Appendix 3

Spelthorne’s Ageing Population and Accessibility Needs

Spelthorne’s ageing population has increased pressure on housing suitability and support services, Census data shows that 18% of residents are over the age of 65 with 14% being over 70. This has increased demand for downsizing options, accessible housing and support to remain independent, this has led to demand for more hospital discharge accommodation and for adaptations and mobility related interventions. This then creates demand for occupational therapy referrals and ultimately places pressure on limited DFG budgets.

The reintroduction of means testing for Level Access Showers (LAS) within the (DFG) framework needs to be considered within the wider demographic, health and socio-economic context of Spelthorne. Whilst the proposal supports the long-term financial sustainability of the adaptations service and aligns with the statutory DFG framework under the Housing Grants, Construction and Regeneration Act 1996, there are wider implications for health inequality, preventative healthcare and independent living outcomes that require careful consideration.

Further evidence from the Census demonstrates that 14.4 % of residents reported some level of disability with 5.7% reporting that there day to day activities were ‘limited a lot’.

Level access showers are widely recognised as both preventative and enabling adaptations and they reduce slips, trips and falls within the home environment. Slips, trips and falls are a major contributor to hospital admissions amongst older adults. So, the re application for means testing these adaptations may have wider implications if households delay or decline adaptations due to financial contribution requirements.

Although Spelthorne performs relatively well based on national indicators, the borough contains pockets of hidden deprivation and health inequalities. Some neighbourhoods record substantially higher disability prevalence than borough averages. With borough wide averages obscuring local concentrations of poor health and disability with low-income households who may then be disproportionately affected by the reinstatement of financial contributions.

The wider housing market in Spelthorne also creates additional challenges with high housing costs relative to income. As a result, there a significant number of owner occupiers who are asset rich, but income limited, particularly older owner occupiers, who may fall within the means tested contribution thresholds despite having limited disposable income to fund adaptations. The reintroduction of the means test could create some behaviour change with these residents possibly leading to a deferral of works or seeking cheaper interim solutions.

This committee report seeks to balance these considerations against the need to ensure the finite DFG resources remain targeted towards households with the greatest financial need. Offering the Council a proposal that supports the equitable resource allocation where demands are exceeding available funding.