Getting through the front door

This blog by Paul Smith was originally published by Inside Housing

Foundations has been the National Body for Home Improvement Agencies since 2000. In that time we’ve seen a significant shift in how these services have been delivered. Back in 2004 around 85% of agencies were managed by a Housing Association and seen as a key part of their service offer to the wider community. But during the Supporting People years the picture changed significantly with many large providers pulling out of the sector. Today just 44% of the sector is managed by a Housing Association with many services consequently being taken in-house by local authorities.

Since 2015 Foundations’ role has expanded to include supporting improvement in the delivery of Disabled Facilities Grants (DFG) – a government funded programme to help people with disabilities make major adaptations to their home. Last year’s comprehensive spending review saw the national DFG budget more than double, increasing to £550m in 2019/20. This money now also forms part of the Better Care Fund, and consequently requires housing services to be included within local health and social care planning.

Over the last couple of weeks we’ve been travelling around the country with our DFG Champions Roadshow. We’ve heard great examples of how some areas are using the increased funding more flexibly. For example, supporting people to move to more suitable accommodation, making homes safer for people with challenging behaviours or more ‘friendly’ for someone with a diagnosis of dementia.

But we’ve also heard that some Housing Associations are starting to reduce the amount they spend on adapting their own stock. In many areas, local authorities and registered providers jointly fund adaptations in social housing but a number of these long standing arrangements are now failing.

There is no data on the amount spent by registered providers on adaptations. It’s typically part of their budget for repairs and improvements. But it does appear, at least anecdotally, that the HCA’s drive on Value for Money is having the unintended consequence of impacting upon the future accessibility of the housing stock.

The cost to the NHS of inaccessible housing has been well documented. Habinteg’s accessible housing toolkit includes a range of resources that highlight the need to plan for the housing needs of an ageing population. Our own research last year showed that an adapted home can help delay entry into residential care by up to 4 years, and in recent weeks the Kings Fund have published a suite of documents looking to develop a more productive relationship between the housing and health sectors.

It would seem perverse then, that registered providers would disinvest in adaptations while at the same time trying to sell the benefit of the sector to the NHS. Past investment has meant that the social housing sector is far more likely to offer a well-adapted environment for someone with a disability, particularly in comparison to the private rented sector. If accessible homes are no longer a priority then it’s going to become increasingly difficult to make the case to the NHS particularly if someone can’t return home from hospital because they can’t get through the front door.

Paul Smith is director of Foundations