JSNA Housing and Related Support

Publication date

This chapter was published in January 2024 and is due to be reviewed by January 2026

Contents

• Introduction
• Key Facts on Housing in Surrey
• Homelessness
• Local Insights
• Needs of Specific Groups
• Issues that may impact on housing services in Surrey
• Services in Relation to Need
• Key Findings and Recommendations
• Appendices
• Data sources
• Contacts and Acknowledgements
• References

Introduction

Housing plays a fundamental part in people’s wellbeing, their employment, health, and relationships.

The Community Vision for Surrey 2030 states, “By 2030, Surrey will be a uniquely special place where everyone has a great start to life, people live healthy and fulfilling lives, are enabled to achieve their full potential and contribute to their community, and no one is left behind.” One of the underpinning principles is that “Everyone has a place they can call home, with appropriate housing for all.”

 ‘A Housing, Homes and Accommodation Strategy for Surrey’ recognised that Surrey is in the grip of a serious housing crisis. This housing crisis manifests most critically in the supply of homes that are truly affordable for local people, at all tenures and most income groups.

Aims and Objectives

This Needs Assessment aims to create a picture of the housing situation in Surrey and how that is affecting people’s health to inform commissioners and stakeholders. We aim to lay out the current provision of services and highlight gaps in that service provision to identify the housing needs of all those living in Surrey. This Needs Assessment recommends priority actions for immediate and long-term response.

Scope

This Needs Assessment covers all people living in Surrey with focus on priority groups identified during a scoping exercise with Stakeholders.

This needs assessment covers all types of homes and tenures in Surrey apart from Care Homes and residential homes which are covered in the Safeguarding Adults chapter.

Approach

A mixed methods approach to data collection was adopted and consisted of:

• A review of relevant guidance, policies, legislation and best practice.
• A review of publicly available data on the topic in the UK.
• A review of data submitted by key stakeholders on housing in Surrey.
• A review of local reports from stakeholders and surveys on user experience in Surrey.
• Conversations with stakeholders and surveying stakeholders to find out the important issues surrounding housing and health in Surrey.

Housing and health

The links between housing and health are well evidenced. In general, the evidence on the relationship between housing and physical aspects of health (such as the link between damp homes and respiratory conditions) is more well-established than the evidence on mental wellbeing impacts. There is growing evidence of the effects of poor housing conditions on increasing stress and feelings of disempowerment and loss of control, all of which have clear links with mental health outcomes. [1]

Housing is a wider determinant of health and as such having a stable and secure home is one of the foundations of a good life. The condition and nature of homes, including factors such as stability, space, tenure and cost, can have a big impact on people’s lives, influencing their wellbeing and health.

Further information around the key housing factors which impact on wellbeing and health are described below.

Tenure

Housing tenure is related to the differences in peoples housing circumstances and support and therefore security. A secure, comfortable home enriches our lives and supports our mental and physical health. [2]

Owner Occupiers typically report better health and wellbeing outcomes and live longer than those living in social housing.  Some of this variation may be explained by confounding factors such as age and income however even when these factors are accounted for there is some true difference in health outcomes across housing tenures. [3] 

Tenure is linked to housing conditions and a person’s immediate surroundings and connection to their neighbourhood which all affects a person’s wellbeing. For example, owner occupiers often have more control over the immediate environment in which they live and social landlords provide services and opportunities for tenants (for example employment support and social events). [4] On the other hand tenants in the private rented sector may be isolated and at greater risk of housing related harms. HMOs (houses in multiple occupation)  often have poorer physical and management standards than other privately rented properties. Occupiers of HMOs tend to have the least control and choice over their housing circumstances.

Condition

Poor housing conditions can put a person at significant risk of health problems. The most obvious and shocking examples of this were the Grenfell Tower tragedy, alongside the death of Awaab Ishak in December 2020 in a property not fit for purpose.

 If a home is in a poor state of repair or if there is a hazard or immediate threat to a person’s life, they may be a source of injury (such as falls) or fire. Homes that are not effectively insulated or heated can be damp and cold which is linked to the exacerbation of respiratory problems (such as asthma and COPD) and excess deaths due to cold. Homes that are not effectively insulated or adapted for hot weather can also impact health, leading to excess deaths from heat. As the climate continues to warm, we can expect to see more frequent and more extreme heatwaves in future, and more health impacts as a result.

One of the causes of excess winter deaths is fuel poverty (which means people can’t afford to properly heat their homes) which has been shown to be as important a driver of health for young people as it is for frail elderly people.

Poor housing conditions can increase the risk of depression, stress, and anxiety. For example, there is strong and growing evidence on the mental health and wellbeing impacts of fuel poverty and cold homes, and the significant benefits to mental wellbeing from tackling fuel poverty across the entire age-range.

