Age, home and community: a strategy for housing for Scotland's older people 2012-2021

CHAPTER 5: BETTER USE OF EXISTING HOUSING

5.1 This strategy recognises the importance of existing housing for older people and places considerable emphasis on making sure that the right services are in place to make best use of that housing. The great majority of the current population, not just those who are already over 65 years, will live their lives in houses which are already built. While new housing continues to be built, current rates of house building in both the private and public sectors will only gradually replace and extend the existing stock of housing.

5.2 We recognise that older people do not all want to live in the same way and in the same types of housing. In finding ways to make better use of our existing housing, our focus will be on all tenures - privately owned housing, private rented housing, local authority and housing association properties. We will focus on both mainstream housing and housing which has been specifically designed to meet the needs of older people.

5.3 Our review of evidence has highlighted five areas where improvements are needed in particular. These are:

• Housing adaptations - making changes to people's homes to increase or maintain their independence and reduce the risk of an accident;
• Repairs, maintenance and keeping warm - maintaining and improving people's homes, particularly where basic amenities fall below standards which are acceptable today;
• Support to move home - helping older people with the emotional and physical demands of moving home, so they can move to a property which better suits their needs;
• Housing with care or support - making better use of our existing stock of housing which has been built specifically for older people, particularly sheltered housing; and
• Using personal resources to adapt and improve housing - assisting older people to use the assets in their home to provide themselves with the housing which is most suitable for their needs.

Housing adaptations

We want to see housing adaptations services across Scotland that respond to the challenges of an ageing population. All older people, wherever they live and whatever the tenure of their home, should have access to services which can adapt their home, reducing the risk of accidents and improving their independence and quality of life.

5.4 Adaptations are a key contribution by the housing sector to enabling people to sustain independent living. They help to prevent falls and have benefits for health and wellbeing, by enabling people to make full use of their homes. They can also help carers, by reducing the risk of injury and improving physical and mental health. Adaptations do not just help people with mobility problems, but also those with sensory impairments, through the provision of devices like flashing doorbells.

5.5 There is now a significant body of evidence that shows the importance and cost-effectiveness of housing adaptations in reducing accidents in the home. For example, in 2007 the cost of a fractured hip was estimated at £29,000, compared with £6,000 for a major housing adaptation, or a few hundred pounds for grab rails. ^[36] Bield, Hanover (Scotland) and Trust Housing Associations recently commissioned a Social Return on Investment study of adaptations in their sheltered and very sheltered housing developments. It found that, for an average cost of £2,800, each adaptation saved the Scottish health and social care systems an average of over £10,000. ^[37]

5.6 Local authorities, housing associations and householders have made substantial investment in housing adaptations in recent years. However, more people will need adaptations, as the population ages. All things remaining equal, it is estimated that the overall number of pensioner households requiring adaptations will rise from 66,300 in 2008 to over 106,000 in 2033. ^[38] We need, therefore, to find better ways to ensure that this investment is available to others who need an adapted home, as outcomes can be improved, if those adaptations are provided at an early stage. Our review of current arrangements has shown that there are opportunities to improve both the quality of adaptations services and outcomes for those who have them, while also improving cost efficiency. There are issues about the time taken to get adaptations installed; design and quality; and questions about how equitable the current funding arrangements are.

5.7 Arrangements for the provision and funding of housing adaptations vary, depending on the tenure of the property. For people in social rented housing, adaptations are undertaken by landlords. For those in the private sector, the Housing (Scotland) Act 2006 ^[39] established the Scheme of Assistance, under which local authorities have a general duty to assist home owners and people in the private rented sector who need adaptations to their homes. The assistance can take the form of advice, practical help or financial assistance.

5.8 Our priority is to improve the arrangements for providing housing adaptations and to make better use of those properties which have already been adapted. We know that locally there are excellent examples of streamlined, effective services. We want to see this good practice replicated across Scotland and to look at ways to make better use of the existing network of Care and Repair services. We are confident that more can be achieved and have established an independently chaired Adaptations Working Group to consider how to achieve simpler, more equitable and more effective delivery of adaptations. As adaptations services also support disabled people, the Group includes organisations representing their interests. It is due to submit its proposals for improvement in June 2012.

