date: 18 december 2008 director of adult social … member for...2008/12/18 · at wealden district...
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Agenda Item 5 Report to:
Lead Member for Adult Social Care
Date: 18 December 2008
By: Director of Adult Social Care
Title of report: Wealden Older People’s Housing and Support Strategy 2008 - 28
Purpose of report: To seek approval for the final strategy and Implementation plan
RECOMMENDATIONS The Lead Member is recommended to endorse the final Strategy and Implementation Plan as described.
1. Financial Appraisal 1.1 The Wealden strategy and implementation plan sets the strategic direction and highlights the key priorities in relation to housing and support services for older people and carers in Wealden District Housing over the next 20 years. Key aims of the strategy are:-
• to promote partnership working between the statutory, independent and voluntary
sectors • to better utilise current resources, • maximise access to financial resources to develop new services and ensure value
for money
1.2 The Wealden document is the third Housing and Support strategy to be presented to Lead Member Panel. The previous two strategies agreed by Lead Member were for Eastbourne and Hastings and Rother. It will be also considered by the County Older People’s Housing and Support Group and the Supporting People Strategic Forum in order to help to identify investment priorities on a county wide basis.
1.3 We are currently in discussions with key partners to jointly finance a plain English version of the executive summary of the strategy to enable a wide distribution and to promote the information and advice outlined in the action plan. Estimated total costs for this work are £1,600.00. 2. Supporting Information Introduction
2.1 The Wealden strategy was developed during 2007/8, led by Wealden District Council and including partners in Health and the voluntary sector. 2.2 The strategy’s emphasis on the social inclusion and wellbeing of older people as a group reflects the important role of housing and environment as part of the ASC approach to preventative services and quality of life. 2.3 Following agreement from the Lead Member and all partners it was agreed that the draft strategy would be circulated for wider consultation for a 3 month period from July to September under the COMPACT arrangements. 2.4 An extensive face-to-face consultation process took place in 2006 with people over 60 on an initial housing and support strategy for Wealden and Lewes Districts. Following the decision to disaggregate the strategy into two strategies for the respective Districts, it was decided to use this
consultation information as part of the consultation process to inform the development of this strategy. 2.5 The draft executive summary and Action Plan were thus put into the public arena for consultation. This included the Wealden District Council and ESCC websites, the Wealden Community Network and the Wealden Seniors Forum. The consultation period closed in September. 2.6 There has been very little feedback from the recent consultation process. It is believed that this is because there have been limited funds available for distribution of the strategy document and many older people do not have access to the internet. 2.7 Since the original publication of the draft strategy, an implementation plan based on key actions and targets has been developed by the multi-agency Locality group. This group will oversee its progress and report annually to the County Older People’s Housing and Support Group (COPHSG), the Core Strategy Group and the Strategic Forum. 2.8 Key areas of work outlined in the Wealden Older People’s Housing and Support Implementation plan include:- the identification of priority areas for the development of new Extra Care housing schemes; the need to address housing and housing-related support needs in rural areas; and the need to develop the provider market and encourage innovative solutions in response to the range of housing needs. 2.9 The strategy and implementation plan were signed off by the Portfolio holder at Wealden District Council on 8 October 2008 and the Departmental Management Team (ASC) on 22 October 2008. 3. Conclusions and recommendations
3.1 This locality strategy reflects the national and local agenda for the role of housing and related support in maintaining the quality of life of older people and helping them remain at home. As such, it is a key platform of the work of the department and it is recommended that the Lead Member gives his support to its further development and implementation.
3.2 That the agreed strategy be forwarded to the Core Strategy Group and Strategic Forum.
Keith Hinkley Director of Adult Social Care Contact Officer : Teresa Lipson - Strategic Commissioning Manager – older people Tel No. 01273 482305 Local Members: All BACKGROUND DOCUMENTS Wealden Older People’s Housing and Support Strategy and Executive summary Implementation plan 2008 - 13
Wealden Older Persons Housing & Support Strategy 2006-2026
Executive Summary
Introduction East Sussex County Council Adult Social Care and Wealden District Council have developed this Strategy jointly in partnership with Sussex Downs and Weald Primary Care Trust, Supporting People, Wealden & Eastbourne Lifeline, Sussex Partnership Trust, Age Concern, Care for the Carers, Alzheimer Society and Anchor Staying Put. The purpose of the strategy is to describe the actions that will be taken by the above organisations from 2007 onwards to develop a range of housing, support options and housing related support which enable people living with the boundaries of Wealden District Council to have the kind of living arrangements they desire in early and later old age. In using the word ‘support’ in this context the focus is on activities directed towards the home and environment rather than the person, i.e. adaptations and repairs rather than homes care or respite care. It signals the direction of the investments that the statutory authorities intend to make with its current levels of funding and the areas for which they will be seeking additional funding and when it becomes available. Though primarily addressing the needs of those people currently over pensionable age, the strategy will also consider the ‘rising elderly’, that is the people who are now around 55 and who during the lifetime of this 20 year strategy will reach retirement. A copy of the full version of this strategy from which this Executive Summary has been produced can be obtained by contacting the Housing Policy Officer at Wealden District Council on 01323 443322 or at [email protected] or the Strategic Commissioner for Older People at East Sussex County Council on 01273 481000 or at [email protected] This summary is structured under a series of sections covering the areas which need consideration, with a list of actions at the end of each section. National Policy Changes in demographics have already begun and will continue as people live longer and the post war baby boomers reach retirement. This has lead to a range of Government publications and initiatives. The importance of housing, environment, leisure activities and transport has increasingly appeared on the Government agenda along with the need to end the
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perception of older people as dependent. Recent national policies aim to ensure that longer life is healthy and fulfilling and that older people are full participants in society. The importance of the kind of accommodation people are living in to their physical and psychological wellbeing has received increasing acknowledgement. This has resulted in policy being focused around increasing choice for users of housing services, increasing the supply of new housing, improving the condition of existing social and private sector housing and creating sustainable communities where people want to live. 1
What are we going to do in Wealden to respond to National Policies?
• Promote telecare initiatives which are designed to enable disabled and frail people to live independently.
• Develop Extra Care Housing to meet the needs of people with high care needs.
• Commission housing related support services for older people across tenure.
• Shift investment over time to preventive services. • Formulate long term plans to address the changing needs and
aspirations of older people in terms of housing. • Address the social inclusion of older people and include them in
the design of new housing schemes for older people.
Key Regional and Local Policies The South East Regional Housing Strategy identifies Wealden as an area with higher levels of people aged 65+, highlighting the need for an increased supply of housing which is both high quality and affordable for older people. Strong emphasis has been placed on the need for joint planning between all sectors involved in the provision of housing and housing related support.
ble Communities: Settled homes, changing lives ODPM 2005 .communities.gov.uk/pub/786/SustainableCommunitiesSettledHokesChangingLivesSumb_id1149786.pdf
1 Sustainahttp:/www maryPDF387K
How is Wealden going to respond to local policies?
• Look to address issues arising from retirement schemes which do not meet future needs and aspirations of older people.
• Work with housing partners to bring all social rented units (both Council & Registered Social Landlords) for older people up to the Decent Homes Standard by 2010.
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Key Statistics In Wealden of the 140,023 people (as at 2001 Census) living in the district 21.1% were over retirement age, 10.7% aged 75+ and 3.1% aged 85+.
What factors do we need to bear in mind when discussing future services?
• The Housing Needs Survey 2005 using 2003 based Office of National Statistics (ONS) sub-national projections supplied by East Sussex County Council and taking into consideration 2001 Census data indicated that the population in Wealden would increase by 15.5% or 21,800 people by 2026. With the over 65’s seeing a 57.5% increase (as a percentage of the current population) or 17,300 people.
• The greatest growth of those aged 65 years+ is in the over 80’s at 59.8% or 5,500 people.
• It is worth noting that the population trends for both males and females show similar trends in Wealden. However, whilst the male population is virtually static between 2016-2026, there is a noticeable rise for females in the same period, with a marked rise in the 2021-2026 period. Between this period the number of females is set to rise by 3700.
• The life expectancy in Wealden is higher than the national profile at 80.7 years as oppose to 78.3 years.
• Women on average live longer than men at 82.8 years compared to 82.2 years.
• Older people make up a higher percentage of the population in Polegate south (40%), Polegate north and Willingdon (34%) than elsewhere in the district.
• In terms of numbers of people aged 65+ Hailsham (2,870) and Crowborough (2,092) have the highest numbers of all places in Wealden.
• Wealden along with Rother District Council has the highest levels of inward migration of those aged 65+ years in East Sussex at 200 out of 600 households (as at 2001 Census).
• The greatest concentration of pensioners is in one-person pensioner households at 55% of all pensioner household compositions.
Wealden and the Rural Dimension The 2001 Census highlighted that 48% of households live in one of the 37 rural parishes in Wealden. National research has indicated that the lack of affordable housing undermines the sustainability of rural communities by breaking up traditional family and social networks, which help provide for intergenerational support. Lack of transport is also a key issue in rural communities and can result in isolation. Additionally there is a lack of
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alternative accommodation in villages to enable older people to move to smaller and/or more suitable accommodation.
How is Wealden going to address the needs of Older People living in rural locations?
• Publicise private renewal assistance • Ensure Local Development Framework Core Strategy includes
Lifetime Homes standard for all new housing. • Develop a support service for vulnerable older people living in non-
retirement housing. • Ensure that the provision of all services to the elderly are rural
proofed so that those living in rural locations are not dis-advantaged. • Seek funding via Voluntary sector sources to pilot innovative solutions
such as Keyring /Homeshare. • Promote the role of ‘activities coordinator/community worker’ to
enable isolated older people to access retirement housing/extra care housing-based activities.
Consultation During the summer of 2006 a number of consultation events were held in Lewes and Wealden to find out the housing preferences of local older people in those areas. Their views corresponded significantly with the results of national surveys with older people wanting maximum independence with support to enable them to remain in their own homes, people also want space to enable friends and family to stay and homes that are close to local amenities.
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What are we going to do as a result of local consultation?
• Incorporate leasehold properties in new housing schemes for older people.• Ensure service charges are kept affordable. • Locate as far as possible new sites for older persons housing close to
transport links, health, leisure and other amenities. • Working with planning departments to include policies relating to Lifetime
Homes. • Seek to provide wheelchair friendly affordable housing units on new
residents schemes according to need. • Seek funding to pilot innovative models of support. • Ensure housing designed for older people meets their changing needs and
aspirations. • Develop appropriate housing related services to reduce the potential
isolation of people with hearing, sight or other disabilities. • Develop appropriate housing related services to reduce the potential
isolation of non-English speakers.
Working in Partnership It is essential there is effective partnership working in delivering the priorities highlighted in this strategy as no one single agency is in the position of being able to deliver it alone.
What will we do to promote partnership working in Wealden?
• Implement this strategy via the Eastbourne, Wealden and Lewes Older Persons Locality Group (strategic group consisting of key stakeholders involved in delivering services to older people), sharing expertise and resources wherever possible.
• Involve older people and their carers in the implementation of this strategy and evaluation of its effectiveness in future years.
• Work with housing partners to bring all social rented units (both Council & RSL) for older people up to the Decent Homes Standard.
• Expand the mobile response service to assist in the prevention of unnecessary hospital admissions.
• Develop a protocol with hospital staff and social workers to reduce delays in discharging older patients caused by a lack of suitable housing with support.
• Link with Environmental Health, Fire and Rescue and other front-line staff to pass on information on any support needs to support providers as appropriate.
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What do older people in Wealden need? The local needs and related actions outlined in the box below have been compiled by looking at Census 2001 data and information from other agencies such as Sussex Downs and Weald Primary Care Trust and the Department for Works and Pensions.
What are we going to do about the needs identified in Wealden and the gaps in current services? Deprivation
• When ranking the 111 wards of East Sussex Hailsham East is ranked 11 with 1 being the most deprived.
• Using Pension Credit as a proxy for income deprivation Hailsham East followed by Polegate South and Crowborough East are the areas with the highest percentages of older people receiving pension credit.
• In acknowledging this health promotion and prevention and support services will need to have particular regard to these areas.
Health
• Limiting long-term illness is greater in the social rented sector. • Percentage of residents with a disability is generally higher amongst
BME households. • Polegate north has the highest percentage of people with a limiting long-
term illness. • Within Wealden those wards which have the highest percentage of older
people also have the highest rates of health issues such as strokes and heart failure within the District.
• Focus health promotion services on areas with high densities of social housing.
• Ensure disabled adaptations and services to people with disabilities are promoted in BME communities.
Diversity
• The BME population in Wealden has remained stable although there has been an increase in the numbers of BME households in East Sussex over the past 10 years.
• It is essential that links with BME groups are made to ensure that the services over the next 20 years address their specific needs.
Dementia
• According to the Alzheimer Society the prevalence rates for dementia are 1 in 5 for people over the age of 80. As a result of the ageing population in the District this will mean an increase from 1,860 people suffering from dementia in 2006 to 2,940 in 2026.
• We need to develop services to meet the needs of those with dementia including extra care and floating support.
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Actions arising from data on housing demand:
• Increase the number of affordable leasehold properties for older people having regard to the fact that nearly 84% of pensioners are owner-occupiers.
• Reduce the provision of bed-sit accommodation for older people in the social rented sector.
• Future-proof new housing for older people through ensuring the provision of 2 bedroom units as far as possible.
• Continue to target private sector assistance towards older people since the 2007 Private Sector Stock condition survey revealed that they experienced higher levels of non-decency and fuel poverty that the average Wealden household.
• Continue to promote the role of Anchor Staying Put to enable older people to remain in their own homes.
• Continue to offer Disabled Facilities Grants in accordance with the Housing Grants Construction and Regeneration Act 1996.
• Develop extra care housing in Wealden. • Expand the take up of services provided by Wealden & Eastbourne Lifeline
including telecare. • Commission floating support services in conjunction with Supporting People,
which are available to all older people (subject to eligibility) regardless of where they live and whether they are owner-occupiers, social tenants or private renters.
The Market Within Wealden the current supply of homes for older people include social rented general needs schemes or those aimed at those over 55 or sheltered housing. Additionally the private market offers a range of housing for rent and sale with retirement housing for sale becoming more popular. The care homes market is likely to decrease at least in terms of the provision supplied by East Sussex County Council as the needs and aspirations of older people change with increasing demand and expectation of maintaining independence for as long as possible at home. Research has indicated that by providing extra care a 10% shift away from residential care would be needed.2 It is probable that in the future most care homes will be owned by large companies rather that the current family-based market. Given the tendencies of these companies for economies of scale and competing for land finding sites centrally located in Wealden may prove challenging. The development of residential care schemes particularly those sites away from key facilities such as shops and GP’s is not endorsed by the partners involved in developing this strategy. 2 Peter Fletcher Associates
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The current update (July 2007) to the Supporting People five year strategy provides a framework for developing any new housing-related support provision. Conclusion This strategy outlines how current government thinking about housing and support for older people can be developed for people living in Wealden. It is essential that older people themselves are actively involved in society and are able to enjoy a good quality of life regardless of sex, disability and economic background. This strategy emphasises the need to work in partnership across sectors and with users and carers to maximise resources and ensure specific needs are being met.
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Wealden
Older Persons Housing & Support
Strategy 2008-28
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Introduction 3-5 1. Strategic Context 5-12 1.1 The National 1.2 Regional and 1.3 Local Strategic Context
2. Wealden and the rural context 2.1 Background information on Wealden 2.2 National Picture
12-16
3. Consultation 3.1 What people want - national evidence 3.2 Local Consultation - East Sussex 3.3 Wealden District Council Housing Needs Surveys 3.4 Consultation with residents of Wealden District Council 3.5 Housing Summit
16-21
4 Forecasting the needs for Older People in Wealden 4.1 Key demographics indicators 4.2 Deprivation 4.3 Health – prevalence & incidence 4.4 Diversity 4.5 Dementia 4.6 Care & Support Needs 4.7 Housing need & demand 4.8 Adaptations 4.9 Transport 4.10 Planning 4.11 Leisure and Cultural Activities
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5 Mapping resources – supply 5.0 Housing Advice 5.1 Sheltered housing - socially rented sector 5.2 Retirement housing to buy 5.3 Other Private Housing 5.4 Care Homes 5.5 Adult Social care provision 5.6 Dementia 5.7 Supporting People funded support services 5.8 Other Housing Related Support Services 5.9 Voluntary/Community activity 5.10 Adult Social care
41-54
6 Gaps emerging from needs and supply data 6.1 Gaps in the supply of Specialist housing 6.2 Provision of suitable general needs housing for older people 6.3 Gaps in Support Services 6.4 Housing Advice
54-58
7 The Market 58-61 8 Resources, Finances and Funding 61-66 9 Partnerships 66-67 10 Action Plan 67- 11 Glossary Appendix 1: Key Policy Documents Appendix 2: Needs Of Older People living in Rural Parishes in Wealden Appendix 3: Breakdown of Ethnicity in Wealden Appendix 4: Older People’s Governance Structure Appendix 5: Activities in Wealden Council’s sheltered stock
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Introduction Following the publication of ‘A Draft Strategy for Housing and Housing related support in Lewes and Wealden’ (2005), it was agreed that individual strategies should be developed focusing on the needs in detail for each district. This publication is intended to build on the original document by setting out a plan for the development of a range of local housing-related options for older people within Wealden District Council in response to locally assessed needs. It covers housing, including extra care, and support services including housing related support and is designed to provide a framework for commissioning. Although initial action is focused on the next ten years, the strategy also considers the longer term needs of the ‘rising elderly’ (over 50’s) in looking forward to possible developments up until 2026. Since the publication of the 2005 document, the housing needs of older people have risen higher on the national agenda. It is increasingly recognised that Housing and Support options need to be developed that will result in a wider choice, greater independence and control for older people in line with changing aspirations. To achieve this, links need to be made across strategies and policies, particularly between housing, social care, Supporting People and health. This strategy has therefore been developed in partnership with a range of key stakeholders in the District, specifically:-
• Adult Social care Services (East Sussex County Council) • Wealden District Council • East Sussex Downs and Weald PCT • Supporting People • Wealden & Eastbourne Lifeline • Sussex Partnership Trust • Age Concern • Care for the Carers • Alzheimer’s Society • Anchor Staying Put
The aim of the strategy is
‘To enhance the social inclusion, dignity, choice and independence of older people living in Wealden District Council, by maintaining people in their own homes and through the provision of a range of housing and housing related support services’
The strategy will be adopted by both Wealden District Council and East Sussex County Council and the County Strategic Forum.