Overcrowded living conditions can put strain on family relationships and reduce privacy and limit space to study/play for children, which can lead to psychological stress. Overcrowding also leads to increased risk of infectious disease transmission

It can however be difficult to separate out the impact of specific housing-related hazards from other confounding factors (such as socioeconomic status or age), which in themselves may give rise to poor health outcomes and are also linked to housing circumstances [1].

Affordability and availability

Surrey (along with the rest of the country) is in the grips of a housing crisis. Lack of affordability and availability of housing related to people’s ability to afford and access housing that suits their needs and circumstances. Difficulty paying the rent or mortgage can cause stress, affecting our mental health, while spending a high proportion of our income on housing leaves less for other essentials that influence health, such as food, and social participation. This is particularly pertinent in 2023 due to the cost-of-living crisis – this has seen houses become less affordable across all tenures. [1]

Homelessness

The health of people experiencing homelessness is significantly worse compared to the general population, and the cost of homelessness experienced by single people to the NHS and social care is considerable. Homelessness is associated with poor physical and mental health and short life expectancy.

Homeless people are more likely to die young, with an average age of death of 47 years old and even lower for homeless women at 43, compared to 77 for the general population, 74 for men and 80 for women. It is important to note that this is not life expectancy; it is the average age of death of those who die on the streets or while resident in homeless accommodation. Health needs can also be a reason a person becomes homeless in the first place.

 A 2017 report commissioned by the Local Government Association found that 41 percent of homeless people reported a long-term physical health problem and 45 percent had a diagnosed mental health problem, compared with 28 percent and 25 percent, respectively, in the general population. The last conservative estimate (2010) of the healthcare cost associated with this population was £86 million per year [5].

Homeless people are more likely to have problems with substance use, which is both a cause of homelessness and a route to addiction. Homeless people who drink alcohol more heavily and abuse drugs are more likely to die from these causes.

Rough sleepers are more susceptible to health impacts due to severe weather and vulnerable to climate change impacts as severe weather becomes more common such as cold and heatwaves

Mental ill health can be a cause and a consequence of homelessness. Rough sleepers are more than 35 times more likely to die by suicide than the general population.

Experiencing violence, fatal traffic accidents, infections and falls are also all more common causes of death in the homeless population.

Homelessness has particularly adverse consequences for children and can affect life chances. Starting life in temporary accommodation may impact on access to universal health care, such as immunisations, and temporary accommodation is associated with greater rates of infection and accidents. Homeless children are more likely to experience stress and anxiety, resulting in depression and behavioural issues. There is evidence that the impact of homelessness on a child’s health and development extends beyond the period of homelessness.

Definitions of key terms used in this chapter

Key terms are defined below, all further definitions and acronyms are outlined in Appendix 1.

Homeless /Homelessness: Where a person or a household are homeless, they may be entitled to be rehoused by a local authority or by another housing provider on behalf of the Council. Housing providers are required, by law, to co-operate with Council in meeting their duties to the homeless.

Housing Health and Safety Rating (HHSRS): is a risk-based evaluation tool to help local authorities identify and protect against potential risks and hazards to health and safety from any deficiencies identified in dwellings. It was introduced under the Housing Act 2004 and applies to residential properties in England and Wales.

Fuel Poverty: A household is said to be in fuel poverty when it cannot afford to keep adequately warm at a reasonable cost, given their income.

Overcrowding: the situation in which more people are living within a single dwelling than there is space for, so that movement is restricted, privacy curbed, hygiene limited, rest and sleep difficult. This is commonly measured by the ‘bedroom standard’.

Private Registered Providers (PRPs): are formerly known as Housing Associations or Registered Social Landlords. PRPs are providers of social housing in England that are registered with Regulator of Social Housing and are not Local Authorities.

Key Facts on Housing in Surrey

Surrey’s reputation and brand is as a place of prosperity. Historically Surrey has been seen as the detached-house-with-space-for-two-cars sort of place. And whilst this is true for a significant proportion of the population, it can mean housing issues experienced by others  are hidden.

This section looks at the housing situation in Surrey and the number of people affected by housing related issues that impact health.

Tenure

As we would expect Surrey has a high proportion of owner-occupied properties. As shown in Figure 1, 72% of homes in Surrey are owner occupied (this includes those owned outright and those owned with a mortgage or loan). This compares to 66% for England and 68% in the Southeast.

A large number of these homes are owned with a mortgage or loan, although this number is decreasing as the number of owned outright increases (as people pay off their mortgages). It should be noted  the 2023 cost-of-living crisis has seen mortgage interest rates rise leading to mortgage costs increasing significantly.

Since 2012, there has been some growth in the Private Rented Sector which is likely at the expense of people owning their own homes/ getting a mortgage. However, by comparison as shown in Figure 2 in the dashboard, the Private Rented Sector (16%) and Social Rented Sector (11%) are smaller in Surrey than those in the South East and England.

As with wider Surrey, consistently within our Districts and Boroughs the largest proportion of homes are owner occupier, with a higher percentage owned outright than owned with a mortgage in every District and Borough. Social rented housing is also the lowest proportion for all Districts and Boroughs. All Surrey Districts and Boroughs have a higher proportion of home ownership than in the South East and England, and a smaller proportion of households in social rented housing.

