Nottingham Insight

Introduction

Everyone is potentially at risk from the effects of poor housing conditions. However, children, older people and those with chronic health problems are especially susceptible. There is clear evidence to link poor health with poor housing; for example the link between poorly heated accommodation and high blood pressure or circulatory problems in elderly occupiers; and a raised level of asthma and other respiratory conditions in children living in damp housing with high levels of mould growth.
A major current priority for Nottingham City is to withstand the effects of the downturn and to channel efforts into activity that creates employment and leads to economic growth. For housing partners this means making the best possible use of the opportunities for delivering new housing, improving existing housing, supporting those people left most vulnerable by the downturn and ensuring that services are delivered in an efficient and effective manner, leading to the improvement of neighbourhoods.
Given the cross cutting nature of housing there are links between this chapter and several others covered elsewhere in the JNSA: Homelessness, domestic violence, asylum seekers and refugees, adults with physical and learning disabilities, mental health, students and falls.
Also there is a link to Nottingham City Council’s Vulnerable Adults Plan 2011 - 2014 relating to Supported Housing Services. 

Key issues and gaps

The three year plan of the Nottingham Housing Strategic Partnership 2013-2015 has the following aims: 

• have a balanced housing market which offers a range of homes and tenures which meet citizens’ varied needs and choices.
• provide a housing offer which makes people want to work and live in the city, particularly aspiring working households.
• have housing to be of a good quality and standard so that it promotes better citizen health and wellbeing and supports our children to thrive and succeed.
• have citizens with a range of needs to be able to access and live in good quality appropriate housing so that they can achieve their ambitions to live as independently as possible and make a contribution.

Much remains to be achieved to improve housing standards and the existing housing offer, particularly in the private rented sector which is becoming the tenure of the future. Also addressing Specialist Housing Needs is important because the needs of vulnerable people come to the fore at a time of economic downturn. Increasing Housing’s contribution in our neighbourhoods remains a priority because we need to work more efficiently in our neighbourhoods to make them more attractive and make them more resilient to negative impacts of the recession.

The Supply of New Homes is important because:-

• There is evidenced need for additional housing
• The city’s housing offer needs to be improved to make it a more attractive location for employers and retain aspiring residents
• Housing development will aid economic growth
• Housing development will help achieve regeneration objectives

Improving Housing standards is important because:-

• It is vital that the best possible use is made of existing housing stock – it is more cost effective and sustainable than building new homes.
• There is a need to reduce the fuel bills of citizens on lower incomes and to cut carbon emissions: retrofit energy efficiency measures to existing homes are the most significant way of doing both.
• The existing stock across all tenures needs to be kept in a good state of repair in order to prevent it becoming a larger, longer- term problem, to which the only solution is major regeneration.
• The private rented sector is growing in importance in the housing market; with this comes a need to raise standards in the sector to meet tenant expectations.
• The private rented sector will expand as a source of accommodation through which homelessness duties will be fulfilled; this and its role as a quality. housing solution brings a need to work with the sector to improve standards
• Some of the poorest housing conditions are experienced by the most vulnerable people in the city: by tackling poor housing a major contribution to other aspects of citizen wellbeing is made.
• Improving housing conditions helps to improve health and reduces the call on resources from health services.
• Empty homes are a wasted resource and can be a source of significant nuisance to people living close by them.

Addressing Specialist Housing Needs and Support is important because:-

• Nottingham is a City with high levels of deprivation.
• Local demographics are changing with the population ageing and numbers of vulnerable people increasing. This increase will impact on the number of physically disabled people in unsuitable accommodation with unmet needs.
• A reduction in the Supporting People element of the Local Authority Formula Grant has led to a reduction in the supported accommodation provision in the City and the loss of a number of services which support vulnerable people to live independently.
• Changes to government policy, particularly elements of the Welfare Reform
Act, and Localism Act impact on vulnerable people disproportionately.
• The effects of the recession also impact disproportionately on the vulnerable
and the homeless and push more people towards reliance on local services
to offer them advice, assistance and support in meeting their housing needs.
• The Health and Social Care Act 2012 confers new responsibilities on local authorities t commission health improvement services to improve the health of their citizens. Specific outcomes include the monitoring of the percentage of adults with mental health problems and learning disability in settled accommodation and the number of households who become homeless.

The increase in the aging population present the following housing issues:-

• We know that the majority of older people want to remain living independently in their own home; this will require additional support services available to all.
• Older people will need repairs and adaptations to their homes to assist them to live independently and prevent them going into care.
• Making the best use of our existing housing stock will be a challenge, terraced properties are difficult to adapt and access upstairs is often problematic.
• We will see an increase in the numbers of people requiring assistance to maintain their home and garden.
• Changes to the way we advise and support people must be tailored to suit the individual needs of older people and must link with other advice services to ensure people are aware of all their options.

Recommendations for consideration by commissioners

1. Take integrated work further to ensure customers that are common to all services only have to engage once, to open the door to all services they require. For example socially isolated people are likely to engage with GP services and related community health professional that may have and illness linked to issues with poor housing standards and affordable warmth.
2. To enable a truly integrated offer for older people whereby an individual can purchase in one step a full package of domiciliary care, housing repair, adaptations and telecare services they need rather than a separately assessed and costed collection of services. The offer may involve the use of :-
• Our Home Improvement Agency as a single point of contact providing advice and information about the options available for self-funders with individual budgets.
• A single assessment process which can identify the nature and level of support required.
• The delivery and housing repair and adaptation with domiciliary care staff.
• Sharing the risks and rewards between statutory services and providers to deliver more for less.

Such integration offers the potential for better and personalised services for individuals. Both housing and care staff are trained to consider the impacts and interconnections of housing conditions and care needs, to enable more effective solutions, (enabling a swift response to repairs which may cause trip hazards, installing minor adaptations and tackling heating problems). This enables a preventative approach that can offer savings e.g. by preventing hospitalisation. The integrated care model could mean that care and housing staff operate as one team with joint appointments.

3. Further develop and integrate into other services, preventative housing services that have an impact on residents' health and prevent hospital admissions. These services may include:

• Home Improvement Agency,
• Handyperson Service,
• Healthy Housing Referral Project
• Adaptations Agency
• Home Safety Service

Graham De Max, Partnership and Policy Manager, Housing Strategy, Nottingham City Council, Graham.demax@nottinghamcity.gov.uk 
Nigel Tandy, Policy Analyst, Housing Strategy, Nottingham City Council,
Nigel.tandy@nottinghamcity.gov.uk