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The above map shows Wealden District Council's location within East Sussex.
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1. Strategic Context 1.1 The National Strategic Context Social inclusion and Housing The publication, in February 2008, of the document ‘Lifetime Homes, Lifetime Neighbourhoods: a National Strategy for Housing in an Ageing Society’ 1marked the culmination of nearly a decade of discussion and research into the needs and changing aspirations of older people. It is well known that older people are living longer but the full impact of this is less understood. A four-year research programme by the Joseph Rowntree Foundation found that services are still based on assumptions that older people represent a burden on services rather than being able to make positive contributions to society themselves and entitled to the same freedom of choice and quality of services as others. Similar issues were raised in ‘Excluded Older People’ based on consultation with older people by the Social Exclusion unit. Older people want joined up services, early intervention to prevent problems becoming worse and the need for more expensive solutions at a later stage; and to be involved in the design and delivery of services. The English Longitudinal Study in Ageing (ELSA)2 identified seven dimensions of social exclusion and the characteristics of those at greatest risk of multiple exclusion – i.e. exclusion from a number of activities. The research indicated that people living alone in rented accommodation, on a low income, with no access to their own transport and suffering from depression were at high risk of social exclusion. Although these factors were seen to be independent of age, people over 80 with limited mobility, in poor health in city areas are also particularly at risk. This inevitably relates to how older people view their quality of life, with people excluded on a number of dimensions reporting a much lower quality of life. Those reporting the lowest quality were excluded from what the authors term ‘the basic dimension’ – namely, access to finance, health services and local facilities such as shops. ‘Lifetime Homes, Lifetime Neighbourhoods’ is the first attempt to address these issues in a holistic manner, with an emphasis on the kind of partnership in planning and delivery and the importance of sustainable neighbourhoods that is reflected in this strategy for Wealden. Some of the key priorities of the Department of Communities and Local Government are :
• increasing choice through supporting innovation • ensure that planning can respond to the needs of an ageing population
through better intelligence and promoting higher design standards • better co-ordination and integration of housing, health and social care • provision of specialist housing such as ExtraCare • development of tenure options such as equity release • expansion of rapid repairs services
1 Lifetime Homes, Lifetime Neighbourhoods: A National Strategy for Housing in an Ageing Society CLG, February 2008 2 Social Exclusion of Older People: future trends and policies – think piece ( New Horizons Research Programme, Department of Communities and Local Government, June 2006).
Housing Related Support The Supporting People programme supports people to live independently helping avoid a move to more institutional forms of care. The National Strategy for Supporting People (2007) reflects the CLOG agenda above emphasing widening choices, the need for joint working and a clear focus within the broader context of sustainable communities. Social Care The emphasis on moving towards a more individualised approach to addressing the needs of older people is underlined in the document ‘Putting People First’. This ministerial concordat establishes the collaboration between central and local government, the sector's professional leadership, providers and the regulator. It sets out the shared aims and values which will guide the transformation of Adult Social care, and recognises that the sector will work across agendas with users and carers to transform people’s experience of local support and services. The intention is to move away from the parternalistic, ‘one size fits all approach’ that has characterised the delivery of some social care services in recent years and to put the user (and carer) firmly in the centre, chosing and guiding their care and support according to pre-agreed outcomes . The importance of partnerships between all sectors in developing a wider range of options than at present, is underlined if this ambitious agenda is to succeed. The implications of this personalisation agenda is discussed in the report by housing21 ‘ Building Choices’: Personal Budgets and Older People’s Housing- broadening the debate3 This approach builds on earlier studies, such as ‘All Our Tomorrows: Inverting the Triangle of Care’ 4. This describes a shift away from a focus on acute care and the most frail older people to a more preventative approach. The concept of a triangle of care is used to depict how most resources currently go to the few. This triangle needs to be inverted, putting community engagement and the promotion of well-being at the top in terms of both importance and resources. The extension of universal services for all older people should be crucial to all agencies. Individuals would benefit from this approach as well as the health and social care economy as a whole (through reduced pressure on services) and the local community (becoming sustainable and retaining its diversity and history). The Triangle of Care
Community Strategy Engagement: Empowerment
Environment: Safety: Housing: Learning
Promotion & Well Being Policies
Specialist Care
Acute Care
Frail Older People
Prevention Policies
Community Strategy Engagement: Empowerment
Environment: Safety: Housing: Learning
Citizens All Partners
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Direct users & Carers
Individuals Families Communities
Ci
Health, Social Care, Housing
tizens
Individuals Families Communities
Direct users & Carers
Public Services Voluntary Sector Faith Communities
Health, Social Care, Housing
Public services
Voluntary Sector Faith Communities
All Partners
3 ‘BuildingC hoices’: Personal Budgets & Older People’s Housing – broadening the debate, Summary Housing 21/CSIP June 2008 4 All Our Tomorrows: Inverting the Triangle of Care Association of Directors of Social Services October 2003
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Dementia services Consultation on the recent draft ‘National Dementia Strategy’ is highlighting the need for the strategy to give more focus on housing related issues and link more with the key strategic Housing documents described above. The development of Assistive technology and Extra Care Housing can be seen as key enablers for achieving the outcome of preventing admission to residential care Health The parallel agenda to ‘Putting People First’ is outlined by the DH in its publications on ‘World Class Commssioning’5 This sets out a vision for the commissioning of health and care services. It outlines what it means to be world class and describes how commissioners will help deliver wider health improvements.
Key messages from National strategies
An increasingly ageing population presents challenges and opportunities Planning needs to be long-term, aiming at the ‘baby-boomer’ generation Older people are part of the ‘social capital’ of an area – authorities enable their
social inclusion and promote their role as active citizens Communities and good accommodation are vital factors for a high quality of life in
old age The aspirations of older people should be addressed through increasing available
options of housing and housing support and ways of paying for it All housing related developments need to be accessible, inclusive socially and
economically and environmentally sustainable Older people themselves should be involved in the design and delivery of care Resources need to be shifted away from a focus on acute care prevention
towards mental and physical wellbeing in old age. Provision should be responsive and flexible and delivered close to home. It
should reflect a wide range of needs and situations including mental health and other complex needs
Provision should be available regardless of tenure All developments must consider the needs of local BME communities People living with long term conditions, including dementia, need to be helped to
maintain independence for as long as possible Importance of joint planning across social care, housing, health, planning and the
independent sector Authorities to act as ‘strategic enablers’ facilitating private sector development as
appropriate Shifts in investment will be required
1.2 The Regional Context Increasingly, good progress is being made towards a cross boundary and multi-agency approach to housing and support development in line with the Government's agenda. In particular this approach applies to the commissioning and development of
5 World Class Commissioning:vision: DH December 2007
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specialist provision e.g. supported housing for people with dementia and extra care housing. The South East Regional Housing Strategy highlights that since older people often live alone or in smaller households, this has a significant bearing on the nature of demand in the region. The Strategy which breaks Wealden into the Sussex Coastal area (includes Hailsham and everything south) and the High Weald (the rest of Wealden), highlights that Wealden has the fourth/fifth highest proportion of people aged 65+ in the region out of 21 sub-regional market areas, with Eastbourne having the highest and Milton Keynes/South Midlands the lowest. The percentage of those aged 65+ averages across the region at 16.4%.
Percentage of Older People
0
5
10
15
20
25
30
Eastbourne Wealden SussexCoastal area
High Weald, Wealden Milton Keynes/SouthMidlands
The Strategy also highlighted that supported housing and the wider health and housing agenda required alignment between resources of revenue funding (including, in particular, Supporting People funding for housing-related support) and the Regional Housing Board’s capital funding. Otherwise there is a real risk that the development of sustainable communities (including conversions and refurbishments as well as new build) will be undermined if funding issues are not resolved so that capital and revenue funding go hand-in –hand. A key target, set by the Government, is for social landlords to bring all their housing up to the Decent Homes Standard by 2010. 1.3 The Local Strategic Context Wealden District Council’s Housing Strategy 2002– 2005 identifies a number of actions required to improve services to older people. Most significantly the Strategy aims to increase support services to a wider range of tenants in the Council’s own housing, one way that this is being done is through Wealden Extended Sheltered Service (WESS) funded through the Supporting People programme. The provision of increasing support services to owner occupiers is also being explored further in conjunction with Supporting People.
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Additionally a sheltered housing review has been undertaken which will result in an action plan being produced to improve the quality of older person’s accommodation in Wealden. Another key target impacting most on older people is the Telecare project which is administered by Adult Social care. Wealden District Council participated in a pilot of Telecare two years ago. The Assistive Technology Grant from Department of Health is for £900,000 over two years (2006 to 2008) across the County. East Sussex Supporting People Strategy 2005-2010 (updated July 2007) The Supporting People programme funds, regulates and gives strategic direction to housing-related support services for vulnerable adults, including older people. ‘Housing-related support’ is accepted as “those lower levels of practical or emotional support, that do not amount to personal care, that allow vulnerable people to obtain or remain in their own home”. The programme works as a partnership of local government, service users, health services, the probation service and support providers. At a local level a Strategic Forum, comprising senior mangers from the six local authorities, four Primary Care Trusts and the Probation Service (Sussex), directs the programme which is administered on behalf of the partnership by East Sussex County Council The strategy sets out the key strategic commissioning aims for the Supporting People programme in East Sussex. These include.
• pursuing a stronger focus on preventative services; • ensuring the outcomes of services maximise the independence of service
users; • promoting equalities and social including; • promoting community safety; and • commissioning housing-related support services on the basis of need
regardless of housing situation or tenure. It identifies a significant gap in housing-related support services for older people many of whom live in general needs housing but would like the same services as sheltered tenants receive delivered to them in their own home. The Supporting People five year strategy was updated in July 2007 with a new framework for commissioning to ensure wider coverage and greater flexibility of housing-related support services. The model for support services set out in this strategy has been developed in discussion with Supporting People to ensure it is broadly in line with the kind of service model likely to be developed in the future. It is however recognised that this may need to be adapted as wider discussions contribute to a more developed model. To date discussions have recognised that there is a diversity of needs within different groups, such as older people who often have a complex range of needs. Many people may have no support needs apart for short periods such as support around a hospital admission and subsequent discharge. A smaller group, however, have ongoing support needs because of additional physical or mental health issues, these can include dementia, enduring mental health problems, alcohol dependency, and learning disabilities. Models of support service need to allow for this diversity and be sufficiently flexible to meet different needs as they arise or diminish.
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The East Sussex Adult Social care three year plan This plan reflects the national policy agenda emphasising the need to develop more preventative services in partnership with housing, healthcare and voluntary organisations, with an emphasis on intensive home care and community-based services for older people to support people in their own homes. Specifically, the plan aims to help 7000 older people to live at home (compared with 6517 in 2005/6) by 2009/10. An East Sussex Joint Commissioning Strategy for Older People for services to people over 65 is currently being finalised by Services, East Sussex Primary Care Trusts and Housing and will be in place by April 2007. The Strategy will inform future service planning and commissioning of care, health, housing and preventative services for older people in the county. In writing the Strategy the priorities highlighted in this and the other individual Locality Housing and Support Strategies in East Sussex (excluding Brighton & Hove City Council) will be drawn upon. The Joint Commissioning Strategy will inform future service planning and commissioning of care, health, housing and preventative services for older people in the county. East Sussex Integrated Sustainable Community Strategy The East Sussex Strategic Partnership brings together different sections of the community - public, private and voluntary sector organisations, community groups and local people - to improve services and the quality of life for all our communities. The Partnership’s current strategy ‘Pride of Place’, includes a number of priorities relevant to older people in Wealden. One of the priorities of the Strategy is working to improve economic, social and environmental sustainability, thereby improving quality of life. This includes tackling the problems of the most deprived communities; modernising communications (including transport); creating faster and easier access to services; and improving community safety. A specific priority is to improve support services to older people, empowering them to live the way they choose, valuing their skills, expertise and contribution to the community, and ensuring that care is organised around people and not around services. Additionally, every local authority is expected to develop a Community Strategy through wide ranging consultation with local residents and stakeholders. East Sussex Local Area Agreement: (LAA) 2008-11 The new LAA is the delivery arm of the ‘Pride of Place’ Community Strategy, developed through local strategic partnerships . The East Sussex’s Local Area Agreement sets out a range of indicators and targets all of which can only be achieved through partnership working between different agencies. The East Sussex Local Area Agreement was revised in 2008 and covers the period 2008-11. The outcomes and targets most relevant to this strategy are:
• Percentage of vulnerable people who are supported to maintain independent living (National Indicator 142). This can be monitored by the number of service users who have established or are maintaining independent living, as a percentage of the total number of service users who have been in receipt of Supporting People services.
• People supported to live independently through social services (NI 136)
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• Carers receiving needs assessment or review and a specific carer’s service, or advice and information ( NI 135)
For 2008/9 the existing reward targets in the original LAA ‘All Together Better’ are applicable
• reduce falls (existing LAA target 7.2) • increase the number of people supported to live independently at home
(exisiting target 9.1)
Key messages from Regional, East Sussex and Local Strategies
The Sussex coastal region is one of the most deprived parts of SE
Region (South East Regional Strategy) Nationally East Sussex has the highest population of people over 80 Reduce reliance on residential care, respond to increasing
aspirations (Adult Social Care 3 y ear plan) Enable people to live in high quality, well-designed accommodation
and receive care and support at home (Adult Social Care 3 year plan) New developments to be done in partnerships between Health,
Housing, Adult Social care and the independent sector Improve the experience of service users Engage older people in the development of local services Improve health outcomes for East Sussex residents Improved wellbeing and choice for older people and those living with
long-term conditions Reduce hospital admissions and delayed discharges Target Supporting People on people in greatest need Increase floating support services
Promote the development of Assistive Technology
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2 Background on Wealden & Rural issues 2.1 Background: Wealden is situated in East Sussex and is the largest District in East Sussex covering 323 square miles. Wealden is home to some 143,000 people (2006 population estimate, East Sussex in Figures). Approximately half the population live in the district’s five main towns: Crowborough, Hailsham, Heathfield, Polegate and Uckfield. The rest of the district is predominantly rural and consists of 37 parishes. Additionally:
• The High Weald and Sussex Downs Areas of Outstanding natural Beauty cover more than two thirds of the District.
• Wealden has 34 conservation areas, 32 sites of special scientific interest and • more than 2,500 listed buildings
Map of the Government Office Region showing Authority boundaries and shaded by Output Area according to the urban / rural definition
The 2001 Census highlighted that in Wealden 48% of households are in rural areas compared to the 22.4% average in the South East region.
• 26% of rural households are single person of which 64% are pensioners (63% of the urban single person households in Wealden are pensioners).
• 13% of all urban households are pensioner households and 14% in rural Wealden. This is not in line with the national trend (seen below) where a
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higher percentage of older people are living higher in rural areas as oppose to urban locations.
As can be seen from the chart below in rural Wealden 7.6% of the population living in rural areas are aged 70+. Age Total Urban Rural Under 10 33,104 17,339 7,509 10 to 19 16,877 8,621 8,256 20 to 29 10,526 6,004 4,522 30 to 39 18,605 10,218 8,387 40-49 19,524 9,557 9,967 50 to 59 20,869 9,684 11,185 60 to 69 15,612 7,594 8,018 70 to 79 13,108 6,737 6,371 80 to 89 7,412 3,885 3,527 90 and over 1,497 803 694 140,257 71,821 68,436 Source: Census 2001 In rural Wealden 82.9% of households live in owned accommodation, 6.2% live in social rented accommodation and 7.9% live in private rented accommodation.6 In urban Wealden 83.8% of households live in owned accommodation, 9.4% live in social rented accommodation and 5.2% live in private rented accommodation.7 2.2 National Picture Rural issues Since Wealden is predominantly rural it is necessary to look at the impact of this on older people: Key issues identified in the Affordable Rural Housing Commission (ARCH) report that are of particular concern for older People8 The lack of affordable housing undermines the sustainability of rural communities, by breaking up traditional family and social networks which help provide for intergenerational support. Increasingly one generation is less able to support one another e.g. childcare responsibilities or shopping for elderly relatives. Without family networks older people become more reliant on support services to provide low level support such as gardening or help with shopping. This support often needs to be provided by paid workers whose low wages means that many cannot afford to live in rural areas. Whilst the majority of older people wish to remain independent in their homes, ARHC highlighted that there some older people living in homes which no longer meet their needs either due to ill heath/disability or the cost of their upkeep, yet these people were unable to move to more suitable accommodation because it is not available in their local community.
