Housing to 2040: consultation analysis

Analysis of Question 4. Do you have any proposals that would increase the accessibility and/or functionality of existing and new housing (for example, for older and disabled people)?

The responses to this question were detailed and varied. Many respondents set out proposals for increasing the accessibility and/or functionality of existing and new housing.

Key issues raised included:

• The increasing need for accessible housing across all tenures
• The affordability of adaptations
• The importance of alternative housing models such as co-housing models and off-site construction
• The need to increase accessibility for specific groups, such as people with learning disabilities and people with MND
• The need for more support to be given to older people to enable them to downsize their homes
• Opportunities to use technology to increase accessibility 

The remainder of this chapter presents a more detailed analysis of the responses to this question.

Adaptations to existing housing stock (across all tenures)

Respondents frequently made reference to the increasing need for accessible housing. Many respondents referred to a shortage of accessible housing, and the need for existing stock to be adapted to meet the needs of older people or people with disabilities.

"There is a significant shortage in accessible housing for people with disabilities, young families and our ageing population. In order to meet the current and future needs of these vulnerable groups, accessible housing should not be considered specialist housing and should be core to mainstream development." - Health and social care body or professional/umbrella body

"One important contribution to the debate is the Equality and Human Rights Commission (EHRC) ‘Housing and disabled people – Scotland’s hidden crisis’ report which states "the demand for accessible housing is increasing, particularly for people who use wheelchairs where projections are that there will be 80 per cent growth by 2024." - National third sector organisation

The need for flexible housing and future-proofing dominated responses. In particular, respondents noted that properties being built currently are too small for adaptation; more level access living is required; improved space standards (e.g. wider doors) are required; and that spending now to futureproof properties will save in the long term.

A few respondents also made reference to flexibility around the use of challenging stock. They noted that while some homes will not be capable of meeting certain standards, these properties should not be disposed of or demolished if people still want to live in these properties.

Some respondents felt that accessibility should be mainstreamed – and not be limited to housing intended for older people or people with a disability, which would enable equity of access and housing meeting people’s needs throughout their lives. Equally, it would enable older and disabled people to visit housing belonging to family and friends. A few people also suggested that in all tenures of housing, when a home has been adapted, it should remain adapted.

"For social housing this means that measures in current legislation around inherited adapted property should be enforced, to ensure those who need it, can get it. For adapted private tenancies, local authorities and the third sector should work with landlords to help them secure tenants. For selling homeowners, they should be encouraged not to remove adaptations and given support to advertise, promote and sell their property to someone in need." - National third sector organisation

Many respondents provided specific examples of the types of adaptations that are required to make housing stock more accessible. 

Table 5.1: Suggestions for adaptations to make housing stock more accessible

General, in all new-builds

• Widen doors and hallways to enable wheelchair access
• Pocket doors to ease opening/ closing
• Minimum room width
• Sockets and switches at various heights
• Automatic lights
• A ventilated area for clothes drying

Bathrooms

• Wet floors
• Low-threshold showers as standard
• Grab rails installed as standard

Kitchens

• Adjustable units and sinks
• 1.2m long activity space in front of the sink and oven
• Ovens should be in a mid-height unit with controls 1200mm above ground level, rather than in an under-counter unit.

Accessibility

• Covered car ports to enable disabled person to get from the car to their wheelchair to their house in wet weather
• Blanket 10% wheelchair accessibility on new builds & existing works
• Room for storing and charging mobility scooters, in-house or communal area of block of flats.
• Automatic doors, and ramps for access

Sleeping areas

• Within the accessible sleeping area, require at least one window to have a cill level at a maximum height of 600mm.
• Install a robust fitting area to the ceilings to accommodate future provision of a hoist

A few respondents highlighted the importance of services such as Care and Repair which enable older people to access trusted services designed to help with adaptations to their home. Some also referenced the need to ensure accessibility outside the home and lack of amenities such as benches or public toilets, which "can keep older people unable to confidently leave their homes."

