Your Home Baseline Assessment

Your Home – Interim Baseline Assessment

Content

Introduction
Overview
Housing Need
Type of Housing
Private Rented
Specialist Accommodation
Alternative Housing Options
Affordability
Housing Conditions
Housing Development and Regeneration
Diversity and Housing Options
Access to Services
Housing Advice
Feeling Safe at Home
Assisted Technology
Home Modifications
Fall Prevention
Handyperson
Hoarding
Gardening
Funding of housing related prevention services
References

1. Introduction

Your Home is the final one, in a series of reports, looking at Age Friendly considerations for York. This is considered against the following Age Friendly, World Health Organisation checks:

Sufficient affordable housing is available in areas that are safe and close to services and the rest of the community
Sufficient and affordable home-maintenance and support services are available
Housing is well constructed and provides safe and comfortable shelter from the weather
Interior spaces and level surfaces allows freedom of movement in all rooms and passageways
Home modification options and supplies are available and affordable, and providers understand the needs of older people
Public and commercial rental housing is clean, well-maintained and safe
Sufficient and affordable accommodation for frail and disabled older people, with appropriate services, is provided locally

2. Overview

Most people want to live in their own home, in the communities they belong to, for as long as possible.

But far too many older people are currently living in homes that are endangering their lives. Much of the housing in England is dangerous or unsuitable for older people. Homes are not safe or warm. They have hazards and are inaccessible for someone with a disability.

This needlessly costs society millions each year in NHS and social care costs. We want to make homes more age-friendly so that more people can remain living independently, healthily and happily as they grow older. ⁱ

This is a national, rather than just a local issue but will try to provide a local context to these issues in this report and the Age Friendly approaches that are taking place in York.

It is noted that the Housing Our Ageing Population Implementation Plan ⁱⁱ requires the Health and Wellbeing Boards to identify the role of housing in their new Joint Strategic Needs Assessments (JSNA) and local clinical commissioning plans; and recognise in its budgeting the centrality of housing in preventing and addressing health and social care problems. This report will therefore be part of the documentation provided through York’s JSNA.

This year the Council will be reviewing their private sector housing assistance policy with Health and Social Care partners. They will be using an evidence base approach taking account of the findings of their recently commissioned Building Research Establishment’s report into housing conditions in the private sector and the Health Impact Assessment.

As these are significant papers that will influence the medium-term strategic direction it is recommended that this paper is regarded as an Interim Baseline Assessment with a revised version submitted after there is a presentation to the Ageing Well Partnership on the key outcomes from these reports. Any recommendations would therefore also be regarded as interim as key findings may influence a shift in priority.

It is clear that there are significant pressures and challenges ahead as the services seeks to deal with impact of the pandemic on the health of residents which has resulted in both increase demand and complexities alongside the cost of living impact residents who are becoming more fearful about paying their bills and keeping their homes warm. We also recognise that contractors who work for our customers are experiencing a range of issues including the cost of materials, higher salaries to attract experienced and qualified staff and supply chain issues. This has led to an increase in work costs of around 12%-15%.

3. Housing Need

The City of York Council has commissioned a Local Housing Needs Assessment which aims to provide an additional evidence base on housing need and mix and will cover from 2021 to 2033.

Initial findings indicate population growth is projected to be concentrated in older age groups (those aged 65 and over) – this age group accounting for all the projected population change. This growth alongside anticipated changes in household formation was used to create a projection of 822 additional dwellings per anum which links to the Council’s Submission Draft Local Plan. The table below shows that the main growth in housing need is for people 80 and over. The research also indicated there will be a need for both social and affordable rented housing and to therefore seek affordable rents at less than 80% of the market to improve the affordability.

