CELG(4) HA 15
Communities, Equality and Local Government Committee
Inquiry into Home Adaptations
Response
from : Age Cymru
1. Introduction
1.1 Age Cymru is the leading charity working to improve the lives of all older people in Wales. We believe older people should be able to lead healthy and fulfilled lives, have adequate income, access to high quality services and the opportunity to shape their own future. We seek to provide a strong voice for all older people in Wales and to raise awareness of the issues of importance to them.
1.2 We welcome the opportunity to submit a written response to the Inquiry and are very grateful for the invitation to offer oral evidence on the 7th March. Our response has been informed by data from Age Cymru Advice our Older Minority Ethnic Network (OMEN) and the work of our local partners. In this written submission we have sought, wherever possible, to avoid duplication or repetition of information offered to the previous Inquiry and to provide quantitative and qualitative evidence gathered to date that we will expand upon in the oral evidence session.
2. General comments
2.1 The impact of people living longer on the availability of homes and the management of improvements and services presents key policy challenges. However, when placed against the backdrop of a testing economic climate these issues force difficult decisions about how to prioritise need and it is important that older people are supported to continue to live independently and in safety.
2.2 Housing is inextricably linked to poverty and inequality and is not just about building new homes but about improving existing homes and enabling people to live independently for as long as possible, reducing demand on the NHS and social care services. These are key issues for older people and this work must be aligned to the Framework for Action on Independent Living. The connections between housing and the Welsh Government’s commitment to older people’s wellbeing and independence, as set out in the Strategy for Older People in Wales, are clear.
2.3 Poor housing has a considerable impact on the health, social and psychological well-being of older people. One of the main focuses of the Welsh Government’s agenda in relation to both housing and social care is that people should be supported to stay in their homes for as long as possible. However, currently people are required to wait long periods to receive adaptations that will make their homes safe and support them to remain independent. Delays persist despite the increased investment that has been made in this area, for example, through the Strategy for Older People in Wales. Leadership from the Welsh Government, with clear performance targets for reasonable adaptations, could ensure that regional variations and unacceptable delays are minimised.
2.4 Suitable housing is a fundamental pillar of a successful community. Older people must be able to live safe, independent and active lives in the setting most appropriate to them. In Wales, 73 per cent of all households with someone aged over 60 are home owners and 16 per cent live in local authority or housing association owned properties. Around 11 per cent of all older households are in the private rented sector.[1]
Terms of Reference
3. Why there are still significant variations in the time it takes to deliver aids and adaptations funded by Disabled Facilities Grants across Wales
3.1 Our local partners work across local authority areas and tell us that there is little consistency in terms of the timescales for delivering aids and adaptations funded by Disabled Facilities Grants. Much of their Information and Advice work relates to benefits including the provision of assistance with the completion of Disability Living Grants. However, there is huge variance in the time it takes to progress these processes, which they find frustrating as this is a matter over which they have no control.
3.2 Whilst most of the calls our local partners receive relate to initiating an application for stair-lifts and bathroom adaptations, they also field a significant number of calls from those that have applied for an adaptation and have been waiting for twelve months or more for work to commence. Local Age Cymru organisations will contact the local authority on the individual’s behalf in these circumstances to obtain an estimation of the likely timescales but are rarely given accurate figures. Local authorities often cite the lack of occupational therapist as part of the problem with delays but the most common explanation is lack of finances.
3.3 Uncertainty in terms of timescales and failing to keep people informed was the biggest issue our local partners identified in relation to DFG’s. Indeed, they highlighted this has led to people considering purchasing or hiring the necessary items when this may not be an affordable option for them.
4. Whether sufficient progress has been made on implementing recommendations from the Equality of Opportunity Committee’s 2009 report on home adaptations
4.1 Failure in local government to provide a holistic service, including the provision of adequate information and advice has led to a lack of clarity about what is available to individuals. This seems to indicate that there has been little progress on the implementation of Recommendations 9 and 10. Our partners have advised that local authorities do little more than send out a form in some areas and whilst local Age Cymru organisations make regular referrals to colleagues in Care and Repair they are unsure how often referrals are made by social services.
