Circular SWSG7/94 5458 - Community Care - The Housing Dimention

ANNEX 1

GUIDANCE ON PROVISION OF COMMUNITY CARE HOUSING INTRODUCTION

1. This annex repeats and updates the guidance on the provision of housing for community care groups given in the 28 March 1991 circular "Housing and Community Care" (Env 8/1991), which is replaced by the main circular.

General

2. There is a very wide variety of types of housing which can be provided for community care client groups, and a non-exhaustive list is set out in Annex 1A. It should always be borne in mind, however, that:-

2.1 The majority of community care users can live in mainstream housing, perhaps with minor adaptations, and support from day or domiciliary health or social care services.

2.2 Housing should not be considered in isolation but as part of a package of housing; and social work, health and housing management services.

Guidelines

3. While some specific guidelines are set out below for the elderly and those with physical disabilities, housing authorities and Scottish Homes should bear in mind that these are intended to be general indicators, rather than fixed targets for each authority. Local circumstances will differ, and in particular the provision appropriate to urban and rural areas may be different. Needs will also vary over time, for example because of changes in the age structure of the population. The general guidelines should therefore be supplemented or replaced by local surveys of need, taking into account information from social work authorities and health boards and the aspirations of care users.

4. Housing authorities are not expected to meet all of the identified community care housing requirements themselves, but to act in their strategic enabling role in partnership with Scottish Homes and other housing providers to try to ensure that provision is made from a variety of sources. Nor is it expected that needs will be met in one housing plan period. Provision over a number of years will be required.

Elderly People

5. While the majority of older people will continue to live in mainstream housing in both the private and public sectors a number will have special housing needs. On the basis of the report "Study of the Housing Needs of the Elderly", the following guidelines are recommended:-

- Very sheltered housing: 20 dwellings per 1,000 people over 65

- Sheltered housing: 46 dwellings per 1,000 people over 65

- Medium dependency housing: 80 dwellings per 1,000 people over 65.

It will be noted that the guidelines refer to dwellings, not people. Definitions of these terms are given at Annex 1B. Copies of this Scottish Office Central Research Unit report can be obtained from the Librarian, The Scottish Office, Room 1/44, New St Andrew's House, Edinburgh, price £4.50.

People with Physical disabilities

6. The majority of people with physical disabilities will also continue to live in mainstream housing. However, reference should be made to the Scottish Housing Handbook No 6 (Housing for the disabled) which recommends that the need for housing for wheelchair users is unlikely to exceed 1% of the total housing stock, with mobility housing likely to comprise around 10% of the total. It must be emphasised that these are not the sole types of housing relevant to the needs of those with physical disabilities. Barrier free housing will enable the needs of most groups as well as wheelchair users to enter a dwelling and access the livingroom and wc. Houses may still require relatively minor adaptations, or medium dependency or amenity housing may be required for their needs. Finally, those with physical disabilities are not a homogeneous group, and different physical adaptations will be needed to take account of different types of disabilities.

7. As part of this approach, housing providers should consider making more of their existing stock accessible to people with community care needs, many of whom may have physical disabilities. Close co-operation between housing, health and social work agencies is essential in this field. For example, when mainstream housing is being built or modernised it may be possible, at little or no extra cost, to include features which would make it more easily usable by people with disabilities, both as tenants and visitors. The following list of items is by way of example and is not intended to be exhaustive:

- where appropriate build or modernise to "barrier-free" standards;

- where possible, wc and bathroom to be available on the ground floor;

- grab rails installed in bathrooms and showers over the bath and beside a wc, when bathroom suites are being replaced;

- sockets at least 500mm and light switches 1,00mm above floor level, when a property is being rewired;

- easy to use/read timers and thermostats when central heating is being installed;

- easy to grip taps when sinks, basins and baths are being replaced;

- lever handles preferable to door knobs.

- easy to open windows cleanable from the inside to be installed in window replacement contracts;

- additional security measures such as locks and door chains to ensure that elderly people feel secure;

- installing care alarms linked to a response service in smaller properties;

- creating a barrier free environment.

- the installation of a chair lift can make the upper storey accessible to a disabled person.

Similarly, co-operative action with other bodies, for example the highways authority over dropped kerbs, will improve access for those with physical disabilities.

8. Occupational therapy services of social work authorities and health boards may be able to offer advice on these and other ways of improving access and useability. They may also be able to offer complementary aids to daily living which will further enhance the disabled person's quality of life.

Other Groups

9. Guideline figures are not available for other community care groups, such as those with mental health problems, people with dementia, those with learning disabilities, drug or alcohol mis-users, and those suffering from HIV/AIDS. This is partly because it is not possible for these groups to specify a one to one relationship between a given physical type of housing and a given group. Instead, housing needs vary according to the degree of dependency and the type of support individuals require. Their needs may also change as their condition improves or deteriorates. This reinforces the need for housing authorities to be flexible, and to consider a package of housing, and health, social work and housing management services in close consultation with health and social work agencies; including the short and long term needs of patients discharged from long stay hospitals. Most of the types of housing mentioned in Annex 1B, and other types, will be relevant to these groups.