Case study: Borders Care and Repair's 'One Stop Shop'

Borders Care and Repair provides a 'One Stop Shop' for major adaptations, under a service level agreement with Scottish Borders Council. The service provides housing adaptations for older people and disabled people living in all housing tenures.

An in-house occupational therapist (the first for Care and Repair in Scotland) ensures that all adaptations are designed specifically for each client's long term needs. Covering all housing tenures means that an overview can be taken to ensure that a consistent approach is taken to eligibility and priority. The single point of contact enables more clients to be seen, which assists with hospital discharge and speeds up the process for those in need to remain at home.

Borders Care and Repair also provides advice to people who wish to fund their own adaptations, providing information on the options available and what to look for in products. They can also provide plans and specifications, arrange estimates from contractors and project manage the works if required. This service helps people to ensure that their homes will remain suitable for a longer time, reducing the need for future adaptation.
http://www.eildon.org.uk/3/58/Borders-Care-and-Repair.aspx

Case study: Highland Council's adaptations self-assessment

Highland Council has introduced self assessment for certain types of housing adaptation. The Council recognised that older people and disabled people were undergoing numerous assessments in order to live independently, so developed a process which makes use of current assessments that people have already undergone for benefits and other entitlements. People who meet the criteria will automatically receive certain types of adaptations, including level access showers (the most common major adaptation), without the need for a further assessment (by an Occupational Therapist).

The main benefits of the initiative have been to speed up the delivery of these adaptations by reducing the number of assessments needed, and to free-up the time of occupational therapists to focus on more complex assessments.
http://www.highland.gov.uk/

Case study: East Lothian Council's Housing OT Service

East Lothian Council established a Housing Occupational Therapist ( OT) service in 2001 to streamline and improve its housing adaptations service.

The Housing OT is a single point of reference for all service users, architects and contractors, saving both time and costs, and is involved in the assessment, design and installation of major adaptations, as well as assessments of need. The post has facilitated the development of expertise in adaptations, ensuring best value and design to meet service users' needs and for long term use of property; consistency in design and provision; and advice regarding options for adaptations and re-housing.

Evaluation of the service in 2010-11 showed very high satisfaction levels among users of the service, with an average satisfaction level across all areas of 99.4%.

In addition, the Housing OT role has expanded to contribute advice on design of new build developments; housing allocations; and planned maintenance and refurbishment programmes.
http://www.eastlothian.gov.uk/site/index.php

5.9 We also need to make better use of those properties which have already been adapted, ensuring that where possible they are allocated to disabled people and older people, and that adaptations are not removed without good reason. We have supported the development of a register of accessible housing to assist people to find accessible or adapted housing in locations that are right for them. It should be particularly helpful to people who need to move to a new area, where they aren't familiar with local housing options.

5.10 We need to recognise that some properties, such as traditional tenement flats on upper floors, are not well suited to adaptation. In cases where adaptations will not produce a good solution, a move to a more suitable property is likely to be a better option. Advice and support will be important for people who have to make such a move, and the register of accessible housing should be helpful in finding a new home.

What we will do

5.11 We will improve the arrangements for housing adaptations by:

• Ensuring that delivery and funding arrangements are fit for purpose. Through the Adaptations Working Group, we will consider whether there is a need for fundamental change to the funding and delivery of housing adaptations, so that they provide the best outcomes for those who need them.
• Reviewing support for adaptations for home owners. We will review the disability adaptations elements of the Scheme of Assistance to assess whether changes are required, pending any more fundamental change in the delivery of adaptations across all housing tenures.
• Making the best use of adapted and accessible properties. We will continue to support the development of a register of accessible housing by Glasgow Centre for Inclusive Living, to help disabled people across Scotland to find homes that are suitable for them.

Repairs, maintenance and keeping warm

Older people should live in homes, which are warm, dry and secure, and should have easy access to reliable tradespeople to undertake repairs and maintenance.

5.12 Many older people, particularly in the private sector, live in homes which have some level of disrepair. In most cases, this is relatively minor and does not cause serious problems. However, in some instances, disrepair is of a level that affects the occupier's health and presents dangers to everyday living.