Table 1: Projected Change in the quantity of Households by Age in York

	2021	2033	Change in Households	% Change
55-59	7,856	6,532	-1,324	-16.9%
60-64	7,021	7,826	805	11.5%
65-69	6,160	7,850	1,690	27.4%
70-74	6,725	7,288	563	8.4%
75-79	5,411	6,139	728	13.5%
80-84	4,115	5,267	1,152	28.0%
85 & over	4,201	5,989	1,788	42.6%
Total (all ages)	90,204	99,781	9,576	10.6%

Key findings for the 2021-33 period include:

A 21% increase in the population aged 65+ (potentially accounting for 63% of total population growth);
A 29% increase in the number of people aged 65+ with dementia and a 26% increase in those aged 65+ with mobility problems;
A need for around 1,540-1,730 housing units with support (sheltered/retirement housing) – mainly in the market sector;
A need for around 610-670 additional housing units with care (e.g. extra-care) – all in the market sector;
A need for additional nursing care bedspaces; and
a need for around 1,200 dwellings to be for wheelchair users (M4(3) compliant). The report proposes all dwellings to meet the M4(2) standards (similar to the Lifetime Homes Standards) and around 10% of homes meeting M4(3) – wheelchair user dwellings (a higher proportion in the affordable sector).

Recommendation: support the proposal for affordable rents at less than 80% of the market to improve the affordability

Recommendation: encourage the proposal for all dwellings to meet the M4(2) standards (similar to the Lifetime Homes Standards) and around 10% of homes meeting M4(3) – wheelchair user dwellings (a higher proportion in the affordable sector).

4. Type of housing

In August 2019 an older person accommodation survey took place with 406 people participating. 29% of people wanted to live in their current property in older age with the next most popular option was a smaller home, bungalow, or apartment with an even split between general needs and accommodation specifically for the 65+ age group.

There are a wide range of services that help people to remain independent in their own home. Just one example, and perhaps a less obvious one, is Keep Your Pet which offers an older person short-term assistance for domestic pet owners at times of health or other emergencies. It is important to understand what impacts older people in feeling that they can no longer manage at home and ensure there are opportunities to address this.

The older person accommodation shows that only 4% would be looking for residential care. This aligns with the Council’s approach of only looking at this option when specifically required and to always maximise the opportunities to maintain independence.

Home ownership is the most common tenure type with 81% of people owning their own home. This also applies to people’s preferences in older life with 77% of people wanting to own their property.

Table 2: Tenure of Older Persons Households in York, 2011 (Source: 2011 Census)

Table 3: Percentage of population with long term health problems or disabilities (Source: 2011 Census)

Table 4: Types of disability or long-term conditions in York

Disability	Age Range	2021	2033	Change	% Change
Dementia	65+	2,704	3,486	782	28.9%
Mobility problems	65+	7,020	8,836	1,816	25.9%
Autistic Spectrum Disorders	65+	337	417	80	23.9%
Learning Disabilities	65+	769	924	155	20.1%

5. Private rented

Today only 22% of those over 65 are tenants (private or social). But this will change. Owner-occupation has been falling and there has been huge growth in the private rented sector – a doubling of numbers since 2000. As this new “Generation Rent” gets older and the chances of buying a home diminish, the number of retired people in the private rented sector (PRS) seems set to change dramatically. Renting has the advantage of shifting the hassles of repairs and maintenance to someone else. There is much to be said for not having to worry about the upkeep of the home particularly if family or friends are not close at hand to help. But renting brings its own problems. It needs to be recognised that the PRS operates in ways that can be problematic for the older tenant:

The absence of lifetime security of tenure is unsettling; the possibility of being required to leave at short notice is not good for one’s peace of mind;
The poor condition of some properties is particularly bad for the health and wellbeing of older people. A quarter of all privately rented properties are “non-decent” – often because they are cold and damp – and these are disproportionately occupied by older people;
The chances of securing necessary adaptations – from handrails to stairlifts – is much lower in the PRS than in other tenures. Councils may be reluctant to provide Disabled Facilities Grants because the tenant may not occupy the property for 5 years or more and landlords may be reluctant to spend money when adaptations may have to be stripped out for the next tenant;
Very significantly, rents which may be affordable when a tenant is in work can become too expensive when they are reliant on pension income. And for those who qualify for Housing Benefit, there may be an unbridgeable gap between the actual rent and the help received.

