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Document Sample
Pathways to Accessible Housing
in Cambridge City and South Cambridgeshire
An assessment of the supply of wheelchair accessible housing
and the needs of wheelchair users
The Papworth Trust
July 2004
“The number of people who need accessible local authority or housing
association homes and who will not obtain such housing within twelve months
is estimated at 168.”
CONTENTS
1. Introduction, summary findings and recommended actions ........... 1
2. Number and age of wheelchair users ................................................ 5
3. Accessible housing – supply and demand ........................................ 6
4. Survey of housing and support needs ............................................... 8
5. Views of Wheelchair Users; Social Care; Health; and Voluntary
Sector Staff ......................................................................................... 21
6. Management report: Full survey results .......................................... 23
Appendix A.................................................................................................... 26
Acknowledgements ...................................................................................... 28
The Pathways to Accessible Housing project was undertaken by The Papworth Trust,
working in partnership with Cambridge City and South Cambridgeshire Council.
The Papworth Trust and the project sponsors are very grateful to all those who
provided information or helped in other ways. These included: nearly 600 people who
responded to the postal survey of wheelchair users or took part in group interviews;
officers of Cambridge City and South Cambridgeshire Council; staff of the local NHS
Wheelchair Service; and representatives of voluntary agencies and consumer groups.
Copies of the published Guide to assessing the housing and support needs of
wheelchair users, together with a software analysis programme on interactive CD and
a report on the original pilot research for ‘Pathways to Accessible Housing’, can be
ordered from:
The Papworth Trust
Papworth Everard
Cambridge CB3 8RG
Tel: 01480 830341
Website: www.papworth.org.uk
1. Introduction, summary findings and recommended actions
The ‘Pathways to Accessible Housing’ project in Cambridge and South
Cambridgeshire is the second to follow the approach laid out in the practical
Guide produced in 2001 by the Papworth Trust and Habinteg Housing
Association. The aim is to assess the current and unmet need for alternative,
accessible housing, home adaptations and support or care services among
those who use wheelchairs. The project relates to all age groups, part-time
and full-time wheelchair users and people across all housing tenures and
types of accommodation.
The method has four stages:
Stage 1 Population estimates
Stage 2 Mapping of supply of accessible housing and known demand
Stage 3 Survey of need for housing, adaptations and support or care
Stage 4 Estimates of current and unmet need
These stages are graphically represented in the ‘house model’ (Figure 1.1).
The method takes you through from Frame 1 to Frame 16, starting with the
number of wheelchair users living in the area and ending with an estimate of
the unmet need for local authority and housing association homes. The
detailed methods used to obtain the information are explained in the relevant
chapters of this report.
The survey and statistical analysis were substantiated by views of wheelchair
users, disability groups and professionals expressed through a series of focus
groups.
The full findings of the needs assessment are given in the management report
(chapter 6). The summary findings presented below relate only to the selected
figures produced for the completion of the model. Further explanation and
comment on the figures is given in the relevant chapters.
Frame 1. The estimated number of wheelchair users in the Cambridge and
South Cambridgeshire area is 5,957. This is 2.5% of the local population
with estimated ages of wheelchair users as follows:
74% of wheelchair users are aged 65 or over
18% are aged from 35 to 64
4% are aged from 18 to 34
4% are aged 0-17.
Frames 2 and 3. There are 645 properties, in general needs stock owned
by the local authority and housing associations, which are known either to
be purpose-designed for wheelchair users or to have some degree of
accessibility. This includes properties which have been significantly or
moderately adapted, Lifetime Homes and houses built to the standards laid
down in Part M of the Building Regulations. There are also 584 fully or
partially accessible properties in sheltered and supported housing owned
by the local authority or housing associations. This is likely to be an under-
estimate of supply in view of some of the difficulties housing providers had
in providing this information.
1
Frame 4. The number of fully or partially accessible properties reported to
be available for letting over twelve months is estimated at 301, or 24% of
the accessible housing stock. This relatively high percentage reflects that
many new properties are now being completed to higher standards of
accessibility.
Frame 5. The number of housing applicants known to be waiting for
accessible properties is reported to be 154. This figure is likely to include
those wanting fully wheelchair accessible housing only.
Frame 6. The local authority and housing associations do not have data on
the percentage of accessible properties which accommodate households
without a wheelchair user.
Frames 7 and 8. The number of home adaptations (£500+) carried out for
tenants who are wheelchair users over twelve months is estimated at 68. A
further 14 Disabled Facilities Grants over £500 were awarded to people
using wheelchairs and living in privately owned accommodation.
Frame 9. Just over two-thirds of wheelchair users (4,042) have suitable
housing and support and do not wish to move or to obtain additional help.
Frame 10. A little under one in ten of the wheelchair users (469) need to
move to alternative accommodation. The most frequently mentioned
reason for wanting to move is that the design of the current home is
unsuitable. The main preference is for bungalows.