6 2001 Census 7 2001 Census 8 ARHC July 2005
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ARHC identified the need to explore and promote specific approaches to provide a range of affordable housing which offers older people in rural areas extra care, independence and choice. ARHC highlights the importance of ensuring that the implementation of, and funding of, the government’s Supporting People agenda in local authorities takes into account the needs of the ageing rural population and that the additional costs of delivering support services in rural areas is recognised in local authority spending allocations. The Ageing Countryside: National Context The research found that the proportion of older people in England’s rural areas is significantly higher than in urban areas, with 31.5% of the rural population is aged 55 or over, compared to 27.9% in urban areas. It is forecast to be a trend that is likely to continue, as more people move to the countryside for quality of life reasons in their 40s and 50s and stay on into retirement. Demographic change has significant implications for housing policy, particularly as it corresponds with a major shift to owner occupation. National findings based on Census information highlight that the increase in percentage of owner occupation over the twenty year period from 1981 are higher among older people and in rural areas where 81% of over 55 years olds are owner occupiers compared to 73% in urban areas (Census 2001). This has created an increasing need or wish of many more people to be supported to live in their homes, despite problems relating to ill health or disability. Further research which highlights other areas of concern impacting on older people and the rural housing agenda:
• Many older households are asset rich but income poor, this means that many have problems with property maintenance and funding adaptations which would significantly enhance their quality of life. Better support for older people to explore equity release schemes and shared ownership schemes could play a role.
• Transport is one of the most significant issues facing older people in the countryside and has a knock on effect in terms of helping sustain housing options in rural areas. Strategies must adopt a holistic approach to housing to embrace other aspects of daily living in which transport and access is a critical factor.
• Low level support and preventative care are of particular importance in rural areas to enable older people to remain in their home. Informal help from neighbours, friends and family is often a main source of support, whilst formal help is provided by voluntary sector agencies. The importance of these support schemes in enabling older people to retain their independence needs to be given greater emphasis.
• Innovative solutions are required such as the development of generic care workers who are able to take on a range of tasks.
The housing option service is primarily used by those who need to consider their housing options primarily due to poor health, access or mobility problems or home maintenance issues and has been particularly valuable to people aged 80 and over.
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• The preferred option is for people to stay in their existing homes for as long as possible. In rural areas supporting this option through adaptations, repairs and practical help is even more critical as it enables older people to retain their important local support network.
• Lack of suitable housing options and support services hampers the ability of many older people planning to move, especially in rural areas.
• In rural areas there is a lack of suitable housing to purchase even for those with moderate equity - so many who move go from owner occupied into social rented housing particularly sheltered housing. There is an unmet demand for general housing which is well located, adaptable and has adequate space standards.
• Design is a key factor in meeting the future needs of an ageing population, particularly in rural areas with limited new housing stock.
National Research Key messages
The proportion of older people in rural areas is significantly higher than in urban
areas and this trend is likely to continue There is a higher percentage of owner occupiers aged 55+ in rural areas than in
urban areas 1 in 10 pensioners rely solely on state pensions and other benefits Between 2001/02 and 2004/05 new affordable homes in rural areas has
increased by just 3% whereas in urban areas there has been an increase of 22% There is a lack of availability of accommodation suitable for older people in rural
areas Low level support and preventative care is particularly important in rural areas to
enable older people to remain in their own home
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3 Consultation 3.1 What people want – National evidence National research indicates that as people age their homes become more significant in defining their identity and shaping their lives. Most surveys show that the majority of people want to remain in their own homes as they age. A study by Counsel & Care9 showed 82% of respondents wishing to remain in their own homes. Other surveys show similar figures of between 77% - 80%. Not only are people less willing and likely to move home in older age but they also spend proportionately more time within the home’10 Research also suggests that the number of people who plan and act in advance to avoid housing difficulties is low. A significant finding from the Life Force study carried out by Age Concern in 2004 is the tendency not to link the desire for maintaining independence (ranked as the number one concern for people now and in the future) with the need to think about the impact of their current housing on this priority (‘the availability of suitable housing’ was ranked only seventeen). When asked to predict the situation in 20 years time, a large proportion of people felt there would be more demand for housing choice. This suggests that expressed demand is not a good indicator of actual demand. However, the Department of Health indicates a growth in demand by older people for Extra Care Housing for rent or sale.11 Key messages from older people about their housing preferences in later life12 are as follows:-
• Housing should be well designed with growing older in mind – adaptable ‘houses for life’
• Older people must be involved in planning future housing options and housing design and have choices to enable them to make decisions and take control of their lives
• More funding needs to be made available to improve and adapt private housing, backed up by reliable repairs and maintenance
• Housing must be accessible to good local transport, facilities and amenities • Older people need more space that is able to meet their needs, not less. This
means 2 not 1-bedroom properties both for single and couple households and rooms need to be larger with good storage.13
• People want real choice, based on access to information and a range of housing options
• Sheltered housing units are experienced as too small and not allowing people to live normally, have family and friends to stay, maintain privacy and move around safely.14
9 ‘Housing Choices in Old Age’. Counsel & Care and the Dept of Applied Social Science at Lancaster University, 2003. 10 ‘Building Our Futures:’ p16 11 Department of Health 2004, ExtraCare Housing for Older People: an introduction for commissioners. London 12Older People’s Strategies; taking account of Older People’s views Housing and Older People Development Group 2006 13 ‘Planning for Smaller Households, summary of Housing requirements of the retired population 2001-21 Anglia Polytechnic University, 2005 14 ‘Our Homes, Our life, choice in later life living arrangements’. Centre for Policy on Ageing and Housing Corporation 2002
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The Counsel & Care study (op.cit) reflects the influence local environment has on people’s housing decisions. Reductions in public transport, anti-social behaviour, rundown appearance, a lack of parking spaces close to home or pavements suitable for manoeuvring motorised scooters are all factors making people wish to move. Other research suggests that the majority of older people have no preference to live in communities exclusively for people of the same age15 as long as their anxieties about safety and accessibility are addressed.
National research and consultation Key messages
Most older people do not think about future housing needs Older people must be involved in planning future housing options and housing
design and have choices to enable them to make decisions and take control of their lives
More funding needs to be made available to improve and adapt private housing, backed up by reliable repairs and maintenance
Housing should be well designed with those growing older in mind -adaptable ‘houses for life’/Lifetime homes
Housing must be accessible to good local transport, facilities and amenities People want real choice, based on access to information and a range of housing
options 3.2 Local consultation – East Sussex During the summer of 2006, a series of consultation meetings looking at the housing and housing-related support needs were held in East Sussex, with two in Wealden, one in the north (Uckfield) and the other in the south (Hailsham) of the district. Similar sessions were held during 2007 in Hastings and in Rother. The results of these sessions generally mirrored exactly the national results described above. The importance of maintaining maximum independence and the factors which contribute to that - accessible housing, mixed communities, sufficient accommodation space for continued family and social life and information about possible options – were all rated as top priorities. Those who attended were mostly retired and reflected the view that most older people do not think about future housing needs. 3.3 Wealden District Council Housing Needs Survey The 2005 survey included face-to-face interviews with 120 older people across the survey area of East Sussex and Brighton & Hove, and whilst their responses do not apply solely to Wealden, they are indicative of the views of older people in the area (A copy of this can be downloaded at www.wealden.gov.uk)
15 Planning for the Majority, the needs and aspirations of older people in general housing. Joseph Rowntree Foundation/Nigel Appleton, 2002
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In terms of problems encountered in their existing home they were either support related or mobility related with over 30% experiencing problems decorating, 12% with gardening, 28% with using the bathroom and 8% with climbing up stairs. The housing needs survey indicates that the majority of older people would prefer a bungalow rather than a flat, and nearly all require at least one separate bedroom, with many requiring two bedrooms to enable friends and family to stay. There is also clear evidence that the needs and aspirations of older people have changed considerably since many retirement housing schemes were developed in the 1960s and 1970s. Today, more than 50% of older people are car owners and they require parking for themselves and their visitors. The survey asked respondents to identify the features of Extra Care housing that they would most value. Their responses were as follows: Valued features of Extra Care housing:-
Feature % respondents who say the feature will benefit them
Improved security 100% Having other people around 93.1% The warden or manager 100% The care and support team 96.6% Not worrying about home or garden maintenance
100%
Meals 93.1% Source: Wealden Housing Needs Survey, David Couttie Associates 2005 The survey did not of course investigate whether Extra Care housing was needed by those people indicating an interest, but this type of housing clearly has a good degree of appeal. However, the important impacts on liking their current neighbourhood were quality of neighbourhood, familiarity of neighbourhood and peace and quiet. These are important when planning for housing for older people. Rural Housing Needs Survey 2004 The survey showed a clear correlation between those wanting retirement housing and those villages that had existing council owned sheltered schemes, such as Forest Row, Buxted, Wadhurst and Westham. There was a higher demand for retirement housing over sheltered reflecting the national picture that older people want independence as long as possible. Additionally there was an aspiration for support services including access to a scheme manager, care alarms and daily/regular visits regardless of people’s choice of accommodation type and tenure (see appendix 2 for more information). 3.4 Consultation with residents of Wealden District Council A survey of 545 people (of whom 16% were over pensionable age) undertaken in Wealden in September 2004 for the Crime and Disorder Partnership found that 72% of respondents rated Wealden as a safer place than the rest of the country and 50% rated it safer than the rest of the county. The most commonly reported concern (31% of the sample) cited “young people causing a nuisance” as a problem.
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Additionally there is a Sheltered Housing Information Exchange which meets twice a year with all residents of Wealden owned sheltered housing invited. It is an opportunity to share information and for residents to ask questions to officers of the Council. A new residents group has recently been formed called Sheltered Housing Residents Group. The group contains a representative from each of the council’s owned sheltered housing schemes who meet on a monthly basis. One of the roles of the group will be to get involved in the sheltered housing review process. 3.5 Annual Housing Summit event 2007 In the summer of 2007 Wealden District Council held there annual housing event which was attended by over 80 stakeholders. The focus of the day was “Planning for our Future”. During discussions the needs of the ageing population were highlighted, with the following issues raised:
• Need to provide at least 2 bed units including bungalows, with no more bedsits.
• Extra care schemes provide a range of facilities (restaurant, hairdresser, bar etc etc) this is a positive step forward, but must be attractive to younger , older people to provide a mixed community with people living there for longer, and bringing a lively and vibrant lifestyle into the scheme. It will also ensure they do not have to move when they become more frail.
• Developments need to have a mix of tenures and property types so that schemes have a balance of ages and family types – this will help to build community spirit.
• Need to encourage older people to move out of their larger houses when their families leave home – incentives needed, and also the supply of good quality smaller homes for people to move into as they become older.
• There was some dislike of retirement villages. • Accommodation for older people is needed throughout the district to enable
people to remain near their connections. • Older people do not necessarily want sheltered housing anymore.
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Key Facts at a Regional and Local Level
Maintaining maximum independence is important Older people want support to enable them to remain in their own
homes which includes: care alarms and gardening/decorating etc
Space is required to enable family and friends to stay Housing needs to be accessible as many older people have
mobility problems 50% of older people are car owners All housing regardless of tenure should be built to ‘Lifetime
Homes at standards to enable people to stay put Telecare products need to be available to people in their homes
as well as in specialist housing There needs to be more innovative thinking to develop a range of
options for people to stay in their own homes, including homeshare and floating support available to those eligible regardless of where they live in the District and whether they own or rent their home.
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4 Demand forecasting for Older People in Wealden 4. 1 Key Demographic Indicators The analysis of need in the section below is based on Census data and findings from ‘Building Our Futures’ published in February 2006.16
Population and population projections
For East Sussex
East Sussex has a higher proportion of people aged 65 years and over, (with over 25% of the population being of pensionable age compared to 18% nationally) than the rest of the country.
East Sussex generally has less people in the 45-64 age group than the national average
the proportion of people aged 85 years and over in the county (those most likely to require health and social care services) is 3.6% against an average of 2% for the country as a whole.
Almost 60% of one person households are pensioners living alone. Retirement migration is approximately 12% across the county.
In Wealden of the 140,023 people (as at 2001 Census) living in the district 21.1% were over retirement age, 10.7% aged 75+ and 3.1% aged 85+. As Fig 1 below indicates that there is a steady increase in the over 70 population throughout the next 20 years, with a significant increase from 2016 onwards. Figure 1:
Wealden - trend based population projections 2003-2026
02468
10121416
50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+
Age Ranges
Per
sons
(x10
00) 2003
20062011201620212026
It is worth noting that the population trends for both males and females show similar trends in Wealden. However, whilst the male population is virtually static between 2016-2026, there is a noticeable rise for females in the same period, with a marked
16 Building Our Futures: Meeting the Housing Needs of an Ageing Population. International Longevity Centre Uk. London 2006
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rise in the 2021-2026 period. Between this period the number of females is set to rise by 3700. The Housing Needs Survey 2005 using 2003 based Office of national Statistics (ONS) sub-national projections supplied by East Sussex County Council and taking into consideration 2001 Census data indicated that the population in Wealden would increase by 15.5% or 21,800 people by 2026. Age band Predicted increase up
to 2026 (in people) Same increase as a percentage of the current population
Over 65 17,300 57.5% 80+ 5,500 59.8% 0-19 1,400 14.3% 30-44 -3,300 -11.8% The current generation of ‘babyboomers’ form what is termed as ‘rising elderly’ As indicated in Fig 2 below, ESCC generally has less people in the 45-64 age group than the national average and Eastbourne has least of all.
Fig 2 shows that the population over 45 sees an increase from 2006 until 2021, when there is a decline. Life Expectancy of People All People Males Females England/Wales 78.3 75.9 80.5 South East 79.4 77.2 81.5 Eastbourne 78.9 75.6 81.8 Hastings 77.4 74.8 79.8 Lewes 80.2 78.2 81.9 Rother 79.3 77.1 81.3
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Wealden 80.7 78.4 82.8 2001 Census It is clear from the Table that both men and women living in Wealden have a greater life expectancy that else where in East Sussex, followed closely by Lewes, with women on average living longer than men. However, within Wealden there are wide variations at ward level in life expectancy with people in Mayfield having the highest life expectancy at 85.6 years and Hailsham East at 79.9 years having the lowest life expectancy of all those living in Wealden (Joint Strategic Needs Assessment 2008, based upon 1999-2003 data).It is worth noting that there has been an increase of 2.6 years of those living in Hailsham East since 2001 Census. Where older people live The table below shows the towns/parishes with the highest concentrations of older people aged 65+ as per the 2001 Census: All People 65+ 65+ as a
percentage of the parish population
Wealden 140,023 29,576 21% East Dean 2,164 690 32% Polegate south 2,250 911 40% Polegate north 4,713 1,601 34% Willingdon 7,184 2,429 34% However, if we look at physical numbers the parishes/towns with the highest numbers of people aged 65+ as per the 2001 are: All People Numbers aged
65+ Wealden 140,023 29,576 Hailsham 8,260 2,870 Crowborough 7,892 2,092 Uckfield 5,535 1,320 Heathfield & Waldron
4,719 1,396
Polegate 3,937 1,907 Increase in Older people by sex and ward In addition, the table below shows where greatest increase of people aged 65+ are predicted to be in 2012, based upon percentage increase and not actual numbers. These figures are based upon work undertaken by the Primary Care Trust through the Joint Strategic Needs Assessment
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Increase in Male Population, 2012 Projections
65+ 75+ 85+ Ward Predicted
Increase in numbers at 2012
Predicted percentage increase at 2012
PredictedIncrease in numbers at 2012
Predicted percentage increase at 2012
Predicted Increase in numbers at 2012
Predicted percentage increase at 2012
Ninfield/ Hooe/ Wartling
268 119.11
Framfield 203 118.71 Uckfield Ridgewood
80 114.29
Uckfield Central
137 114.17
Herstmonceux 28 121.74 Crowborough Jarvis Brook
17 121.43
In all wards there is predicted to be an increase in the number of men aged 65+, 75+ and 85+ at 2012. Increase in Female Population, 2012 Projections
65+ 75+ 85+ Ward Predicted
Increase in numbers at 2012
Predicted percentage increase at 2012
PredictedIncrease in numbers at 2012
Predicted percentage increase at 2012
Predicted Increase in numbers at 2012
Predicted percentage increase at 2012
Chiddingly and East Hoathly
255 14.35 44 10
Hartfield 279 13.88 Cross In Hand/ Five Ashes
69 9.52
In all wards there is predicted to be an increase in the number of women aged 65+ and 85+ at 2012. However, in all wards there will be a decrease of women aged 75+ with the highest decrease in Crowborough St Johns at 5.63% and the lowest decrease in Heathfield East at 4.13%.
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Household composition for pensioners All
HouseholdsAll pensioners only households
One person pensioners
One family & no others: All pensioners
Other households: All pensioners
East Sussex
214,638 70,105 (33%)
41,088 (59%*)
27,612 (39%*)
1,405 (2%*)
Eastbourne 40,918 14,169 (35%)
8,901 (63%*)
4,945 (35%*)
323 (2%*)
Hastings 37,604 9,651 (26%)
6,316 (65%*)
3,133 (33%*)
202 (2%*)
Lewes 39,728 13,123 (33%)
7,565 (58%*)
5,324 (40%)
234 (2%*)
Rother 38,114 15,047 (39%)
8,413 (56%*)
6,342 (42%*)
292 (2%*)
Wealden 58,274 18,115 (31%)
9,893 (55%*)
7,868 (43%*)
354 (2%*)
The table above shows that Wealden has the largest population in East Sussex (2001 Census). *as a percentage of all pensioners only households Migration patterns All
People 0-14 15-24 25-44 45-64 65+
East Sussex 3,400 900 -1,100 1,300 1,700 600 Eastbourne 1,000 300 0 200 400 100 Hastings 300 0 -100 200 400 0 Lewes 400 100 -300 200 400 0 Rother 1,100 200 -200 300 600 200 Wealden 600 300 -500 400 200 200 2001 Census The table above shows that migration is greatest in Rother, then Eastbourne followed by Wealden, with Wealden having the highest inward migration into the district of those aged 45-64, as well as the highest outward migration of those aged 15-24. The key issue here is that Wealden and Rother have the highest inward migration of those aged 65+ which will have an impact on housing and support services in the district.