The next series of graphs show us tenure in relation to demographic and economic characteristics of residents in Surrey. Figure 4 shows tenure by age of resident in Surrey. This shows that the older a Surrey resident is the more likely they are to own their home outright. Adults aged between 35 and 64 are more likely to own their home with a mortgage. Young adults aged 16 to 24 are more likely to live in private rented accommodation. Interestingly those under 15 years of age are the most likely of the age groups to live in social rented accommodation as those in this age group will more likely be living with their parents this implies families are more likely to live in social rented accommodation.

Age

Household type

Household family composition by tenure shows that those aged over 65 and living alone are most likely to own their own home outright. Lone parent families are most likely to be in social housing (Figure 5).

Figure 6 in the dashboard shows tenure compared to household type in Surrey. This shows similarly that one person households are more likely to own their home outright but those in a couple household are more likely to own with a mortgage. Lone parent households are most likely to be socially renting.

Figure 7 in the dashboard shows household economic status and tenure. This shows those who are retired are more likely to own their own home outright and those who are economically active are more likely to own their own home with a mortgage. Those who are economically inactive are more likely to be in social rented accommodation.

Figure 8 shows the amount of housing stock owned by each District and Borough in Surrey. Note some Districts and Boroughs have small numbers of their own stock, and some have almost none, this is because 6 of the 11 Districts and Boroughs stock has been transferred to Private Registered Providers (also referred to as Housing Associations.

Dwelling stock

Figure 9 in the dashboard shows the number of homes in each District and Borough in total. The graph is broken down by sector of tenure. There are however some subtle differences in tenure between our Districts and Boroughs as shown in the figure. For example, Runnymede, Guildford, and Spelthorne had the highest proportions of households in social rented homes in Surrey. Woking had the highest proportion of households in private rented housing.

The number of homes (dwelling stock) over the last 5 years has been gradually increasing in all Districts and Boroughs as shown in Figure 10 in the dashboard. This combines homes in all tenures.  

Figure 11 in the dashboard shows the number of dwellings in Surrey by Sector over time. This reflects tables above with most properties being privately owned. This shows that overall, the number of dwellings in the private sector (owner occupiers and private rented) and public housing is gradually increasing. However, the proportion of homes in the sector is gradually increasing at the expense of the proportion of homes in the public sector.

Some homes are classed houses of multiple occupation (HMOs). Table 1 below shows the number of HMOs in each District and Borough. The numbers of HMOs vary in each District/Borough but are likely to be an underestimate as we know many HMOs are not licenced. Guildford and Runnymede have particularly high numbers of HMOs because they have high numbers of Student Accommodation due to proximity to university in Surrey (Royal Holloway in Runnymede and Surrey University in Guildford).

Numbers of student households have increased by an average of over 60% in 10 years, with concentrations in Runnymede and Guildford where this constitutes 3.5% to 4.5% of overall housing stock.

Well-being, by tenure

Figure 12 shows wellbeing score by tenure in England 2021-22. Self-reported personal well-being scores varied by tenure. Those surveyed were asked to rate distinct aspects of their life out of 10, owner occupiers had higher average scores for life satisfaction (7.8), thinking life is worthwhile (8.0), and happiness (7.7), and lower scores for anxiety (2.7), than the private rented sector (7.2; 7.6; 7.3 and 3.3 respectively). In turn, private renters report higher well-being scores than social renters (7.0; 7.4; 7.0 and 3.6 respectively). Among owner occupiers, outright owners showed higher scores than mortgagors for life satisfaction (7.8 compared with 7.7) and happiness (7.8 compared with 7.6), and lower scores for anxiety (2.6 compared with 2.9).

These findings may suggest that there is a direct relationship between well-being and tenure. However, there were significant differences between the types of households that typically live in each tenure, and these differences may be related to well-being. For example, social renters were more likely to be unemployed or ‘other inactive’ (this includes long-term sick or carers) than owner occupiers or private renters, as well as being more likely to be in the lowest income quintiles. This data is not available at Surrey level.

Figure 13 shows self-reported health by tenure in Surrey from the general health survey in 2021. This shows that people in the social rented sector are most likely to report themselves as in very bad health (2%) or bad health (7%). Those who own their homes with a mortgage are most likely to report themselves as exceptionally good health (66%), this is even though as shown earlier in this section those who own their own home are older. This decreases to 40% in those who own outright (this likely to be due to the fact this cohort tend to be older).

Condition

For social housing the condition of homes nationally has improved significantly since the introduction of the Decent Homes Standard in 2003. In Surrey 6 of the 11 Districts and Boroughs no longer own and manage the bulk of their own stock of social housing (this stock has been transferred to Private Registered Providers).  Legislative changes mean that private rental properties could also soon be subject to the Decent Homes Standards. Additionally all domestic private rented properties must meet the Domestic Minimum Energy Efficiency Standard Regulations which make it unlawful to let a property with an EPC rating below E.