Frame 11. Almost a quarter of wheelchair users (1,046) require adaptations
to their current home. The most frequently mentioned adaptations needed
are ramps to the entrance and level access to the garden/outdoors.
Frame 12. A relatively small number of wheelchair users (301) need extra
support or care services in their current housing. Domestic assistance
(cleaning, shopping, food preparation etc) and help with transport/mobility
are the most frequently mentioned needs for extra support.
Frame 13. The number of people who need extra support and care
services, including all those who want to move and will need additional
support when they do so, is estimated at 466.
Frame 14. The number of people who need home adaptations and who will
not obtain such adaptations within twelve months is estimated at 702.
Frame 15. The number of people who require more accessible alternative
housing, and who wish to move because their home design is unsuitable or
they want to live more independently, is estimated at 469. This includes
people wanting privately owned accommodation as well as those looking to
the local authority or housing associations.
Frame 16. The number of people who need accessible local authority or
housing association homes and who will not obtain such housing within
twelve months is estimated at 168.
2
Recommended actions
The Local Authority housing strategies; the Cambridge Sub-Regional
Housing Strategy and the Regional Housing Strategy should recognise the
figure for unmet housing need (Figure 1.1, Frame 16) and seek ways of
increasing the supply of accessible housing and improving the efficiency of
letting adapted properties. The Councils should also work with private
developers to increase the number of accessible new homes in the private
sector (Note – The Greater London plan recommends 50% of new housing
to be built to Lifetime Home Standards and 10% to be fully wheelchair
accessible including new private sector housing).
There should be more accurate records of the supply of accessible and
adapted housing within Cambridge and South Cambridgeshire. In
particular, local housing providers need to improve their knowledge of
properties that are designed to mobility standards or that have been
significantly or moderately adapted.
The number of accessible or adapted properties let or re-let each year
should also be recorded by individual housing providers and monitored by
the Councils, as these figures establish the availability of such properties
as a baseline for assessing housing need.
Bungalows remain the accessible property of choice for wheelchair users.
Children and young people who use wheelchairs appear to be relatively
neglected groups. The use requirements of the whole family need to be
recognised when designing for households that include a child who is a
wheelchair user.
Housing lettings policies should recognise that some disabled people
require a larger property in order to accommodate a personal assistant.
There is a continuing high demand for adaptations to make properties more
accessible (Figure 1.1, Frame 14). Housing associations are currently
offering a very low level of adaptations work. This issue should be
investigated to see if housing association tenants are disadvantaged.
The number of disabled facilities grants and housing association
adaptations carried out for wheelchair users should be monitored – as
should adaptations for wheelchair-using council tenants. This will aid an
understanding of the respective contribution that adapting existing homes
can make in comparison with new build fully wheelchair accessible
housing.
The need for additional support or care services is significantly lower than
the need for adaptations (Figure 1.1, Frame 13), but attention should be
given to the particular needs of those who want to move and will require
extra support when they do so.
3
Figure 1.1
Pathways to accessible housing in
Cambridge City and South
Cambridgeshire
16. 15. 14. 13.
Current Current Unmet need Current and
unmet need housing need for anticipated
for local (all tenures) adaptations need for
authority and (all tenures) support and
HA housing care services
168 469 702 466
9. 10. 11. 12.
Housing and Need to move Need for Need for extra
support/care to alternative adaptations in support/care in
appropriate housing current housing current housing
4052 469 1046 301
8. 7. 6. 5.
Number of Number of Percentage of Number of
private sector local authority accessible housing
adaptations and HA properties with applicants
(DFGs) – adaptations – no wheelchair (new and
12 months 12 months users transfer)
14 68 28 154
1. 2. 3. 4.
Population of Accessible Accessible Vacant and new
wheelchair local authority sheltered and accessible
users and HA supported properties
properties – housing – available –
total supply total supply 12 months
5889 645 584 301
4
2. Number and age of wheelchair users
The first figures to be produced for the planning model are the total population
of wheelchair users and the numbers in different age groups. The method
used takes the number of people supplied with NHS wheelchairs and makes
adjustments for those who use a private provider instead (estimated at 2%)
and those who are no longer using the chair supplied (estimated at 1%). The
estimates were made by the NHS Wheelchair Services.
This gives an estimated population of 5,889 wheelchair users (2.5% of the
total population of 238,966). The breakdown by age based on information
provided by the NHS Wheelchair Services, and is shown in Figure 2.1.
