HOP0027 - Evidence on Housing for older people

Summary

2.1. The number of people aged 75 and over is projected to rise by 89 per cent by mid-2039 (to 9.9 million); and the number of people aged 85 and over is projected to more than double, reaching 3.6 million by mid-2039.[1] People living for longer is of course a sign of good progress, but it does present challenges for our public services.

2.2. Poor housing contributes to bad health and costs the NHS at least £1.4 billion a year.[2] There is also an acute shortage of homes suitable to support our ageing population. Housing built especially for older people accounts for just six per cent of our existing stock. However between 2008 and 2039, 74 per cent of household growth is projected to be made up of households with someone 65 or older.[3]

2.3. As part of a cross-cutting Housing Commission [4] the LGA has reviewed evidence from councils and other stakeholders on the suitability of current housing provision to meet the needs and aspirations of an ageing population. Our inquiry highlighted the lack of mainstream new housing built for older people, despite this group representing a large proportion of the housing market with significant purchasing power. It is clear there is a distinct and urgent need to better provide a range of housing options to meet the wide variety of people’s housing circumstances, aspirations and needs as they age.

2.4. We must build on existing partnerships between local government, central government and health and care services to put housing at the heart of integrated health and care. Getting this right is critical to the future health of individuals, as well as public spending particularly on health and social care. Councils need to be ambitious in their strategy to deliver housing for older people to ensure the wellbeing of the ageing population. Housing and the wider infrastructure, such as roads, utilities, services and access to good quality broadband are crucial to meeting this goal.

2.5. Giving councils the tools and support they need to proactively plan for meeting the housing, care and health needs of their ageing populations will support effective local solutions to meet the housing needs of all ages. The LGA has identified a number of areas where central and local government need to work together to plan for an ageing population and support wellbeing:

Develop a renewed national and local focus to create homes and neighbourhoods which are integrated with local health and care services.
Ensure sufficiently funded systems are in place to enable older people to modify their homes to support positive ageing.
Provide stable funding and policy support to increase the supply of specialised housing for more vulnerable older people and healthy lifetime homes.
Age friendly neighbourhood principles should be built into planning policies, integrating All Age Friendly housing as part of healthy, inclusive mixed tenure housing developments.

2.6. We need to ensure that existing homes can be adequately adapted. Injuries due to falls among older people have been estimated to cost the state over £1 billion a year, and the majority take place in the home [5]. We need to ensure homes can be easily modified to help older people stay in their own homes for longer and retain their independence. This will have direct benefits for health and care services.

2.7. We want to see planning teams properly resourced to that they can deliver homes faster and planning powers given back to councils to build homes that have a positive impact on communities. There needs to be renewed investment in local infrastructure in order to build homes. The Government should support partnership efforts by developing a viable long-term strategy and funding model that enables local housing and health partners to increase the mix of quality specialised and supported housing options, to rent or buy, for older and vulnerable people.

2.8. We welcome the focus on older people in the Government’s Housing White Paper as this group is not well served in the current housing market. We will engage with the Government on its proposals to produce guidance to local authorities on the assessment of housing needs for older and disabled people. To deliver on this councils need tools in their viability negotiations with developers to ensure developers deliver more accessible homes. The Government have also committed to engaging widely with stakeholders, including local government, on the different strategies through which partners can deliver better outcomes for older people. We look forward to taking forward our ideas further with the Government and partners. Local authorities are well placed to work with partners to proactively plan for meeting the housing, care and health needs of their ageing populations.[6]

2.9. The Government has also set out its intention to reform supported housing funding. Supported housing provides a vital bridge between housing, health and care. It helps many vulnerable people in our communities live more independent lives, including older people. In responding to the Government’s consultation on supported housing, the LGA has stated that any funding gaps created by the Government’s proposal to apply local housing allowance (LHA) rates to supported housing must be adequately assessed, should not be taken from already stretched local authority budgets, and should provide a sustainable funding stream for the future growth of the sector.[7]

Provision of homes for older people and the challenges people face in accessing housing which meets their needs

3.1. The English Housing Survey found that 9.5 million older people live in 43 per cent of all housing and will need help to maintain their independence and health in those homes.[8] It is important that national policy and local action meets the need for good quality accessible homes for our ageing population, and that plans to increase housebuilding cover all types of households, including older people.