70% of dwellings in Surrey have an energy efficiency of below EPC C, indicating poor energy efficiency of Surrey’s housing stock. Furthermore, 3% of private rentals in Surrey do not meet the Domestic Minimum Energy Efficiency Standards regulations of minimum EPC E, indicating very poor energy efficiency, with increased likelihood of very high energy bills, and problems with draughts and damp. More detailed data on EPC rating of homes in Surrey can be found here: Fuel Poverty and Energy consumption | Tableau Public

The condition of social housing in Surrey can be inferred by those who meet the decent homes standard. Table 2 shows the proportion of homes by District and Borough which were deemed non-decent in the financial year 2021/22. This data includes stock owned by both Local Authorities and Private Registered Providers Figure 14 shows the number of homes by District and Borough which were deemed non-decent in the financial year 2021/22. Data is only available for four Local Authorities which manage their own stock. There are large differences in the proportion of homes meeting the decent Standard between Districts and Boroughs. For example 31% of Local Authority owned homes in Runnymede (911) didn’t meet the standard compared to 3% in Woking (85). Note that there are difference categories of HHSRS and most of these homes are deemed ‘not in a reasonable state of repair’ rather than the more serious category of ‘category 1 hazard’.

In recent months the problem of damp and mould in all housing tenures has become a more prominent issue likely linked to the cost of living crisis meaning people are cutting back on heating and insulation. Additionally nationally there is a shortage of trained, skilled repair workers who are needed to maintain, repair and refurbish affordable homes in the housing sector. This is compounded by high rates of inflation in costs and labour while rents, which provide the funding for services, have been capped, frozen or cut in recent years, reducing the income and available budget for work.

Fuel Poverty

A Housing Homes and Accommodation Strategy for Surrey highlights the impact of fuel poverty, poorly insulated homes and historic disrepair in some homes has brought a much sharper focus on how many lower-income and vulnerable residents are living in unhealthy homes.

Overall, in 2021 Surrey has smaller proportions of households in fuel poverty (7.3%) than the English average (13.1%). Waverley had the highest proportion of households in fuel poverty at 8.3% alongside Guildford with 8.1% in fuel poverty. Surrey Heath had the smallest percentage of households in fuel poverty at 5.9%.

Figure 15 show the percentages of households in fuel poverty in Districts and Boroughs in Surrey in 2021. Percentage of households in fuel poverty in 2021:

Figure 16 shows fuel poverty levels in Surrey compared to other areas in the Southeast.

Figure 17 in the dashboard shows that from 2015 to 2018 fuel poverty was gradually decreasing in Surrey, but has since then has been increasing, this reflects the national picture. It is likely fuel poverty will continue to worsen as figures are updated due to the cost of living crisis and increases in energy price across the country.

Figure 18 in the dashboard shows there is pronounced regional variation in the distribution of households experiencing fuel poverty. The West Midlands has the highest proportion of its households living in fuel poverty (around 18.5%, 2021), while the South East has the lowest proportion (around 8.4%, 2021). Southern regions tend to have average annual temperatures higher than in the Midlands and Northern England, which is one reason fuel poverty is lower in the Southern regions.

Houses in multiple occupation

Houses in multiple occupation (HMOs) often have poorer physical and management standards than other privately rented properties, sometimes involving poorly converted self-contained units without the requisite building regulations, and/or collocated with commercial premises. Added to their high occupancy, this means that HMOs are subject to greater risks of certain hazards, such as fire. Occupiers of HMOs tend to have the least control and choice over their housing circumstances, and ensuring that standards in this sector meet the legal minimum is important to protect these tenants.
The number of licenced HMOs in Surrey’s Districts and Boroughs which have been found to have category 1 hazards in the HHSRS are presented in Table 1. The numbers of category 1 hazards are small and hard to compare due to the small numbers.

Table 3 shows estimates of housing stock condition using HHSRS, this is making estimates for all dwellings regardless of tenure. The number of category 1 hazards in occupied homes in different localities has been modelled. It is estimated that Surrey has a lower proportion of homes with category 1 hazards (5.8%) than England (9.9%) and the South East (6.5%). Of Surreys Districts and Boroughs, Surrey Heath is estimated to have the lowest proportion of homes with category 1 hazards (4.3%) and Mole Valley has the highest (7.3%).

Table 4 shows estimates of homes with category 1 hazards by tenure. Surrey is estimated to have lower levels of category 1 hazards for each tenure listed than in England and the South East. As reflected nationally and regionally, it is estimated that the tenure with the highest proportion of category 1 hazards is in owner occupied properties and the lowest in social rented. This is because the condition of properties is more heavily regulated in the social and private rented sectors and people have more scope to choose the hazards they live with in the owner occupied sector.