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SIGNIFICANT DEMOGRAPHIC INFORMATION ABOUT WEALDEN
It is predicted that there will be a 57.5% increase in those aged 65+ in
Wealden up to 2026 with the largest increase in those aged 80+ at 59.8%
People living in Wealden have a greater life expectancy than those living elsewhere in the County
Polegate South has the highest percentage of those aged 65+ of all Towns & Parishes in Wealden
Wealden along with Rother District Council has the highest levels of inward migration of those aged 65+ years.
4.2 Deprivation17 The South East has 77 of the 10% most deprived areas England. The South East has 5,319 areas in total with just over 1% of all these being within the 10% most deprived. The most deprived Super Output Areas (SOA) are concentrated in some of the coastal resorts of the South East, such as Brighton and Hove, Thanet, Portsmouth and Hastings. On the other hand just under a quarter (1,317) of the South East areas are in the 10% least deprived group. The South East has the lowest percentage in the country by region of older people living in income deprived households at 11.02% (176,541) followed by the South West at 12.59% with London having the highest at 20.9%. Within East Sussex Wealden is the least deprived District in East Sussex with only 11.3% of the population on low incomes. When ranking the 11 wards of East Sussex Hailsham East is ranked 11th (with 1 being the most deprived - Indices of Deprivation 2000). The least deprived wards in Wealden (as of 2004) are Uckfield Ridgewood, followed by Crowborough North. Although Wealden District is generally quite affluent, such a statement disguises pockets of income deprivation. Research carried out highlights the percentage of older people affected by income deprivation. Based upon the Indices of Multiple Deprivation 2004 within Wealden District:-
• Hailsham East ward suffers from the highest levels of older people affected by income deprivation at 18.52%
• Uckfield New Town ward ranks high within Wealden as does Horam
• East Dean ranks the lowest with 2.16% of older people affected by income deprivation
17 Wealth of the Nation, quoted in ‘The Argus’ Oct 2006-11-03
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• Areas such as Hartfield, Framfield, Crowborough North, Rotherfield, Frant/Withyham, Alfriston, Heathfield east and Crowborough Jarvis Brook all rank low at less than 6% of older people affected by income deprivation
The Housing Needs Survey indicates that 56.7% of households of older people across East Sussex and Brighton and Hove have incomes below £10,000 pa (compared to 21.3% of all households) in the same area.
• However, 69.2% of households responding included additional private pension as an income source. The authors of the survey comment that this is high compared to other areas they have studied.
• Nearly a third of respondents had savings over £9000 – again high in comparison with other parts of the country – though over a quarter (27.4%) said they had less than £3000.
• 84.9% of respondents owned their homes outright
• 14.7% said they would be willing to consider an equity release scheme to release money to pay for essential repairs or undertake a move to more suitable property.
Wealden District Council is ranked 307 out of all local authorities on the national Index of Deprivation 2004 (with 1 being the most deprived).
Wealden is the least deprived district in East Sussex with only 11.3% of the population on low incomes (2000 Indices of Deprivation)
When ranking the 111 wards of East Sussex, Hailsham East is ranked 11th.
Using pension credit as a proxy for income deprivation, the wards within Wealden with the most income deprived older people are Hailsham East at 36.7%, Polegate South at 33.5% and Crowborough East at 29% (Department for Works and Pensions – Feb 2006).
Males and females with the lowest levels of income deprivation have higher life expectancy than those that are most income deprived.
4.3 Health (including prevalence and incidence) A review reported in Health Statistics Quarterly (Autumn 2002) reached the conclusion that healthy life expectancy has increased significantly over the past 20 years, but not as fast as total life expectancy. This means that, despite living longer, people can also expect to live more years in poor health. Though care needs may increase in later life, they also fluctuate, indicating that care and support needs to be available on a flexible basis according to individual need. East Sussex was successful in obtaining £3.2 million over 2 years in the first national Partnerships for Older People Projects (POPP) bidding round to develop a range of services across health, social care, the ambulance service, mental health and voluntary sector. The emphasis is on innovation, prevention and wellbeing, delivered in partnership. Proposals include the Navigator Project which aims to direct people to personalised help and support in their local community.
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Telemedicine, whilst having huge potential for management of long term conditions, has yet to attract any finding from either central government or local Primary Care Trust. Although strictly related to health conditions, this is an important potential development for extra care housing where the response to support, care and health needs could then be jointly commissioned, offering efficiencies and added value. At the time of writing the East Sussex Downs and Weald Primary Care Trust have just published a Draft Strategic Commissioning Plan which seeks to explain it’s approach to commissioning, and it’s stratgies for both preventative healthcare and care management for the coming years. One of the proitities is to increase investment in services for older people and in services that promote well-being in older people (aged 50+). With regads to older people the strategy encompasses a set of action plans that are organised into around 5 new sorts of care pathways:
1. Fit and well although growing older – aim is to encourage people to adopt a healthier lifestyle to reduce the risk of becoming ill
2. Experiencing problems that might be preventative – the focus is on minimising risk of deterioration or an emergency happening by co-ordinating all aspects of care and support for those that have already developed particular illnesses or problems
3. In immediate need of help or treatment – support for those that experience a fall or stroke. Although emergency hospital admission may be appropriate services to address these acute episodes may include alternatives such as rapid provision of home care
4. Ready/preparing to go home –support for those that area ready to go home or need further care, support or treatment to recover.
5. In need of long term support – people needing care, support or treatment for a long time or indefinitely.
Census figures for 2001 and the results of a recent report from the Primary Care Trust in conjunction with East Sussex County Council 18 indicate the following key health-related issues influencing the future direction provision of housing and housing related support in Wealden: - Strokes In England, strokes are a major health problem and, with over 111,000 people having a stroke every year, they are the third largest cause of death. Strokes can affect people of any age. Nine out of ten strokes occur in people over the age of 55. There is also a related condition known as a transient ischaemic attack (TIA), where the supply of blood to the brain is temporarily interrupted, causing a sort of 'mini-stroke'. Within Wealden, Polegate South, Polegate North and Willingdon have the highest prevalence rates of strokes/TIA per 1,000 population, (this does not mean the highest numbers of people having strokes). This directly correlates to the wards which have the highest concentrations of older people in Wealden as at 2001 Census (see page 24). Heart Failure Heart failure can happen to anyone, but it is more common in African Americans and people 65 years of age and older, and it is the number one reason for a hospital visit for those aged 65+. 18 Joint Strategic Needs Assessment: Local Authority & Ward Profiles. East Sussex Downs and Weald PCT, Hastings & Rother PCT & East Sussex County Council October 2007
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Within Wealden, Polegate North, Polegate South, Ninfield & Hooe and Wartling have the highest prevalence rates of heart failure per 1,000 population at over 12 per 1000 population. Again there is a direct correlation in Wealden between heart failure and the wards which have the highest concentrates of older people. However, the overall rate in Wealden at 8.30 is lower than the East Sussex rate of 8.90 per 1000 population. Hypothyroidism Hypothyroidism is commonly referred to as underactive thyroid. Likelihood of suffering increases with age and is commonest around the age of 60 years. Within Wealden Polegate South, Polegate North have the highest prevalence rates of hypothyroidism per 1,000 population at over 50 per 1000 population closely followed by Willingdon at 49.50. These rates exceed the Wealden average of 36.90 which is higher than the east Sussex rate of 33.80. Again In Wealden there is a direct correlation between hypothyroidism and the wards which have the highest concentrates of older people. Blindness It is not surprising that within Wealden Polegate South and Polegate North have the highest number of people currently registered blind/partially sighted per 1000 population as at 2007. This is because by the age of 65 one in six people will be blind or partially sighted and these are the two wards with the highest concentrations of older people in the Wealden District. Age-related macular degeneration (AMD) is the most common cause of vision loss in older people and it accounts for 40% of all causes of blindness/visual impairment.
KEY HEALTH ISSUES FOR OLDER PEOPLE LIVING IN WEALDEN
Whilst East Sussex as a whole has a high proportion of households with at least one person with a Limiting Long-term Illness (LLTI), Wealden has a LOWER than average proportion of households at 15.9%. Numerically this means there are 136,930 people over 50 of whom 21,785 have a LLTI.
There are a high number of men aged 75 and above with a limiting long term illness (more than 50% of the population in all age bands above 75 except the 75 – 79 age band which is just below 50%). For women, the impact of a limiting long term illness sets in later, at over 80, with very high percentages in the over 85 age group.
The proportion of people with a LLTI is higher in the social rented sector than owner occupied – at 47.9% for those aged 65-84 as oppose to 37.66%, and 72% as oppose to 65% for those aged 85 and over.
22.9% of BME households had a member of their household with a disability or limiting long term illness. Of these Limiting Long Term Illness was the highest form of disability at 41%, followed by Learning disability at 21.9% and walking difficulty at 20.7%. Overall, the percentage of residents with disabilities was generally higher amongst BME households-(exceptions being visual/hearing and impairment, asthmatic/respiratory problems).
Within Wealden, Polegate North and Polegate South are the wards with the highest percentage at just over 27% of people with a Long Term Limiting Illness.
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4.4 Diversity Appendix 3 gives an indication of the breakdown of ethnic groups in Wealden at the time of the 2001 Census. The total Black and Ethnic Minority population in Wealden is 1.696% of the total population, of which the highest group is those of mixed race (0.64%). There are currently no significant groups of ethnic elders. Little is known about the housing needs of other ‘hard to reach’ communities such as those based on sexual orientation, religious groups (e.g. those of Jewish or Muslim faith) or gypsies and travellers. Although work with regards to gypsies and travellers is ongoing.
KEY ISSUES Appendix 3 indicates that the BME Figures are low in Wealden, particularly in the over 75 age group Within Wealden the BME population has remained stable between 1991 and 2001 Census at 1.7% of the population. However, the Black and Ethnic Minority population has increased in East Sussex over the past 10 years The BME population are distributed throughout the district with slightly higher concentrations in Jarvis Brook, Crowborough (3.155% of the total population), Forest Row (3.45%) and Mayfield (4.34%) In terms of the BME population in Wealden the Census 2001 highlighted that the highest numbers are in Hailsham (75 people), followed by Crowborough (57 people) and Uckfield (36 people) In terms of percentage of the parish that are BME the highest is Longman at 3.6% but this in reality is only 6 people.
4.5 Dementia One of the most challenging long term conditions nationally and locally is the presence of dementia in old age. Dementia is a disease in which a progressive decline occurs in memory, thinking abilities, personality and behaviour. An estimated 5% of those over the age of 65 have dementia, rising to 20% over the age of 80. There are over 50 causes of Dementia but the commonest cause of Dementia in older people is Alzheimer's Disease. Between 50 and 70 percent of all people with dementia are suffering from Alzheimer's disease. Taking the Alzheimer’s Society prevalence rates for dementia as 1 in 5 over the age of 80, the table below depicts the anticipated increase in the numbers of over 80’s having dementia.19 The chart below shows the projected growth per 000’s in the incidence of dementia, between 2006 and 2026 it is anticipated that Wealden will have a 58.85% increase during this period (1,860 rising to 2,940).
19 These figures do not reflect the increase in the prevalence rates for people over 85 and over 90.
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0 2000 4000 6000 8000
10000 12000 14000 16000
Wealden pop over80
Prevelance of dementia
2006 2011 2016 2021 2026
Within Wealden, based upon Primary Care date (Joint Strategic Needs Assessment) in 2006/07 Ninfield & Hooe, Wartling had the highest prevalence rate of dementia at 10.40 per 1000 population, followed by Hertmonceux at 8.30, Polegate North at 7.60, Hailsham Central and North at 7.20 and Polegate South at 7.10 per 1000 population. The ward with the lowest prevalence rate was Uckfield New Town at 2.70. The overall rate in Wealden at 5.40 per 1000 population is below the East Sussex figure of 5.80. 4.6 Care and Support needs The Housing Needs Survey 2005 across East Sussex including Brighton and Hove Specialist interviews with Older People identified that 44.5% of the population interviewed received some form of service (including health services). Almost 32% respondents said that they had some difficulties managing in their current home with 32% of these already receiving some service as part of a support package. Profile of residents with a limiting long-term illnes
Wealden East Sussex
South East
All residents 16.8% 19.8% 15.5% Residents aged 16-74 10.7% 13.4% 10.6% Residents aged 74+ 52.7% 53.6% 55.0% Carers Local Authority Funded Care East Sussex County Council, Adult Social care are responsible for ensuring that qualifying people receive homecare. It is not surprising to note that Polegate South at 10.10 per 100 population and Polegate North at 9.40 per 1000 population are the two wards with the highest number of people receiving homecare, given that they are two of the top wards with the highest concentrations of older people. Overall in Wealden 4.50 people per 1,000 receive homecare which is lower than the East Sussex figure of 5.50.
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Informal Care In addition to formal support received, many older people receive support from family and friends:
Total 65+
Numbers of People 65-84
Providing Care
Providing 50+ hrs
Care
Providing 50+ hrs Care- Not In
Good Health (65+)
Nos 85+ Providing 50+ hrs
Men 12422 5076 366 80 54 Women 17154 6065 496 90 43
Wards with the highest number of people providing unpaid care are:-
• Heathfield north and central
• Buxted and Maresfield
• Danehill
• Fletching and Nutley
• Frant and Withyham All these have over 500 per ward. Those wards with the highest number of people providing more than 50 hours unpaid care per week are:-
• Crowborough East
• East Dean
• Horam
• Uckfield North All wards between 17.5% and 20.4% Carers in Wealden A fuller picture of the numbers of carers known to Adult Social care is obtained by adding those in receipt of a carers allowance. However, these numbers include carers of younger people as well as over 60’s. Overall there are 4.80 carers per 1000 population in Wealden which is the joint lowest with Hastings, with Eastbourne having the highest rates of carers at 7.50 per 1000 population. The overall East Sussex figure is 5.60. The two wards with the highest number of carers per 1000 population are Polegate South at 12.70 per 1000 population and Polegate North at 9.40 per 1000 population based on data from August 2006 and July 2007. This compares with an East Sussex figure of 5.60 per 1000 population, Typically, in Wealden as with much of the data there is a direct correlation between wards with the highest concentrations of older people and those with the highest numbers of carers.
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4.7 Housing need and demand Tenure Tenure of people of pensionable age
Wealden South East England All Households where the Head is of pensionable age
20,735 942,573 5,776,660
Owner Occupied Households 17,353 700,147 3,939,809 Rented from the Council 1,499 94,444 974,654 Other Social Rented 494 81,090 424,115 Private rented or living rent free 1,389 66,892 438,082
As can be seen from this chart nearly 84% of pensioners are owner occupiers compared to 2.4% who rent from a social landlord other than the Council. Quality of Housing Stock and Housing Conditions In 2005 as part of the Housing Needs Survey specialist interviews with 120 older people were carried out. 70% of those interviewed aged over 60 were owner occupiers and 30% were renting, with 71% of those renting having accommodation in the social rented sector. 95% of the older people interviewed indicated that their present accommodation was suitable for their needs. This compares to 86.7% of all households in Brighton &Hove and East Sussex.
• A small number (13) of older people in the above survey had moved within the last 2 years. 10 people cited health reasons, difficulties of maintaining large property or safety/security as the main reason for moving.
• Some 43.3% of respondents described their property condition as very good.
94.9% gave a rating of satisfactory or better.
• 53.8% of those interviewed had done no repairs or improvements in the last 5 years. 6% felt that some are needed currently but have not been carried out.
• Of the people interviewed, 68.1% indicated they had no other housing-related
problems. The remaining respondents identified decoration 60.5%, difficulty using the bathroom 52.6% and gardening 23.7% as key problems.
• 32.5% of respondents said they were unaware of financial and other
assistance available from the local authority to help getting essential adaptations to their home.
• 38.3% did not know where to go to get assistance and advice with making
energy efficiency improvements to their property.
Access to Facilities: The Housing Needs Survey 2005 included specialist interviews with older people (aged 60+) across East Sussex and Brighton & Hove, one of the issues discussed was access to facilities and the table below indicates the findings %
Cases Hot water 99.2% Inside toilet 99.2% Wash hand basin 99.2% Central heating 87.5% Bath 88.3% Access to garden 74.2% Off road parking 68.3% Standard shower 44.2% Level access shower 30.0% The table shows that the majority of those interviewed across the County have access to hot water, inside toilet and wash hand basin but fewer have access to central heating. General demand for housing for older people – Housing Register Wealden District Council maintains a register of households seeking affordable housing in Wealden. There are currently 2018 households on this register of whom 392 are aged 60+ (19%):
Ages of those on the Council's Housing Register
0-2419%
25-5962%
60-7914%
80+5%
Whilst only 204 of these households have expressed a preference for retirement housing there is a clear need for a range of accessible units throughout the District to meet the needs of these applicants.