5.13 The Scottish Housing Quality Standard ( SHQS) ^[40] is the Scottish Government's principal measure of housing quality. It provides a minimum standard, below which a property should not fall. Housing owned by local authorities and housing associations must meet the standard by April 2015. Many social landlords are undertaking refurbishment and improvement programmes in their housing stock to meet the SHQS. Such programmes can be used to deliver housing adaptations to tenants who need them, or are likely to do so in future. In 2004-05, 23% of people aged 60 and over were living in properties which passed the SHQS, compared with 25% of the population as a whole. This increased to 38% for both groups in 2009. ^[41]

Private sector housing is not required to meet the SHQS, but can be assessed against it.

5.14 The Scottish Government is also working with social landlords to develop a climate change standard for social housing to go beyond the SHQS, which will help reduce greenhouse gas emissions and improve the energy efficiency of housing. The new standard is due to be announced in late 2012, and landlords will be expected to meet it by 2020.

5.15 The Tolerable Standard defines the minimum condition that is required for a home to be habitable. A very few homes in Scotland do not meet the Tolerable Standard, with a relatively higher proportion in rural areas than urban areas. Around 1.2% of people aged 75 and over live in homes which do not meet the Tolerable Standard, compared with 0.6% of the population under 75.

5.16 Responsibility for repairs and maintenance is an important part of home ownership, but older people can find it more difficult to maintain their homes in a good state of repair, often due to problems in finding reliable tradespeople to undertake repairs. Helping older people to maintain their homes can help to improve health and reduce hospital admissions. In these circumstances, access to good information and advice is important to let people know what services are available in their area. Care and Repair have particular expertise in assisting older home owners with homes in disrepair.

Case study: Home Happening programme

South Lanarkshire Council has been carrying out a major improvement programme to upgrade kitchens and bathrooms in its housing stock since 2004. To make best use of existing housing stock to meet the needs of older people and increasing demand for adaptations, the Council employed occupational therapy staff to work on the programme. Their role was to assess the individual needs of tenants, who had been identified as needing specific help, and provide flexible long term solutions within the design specification of the new kitchens and bathrooms.

To date, adaptations have been carried out to over 2,400 properties through the Home Happening programme (around 10% of the Council's stock). As well as ensuring the specific needs of tenants are met, this also improves the longer term flexibility of homes to meet a range of needs. This approach has proved cost-effective, with a significant reduction in the number of responsive adaptations required in Council housing stock, from over 2,000 adaptations costing £2.6 million in 2005-06 to 1,124 costing £1.8 million in 2010-11. This reduction has taken place against the background of an increase in the number of older households and has helped the Council to continue to meet overall demand for adaptations.
http://www.southlanarkshire.gov.uk/

Keeping warm

5.17 Keeping the home sufficiently warm is a major challenge for many older people, particularly in rural areas, where many homes are not on the mains gas network. 'Fuel poverty' is the term used to describe the situation where a household would need to spend more than 10% of its income on all fuel use to heat the home to a satisfactory level. We remain committed to working to eradicate fuel poverty, as far as is reasonably practicable, by 2016.

5.18 The Energy Assistance Package ^[42] is the main vehicle to achieve this aim. The scheme is a holistic package of services and support, which takes a four stage approach, with the aim of increasing energy efficiency and reducing fuel poverty for those who are most in need. In addition to physical measures for eligible households, such as installation of central heating, the package also offers income maximisation advice and benefit and tariff checks to improve energy efficiency in the home. The majority of people, who have benefited from the Energy Assistance Package, have been older, but it has now been extended to new groups, including people in receipt of Carer's Allowance. In addition, the new £50 million Warm Homes Fund will be used to deliver energy efficiency, district heating and other measures for people who are fuel poor. Delivery of the Warm Homes Fund will be considered as part of the Review of the Fuel Poverty Strategy.

5.19 Despite all that is being achieved through fuel poverty and energy efficiency programmes, the dramatic increases in fuel prices could push additional households into fuel poverty. The Scottish Fuel Poverty Forum has been tasked with leading an urgent Review of the Fuel Poverty Strategy. There will be three strands to the Review - a review of the nature of fuel poverty and its drivers; future options for our fuel poverty programmes and maximisation of the leverage of external funds; and an examination of engagement on issues, which are reserved to the UK Government. The outcomes of the Review will be reported to the Scottish Parliament early in 2012.

