23 May 2022

Stopping catastrophic falls by doing nothing

The rising costs of health and social care are never far away from the news. The Department of Health and Social Care knows that housing has a key part to play, and put aside £300m as part of last year’s Social Care White Paper. It makes sense - we spend more time at home as we age, and we also become increasingly likely to suffer a serious fall.

The government has significantly increased funding of the Disabled Facilities Grants (DFG) to pay for adaptations after a fall - but wouldn’t it be better to make our homes safer so that we don’t fall in the first place? So why do we routinely make our homes more hazardous?

Data from the English Housing Survey shows that the percentage of adapted housing association dwellings has dropped from 21% in 2009 to just 18% in 2018. That’s despite £200m of DFG funded adaptations every year and 54% of tenants having a long term illness or impairment.

In a survey of staff responsible for home adaptations we heard how level access showers, stairlifts and grabrails are routinely removed on a change of tenancy - with the pressure to reduce void times cited as the reason for minimal attempts to find a prospective tenant who needs them.

So the new tenant doesn’t need adaptations right now, but what about the future. A study in America looked at people who had been widowed but remained living in a home that had been adapted for their spouse. The presence of adaptations did not reduce the number of falls, but they made them far less likely to be catastrophic - a 38.6% reduction in serious falls for individuals aged 75 and older.

So if we could reduce serious falls by nearly 40% by leaving adaptations in place, why do we rip them out without a second thought?

In our new report Housing Associations and Home Adaptations: Finding Ways to Say Yes, produced in partnership with Habineg, Anchor and Taylor Wimpey, we make a number of key recommendations to improve this situation. It includes ways in which landlords can take a bigger role in improving the accessibility of their own stock and supplement DFG to invest in more attractive and sustainable adaptations.

Adaptations should be a long term investment in the accessibility of the stock, rather than a cheap and short term welfare provision for the existing tenant. This shift in thinking is likely to reduce the cost of voids, but more importantly you will be saving future tenants from the sort of fall that they will never properly recover from. When you look at it like that, it’s difficult to justify current practice.

Written by Paul Smith

Paul Smith is the director of Foundations.