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Numbers on the Council Register requesting
sheltered housing Retired Single 145 Retired Couple 59 It is worth pointing out that many of those selecting sheltered housing have done so because realistically it is the only type of accommodation that they will be offered or have a realistic opportunity of being housed in. Indeed for older people from outside the district it is the only type of accommodation which they would be offered. During 2006/07 58 households were housed in sheltered accommodation, sheltered housing vacancies representing 14.8% of all vacancies which is in line with the stock levels of such units at 16% of all social stock in the district (739 units). The register also records the following preferences for the size of homes required: Table 5: Range of needs recorded on Wealden’s Housing Register
Type of home required Single Retired Households
1 bed 2 bed 3 bed
Bed sit (general needs) 1 0 0 Bed sit (sheltered) 62 0 0 Flat (general needs) 135 0 0 Flat (sheltered) 227 0 0 Bungalow (general needs) 107 0 0 Bungalow (sheltered) 26 0 0 House 8 0 0 Totals 566 Source: Wealden District Council, April 2007
Type of home required Retired Couples
1 bed 2 bed 3 bed
Bed sit (general needs) 0 0 0 Bed sit (sheltered) 0 Flat (general needs) 60 1 0 Flat (sheltered) 84 1 Bungalow (general needs) 90 7 0 Bungalow (sheltered) 24 0 House 15 0 0 Totals 273 9 Source: Wealden District Council, April 2007 It should be noted that applicants are able to select more than one accommodation type hence the high totals in comparison with those aged 60+ on the register. Additionally, these preferences are in may cases tempered by the applicants modest expectations of what type of housing is likely to be available, For example:
• Most applicants will take a pragmatic approach and due to the shortage of 2 bedroom sheltered flats will not register a wish for such a unit because the
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supply of retirement housing has traditionally been in the form of small flats and bedsits.
• Although the housing register includes 63 people who have indicated a need for a bedsit, in reality such units when they become vacant are difficult to let.
• Due to the high demand for affordable housing the average waiting time for general needs accommodation in 2006/07 (i.e. non-retirement housing) was 80 weeks (this is based upon those that do get housed and does not take account of those that may never get helped), therefore older people will often elect retirement housing as their preferred option in order to increase their chances of earlier re-housing with waiting times reduced to 45 weeks during 2006/07.
Nevertheless, the expressed demand for 416 self-contained units for retired households (out of 839 preferences representing 49.5%) endorses the outcomes of the local and national consultations mentioned in Section 2 demonstrating that the aspirations of older people have changed over the years with a preference for great independence. In addition, the Housing Needs Survey demonstrated a likely demand for 946 units of retirement housing in Wealden in the five years to 2010. Of these, 401 are required in the affordable housing sector: Table 7: Demand for retirement housing in Wealden
Demand from:
Private market housing
Affordable housing Total
Existing households 9 17 26 In-migrant households 536 384 920 Total 545 401 946 The demand from in-migrant households was predicted by the families of existing residents of the District, based upon the perceived needs of their older relatives who have expressed a wish to relocate to be near their adult children. The survey provider advised caution in relying too heavily on this figure as in their experience most older people preferred to remain in their own homes in the area where they have existing social networks. As well as retirement housing, the adult children of elderly parents also predicted a potential need for a range of other types of housing over the next 5 years: Table 8: Predicted future demand for housing for older people in Wealden
Type of housing required
% responses
Numbers implied
Private general housing 12.3 309 Residential care / nursing home 20.7 522
Live with respondent (with a need for extension/adaptation to accommodate them) 14.4 364
Live with respondent (existing home adequate) 6.3 159 Total 1,354 Source: Wealden Housing Needs Survey, David Couttie Associates 2005
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This demonstrates a potential total demand for 2,523 homes for older people by 2010. General demand for housing for older people – Housing Needs Survey Of the people interviewed across East Sussex and Brighton & Hove nearly 42% of those interested in retirement housing said they would prefer to rent, with a mere 6% choosing shared ownership products. This may however indicate a lack of awareness of this tenure rather than a lack of demand. The spread of responses was as follows: Table 6: Types of private homes required by older people by 2010
Type of tenure % of respondents Renting 41.7% Buying 27.1% Shared ownership 4.2% Shared equity 0 Either shared ownership or shared equity 2% Don’t know 25% One quarter of all respondents said that although they are interested in retirement housing, they do not know the type of tenure they prefer. This may indicate a need for clearer explanation and more robust marketing of the various types of retirement housing by local authorities and providers. However, nearly 30% of older people surveyed are existing tenants, of which more than 70% were renting in the social housing sector. This means they are unlikely to have the means to buy, either outright or through shared ownership schemes.
Key issues in housing demand
Aspirations of older people have changed with an expectation of self-contained accommodation at the very least
Demand from in-migrant households need to be treated with caution There appears to be a lack of understanding around shared equity products Waiting times are greatly reduced for those requiring sheltered housing as
oppose to general needs accommodation
Priorities for the development of Housing In prioritising the need for the development of extra care in Wealden it is essential that regard is had to where older people in the district are concentrated (see 4.1). Bearing in mind that there is currently no provision of extra care in Wealden Uckfield has been identified as a good location for the first development of extra care as it is the most central town within Wealden. Future developments of extra care will seek to provide a scheme in the south of Wealden around Hailsham/Polegate and the north of Wealden around Crowborough these areas having the highest numbers of older people.
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4.8 Adaptations The Wealden Housing Needs Survey identified significant number of people with disabilities (19.2% of all respondents) of whom a large proportion (48% of first members and 53.8% of second members) had difficulties walking. Of those who reported a disability, 67.9% were aged over 60 (of this 42.9% were aged 75+). Information about adaptations were compared with responses asking about wheelchair users, and revealed that only 36.4% of homes suitable for wheelchair users were actually occupied by people needing these adaptations. This indicates a probably mismatch between adapted housing and needs and consequent unmet need amongst those needing wheelchair housing. 4.9 Transport The East Sussex and Brighton & Hove Housing Needs Survey Specialist interviews 2005 found that more than 50% of older people were car owners and as such would require parking for themselves and their visitors where they live. Access to amenities and good transport links are important factors in the choices older people make about where to live. Some sheltered schemes are more popular than others because they are located close to transport links and local amenities such as shops. Ensuring easy access to shops and other amenities is essential when selecting sites suitable for new schemes. Wealden Senior’s Forum regularly raise the issue of poor transport links in Wealden as an issue which impacts on the life’s of older people. 4.10 Planning In meeting the needs and changing aspirations of older people it will be essential to consider the needs of the aging population when looking at potential sites as part of the Local Development Framework. In addressing the agenda set by ‘Lifetime Homes & Lifetime Neighbourhoods’ it is clear that sites that can provide easy access to key services such as shops, doctors and public transport should be specifically identified and prioritised for older persons accommodation, including Extra Care when preparing a development plan for the site. The framework which sets out the number of new homes which will be built in Wealden is known as the South East Plan, which ultimately takes its proposed numbers from government plans. The South East Plan which runs from 2006-26 (and the recommendation of the Panel of Inspectors) is for Wealden's to build 480 units per annum up to 2026 (200 in North Wealden and 280 in the Sussex Coast Policy Area). However, more recently a government green paper published in the summer of 2007 is suggesting even higher numbers of new homes being built throughout the country.
It is essential that all new homes meet Lifetime Homes standard and not just affordable homes. Current proposals want to ensure that this is in place by 2010. The importance of Lifetime Homes which incorporates a set of design standards into new developments is that these homes ensure people are able to remain in their own home as they age, being easily adaptable. Additionally, it is important the all new homes are as sustainable as possible to prevent fuel poverty which is particularly associated with older people (see 5.3). This
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could include ensuring high levels of insulation are used to keep down fuel bills. Sustainability aims to ensure that new housings impact on the environment is as minimal as possible, including the use of less water. The sustainability agenda is currently very high on the agenda with a Government consultation document out during the summer of 2007 which is looking at gradually extending the requirements placed on private developers when building new homes. Current arrangements mean that social housing is currently produced at higher sustainability levels than private housing.
Creating Sustainable Communities Creating communities where people want to live and are able to live in older age is essential and the Government have introduced a range of planning papers to deliver such communities: Planning Policy Statement 1: Delivering Sustainable Developments. It sets out the overarching planning policies on the delivery of sustainable development. It sets out to ensure that through the planning system planning that we get the right development, in the right place and at the right time, acknowledging that this makes a positive difference to people’s lives. Planning Policy Statement 3: Housing. This paper emphasises that good design should apply to all housing and that priority for pedestrians is a key feature of good design. Planning Policy Statement 13: Accessible Transport. This paper makes it clear that the assessment of new development proposals should include their accessibility by a range of transport methods and developers are required to demonstrate how they will reduce travel to the site by car. Towards Lifetime Neighbourhoods: Designing sustainable communities for all. One of the key features of this paper relevant to this strategy is that lifetime neighbourhoods have a vital role to play in promoting ‘active ageing’ and meeting the challenges of an ageing population. They involve the creation of multi-generational space where the needs of all ages are catered for with a considered, negotiated balance. Lifetime neighbourhoods should also constitute a preventative investment in good health for future generations. Lifetime Neighbourhoods, Lifetime Neighbourhoods highlights that neighbourhoods not only need to be sustainable in terms of changing climate conditions, but it also in terms transport services, housing, public services, civic space and amenities. All of which make it possible for people to have a full life and take part in the life of the community around them. 4.11 Leisure and Cultural Activities
Promoting quality of life and wellbeing is important and can be achieved by offering and engaging older people in leisure and cultural activities. Wealden District Council’s Corporate mission is to work together to improve the quality of life in Wealden and within the Housing Service residents of Wealden's sheltered schemes enjoy various cultural and social activities, including vibrant resident-led social committees; Hidden Talents annual art exhibition and associated
Comment: This needs updating
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activities within the schemes; active art and crafts clubs (hobbies rooms in most schemes); lunches out and trips to different events; Busy Bees travelling knitting club; coffee mornings; short mat bowls; visiting libraries; fish supper evenings; bingo; bus trips to shopping outings; monthly Church Services in lounges where requested and possible. These all provide valuable opportunities for residents to socialise, expand their horizons and stay fit and active. Some residents, for example, had not painted before entering their scheme, and subsequently found it hugely enjoyable thanks to the encouragement and facilities provided. More recently ActOnIt, a well-respected drama workshop group, has visited three schemes and the feedback from residents has been very positive. During the summer of 2007 East Sussex County Council published “The Time of our Lives; Developing a Strategic approach to improving older people’s quality of life in East Sussex 2007-10.” The document acknowledges that it is widely recognised internationally, nationally and locally that older people’s quality of life is an important factor in the sustainability of communities with health, social care, voulntary organisations and housing support services all playing a part. During consultation with older people whilst formulating the Strategy older people in East Sussex highlighted that good quality of life cuts across the seven areas, some of which relate to leisure and cultural activities:
• Access to activities that promote a healthy old age. A proactive culture of health and fitness in the widest sense should be a key part of later life and there are clear benefits that this can bring for both physical and mental wellbeing into old age and preventing the onset of ill health.
• Opportunities to learn and develop in later life. Keeping an active, healthy
mind is an important part of growing older. People also continue to need fresh opportunities to learn new skills, take on new roles and to renew, stretch and change on a personal level. Although the desire for learning will vary widely in the post-fifty age group generally learning needs in later life fall into two areas:
o Learning for life – sometimes known as cultural, personal or leisure learning. o Learning for work – both for the pre-retirement post-fifty age group as well
as older retired people who would like to be economically active
• The ability to get out and about. The ability to get out and about has a key impact on people’s lives as they get older. In some cases a lack of adequate transport can be the main factor in causing social exclusion, and the provision of easily accessible passenger transport can increase older people’s quality of life in urban as well as rural areas. Of importance here is ensuring people can participate in social, leisure, cultural and educational opportunities.
The Strategy proposes lots of ideas to improve older people’s quality of life which need to be explored further including helping people access courses and introducing exercise classes as well as providing free bus passes across the County.
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5 Mapping Resources/Supply 5.0 Housing Advice It is essential that older people are able to obtain housing advice. Wealden District Council is able to provide advice to people including older people. In partnership with East Sussex County Council work is underway to ensure accessible information is available for older people on where to go to access service including housing advice and support. The Government's Lifetime Homes, Lifetime Neighbourhoods Strategy highlighted that there is a need for a single, simple and accessible route to obtaining independent, impartial information and advice and related issues, including finance and care options. From 2008-09 work across government and with external partners will take place to fund and develop approaches to a national advice and information service for older people. It will build on existing advice and information services, supporting a national web-based and telephone service run by independent organisations. It will be progressively linked to information services of local authorities, home improvement agencies and other local voluntary agencies. In time it will become a one stop shop covering social care and financial support for older people, progressively developing links to Pensions and Benefits service.
5.1 Sheltered Housing
Sheltered housing is housing designed to meet the needs of the elderly. It usually consists of a group of unfurnished self-contained homes. The aim is to provide independent secure accommodation with additional social and domestic facilities which typically includes a furnished communal lounge, hobbies/library room, guest room, laundry room, hairdressing room and door entry system for security. Council owned and managed stock Wealden District Council has a total stock of 577 retirement housing units across 14 schemes for rent (which excludes the units which are in the process of being vacated at Towermill Place, Polegate). Of these 577 the Council manages 97 leasehold sheltered units, which is where the household buys a share of the property which varies from around 10% to 99% and pays a weekly rent against the remainder. These units are generally only available to those aged 60+ unless there is a medical reason why younger people should live in such accommodation Address Town/village Number of units Amenities Buxted Court Buxted 22x 1 bed flats (1
person) 18 x 1 bed flats (2 persons) (10 leasehold) 15 x 1 bed bungalows (leasehold) 1 x 2 bed bungalow
Lift Assisted bath with hoist
Comment: I would put this in an Appendix – it doesn’t add to the main point of the text
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(manager) Rumsey Court Crowborough 3 x bedsits
46 x 1bed flats 4x1 bed bungalow 1x3 bed flat (manager)
Assisted bath with hoist walk in shower No lift
Evelyn Clark House
Forest Row 25 x bedsits 16 x 1 bed flats 1 x 2 bed flat (manager)
Walk in shower Lift
Wade Court Forest Row Being refurbished 14 x 1 bed flats
Elizabeth Court Hailsham 25 x bedsits 8 x 1 bed flats 1 x 2 bed flat (manager)
Walk in shower room Lift
Hampton House Hailsham 35 x 1 bed flats 1x 2 bed flat (10 leasehold)
Walk in shower Lift
Maryan Court Hailsham 22 x 1 bed flat 1 x 2 bed flat (5 leasehold) 1 x 2 bed flat (manager)
Assited bath with hoist Lift All flats have showers with seats
Mary Burfield Court/Newnham Way
Heathfield 37 x 1 bed flats (1 person) 13 x 1 bed flats (2 persons) 1 x 2 bed flat 12 x 2 bed bungalow 1 x 3 bed bungalow (manager)
Assisted bath with hoist walk in shower 2 x lifts
Cherry Tree Court/Hillside Drive
Horam 16 x 1 bed flats ( 1 person) 15 x 1 bed flats (2 persons) (9 leasehold) x 2 bed cottage 8 x 1 bed cottage 1 x 2 bed flat (manager)
Assisted bath with hoist walk in shower Lift
Joan Hughes Court
Polegate 46 x bedsits 23 x 1 bed flats (2 persons) 1 x 3 bed flat
Assisted bath with hoist walk in shower
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1 x 3 bed flat (manager)
Grants Hill House Uckfield 23 x bedsits 17 x 1 bed flats 1 x 2 bed flat 1 x 2 bed flat (manager)
Assisted bath with hoist walk in shower
Streatfeild House Uckfield 31 x bedsits 10 x 1 bed flats 1 x 2 bed flat 1 x 3 bed flat (manager)
Assisted bath with hoist walk in shower lift
Fazan Court Wadhurst 24 x 1 bed flats (2 persosn) 1 x 2 bed flat (manager)
Assisted bath with hoist walk in shower lift
Church Bailey Court
Westham 28 x 1 bed flats (1 person) 10 x 1 bed flats (2 persosn) 1 x 2 bed flat (16 leasehold) 1 x 3 bed flat (manager)
Assisted bath with hoist walk in shower 2 lifts
In addition to these sheltered units Wealden has access to and owns other units which are only available to people aged 55+. These include 30 council owned units in Uckfield (over 2 sites) which consist of 1 and 2 bed flats as well as 1 and 2 bed houses. There are also 20 units at Rotherfield consisting of 1 and 2 bed flats, bungalows and cottages. Data regarding RSL non sheltered units available to those aged 55+ should hopefully be available soon. Quality of Wealden District Council’s Stock
• 153 sheltered units owned and managed by WDC are bedsits or studios, with no separate bedrooms. One scheme has no lifts to upper floors, one only has a stairlift.
• Demand for housing units in some schemes, particularly those with bedsits, is low due to changing aspirations and they are often eventually let to people who have very few alternative options and are often not in particular housing need. Average void times in sheltered housing schemes are 6.02 weeks compared with 3.09 weeks for general needs housing. This is partly due to the lower demand for sheltered housing hence it is harder to let and also the time delays in arranging for older people to view vacancies.
The future of sheltered housing in Wealden In 2006 Wealden District Council commissioned independent consultants to undertake a review of Wealden’s sheltered housing stock. The purpose of the review was to look at the options available for sheltered housing and create a strategy that would ensure that Wealden District Council owned and managed stock and related services physically and financially fit for the future
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The recommendations of the initial review concluded that further investigation into the those 5 schemes containing bedsits was needed in order to ensure that they were capable of meeting the aspirations of older people in the future (future proofing). Secondly in light of the recognised need for Extra Care Housing further investigations into the provision of such a scheme in the Uckfield locality and a further extra care scheme at the very least in the south of the district was needed. Finally the housing options of the younger more mobile older people need to be explored further. Since the Sheltered Housing Review the decision has been made to decommission Towermill Place, Polegate which was failing to meet the aspirations of older people and due to a number of factors was not deemed viable for extra care or re-modelling. To date the decanting of residents continues. Work is currently underway to produce an action plan on how Wealden District Council will respond to the recommendations made in the review. Housing Associations Sheltered Stock, including other charitable and independent providers: Also in Wealden there are a number of units of rented sheltered housing that are owned and managed by housing associations and other charitable and independent providers, some of these providers are willing to accept people aged 55+. Attempts will be made to identify the number and types of units in the near future.