3.2. Projections indicate that between 2008 and 2033 around 60 per cent of household growth will be made up of households with someone aged 65 or older.[9] The aspirations and needs of older people are growing and diversifying, and there is a need for all partners to consider how the existing and new supply of housing options can positively respond to that diversity.

3.3. The number of people owning their home outright has risen to 34 per cent of households, at the same time that the number of mortgages has fallen.[10] This is attributed by the English Housing Survey to the ageing population and ‘the baby boomer generation’ reaching retirement and paying off their mortgages.

3.4. Local government is playing a leading role in bringing together housing, health and care. Councils have an opportunity to shape the provision of housing for older people in a way that supports independence and positive ageing, reduces demand on expensive health and care services, and helps improve the housing market by better matching homes to households.

3.5. As part of a cross-cutting Housing Commission [11] the LGA has reviewed evidence from councils and other stakeholders on the suitability of current housing provision to meet the needs and aspirations of an ageing population. This highlighted the lack of mainstream new housing built for older people, despite this group representing a large proportion of the housing market with significant purchasing power.

3.6. New solutions can be developed through a local approach to building. Councils that are building homes directly, or with private and public sector partners, have an opportunity to significantly scale up the delivery of properties designed in locations and to standards. For example the Housing our Ageing Population: Panel for Innovation (HAPPI) principles, which meet the growing need for homes that support people as they age. Locally led housing developments could also seek to support affordability as well as accessibility by including shared ownership, co-housing and collaborative housing options.

3.7. At a national level, we are calling on the Government to work with councils, house builders, investors and lenders to meet the needs of this growing market as part of their general offer.

3.8. We should not overlook the needs of people who stay in their existing homes and assistance to help them live independently. There are significant advantages that the security of a longer term tenancy or lifetime tenancy can bring for many households. Adaptations can provide a more strategic use of housing resources as they are less costly than re-housing. As such, it is important that they are adequately resourced.

3.9. The Disabled Facilities Grant (DFG) funding was increased to £394 million in 2016/17, up from £220 million in 2015/16, providing a welcome injection of additional capital into home adaptations.[12] However, this was at the expense of the Social Care Capital Grant (SCCG), worth £134 million, so the increase in funding was not as significant as we were led to believe.[13] We have expressed concern that Government did not make clear at the time of the 2015 Spending Review that the SCCG would be lost in favour of the additional funding to the DFG, and councils had financially planned to have both elements of funding available. In two tier areas, the SCCG was funding provided to the County Council, whilst the DFG is delivered to District Councils via the Better Care Fund (BCF). As such, the loss of funding, and the lack of notice of this decision is a particular source of concern for County Councils.

3.10. To provide a local example of best practice, councils and third-sector organisations in South Staffordshire [14] have come together to provide housing aids and adaptations to help people live independently at home. Streamlining DFG applications, assessments and provision has resulted in a reduction in costs of 40 per cent and huge cuts in waiting times.

Current planning policy and Government initiatives in England in meeting the housing needs of older people

4.1. Councils continue to play a key leadership role in influencing the design of the wider built environment where people live, work and visit. Local planning departments aim to promote higher standards of building design and layout of new developments to improve accessibility for all.

4.2. For example, case studies of good practice and effective engagement in supporting people with dementia by creating local dementia friendly communities were published in the LGA and Innovations in Dementia guidance ‘Dementia friendly communities: guidance for councils’.[15]

4.3. The right homes in the right places have huge benefits for people and places. They improve the health of local people, create jobs and build stronger communities. Poorly planned developments can lead to higher rates of chronic health conditions, traffic deaths, pollution and loneliness.