These factors led the Inquiry members to conclude that although some of the problems for private sector renters could be alleviated in ways the Rental Housing for the Older Population report describes, broadly the PRS is not best placed to meet the needs of renters who move into older age.

The corresponding benefits of living in the social rented sector – in the homes of housing associations and councils – are another story. Tenancies are likely to be for life, numbers of “non-decent” homes are very much lower, adaptations are very significantly more likely, and there is the expectation that rents will be at levels that do not cause hardship and distress. But at present there is little sign of the provision of a much enlarged social housing sector geared to the needs of older people. Although findings indicated excellent developments of more specialist Extra Care housing – often taking the place of residential care homes – they did not detect any signs of a modern-day equivalent to the extensive building of sheltered housing in times past. ⁱⁱⁱ

The Local Government Association Report – housing our ageing population identifies that, given the scale of demographic change and the centrality of this growing older population to many aspects of housing policy, there is an opportunity for the Government to set out to comprehensively address the housing needs of an ageing population for England, through working with and supporting councils and other stakeholders.

It is essential that a renewed national and local effort to build more homes for older people is:

intelligence led, including working with older people to understand demand
enabled by a local planning, set within clear national policy
collectively led by local housing and health partners
taking opportunities to increase supply of a wide mix of housing supporting positive ageing
integrating housing with health and care strategies and services
successfully adapting existing housing and providing older people that want to ‘rightsize’ the means to do so
able to inform older people of their options for their current and future housing needs. ^iv

Recommendation: support intelligence led housing development decision, including requesting working with older people to understand demand

Recommendation: seek to embed ageing and housing considerations in all relevant strategies

Nearly 230,000 private renters in England have received no-fault eviction notices since 2019, with female-led single parent households making up a quarter of those threatened with eviction in England, in 2020-21, according to an April 2022 survey by Shelter and YouGov. The Department for Levelling Up have revealed that 8% of private renters leaving accommodation in 2019 and 2020 had been asked to go by their landlord.

The government introduced the Renters Reform Bill. This includes proposals to:

make all tenancies periodic;
double the notice periods for rent reviews;
make it illegal for landlords to have blanket bans on those in receipt of benefits;
strengthen the ability of renters to challenge poor practice and unjustified rent increases
obtain rent refunds for unhealthy, unsafe or poor-quality homes; and give councils stronger powers to tackle the worst landlords and increase fines for serious offences.
abolishing Section 21 of the Housing Act 1988, which allows landlords to evict tenants without reason
establishing a private-renters' ombudsman to settle disputes

6. Specialist accommodation

Some people’s care and support needs mean that specialised housing is likely to offer the best option for them. Section three of this report identifies the project need for sheltered, extra-care, nursing care and wheelchair standard properties. However, we recognise that most people will continue to live in mainstream housing, and we need to ensure they can adapt their homes to meet their needs where necessary.

In fact, around 1.9 million households in England are home to someone with a health condition that requires an adaptation to their home to support everyday tasks like washing and using the bathroom, cooking, or getting out and about easily. In 2019 to 2020, 53% of households requiring an adaption do not have all the adaptations needed, a rise from 45% in 2014 to 2015 ^v

The white paper goes on to say: “For older people, having a home that sustains safe, independent living can help prevent ill-health, reduce the amount of care and support they need, and delay or avoid altogether the need for residential care.”

and

“People's homes should allow effective care and support to be delivered regardless of their age, condition or health status. We want people to have choice over their housing arrangements, and we also want to ensure places ‘think housing and community’ when they develop local partnerships and plan and deliver health and care services”

In order to try and address the myriad of challenges identified in this report key stakeholders came together to form HoME (Housing Made foe Everyone). There statement is:

“We want to work with policymakers, local authorities and homebuilders to ensure that all new homes are built to better meet the needs of current and future generations.” ^vi

Independent Living Communities provide a range of “sheltered” accommodation models with care allocated based on need and usually an allocated “warden” or equivalent. Most provision of this nature has communal living spaces and a hard wired alarm as part of their service charge. In York there are a range of this type of accommodation which are run by the Council; Housing Associations, alms-houses as well as private companies.

