Thursday, 28 March 2013

No place like your own home

Older people tell us they prefer to live independently in their own homes and communities, and we aim to make this a reality for as many as we can. Some important Welsh Government policies have similar ambitions. Together for Health recognises the need to change how NHS services are delivered to an ageing society, providing more preventative services, closer to home. The Social Services and Wellbeing Bill proposes more preventative services and closer working between Health and LAs. There is no doubt that greater integration between health and social care is essential if Wales is to deliver effective services that reduce the impact of high levels of chronic ill-health in an ageing population.
And yet, the role of housing in this is too often forgotten. Good quality, safe, accessible housing is an important part of a more integrated system, and can improve health and social care outcomes, while delivering cost savings. The challenge for housing organisations is to make sure that those who develop policy and commission health and social care services are well informed about the role that housing can play in improving older people's health and producing savings across an increasingly stretched health and social care system.
Some examples... Extra care housing, designed to meet the needs of residents by offering care and support on site and on call, has been shown to improve health and wellbeing for older people, while delivering cost-effective support outside of residential care. Services that improve home energy efficiency and help older people to afford to pay their fuel bills reduce demand by avoiding A&E visits and emergency hospital admissions. Given the scandalous 1,700 annual extra winter deaths, and many thousands more winter admissions, it is crucial that we make clinical commissioners fully aware of the threat of cold homes to our older people. We must also convince them of the return on investment that services like Care & Repair and adaptations can provide. Last year in England saw a huge breakthrough on this front with the Department of Health announcing an additional £40 million for Disabled Facilities Grants. This is a first in terms of significant health investment into housing adaptations. Care & Repair Cymru urges the Welsh Government to take similar steps by diverting relatively small amounts of Health capital funding to the highly successful Rapid Response Adaptations and Independent Living Grant programmes, both of which are more cost effective and quicker than Disabled Facilities Grants.
We also need greater housing input into safe hospital discharge plans. Each local health system should have budgets to allow swift housing adaptations to support recovery and rehabilitation at home, reducing the cost of delayed discharges or readmission. The same is true for the growing number of people with dementia; relying purely on hospital provision to meet their needs is undesirable for those affected and also impossible for the taxpayer. Conversely, greater investment in telehealth, assistive technology and low-level interventions can help people with dementia stay in their own homes in a cost effective way.
The case is clear. Housing needs to be part of an integrated architecture of building healthier communities tailored around someone at home. At a strategic level, housing must be aligned more effectively with health and social care policy. Operationally, housing services, including Care & Repair, must be better networked within local health and social care economies. In this way, we can really begin to plan and deliver the health, social care and support that people aspire to in their own homes and neighbourhoods.
Chris Jones, Chief Executive
Care & Repair Cymru


  1. Have just read this after the Easter break and it is now quite a poignant blog in many ways after this weeks passing away of the architect of a national housing policy that had no care or interest on its future impact.
    Today my caseworker brought me a case of a young older man who was living with his elderly disabled parents and had been their main carer. Now that they have passed away he has inherited the house and lives alone as one of the benefactors of the policy for maximising home ownership. Yes it was a RTB and yes it is in a poor condition with dampness and disrepair. The gentleman concerned who is aged 64 probably never thought much about the Lennon and McCartney song of the 60's when he was a very young man as meaning much to him but may have thought that his country would still love him,help him and if neccessary look after him in times of need, for that was the vision of the future. Now in receipt of minimum pension credit with little prospect of a job and no cash in the attic the realities of home ownership are at the fore and he cannot control his future and has little to look forward to on the home front.
    My hope is that he can plan for the future and we will try to help him but with fewer tools in the box these days what I would like to see as part of an integrated Welsh housing policy is real progress on property appreciation loans. They are not a hand out and with proper funding and planning can become self funding.
    So a lesson for policy advisors/makers and government is if you really believe there is no place like your own home then develop and back the policies that help the needy and are truly sustainable. You can then help to bring hope where there is no hope, harmony where there is no harmony etc. Many of us are unable to control our own means and needs and none of us can control the aging process.
    Cris Davies
    Blaenau Gwent Care and Repair

  2. Totally agree. There is a big policy and funding gap for helping people living in the poorest housing (unfit for habitation under the old definition). Care & Repair Cymru believe that public funding in the form of loans, repayable at the point of sale, would help many thousands of vulnerable older people repair their homes. This would also reduce demand on the NHS from hospital admissions from, for example respiratory illness and falls. Loans would also be a longer term sustainable solution, with repaid loans recycled and used for further lending over time. Chris Jones, Care & Repair Cymru


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