We have all spent a lot more time at home over the last year, and many of us have discovered that our physical environment can present barriers to doing the things we need to do. Suitable space for working from home and home schooling are two obvious examples. Thankfully, for most of us, these challenges will be temporary, but this isn’t the case for everyone. Many people across the UK, and especially those who are disabled, live in homes that do not meet their needs. As occupational therapists we have a role in changing this.
The Town and Country Planning Association launched the Healthy Homes Bill in September 2020, and is calling upon the UK government to adopt the bill as legislation. The Royal College of Occupational Therapists (RCOT) is pleased to support the Healthy Homes Act campaign and the eleven key principles on which it is founded.
One of the key principles of the bill states:
All new homes and their surroundings must be designed to be inclusive, accessible, and adaptable to suit the needs of all.
As a specialist housing occupational therapist by background, I feel strongly about the importance of creating more accessible homes and communities. I have seen first-hand the debilitating effect that inaccessible housing has upon individuals and families. I have also witnessed the significant improvements in independence, health and wellbeing that people experience when they live in a home designed to meet their needs.
The current supply of accessible and adaptable housing in the UK is shockingly low, creating significant disadvantage for people with access requirements. Habinteg Housing Association’s report Forecast for accessible homes 2020 shows that less than 10% of homes in England have design features which make them ‘visitable’ by disabled people, while around 400,000 wheelchair users are living in homes that are unsuitable for them. Currently, the proportion of homes in England (outside of London) due to be built that are suitable for wheelchair users is only 1.5%.
In December 2020, RCOT submitted a response to the UK government consultation Raising accessibility standards for new homes recommending that all new homes in England should achieve a set standard of accessibility and adaptability, and that a certain percentage should be fully accessible from the outset.
Occupational therapists have expertise in designing and adapting homes that enable people to live independently and do the things that matter most to them. We have a crucial role in ensuring that accessible homes are available to those who need them.
The Healthy Homes Bill also states that:
Substandard homes damage lives and make society less resilient.
The bill notes that living in substandard housing increases the risk of a range of preventable health conditions, such as respiratory and cardiovascular diseases, as well as mental health conditions such as depression and anxiety.
Many studies, including Health equity in England: The Marmot Review 10 years on from the Institute of Health Equity, show that poor quality, unaffordable housing disproportionately impacts certain groups, including those from lower income households and people from minority ethnic backgrounds. Enacting the recommendations of the Healthy Homes Bill would be an important step in addressing health inequalities and helping to improve access to suitable accommodation for those in greatest need.
As occupational therapists, we must take a holistic approach to housing needs and consider all of the ways in which people’s health and wellbeing are affected by their homes. As noted in the Healthy Homes Bill, this includes fire safety and security from crime. Drawing on the findings of the Marmot Review, it also applies to factors such as the affordability of housing and utilities, overcrowding, and disrepair. Occupational therapists can seek to address health inequalities in their daily practice by making links with local services that offer support in these areas.
Everyone has the right to a home in which they can thrive. This belief closely aligns with the principles of occupational therapy and underpins the Healthy Homes Bill. Occupational therapists are key to making this belief a reality.
More information:
For more information on the Healthy Homes Act campaign and to get involved, please contact Daniel Slade at: Daniel.slade@tcpa.org.uk
You can find out more about the role of occupational therapists in housing and the RCOT Specialist Section for Housing on the RCOT website.
Suggested resources:
Fire safety – all UK fire services offer free home safety checks to households at increased risk of fire. Search online for information of your local service.
Crime prevention – advice can be found at www.police.uk and www.crimestoppers-uk.org. Some local handyperson and home improvement agencies will install security measures for eligible residents.
Home Improvement Agencies – these organisations provide adaptations and essential home improvements to older and disabled people across the UK. Search for ‘Care and Repair’ in England, Scotland and Wales. Information for Northern Ireland can be found here.
Citizens Advice – this service offers information on a wide range of subjects including access to benefits, financial support and housing issues. www.citizensadvice.org.uk