Where an older person requires 24 hours care a care home may be the best option. There are 34 residential care homes in York with additional residential accommodation in the surrounding area. If residential accommodation is the best option then there is a range of accommodation prices and advice on paying for care.

Independent living communities are offered by the Council and a range of both private companies and housing associations.

As there is a range of options, including downsizing and staying in your existing property there is an accommodation guide for older people.

Recommendation: Recognise HoME as a national voice that can represent the older people and where appropriate support and/or provide evidence to strengthen their call for change

7. Alternative housing options

Homeshare York matches an older homeowner (the ‘Householder’) with a younger person (the ‘Homesharer’). The Householder offers a spare room in return for 10 hours support a week. Although this is picking up interest slowly, we recognise the importance of offering a range of options, particularly where an older person is starting to struggle but wants to remain independent at home. The match can provide far more than maintaining independence in the home, we have found a number of older people who no longer have the confidence to drive so a trip to the seaside or to visit a relative or friend with a Homesharer who has a car can suddenly feel less daunting.

Purpose built intergenerational accommodation – the older people accommodation survey identified that 12% of older people would like a mixed aged community. The Council is currently seeking planning permission for self-contained accommodation for both older and younger people in the same development, creating a deliberate social model as part of the allocation process and designing in communal intergenerational spaces.

Table 4: Thinking of your later years, what type of property would you like to live in? (source: York older people’s accommodation survey Aug 2019)

Airbnb was identified as a concern by the Age Friendly York Citizen group, this because it is not regulated creating the potential for significant impact to residents that live close by. This is specifically where the whole property is used for this purpose creatin a double impact from the disturbance caused by guests and the erosion in the community due to empty properties.

Perhaps surprisingly, studies show, people over the age of 55 are more likely to use Airbnb than younger people. The Freebird Club is expressly for older people, connect seniors with spare rooms with seniors looking to travel. However this is the model where the host stays, the negative impacts on the community appear to be when a vacant property is used for Airbnb.^vii

The Government issued a call for evidence with submissions required in September 2022. These seek

The Council produced a scrutiny report which outlined the key impacts. There has been a 181% increase in entire home rentals in York from 2018 to 2022 which represents an increase in the housing stock used for these purposes of 0.68% to 1.87%. Its also worth noting that York has a higher proportion of entire home rentals to individual rooms to Comparator cities (in comparison with Bath, Oxford etc).

8. Affordability

Since 2011, over 300,000 households nationally, with people over 55 years old, have released equity in their property to provide cashflow in latter life. There are a lot of detailed considerations both economic and social to make including exploring down-sizing as an alternative.

Where a care home is the best option the person would be assessed to determine what financial contribution they need to make and their capital will be taken into consideration. This can result in the person being required to sell their previous home. If the person moved in paying for care themselves and then needs financial support at a later date they may be required to move or a top up be paid.

Private rented, alongside other identified challenges, can create significant challenges in respect to affordability. Depending on their financial circumstances they may be able to claim Housing Benefit and/or Council Tax Benefit. A 24% discount on Council Tax is also available if living alone.

It is recognised that not everyone applies for the benefits they are entitled to, including Pension Credit. This can create poverty in households where the impact can be reduced. York has focused campaigns to raise awareness of benefit entitlement. This includes rebates on fuel and insulation.

Affordability not only includes the cost of the accommodation or fuel but the maintenance and adaptation of the accommodation as their needs change (see section 4)

9. Housing conditions

A new investigation commissioned by the Centre for Ageing Better as part of the The Good Home Enquiry ^viii has revealed the damaging impact of homes in poor condition on people in their 50s and 60s. There are an estimated 4.1 million homes in England that do not meet basic standards of decency, and around half of those homes are lived in by someone aged 55 or over. A report by Ageing Better warned that those living in cold, damp or poor-quality homes could be at a greater risk from COVID-19.^ix

The new analysis, released today, finds that problems such as cold and damp, or fall hazards, are leaving people feeling ‘miserable’ and ‘overwhelmed.’ However, emotional attachments to the home can prevent people from making the changes needed – or people don’t see themselves as ‘old enough’ to make adaptations that would help them live more safely.