4.2 Whether or not local authorities provide advice on all the available options is also an issue. Our partners report that people are often surprised to discover that rental can be a much quicker way of obtaining items such as a stair lift, which can be supplied and fitted in a week or less through this method. There would seem to be a lack of unawareness that adaptations can be made without a grant and the associated bureaucracy.
4.3 The issue of poor information is perhaps emphasised by data from Age Cymru Advice. Between April and December 2012 we issued 1,082 copies of our Information Guide ‘Adapting your home’ and 4393 copies of our factsheet ‘Funding repairs, improvements and adaptations’. These figures represent 6.65% of our total level 1 enquiries and 2.62% of our level 2. We also issued 1,592 copies of our factsheet ‘Disability equipment and how to get it’.
5. What impact reduced resources for housing are likely to have on the provision of home adaptations
5.1 As mentioned earlier, local authorities often suggest that the lack of occupational therapist contributes to the problem of delays but the most common explanation for delays is lack of funding. Although now well rehearsed, the Care and Repair analogy of every £1 spent on Rapid Response Adaptations saving £7.50 in health and social care carries no less impact. The impact of preventative measures such as this not only represent potential saving is public spending but offer significant benefits in terms of the health and wellbeing of older people.
5.2 In light of the current economic climate and the welfare reforms, that will include alterations to housing benefit, we feel that any reduction in the overall housing revenue grant will have an adverse effect on the provision of home adaptations. We accept that cost efficiencies can and must be achieved through more efficient allocation of existing budgets but reductions in the overall housing budget in Wales must be set against a backdrop of an ageing population living in what is acknowledge to be amongst some of the poorest quality social housing stock in Europe. Cuts here will have a disproportionately adverse impact on older people.
6. Is the Welsh Government effectively monitoring the provision of adaptation services
6.1 The concerns regarding the limited scope of monitoring and evaluation mechanisms were raised during the last review and we feel these are still relevant. The performance indicator for Disabled Facility Grants currently relates to waiting times only and this narrowly focussed measurement fails to acknowledge the complexities of adaptations.
6.2 There is also no facility for cross referencing the waiting times for other grant aided adaptations. In relation to the first Inquiry question on variations in adaptation delivery times, failure to develop a suitably robust and meaningful suite of focused performance indicators has been a contributory factor in the inconsistency of adaptation services.
6.3 We feel that equality impact assessments (EIA) should be utilised to ensure the needs of individuals with relevant protected characteristics, as detailed in the Equality Act 2010, are accommodated in future assessment processes. Age is a protected characteristic and we feel that older people will receive better adaptation services through effective implementation of both the General and Specific Duties under the Act. Age Cymru’s older person specific EIA process ‘Age Proofing’ would prove a useful tool in developing future PI’s for adaptations.
7.0 What more needs to be done to improve home improvement services in Wales
7.1 Age Cymru believes that an integrated approach to both the design and delivery of improvement services will deliver the positive changes needed for older people. As detailed in the previous Inquiry, more effective multi agency partnership working and information sharing will be central planks in the delivery of more efficient and effective services to older people. Such changes will facilitate more effective use of accessible housing and adapted property registers.
7.2 Closer working between health, social care and the third sector will have a beneficial impact on service delivery to older people but this must be complemented by policy integration at a strategic level. To achieve the transformation necessary there will need to be cognisance between relevant strategic and legislative drivers and in this context perhaps the most crucial connections necessary will be between the following:
· The Strategy for Older People (Phase 3)
· The Framework for Action on Independent Living
· The Housing Bill
· The Social Services Bill
· The Welsh Governments Strategic Equality Objectives
The single recurring theme across all these policy drivers is the need for information and advice and this would seem particularly pertinent in the case of housing adaptations.