Unsuitable Homes

A suitable home contributes to positive physical and mental health and wellbeing and meets basic physiological needs. An unsuitable home does not meet the needs of its household due to size, amenities, location, or for many other reasons. Most housing need is met through the open market – general market housing or housing for specific population groups. Public sector organisations (such as local authorities) can influence the market and improve their local housing offer by shaping planning policies and agreeing housing design standards for new build properties. People with a disability, a physical or mental health condition, that have a low income, that have a particularly large family, or are over the age of 65, can find it especially difficult to access suitable housing. Health outcomes are greatly improved when the right home is available, is affordable, accessible, and in the right place.  An ageing population means it is becoming more urgent to increase the availability of extra care housing, supported housing, and support for people to adapt their existing homes, allowing people to better plan for their future housing needs, and to continue to live independently for longer, as circumstances change. 

For people with disabilities, mobility issues, chronic illness or injury, many aspects of life are improved by the provision of accessible homes and related support services. Lack of accessible housing limits choice and leads them to reside where suitable accommodation is built, not where it is required – this often means being displaced from an existing social circle. As people age, there is a greater risk of social isolation, and loneliness, and mental health problems such as depression. Lack of suitable housing in the right place undermines wellbeing and contributes to social isolation. Faced with unaffordable or unsuitable housing options, people are forced to move away from their social networks leading to, or exacerbating, social isolation and loneliness (Source: Scottish Government). 

Provision of suitable homes reduces pressure, and costs on health and care services by: 

• Preventing or reducing hospital admissions, length of stay, delayed discharge, and likelihood of readmission. 

• Increasing independence for longer, smaller domiciliary care packages, reduced pressure on informal carers, and less requirement for residential or nursing care placement. 

Digital connectivity, hoarding, and other factors must be addressed to ensure a person’s home is and remains suitable for them. Working collaboratively across health, care, and housing services through existing governance structures helps authorities meet statutory obligations and reduce costs. 

• The Care Act 2014 requires greater integration of health and social care services and references housing as a contributor to providing good care. 

• The National Planning Policy Framework sets out Government planning policies for England.  

• The National Design Guide (2019) covers ten characteristics of well-designed places including; homes that are functional, healthy and sustainable; and a Nationally Described Space Standard exists. 

• NHS guidance Putting Health Into Place was published following the Healthy New Towns programme that advocates providing suitable homes that are healthy and efficient. 

• Homes for health provides resources for local authorities, health and social care commissioners and decision makers to improve health and wellbeing through the places people live. 

• The Housing Grants, Construction and Regeneration Act 1996 sets out the basis for the mandatory Disabled Facilities Grant (DFG). 

• The Regulatory Reform (Housing Assistance) Order 2002 provides local housing authorities the power to award discretionary housing assistance in line with an adopted policy. 

• Housing for independence is a priority of Lincolnshire’s Joint Health and Wellbeing Strategy. A Housing Health and Ageing Well Delivery Group (HHAWDG) will implement the Priority Delivery Plan. 

• Housing is featured in the local Integrated Care Partnership (ICP) Strategy. 

• Lincolnshire does not have a single countywide housing strategy as individual district councils produce housing strategies to address housing needs within their local authority area and wider housing market areas. Further information is available from individual district council websites: 
  • Boston  
    
  • City of Lincoln  
    
  • East Lindsey 
    
  • North Kesteven 
    
  • South Holland 
    
  • South Kesteven 
    
  • West Lindsey
• The HHAWDG published a Lincolnshire Homes for Independence blueprint, outlining how local partnerships will assist people with care and support needs to live independently. 

• The Ideas for Change 2017: Extra Care Housing in Lincolnshire  report captures innovative solutions for Extra Care Housing that could be encompassed in Lincolnshire County Council’s strategies for such housing. 

As the population changes, demands for different types of housing changes too. An ageing population now presents the greatest challenge. People aged 65 and over, with a long-term illness, or whose activity is limited, is already high and is likely to continue to increase. This will require the provision of a range of accommodation and support solutions to mitigate predicted increased demand for health and social care. 

Many older people remain resident in their family home which often becomes larger than required, harder to move around in, and difficult to maintain and heat. Others live with family members who might become unable to accommodate them as circumstances change. For many, options are limited to their existing home or a care home, which may not be suitable or desirable, and so the offer needs to be broadened. Professionals and the public must understand new options being delivered, and these must be promoted appropriately, allowing everyone to determine suitability and encourage uptake. 