Case study: Angus Care and Repair's Energy tariff check

Angus Care and Repair carries out an impartial energy tariff check for older or disabled people. The service was developed by Angus Council Trading Standards, in conjunction with uSwitch. Care and Repair is leading with the service for older and disabled people to give them alternative supplier options or other ways of saving money on their energy costs.

Most clients do not have computer access or are not comfortable using technology. They also tend to spend a lot of time at home and are usually less mobile, so need more heat to stay warm. A service which can help them to save money on energy costs is important.

To date, half of the clients seen spent more than 10% of their income on energy costs . The options suggested through the energy tariff check would save an average of £200 per person per year. Angus Care and Repair is now also able to take the service into people's homes, with funding from British Gas Energy Trust to purchase the necessary technology.
http://www.anguscareandrepair.org/index.htm

What we will do

5.20 We will help older people to maintain and improve their properties by:

• Improving the quality of our housing stock. We will support the improvement of housing quality, so that housing in the social rented sector meets the Scottish Housing Quality Standard by April 2015 and the new climate change standard by 2020.
• Helping older home owners to maintain their homes. We will support the extension of information and advice on housing options to help home owners to find reliable tradespeople to undertake repairs and maintenance, including through the development of trusted traders schemes.
• Keeping warm. We will undertake an urgent Review of the Fuel Poverty Strategy, in the light of increases in fuel prices. We will also take forward the Warm Homes Fund and continue to develop the Energy Assistance Package. These measures will help older people to maintain a comfortable and warm home environment.

Support to move home

Advice and practical assistance should be available to all older people, to help them find housing, which provides a suitable physical environment to meet their health, social care and support needs.

5.21 We know that older people want to remain living at home for as long as possible. However, we also know that, in some cases, it may not be possible to undertake the adaptations required to meet the individual's needs. A move to an accessible home may help some people to continue to live independently for longer. A smaller home may also provide financial benefits, in terms of being cheaper to heat and maintain. Where this is the case, it is important that a move to a more suitable home takes place before a crisis point is reached.

5.22 Moving home can be stressful at any age, but for an older person it is often more so, partly because the move may mean leaving a long time family home with the emotions that surround this, but also because of the physical and financial demands associated with moving house. They may also face difficulty in finding a suitable alternative property. Informal support networks can be important here, but there can be a need for practical support for moving, including the provision of independent information and advice about alternative housing options, where location, quality and affordability will be key. This would assist older people to move at the right time to homes which better meet their current and future needs.

5.23 Some social landlords offer 'downsizing' schemes, which help people living in homes which are too big for their needs to move to a more suitable property, which may be nearer to family support networks. Provision of practical support usually forms a key part of such schemes, and there is sometimes an additional financial incentive.

5.24 There are benefits to the wider housing system when older people move from larger to smaller properties, in terms of 'freeing up' family homes. However, we are clear that such moves should be an independent choice, and older people should not be coerced into moving.

Case study: Highland Council's 'Downsizing' scheme

Highland Council has introduced financial and practical incentives to support tenants of all Highland Housing Register landlords to move to a smaller home. The scheme is designed to provide suitable housing for older people and others with homes that are too big for them, and to stimulate the supply of much-needed family sized social rented houses in areas where there are pressures.

Practical support available under the scheme includes the provision of information and advice; help with removal arrangements; and with preparation of the new home, if needed. Financial incentives vary, depending on the number of bedrooms given up and removal costs.

The scheme is a partnership between the Council and local housing associations, with the practical support and costs of the incentives being met by Highland Housing Register landlords.
http://www.highland.gov.uk/

Case study: Accessible Housing Register

Glasgow Centre for Inclusive Living ( GCIL) provides a range of user-led services, including a housing options advice and advocacy service in Glasgow. It has also developed an online Accessible Housing Register to help disabled people to find suitable housing, with the aim of rolling out across the whole of Scotland.

