Improving homes and changing lives for older people across Wales
At the start of this new decade, Chris Jones, Chief Executive of Care & Repair Cymru reflects on the housing issues older people continue to face, and how developing partnerships and innovative approaches from Care & Repair are offering tailor made solutions.
Care & Repair Cymru is a registered charity and national body for 13 Care & Repair agencies operating across Wales. Our vision is a country where all older people can live independently in warm, safe and accessible homes. Every year we support over 30,000 older people to make this vision a reality. Our expert teams and network of trusted local contractors work one-to-one with clients improving their health and wellbeing through life changing adaptations to the properties they live in. Last year we made a total of £14.8m in housing repairs and improvements for our clients and increased their household income by nearly £8.5m by helping them access unclaimed benefits.
Wales has some of the oldest and least thermally efficient housing stock in Europe and older people are more likely to experience poor health as a result of poor housing. We know our work enables our clients to live with greater independence and dignity and enhances their health and wellbeing. It also makes long-term financial sense for government resulting in reduced pressure on services and savings to health and social care budgets. Public Health Wales recently identified poor housing as costing the health service in Wales £95m a year and Welsh society over a £1bn a year.
Tailored solutions to the housing problems facing older people
“I just want to live independently, be able to use my kitchen and bathroom and get out of my front door safely without having to be picked up by an ambulance.” (Mrs D, Bridgend).
Our nationwide core Care & Repair service delivers tailored solutions to older people’s everyday housing problems. It is the heart of what we do and led by our Caseworkers who build trusted relationships with clients in their homes, helping determine their housing, personal and financial needs. We discuss solutions and provide advice on welfare rights and funding available for home improvements. A property inspection is undertaken by our Technical Officers who complete the picture of works needed to help clients remain living safely, independently and comfortably at home.
“Since I had the handrail fitted to two steps up into the garden my quality of life has improved immensely. I can now go into the garden and see the flowers in “close-up” (I have impaired vision) but the good eye allows me to enjoy life. I can now sit under a tree when the sun is out and read or knit and enjoy the bird song and the sounds and smells of the season. Perfect!” (Mrs R, Caernarfon)
Even the smallest home improvements can have life changing impacts. A level access shower can prevent falls and more importantly restore privacy and dignity by enabling a person to wash themselves independently. 90% of our clients say their quality of life has improved as a result of our work. This in turn has knock-on-benefits in-terms of reduced demand on health and social care services. We also deliver a Rapid Response Programme across Wales which provides timely adaptations to client's homes, aiding quicker hospital discharges and improving safety and independence.
While home improvements are central to what we do, Care & Repair is much more than simply a home improvements service. Guided by our everyday relationships with older people, we work collaboratively with partner organisations in housing, health and social care to improve the lives of the most vulnerable.
Partnership work delivering specialist services
For the past four years our Managing Better project has provided invaluable support to older people across Wales with sensory loss. Our partnership with Action on Hearing Loss Cymru and RNIB Cymru has enabled us to integrate sight and hearing impairment into our home improvements work. Over half a million people in Wales experience deafness or hearing loss. Over one hundred thousand, many of them older people, are living with sight loss. The need for such a specialised service and the collaborative work to make it happen has never been greater.
“The loss of my eyesight has been very challenging. The help I’ve received has made me much more independent, I’m able to care for myself and feel safer. I’m able to use the handrails and lighting to move around my house more safely.” (Mr G, Swansea)
90% of Managing Better’s over 6000 clients say the service has improved their quality of life. It also provides a strong social return on investment of £4.50 for every £1 invested, resulting in significant savings for health and social care services. Our future vision for Managing Better is an expanded partnership, including Stroke Association Cymru and Alzheimer’s Wales, helping even more vulnerable older people with targeted, specialist preventative interventions to help them live independently in their own homes.
Our National Lottery Funded Attic Project is another good example of our collaborative working. The partnership with Safer Wales enables older people to make space at home and reminisce about their treasured possessions. Specialist caseworkers and volunteers work in Cardiff, Newport and the Vale of Glamorgan helping older people sort through and then dispose of their possessions in a way that is good for them, and the environment.
“It’s made such a difference. The boxes were overwhelming me and draining my spirit. Overall, it’s improved my quality of life - it sounds a cliché, but it’s true” (Attic Project Client)
So far over 146 older people have been referred to the specialist service and nearly 1000 bags of possessions removed from older people’s homes making them more independent, more comfortable and safer.
Innovative approaches to safer hospital discharge and moving home
A key focus for Care & Repair Cymru is looking to the future and pioneering and piloting new ways of working that improve the everyday lives of older people. In the last year alone, we have piloted two innovative new areas of work supporting hospitals to safely discharge patient's and helping older people to move home.
Our Hospital to a Healthier Home service works directly with thirteen hospitals across Wales. Care & Repair Caseworkers are co-located in wards, clinics, discharge hubs and A&E departments. They talk directly with patients, nurses, doctors and other clinical staff about the housing adaptations and improvements needed to facilitate safer and quicker hospital discharges. In eight months from April to November 2019, over 1800 patients were discharged more quickly and safely to a warmer more accessible home, helping patient flow and saving over 10,000 hospital bed days. Our service also helped prevent readmissions through over £564,000 of home improvements, continued contact with patients at home after discharge, and helping them increase their income through unclaimed benefits of £623,00 per year over the eight months.
“I’ve had a lady here on the ward, very, very poor, no money, wasn’t sleeping in a bed, they helped me to get her home with a bed. And that was fantastic, that woman has stayed out in the community, no ulcers on her legs, no swelling on her legs, because of that bed.” (Jenny Jones, Social Worker based at Wrexham Maelor Hospital)
We are also working on a new Help to Move pilot service with Bridgend Care & Repair helping older people to move home when they feel their current house no longer meets their needs. The Welsh Government funded pilot, delivered in partnership with Nesta and Y Lab, found that older people are not being asked their views on housing options in later life despite most being interested. In a relatively short period of time, the pilot service has helped clients move to more suitable housing and improved their health and wellbeing. The pilot has also identified potential cost savings for Care & Repair agencies and health and social care services.
Improving homes and changing lives into the future
As the population of Wales grows older, the work we do to tackle poor housing up and down the country is more important than ever before. We work closely with Welsh Government, public bodies and the third sector to ensure a safe home environment is at the heart of policy making. This involves playing an integral role in alliances such as the National Prudent Healthcare Falls Prevention Taskforce which addresses the critically high levels of falls amongst older people, Age Alliance Wales, and the Ministerial Advisory Forum on Ageing.
There are many challenges ahead of us, including poor housing conditions in the owner occupied and private rented sectors and ongoing pressures on vital services. We need to work more collaboratively and preventatively across housing, health and social care if we are to meet these challenges. If successful, we have the opportunity to build a society where older people can better adapt to change and are defined by their strengths, rather than by their problems. As the housing champion for older people in Wales, we are determined to increase awareness of the poor housing conditions experienced by so many older people. We continue to work to improve policies and resources to help the most vulnerable live better lives at home, while building on Care & Repair’s strong reputation as a strategic thinker, innovator, and an organisation that truly helps deliver better integrated services for older people across Wales.