecting all of the families residing there, following one of the children being bitten on the toe by a rat during the night. They were told by their temporary accommodation provider that if they “did not like it, then they should find themselves a privately rented property”. This family reported feeling as though they were too nervous to report further issues as they have complained ‘too much’. Additionally, they feel they are being penalised for complaining, by being charged more for their service charge than other residents in the same property. Each of the families in this property are from ethnic minority backgrounds and feel their concerns are not taken seriously.

There is an abundance of recent research that highlights the inequalities posed to non-white households in poor quality temporary accommodation. Herriott-Watt University has published findings outlining that Pakistani-Bangladeshi households are seven times more likely to be overcrowded in temporary accommodation than white headed households[11]. Linked with this, a recent report released by Shelter highlighted the experiences of Black and Black Mixed heritage people in temporary accommodation and for social housing allocations[12]. Participants in the research for the report emphasised they were offered poor quality housing in unsuitable locations but their concerns are routinely ignored. Some reported being told to “be grateful” by services because they have a roof over their head, despite there being no consideration for the harm that the housing they are in is causing them.

Residents in temporary accommodation have expressed fears of being made intentionally homeless if they complain about their poor quality accommodation due to risk of eviction. The stigmatisation of homelessness and racial discrimination is significant in contributing to families suffering the effects of poor quality accommodation in silence, due to fears that if they complain, they will not have the chance to obtain a permanent home. Homeless households must be supported to raise issues with the condition of their temporary accommodation without fear of being wrongly labelled as intentionally homeless. 

Acknowledgments

This response has been prepared by the policy team at Shared Health Foundation with contributions from:

-        Sam Pratt, Policy and Communications Lead

-        Isabel Kaner, Policy and Campaigns Officer

August 2025