The Accessible Housing Register provides information about disabled people's needs for accessible homes and a single database of accessible and adapted homes by location, size and accessibility features. The idea is that disabled people can be matched with accessible housing coming available for let. The national system is currently at the pilot stage. It includes a framework to capture information on accessible and adapted housing, in both the social rented and private sectors, in all local authority areas in Scotland.

The Register focuses on accessibility rather than impairment, and seeks to involve everyone in identifying solutions and encouraging co-operative problem-solving. It aims to deliver an on-line housing system, which will create opportunities for disabled people to find accessible housing in their own area and across Scotland, and lead to improvements in health and wellbeing.

The Register also helps housing providers by improving information about accessible housing; ensuring investment in housing adaptations is put to best use; and speeding up housing allocations, thus reducing the time that properties stand empty, with corresponding rental loss.
http://www.gcil.org.uk/

What we will do

5.25 We will help older people seeking a move by:

• Building on best practice in the social rented sector. We will encourage all social landlords, both local authority and housing association, to build on the experience of those landlords that have introduced packages of support and assistance for older people to move to more suitable properties.
• Making available comprehensive information and advice on housing, support and care options. We will re-shape and, if necessary, extend, existing services, so that older people, whatever their housing circumstances, have the opportunity to access information and advice about their housing, support and care options. The importance of information and advice has been a recurring feature across the Reshaping Care programme, and older people have made it clear to us that they want more information and advice which is relevant to their individual circumstances to help them make decisions.
• Developing practical services. We will explore the feasibility of and, if appropriate, support the development of services operating as social enterprises, which support older people in looking for a suitable home and in making the move.
• Making the best use of adapted and accessible properties. We will continue to support the development of a register of accessible housing by Glasgow Centre for Inclusive Living, to help disabled people across Scotland to find homes that are suitable for them.

Housing with care or support

We should make best use of our public investment in sheltered and very sheltered housing, so that it helps 'shift the balance of care' away from care homes and supports objectives to reduce the need for emergency admission to hospital.

5.26 Housing with care or support covers specialised forms of housing for older people, including amenity housing, sheltered housing, very sheltered housing and extra care housing. Around 6% of people aged 65 and over live in these types of housing. As people's needs increase, these more specialised forms of housing, which include varying levels of additional support, can help them to remain in their own homes for longer. Housing with care or support is popular with the great majority of current residents as a positive choice of independence with support. Most of this housing is in the social rented sector, although private retirement housing offering similar services, has increased in popularity in recent years. One of the main benefits to residents of such housing is its impact in reducing isolation and loneliness, through the opportunity to live in a ready-made community with provision of social activities. A recent Social Return on Investment study undertaken by Bield, Hanover (Scotland) and Trust Housing Associations found that very sheltered housing reduced the need for care home provision by £19,000 per tenant and produced benefits, including greater levels of confidence, independence and autonomy among residents. ^[43]

5.27 Substantial changes are taking place in the way that housing with care and support is delivered, and there are a number of issues to be addressed to make best use of the existing sheltered housing in the social rented sector. Some developments face low demand and are proving difficult to let. This is usually due to their location, quality or design, with bedsit accommodation now particularly unpopular. Some providers are seeking to remodel these developments, so that they meet the changing needs of older people. Others have remodelled collocated mainstream housing (such as high rise blocks) to provide amenity or sheltered housing.

5.28 Other changes, including the EU Working Time Directive and pressures on funding for housing support services, have affected the traditional model of warden services and arrangements for common services, so that sheltered housing developments with full-time on-site wardens are now increasingly rare. At the same time, there is growing interest in new and innovative models of support and the role that very sheltered and extra care housing can play as an alternative to care homes, and in the provision of services to the wider community. These include the provision of intermediate care and respite, as well as providing a 'hub' from which outreach services to older people living in the local area can be delivered. Given these changes away from traditional models, there is a need to increase awareness among older people and their families about what sheltered housing now is, and the services it provides.