With the increase in fuel prices the is significant risk of excess winter deaths due to living in a home that is not at a sufficient temperature. There are many considerations from climate crisis, benefit entitlement, community-based solutions and insulation. Due to the level of importance with this issue, it is recommended that a separate ‘staying warm’ report is completed.

Recommendation: create a supplementary Age Friendly – Staying Warm report.

10. Housing development and regeneration

We have a housing shortage (both locally and nationally) so it is in everyone's interest to help those who'd like to move from family-size houses to something more suited to their needs. The choices have to be wider than struggling to cope with limitations in unsuitable property or moving to one room in a care home.

As the data in this report shows, the proportion of older people in York is projected to increase so developments need to take into consideration how age friendly they are and whether they can be easily modified to meet changing needs. Age Friendly Ireland have produced an Age Friendly Homes Rating Tool ^xwhich will help homeowners, tenants, landlords, developers, local authorities and practitioners to assess the suitability of housing for the needs of older people.

In America they recognise what they call NORC (Naturally Occurring Retirement Communities) and have identified this can often be in places which are less liveable communities. Some initial work has been done for the Ageing Well Partnership on the State of Ageing York with, at the time of writing, on high level 2021 Census information being available. Of the 120 areas within York, only 2 are within the bottom 10% of all areas of England for within the Income Deprivation Affecting Older People Index (within Clifton and Hull Road wards) and a further 3 within the bottom 20% (within Micklegate, Westfield and Guildhall).

Recommendation: raise awareness of the Age Friendly Homes Rating Tool and look to see where this can ensure there are age friendly considerations in housing development decisions in York.

Recommendation: push for housing development to be Accessible and Adaptable, demonstrating the cost benefit.

11. Diversity and Housing Options

There is a need to understand housing preferences from specific demographics of the community. This will help to identify unmet need with consideration for future options like retirement housing for the LGBT+ community ^xi

When the 2021 Census information becomes available we will be able to determine if there is any growth specific demographic areas with older people. This will help to identify whether there is any focused pieces of work required around housing need.

Age Friendly Manachester created a Framework for Age Friendly homes. ^xii Within their findings they identified that “People are diverse and want different things from their homes and communities and by engaging directly we can deliver a housing offer that is truly ‘fit for purpose’.” A simple concept but this reenforces the need for genuine co-produced approaches in ensuring housing improvements and development are fit for the future.

On the national stage, the government published its Planning White Paper. ^xiii The measures outlined are a green light for housebuilders to construct new housing within certain confines; namely, on sites designated for growth. Despite lobbying with other sector bodies for more favourable planning conditions for housing an ageing population, the paper did not propose anything specifically to boost planning for accessible homes for an ageing population, although they do invite suggestions on how best to meet the needs of diverse groups and to meet equalities legislation.

In addition, researchers at Newcastle University and the University of Manchester, found that urban regeneration is often only advantageous to younger, more affluent residents. For example, less than half of local housebuilding plans in England included provision for accessible homes to allow independent living for people with disabilities. ^xiv

Recommendation: Encourage and contribute to co-produced approaches in housing development and regeneration

12. Access to services

The York accommodation survey for older people showed relatively equal weighting with a lower rate of preference for the more specialist provision like being provided with a daily hot meal or having access to a shared living space.

Table 5: Thinking about the range of facilities and services available in older people accommodation, which of the following would be most important to you?

“The siting of housing for older people also relates to consumption and costs in terms of the transport needed to access shops. healthcare, leisure etc

It seems that out-of-town sites are preferred by both developers and planners rather than using city-centre sites within easy distance of desired facilities.