One respondent referred to the need to also consider environmental adaptations for those with cognitive impairments e.g. dementia, autism etc. not just physical adaptations. Another respondent referred to existing building codes which make requirements for downstairs bedrooms, wide doorways etc. highlighting that this should mean that as time goes by the proportion of homes with improved accessibility will increase.

Affordability of adaptations

Some respondents referred to affordability in relation to the availability and cost of suitable housing. For example, one respondent noted that:

"Private renting has increased in our area from 9.5% of stock in 2007 to 19% in 2017, and there is concern that affordability is an issue as this sector can often be more expensive than social tenancies. Creating a housing system where people spend less of their income on housing costs will help to alleviate poverty and allow more finance to find its way into the real economy. Ensuring that investment in new affordable housing is a priority will increase affordability and assist in providing choice over where tenants want to live. This will meet the vision of ‘A Well- Functioning Housing System’ as people will not have their options limited when choosing where to live." - Local authority

Another respondent suggested that Government should require RSLs to set a flat rate for rent across a local authority giving the example that the rent for a one-bed council home would be the same in Kirkcaldy as St Andrews. 

Some respondents highlighted issues of affordability in relation to the costs of improving accessibility of existing housing across all tenures. In particular, respondents highlighted issues related to the affordability of ongoing service charges to maintain lifts in flatted dwellings, and the challenges of keeping people in their homes, for example in older tenements, where it is not possible to install a lift. Some raised concerns about other barriers face by disabled households which could affect affordability – for example, highlighting the need to consider the relationship between other equality issues in areas such as employment and the impact this has on housing options.

Some respondents noted the importance of ensuring that adequate guidance is in place to ensure that adaptations are undertaken to a high standard, meet needs and are affordable. A few also commented on the need for the process for adaptations to be more efficient, emphasising that local authorities need to address bureaucratic hurdles and delays that exist within adaptations systems, to ensure that low-cost, minor adaptations in particular can be installed quickly and easily. Care and repair services were highlighted by some respondents as an effective way of addressing deficits with one respondent suggesting that these become a mandatory service offered by local authorities.

Another suggested that there would be value in recruiting housing officers to support specific complex needs and the needs of older people to ensure more personalised housing planning approaches. Some also highlighted the value of involving Occupational Therapists to identify need and oversee the provision of adaptations.

"Steps should be taken to increase the efficiency of the adaptations process, by implementing the guidance within the Royal College of Occupational Therapists (RCOT) report 'Adaptations without delay'. There are current examples of good practice in this area, for example in East Lothian, where Occupational Therapists are training and working alongside community care workers to specify and oversee the provision of adaptations for residents of all tenures in a timely and equitable manner." - Health and social care body or professional/umbrella body

"Where existing housing stock is being refurbished, Occupational Therapists can provide expertise and generate cost savings by ensuring that works maintain or enhance the existing level of accessibility, thereby ensuring that the availability of accessible homes does not decrease and, in some cases, increases. This will reduce the need for additional adaptations in the future and can remove risk factors that may result in injury and cost to the health system. Many housing associations and councils are already building in this approach to their asset management and cyclical maintenance programmes – good practice should be highlighted and shared and built into the Regulation Framework going forward." - Health and social care body or professional/umbrella body

Scottish Government was also referenced as having a key role to play in ensuring provision and equity of funding for adaptations, and ensuring the right regulatory framework is in place. For example, one respondent suggested that Scottish Government should provide additional funding to disabled people’s organisations and advice agencies, to increase the supply of independent advice and information regarding housing options, including adaptations, with a particular focus on the private rented sector. Another respondent referenced the need to address the disparity between tenures by reviewing and amending the elements of the Housing (Scotland) Act 2006 that relate to the Scheme of Assistance legislation together with a review of the related funding and guidance, in order to ensure consistency of outcomes, good practice and equal rights for disabled people, regardless of tenure type.

Increased accessibility of new housing

Many respondents referred to improvements that were required to ensure the accessibility of new housing for older and disabled people. This included consideration of new forms of design and construction methodology being encouraged to put accessibility and flexibility at the forefront of planning.

