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Participants - 17^th July 2018:

Emma Dent Coad – MP Kensington and Chelsea and Round Table Chair

Andy Shipley- Policy Manager, Aspire

Angus Cleary – Inquiry Head, Equality and Human Rights Commission

Helen Rowbottom   – Policy Officer, National Housing Federation

Tansy Hutchinson – Women and Equality Select Committee

Jacquel Runnalls – Housing Occupational Therapist, London Borough of Waltham Forest and

Royal College of Occupational Therapist’s Specialist Section in Housing’s Co-opted Lead in Access & Inclusive Design 

Clare Goodridge – Inclusive Design Officer, London Borough of Islington.

Christopher Holley – Chief Executive Officer, Harrow Churches Housing Association.

Christina McGill – Head of Communications, Habinteg.

Darryl Smith – Policy Officer, Chief Executive’s Office, Bradford City Council.

Anabel Osborne – Senior Adviser, Design Council CABE

Lucy Seymour-Bowdery – Senior Planning Officer, Ministry of Housing, Communities and Local Government.

 

Introduction

For nearly 20 years, Aspire’s Housing Programmee has been supporting people with spinal cord injuries by providing fully accessible temporary housing and the help they need to secure permanent suitable homes.  However, for all its housing team’s dedicated work, Aspire cannot meet demand and every year hundreds of people with Spinal Cord Injury are forced into inappropriate accommodation.   

In 2012 Aspire published research revealing that due to the lack of suitable wheelchair accessible housing 20% of people with Spinal Cord Injury are actually discharged into care homes for older people and other institutionalised settings.  Further research, undertaken by Loughborough University in 2013, exposed the real impact on spinal injured people living under such circumstances.  The report, Understanding the Health and Wellbeing of Spinal Cord Injured Adults in a Care Home, established that people with spinal cord injuries experience severely detrimental effects on their physical and psychological health, directly attributable to their living conditions. In 2016 Aspire published independent research revealing what the picture looks like for the 80% of people with Spinal Cord Injury not discharged into care homes.  Also conducted by Loughborough University, The Health and Wellbeing of Spinal Cord Injured Adults and the Family: Examining Lives in Adapted and Un-adapted Homes, shows the significant physical and psychological impact that living in both types of property has upon the lives of people with spinal cord injuries and their households. For those fortunate enough to be discharged into a wheelchair accessible home, or to have their own homes adapted, their housing enabled them to take care of themselves, to be able to move freely around the home, to pursue leisure and employment opportunities, and to maintain personal dignity. Life in an inaccessible home however, was found to prevent people with spinal cord injuries from undertaking basic activities, often confining them to one room for extended periods, negatively impacting upon their physical health, psychological wellbeing and contributing to the deterioration of family life.

On 11^th May 2018 the Equality and Human Rights Commission published the findings of its inquiry into housing and disability. The report ‘Housing and disabled people: Britain’s hidden crisis’, reveals “a chronic shortage of accessible homes” and the continuing failure to respond to the unmet housing needs of 365,000 disabled people.  It identifies that “Building regulations in England, Wales and, until recently, Scotland have produced houses that are generally inaccessible, particularly for people who use wheelchairs.” The result is that, “in England only seven per cent of homes offer minimal accessibility features” (DCLG, 2015).  The inquiry also found that the systems used to identify disabled people’s requirements and deliver accessible houses are “weak”.

Few local authorities across Britain set targets for accessible housing and many reported that developers are reluctant to build accessible homes. Where authorities do set a percentage target the average proportion of new homes required to be accessible and adaptable was around four in 10 (44%) and only 5% for wheelchair-accessible housing.