Affordability and Availability

Surrey is in the grip of a serious housing crisis.  While this is very different from the scale and severity of the housing crisis that might be seen in large cities, it is a crisis nonetheless and action is required to tackle it.

This housing crisis manifests most critically in the supply of homes that are truly affordable for local people, at all tenures and most income groups. This shortage of housing affects the lives of many local residents. It also deters or prevents people moving to, or staying in, Surrey. Critically, local businesses, the NHS and other public services are struggling to recruit and retain the staff needed to maintain good quality public services and a thriving local economy.

The strategy suggests that affordability is particularly an issue in Surrey. Due to being priced out, living in Surrey is a less feasible option for growing families, young graduates or young professionals to continue to afford to live within the county, or for workers with the skills and qualifications the economy needs, or for households to move to the county and/or businesses to locate here.

The high-quality way of life that Surrey is known for, and that residents rightly celebrate and wish to protect, is at risk from the shortage, quality and unaffordability of homes.

The nature of the crisis across Surrey is different, more complex and more challenging than in some other areas. This arises from the extremely high land values across a large geography, the very low rates of housing affordability, the very high proportion of Green Belt designations and other protected land types, an ageing population with reducing proportions of younger professionals; and the close proximity to London and Heathrow and Gatwick Airports yet failing to sustain its positive economic status compared to neighbouring regions.

Increases in student housing in places like Guildford and Runnymede in particular contributes to further pressure on private rental sector provision and housing of multiple occupation.

Key to meeting demand and tackling unaffordability is the provision of new housing to meet unmet and rising demand. Figure 19 shows the five-year average number of affordable units granted permission between April 2017 and March 2022. Some Boroughs and Districts are delivering a much greater share of this compared to others.

Occupancy rate of rooms in Surrey households

Occupancy rating provides a measure of whether a household’s accommodation is overcrowded or under-occupied. An occupancy rating of negative 1 or less implies that a household has fewer rooms than the standard requirement, positive 1 implies that they have more rooms than required, and 0 implies that they met the standard required.

Occupancy rate can also give us a demonstration of affordability and availability across the county

Figure 20 shows the occupancy rates in Surrey. Levels of under occupancy are higher in Surrey (74.8%) than in England (72.0%) and the South East (73.3%).  Many older residents are living in the homes they have lived in for most of their lives, with more bedrooms than they require. There is a lack of accommodation options to attract older people to move and downsize. This is seen in the very high levels of under occupation.  This is made more difficult with a lack of information about housing options and support with moving.

A lower proportion of households in Surrey lived in overcrowded homes (5.0%) is lower than the South East (5.6%) and England (6.4%). However, a total of 24,235 households in Surrey lived in an overcrowded home at the time of the 2021 Census.

Figure 21 in the dashboard shows the number of rooms in Surrey’s dwellings. Across Surrey, 52,472 households had one or two rooms (10.9%), 313,228 households had three, four or five rooms (65.0%), 100,939 households had six, seven or eight rooms (20.9%), and 15,181 households had nine or more rooms (3.2%).

In general, Surrey households had homes with more rooms than the average household living in the South East or England. In Surrey, 20.9% of households lived in homes with six, seven or eight rooms compared to 16.8% of the South East and 13.8% of England.

Homes with 9 or more rooms were also more common in Surrey (3.2%) than the South East (1.8%) and England (1.1%).

Figure 22 in the dashboard shows the number of bedrooms in Surrey dwellings. While the proportion of households in Surrey who lived in a home with just one bedroom (11.4%) was similar to the South East and England averages (11.6% each), a higher proportion of Surrey households had access to four or more bedrooms (30.9%) than those living in the South East (25.0%) and England (21.1%).

Figures 23 to 25 in the dashboard show overcrowding and under-occupancy by household characteristics: Figure 23 shows occupancy rating by tenure. Those who own their home outright are most likely to be underoccupied and those in social housing are most likely to experience overcrowding.

Figure 24 shows occupancy rating by ethnicity, and highlights that those from a Black ethnic background are most likely to experience overcrowding and those from a White ethnic background are least likely to experience overcrowding.

Occupancy rating by age or household age mix is presented in Figure 25 in the dashboard. This shows that those living in mixed age groups are most likely to experience overcrowding, implying that families potentially those with 3 generations in the same household are most likely to experience overcrowding. Those in households only with people aged 65 and over are least likely to experience overcrowding but most likely to be under occupying.

Rent prices

Table 5 shows that Rent have increased in Local Authority social housing and housing provided by a Housing Association in the last 10 years. This data lags behind new Government Policy that for rent periods that beginning in the 12 months from 01 April 2023 to 31 March 2024 social housing rents can be increased by up to 7% due to the cost of living crisis. We also know anecdotally that rents are increasing quickly and significantly in the private rented sector due lack of availability and the cost of living crisis as landlords try to make up the difference as their mortgages rise in cost.

Figure 26 in the dashboard shows that median weekly rents in the South East are some of the highest in the country after London.

