Reducing admissions to hospital through Warm at Home scheme

Featured article - 03 February 2017
By Jan Gilbertson, Senior Research Fellow in the Centre for Regional Economic and Social Research at the University of Sheffield Hallam

David has a liver condition and is in remission from cancer. Last winter his boiler broke and he and his wife Caroline couldn’t afford a replacement. They had no heating or hot water for a week. With David in such poor health, the couple thought they might qualify for funding. But an application to a government scheme for a new boiler was unsuccessful because they weren’t on means tested benefits as Caroline works one day a week. MacMillan Cancer Support suggested the local home improvement agency. Their HIA found funding from ‘Warm at Home’, a programme run by charity FILT (Foundations Independent Living Trust) to help vulnerable people live safely in their own homes. Funding was released in two days, a speedy turnaround that was key to keeping David out of hospital.

• SCIE: prevention and wellbeing
• Warm, safe and well: evaluation

Unfortunately this story is all too common. Many vulnerable people in poor health are forced to live in cold properties because their income is just above qualifying thresholds for energy efficiency support. Yet these people are often over 65, living in badly maintained homes and unable to pay for repairs. They enter a vicious circle when an incident strikes – such as a boiler breaking. They might become ill and stuck in hospital but unable to leave because they can’t afford maintenance or assistance. These are all issues identified in a study by Sheffield Hallam University's Centre for Regional, Economic and Social Research. We evaluated energy efficiency measures made to the homes of 4,000 vulnerable people in 2016. £637,000 in funding paid for thousands of repairs, from fitting reflector radiator panels to replacing boilers.

FILT managed the programme and work was delivered by 71 HIAs across 183 local authority areas. HIAs are local organisations, often council-run, that provide services including handyperson repairs and disability facility grants. They are regularly in touch with and trusted by vulnerable people, many of whom are on low incomes, disabled or have chronic illnesses. They might not be registered with a GP, they could be mistrustful of council services or socially isolated, so HIAs are key to identifying who is most at need in the cold weather. This ability to target ‘hard to reach’ clients is one of many findings from our research that are relevant to social care teams. Another conclusion links with David and Caroline’s experience. We found many examples where funding was provided in a few days for urgent home repairs and this swift action prevented further illness or harm such as falls, carbon monoxide poisoning, burns and admissions to hospital or residential care. Yet this rate of response isn’t the norm when it comes to energy efficiency funding. Our research showed that low cost home improvements such as bleeding radiators or draught-proofing windows and doors enhanced wellbeing significantly. Survey data indicated that minor measures improved people’s life satisfaction, stress levels, feelings of financial security, safety and independence.

We also found that home repairs increased a recipient’s ability to self-manage their illness. Beneficiaries of Warm at Home reported that interventions relieved their symptoms due to less worry and stress, making them feel healthier and better able to manage long term conditions themselves rather than calling on health services. Many home assessments identified wider issues and HIAs referred clients to further in-house support and onto other local services including social care, income maximisation, security measures such as door safety chains and smoke alarm installation as well as befriending support. These referrals all helped to minimise poor health, prevent further harm and boost wellbeing. Preventative action on fuel poverty through initiatives like Warm at Home can support a range of priorities from the Adult Social Care Outcomes Framework. Keeping people with care and support needs warm, safe and well in their homes decreases (or delays) hospital admissions and the need for more intensive support, thereby reducing the burden on local authorities by cutting social care costs. The challenge now is ensuring that social care commissioners recognise the benefits that minor home repairs can deliver for their services, and invest appropriately.