Aspire has also recently undertaken research looking at how people in England requiring a wheelchair accessible home can expect to fare.  Our Freedom of Information request to English local authorities enquired how many people are currently on the waiting list for a wheelchair accessible home and how many wheelchair accessible homes have been allocated in the last three years, and found that the story is one of stark extremes.  When we calculated the average waiting time from the number of people waiting and the annual allocation rate, we found that in some local authorities the projected wait for a wheelchair accessible home is a matter of months, but in others, projected waiting times are over five years and in some cases decades. Of those authorities who gave us data for the full period, 12.6% have waiting times of more than twenty years, 23% more than ten years, 35.7% more than seven years and 43.6% more than five years. 

The EHRC’s report is the latest in a series of inquiries to have identified that a crisis in the supply of accessible housing exists and called for government action to address this.

Since 2015, four Parliamentary Select committees have expressed concern about the challenges that disabled people face when trying to find a home that meets their access requirements and made specific recommendations for government action.  

The aim of the round table was to bring together a range of stakeholders and experts in a Parliamentary setting, to consider the latest evidence and offer recommendations for action that might have a significant impact on the supply of accessible housing and the experience of disabled people looking for a suitable home.

Opening remarks and introductions.

In her opening remarks as Chair, Emma expressed her particular interest in the need for more accessible housing. Speaking from her experience as MP and Councillor for the Royal Borough of Kensington and Chelsea (RBKC), Emma shared her concern about the lack of understanding of the need for accessible homes, describing how, to her knowledge, little consideration had been given to the accessibility of the 300 new homes purchased by RBKC to rehouse households affected by the Grenfell Tower fire. Emma reported that 30 households from Grenfell Tower are in need of accessible homes.     

Participants then introduced themselves and each read out a quote from cards circulated by Aspire, containing the verbatim testimony of people with Spinal Cord Injury, describing the effects of living in inaccessible or accessible housing.

Increasing the supply of accessible homes

Angus Cleary shared findings and recommendations from the EHRC’s inquiry.  Reflecting on the current way we plan for accessible homes, Angus observed that the simplest way of providing the accessible homes we need would be to make it a minimum requirement of building regulations.  The UK government seems to have taken the complicated approach.  Given the clear evidence of need revealed by the EHRC and Aspire’s research, as well as previous studies and Parliamentary Select Committee inquiries Angus questioned why aren’t accessible homes being built? 

Participants felt that the principle reason for the low numbers of new accessible homes being delivered is the dominance of volume developers in the housing market and their resistance to the introduction of policies and standards that they believe will impact on their business model. The point was made that rather than adopting standards that would see the design of general needs housing being future-proofed to meet the changing needs of our diverse and aging society, it appears that the commercial response to this challenge is to create greater market segmentation in the form of an increasing array of specialist products, such as retirement housing, starter homes or ‘pocket living.’  

The nature of the current planning system seems to also militate against developers seeking to deliver more accessible housing.  We heard from one attendee how the additional cost attached to obtaining planning consent for accessible housing schemes, as opposed to high density standard housing developments, can be prohibitive with some local authorities.

It was also felt that too much of the burden currently falls on the local authority. This is not only in terms of the resources required to develop the evidence base to justify accessible homes targets, but also having to defend the position when challenged by developers.  This at a time when local planning departments are experiencing diminishing capacity and dwindling resources. Evidence obtained by the EHRC inquiry indicates that smaller local authorities struggle to undertake the necessary work that is required to support the adoption of accessible housing targets in their areas.   Conversely, the volume developers possess abundant financial resources and have a wealth of planning and legal expertise at their disposal to challenge local authorities. Essentially out-gunning them.

On a positive note however, engagement between the EHRC and the National Planning Inspectorate has resulted in a shift in attitude towards the inspectorate’s responsibilities under the Public Sector Equality Duty.  Where currently local authorities would typically remove accessible housing policies from local plans where they hadn’t been justified, going forward, the emphasis from the Planning Inspectorate will be for authorities to justify why accessible housing policies are absent from local plans.

It was also felt to be difficult to understand why publically funded development, such as that supported through Homes England, wouldn’t be seeking to achieve best value for the public purse across the board by investing in housing that enables people to live more independently. This would reduce the strain upon already over-stretched health and social care budgets.