Landlord
Location of Scheme
Number of rented units
Number of shared ownership units
Anchor Housing Trust Hailsham 37 Studios, 11 one bed
flats and 1 two bed flat
Elizabeth de la WARR Withyham Hanover Housing Association Hailsham 24 one bed
flats 1 two bed flat
Moat Housing Society Crowborough 18 one bed flats
Raglan Housing Association Crowborough 40 one bed flats
St Mary Dower Trust Heathfield 12 flats Sussex Housing & Care Crowborough 19 one bed
flats 9 studio flats
7 two bed bungalows
Heathfield 20 one bed flats 2 two bed flats
Westham 33 one & two bed flats 6 two bed cottages
Mayfield 9 studios 19 one bed
flats
Uckfield & District Housing Uckfield 17 flats
Comment: Does this section need updating now the plan is agreed?
Comment: Again, I think the table should be an appendix
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Association Warbleton Housing Association
Rushlake Green
12 flats
Warden Housing Association Hailsham 30 one bed flats
Anchor Guardian Retirement Housing
Polegate 10 one bed bungalows 33 one bed
flats 17 two bed
flats
Crowborough 16 two bed bungalows
Thomas Scanlan Trust Uckfield 8 one bed flats 2 two bed flats11 two bed bungalows
Polegate 20 two bed bungalows
Condition of Non Council owned Social Housing As with the council’s housing stock, the self-contained flats in popular areas are in high demand, whilst those that share facilities or are located in outlying areas are harder to let. As social landlords are required to direct most of their resources to bringing up their properties to the Decent Homes standards by 2010 very little funding is left to remodel unpopular schemes. They will need to have clear business plans to ensure that resources concentrate on accommodation meeting current and future aspirations of older people. 5.2 Retirement Housing to buy In addition to the social rented and leasehold units available through social landlords there are properties that are built/owned by private organisations which can be purchased on the open market . Despite research into this area the true extent of the availability and location of such housing is unknown. This type of housing can take many forms including traditional sheltered housing described above, with a resident manager on site, community alarm service, laundry room, some also have guest rooms and gardens.
Comment: As a bove – put table in appendix. It detracts from the text
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Scheme Location
Scheme Name
Provider Unit nos Comments
Hailsham
Garrett Court
McCarthy &
Stone
30 – mix of one and two
bed flats
Retirement/sheltered housing which is
nearing completion
Hailsham
Southdown Court
Managed by Peverel
Management Services
32 units – mix of 1 and 2 bed
flats
Sheltered housing
Crowborough
tbc
McCarthy &
Stone
Approx 40
Plans in the pipeline to develop a scheme
near the centre of the Town
Heathfield Risingholme
Court McCarthy & Stone
46 one bed flats
Assisted Living Scheme which is
nearing completion
Heathfield
Parkside Managed by Peverel
2 one bed bungalows
3 6 two bed bungalows
4 9 one bed flats
Sheltered scheme
Heathfield Davenport Park
Managed by Peverel
45 one bed flats
Sheltered scheme
Uckfield Millington
Court Right To Manage
Company
41 apartments sheltered
Uckfield tbc McCarthy &
Stone 31 one bed
flats and 9 two bed flats
Assisted Living Scheme
Wadhurst
Crittles Court
English Courtyard
Association
21 houses and 8 flats – all two
and three bedrooms
Sheltered
One major private developer has traditionally built two kinds of models: sheltered schemes, with a scheme manager on site during normal working hours or Assisted Living Schemes which include an onsite restaurant and 24 hour on site resident manager. In addition to these services residents can buy in extra services that they may. require. A key requirement when developing new homes is that facilities are located within half a mile including access to public transport and shops. As well as the above schemes there are companies that offer leases for life where the occupier pays a sum for the lease of the property and can live there until they die (known as lifetime owners), once they die the ownership of the property reverts back to the company. Such companies allow older people to buy a property on the open market without the traditional services usually associated with retirement housing
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5.3 Other private housing
• 6.7% of older people in Wealden live in private rented housing. • 83.7% live in owner-occupied housing. • The highest numbers of older peole (65+) living in private rented
accommodation as at 2001 Census are in Hailsham (138 people), followed by Heathfield/Waldron (89 people) and Polegate (85 people).
Private housing including private rented sector:
• Around 29.4% of the stock (17,100) are non-decent mainly due to thermal comfort features (9,900 or 17%). In Wealden non decent dwellings are most assocaiated with pre 1919 poperties, the private sector, converted flats and also with occupiers on the lowest incomes and those in recepit of benefit.
• Non decency is also associated with heads of households aged 25 to 34 at 37.6% and 85+ at 38.2%
• Rural areas north and south have the highest rates of non decency by area • The highest rates of non decency is for households where the age of the head
of household is 85+ at 38.2%. • The overall rate of unfitness of 2.5% (1,440 dwellings) in the private sector
housing across Wealden is below the average in England (4.4%) As from April 2006 requires Local Authorities to address category 1 hazards. Category 1 hazards are associated with older dwellings, private rented sector and converted flats. There is also a clear association between low income households, households in receipt of benefits, residents with a disability and older heads of household.
• 1,100 dwelling, 1.9% of the private sector housing stock fail the Decent Homes Standard because they provide inadequate modern facilities. This is slightly above the national average of 1.6%.
• Fuel poverty is almost always associated with those residents on the lowest incomes. No households were found to be in fuel poverty where household incomes were above £15,000 per annum, only 140 dwellings where income was above £10,000 per annum and the remaining 3,160 (95.8%) were found where household incomes are below £10,00 per annum. This means the rate of fuel povery is 34% amongst those households on lowest incomes.
• Low income is most associated with the youngest and oldest heads of households. The greatest proportion of low income households are where the head of housing is over 85 years of age. With 58% of lone olders having incomes of less than £10,000, only 2% in the highest earning incomes of £30,000+.
• Interstingly, age of head of household by dwelling condition research shows that with the condition indicators only fuel poverty rates in dwellings occcupied by older heads of households is higher than the District average
• Tackling fuel poverty is a key target as it aids those residents most in need, as well as improving thermal comfort under the Decent Homes Standard. There are estimated to be 3,300 (5.7%) dwellings in fuel poverty within Wealden (national average is 11%). One of the greatest impacts in terms of reducing fuel poverty can be achieved by focusing on making energy efficiency improvements to dwellings with older heads of households .
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Housing Condition Indicator
Wealden Average
Over 65 age group
Category 1 Hazards 15.9% 15.7% Unfit 2.4% 1.5% In disrepair 10.3% 10.2% Fuel poverty 5.7% 7.8%
5.4 Care homes – Statutory sector There are substantial opportunities around Sheltered Housing for keeping people at home for longer rather than entering care unnecessarily. Nationally, it would appear from a number of studies that a significant number of those going into residential care could have entered Extra Care Housing. In a recent study (2003) by the Institute of Public Care (IPC) a small group (36) of older people who had entered residential care were surveyed to see how many could have gone into extra care housing. The key findings were:-
• 28 of the 36 (78%) had gone into residential care following a critical event. • Levels of informal care were high and formal care low prior to entering
residential care.
• Based on key considerations it was estimated that 11 (30%) people could have entered extra care at the time of going into a home and a further 13 (36%) could have entered extra care at the time of an earlier move.
• 31 people had already moved once from the family home. Peak times for
moving are often just after retirement and again around the age of 80 (from research by Dalley).
• Figures from Lewes and Wealden Assessment and Care Management Teams
indicate that nearly 30% of residential placements from residents of Lewes and Wealden are outside of the area. This disconnects older people from their communities and causes considerable difficulties for carers and friends due to transport limitations.
5.5 Adult Social care provision Adult Social care is currently reviewing all its Directly Provided Services. It current runs one Care Home for frail people (Gilda Crescent, Polegate) and one for people with dementia (Hookstead, Crowborough – see below) within the boundaries of Wealden DC. The future of both buildings will be reviewed during 2009 Following the closure of Ridgewood Rise Care Home and day centre, provision for older people with high level care needs was made at the Uckfield Club.
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Adult Social care has also obtained monies from the Private Finance Initiative to build a care home offering nursing care and respite on the site of its former Ridgewood Rise Home. Independent sector (October 2007)
No of residential places
No of residential places – (elderly mentally Infirm)
Older People- mental health (not dementia)
No of nursing home places
No of nursing home (elderly mentally Infirm)
558 124 40 191 +30520 30
Discussion with CSCI indicates that much of the local provision is not fit-for-purpose and that the cost of updating to requirements may force some owners out of the market in the next few years. More pressing, however is the likelihood of closures due to owner’s retirement and the rising price of property as home owners find more lucrative and less demanding rewards from selling the property to developers. In common with the national position, there is concern about the quality of the provision overall, particularly in areas of specialist care such as dementia. Staff recruitment is always a challenge and there is a high turnover (see Workforce issues). 5.6 Dementia services – statutory Hookstead 9 – bed respite facility for people with dementia (ESCC) and day centre. Sussex Partnership Trust Extended Older Peoples Mental Health team (evenings and weekends) 30 place day assessment for Older People with complex mental health needs (Sussex Partnership Trust). 5.7 Supporting People funded support services The Supporting People funded services in Wealden are largely a legacy of traditional models of service provision but there is scope for more creative commissioning in the future. Data as at June 2007 is as follows:- Wealden District Council Housing related - Older People Accommodation Based Service 821 48.4%Community or Social Alarm Service 30 1.8%Floating Support Service 146 8.6%Home Improvement Agency (HIA) 700 41.2%Total 1697 :0.0%
20 includes dual registered
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• Of the 1,697 units of support provided, 700 units are short term inputs of help with repairs, adaptations etc. either through the Home Improvement Agency, supplied to disabled and older people living in their own homes.
• The remainder are accommodation based all being provided in sheltered housing schemes.
• It is clear from the table that floating support provision is currently limited and so is the use of Community or Social Alarm Service
5.8 Other housing related support services Home Improvement Agency (HIA) In Wealden, the Home Improvement Agency is managed by Anchor Staying Put as a combined agency for the Wealden and Lewes District areas. It is funded by Supporting People, Adult Social care, Wealden District Council, Parish Councils and other charitable funding sources. The Core activity of the HIA is to provide a comprehensive service to help clients through the whole process of carrying out adaptation and repair works to their homes. This includes the provision of general and technical on-site advice and practical assistance, as well as help in identifying and securing funds (whether from private sources, from clients' own resources or from public sources). The agency also provides welfare benefits assessment and advice and provides practical assistance in obtaining funds from community care grants, savings, trusts, charities, loans, insurance, home equity and Local Authorities as appropriate. The current arrangements are under review as the contract with Anchor is due to expire in 2009. The review will focus on ensuring that a good and comprehensive value for money service is provided to clients. A service level agreement with Wealden targets the agency to dealing with 1000 enquiries per year and completing 240 core service work and 399 handyperson jobs. In 2006/7 the agency actually dealt with 1186 enquiries and completed 194 core service jobs and 428 handy person jobs. Home Repairs Assistance Wealden District Council provides grant assistance for private tenants and owner occupiers of up to £5,000 with priority given to those people of a pensionable age who receive an income related benefit. Home repairs grants typically include:
• securing the walls and roofs of a property from wind or rain, • protecting the residents from immediate danger • insulation, • replacement of lead pipes • repair to windows or doors, • minor disabled adaptations
Renovation Grants The Council provide to owner occupiers subject to conditions, renovation grants which are means tested, typical Renovation Grant will include essential work to an
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unfit property to make it fit for human habitation, including the provision of adequate thermal insulation as part of a general scheme of improvement and repair. Disabled Facilities Grants Disabled Facilities Grants are means tested grants administered by the Council. They are available to owner occupiers, those renting from a Housing Association or private landlord. The grant is mandatory for essential adaptations to give the disabled person better freedom of movement into and around their home and to access essential facilities within it. The Council also offer a similar service for its own tenants, with the majority of those requiring such works being those aged over retirement age. Assistive Technology The telecare service in East Sussex is available county-wide to all vulnerable adults. It comprises the provision, installation and maintenance of equipment plus a monitoring service and at this stage is fully funded by East Sussex County Council using the Preventative Technology Grant (PTG), although it is likely that a charging policy will be introduced after the expiration of the grant in April 2008. Telecare rollout commenced at the end of February 2007 with more wide spread implementation taking place since June 2007. Between April 2007 & end of June 2008 there have been 832 new telecare installations, bringing a cumulative total to over 1000 users, of which 87% are aged 65 or over. About 20% of installations have been to people living within Wealden District Council boundaries A sustainability plan will be developed during 2008/09 which will include a projection of the cost and resource implications of providing telecare post PTG; including any potential revenue gained from charging and any other possible revenue sources (e.g. partners, Supporting People etc). In addition to telecare activity, a pilot project is also underway to provide telehealth monitoring systems for patients within 2 main disease groups (Heart Failure and Chronic Obstructive Pulmonary Disease) in partnership with East Sussex Downs & Weald PCT (ESDWPCT) & Wealden & Eastbourne Lifeline (WEL). There are 41 patients enrolled in the programme; 29 patients with Heart Failure and 12 patients with COPD who will be monitored on a daily basis until the end of October 2009. The aim is to run the pilot as a preliminary to mainstreaming telehealth in the community on a long term basis. Lifeline The community alarm system is provided by WEL and is currently supporting 1000 people in the community. Within Wealden as at July 2007 the number of people receiving Adult Social care funded lifeline per 1000 population was highest in Polegate North at 7.00 per 1000 population, followed by Hailsham East at 5.30 and then Polegate South and Willingdon both at 4.40 per 1000 population. Overall 2.90 people per 1000 population in the Wealden District receive Adult Social Care funded lifeline compared to Lewes which is the highest at 3.50 and Hastings which is the lowest at 1.00 per 1000 population.
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5.9 Voluntary & Community activity Care for Carers: work to support all those people in East Sussex who look after sick or disabled relatives, friends, neighbours, partners or children in their own homes. There are an estimated 47,000 carers in East Sussex aged over 16; there are also an unknown number of 'young carers'– children and young people under the age of 18 who look after parents, grandparents, brothers or sisters. The main focus of their work is our Outreach Service. This is a home-visiting service where an Outreach Worker meets with the carer to identify their need for support services, information, social security benefits, etc, and then helps to arrange these. Among other services for carers provided are:
• A Back Protection Service to advise carers on safe ways of moving their disabled person
• Training courses and taster sessions to enable carers to access therapeutic activities and to learn new skills
Age Concern is the UK’s largest organisation working with and for older people: services offered include: • Information and advice which is a signposting service offering detailed
information and advice on issues such as finance, benefits, housing and residential care.
• Activities outside the home including day care, lunch clubs, outings, learning and leisure opportunities such as computer training
• Emotional and social support at homes: this is a befriending service, particularly aimed at those that are housebound, as well as advocacy and counselling services
• Personal care: which includes care at home such as help with bathing and dressing, foot care and hairdressing and the provision of mobility aims.
Meals in the community In East Sussex meals on wheels are available to older people and adults with a mental health problem or physical, sensory or learning disability. As at September 2008 there were 1677 people receiving such services in the District. Based on Wealden District ward data as at July 2007 the number of people currently receiving meals on wheels per 1000 of the adult population was highest in Polegate South at 6.60 per 1000 population followed by Polegate South at 4.50 per 1000 population. Again this is not surprising since these are the two wards with the highest concentrations of older people. Alzheimers Society Alzheimers Society offers a range of support, advice and social activities to carers and people living with dementia.
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5.10 Adult Social care At October 2007 all independent sector home care services in Wealden are provided under 6 block contract arrangements as follows:-
Block Provider Contracted Block Hours
Lewes & Uckfield Crystal Care 1100 Crowborough Care at Home 320 North Border Care at Home 300 Heathfield Wealden Community Care 235 Hailsham Wealden Community Care 575 Polegate Companions 560
For residential and nursing care it is intended to move from the current position whereby only 11% of beds are purchased on a block contract basis to 25% by next spring.
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6 Gaps Emerging from the Needs and Supply Data 6.1 Gaps in supply of specialist housing Affordable Retirement Housing It has become clear from the consultation with older people (see Section 2.4) that many of the affordable sheltered housing units will not meet the requirements of older people today because of the high number of bedsits available within the stock. The Housing Needs survey points out that the expectation of “children” of older people rarely accords with the wishes of their parents and the figure of 946 total (401 affordable) demand for sheltered housing units over five years must be regarded with extreme caution. The demand from 204 older person households who are currently registered for housing in Wealden is more telling but, again, the majority would not regard bedsit and studio accommodation as acceptable. Wealden therefore need to respond to these changes in reviewing the current supply of accommodation for older people. The Housing Needs survey identified that a relatively high proportion of older people in Wealden live in accommodation already suitable for their needs so whilst there may be an aspiration to move into specialist accommodation, the needs for moves may not be so high. The additional services highlighted by respondents highlighted as important advantages in sheltered housing could be made available to people living in their own homes. Although such measures would not meet the aspirations or needs of all customers who would otherwise seek to move to sheltered housing some could be met at least in part. Leasehold / shared ownership Leasehold/shared ownership can take two forms those owned by Councils and Housing Associations or those owned by private companies. Shared ownership is one way in which current owner occupiers could release equity from their homes and still afford service charges. This option primarily provided by Housing Associations allow a purchaser to buy a share of the property usually ranging from 25% to 75% with a rent payable on the unsold share. This option also offers the safety net of Housing Benefit on the rental portion of outgoings and allows people to leave wealth to their family whilst enjoying life in a more affluent state. The Council have been keen to promote shared ownership within its sheltered schemes and indeed such tenure diversifications has helped to pay towards the capital costs of remodelling sheltered schemes. In light of the sheltered housing review such approach is likely to be expanded and is welcomed as it helps to enhance mixed and balanced communities. Demand remains constant for leasehold sheltered units (flats and bungalows) with the size and location of the schemes influencing their desirability, with those nearest to accessible facilities more desirable.
