1. The Scottish Government has a longstanding policy of 'shifting the balance of care', supporting people to remain at home independently for as long as possible, rather than in care homes or hospitals. Emergency admissions to hospital by older people cost £1.4 billion each year. The benefits of providing the right housing and support at the right time could be considerable, by reducing both the costs and trauma of unplanned hospital admissions.
2. Demographic change will lead to increased demand for such services. At the same time, we face the most challenging financial situation since devolution, with a cut of 12% in real terms to the Scottish Government's budget. It could take until 2026 for the Scottish Government budget to return to 2009-10 levels. We need to find new ways of delivering services and improving the effectiveness of the services we already provide. The outcome of Spending Review 2011 marked a shift towards preventative spending.
3. The Reshaping Care for Older People programme was established to consider the future delivery of services for older people to ensure they are sustainable. The development of a strategy for housing for older people was the main early action proposed by the Wider Planning for an Ageing Population working group.
Older people in Scotland are valued as an asset, their voices are heard, and older people are supported to enjoy full and positive lives in their own home or in a homely setting.
4. The Wider Planning for an Ageing Population working group identified five key outcomes for housing and related support for older people, covering: clear strategic leadership; information and advice; better use of existing housing; preventative support; and new housing provision. These five outcomes form the framework for this strategy. Underlying the outcomes are four key principles: older people as an asset; choice; planning ahead; and preventative support. The strategy presents a ten year vision and programme of action.
5. The strategy sets out a clear vision for housing for older people. Decisions on local policy and service delivery, however, are best taken by local authorities. Many different types of organisation are involved in the delivery of housing and support services to older people. It is important that these organisations work in partnership, so that older people have choice in the services that can support them to maintain independent living. We are also clear that we need to listen to older people and encourage their opinions.
6. We recognise that effective strategic planning processes are vital to ensuring that we have the right mix of housing and support services. We need to strengthen the connections, particularly between housing, health and social care, with greater use of shared objectives and performance frameworks. A new Change Fund for Older People's Services has been established to support the improvements needed to 'shift the balance of care' from institutional care settings to the community.
7. We will therefore:
- Promote consultation with older people and take account of their views;
- Support service innovation and alignment across housing, health and social care, through the Change Fund for Older People's Services; and
- Help demonstrate the benefits of investment in housing and related services for 'shifting the balance of care'.
8. We need to ensure that older people know about the housing options and support services that are available to them, and how to get them. High quality information and advice services will be vital to ensuring older people have access to the right housing and support.
9. We will therefore:
- Review information and advice services and publicise information sources;
- Work with local authorities to pilot housing options approach for older people; and
- Encourage accreditation under the Scottish National Standards for Information and Advice Providers.
10. The strategy recognises the importance of existing housing for older people, and ensuring we make best use of that housing. The great majority of the population will live their lives in homes which are already built. As the population ages, more people will need housing adaptations, but there are issues about the time taken to get them and questions about the equity of current funding arrangements. We have established an Adaptations Working Group to consider how to achieve simpler, fairer and more effective delivery of adaptations.
11. Older people can find it more difficult to maintain their homes in a good state of repair. Helping them to do this can improve health and reduce hospital admissions. Keeping the home sufficiently warm is also a major challenge for many older people, particularly in rural areas. We remain committed to working to eradicate fuel poverty, as far as is reasonably practicable, by 2016. The Energy Assistance Package is the main vehicle to achieve this aim. In addition, a new £50 million Warm Homes Fund is being established.
12. Moving home can be particularly stressful for older people, as it can mean leaving a long time family home. There may be a need for practical support, including the provision of information and advice about alternative options. Specialised forms of housing with care or support can help older people to remain in their own homes for longer. However, there are issues of low demand in some areas, and some providers are seeking to remodel such developments.
13. Many older people have considerable amounts of equity in their properties, but very low incomes. They could benefit from products or services, which would enable them to release money for adaptations or improvements.
14. We will therefore:
- Work with the Adaptations Working Group to ensure the system for delivering and funding adaptations is fit for purpose;
- Make best use of adapted property, supporting development of a national register of accessible housing;
- Encourage the social rented sector to meet the Scottish Housing Quality Standard by 2015 and the new climate change standard by 2020;
- Help older home owners maintain their homes through access to information and advice services and trusted trader schemes;
- Review our Fuel Poverty Strategy, in the light of increases in energy prices;
- Encourage more use of 'downsizing' schemes;
- Prepare a practical guide to the redevelopment of sheltered and very sheltered housing; and
- Make it easier and safer for older people to access any equity in their homes to meet their own housing needs and maintain independent living.
15. Preventative support services are particularly useful for people who need a small amount of help to live independently. They contribute to health and social care objectives of reducing unplanned hospital admissions and delayed discharge. They can also make a big difference to quality of life and are cost-effective. We have established a Preventative Support Working Group, with a remit to consider how a range of housing-related preventative services can be developed in ways that are financially sustainable.
16. Housing support services currently play a small, but significant, role in supporting older people to remain living at home, but could do a lot more. Handyperson services are provided by a range of organisations, including most Care and Repair projects. A supportive local community and strong social networks are recognised as important in supporting older people, particularly single older people, to reduce loneliness and live independently at home. Many older people receive telecare services, most frequently in sheltered housing. Telecare can provide significant benefits for older people and carers, as part of a package of support to maintain independence and wellbeing.
17. We will therefore:
- Explore ways to extend the availability of Care and Repair, handyperson and housing support services, looking at the scope to develop social enterprise models;
- Showcase the contribution housing organisations make to building community capacity and supporting social networks for older people; and
- Continue to develop and mainstream use of telecare, through the Change Fund for Older People's Services, to support older people to live safely and independently.
18. Building new, affordable and sustainable housing is a priority for government, with a range of house types and sizes that encourages mobility in the housing system and enables downsizing for those that wish it. The Scottish Government has pledged to deliver 30,000 affordable homes over the next five years. However, we recognise that only a small proportion of older people will live in new build housing. Nevertheless, it is important that new housing makes the maximum impact, meeting the needs of an ageing population. Homes must be easily accessible and adaptable.
19. Scottish Planning Policy requires that new housing developments should include a variety of house types and sizes, reflecting local community needs. We will work to increase awareness of the features of new housing that are important to older people and how they can be built into new developments. We are also keen to encourage the development of new models of housing that enable older people to maintain their independence in the community.
20. We will therefore:
- Review whether current building and design standards meet the needs of older people; and
- Encourage development of new models of housing with care and support in all tenures.
21. This strategy recognises the vital contribution made by our older people, not least in caring for others in society. We are going through difficult times, with an ageing population and major financial challenges. These challenges can only be tackled in partnership with others, by listening more to older people, and recognising their right to choose what suits them. Solutions will not be the same everywhere or for everyone, but an increased focus on prevention should be evident everywhere. The launch of this strategy marks a shared commitment to give greater priority, collectively, to these issues in future to help our older people live independently at home in their communities.
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