Some argued that all new designs should be fully accessible, while others felt that investment should be focused on a minimum number of units in any site.

"Rather than spreading investment across all units it may be more effective to focus investment on a % of total units. For instance making all sites fit site level and Disability Discrimination Act (DDA) accessibility adds materially to site cut and fill costs but will only be of relevance to a minority of purchasers. Agreeing a subset of more adaptable units within a wider development may create more effective and focused investment" - Individual

"The Scottish Government to require all local authorities to ensure that a minimum of 10 per cent of new-build homes across all tenure types are built to a wheelchair-accessible standard. This should be monitored and reviewed." - National third sector organisation

"There should be a requirement for new developments to provide suitable housing for older people / sheltered accommodation in same way they are required to provide affordable housing. But need to be cautious as if too many requirements, house builders will go elsewhere." - Agencies, advisory groups and other national bodies

Flexibility in design at the outset was considered by many to be key, with the potential to enable people to remain in their own home for longer, reduce the risk of injury, reduce demand on health and social care and reduce costs associated with major adaptations. This included suggestions to ensure that future housing can be split into smaller units to enable downsizing; requiring new and re-developed homes to follow lifetime homes principles of inclusivity, adaptability, accessibility, sustainability and good value to ensure that there is flexibility within the housing stock to adapt to changing needs and allow people to remain in their communities. For example, one respondent referenced a model in New Zealand /Australia, where new builds have moveable walls so that houses can be easily modified to suit changes in family requirements.

As previously noted, the majority of respondents stated that designs for new housing should accommodate a range of features including electric wheelchair usage within the property and charging points for these, mobility scooter storage/parking; provision for future lift space; and a downstairs footprint that is large enough that it can be converted to a downstairs bedroom along with a space for a wet floor shower.

Views were mixed in relation to the size of properties which should be built with some respondents arguing that all new housing for older or disabled people should have a minimum of two bedrooms to accommodate friends and family visiting, and carers/future carers. This would also allow for changes in health/disability where couples may later require separate bedrooms. 

Others argued that the range of size of new houses being built should depend on demand in an area.

"For the majority of people, the smallest size house should be a 2-bedroomed. Maybe young single people would like a 1-bedroomed house, but for a young couple, then when they start a family, they would not have to move house; for an elderly couple/disabled person, they could have carers staying if required." – Individual

"Require new developments to have a wider mix of housing size that would allow people who want to downsize to move to a smaller home that will support future mobility constraints." - Consultation event attendee

"We need to provide properties that people want to live in. Currently within the (Aberdeen) city housing stock we have an over-supply of 2 bedroom properties and not enough 1 and 3+ bed properties. However, 2 bed properties continue to be built. The increase in single households as well as large (often blended) families is not being catered for in the current housing stock. Amongst council housing tenants there is a desire for houses, with their own front door and garden. There are fewer people wanting to live in flats, yet we continue building flats." - Consultation event attendee

"To create communities we need to see a mix of building types within developments, allowing first time buyers, families and older people to have a home that is suitable for them – facilitates independence and remaining in community. We should not allow developments with only one or two property types e.g. just 4 or 5 bed villas." - Consultation event attendee

Alternative models

Some respondents provided a range of suggestions for alternative approaches to the provision of accessible, flexible housing for older and disabled people. There was little homogeneity amongst these – however a few recurring ideas were presented including proposals for co-housing models; off-site construction; and the introduction of more common spaces to promote a sense of community.