Figure 2.1 – Age of wheelchair users in Cambridge City and South
Cambridgeshire
Age Number (% of all wheelchair users)
0-17 235 (4%)
18-34 235 (4%)
35-64 1060 (18%)
65+ 4359 (74%)
5
3. Accessible housing – supply and demand
The figures on the supply of accessible housing and known demand are
obtained through a postal survey of all registered social landlords (housing
associations) and the local authority housing departments. Survey forms were
sent to the thirty housing associations known to have property in the area. Of
these, twenty four responded. The supply figures are therefore likely to be on
the low side.
There are three levels of accessibility defined for the needs assessment (see
appendix A). These are:
Fully wheelchair accessible housing
Significantly adapted or mobility housing
Moderately adapted housing, Lifetime Homes or ‘Part M’ housing
There is a total of 43 general needs properties known to be fully wheelchair
accessible, plus a further 91 units in sheltered and 366 in supported housing.
The combined totals for the other, more modest levels of accessibility are:
general needs – 602; sheltered – 72; supported housing – 55. This gives an
overall total of 1229 properties built to certain defined standards of
accessibility or adapted for a specific tenant (Figure 3.1). This is approximately
6.5% of all properties in the area owned by the local authority or housing
associations.
Figure 3.1 – Supply of accessible housing in Cambridge and South
Cambridgeshire
Level of General needs Sheltered Supported
accessibility housing housing housing
Fully wheelchair accessible 43 91 366
Significantly adapted or
46 0 48
mobility standard
Moderately adapted,
556 72 7
Lifetime Homes or ‘Part M’
All levels 645 163 421
The figures suggest that Cambridge and South Cambridgeshire has a
relatively low supply of accessible housing, as Housing Corporation figures
nationally show that 1.6% of housing association properties are designed to
full wheelchair standard and 12.4% reach the level of ‘general accessibility’.
However, the responses from both housing associations and the local
authority indicate that accurate and up-to-date information on the number, type
and location of accessible and adapted properties is not generally held by the
individual housing providers. It is possible, therefore, that the figures, in
particular for adapted properties and those that are not fully wheelchair
accessible, under-estimate the supply.
6
The total number of accessible and adapted properties known to have been let
over twelve months to new tenants, or people transferring from other
properties within the same organisation, is 301. This is 24% of the 1229
accessible properties identified, a much higher figure than the 6.25% national
figure given by the Housing Corporation for the annual rate of re-lets of
wheelchair standard properties.
The planning model asks for the number of adaptations carried out over twelve
months for tenants who are wheelchair users and for other people, also
wheelchair users, living in private accommodation. Five of the housing
associations responding to the survey said that they had carried out an
adaptation costing over £500, with four of the five undertaking more than one
adaptation. This represents a relatively good response compared with
previous research in other areas as part of the piloting of the Pathways Model.
Cambridge City Council reported doing 84 adaptations over £500 in its own
properties, but had no record of how many were for wheelchair users. The
local authority also paid out 93 Disabled Facilities Grants over £500 to people
in private sector housing. South Cambridgeshire carried out 104 adaptations
over £500 in its properties, 34 of which were for wheelchair users. It paid out
72 Disabled Facilities Grants and an estimated 6 were to wheelchair users.
7
4. Survey of housing and support needs
The quantitative information on the needs of wheelchair users for suitable
housing and support services is collected through a postal survey of people
who have been supplied with wheelchairs by the NHS Wheelchair Service. In
addition, the method involves interviews with individual wheelchair users
contacted through local voluntary organisations or service providers. These
interviews, which are reported on in chapter 5 of this report, give qualitative
data against which to assess the quantitative information obtained through the
wider postal survey. They also provide details of people’s experiences and
their views on current provision and services.
The survey questionnaire was sent to 1350 people, across all age groups. The
sample selection was carried out by staff of the NHS Wheelchair Service,
which serves the Cambridge and South Cambridgeshire areas. While this
method of sampling excludes those who do not use the NHS service, the NHS
Wheelchair Services indicated that this group constitutes only a very small
percentage of all wheelchair users. It is not possible to include private
suppliers of wheelchairs in the needs assessment, for two reasons: firstly,
some people will have both an NHS wheelchair and a privately-owned chair
and so could be double-counted; and secondly, issues of commercial
confidentiality come into play when requests are made for detailed figures on
wheelchair use and supply.
The response rate to the survey was 44% (589 people), which is good for a
postal questionnaire. The age breakdown of the sample shows that the
number of people aged 65 and over matches the national figures (51%), is
lower than the national figures (66.2%), while the 35-64 age group (36%) is
lower than the sample (22% nationally). The two younger age group samples
are similar to national figures (Figure 4.1).
Figure 4.1 - Age of respondents
60
52
50
40 36
Percentage
30
20
10 6 6
0
0-17 18-34 35-64 65+
Age
8
The gender breakdown of respondents (63% female and 37% male) is similar
to the national figures for wheelchair users, which indicate that 64% are female
and 36% male (Figure 4.2). The ethnic origin of respondents is given in Figure
4.3.
