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Making Adaptations Work for Older People in Scotland

Report: Making Adaptations Work for Older People

Being able to live independently, safely and well in your own home for as long as possible is the consistent aspiration of the vast majority of older people in Scotland. This has been highlighted loud and clear through a wide range of Age Scotland research as people want to keep that connection to their community, family and friends.

Age Scotland is delighted to have worked with the University of Stirling to co-produce this report focusing on the role of adaptations in future-proofing homes and environments for our ageing population. Together we have analysed the findings from national surveys which asked older people about their experience of home adaptations, followed by focus groups and interviews with people aged 55 and over across social and private sector housing tenures.

Are we there yet, or what needs to happen for this to become a reality?

"Making Adaptations Work for Older People in Scotland" has a range of key recommendations, including the establishment of local and national-level adaptation hubs and investment in a ‘Home Upgrade’ campaign for older and disabled people. All of which will need strong collaboration between national and local government to make it a reality.

We believe that this report adds to the growing body of evidence on housing and ageing and is firmly grounded in the views of older people themselves. Through this extensive engagement hundreds of older people were able to identify and share what they believe contributes to a good life in older age, the role their home plays in that, and what needs to change to meet their housing requirements today and in the future.

Download a copy of the report

This report is for decision makers and the public alike and we hope that it shapes our housing policy and practice so that the needs of older people are much better met and improves their quality of life in the years ahead and for generations to come.

Conclusions

The understanding of adaptations from older people’s perspectives is quite straight forward yet inclusive: things that make life easier and comfortable for people, especially those living with health support needs.

It is the process behind adaptations that makes it complex. Key points include diverse and fragmented pathways for information and advice, issues of consent (especially for private renters), lack of understanding of ‘good’ inclusive design options and finding and managing trusted contractors. General help with project management is a clear place for additional support–including creating easy points of contact for smoother communications between services and service users. This would help to avoid the perceived ‘fight’ for help, information, updates and progress.

Older people have a range of interventions that help them with everyday living, the most popular eing supporting equipment for moving safely and changes to bathrooms. This report highlights that older people will often begin by self-funding their own adaptations, and little is known about the informal processes that begin before any formal connections with health, social and housing services. There is a clear unmet need and willingness to adapt via a variety of pathways.

There is a requirement for consideration of household needs both for immediate and future physical, mental, and emotional support. When effective adaptations are in place, they can have a positive impact on not only service users but carers and other people in the network. This support can link with wider agendas such as energy efficiency and digitisation. From older people’s perspectives, these different policy arenas are not visible. They perceive one household, network and area for support and adaptations to home environments can help with everything.

The report gives further insight into the process of delivering adaptations at the front-line of Local Authority and third sector services in housing, health and social care. Key areas for making the process smoother were seen to include:

  • Effective governance and partnership working mechanisms;
  • Investment in staff resources;
  • Simplifying funding processes;
  • Person-led ‘say yes’ culture to adaptations.

Like older people’s experiences, front-line professionals had challenges finding and managing contractors and this is a key area for needed support. The methods that were applied in the research helped to provide an insight into what services Local Authorities were providing and help to identify good practice that other Local Authorities could adopt/interpret for their local circumstances to improve service provision.

Podcast: Making adaptations work

Dr Vikki McCall from the University of Stirling and Age Scotland's David Petrie discuss their research into the experience of older people trying to make their homes more accessible and ways to reform the system.

Recommendations

Understanding the importance of adaptations within older people's lives

  • Invest in local and national hubs for a ‘one-stop shop’ for adaptations support
  • Redefine and expand adaptations criteria to include wider consideration of support needs within the home
  • Invest in a ‘Home Upgrade’ campaign for older and/or disabled people as an investment in preventative support focusing on upgrading current housing stock across Scotland that is not fit for purpose, which has the most potential for planning for ageing

Improving information, advice and communication

  • Create consistent language, avoiding jargon, in information and advice around adaptations
  • Review the suitability of the private rented sector for healthy ageing
  • Expand support for adaptations to include informal stages

Support front-line practice to improve adaptations

  • Ensure consistent funding mechanisms between areas and tenures
  • Ensure that all Care & Repair services are funded appropriately
  • Increase support for effective partnership working between housing, health and social care
  • Link in wider housing condition surveys and carbon neutral ambitions to adaptation processes
  • Improve evaluation processes and existing outcome measures
  • Establish a good practice review on contractor procurement

Reimagining the adaptations process from older people's perspectives

  • Take a proactive Inclusive Living Approach to planning for housing and adaptations
  • Enable advice services and the public in understanding what good, inclusive design looks like
  • Create a consistent, household approach to assessment across all tenures and throughout Scotland

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