A few examples of suggested models are noted below:

"The Cohousing model is a particular form of neighbour commitment, involving a sharing culture - extending to a common house, gardens, and even cars. The common house is usually configured such that it allows shared cooking and dining, meeting and performance space, guest bedrooms and laundry facilities. Like its bedfellows, Cooperative housing and collective self-build, there is usually a determination among Cohousing groups to build as environmentally-responsibly as possible and on a not-for-profit basis - such that cost is price and price is cost." - Local third/community sector organisation

 "With an ageing population and an increasing need for smaller unit dwellings to accommodate more single person households, there is an increased opportunity for the use of offsite construction to become more commonplace in Scotland over the next twenty years." - Architects and design/development organisation and professional/umbrella organisation

"Remodel backcourts so that they have an accessible street level access door through which then allows people to store bicycles in communal bicycle sheds out the back, older people can store electric bikes and trikes; Retrofit lifts into tenement blocks - where it makes more sense join blocks together; take washing machines out of tenements and instead have communal facilities in the basement - as Sweden does - this makes life more communal and therefore means neighbours are more likely to notice if someone needs help." - Individual

Self-build opportunities

A number of responses focused on the need to improve opportunities for self-build. It was seen by some respondents as a more affordable route, one that was flexible and enabled design to meet individual needs, provided choice and variation, and offered opportunities to include energy efficiency build methods. Barriers identified included lack of weighting in planning processes currently, objections from the house building industry, issues with health and safety, and challenges getting finance from lenders. An example of how this is being approached in Glasgow is given below.

"In order to achieve our housing supply targets and meet future housing needs and demand, Glasgow’s Housing Strategy is committed to exploring options for innovation in construction methods and new housing delivery. An example of this approach is Glasgow’s new self-build programme. 

The Council has established a Register of Self-builders and committed to a pilot project within the Maryhill Transformational Regeneration Area (TRA). It seeks to address the three main issues and constraints to self-build which include land availability, planning permissions and access to finance. At Maryhill, vacant and derelict land has been remediated and services installed to plots to enable release for self-build. 

The council has developed an innovative ‘Planning Passport’, which provides a ground-breaking design code and a plot passport route for Self-Builders, streamlining the planning process. Glasgow Self-Build Programme is also engaging with lenders and mortgage brokers to identify potential for developing new, bespoke products that would increase opportunity and access for households interested in self-build." - Local authority

Standards/regulations

Some respondents to the consultation highlighted a need for further prescription through standards and regulations. Many of the comments focused on the need to set meaningful targets that could be enforced, supported by strong building standards. Some went as far as to call for mainstreaming of standards of accessibility and functionality making housing adaptable and flexible to meet occupants’ needs over the life course.

Some respondents suggested that Scottish Government should bring housing building standards in line with commercial building standards; some though that developers should be compelled to consider the needs of an ageing population with multiple health needs; and some respondents thought that regulations should be tenure-neutral, with a single governance framework for adaptations, irrespective of tenure. 

Enforcement was a recurring issue highlighted by respondents.

"The private sector isn’t producing the homes that older people need. This could be controlled through planning and a more assertive public sector. Question over who is/will be enforcing requirements – local authorities don’t have the resource to do so." - Consultation event attendee

Some also suggested a ratings system be developed for private housing which indicates how accessible the house is with suggestions including incorporating some form of ratings system into home reports; and the creation of a database to help people find a suitable technology-accessible home.

Some respondents made specific suggestions with regards to enhancing or adapting current regulations and guidance. These suggestions included:

• Mainstreaming space standards for housing that are inclusive of everyone’s needs.
• Updating the Housing for Varying Needs standards which have not been updated for some time.
• Introducing national up-to-date standards applying to all tenures for all new build housing to mainstream standards of accessibility and functionality making housing adaptable and flexible to meet occupants’ needs over the life course.
• Consider introducing further enhancements/amendments to the Domestic Building Standards Handbook to ensure future (and altered & extended) housing is more readily adaptable should the need arise. 

Increasing accessibility for specific groups

A few respondents made suggestions related to addressing the needs of specific groups – these included suggestions related to people with motor neurone disease (MND), people living with dementia, and gypsy travellers. The issues they raised are summarised below.

People with MND

The respondents who commented on people with MND noted that they not only need greater space for their wheelchairs (which are larger than an average wheelchair) but potentially hospital beds, hoists and a range of other equipment, all of which is essential to them living at home for as long as possible. They called for a new cross-tenure space quality standard to ensure that the needs of people affected by MND are met in the future.