The problems are compounded by piecemeal decisions at different levels, local and national, where policies can appear inconsistent.” Age Friendly Citizen Group member

13. Housing Advice

The Home Truths report in Leeds states - Our behaviour when seeking advice about housing is comparable to when thinking about our health as we age or when we expect to retire - avoiding planning and preparing until we are in a moment of crisis. It is at this critical moment that accessible, high-quality information and advice services that are responsive to the needs of the individual and household are vital. The benefits of providing this are multifaceted, not least maintaining or improving the quality of life for the individuals concerned and reducing demand on public services.^xv

So what approaches do we have in York:

Housing options team –there is a duty to those at risk of being homeless within 56 days or homeless imminently. Duty also provides advice on housing options to anyone else who calls, this is generally signposting as they can only offer an actual duty to those at risk of homeless within 56 days. There are some exceptions where they can work outside of this.
Housing options fact sheets
Live Well York – provides a range of housing information pages, some specifically for older people. It also provides the opportunity to navigate advice and accommodation services. For those that do not use the internet, the relevant pages can be added to a personalised booklet and printed.
Other advice services – a wide range of advice services are listed on Live Well York.

Recommendation: ensure older people have a range of different methods to access information on housing options, aligning with the York All Age Community Information Strategy

Recommendation: ensure opportunities are promoted to enable older people to explore housing options before crises point to enable informed and positive decisions

14. Feeling safe at Home

Scams are cross cutting and include impacts on people at home like doorstep or telephone scams but also about their home, this may include even losing their property due to fraud. Often older people are targeted with an older person being defrauded every 40 seconds, potentially losing a sizeable chunk, if not all, of their retirement savings and harming their well-being.

In York there are regular awareness media, as well as access to information to reduce the risk of scams for example Staying Safe Online at Live Well York. Age Friendly York has also shared a story from an older person to show that this can happen to anyone.

Preventing the risk of falling is a key consideration regarding people’s homes where an older person is frail, has a disability or a long term condition. Falls prevention, handyperson prevision and minor adaptations to enable people to feel safe at home are covered later in this report. The handyperson services also help people feel safer from the risk of intruders through provision of locks, door chains and spy holes.

Age UK York provides a Trusted Traders directory so that they can feel safe in the decisions they make to repair and improve their home.

15. Assisted Technology

In the Older People Accommodation survey 83% of people said that they would feel comfortable with technology is assisting them. Particularly with reminders and sensors. People generally felt comfortable with people GP’s and family accessing the data but less so care service.

When asked a specific “There are many different stakeholders and providers that play a role in the provision of care. Do you think that these stakeholders have your best interests at heart?” 72% said no. The data from the previous Your Service baseline assessment showed high satisfaction in care which increase as people got older. A conclusion could be reached that those preparing for older life have more suspicion and distrust of carers than those receiving care. Therefore if access to technology data is required by carers to provide the best service this trust may be achieved once they start receiving the care and the trust of GP’s and family will help to allay this distrust.

16. Home modifications

Home adaptations are changes made to the fabric and fixtures of a home to make it safer and easier to get around and to use for everyday tasks like cooking and bathing. Adapting a home environment can help restore or enable independent living, privacy, confidence and dignity for individuals and their families. Adaptations can include the installation of stair-lifts, level access showers and wet-rooms, wash and dry toilets, ramps, wider doors, and, in some instances, bespoke home extensions to existing dwellings as well as improvements to access to and from gardens. Heating systems, insulation and telecare and assistive technology (where it is capital) can be other forms of adaptations.

Disabled Facilities Grants (DFG) are capital grants that are available to people of all ages and in all housing tenures (i.e. whether renting privately, from a social landlord or council, or owner-occupiers) to contribute to the cost of adaptations. They are administered by local housing authorities in England and enable eligible disabled people to continue living safely and independently at home. This includes autistic people, those with a mental health condition, physical disabilities, learning disabilities, cognitive impairments such as dementia, and progressive conditions such as Motor Neurone Disease. It includes those suffering from age-related disabilities and can also include those with terminal illness. The DFG is one of a range of housing support measures that a local authority can use to help enable people to live independently and safely at home and in their communities^xvi

In York the adaptation programme includes the DFG and a non means tested grant of up to £5k as well as other assistance including relocation packages to support residents move to homes which can be more easily adapted. A complimentary loan programme is also available to help vulnerable residents repair and maintain their homes. Other home improvement options include a range of energy efficiency grants to make cold homes warmer and safer to live that are occupied by low-income households.