Adapting an existing home to meet personal needs can present challenges, particularly in the private rented sector, due to short term tenancy agreements, poor conditions, and overcrowding. Park homes and caravans, predominantly found along Lincolnshire’s east coast, are particularly difficult to adapt. For some people their current home may not be adaptable, or cost effectively adaptable, meaning moving to a suitable home is their only option. This could lead to health inequalities where suitable housing is not available in the right place at an affordable cost. 

The number of overcrowded households in Lincolnshire is less than the national average but there is geographical variation, with Boston, Lincoln and South Holland having the highest number (Source: Ministry of Housing, Communities and Local Government (MHCLG)). Living in overcrowded housing contributes to the following health inequalities: 

• Children are up to 10 times more likely to contract meningitis, and 3 times more likely to have respiratory problems. 

• Children are more likely to: encounter stress, anxiety and depression; have poorer physical health, slow growth; and display lower attainment at school due to missing school more frequently through illness and infection. 

• All ages are at increased risk of accidents, respiratory and infectious diseases. 

• Irregular or disturbed sleep. 

• People in overcrowded households are more likely to indicate psychological distress. 

(Sources: The Health Foundation and Shelter) 

Two partnerships are working on addressing existing unsuitable homes. These groups report into the Housing Health and Ageing Well Delivery Group (HHAWDG) and Lincolnshire Health and Wellbeing Board as shown in this diagram: 

• Lincolnshire Healthy and Accessible Homes Group (equipment, aids, and adaptations) 

• Lincolnshire Housing Standards Group (overcrowding)

The housing Infrastructure Group oversees newbuild housing provision, and infrastructure needed for growth.  

District councils are the local housing and planning authorities with statutory duties and discretionary roles relating to housing advice, allocation policies, and new housing provision in their area. To understand the current housing situation: 

• Local Housing Needs Assessments (formerly Strategic Housing Market Assessments): Assess and analyse local housing need based on projections of the households and the national population.  

• Housing stock condition survey or modelling: Provides a profile of the current housing stock, and can include an assessment of overcrowding, demand for adaptations, and other factors such as broadband speed.

These assessments identify a shortage of homes. Greater Lincolnshire’s local authorities aspire to deliver 100,000 new homes by 2031, as outlined within their Local Plans.  

A mix of appropriately located sized, priced, and accessible homes will give the population suitable choices. Lincolnshire County Council (LCC) supports the planning and commissioning of new housing for specific service user groups (e.g. care leavers, working age adults with specific needs, and older adults).  

District councils administer the Disabled Facilities Grant (DFG) that supports homeowners or private sector tenants to adapt their home with, for example, stair lifts, level access showers, door widening and ramps. DFGs are means-tested and require a Social Care occupational therapy assessment to confirm the adaptation is necessary and appropriate. DFGs and discretionary housing assistance are funded from allocations of the Better Care Fund. 

The HHAWDG is working in partnership with the Centre for Ageing Better, to give people greater choice about how and where they live as they age. HHAWDG is implementing some recommendations of the Centre for Ageing Better, Good Home Inquiry by developing a model for a Good Home Hub through an alliance of organisations, which supports people to improve their home or, if the property is unsuitable for their needs, advises and assists them to move to a more suitable home. The Hub, known as Good Home Lincs, provides a wealth of self-help information and advice on the Connect to Support Lincolnshire website, and more vulnerable residents can access support from a caseworker through a referral partner (a service being piloted to June 2026). 

The Wellbeing Service is available to Lincolnshire residents, aged 18 years and over. The service enables independent living by delivering community-based support and facilitation within housing, health, and care settings. The service also provides small aids and minor alterations, and where these are insufficient to meet needs, it supports access to equipment and adaptations to maximise independence. This and other service outcomes can address housing issues at the earliest opportunity, helping to prevent further interventions or unnecessary delayed transfer of care from hospitals and other health and care settings. 

Hoarding is an issue in Lincolnshire. A joint agency Hoarding Protocol has been adopted and a hoarding support pilot project is underway.

The views of stakeholders, residents or key parties regarding the topic/issue.
(Views collected through active engagement with wider partners and stakeholders. Contributions can be in wide range of formats including surveys, focus groups or meetings with stakeholders).  

District councils report that Environment Agency rules relating to flood risk are a significant factor in determining where housing can be provided and may create a discrepancy between where housing is most needed and where housing is provided. 