They also highlighted barriers to people with MND trying to access adaptations or alternative accessible housing which included protracted decision-making processes and bureaucratic hurdles. They noted that people with MND have an average life expectancy of just 18 months from diagnosis and so waiting times of 12 months, and requiring three separate quotes for adaptations, for example, are not acceptable. They also supported calls for improved identification and marketing of accessible homes such as ratings systems, as previously suggested. They called on the government to introduce a fast-tracking system for some groups of people for accessible housing to avoid postcode lotteries.

Gypsy / travellers

A few respondents highlighted challenges facing older or disabled members of gypsy/traveller communities, noting that there are particular issues around adaptations for static caravans/chalets which are classed as unsuitable or ineligible for adaptation. Some gypsies/travellers are therefore forced into mainstream housing as a result of ill-health or disability, and this is known to have a detrimental impact on their wellbeing. Most gypsies/travellers do not move into brick-and-mortar housing by choice. The majority would prefer to remain on site. It was also noted that gypsies/travellers have expressed their sadness at being forced to live in houses and the consequent loss of culture, as well as practical support from extended family.

Another respondent referred to Scottish Government’s standards for gypsies/travellers which they described as challenging to meet in their local authority. In addition they noted that the gypsy/traveller community cannot access Strategic Housing Investment Plan (SHIP) funding as a property is required, and members often prefer to stay in a caravan. They suggested a relaxation of the rules to address this.

People with learning disabilities

A few respondents highlighted particular issues facing people with learning disabilities and the need for them to be able to exercise maximum choice over where and with whom they live. A lack of support from housing providers was cited as a particular challenge - this ranged from a reluctance to provide information in accessible formats, such as ‘easy read’, to a lack of specificity in advertisements for accessible properties and a lack of assistance with applications. It was also reported that tenancy agreements and correspondence from landlords, contains language that is legalistic and therefore inaccessible to many people. 

Another respondent noted concern about the lack of choice and restriction on independent living resulting from a lack of accessible housing of a variety of tenures available to people with learning disabilities. They also highlighted a trend back towards shared tenancies for people with learning disabilities in some local authorities which they believe is motivated by cost.

People living with dementia

Some respondents highlighted the challenges being presented by our ageing population and in particular the expected rise in dementia. 

Respondents recognised the Scottish Government’s understanding of the importance for people living with dementia of housing design and flexibility and timely and person-centred support for them and their carers. A few, for example, cited ‘Age, Home and Community: the Next Phase’ in which the Government listed some of the actions taken, such as supporting the development of a dementia and housing design guide. 

Respondents’ suggestions for improvements included Scottish Government issuing guidance around provision of dementia-friendly housing; increased funding and support for Health and Social Care Partnerships to support improved post-diagnostic support; frontline staff being trained to support people living with dementia; and focusing on early intervention support being prioritised for people living with dementia, including home adaptations.

Supporting independent living

Many respondents emphasised the importance of adaptations in enabling people to remain in their own home for longer and maintain their independence. They emphasised the need for provision to ensure this, whilst maintaining safe levels of care and support. Adaptations were also highlighted as a preventative measure for reducing crisis and acute interventions, thereby reducing demand upon health and social care services. 

One respondent highlighted that the availability of accommodation where there is a warden service is becoming rarer and called for the Government to consider ways to encourage the increase in wardens supporting people in assisted and sheltered accommodation. 

Support with downsizing

Some respondents raised the issue of downsizing and noted the need for more support to be given to older people to enable them to downsize. Suggestions for this type of support included:

• Tailored advice to older people on how to market their home and assistance with practical matters like packing and moving, as well as property searching. 
• All housing partners and the Scottish Government need to work together to shift emphasis from downsizing to ‘rightsizing’ for older people. It should be viewed as a positive choice for older people to choose to move home to meet their needs and improve their quality of life. This has the added benefit of freeing up larger family homes for those who need them.
• Provide moving assistance for older people seeking to downsize – to help with information, advice and practicalities, as well as helping them to find suitable properties (which is hard when they are often competing with first time buyers for smaller homes). 

