Ditching the clipboard – a new approach to housing inspection in Thurrock

 

Poor Housing 

Thurrock is a unitary authority area located in Essex. Part of the London commuter belt, it has been an area of regeneration within the Thames Gateway redevelopment zone for several years now.

Thurrock’s Council’s Housing service, however, recognised that its ongoing regeneration programme could not eliminate all of its poor housing stock. As a result the local authority wanted to try a new way of working, which would not only improve housing conditions in its private sector but also improve residents’ access to a range of other services, including local health provisions.

The idea behind this new approach, called the Well Homes scheme, was that residents would have the luxury of a ‘Well Homes Advisor’ visiting them at their own home. During the visit, the Advisor would provide information and advice about a broad range of housing, safety and health services to them, with a focus on what would make them feel better at home.

Finding inspiration in Liverpool Council’s Healthy Homes Programme, Thurrock’s housing team progressed with profiling and carrying out a Health Impact Assessment on their private housing stock. The results were then used to build up relationships and conservations with the council’s Public Health Team.

The Health Impact Assessment (HIA) identified 8,500 severe housing hazards, including 3,000 fall hazards and 2,000 excess cold hazards. Furthermore, outcomes from the HIA found that if no work was carried out to reduce the total number of severe housing hazards, the estimated annual cost to the NHS for treating accidents and ill health would be £953,000.

As a result, the results from the HIA enabled Thurrock’s Public Health team to recognise that the private housing service could form a part of its wider workforce supporting its priorities. It was subsequently agreed that Public Health would 100% fund the new Well Homes scheme, with housing as the operational arm of the business.

To get started, a ‘Thurrock Well Homes Index’ was set up, which mapped-out the HIA information and other local indices of multiple deprivation such as income/health, living environment etc. This helped identify areas with the most pressing housing-related problems and where residents were considered to have poorer health outcomes. Well Homes was therefore set up to target these ‘hot spot’ areas.

The Well Homes scheme started off as a small project, with only one Well Homes Advisor (Advisor) who was supported by many partners, such as health, community safety partners, trading standards, domestic abuse, and fire safety.

Residents were then visited at their home by the Advisor, who ditched the ‘clipboard and hard hat’ and simply had a conversation. Where problems were discovered, residents were then referred, signposted or offered one of the new range of Well Homes financial offers, such as improving security measures or gardening services.

In the first year, the single Advisor completed 466 assessments and visited more than 1,500 people, with 85% of residents confirming that they felt healthier and safer at home, as a result of their Well Homes assessment.

Furthermore, 98% of resident’s visited told the council they thought this new approach was a good idea and 100% of residents found the advisor to be knowledgeable.

The Well Homes scheme has just finished its first year and the initial investment of £45,000 has led to savings of more than £640,000 for the NHS and other services, as well as removing more than 120 severe housing hazards. These successful results have resulted in a further two years of guaranteed funding from Public Health.

The Well Homes schemes bases its success on partnership working and is now sponsoring an Apprentice with one of their partner agencies, Thurrock Lifestyle Solutions, which is a community interest group that supports disabled residents to take control over their own life choices.

The Apprentice is disabled and while gaining experience by shadowing the handyman service, the Well Homes Advisor and other partner agencies, he is also attempting to qualify in health and social care.

There are further examples where the Advisor has added value to other partner organisations.

Trading Standards have agreed to share their list of clients who have been identified as possible victims of ‘scam/fraud’ crime. The Advisor, who has been trained by Trading Standards to identify where people have suffered fraud, arranges home visits for vulnerable residents.

Thurrock Council’s Housing Domestic Abuse service and the Essex Fire and Rescue Service’s home technicians have both also added the Well Homes Advisor to their process, where clients are referred on as part of the support package offered.

Well Homes surveys all clients after 28 days from the home-based consultation and then again at six- months. The scheme has been warmly welcomed, with one resident commenting:

“The well home advisor made me feel more secure in my home and more positive about getting my life sorted again.” and;

 “A lot of people don’t know where to get help and the Well Homes project is the answer.”  

Thurrock have since shared lessons learnt from their Well Homes scheme to the CIEH National Conference and the Kings Fund Integrated Care Summit, as well as continuing to present to other local authorities and businesses who are at the beginning of developing their own integrated schemes.

The Well Homes scheme is also featured as a case study within the ‘Housing and Health Resource’, a specially designed website launched by the Chartered Institute of Environmental Health and supported by Public Health England (PHE) that aims to inform Environmental Health Practitioners and local authorities on the impact that housing conditions can have on physical and mental health, with the objective to improve health and wellbeing and reduce health inequalities.

 

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