Figure 4.2 – Gender of respondents
Gender of Respondents
Male, 37%
Female, 63%
Figure 4.3 – Ethnic origin
91.17
100
80
Percentage
60
40
2.55 0 0.17 0 0.17 0.68 0.85 0 0.34 1.19
20
0
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Ethnicity
The great majority of respondents are either retired (53%) or long term sick or
disabled (31%). Twenty-four people in the sample say that they are in full-time
or part-time employment.
In response to the question on how much they use their wheelchair, just under
a third (30%) say that they use it all the time. The majority report using their
wheelchair some of the time (both inside and outside) 18%, or outside only
52% (Figure 4.4). The figures for part-time wheelchair use in Cambridge and
9
South Cambridgeshire are considerably higher than those reported in the
earlier pilot Pathway studies.
Figure 4.4 – Use of wheelchair
60 52
50
Percentage
40
30
30
18
20
10
0
Use a wheelchair all the Use a wheelchair some Use a wheelchair outside
time of the time only
(inside & outside) (inside & outside)
Use of Wheelchair
The survey includes a number of questions about respondents’ current
housing situation, the accessibility of their home and their level of satisfaction.
A third of the respondents (23%) live on their own. Approximately half of the
respondents live with a partner only (43%) or with a partner and children (11%)
(Figure 4.5).
Figure 4.5 – Types of household
50 43
45
Percentage
40
35 23
30
25
20 11
15 11
5
10 4 3
5
0
accommodation
relatives in
With children
Not stated
With parents
With partner
and children
and/or other
With non-
shared
only
With partner or
relatives
On own
friend only
Household
Almost 73% of respondents live in their own/joint home, including both owner-
occupied and rented accommodation. The next largest groups are living in
sheltered housing (7%) or (in the home of parents, relatives or friends 9%).
More than half of the 18-34 age group live in the home of parents etc, while
18% of the people aged 65 and over live in sheltered housing. A very small
proportion (3%) live in supported housing, (Figure 4.6).
10
Percentage Percentage
20
40
60
80
0
20
40
60
0
Figure 4.8.
Live in own/joint home
73
Owner occupied (owned or rented)
50
housing/buying
on a mortgage
Live in own/joint home
7
(sheltered housing)
Local authority
tenancy
30
Figure 4.7 – Housing tenure
Live in the home of
9
parents/relatives or friends
Housing association
9
tenancy
Live in supported
3
housing
Figure 4.6 – Current housing circumstances
Private landlord
3
Current Housing
tenancy Live in a residential or
2
Housing Tenure
nursing home
1
Shared ownership Live in NHS/hospital
0
(part buy/part rent) acccommodation
Other (please Live with parents/relatives
2
1
specify) & stay at school/college
5
accommodation (Figure 4.7). The types of accommodation are shown in
Not answered
Not stated 5
50% of respondents live in owner occupied housing, while a further 39% are
local authority or housing association tenants. Only 3% live in private rented
11
Figure 4.8 – Type of accommodation
60 50
Percentage
40 31
20 9
1 3 1 2 2.5
0.5
0
floor or above without
Other (please specify)
(detached/semi/terrace)
access by lift
floor flat or with access
Flat/maisonette - 1st
Flat/maisonette - ground
Flat/own room in
Flat bungalow in
Residential or nursing
Not answered
supported housing
House
sheltered housing
Bungalow
by lift
home
Type of Accommodation
19% of respondents say that their home is fully wheelchair accessible. Much
more commonly, the home has no adaptations at all for wheelchair use (38%)
or it has been adapted to some degree (26%) (Figure 4.9).
Figure 4.9 – Accessibility of home, by age and gender
Q10. Design of home
Accessibility Age Gender
counts Age Age Age
%columns 0- 18 - 35 - Age Not
17 34 64 65+ answered Male Female Total
Fully wheelchair 0 2 11 23 0 14 22 36
accessible 0% 12% 13% 11% 0% 12% 12% 12%
Significantly 1 4 9 11 0 12 13 25
adapted for 33% 25% 11% 5% 0% 11% 7% 8%
wheelchair use
Moderately adapted 1 4 15 35 1 21 33 55
for wheelchair use 33% 25% 18% 17% 100% 18% 17% 18%
No adaptations made 1 5 45 120 0 60 111 171
at all for wheelchair 33% 31% 54% 59% 0% 53% 58% 56%
use
Not answered 0 1 4 13 0 7 11 18
0% 6% 5% 6% 0% 6% 6% 6%
Total 3 16 84 202 1 114 190 305
The satisfaction of respondents with the design and location of their home is
shown in Figures 4.10 and 4.11. These questions relate specifically to the
accessibility of the accommodation and the local area, in terms of people’s
ability to get around and use facilities (within the home) or local amenities.