Use of technology to increase accessibility

Many respondents referred to the need to apply new technology to homes to improve their accessibility for older and disabled people. Technology was seen as key to enabling people to stay in their own homes for longer, and planning ahead for these needs was considered to be important.

Some respondents referred to the need to ensure that homes are digitally enabled to keep people connected and mitigate against digital exclusion amongst the growing older population. This was seen as an opportunity for housing to embrace emerging assistive technologies enabling people to live independently in their own home and increase accessibility. They were keen to see innovation and best practice in new technology prioritised, for example through evaluation and roll out of innovation such as the Fit-homes project being delivered through City Deal funding in Highland.

A few respondents highlighted that house building design and construction needs (across all tenures) to take more account of the new technologies and materials currently available to enhance the digital capability of all houses for residents’ benefit. Some respondents also referred to the need to further develop the national strategy for the use of Technology Enabled Care (TEC) with some seeing this as an essential support to core NHS services, and others stating that this should be incorporated into the replacement for Housing for Varying Needs.

Ensuring that there were sufficient numbers of staff appropriately trained to apply and support more extensive use of technology in housing was another recurring theme.

Some respondents provided specific examples of actions they would like to see taken, for example the installation of automated shading devices to avoid overheating of the elderly and infants; ensuring all homes have affordable internet connectivity as standard to ensure communities are well-connected to each other; and offering subsidies to companies to assist in developing innovative and cost-efficient approaches. 

One respondent gave a detailed example of interesting use of technology in one project in the North East of England:

"Gateshead Innovation Village is a live research project led by Home Group and supported by Homes England and development partner ENGIE. The project has delivered a range of traditional and modular homes with energy efficient smart technologies to test the benefits and durability of different construction methods and technologies, aiming to improve public perception of modular homes. Home Group is working with specialist partners to robustly compare and contrast traditional construction against different modular methods by building a new village of 41 homes with 35 modular houses (16 volumetric and 19 modular houses), alongside 6 traditional houses, using five different modern methods of construction (MMC). As well as testing construction methods, we have partnered with leading smart tech companies in the UK and Northumbria University to see how smart technology can be used in our affordable homes. 

We want to explore how we can deliver our mission to build independence and aspirations for households using technology traditionally considered out of the reach of many people in society in order to help us improve support for people with mental health or social care needs.

We have at our disposal, monitors that detect falls – and even predict when falls may occur; activity-monitoring systems allowing people to check on relatives living elsewhere; technology that monitors the temperature in a frail persons’ home and sends alerts via text if temperatures rise or fall outside of pre-set limits. 

Initial findings have revealed the dramatic impact it could have on the lives of people with learning disabilities and autism. The research looked at how assistive technology can not only improve independence and quality of life for people requiring care, but also enable family and health professionals to spend more quality time with those they care for. 

For example, utilising smart sockets to collect motion, temperature and power usage data. This can be viewed by family and carers to indicate the person is warm, drinking, eating and active. It also sends alerts when unusual behaviour, such as inactivity, is detected.

Smart watches were also used to track steps, calories and sleep. This is important for people with learning disabilities as it indicates whether a person was awake during the night or had a light or restful sleep. Health care professionals can then access the data prior to a home visit. The live research is being undertaken by a senior research assistant, who is living and working in one of the houses in order to gain a deeper understanding of the advantages and practicalities of assistive technology.

In terms of risk management, the benefits of assistive tech are considerable. As well as helping keep people safe, in a social care setting they also free up staff to deliver more value-added care, rather than spending large chunks of time doing checks.

Research findings will start to emerge in the coming months, with the bulk expected in the middle of 2020. Representatives from Home Group and Northumbria University will present the first phase of research to senior NHS (England and Wales) leaders at the Mental Health Network conference next week (March 5th), with a full research report due to be published later in the year.

Those findings should help us answer a plethora of questions relating to a range of topics and issues that we are sure the Scottish Government will find useful." - Registered social landlord