Median weekly rents in the South East were second highest in the social rented sector compared to other places. Affordable rent in the South East is the third highest of any regions and intermediate rent the fourth highest of any regions (Figure 27 in the dashboard).

Within the affordable housing sector, it’s clear that, while “Affordable Rent” offers a more affordable home for some residents, it remains inaccessible to higher-need families (in particular larger, non-working household) who are unable to afford that level of rent. This leads to some high-need families remaining in Temporary Accommodation, which is insecure for residents and expensive for Local Authorities.

The number of new social lettings (number of social lettings properties that became available for rent over the year) by provider type across Surrey’s Districts and Boroughs for the 2021/2022 financial year is presented in Figure 28 in the dashboard. These new social lettings could be due to properties becoming available to let as tenants move on or new homes being built.

The numbers of new social lettings overall in Surrey and by all social lettings type had been decreasing from 2018/19 up until 2020/21 when they began to increase (Figure 29 in the dashboard). Similar trends have been seen nationally and it is likely It is likely that the sudden increase was due to a rebound effect from 2020/21 where COVID-19 restrictions caused a large decrease in new social lettings.

In all of Surrey’s Districts and Boroughs the rate of new social lettings per 1,000 population is lower than in England (4.48 per 1,000) and the South East (3.64 per 1,000) (Table 6).

The number of long term empty homes varies across the Districts and Boroughs. With more than 1,400 in Guildford and less than 400 in Tandridge (Figure 30). The Surrey Housing Strategy suggests while there is mileage in looking at empty homes to help with the housing crisis it will not make much difference with meeting the shortfall.

Figure 30

Source: DLUHC, Local Authority Council Tax Base, 2021

Homelessness

Both statutory homelessness and rough-sleeping are growing problems nationally and across Surrey. The numbers of household approaching their local authority for assistance with homelessness varies considerably across Surrey as shown in Figure 31 (although it should be noted that these are numbers and not rates so does not reflect how many people live in each local authority). 

Surrey has a lower rate of households assessed as homeless (2.74 per 1,000) compared to England (6.08 per 1,000) and the South East (4.71 per 1,000) (Table 7). The rate of households assessed as homeless in Surrey Districts and Boroughs varies but is generally lower than England and the South East with the exception of Epsom and Ewell (4.80 per 1000). The rate of households assessed as threatened with homelessness is also lower in Surrey (4.05 per 1,000) compared to England (5.63 per 1,000) and the South East (4.81 per 1,000). However, some of Surreys Districts and Boroughs have rates higher than England (Woking at 6.29 per 1,000 and Spelthorne at 5.95 per 1,000). Rates vary across the Districts and Boroughs with the lowest rate being in Surrey Heath (1.49 per 1,000) (Table 7).

Figure 32 shows the number of statutorily homeless households placed in temporary accommodation by the local authority (quarterly data January to March 2023). Numbers vary across the county but are highest in Epsom and Ewell and Reigate and Banstead.

The expectation would traditionally be that in larger conurbations people are more likely to become homeless than in smaller settlements. “Urban areas also have the highest rate of homelessness, with approximately 29 homeless people per 10,000. By contrast, rural areas have a rate of less than half that, with 14 people experiencing homelessness per 10,000.” (Are there more homeless people in cities or rural areas? – TeachersCollegesj)

Also, homeless numbers would be anticipated to be lower in more affluent areas than in those that are more deprived. Deprivation exists in all Districts and Boroughs across Surrey although more concentrated pockets exist in 21 wards, (known as Surrey Key Neighbourhoods)

While numbers of homeless people vary across Districts & Boroughs, there are several thousand individuals and families waiting on housing registers across Surrey, while only a few hundred are being housed in temporary accommodation. A shortage of suitable housing means that in some cases families from Surrey who become homeless are not able to remain in their local area and are placed in other temporary accommodation elsewhere in Surrey or out of the county, away from existing schools, work and social networks.

Differing homeless numbers across Surrey

The patterns of homelessness across Surrey vary considerably. All authority areas experience factors which are impacting on homeless numbers such as:

• Lack of affordable privately rented accommodation
• A disparity between welfare benefit housing payments and private rents
• Limited numbers of social housing properties
• Rising mortgage payments
• Parental evictions
• Relationship breakdown
• Households with multiple social and health issues such as drug and alcohol abuse, mental health illnesses etc.
• Changes in those being displaced from other countries. For example many of those welcomes from Ukraine are now being asked to leave by their hosts resulting in homelessness

The above issues are likely to be more impactful in deprived areas as resident’s financial resilience is likely to be lower than in more affluent areas.

Access to social housing is inconsistent across the County as the number of units per head of population differ markedly. Furthermore, homelessness rates differ and authorities who no longer have their own accommodation have less control over access than they did historically (see Figures 28 and 33 which show that high levers of social letting by private registered providers in Surreys Districts and Boroughs). Additionally, levels of privately rented accommodation within each District and Borough vary considerably presenting different challenges to each authority to gain access to the accommodation required.