12
Figure 4.10 – Satisfaction with design and layout of home
40
32
Percentage
30 25
20 17 16
10 6
4
0
dissatisfied
Extremely
response
satisfied
Extremely
Not very
satisfied
satisfied
satisfied
Quite
Very
No
Design of Home
Figure 4.11 – Satisfaction with location of home
40 36
Percentage
30 22
17
20 13
8
10 4
0
Extremely
satisfied
response
satisfied
Not very
satisfied
satisfied
dissatisfied
Extremely
Very
Quite
No
Location of Home
The survey also asks whether respondents receive regular home care services
(domestic help) or personal care (help with getting up, bathing etc). In answer
to these questions, 70% say they receive home care and 64% say they
receive personal care. The survey does not enquire about the source of such
assistance (whether privately purchased, provided through public funding or
given informally by relatives or friends). In response to a further question, 62%
say they do not have regular visits from social care or health professionals
(e.g. district nurse, social worker).
13
Figure 4.12 – Home care
Receiving regular Home Care
Yes 70%
No 30%
Figure 4.13 – Personal care
Receiving regular Personal Care
Yes 64%
No 36%
14
Figure 4.14 – Visits from social care or health professionals
70 62
Percentage
60
50
40
30
20
20 11
4
10 2 1
0
Yes – once
No response
a week or
Yes – between
once a week &
Yes – once
Yes – once
No
every 6-12
once a month
every 3-6
more
months
months
Visits from Care/Health Professionals
The responses to the key question on the need for suitable housing and
support show that almost two thirds (66%) think that their current housing and
support services (if any) are fully appropriate. 18% say they need adaptations
to their present housing and a small number (6%) say they need extra support
or care services. This leaves fifty-seven people in the sample of 589 (10%)
who say their housing is not satisfactory and they need to move (Figure 4.15).
Figure 4.15 – Need for housing, adaptations and support
66
80
60
Percentage
40
18
20 10 6
0
Housing & Housing is not Do not need to Do not need to
support are fully suitable and move but do move but do
adequate and need to move to need need extra care
do not need to alternative adaptations to and support in
move housing current housing current home
Current Position
15
Among those who say they need to move, nearly a half (46%) want a move
involving the whole household, while in 23% of cases it is the wheelchair user
only who needs to move (Figure 4.16).
Figure 4.16 - Who needs to move
60 46
Percentage
29
40
23
20
2
0
Wheelchair
user only
Non-respondents
in the household
Wheelchair user
& everyone else
Wheelchair user
household (but
& one or more
not everyone)
others in the
Who needs to move
Figure 4.17 - Reasons for needing to move
50 45
40
Percentage
30
20 11 11
9
6 6 6
10 4
2 0
0
Want to change tenure
Need a larger home
Want to live with
Need more support
Other
Design of current home
Need a smaller home
Want to live nearer
Location
Want to live more
partner
independently
family
Reasons need to move
The main reason given for needing to move is that the home is unsuitable for
wheelchair use. The next most frequent reasons are the wish to live more
independently and the need for a larger home (Figure 4.17). When asked
what type of accommodation they would like, the great majority of those
needing to move (72%) say they would like a bungalow (Figure 4.18).
16
Figure 4.18 - Type of accommodation wanted
72
80
Percentage
60
40
20 7 4 4 5 6
2 0
0
Residential or
Other
nursing home
Flat/maisonette
Bungalow
Non-respondents
sheltered housing
(detached/semi/terrace)
in supported
Flat/bungalow in
Flat/maisonette
housing
House
Type of accommodation would like
49% of those who say they need to move also report that they need fully
wheelchair accessible accommodation (Figure 4.19). 26% opt for
accommodation that is significantly or moderately adapted for wheelchair use.
Figure 4.19 - Level of accessibility required
60 49
40
Percentage
21
11
20 9
5 5
0
wheelchair use
wheelchair use
Non-respondents
Significantly
wheelchair
adapted for
Don’t know
No adaptations
wheelchair use
adapted for
Moderately
made at all for
accessible
Fully
Level of accessibility would like
When asked whether they would need additional support or care services if
they move, just over a third say they would need such services (Figure 4.20).
17
Figure 4.20 - Extra care and support required
Extra care and support required
No 53%
Yes 35%
The survey asks those who need adaptations to their home what kinds of
adaptations they require. The most commonly mentioned adaptations are:
ramps and level access; nearly one quarter of those needing adaptations
(23%) say they do not know where or how to apply (Figure 4.22).