4.4. Large residential developments, urban extensions and estate regeneration projects present particularly good opportunities for the inclusion and integration of housing for all ages at their ‘heart’, in order to create sustainable, healthy, age friendly communities. The Healthy New Towns initiative provides an opportunity to test this out further.

4.5. We have argued that council planning departments need to be sufficiently resourced to fulfil their functions and to deliver more housing. We are pleased that this has been acknowledged in the Government’s recent Housing White Paper. Currently taxpayers are subsiding approximately 30 per cent of the estimated cost of processing planning applications,[16] and we have argued that fees should be set locally by councils. The introduction of locally-set planning fees would enable councils to deliver responsive council planning services that are crucial to growth and building the homes that communities need.

4.6. Local partnerships and, in particular, Health and Wellbeing Boards, can play a key role in bringing together planners, environment, housing, and health and social care partners to provide a shared understanding of where there are opportunities and gaps in provision that can be reflected in local planning policy.

4.7. Local and central government should work together to build Age Friendly neighbourhood principles into planning policies, integrating All Age Friendly housing as part of healthy, inclusive mixed tenure housing developments.

4.8. Local authorities have been able to build new low cost homes since 2008 using grants and other funding initiatives. Councils and other social landlords build in accessible design as this will have benefits in the longer term by allowing people to stay in their home as their needs change, and avoiding costly adaptions.

4.9. To provide an example, the Excellent Homes for Life project in Kirklees began in 2012 and will build 466 new one and two bedroom flats for council tenants. The new homes are tailored to local housing need and the project includes 35 flats designed for wheelchair use and 140 extra care flats, 10 of which cater for people with dementia. Kirklees Council has specified high sustainability and design standards and the homes are adaptable to meet tenants’ needs throughout their lifetime. The scheme has been delivered through private finance initiative and delivered in partnership with the Regenter Excellent Homes for Life consortium.[17]

4.10. Partnerships between the private sector and councils and their partners can play a central role in increasing the supply of housing that is not being met by mainstream housebuilding. For instance, councils can release their own land for the purpose of providing healthy housing for all ages, and find new ways of investing directly in the construction of housing suitable for meeting the needs of older people in their area. There is a particular opportunity for councils and the NHS to work collaboratively in releasing land for development of healthy, inclusive housing as well as housing for specialist needs.

Could more housing designed specifically for older people help address England’s wider housing needs?

5.1. All local areas are set to see an increase in the number of older people, but the scale of demographic change varies locally. It is not sufficient to assess demographic change on population growth overall, and more should be done to also factor in the trends between areas that impact on the proportion of older people. This could include house building, or the movement of young people in or out of an area.

5.2. The complexity of England’s housing market makes it difficult to apply effective national solutions. Councils have responsibilities for planning, housing, social care and public health, as well as playing a strategic role in partnership with clinical commissioning groups and others in the planning and provision of healthcare services. Giving council the right tools and support they need to proactively plan for meeting the housing, care and health needs of their ageing populations will support effective local solutions to meet the housing needs of all ages.

5.3. There could also be a range of solutions that provide suitable homes for older people, from purpose-built homes for older people to homes that are for people of all ages that can be easily adaptable. The key issue is choice and working with local people to understand their needs and ambitions for how they want to live in older age.

The extent to which improving specialist housing provision in England could improve people’s health and wellbeing, and deliver savings in public expenditure

6.1. The Care Act 2014 brings together under statute the provision and funding of care and support. For the first time, the contribution of housing to the care and support system has been recognised in primary legislation. Housing is defined as a ‘health-related service’, placing housing firmly on the care and support map.

6.2. To emphasise the key role of housing, Care Act Guidance states that “Integrated services built around an individual’s needs are often best delivered through the home. The suitability of living accommodation is a core component of an individual’s wellbeing and when developing integrated services, local authorities should consider the central role of housing within integration, with associated formal arrangements with housing and other partner organisations.”[18]

6.3. Implementation of the Act will also take place in the wider context of continuing change to the NHS. The ‘Five Year Forward View’, published in late 2014, sets out a proposed future direction designed to close three major gaps around health and wellbeing, care and quality, and funding and efficiency. Addressing these gaps will require more engaged relationships with citizens, investment in prevention, and the testing and development of new models for delivering health care. In addition, the development of the 44 Sustainability and Transformation Plans (STPs). Place-based integration and efficiency plans designed to be based on the needs of the local population means that the landscape will continue to evolve. The imperative to establish the role of housing in developing integrated care and support is therefore likely to remain a constant.