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Empirical evidence in the private sector including the lack of vacancies on such schemes, highlights that there is a demand for leasehold schemes, and indeed Section 4.7 table 8 indicates an expressed demand for a total of 545 private market units over the next 5 years. However, older people on lower incomes may not consider these because of high and highly variable service charges, rather than because of the capital cost of purchase. Supporting People has taken the decision not to pay for charges on leasehold schemes, other than customers already receiving subsidy as legacy from 1st April 2003. This could make any significantly supported leasehold scheme even less affordable for many customers. Extra Care Housing There is no nationally agreed capacity planning formula for extra care housing, knowing the health indicators and caring patterns for the population is particularly important when considering developments such as extra care sheltered housing which cater for people who have care needs on a daily basis. Peter Fletcher in his report for East Sussex in 2000 suggested that as a minimum that a 10% shift away from residential care provision be used. Since 2001 extra care schemes have been developed nationally as a positive housing option for some older people. Wealden District Council have identified a Wealden owned site for an extra care scheme and work is under way to bring this forward.
Residential Care Peter Fletcher Associates used a 10% shift away from residential care provision on the basis that these people would be better placed in extra care housing. 6.2 Provision of suitable general needs housing for older people This Strategy has highlighted that older people want to remain in their own homes as long as possible before considering moving in homes that have been especially designed for older people whether it be sheltered/retirement housing, extra care or residential care. The Government have acknowledged this and Lifetime Homes, Lifetime Neighbourhoods sets out how older people can be helped to remain in their own homes as long as possible. One key feature of the strategy is around ensuring new homes meet lifetime homes standard:
• All public sector funded housing is to be built to Lifetime Homes Standard by 2011.
• Aspiration is that by 2013 all new homes will be built to Lifetime Homes Standard. Trends will be monitored and if actual and predicted take up are not sufficient to meet the needs of our future society; consideration will then be given to the need to regulate for Lifetime Homes in Part M of the Building Regulations.
• Take steps to increase the supply of inclusive and adaptable housing in all sectors, which are safe, high quality etc. Funding will continue to be given to
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the Academy of Sustainable Communities to raise awareness about the benefits of inclusive design and its practical application to homes.
• It is critically important for housing needs assessments to consider and plan for appropriate levels and provision of wheelchair standard housing. This should be considered within mixed tenure residential developments in locations with good access to amenities and services.
6.3 Gaps in support services Floating Support There is currently very limited floating support services for older people other than the Wealden and Eastbourne Lifeline service and short term input services for practical issues (such as adaptations). Things are changing recognising that support needs to be available to those regardless of their tenure whose housing meets their physical and social needs, but who have a need for advice, enabling and other support activities. Wealden District Council housing management service currently operates a Wealden Extended Support Services run from some of the sheltered schemes to residents living out in the community. As part of the sheltered housing review the provision of such outreach services to older people living in the community will be investigated further. In partnership with Supporting People ways of funding this service which would ideally be available on a needs rather than tenure basis will need to be explored. Floating support is particularly important in meeting the needs of older people being discharged from hospital after events that temporarily reduce mobility, to help them regain their confidence to do things for themselves. This could be a short term input which diminishes over time and is a rehabilitative rather than a caring function. This would contribute to the health and social care targets for early discharges and older people helped to live in the community. Other older people need longer term support with the facility to increase and decrease flexibly as circumstances change, possibly linked with Assistive Technology. The numbers of older people with a need for a floating support service are relatively unclear; no needs data currently exists that comprehensively assesses the level of need for support services, but it could reasonably be expected from supply data in other areas, that 10% of the population over 75 years old need support at least intermittently and either do not have that support available from family or friends, or feel they cannot ask. For Wealden this equates to 1,400 (2001 Census data) on a modest estimate, with numbers generally rising. Innovative models of support Other support needs largely consist of the expressed need for assistance with arranging repairs and adaptations as well as practical help with things like gardening. The Home Improvement Agency and the Handyperson service is clearly is a valuable service which with further funding has huge potential to expand. Respondents to the
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Housing Needs Survey particularly identified difficulties with maintenance and repairs, using facilities such as bathrooms and stairs as challenging their ability to cope in their homes. Ways of empowering older people as givers as well as users of support need to be developed. National models of support such as Homeshare and Keyring (a housing-based mutual support scheme currently aimed at people with learning disabilities) as well as extending the ESCC Adult Placement Scheme need further exploration. 6.4 Housing Advice Information and advice on housing and support options There is currently little comprehensive advice available on possible housing and support options, particularly for people likely to be self-funders of care. Recent consultations in Wealden and elsewhere across the county confirmed the value of providing this information, and Adult Social Care is currently working with its Older Peoples Forums to explore options for disseminating this information whilst involving older people themselves in this activity. A pilot scheme is also being developed by Adult Social Care to give housing and housing related advice to people making enquiries via Social Care Direct. Options for Elders from Black and Ethnic Minority Communities With the ageing of the current cohorts of members from different BME communities more work is required to explore their preferences for the future and ensure their inclusion in all the above developments.
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7 The Market Care home market As indicated earlier in this document, the aspirations of older people are changing with increasing demand and expectation of maintaining independence for as long as possible at home. This is supported by government targets. ESCC is currently under-performing in the area of reducing residential care admissions. ESCC currently has approximately 30% of the local market and this is likely to decline, except for residential and nursing care. It is hard to get a picture of how much the market is currently sustained by people moving into the district, but as more authorities develop local alternatives this flow is likely to increase as people move into Wealden to be closer to their families. Private retirement housing schemes The price of purchasing units on private schemes varies widely, depending on demand and what the market will bear. There are other “one-off” costs (besides the normal costs of purchasing any property) that might include having to buy the call system plus service charges which will vary depending on the property and services provided. It could be anticipated that for most people the majority of equity in current homes would be needed to meet the costs of purchase and moving home, leaving little to fund additional costs of service charges in such schemes and therefore most people will have to rely on the affordability of the running costs from their own pensions. However, the Housing Needs Survey indicates that 56.7% of older households have incomes of £10,000 per annum or less. House prices The table below shows the average property price by type in Wealden and compares it to the East Sussex averages. These prices are taken from the Land Registry for sales between January and March 2008. Detached Semi
Detached Terrace Flat/maisonette
Wealden £438,039 £240,927 £234,944 £147,836 East Sussex £369,949 £230,506 £203,203 £147,836 When comparing prices of private retirement housing prices vary with providers like McCarthy and Stone and English Courtyard Association at the higher end of the market and those managed by Peverel management Company being a more affordable option. Location of scheme
Provider Type of accommodation
Starting prices of homes
Garret Court, Hailsham
McCarthy & Stone
Retirement April 2007 £166,950 for a 1 bed
Risingholme McCarthy & Assisted Living £209,950 for a 1
Comment: Again, this needs to go in the appendix and may need prices amendment
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Court, Heathfield Stone bed Crittles Court, Wadhurst
English Courtyard Association
Retirement £349,500 2 bed cottage
Davenport, Heathfield
Managed by Peverel Management Company
Retirement As at March 2006 £79,000 for a 1 bed apartment
Parkside, Heathfield
Managed by Peverel Management Company
Retirement As at March 2006 £74,950 for a 1 bed flat and £124,950 for a 2 bed flat
Southdown Court, Hailsham
Managed by Peverel Management Company
Retirement As at March 2006 £114,000 for a 1 bed flat and £132,750 for a 2 bed flat
Figures based on latest sales figures from the internet for properties at these schemes. Affordability of these private retirement schemes is therefore clearly an issue for local people and it is likely that providers will rely on in-comers to the town to purchase many of their flats, especially since most advertise for their developments nationally. Not only do prospective purchasers need to consider the capital cost of purchasing retirement housing but there are also issues around long term financial planning in terms of the ongoing service charges. There is currently no data around the actual service charges costs in private schemes but anecdotal evidence from Older People’s Forums suggest that they can be very high. These ongoing costs must be borne by the owners since Supporting People no longer help to cover these costs and Housing Benefit also is not payable. It is therefore highly likely that significant savings will be needed in the long term. Extra Care market ESCC is currently market testing the potential interest in this specialist market as a result of being approached by a number of RSL and private providers in the past two or three years. At the time of writing (August 2008) there are 2 operational schemes in the county, with another in the process of being built. Planning permission has been granted for the first Extra Care scheme in Wealden District, to be sited in North Uckfield. A bid for funding will be submitted to the Housing Corporation in the autumn. Plans are under discussion to identify a further two sites for Extra Care developments in other parts of the county. Support Services market Due to limited Supporting People budgets in order to provide support services to new schemes it will be necessary that funding will have to be recycled from other schemes or savings made by renegotiation existing contracts. This will have an impact on the current market supply of support services to older people, but will hopefully ensure support is channelled to those that need it. Additionally on new schemes in order to try and reduce the impact of the revenue funding implications leasehold units will be considered, which may bring to the
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scheme people who will be able to pay for the services themselves without the reliance on Supporting People money. In addition there are support services offered by agencies like Anchor Staying Put (see section 5.8)
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8 Resources, Finances and Funding New affordable housing New housing requires some form of subsidy to make it affordable. This subsidy may be provided in the form of:
• Free or discounted land • Grant from the government or local authority • Contributions from a private developer
In many cases there will need to be a combination of these to make affordable housing financially viable. In some cases the inclusion of market housing for sale and/or shared ownership units will provide a capital receipt to the developer which will reduce the level of the loan needed to finance the development. Land costs generally represent around one third of the total cost of developing new housing. Where the Council is the land owner and they may make a strategic decision to reduce the price they ask for the land. As such since the provision of affordable housing is a corporate priority for Wealden where land is deemed to be suitable for the provision of such homes the Council will sell the land at a discounted price to one of its Registered Social Landlord (RSL) partners. Only 25% of the receipts from the sale of any land or property can be retained and used by Wealden District Council, unless the receipts are recycled for the provision of new housing or regeneration projects in which case 100% can be re-used. Therefore any proposals to sell housing assets needs to be assessed for their impact on housing needs in the District against competing needs and duties of the Council. Land is a valuable asset, not only in terms of its financial value on the market, but because of the difficulties there are identifying suitable land to meet community needs. Planning policies govern the use of particular areas of land and larger sites may be earmarked for particular uses. It is essential that specific needs relating to older people’s housing, such as retirement schemes and extra care, are flagged up so that suitable sites can be identified. Government funding is available to some developers through Housing Corporation arrangements. To date, these have entailed bidding through competitive bidding rounds, currently held every two years, but with a three year bidding round in 2007-10. In addition the Department of Health have separate pots available which they set aside for housing projects for Older People with an extra care scheme in Peacehaven (Lewes District Council) recently securing funding via this means. Wealden District Council has limited funding from its own capital receipts to subsidise schemes which meet its strategic priorities. The current annual pot set aside by the Council is £250,000. There are significant demands on this capital which in comparison with the cost of providing new homes is very small. A important form of subsidy can be provided through planning related (section 106) legal agreements made with developers as contributions to affordable housing development. To date no commuted sums have been accepted by the Council in lieu
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of affordable housing on site, however, the current Non Statutory Local Plan does set out situations in which this may occur. There is not currently in place any restrictions which ring-fence contributions from general needs or private housing for older people to the provision of new homes for older people, as a result the needs of such group would need to be balanced against the demand for other specialist accommodation and general needs housing when allocating such money. Private Sector Housing Previous tables show that nearly 90% all older people live in private sector homes, either as owner occupiers or private tenants. In 2007 Wealden District Council undertook a survey of the condition of private housing. This survey indicated that: • The cost to remedy all the items that make dwellings non decent is £58.7 million.
An average of £3,920 per non decent property. • Public Services Agreement 7 requires a reduction in non decent households
occupied by vulnerable people of 65% for 2005/06 and 70% for year end 2010/11. It is estimated that Wealden meets both of these targets
• In order to meet the 2020 target (Public Services Agreement 7) of making 75% of vulnerable occupied private dwellings decent, 300 dwellings would have to be made decent beyond the 2010 target and would cost an additional £1.2 million.
• The total requirement for comprehensive repair in all dwellings that fall under the repair criterion of the Decent Homes Standard is £12.8 million, an average of £2,140 per dwelling, to achieve comprehensive repair of these dwelling £58 million is required or £9,700 per dwelling. A large part of the demand for repairs is likely to come from households where income is below £10,000 per annum and where vulnerable occupiers live
Following the recent completion of this Private Stock Condition Survey Wealden need to determine it’s priority for actions. Wealden District Council have an annual budget set aside for private sector housing renewal in 2006/07 this stood at £350,000. Disabled Facilities Grants (DFG’s) The Government in Lifetime Homes, Lifetime Neighbourhoods highlighted the importance of DFG's in enabling older people to continue to remain in their own homes. DFG's are grants available frrom the Local Authority to help towards the cost of adapting sommeones home to enable them to continue to live there. In 2006/07 118 DFG’s were carried out, 27 to Council properties totalling £188,056 and 91 to other tenures including 81 to owner occupied properties, this work totalled £703,835. In addition to these works 90 minor adaptations were carried out totalling £32,500. As part of the Lifetime Homes, Lifetime Neighbourhoods Strategy the Government announced:
• Raising DFG budget by 20% taking the annual budget up to £146 million in 2008-09 and then in 2010-11 a budget of £166 million (31% increase).
• Raising maximum grant limit to £30,000 from April 2008.
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• Improve the means test – people claiming Council Tax Benefit, Housing Benefit and tax credits for those on low incomes will be fast tracked through the means test process as they will not be required to provide any further financial information in addition to these benefits.
• Access to garden from April 2008 will become a specific criterion for entitlement for the grant where it is reasonable and practicable.
• Changes will be made to the funding given to Local Athorities, including removing the need for Local Authorities to match the funded given by Government.
• Levying limited property charge – from April 2008 Local Authorities will be able to impose charges on adapted owner occupied properties where the cost of the DFG exceeds £5,000.
Funding is also available to improve the energy efficiency of private homes from the following schemes: Warm Front Warm Front, is a the central Government scheme providing grants of up to £2,700 (£4,000 for oil fired systems) for heating and insulation measures. Householders in receipt of a qualifying, means tested or disability related, benefit are eligible to apply. A total of 457 measures (heating, cavity wall and loft insulation) were installed in the Wealden District under the Warm Front scheme in 2006-2007. Ulitility Companies Utility Company schemes provide full and part-payment grants for loft and/or cavity wall insulation. 100% funding is available for those in receipt of a qualifying benefit and discounted rates are available for the able-to-pay sector. A total of 288 cavity wall and loft insulation measures were installed under The Heat Project scheme, managed by Enact Energy and a further 577 under HCL Energy in 2006-2007. Both these schemes are utility funded and Council endorsed. Home Repair Assistance Wealden District Council can also offer a Home Repair Assistance grant of up to £5,000 for owner occupiers in receipt of a qualifying income related benefit. This can be used to undertake repairs, adaptations, and improve the energy efficiency of a property. In addition, fuel poor households who do not meet the benefit eligibility and are unable to access other grant assistance schemes, can apply for Home Repair Assistance grant which, in 2005, was expanded to offer full grants for energy efficiency measures to applicants proven to be in fuel poverty. The Government in the Lifetime Homes, Lifetime Neighbourhoods Strategy pledged to introduce a new rapid repairs and adaptations service,to make it safer and easier for people to stay in their own homes with new national funding from 2009 to expand coverage of the handypersons services. Through work with health, local authorities and other partners delivery of handypersons will be linked into related services including falls and accident prevention, home security, fire safety, energy efficiency, adaptation and targeted health improvement. To ensure fair allocation to people and places in greatest need between 2009-11 funding will be made available through a local and regional development biding process
Comment: Needs to be linked to HIA review – Wealden has a different position I think
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Anchor Staying Put Anchor Staying Put (who are a registered charity) continues to be supported by Wealden and a number of other agencies to help older people stay in their own homes. The Handyperson Service remains extremely popular and successful and demand continues to grow (see 5.8). The service is part funded by Wealden District Council and East Sussex County Council Additionally in partnership with WDC, Age Concern and the Fire Brigade, Anchor continue to offer an electric blanket testing service. In Wealden The Home Improvement Agency is managed by Anchor Staying Put as a combined agency for the Wealden and Lewes District areas. The agency is funded by Supporting People, Adult Social Care, Wealden District Council, Parish Councils and other charitable funding sources. The Government in the Lifetime Homes, Lifetime Neighbourhoods Strategy highlighted that Home Improvement Agencies like Anchor Staying Put have not reached their potential and they made a pledge to the development of Home Improvement Agencies which is to be supported by new funding for a three year contract for a National Body for Home Improvement Agencies from 2008. At the time of finalising this Strategy (September 2008) Supporting People have commissioned consultants Foundations to undertake research on the provision of HIAs across the county. Additionally, Wealden District Council's own Community Scrutiny Committee in October 2008 will be undertaking a review of the working arrangements that the Council has with Anchor Staying Put. Equity Release For Owner Occupiers Equity release enables home owners to take out some of the value of their home to use for works to their home or for other purposes. There are many private companies which offer schemes currently. The Government in the Lifetime Homes, Lifetime Neighbourhoods Strategy highlighted that more needed to be done to promote and encourage the take up of equity release. The Government announced that through work with Government Offices and Regional Assemblies work would continue with local authorities, home improvement agencies and other agencies to expand the range of products and coverage of regional loans schemes for those who are unable to access financial products which are available in the market place. The long term aim of which is to reduce reliance on public funds. Supporting people resources The Supporting People Five Year Strategy which is currently being updated highlights the need to shift support from accommodation-based services to more generic floating support that can be available to anyone who needs it, regardless of tenure and locality. Whilst East Sussex Supporting People partnership might reasonably expect a large injection of additional funding based on the department of Communities and Local Government’s national distribution formula, the implementation of shifts from highly funded areas to those with relative under-funding is taking place much more slowly than originally anticipated, with an increase of just
65
1.75% in 2007/08 (East Sussex being just one of three areas in the South East to receive an uplift). Despite this increase and anticipation of a fairer distribution of resources across the Country it is anticipated that a decrease of 5% per annum thereafter is reasonable given being recent documentation. As such the five year financial plan is being adjusted in light of this, with contracts being re-negotiated to save money to deal with this. In effect, therefore, new services can only be planned on the basis of others being closed or re-designed to cost less, releasing funding. The intention is to redistribute limited resources to those in greatest need, irrespective of current tenure. Land Availability Adult Social Care is increasingly working corporately and with local councils to establish how council land – which may become available in future years due to changing priorities can be best utilised to address the new emerging agendas, such as the need for Extra Care Housing, whilst still meeting audit requirements for best value. Wealden District Council also have an asset management procedure to assess the best use of its existing land, one option is the possibility of selling off the land for private development or affordable housing. This process will also include an assessment of the suitability of the site for different types of housing including extra care. Workforce issues National and local demographics point to a shortage of care workers both now and in the foreseeable future as many current carers reach retirement and recruitment is low. Additionally, new models of support will require a different kind of skills mix which places more pressure on the independent sector to ensure that their employees have the correct training and backup.