The Mental Health, Learning Disability and Autism (MHLDA) Partnership Board has identified that: 

• There is not enough choice of housing for people with learning disabilities in some parts of the county.
• Accessing online housing lists is a problem for some people.
• People need more help to find out about the different sorts of housing available.
• Getting a house can be complicated – fitting everything together requires support.
• Housing should be planned around easy access to shops and provision of day support.
• Housing and support are separate, but not considering the two together result in housing that does not work for some people with learning disabilities.
• Planning support takes time, support does not end for the family, even when a housing package is in place.

The Good Home Lincs project team collated responses to public and staff surveys, workshops, and interviews, and engaged a group of residents to develop and co-produce the Hub model.

There are differences in the available assistance across the county. District councils have adopted a common Discretionary Housing Assistance Policy that, subject to eligibility, can assist residents to stay safe and well by contributing towards discretionary adaptations or aids, assistance above mandatory DFG limits, or meeting financial contributions assessed through the prescribed means test. These actions should help people with disability and health needs to remain in their existing home or move to a more suitable home. However, DFG funds have been fully utilised on mandatory DFGs in some areas meaning no discretionary assistance can be offered. The Lincolnshire Healthy and Accessible Homes Group plans to better embed DFGs within the wider health and care system, using funding streams more efficiently alongside equipment services and digital technologies. 

The services and sources of funding across the county can be confusing to find and to navigate for residents and professionals. Good Home Lincs is intended to act as a ‘one stop shop’ making access to services, advice, and support easier from across all sectors. There is a gap in data, and community and stakeholder views regarding the supported housing needs for older people, people with mental health conditions, learning disabilities and autism, and black and minority ethnic populations. 

Homes for temporary residents, Gypsies and Travellers needs to be considered in the context of temporary accommodation, park homes, and sites provided for short- or long-term stays, and where there may be a disabled occupant requiring specialist amenities. It is suggested a health needs assessment is carried out for this cohort in relation to temporary and permanent accommodation needs and to facilitate care closer to ‘home’. 

Further analysis and demand modelling is required to predict the need for adaptations for people with disabilities, hoarding support, overcrowding and under-occupancy.  

Housing inequalities often mirror the more deprived areas of Lincolnshire and exist for the cohorts of people identified in the Integrated Care Partnership (ICP) plans and the Lincolnshire Homes for Independence blueprint. The local response to make more suitable homes affordable and available to people who need them, and addressing gaps and unmet needs, better targeted at areas of deprivation and these cohorts, will reduce health inequalities. Providing more suitable homes as a wider determinant of health will support health improvement, physiological impacts of unsuitable homes (e.g. high blood pressure), and psychosocial factors (e.g. isolation, self-esteem, perceived level of control). 

Care closer to home can often be achieved in the home where someone has a suitable home to reside in and good digital connections. Supporting people with health and care needs and people vulnerable to ill health or accidents who are currently living in unsuitable homes helps prevent physical and mental health conditions developing and more costly treatment costs associated with them. 

Next steps are outlined in the Joint Health and Wellbeing Strategy and in the delivery plans of Growth Vision for Greater Lincolnshire. The following aspirations are to be delivered by housing partnerships: 

• Inclusion of housing in the prevention chapter of the local ICS Strategy permits a deeper, co-ordinated, and mutual understanding between NHS and local authorities. This will ease development of coordinated strategies and pathways to identifying accommodation needs. There will be a priority focus on supporting those with mental health conditions and on improving hospital discharges. 

• Identify further opportunities to improve hospital discharge rates, minimising delayed transfer of care caused by housing issues. 

• Complement existing housing advice through; in-house services, commissioned services, social prescribing, and throughout the voluntary and community sector to create a holistic housing advice service.

   

The HHAWDG will implement the Lincolnshire Homes for Independence blueprint by: 

• Expanding the evidence base and developing the case for investment in people’s individual homes, thus, restricting demand for more, residential and nursing care rooms. 

• Helping organisations across Lincolnshire to recognise and implement their role in the housing, health and care system and work in a joined-up way to better improve that integrated system. In turn: 

• Ensuring provision of alternative, suitable homes – and supporting people to move to them; or 

• Helping people to adapt, improve, and so remain living in their current home. 

Boston
City of Lincoln
East Lindsey
North Kesteven
South Holland
South Kesteven
West Lindsey