6.4. Home modifications and repairs can enable independence at home, speed up hospital discharge, prevent the escalation of need and support wellbeing. All of these reduce financial pressure on councils and NHS services, and help the individual. For example, injuries due to falls among older people have been estimated to cost the state over £1 billion a year, and the majority take place in the home [19]. If homes for older people have the necessary adaptions and support in place, then more can be done to prevent greater ill-health and frailty, as well as reduce or eliminate the risk of falls in the home. Greater mobility also helps to address issues of social isolation and loneliness, which is a particularly important issue for councils.

The availability of finance to help older people “right size” in retirement, and the impact of the cap on housing benefit from April 2017 on the development of specialist housing

7.1. Supported housing provides housing and support solutions for vulnerable and disabled people, including those with learning disabilities and mental health issues. Bringing a greater role for the commissioning of supported housing within the local health and care landscape provides more opportunities for the integration of these services that will ultimately provide better support for vulnerable and disabled people.

7.2. It was positive that the Government announced that the application of the Local Housing Allowance (LHA) cap to the rents of supported housing has now been delayed until 2019/20 whilst the development of an alternative funding solution for this important sector is developed.[20]

7.3. The Government has proposed applying the general needs LHA cap to supported housing and giving councils a local ‘top-up fund’ so they can fund the gap between the LHA cap and actual rents in this sector.

7.4. The LGA has proposed that there should be a separate LHA rate for supported housing that is designed based on rents and charges in this sector, to avoid creating regional distortions and to provide certainty over future funding. A sustainable funding system will enable councils and their partners to develop new specialist housing. The focus on rental costs does not take into account the existing investment councils make in paying for what is termed ‘eligible support’, ‘support’ and ‘care’, or where some councils are already paying an element of the rent.

7.5. Seventy per cent of the total units for supported housing are for older people.[21] The issue of the administrative burden of managing the expected high volume, low additional unit cost of older people’s housing has been raised by Government and partners. Proposals have included additional funding in Pension Credit to meet older people’s housing needs and as a way to reduce the administrative burden locally. Whilst this could have some merit, we are concerned that this would reduce the overall funding envelope for councils. This would provide them with less scope to ensure the funding is directed in a way that meets those with the most needs, and is preventative.

7.6. We are also concerned that the Government’s supported housing proposals bring older people prematurely into the remit of the current welfare reforms linked to the introduction of Universal Credit even though they were explicitly excluded from other welfare reform provisions. Retired members of our community are not eligible for Universal Credit, and their inclusion in this policy change could create confusion amongst older tenants and additional bureaucracy for councils.

7.7. There should be a range of options for older people with regards to how they can manage their properties in retirement, beyond an expectation to sell their property and move. There could be opportunities, for example, for older people to rent out spare rooms, or convert their property. As such, any proposals for financial help for older people to ‘right size’ should take into account a range of options and the potential for innovation, and ensure it does not adversely skew the market.

Whether a national strategy for the support of housing provision specifically for older people is needed

8.1. A number of councils have already included the supply of housing provision for older people in their local strategies, and have linked them to their health and social care strategies. For example, North Tyneside Council has developed a market position statement for specialist housing in their area, which specifically focuses on the housing needs of older people and those approaching later life.[22]

8.2. The provision of housing for older people should not be viewed in isolation from health and care. Greater acknowledgement of the interdependencies between these sectors is needed to enable older people to live fulfilling, independent and health lives.

8.3. It is vital that local government is given the tools and resources necessary to determine local priorities on housing provision. Councils are best placed to consult with local people about the sort of homes people are aspiring to in older age and engage with their residents on this issue.

March 2017