Over 75% of our DFG customers are over the age of 67 years old with 100% of our customers who responded to the Councils customer satisfaction questionnaires said that they felt safer and that their quality of life had improved.

Quantity of Disabled Facility Grants allocated in York:

2016/17	2017/18	2018/19	2019/20	2020/21	2021/22
160	219	274	299	264	323

Minor adaptations include a work such as grab rails at the front door to help residents access their home or next to the WC to assist toileting and second banister rails to help safe access to bedrooms. In York 60% of all referrals are received from NHS services to enable customers to be discharged directly from hospital or from outreach services. 40% are from social care staff and housing staff focussing on prevention and reablement.

Quantity of households in York that where minor adaptations took place:

2016/17	2017/18	2018/19	2019/20	2020/21	2021/22
1545	1541	1599	1555	1151	1322

It is much more effective to build the type of homes we need now than to adapt unsuitable properties in the future, often at much greater costs:

Building new homes that are ‘Accessible and Adaptable’ as standard = £1,387 per dwelling.

The potential cost of not building the homes we need, based on the figures available:

An average Disabled Facilities Grant to adapt a home = £7,000 (one-off payment)
Residential care costs if your home becomes unsuitable = £29,000 per year ^xvi

Home modiﬁcations included handrails for outside steps and internal stairs, grab rails for bathrooms, outside lighting, repairs to window catches, high-visibility and slip-resistant edging for outside steps, fixing of lifted edges of carpets and mats, non-slip bathmats, and slip-resistant surfacing for outside areas.

The good home enquiry ^ivwas partially triggered by identifying that 17,000 people dying in 2018 because they could not afford to heat their homes properly. Since the report there has been significant rises in fuel bills creating even greater concern in households not being able to carry out minor repairs to reduce drafts along with other insulation improvements through retrofitting.

The Good Home Enquiry recommended a national network of local delivery agencies providing trusted advice, information, access to financial products and grants, supported by a national strategy, ideally owned at cabinet level. The report recognises that the answers will best be found locally, reflecting unique local challenges and opportunities.

The report concludes: “Individually, we will be happier and healthier if our homes are good. We will be more comfortable if they are energy efficient. We can reduce some of the pressure on our health service. We can help to stimulate economic growth by creating new apprenticeships, new skills, and new jobs. And we can make a significant contribution towards meeting our international climate change obligations.”

One in five homes in England is deemed non-decent, and only 7% of UK homes meet basic accessibility requirements. Non-decent homes are disproportionately lived in by people in later life, many of whom manage long-term health conditions and have disabilities. ^xvii

However the government has announced the intention ^xviiito require all new homes to have entrance level step-free access and other accessibility features as a minimum requirement.

17. Fall prevention

Modelling would suggest 80% of people do not receive any medical attention after having a fall. Of the 20%: 61% use an ambulance, 51% use a GP appointment. This provides the following estimated figures for York:

However, falls data does not identify whether this is in the home or while out and about. This reduces the ability to have maximum impact from prevention approaches. It does however go without saying that designing in reduced risk of falls in new builds as well as in retrofitting existing buildings will reduce falls in the home. This will improve wellbeing and physical health as well as create efficiencies in health and Adult Social care costs.