Differences in the levels of homeless can be because authorities often interpret the homeless legislation differently leading to disparities in assistance for households.

Households more vulnerable to homelessness

Headline homelessness data can hide some inconsistencies in the propensity of households to become homeless.

Individuals with protected characteristics are much more likely to become homeless compared to the population as a whole. For example, those with a disability and from a minority ethnic background. [6]

Ethnic group

The majority of lead applicants of homeless households are White in Surrey, representing 72% of households owed a duty. White individuals comprise 84% of the population in England, suggesting they are underrepresented in the homelessness population.

Lead applicants of Black, Mixed and Other ethnicities are over-represented in homeless households owed a duty, representing 13% of households compared to the combined 7.5% they comprise of the population in England.

Black lead applicants are the most disproportionally homeless.

The ethnicity of main applicants assessed as homeless in Surrey by ethnicity is presented in Figure 34 in the dashboard.

Age

In Surrey 28% of main applicants were aged 25 to 34 years old and 23% are aged 35 to 44. This  masks the number of children who are considered homeless as they will not be the main applicant. The ages of main applicants assessed as homeless in Surrey are shown in Figure 35.

Employment status

Nationally 35.7% of main applicants were registered unemployed at the time of application.

Those experiencing domestic abuse

Nationally 30.7% of households with children were owed a relief duty due to domestic abuse.

LGBTQ+

The recorded sexuality of main applicants who are homeless in Surrey shows that 3% of applicants describe themselves as homosexual or other. However, nearly a third of applicants chose not to describe their sexuality meaning it is likely higher (Figure 36).

A higher proportion of households in Surrey (53.0%) owed a homelessness duty have a support need than in England (51.7%) and the South East (52.1%) (Figure 37 in the dashboard). This remains true when those households where the support need is unknown is taken into account.

The same data in Figure 37 is broken down further in Figure 38 in the dashboard to show the wide variation in those households with a support need by District and Borough compared to England and the South East.

Figure 39 shows the main reasons for support needs of those owed a homelessness duty in Surrey. Mental Health tops this list (19%) followed by physical health and disability. It is worth noting that some people will have multiple support needs which is not reflected here.

Former armed forces personnel are also more likely to become homeless and sleep rough than the population as a whole. Although additional safeguards are in place for this cohort these are failing to stop this higher propensity of rough sleeping. 

People leaving institutions settings such as prison, care settings, hospitals etc. are also more likely to experience homelessness. In many cases due to their often-challenging support needs this can lead to a revolving door of regular spells of homelessness and rough sleeping.

These individuals are also often known to statutory and non-statutory agencies such as police, health, social services and housing authorities. Often their needs do not meet the thresholds to assess care or hospital settings, leaving them to present challenges to other statutory agencies, including Local Housing Authorities. There is more information on these cohorts of people in the needs of specific groups section.

What is the future looking like?

Tightening of economic conditions and increasingly restricted access to accommodation is and will continue to drive up homeless numbers. Frozen welfare benefit levels (Local Housing Allowance) are also serving to limit access to much of the private rented sector for households in receipt of benefit.

The delivery of low number of new affordable housing is also serving to drive up Housing Register numbers and impact authority’s ability to meet ‘housing need’ in their area.

Home Office Local Authority Housing Statistics tell us that in Surrey in 2021 465 new build affordable homes were built in Surrey and 23 non new build. Table 8 shows us this information broken down by provider.

Figure 40 in the dashboard shows us new affordable housing supply in Surrey by Local Authority in 2021 / 2022.

The number of households initially assessed as owed a homeless duty by financial year in Surrey is presented in Figure 41 in the dashboard.  Data prior to 2018 is not directly comparable due to significant changes in the homelessness legislation, which introduced new homelessness duties through the implementation of the Homelessness Reduction Act 2017 (HRA). Additionally, it is hard to consider trends in this data due to the extraordinary dip in 2020/21 due to the impact of the COVID-19 pandemic.

However, nationally statistics already show homeless numbers rising [7]. This trend is replicated during the financial crisis in 2008 and in recessions in the 1990s and so given the cost-of-living crisis it is predicted that homeless numbers will continue to rise until economic conditions improve. In Surrey, homelessness figures are also increasing.

Organisations who work with homeless people in Surrey, such as Rentstart have also reported an observed  increase in the number of people requiring help since the beginning of the cost-of-living crisis. In the quarters following the onset of the crisis in 2022, Rentstart helped more than double the number of people than the same quarters the preceding year. Local people who have always considered themselves safe from homelessness or deprivation are now facing these situations.

The aftermath of the pandemic has also led to additional and increased issues with supporting housed clients to remain safely housed. Clients experienced increased anxiety, faced additional debt issues and often struggled to access benefits in a timely fashion.