5.29 Housing with care or support is a limited resource, and it is important that it is provided to people who need and can benefit from the services it offers. The Scottish Government's Social Housing Allocations: A Practice Guide ^[44] provides guidance to local authorities and housing associations on the allocation of social housing. It sets out the issues landlords should consider when determining a person's priority for housing on the grounds of health or disability, and on allocating them a home. How an applicant's priority is determined will depend on an assessment of their housing needs, and the outcomes the policy aims to achieve more generally. In deciding how to allocate, landlords also have to balance a range of factors, including the needs of an individual, suitability of housing and the needs of the community. Developing the right policies and procedures to achieve this is vital in addressing housing need, creating sustainable tenancies and making the best use of housing stock. We have committed to giving social landlords more flexibility to deliver housing services in ways which best suit their communities. We will consult shortly on minimising the legislative constraints on landlords' allocations policies to give them greater flexibility to determine their own approach to meeting need.

5.30 There are some particular issues around the allocation of housing with care and support to older people. An assessment of need should be undertaken before entry to this type of housing to ensure that those to whom it is allocated actually need the services it provides, ensuring that prospective tenants are made aware of the charges for those services. However, this needs to be done quickly to ensure that people receive the services they need as soon as possible, and to reduce the amount of time that properties stand empty. Integration of assessment between housing, health and social care ( e.g. through the use of single shared assessment) will help to ensure the best use of our stock of housing with care or support and also of mainstream homes with features which are particularly useful for older people.

Case study: St Margaret's Court

St Margaret's Court is a purpose designed housing with care complex in Greenock. It provides quality homes and services that promote independent living and are a real alternative to care home provision.

Over a two year period, Inverclyde Council and Trust Housing Association planned a change in the model of care from sheltered housing to housing with care. This was seen as a key element in beginning to 'shift the balance of care' away from institutional settings. Some physical conversion of the premises was required, and the traditional warden role was changed to that of a Housing with Care Manager, responsible for monitoring the care needs of tenants. The Inverclyde Housing Demonstrator initiative enabled the development of a multi-disciplinary housing panel to consider housing needs and re-housing requirements and provide individually tailored packages of care to fully meet tenants' needs.

The establishment of close working links between different agencies has ensured that any relevant information relating to potential care of tenants is shared. This allows for a fuller assessment of complex needs and supports optimal planning of care. The housing with care model has also assisted the provision of suitable accommodation for people awaiting hospital discharge, who would otherwise have been admitted to a care home.
http://www.inverclyde.gov.uk/
http://www.trustha.org.uk/

Case study: Rowan Court

Renfrewshire Council converts properties as they become void to amenity standard in four multi-storey blocks in Paisley. Lets are then targeted at older people and people with mobility problems. The initiative was developed to increase the availability of suitable housing to help sustain independent living by older people, after the Local Housing Strategy identified a shortfall.

One of the blocks, Rowan Court, has had an extension built on the ground floor to provide a communal lounge, kitchen facilities and meeting rooms. This provides a venue for residents to socialise in a safe environment, with many of the features of sheltered housing. The aim is to reduce the need for residents to move to more specialist accommodation.

The initiative has enabled the Council to make best use of its stock to meet the housing needs of older people in a good location near local facilities, allowing them to remain part of their existing community. Since 2008, 50 properties have been converted to amenity standard. Residents have reported that a good community spirit has been fostered, with an active social club organising activities such as bingo nights and film afternoons.
http://www.renfrewshire.gov.uk/ilwwcm/publishing.nsf/Content/InternetHomePage

Case study: West Lodge Gardens

West Lodge Gardens started life as a sheltered housing development for older people in Alloa, managed by Trust Housing Association. It was subsequently changed to sheltered/very sheltered housing to cater for an increasing number of older and frailer tenants.

Following discussions with Clackmannanshire Council and consultation with tenants and staff, it was agreed to develop a housing with care service which began in 2010. Key elements include:

• new tenants must have a requirement for support and/or care.
• landlord, housing support and personal care services are delivered by an on site team of staff, ensuring that services are tailored to the needs of individual tenants.
• all tenants can now access an on site meals service, promoting good diet and greater social interaction.
• tenants should be able to remain in their home for life, unless intensive nursing/medical care is required.

The change of service model has ensured integrated delivery and continuity of services to tenants. It is cost-effective, reducing admissions to residential care, and has the ability to reduce or increase support as needed, with little or no advance notice. It also has the scope to support hospital discharge, with the introduction of respite care.
http://www.trustha.org.uk/
http://www.clacksweb.org.uk/

Case study: Stewart Court

Bield Housing Association provides activities for tenants and older people from the wider community within its sheltered housing development at Stewart Court in West Calder.