We also heard how the Women and Equalities Select Committee has taken the view that every local authority shouldn’t be expected to re-prove that we have an aging society to justify the need for more accessible, adaptable homes.  Moreover, disabled people have the same rights as everyone else to be able to move house when they want to.  So a system that requires local authorities to justify accessible housing, based on an assessment of local need alone, is denying disabled people the ability to take-up employment opportunities and the right to choose where and with whom they live.  Additionally, the social model of disability would expect the planning system to play its part in ensuring that we build homes and neighbourhoods that enable disabled people to participate, and avoid the introduction of barriers that prevent this.

We should simply be ensuring that we build according to inclusive design principles and new homes should be adaptable enough to respond to the needs of our society.

The view was expressed by round table participants that revision of the building regulations and setting national planning policies requiring adaptable and wheelchair accessible homes, would simply create more of a level playing field for local authorities and developers alike.

Recommendations:

• Government should revise building regulations and national planning policy to meet the need for more adaptable and wheelchair accessible homes.
• Rather than local authorities being forced to consider the needs of different social groups to justify specific local housing targets, our planning system should move to a ‘presumption in favour of inclusive development, which would expect developers to design homes and communities to inclusive principles, to ensure that homes, facilities and wider infrastructure can be used and enjoyed by all on equal terms.

 

Good inclusive design has a critical role to play in making accessible and adaptable properties attractive and non-institutional, and consequently more desirable to developer and potential resident alike.  In some cases, where accessibility standards have been applied for the purposes of compliance alone the design of the property has created what could be described as undesirable internal lay-outs.

Annabel Osborne emphasised the point that inclusivity needs to be considered from the outset, in the design of the external as well as the internal environment, rather than being retrofitted into the project at a late stage in the design process.        

The point was made that whilst the volume housing development model generally militates against inclusively designed homes and neighbourhoods, “innovative designers” do rise to the challenge when involved in a project.  That said, it was felt that a lack of awareness of inclusive design still persists within the built environment professions. Where local authorities have retained the expertise (in the form of Inclusive Design Officers and Specialist Housing Occupational Therapists) they are able to intervene to ensure that proposed development conforms to good access and inclusion principles.   

Bradford Council is currently developing a programme aimed at improving housing design. This is part of the Design Quality stream of the government’s Planning Delivery Fund. This consists of three separate yet interrelated projects:

• Master Delivery Plan for the City Village Regeneration Scheme – a demonstrator project of a new healthy neighbourhood of 1,000 homes in the ‘Top of Town’ area of the city centre.
• Bradford Housing Design Guide – will set out the key principles to guide the design of new development across the district.
• Training Programme – to improve the design skills and awareness of officers and members, ensuring that achieving quality is embedded into the culture of the organisation.

The overarching aims of the programme are to achieve a step change in the quality of housing development and to improve health outcomes through design and its impact on the wider environment.

There is, however, great concern about the lack of capacity within most local authorities to ensure that development is meeting accessibility and inclusion standards. With a few notable exceptions, the vast majority of local authorities do not employ Inclusive Design Officers or Access Officers.   

Recommendation:

• Local authorities should appoint Inclusive Design Officers to promote and enforce accessibility and inclusion standards.

 

A number of participants highlighted the critical relationship between housing and health and wellbeing outcomes. A bed in a Spinal Injury Centre costs around £1,000 per day.  When spinal cord injured people are unable to be discharged as there isn’t a suitable home for them to move into, or they have been readmitted, because an un-adapted inaccessible home has led to infections or pressure sores, the cumulative cost of the consequent extended stay can be considerable.

One attendee shared an account of a Harrow Churches resident, who prior to moving into his accessible home, was forced to live for many months in inappropriate residential care, leading to very detrimental effects on his psychological wellbeing and physical health.  Similar cost savings are evidenced in a housing case study for the Royal College of Occupational Therapist’s Improving Lives, Saving Money campaign whereby a gentleman was able to leave residential care and move into an adapted property to live independently with his family.  This was also illustrated by the testimonies of spinal cord injured people that round table participants read out at the beginning of the event.