Figure 4.21 - Adaptations and equipment required
Adaptations Percentage
Installing stair lift 48
Ramps to entrance of home 43
Other 42
Level access to
35
garden/outdoors
Installing downstairs toilet or
21
bathroom
Installing rails in bathroom or
18
toilet
Adjusting the height of
electrical switches and power 13
sockets
Installing an entry system 12
Adjusting the height of kitchen
12
equipment and appliances
Adjusting the height of
12
surfaces in kitchen
Installing an alarm 10
18
Figure 4.22 - Steps taken to get adaptations
Q28 Applied yet Percentage
No - not sure where or how to
23
apply
Non respondents 18
Yes - applied to local authority or
16
Housing Association
No - haven't applied yet but intend
12
to apply for grant/assistance
Other 11
No - will be arranging and paying
11
for them privately
Yes - applied for a Disabled
5
Facilities Grant
Yes - agreed and now waiting for
4
work/installation
Yes - agreed and work in
0
progress
The main additional services required by those who say they need extra
support are home care (domestic services) and help with transport and
personal care (Figure 4.23). 40% of those needing extra support say they also
need adaptations to their home (Figure 4.24).
Figure 4.23 - Types of extra support required
Type of support Percentage
Home care (meals, cleaning,
50
cooking, shopping etc)
Help with transport and
54
mobility
Personal care (getting up,
50
bathing, eating)
Nursing care (changing
18
dressings, injections, etc)
Other support or assistance 25
Help with managing finances 25
Help with developing
14
domestic/practical skills
Social support and help with
32
developing activities
Help in gaining access to
11
work/training/education
19
Figure 4.24 – Adaptations required by those needing extra support
Any adaptations or equipment
Yes 40%
No 60%
20
5. Views of Wheelchair Users; Social Care; Health; and Voluntary Sector
Staff
The following is a collection of views expressed by those participating in focus
groups held as part of the project.
Older People
Daughter able to easily arrange “home help”
Sister of wheelchair user able to arrange a move from 1 st floor London
flat to Anchor sheltered housing scheme in Cambridge – “a bit of a wait
(one year) – but they managed”.
Referred to a “Safer Homes” agency who arranged for grab rails to be
fitted in the bathroom.
The Council arranged for a friend to move from a first floor maisonette
to a nearby ground floor flat having become a wheelchair user. New flat
fully adapted to meet his needs
A woman is having to wait for the Council to install a ramp to her front
door.
A wheelchair user living in a sheltered housing scheme finds the front
doors very heavy.
Children
Policies - Housing needs to be put onto policymaker’s agenda. There
seems to be a major mismatch between what is needed and what is
being built or available; both within the social and private housing
sectors. Policies regarding the points system are seen as unfair.
Building Regulations can be inflexible and not allow for special needs.
Legislation needs changing to reflect the needs of disabled children and
housing.
Design - Children want to be as independent as possible. All children
need access to a bedroom as their own private space whether they
have disabilities or not. Good design has to reflect the long term needs,
this needs to include space for equipment and storage. New build
properties need to have ‘disability factors’ designed in from the
beginning. Children need an advocate in the design process.
Planning for adaptations/new build properties - Ideally there needs
to be purpose built housing; locally there is a lack of accommodation
and a lack of space to build. Local planning decisions need revising –
where new developments are being planned with accessible schools,
planners need to ensure that there is suitable housing for families with
disabled children. Location of adapted housing can be very important.
Housing Departments need to be involved early on in the care pathway
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for a child. At present it would seem in some areas that there is a lack
of co-ordination and information.
Other housing concerns - There is a perceived inequality in obtaining
adaptations for children who are fostered or adopted compared with
those children living within their own families. Concern was expressed
that having an adaptation built onto a privately owned house could
devalue the property. Concern also expressed that social housing can
be located in a poor environment.
Other
There are real issues of different levels of service delivery depending on
where people live. For example people living in towns and cities are
advantaged by being able to access a wider range of services, whereas
those living in rural areas do not have local access and need to travel to
receive services.
People with learning difficulties are perceived to have access to a wider
range of support services than people with physical impairments. A
number of reasons were cited for this. Firstly, this client group received
a higher focus and priority as part of the programme to close
institutions. Also the learning disability client group has traditionally
had a more active user/advocacy support network. Physical disability
services have had a lack of focus in the past, being subsumed as part
of services for older people.
There is a maze of bureaucracy that needs to be negotiated to achieve
any form of housing solution. Comments were made such as “there
isn’t any housing”, “it’s a nightmare for clients”, “there are no options, no
choice”.
The time it takes to adapt a home or achieve appropriate re-housing for
someone who has acquired a disability is a real problem. A halfway
house for people who have acquired a disability and are undertaking
rehabilitation would be helpful.
“I can think of two people with MS, who are wheelchair users, and cannot even
get out of their house without being carried over awkward steps or door
ridges”.
“People cannot wait the length of time it takes before appropriate wheelchair
housing can be offered”.
“Fitting grab rails to the walls of some of the all new properties being built can
be a real problem”
“The housing needs of clients with motor-neurone disease are not well
understood. Needs can change very quickly and sometimes have to be
provided rapidly”.