The main findings revealed a 31% reduction in home fall injury rates per year in the intervention group and a 40% reduction in falls injuries specific to the intervention (previous study values were 26% and 39% respectively). This is considered a highly cost-effective intervention for falls injury prevention as the average cost of the home modifications was approximately £300 per dwelling. ^xiv

It is recommended that older people who report falls or are at risk of falls, should be observed and offered a multifactorial risk assessment. Multi-level response

strength and balance training
home hazard assessment and intervention
vision assessment and referral
medication review with modification/withdrawal
information and advice

In York the falls prevention team in the Council team offer a falls prevention service. This included:

Referral rates into the City of York Council team for falls prevention:

2018/19	2019/20	2020/21	2021/22
417	437	386	680

Initial figures for 2022-23 would indicate that there will be a further increase in referrals
Average waiting time from referral to initial assessment 10 days
Source of referrals varied and reflective of work being done to refresh links within ASC Teams, Local Area Co-ordination and NHS Teams in order to streamline processes and support response time

18. Handyperson

The City of York Council also provide a handyperson service.

City of York Council handyperson referrals:

018/19	2019/20	2020/21	2021/22
122	362	280	291

Indication is that there will be a further small increase in referrals for 2022/23.

Task include:

212 keysafes
77 new lightbulbs / changing lightbulbs
46 broken WC seats
6 smoke alarms / batteries to smoke alarms or CO alarms
71 others - such as curtain rails / blinds / curtains to put up, easing gates, changing door handles, securing carpets

19. Hoarding

It is estimated that around 2% – 6% of the population suffers from hoarding disorder. This appears to affect men and women at similar rates. It is believed to be a universal phenomenon with consistent clinical features in all races, ethnicities, and cultures around the world.

Hoarding symptoms appear to be almost three times more common in older adults (ages 55-94 years) compared to younger adults (ages 34–44 years), although hoarding symptoms can occur in young children as well.

Hoarding symptoms begin to appear early in life and continue throughout the entire lifespan, increasing in severity with each passing decade. Around 75% of individuals who have HD have a co-occurring mental health condition (the most common co-occurring disorders are major depressive disorder, social anxiety disorder/social phobia, and generalized anxiety disorder).

20. Gardening

Older people that are frail, have a disability or long-term condition may no longer be able to manage their garden, if they have one. Where they can afford to do so they can employ a private gardener, but this is not always possible.

Where they live in private rented or social housing, it is a condition of their tenancy to manage their garden.

The Council provide or commission a number of services to help address these issues, where possible providing community-based solutions.

21. Funding of housing related prevention service

The majority of non-commercial solutions in maintaining people’s homes are provided by or commissioned by the Council. There is a grant based programme called Small Tasks at Home as well as a Garden Assistance Scheme run by the housing team in the Council.

22. References

Suitable Housing for later life – Centre for Aging Better (Jan 2019)
Housing our ageing population Implementation Plan – All Party Parliamentary Group (Nov 2012)

Rental Housing for an Ageing Population – All Party Parliamentary Group (Jul 2019)

Housing our ageing population – Local Government Association (Sep 2017)
English Housing Survey 2019-2020 – Ministry of housing, communities and local government
Housing Made for Everyone - HoMe Coalition (2020)

Can this Airbnb keep elderly people connected – world changing ideas (May 2016)
Good Home Enquiry – the Centre for Ageing Better (Aug 21)

Homes, Health and COVID-19 – The Centre for Ageing Better (Sep 2020)
Age Friendly Homes Rating Tool - Age Friendly Ireland (June 2021)
Retirement Housing for the LGBTQ+ community – TONIC (Sep 22)

Framework for Age Friendly Homes –Age Friendly Manchester (2021-2024)
Planning White Paper – Government paper (Aug 2020)
Ageing needs to be part of the debate about urban regeneration – Center for Ageing Better (Jan 2020)

Home Truths – Housing Options and Advice for people in Later Life – Centre for Ageing Better (July 2019)

Homes for Life – It’s time to build the homes that we need – The Centre for Ageing Better
Disability Facilities Grant – Gov. UK (Mar 22)
Raising minimum accessibility standards – Centre for Ageing Better (Jul 22)
Craig J, Murray A, Mitchell S, Clark S, Saunders L, Burleigh L. The high cost to health and social care of managing falls in older adults living in the community in Scotland. Scott Med J. 2013;58(4):198-203.

Last updated: 06/03/2024

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