It was reflected that whilst the beneficial impacts upon health and social care costs achievable through the provision of adaptable and accessible housing are apparent, these savings offer little by way of incentive to the housing market.  Additionally, government policy currently does little to influence the market towards greater social responsibility in the delivery of homes with the potential to achieve beneficial health and social care outcomes. 

Recommendation:

• More work is needed from government to drive greater integration of housing, health and care policy.
• The Department for Health and Social Care cannot drive this alone. It requires collaboration from the Ministry for Housing, Communities and Local Government by aligning housing policy to further underpin and enhance the social return on investment in health and social care services.

 

Monitoring and matching supply with need

We also have to make more effective use of the existing stock, and examples were given of where wheelchair accessible homes have been built or adaptations have been made, these often end up being occupied by residents that don’t require the adaptations or access features.  In some cases, expensive adaptations such as wet-rooms are simply ripped out.

We also heard that new accessible homes built in London aren’t being registered by local authorities.  Consequently, the value of the investment in their accessibility can be lost, as it can be difficult to identify them at the point of need for households that would benefit from the access features they contain.

It was argued that if you have an idea of a person’s access needs at an early stage of the development, the design of a property can be adapted to meet them.  However, it was also observed by a number of participants that whilst this might meet the needs of an individual, it may not represent best value, as the property’s adaptations may not be suitable for subsequent households.  Therefore, by designing homes to a standard level of accessibility, with capacity for later adaptation for specific individual needs, it was felt that greater use by a wider range of occupants can be made of the property.

We heard from the EHRC how the private sector needs to do more to identify and positively promote accessible homes and the features they offer.

To ensure that accessible and adapted homes go to those who need them we need accurate data on accessible properties and the access requirements of households. The EHRC found that only 12% of local authorities across Britain rated the data available to them as ‘good’ or ‘very good’ in terms of its overall usefulness, while 21% rated it ‘poor’ or ‘very poor’.

We felt that we urgently need to make the most of investment by recording where and how many new accessible homes are built, as well as registering those that have undergone significant adaptation through Disabled Facilities Grant funding. 

We heard that even where they exist, accessible housing registers often need to be updated. There is a lack of consistency in accessible housing descriptors between local authorities.  Some are even yet to adopt the building regulation optional accessible housing standards for Category 2, ‘accessible and adaptable’, and Category 3, ‘wheelchair user housing’, which were introduced in 2015.

The EHRC also found that many housing providers lack necessary expertise, which often results in disabled people being offered unsuitable properties.

The round table heard that dedicated Housing Occupational Therapists can make a real difference in ensuring that accessible and adapted homes are used more efficiently by matching them more appropriately with the people who need them.   

Recommendation:

• Inclusion of a question on the standard planning application form requiring the number and location of any Category 2 and 3 homes a proposed development contains.
• Registration of Category 2 and 3 homes signed off by building control, including number and location.
• Registration of homes adapted through Disabled Facilities Grants where structural alterations have achieved a wheelchair accessible property.
• All local authorities required to hold the above data on an accessible housing register.
• The standardisation of accessibility descriptors at a national level.
• Local authorities and social providers should make much greater use of specialist Housing Occupational Therapists when letting accessible housing.

Conclusion:

We heard that the Ministry of Housing, Communities and Local Government (MHCLG) is alive to the health and wellbeing benefits of accessible housing. It will be publishing planning guidance on housing for older and disabled people after the summer.  The round table would urge the MHCLG to take on board the views expressed here, and its recommendations, in shaping the forthcoming planning guidance.  Furthermore, we would urge that government establishes an advisory forum comprising stakeholders, such as those represented at this round table event, to actively contribute to shaping of policy and guidance in this area.