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6. Management report: Full survey results
This management report gives the key findings of the ‘Pathways to Accessible
Housing’ project carried out in the Cambridge and South Cambridgeshire area
in 2004. The project looked specifically at the housing and related support
needs of people who use wheelchairs.
Population of wheelchair users
1. The estimated number of wheelchair users in Cambridge and South
Cambridgeshire is 5,889. This is 2.5% of the total local authority
population of 238,966. The figure includes people who use a wheelchair
all the time and those who do so on a part-time basis.
2. There are an estimated 4359 wheelchair users aged 65 or over (74%). A
further 1060 are aged between 35 and 64 (18%), 235 are aged 18-34
(4%) and 235 (4%) are aged under 18.
Survey of housing providers
3. There are 43 homes known to be fully wheelchair accessible in general
needs housing owned by the local authority or housing associations
(Registered Social Landlords - RSLs).
4. In addition to the fully wheelchair accessible homes within general needs
housing, there are an estimated 46 which are to mobility standard or
significantly adapted and 556 which are moderately adapted, designed to
Lifetime Homes standards or meet the requirements of Part M of the
Building Regulations.
5. Sheltered housing for older people. The current supply is estimated to
comprise 91 fully wheelchair accessible properties, 0 that is significantly
adapted or to mobility standard and 72 that are moderately adapted,
Lifetime Homes or ‘Part M’ standard.
6. Supported Housing. The total supply is estimated as 421 made up of 366
fully wheelchair accessible, 48 significantly adapted or to mobility
standard, and 7 moderately adapted, Lifetime Homes or ‘Part M’
standard.
7. The number of accessible homes in general needs housing which have
been let or re-let by the local authority or RSLs over twelve months is
301.
8. The number of housing applicants known to be needing a home with
some degree of accessibility is 469.
9. The percentage of fully wheelchair accessible properties in local authority
and RSL stock which is occupied by households with no wheelchair user
has not been estimated as no figures are available.
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10. The number of housing adaptations carried out for wheelchair user
tenants by the local authority and housing associations over twelve
months is 40.
A further 6 people who use wheelchairs have had major adaptations to
their privately owned homes through a Disabled Facilities Grant.
Survey of wheelchair users
11. A postal questionnaire was sent to 1350 wheelchair users, of which 588
were returned (44% response).
12. Age, gender, ethnicity and employment status. The majority of the
respondents (52%) are aged 65+, with 36% aged between 35 and 64, 6%
between 18 and 34 and 6% under 18. The majority of those responding
(62%) are female. Almost 91% of the respondents define their ethnicity as
‘White UK’, with 2.5% describing themselves as White European. Only
4% of the respondents are in full-time or part-time employment.
13. Wheelchair use. Nearly two thirds of the respondents (52%) use a
wheelchair outside only. The second largest group (30%) use a
wheelchair all the time.
14. Living circumstances. 23% of respondents live on their own.
15. Tenure and type of accommodation. 73% of respondents live in their
own/joint home. 7% per cent live in sheltered housing and 9 % are in the
home of parents, relatives or friends. 50% of all respondents are in owner
occupied housing, with 39% being local authority or housing association
tenants.
16. Design of property. Only 19% of respondents have fully wheelchair
accessible housing. 38% say that no adaptations have been made for
wheelchair use.
17. Satisfaction with design and location. Overall, 42% of respondents are
extremely or very satisfied with the design and layout of their home and
another 32% are quite satisfied. The levels of satisfaction with the
location of the home follow a very similar pattern.
18. Use of care and health services. 30% of all respondents do not receive
any home care services and 36% do not receive personal care services.
62% of the respondents are not visited by social services or health staff.
19. Need for alternative housing, adaptations or support and care services.
The majority of respondents say that their current housing and support
are fully appropriate. 10% need to move, 18% need adaptations to their
current housing and 6% need extra support in their current housing.
20. People who need to move. Where people express a need to move to
other housing, 23% require accommodation for themselves only, while
46% need a move for the whole household. The most common reasons
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are: the design of their current housing is not suitable for wheelchair use
(45%) and the person wants to live more independently (11%).
21. Type of housing preferred. A bungalow is the preferred choice of housing
for 72% of those needing to move. 49% say they need fully wheelchair
accessible housing, while 26% require housing that is significantly or
moderately adapted for wheelchair use.
22. People who need adaptations. Where people are not seeking to move but
say they require adaptations to their current housing, the most commonly
mentioned adaptations are: entrance ramps and level access;. Twenty
three per cent of the people who need adaptations say they are not sure
where or how to apply.
23. People who need extra support or care services e.g. Among those who
need extra support to stay in their home, home care (domestic services)
help with mobility and transport; and personal care are the most
frequently mentioned type of additional support required.
