In all the debate about the funding and integration of health and care, too little attention has been paid to housing. Yet we know that an older or disabled person's home is crucial to their health and quality of life.
Now a new report shows how much can be done through relatively small home improvements to make householders 'warm, safe and well' so they can stay in their own home.
An independent evaluation shows how a £637,000 programme managed by the national charity Foundations Independent Living Trust helped 3,600 people stay in their own home warm and well over a 12 month period.
The funding enabled life-changing interventions to make the homes more energy efficient and easier to keep warm. The measures ranged from draught proofing and fitting reflector radiator panels to replacement of boilers and central heating systems. The programme beneficiaries were over 60, on a low income or with a disability or long-term illness.
The evaluation report, 'Warm, Safe and Well' by the Centre for Regional, Economic and Social Research at Sheffield Hallam University, found that the Warm at Home programme alleviated stress and had a positive impact on people's quality of life and wellbeing, their feelings of safety and security and their control of the home environment. Smaller practical improvements often made a big difference to daily lives, which enhanced wellbeing and independence.
Benefits were sizeable when compared to the average cost of the intervention, which was £241. For every £1 of funding through the Warm at Home programme, an additional minimum £2.42 was levered in from other sources.
The review also found that the programme appeared to be filling a gap in service provision, helping people who were suffering from ill health and enduring cold or unsafe conditions in their homes, but who were just above the income eligibility criteria for other energy efficiency schemes.
Work on the ground was delivered by 71 home improvement agencies (HIAs) operating across 183 local authority areas. HIAs are local, trusted organisations which can provide access to tailored services that address common barriers to tackling cold homes. They are in a unique position to identify, reach and provide solutions for at-risk people, who are often on low incomes and facing the challenges of living in cold homes - worsening health, risk of injury and social isolation.
The timeliness of the intervention and being able to provide immediate relief to householders were seen as major advantages of the programme. HIAs provided numerous examples of cases where they had been able to intervene quickly and they had prevented further illness or harm, such as hospital admissions, falls, prevented accidents and exacerbations of underlying chronic conditions.
The people helped through the programme regarded HIAs as safe, trusted organisations that went the 'extra mile' and checked to see if everything was ok after work was completed. Having a trusted organisation provided people with reassurance. Contact with HIAs resulted in some householders being given additional information, advice and support and benefiting from follow up services provided either by the HIA themselves or by other local agencies.
The evaluation shows how thousands of householders have been helped to live 'warm, safe and well'. Relatively small and swift improvements to their homes and heating made a big difference to their quality of life, their health and their peace of mind.
With more funding, Foundations Independent Living Trust and local home improvement agencies could help many more people stay in their own home. It would also lead to big savings for our health and care services at such a crucial time for our ageing population.
Stephen Burke is director of United for All Ages and Good Care Guide