The scheme manager works with 20 volunteers to provide the activities, which are funded by a grant from West Lothian Council, in an informal day centre in the communal lounge. There are two lunch clubs a week. Other activities include bingo, armchair exercises, dominoes, arts and crafts, Silver Surfers (one to one training on using the computer), reminiscence class, indoor curling and one to one befriending.

The activities ensure that the facilities are used to benefit a greater number of older people and encourage their participation in the community. This helps them to stay fit and active, both mentally and physically, and addresses social isolation. Tenants and members of the community have input into the activities that are provided. If there is a demand for different activities, the group looks at how they can be provided.
http://www.bield.co.uk/

What we will do

5.31 We will make best use of our existing stock of sheltered and very sheltered housing by:

• Gathering and sharing experience. We will prepare a practical guide to the redevelopment of existing sheltered housing to provide a varied and flexible range of supported housing for older people. This will be prepared as a priority in recognition of the immediate issues for social landlords who have sheltered housing, which is no longer fit for purpose or which could be used more effectively.
• Addressing barriers. We will provide practical advice about the development of supported housing, the issues to be addressed and ways to do this. This will include ways to achieve an integrated package of funding for both construction work and service provision. We will support the objective within the wider Reshaping Care programme to put in place arrangements, so that we make best use of resources from all sources ( e.g. NHS, local authorities and benefits) to meet individual support needs.

Using personal resources to adapt and improve housing

Products and services should be available to provide older people with choice and flexibility to invest safely in their housing and support, and to achieve the personal outcomes they want.

5.32 An increasing proportion of older people are home owners, and most wish to remain so. In 2006-08, 65% of households in Scotland owned property, with an average (median) net property wealth of £100,000. ^[45] However, although many older people own their homes outright or have considerable amounts of equity, they often have very low incomes, which do not allow them to make adaptations or improvements, which could enhance their ability to remain living independently at home. People in this situation could benefit from products or services, which would enable them to release money from their property to fund adaptations or repairs or pay for care and support. Changes which support this would not only achieve the outcomes desired by many older people, but could also ease pressures on the social rented sector and bring in much needed resources to the housing sector. In England, the Commission on Funding of Care and Support (known as the Dilnot Commission) has made recommendations on the use of personal resources for social care. ^[46] Scottish Ministers will carefully consider the implications for Scottish funding of care and support, in the light of the UK Government's response to the report.

5.33 Products and services which enable people to use their personal resources to meet their needs are clearly important, but current equity release models have limited uptake. This is, in part, due to their poor perception among older people. We recognise that it is a matter of personal choice for any older person, as to whether they want to take up these types of products. It is also vital that anyone considering taking up such a product should only do so after taking independent financial advice. However, while these products will not be right for everyone, particularly for people with low levels of equity in their homes, we believe that the expansion of choice for older people should include the option to use resources from property equity to improve their ability to remain at home.

5.34 In addition to equity release, there are also other ways in which people could potentially access resources in their home to fund adaptations or improvements. There are examples where people can opt to change the tenure of their home by entering into a shared equity or shared ownership arrangement. This can enable the release of cash from the property to cover the cost of required works, while a share in the property is taken by another body, such as a housing association. Another possible variation is an equity swap scheme, which could be particularly helpful to older people, as it could involve the funding partner managing the improvement works and ongoing maintenance. We are keen to see the development of a greater variety of mixed and flexible tenure models, which would help people to live comfortably in homes that meet their long term needs.

What we will do

5.35 We will seek ways to improve the options for older people by:

• Making it easier and safer for older people to access the equity in their homes. We will consider whether there are ways of, and benefits to, developing financial products that are more attractive.
• Encouraging new and sustainable financial models. We will consider the potential for new mixed or flexible tenure arrangements, which support national policy objectives and help individuals better to achieve the personal outcomes they seek.

Our vision for 2021 is that a greater proportion of older people will live in well-maintained and warm homes, which are adapted where necessary, and which increase their independence and quality of life.