Estimates of need for accessible housing and support
24. Once the results of the survey of wheelchair users have been weighted
for age and applied to the total population of wheelchair users in
Cambridge and South Cambridgeshire, the estimate for the number of
people requiring additional support or care services is 466 (Box 13 in
Pathways model).
25. The estimated number of people currently needing housing adaptations,
including all tenures, is 702 (Box 14 in Pathways model).
26. The estimated number of people currently needing to move to alternative
housing, including all tenures, is 469 (Box 15 in Pathways model).
27. The estimated number of people who currently need an accessible local
authority or housing association property and whose need will not be met,
given the present rate of supply, is 168 (Box 16 in Pathways model).
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Appendix A
Pathways to Accessible Housing:
Definitions of accessibility
Fully wheelchair accessible housing
This definition is based on the Housing Corporation’s Scheme Development
Standards, as laid out in the Wheelchair Housing Design Guide (Construction
Research Communications, 1997).
1. High degree of accessibility within the housing development
2. Spaces within the area of the home are accessible, useable and, where
appropriate, secure
3. Ease of approach to the home by car, wheelchair or intermediate vehicle
with good cover and protection at entrance and point of transfer
4. Entrance doors can be operated and negotiated independently, whether
entering or leaving
5. Wheelchair users can: approach and open door, enter, transfer from
outdoor to indoor chair, leave outside chair on charge
6. Direct connection to external spaces by an easily opened but secure door
7. Wheelchair users can conveniently manoeuvre, approach and negotiate all
doors within the circulation area and approach and use storage space
8. Wheelchair users can move between floor levels, if necessary, without the
need to transfer and without restriction to space
9. Living and bedrooms can accommodate the normal range of furniture,
while allowing the wheelchair user to approach and transfer to beds,
operate windows etc.
10. Ease of approach to, and use from a wheelchair of the sink, worktops,
equipment, appliances, controls and all kitchen storage
11. Independent approach and safe transfer to all bathroom fittings. Choice
between shower or bath, or both
12. All internal doors can be operated conveniently
13. Independent control of windows, passive and mechanical ventilation.
Balance of daylight, views out, privacy and security
14. All essential controls are accessible and easily manipulated or operated
Significantly Adapted or Mobility Standard Housing
This includes properties which have been designed to high levels of ‘visitability’, but
not to full wheelchair accessible standards. The category of ‘mobility housing’ is now
less widely used, as new categories have been introduced (see below). ‘Significantly
adapted’ properties are those that have had major structural adaptations, usually to
allow a particular wheelchair user to live in and make proper use of the home. They
should have a good proportion of the features outlined above for fully wheelchair
accessible housing. Examples include: a property which has had an extension or re-
design of the ground floor to allow for an accessible WC, bathroom or bedroom; and a
property which has had major alterations to the kitchen to enable it to be fully used by
the occupier.
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Moderately Adapted, Lifetime Homes or ‘Part M’
Moderately adapted homes have been adapted to a lower standard of
accessibility and have fewer of the features of fully wheelchair accessible housing
than those in the previous category (significantly adapted).
Lifetime Homes - definition from Building Lifetime Homes, Joseph Rowntree
Foundation, 1997:
1. Where car parking is adjacent, it should be capable of attaining 3.3m width
2. Minimum distance from car parking to home, level or gently sloping
3. Approach to all entrances level or gently sloping
4. Illuminated entrances with level threshold and covered main entrance
5. Accessible lift, where provided
6. Width of doorways and hallways to accord with established accessibility
standards
7. Space for turning of wheelchair in kitchens, dining areas and sitting rooms and
adequate circulation space elsewhere
8. Sitting room/family room at entrance level
9. In houses with two or more storeys, ground floor space that could be used as
bed space
10. Wheelchair accessible downstairs WC and drainage to provide for a shower to
be fitted at a later date
11. Walls capable of taking handrails etc
12. Provision for a future stair lift and space for the installation of a through-floor
lift to the first floor
13. Bathroom/bedroom ceiling strong enough to support a hoist. Provision for a
connecting floor to ceiling door to allow passage of hoist between bedroom
and bathroom
14. Bathroom layout designed for ease of access to the bath, WC and wash basin
15. Living room glazing to begin at 800mm or lower and windows easy to operate
16. Switches, sockets and service controls at a height of between 600mm and
1200mm from the floor
Part M (Building Regulations, 1999 – applying to all new flats as well as houses)
1. Level or ramped approach to the house, at least 900mm wide
2. Accessible entrance threshold
3. Entrance door with a minimum clear opening of 775mm
4. WC at entrance level with access for wheelchair users
5. Corridors and hallways at entrance level sufficiently wide for circulation
6. No changes of level in entrance storey using steps (except on steeply sloping
plots)
7. Switches and sockets sited between 450mm and 1200mm from the floor
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Acknowledgements
To follow
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