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9 Partnerships A partnership approach has been taken to the development of extra care housing and the broader housing and support agenda over the past 4 years. This is set within a broad partnership context across Health, Housing (local authorities and LSVT partners) Adult Social Care and the Independent Sector. This partnership approach to housing and support will be re-enforced through the implementation of the Joint Commissioning Strategy for Older People . The Locality based housing groups have a wide membership which includes a range of local partners from the statutory, independent and voluntary sectors. The importance of effective partnership working in the development of this agenda cannot be stressed enough. It is recognised that no one agency is in a position to develop this agenda. Expertise and resources need to be shared. It is likely that further work needs to be undertaken on reviewing partnership arrangements through partnership agreements or an equivalent mechanism where new Extra Care / housing and support developments are initiated. These will be in line with Partnership Arrangements for all agencies. Key Actions – see Action Plan below Monitoring arrangements The implementation of this strategy will be overseen by a Lewes, Wealden and Eastbourne Implementation Group which will report to the County Older Peoples Housing and Support group and the East Sussex County Strategic Forum.
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10 ACTION PLAN: 2007-12
To follow
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11 GLOSSARY
Assistive Technology (see also Telecare) – equipment which enables vulnerable individuals to improve the way they carry out daily living tasks. Capacity Planning – building networks aimed at community control of the decisions that affect them. Carer - a person aged 16 or over who provides or intends to provide a substantial amount of care on a regular basis for an adult or a disabled child, but excluding anyone who is paid for caring or who works as a carer on an unpaid basis for a voluntary organisation. Commissioning – activities assessing needs, purchasing provision to meet those needs and evaluating the services purchased. Delayed Discharge – people who could be discharged from hospital but are unable to leave as a result of a lack of health or social care resources. Domiciliary Care – help in the home – practical or personal care. Equality impact assessment – a way of systematically assessing and consulting on a proposed policy on people, focusing on the impact on different racial groups (definition from the Commission for Racial Equality). Equity release schemes – ways for owner occupiers to turn the value of their property into cash. ExtraCare Housing - a concept rather than a housing type covering a range of specialist housing models. Can include projects of different sizes and tenures. The emphasis is on independence in a safe, secure environment enhanced by good design features enabling people to age in place. Floating support - a housing related support service that is not tied to any specific accommodation (can include support to owner occupiers). HIA – home improvement agency, often also known as ‘Care & Repair’ services. These are floating support services available across different tenures designed to enable people to remain in their own homes for as long as they wish and to promote independent living. HIA services are usually around practical support – such as maintenance and adaptations – but can also provide services such as advice, advocacy and signposting to other services. Housing Association – a non-profit making organisation providing affordable housing. (see also RSLs) Housing Corporation – a non-departmental public body, sponsored by the Office of the Deputy Prime Minister (ODPM), whose role is to register, regulate and fund RSLs (see below) in England. Housing (related) support – supported services which are provided to any person for the purpose of developing that person’s capacity to live independently in accommodation or sustaining his capacity to do so. Intermediate Care - short-term treatment in the community for people leaving hospital or to prevent them from having to be an inpatient. LDF – Local development framework – a key planning document bringing together a range of local planning documents to assist coherent planning and enable local communities to contribute to local developments by providing one source of information. Lifetime Homes – homes which reach 16 quality design standards which make homes suitable for occupation by people with disabilities. Limiting Long-term Illness (LLTI) – a long-term illness, health problem or disability which limits daily activities or work a person can do (2001 Census). Local Area Agreement (LAA) - agreements between Government and local public sector organisations on local priorities and targets.
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Mixed Tenure – an area of housing consisting of a mix of different tenures, normally social rented housing and privately owned housing. PCT – Primary Care Trust - Preventive Technology Grant – government funding to develop Telecare and Assistive Technology (see below for Telecare). Registered Social Landlords (RSL) - an organisation registered with the Housing Corporation as a housing association. Residential Care – 24 hour group care. Self-funders – people whose income are above a level making them eligible for state support (currently £12,000 – March 2006). Sheltered Housing – rented or leasehold housing, usually for older people, with an onsite manager. SITREP (situation report) – a weekly snapshot of patients whose hospital discharge has been delayed for health and/or social care reasons. Social Inclusion – ensuring that projects/proposals can reach people who suffer from a combination of linked problems such as unemployment, low incomes, poor housing, old age, disability. Social Rented accommodation – subsidised housing provided by local authorities or RSLs. Super Output Area – a new geography for the collection and publication of small area statistics (the Department of Work and Pensions). Supporting People – a programme to deliver housing-related support services to vulnerable people through a single funding stream, administered by local authorities according to the needs of people in their area. Sustainable communities – places where people want to live and work, now and in the future. They provide a high quality of life, are safe and inclusive, well planned, built and run. Sustainable Development – balancing environmental, social and economic needs in a way that can be carried on for future generations. Telecare – use of a combination of modern technological devices to provide a means of signalling need for assistance to a centralised service centre which can then deliver or arrange an appropriate care response. Telemedicine - is the term used for the delivery of medicine at a distance. Telemedicine may be as simple as two health professionals discussing a case over the telephone, or as complex as using satellite technology and video-conferencing equipment to conduct a real-time consultation between medical specialists in two different countries.
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APPENDIX 1: KEY POLICY DOCUMENTS
• Planning and Compulsory Purchase 2004 Act (OPDM 2004) • Sustainable Communities: Homes for All (ODPM 2005)
• Lifetime Homes, Lifetime Neighbourhoods (CLG 2008)
• Our Health, Our Care, Our Say: A New Direction for Community Services (
DH 2006)
• Putting People First (DC 2007)
• Draft National Dementia Strategy (DH 2008)
• Everybody’s Business: Integrating Mental Health Services for Older People (CSIP 2005)
• A Sure Start to Later life (Social Exclusion Unit 2006)
• Developing and Implementing Local Extra Care Strategies (Department of
Health 2003)
• 20/20 A vision for the Housing and Care (Research report by National Older People’s Housing Stakeholders – 2005)
• Delivering housing for an ageing population: Informing housing strategies and
planning policies (HOPDEV Housing and Older People Development Group 2005)
• Life Chances for Disabled People (DH 2005)
• Preparing Older People’s Strategies: Linking Housing to Health, Social Care
and other Local Strategies (ODPM 2000/2001)
• South East Regional Housing Strategy, 2006 onwards (South East Regional Housing Board, GOSE 2005)
• Draft SE Plan (SEERA 2005)
• National Service Framework: Long-term Conditions (Department of Health
2005)
• Securing Good Social Care for Older People :Taking a Long Term View (Wanless Report 2006)
• Opening Doors to Independence: a longitudinal study exploring the
contribution of Extra Care housing to the care and support of older people with dementia (Housing Corporation/Housing 21 2006)
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Appendix 2: The Sussex Coast Sub-Region as defined by the principal authorities. The main coastal towns covered by the strategy are all shown in light blue shading. Different colours (for each district) are used to show other wards included in the sub-region.
Eastern Rother
Crowhurst
Marsham
Ouse Valley& Ringmer
Kingston
Helling ly
Alfris ton
Herstmonceux
EastDean
Pevensey &Westham
Ninf ield & Hooewith Wartling
5
© Crown CopyrightAll rights reservedEast Sus sex County CouncilLA076600, 2004
FuntingtonBoxgrove
LavantWestbourne
Sou
t hb o
u rn e
Bosham
Do n
n in g
ton
Sidlesham
NorthMundham
Barnham
Yapton
Tangmere
WalbertonFindon
Annex 1 - Map of the Sussex Coast Sub-regionWards included in the sub-region as defined by the principal authorities.
indicative boundary as drawn by SEERA in the strategy brief.
Chichester
Horsham
Arun
Rother
MidSussex
Crawley
Worthing
Adur Brighton & Hove
Lewes
Wealden
Eastbourne
Hastings
West Wit tering
EastWit tering
Selsey
Nort
h
SelseySouthCHICHESTER
1. Chichester East2. Chichester North3. Chichester South4. Chichester W est5. Fishbourne
12
35
4
Pagham
& Rose G
reen
Bersted
12
610
7
11
121314
ARUN1. Aldwick East2. Aldwick W est3. Beach4. Brookfield5. East Preston with Kingston6. Felpham East7. Felpham West8. Ferring9. Ham10. Hotham11. Marine12. Middleton-on-Sea13. Orchard14. Pevensey15. River16. Rustington East17. Rustington W est18. Wick & Toddington
1413
1211 10
9
87
6
43
2
1
1312
11
9
8 76
54
32
1
BRIGHTON & HOVE1. Brunswick & Adelaide2. Central Hove3. East Brighton4. Goldsmid5. Hangleton & Knoll6. Hanover & Elm Grove7. Hollingbury & Stanmer8. Moulsecoomb & Bevendean9. North Portslade10. Patcham11. Preston Park12. Queen's Park13. Regency14. Rottingdean Coastal15. South Portslade16. St. Peter's & North Laine17. Stanford18. Westbourne19. Wish20. Withdean21. Woodingdean
12 34
5
6
89
10
11
121314
161819
20
21Angmering
34 89
1516
17
18
WORTHING1. Broadwater2. Castle3. Central4. Durrington5. Gaisford6. Goring7. Heene8. Marine9. Northbrook10. Offington11. Salvington12. Selden13. Tarring
ADUR1. Buckingham2. Churchill3. Cokeham4. Eastbrook5. Hillside6. Manor7. Marine8. Mash Barn9. Peverel10. St. Mary's11. St. Nicolas12. Southlands13. Southwick Green14. Widewater
510
54
123
4
56
78
9
HASTINGS1. Ashdown2. Baird3. Braybrooke4. Castle5. Central St. Leonards6. Conquest7. Gensing8. Hollington9. Maze Hill10. Old Hastings11. Ore12. St. Helens13. Silverhill14. Tressell15. West St. Leonards16. Wishing Tree
2
3
6
7
8
910
11
4
121314
16
15
EASTBOURNE1. Devonshire2. Hampden Park3. Langney4. Meads5. Old Town6. Ratton7. St. Anthony's8. Sovereign9. Upperton
1
23
4
5
6 7 8
9
LEWES1. Lewes Bridge2. Lewes Castle3. Lewes Priory4. East Saltdean & Telscombe Clif fs5. Newhaven Denton and Meeching6. Newhaven Valley7. Peacehaven East8. Peacehaven North9. Peacehaven W est10. Seaford Central11. Seaford East12. Seaford North13. Seaford South14. Seaford W est
4 8
9 76
5 1410
12
1113
Will in
gdon
1
23
4
5
Rye
ROTHER1. Central2. Collington3. Kewhurst4. Old Town5. Sackville6. St. Marks7. St. Michaels8. St. Stephens9. Sidley
WEALDEN1. Hailsham Central & North2. Hailsham East3. Hailsham South & W est4. Polegate North5. Polegate South
1517
123
1
Arundel
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APPENDIX 2: NEEDS OF OLDER PEOPLE LIVING IN RURAL PARISHES IN WEALDEN
Ret
irem
ent
Hou
sing
Ow
ner
occu
patio
n
HA
/LA
rent
ed
Shar
ed
owne
rshi
p
Priv
ate
rent
ed
Self
Bui
ld
Shel
tere
d H
ousi
ng
Due
to a
di
sabi
lity
Ow
ner
occu
patio
n
HA
/LA
Ren
ted
Shar
ed
Ow
ners
hip
Priv
ate
Ren
ted
Self
Bui
ld
Sche
me
Man
ager
A
ssis
ted
Hou
sing
Emer
genc
y C
are
Ala
rm
Dai
ly/re
gula
r vi
sits
Ada
ptat
ions
Alfriston 2 1 1 1 0 0 4 1 1 1 0 3 0 1 0 Alciston 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Berwick 0 0 0 0 0 0 1 0 1 0 1 2 1 0 0 Buxted 15 7 7 1 0 1 2 0 2 0 1 10 8 6 6 Chalvington & Ripe
6 1 4 0 0 0 3 0 2 1 0 5 1 2 0
Chiddingly 2 2 1 0 0 0 0 0 0 0 0 2 0 0 0 Cuckmere Valley 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Danehill 4 4 0 0 0 0 0 0 0 0 0 8 3 2 0 Hellingly 3 1 2 1 0 0 2 2 1 0 0 4 1 3 0 East Hoathly & Halland
2 2 0 0 0 0 2 0 2 0 0 0 2 3 0
Fletching 3 2 1 1 0 1 2 1 1 Forest Row 20 14 5 0 1 0 5 2 3 0 0 0 14 5 8 8 Framfield 7 5 2 0 0 0 4 3 1 3 1 3 Frant 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 Hadlow Down 6 4 2 0 1 0 2 2 0 0 0 0 3 1 5 2 Hartfield 6 4 2 1 0 0 2 2 3 1 5 1 Heathfield 16 9 8 1 0 0 9 2 4 1 1 0 19 7 18 5 Hellingly 3 3 0 0 0 0 1 1 0 0 0 0 2 1 5 1 Herstmonceux 4 1 1 1 0 0 2 1 1 0 0 0 5 2 3 2 Hooe 0 0 0 0 0 0 0 Horam 1 0 1 0 0 0 7 3 2 2 1 0 6 2 7 5 Isfield 0 0 0 0 0 0 0 0 0 0 0 0 2 1
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Jevington 0 0 0 0 0 0 0 0 Laughton 2 2 0 1 0 1 1 Little Horsted 0 Long Man 1 1 1 0 3 Maresfield 8 7 1 0 8 0 6 2 Mayfield & Five Ashes
10 4 6 1 0 0 7 4 4 11 1 5 2
Ninfield 3 1 2 0 3 1 2 2 Pevensey 12 8 4 3 1 0 7 5 3 1 10 5 10 5 Rotherfield 8 3 4 1 0 1 4 2 7 2 Selmeston 0 Wadhurst 11 7 2 7 2 5 5 8 13 7 Warbleton 6 3 3 2 1 3 0 6 0 Wartling 0 0 2 Westham 11 5 6 2 1 0 4 0 4 9 6 5 5 Withyham 7 1 5 1 1 0 2 2 3 2 5 1
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APPENDIX 3 – ETHNICITY IN WEALDEN
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APPENDIX 4 – Activities in Wealden Sheltered Schemes
In addition to the usual weekly coffee mornings and other resident led social get-togethers, birthday parties etc. Below is a list of activities for 2007/2008
Scheme Name Activities Buxted Court Arts + craft group, weekly; Short mat
bowls, weekly Cherry Tree Court Arts + crafts group, weekly; church
service monthly; trips to lunches out, shopping trips (monthly), etc.
Church Bailey Court French conversation group, weekly; Bingo, weekly; Exercise classes weekly; Chiropodist x 6wks; Cards + games nights weekly; numerous excursions
Elizabeth Court Grangemead Reminiscence Group, run by MH team, weekly; Town Farm Over-50s club, weekly; Craft + musical demonstrations regularly
Evelyn Clarke / Wade Court Tai Chi weekly; excursions; lunches out
Fazan Court Yoga classes for the disabled, weekly; Residents’ association meetings, monthly
Grants Hill House Fashion shows, twice monthly; Bingo, weekly; Short mat bowls, weekly; Monthly live music afternoons; local school choir visits every two months
Hampton House / Maryan Court Leg club weekly; Radio ham lessons +examinations; Red Cross annual meetings; Extend chair-based exercise class weekly
Joan Hughes Court Hearing Support Group, weekly; Basic computer classes weekly; Crossroad Carers support group, weekly; Friendship Circle, weekly;
Mary Burfield Court chi, weekly; short mat bowls, weekly; chair-based exercises, weekly; Darts, weekly
Rumsey Court Arts group, weekly; Bingo evenings, weekly; Darts, weekly;
Streatfeild House Gardening club + allotment; arts + crafts club;