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Case Study

Rentstart work in Elmbridge and work to support homeless people into sustained tenancies. In 2021/22 they housed 127 people and made 565 interventions to prevent potential homelessness. Once housed they offer wrap-around support in financial management, employment, wellbeing and tenancy sustainment.  

Rentstart worked with Tom (name changed) who spent several months sleeping in local woods after being made homeless due to a relationship breakdown. While attempting to find a way to shelter, he found a shed to sleep in at the back of some local shops. The shop owner became aware of this and allowed him to stay in exchange for him volunteering at the shop, a precarious and vulnerable situation for him.  Tom did not meet the threshold to be provided with temporary accommodation arranged by the local authority,so he accessed Rentstart daily hub which provided access to showers, meals, advice and support.

Rentstart housed Tom in shared accommodation in the private rented sector in one of our managed properties. Due to the nature of the sector, he was required to manage his rent payments more strictly than if he had social housing. This began well initially, and he continued his proactive engagement, beginning life coaching, employment sessions and volunteering. However, very sadly, he became a victim of cuckooing in his new home which led to him spiralling downwards, with old and unaddressed issues resurfacing, and failing to pay his rent due to losing all of his money through the abusive relationship and at risk of being homeless again. Rentstart were once again able to provide support. They supported Tom to access services to begin rebuilding his life again in a trauma-informed and person-centred way. Tom is now proactively engaging with the right places that will get him help and allow him to independently take care of himself while he addresses ingrained and historic issues. Tom is currently sustaining a successful tenancy.

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Rough Sleeping

The rough sleeping snapshot in Surrey (Autumn 2022) is presented in Figure 42. This data is captured annually on a single night and not always considered representative of numbers of rough sleepers in a Local Authority. However, we can see that the number of rough sleepers varies across Surrey with high numbers in the west of the County.

The number of people sleeping rough on the streets or in the countryside of Surrey is high by historical comparisons. Numbers have dropped considerably since a high point in 2015 and hit a relative low point during the COVID-19 pandemic, although the numbers remained higher than historic trends.

The ‘Everyone In’ initiative during the COVID-19 pandemic served to ensure that the majority of rough sleepers were accommodated. This was designed to limit rough sleeper’s exposure to the virus and improve their overall health. [8]

It is difficult to predict where trends in rough sleeping are going. It is anticipated that as a subset of homelessness, where overall numbers are predicted to rise, rough sleeping will also do the same in the short term. 

Figure 43 in the dashboard shows trends in the rough sleeping snapshot data for Surrey. As described above numbers were increasing before falling in 2020 due to the pandemic and in 2022 began to increase again.

The demographics of people sleeping rough in Surrey (Autumn 2022 snapshot) shows men are far more likely to rough sleep. Six percent of rough sleepers are aged 18 to 25 and 80% of rough sleepers are UK nationals (Figure 44 in the dashboard).

Local Insights

Overview of responsibilities in Surrey

The Strategic Housing Function is carried out in Surrey by the 11 District and Borough councils who work in partnership with a range of statutory and voluntary organisations and residents to deliver the wide range of functions that sit within this role.

Broadly, the strategic housing role includes the following functions:

• Assessing and planning for the current and future housing needs of the local population across all tenures
• Housing advice and options service
• Having a Housing Allocations Policy and Housing register
• Allocations and lettings
• HMO licencing
• Disabled Facilities Grants (DFGs)
• Grants and loans assistance for housing adaptations
• Homelessness prevention, assistance and tackling rough sleeping
• Housing standards and conditions including in the private sector
• The enabling role to deliver affordable housing

From this list it is clear that there are many links between health and housing including, for example, the demand for health services being disproportionately required by those living in poor housing conditions or with the risk of falls and accidents; homeless households and rough sleepers or those living in inadequate housing or being overcrowded.

The British Research Establishment estimate the impact of poor housing on the cost of health services to be £1.4 billion per annum; similar to the health costs of smoking.

In contrast, those who are well housed, with appropriate levels of support, use health services far less.

Therefore, if health, housing, planning, social welfare agencies, landlords and residents work together to reduce housing risks, and improve housing, then there are likely to be very tangible benefits for health and housing services, as well as for the individuals and households affected.

The 11 District and Borough councils that hold the strategic housing function in Surrey are:

• Elmbridge
• Epsom and Ewell
• Guildford
• Mole Valley
• Reigate and Banstead
• Runnymede
• Spelthorne
• Surrey Heath
• Tandridge
• Waverley
• Woking

Specific responsibilities for Gypsy Roma Traveller (GRT) plots are outlined in the Needs of Specific Groups section.

Highlights from Districts and Boroughs

In delivering their housing services the district and borough councils contribute positively and significantly to the health and wellbeing of their residents. It is acknowledged that there is always more to do in terms of delivering affordable housing, helping those in housing need, improving housing conditions and providing support to vulnerable residents. These challenges are set out in other parts of this chapter including for example the fact that across the 11 District and Borough councils in Surrey 3,361 households were assessed as homeless or threatened with homelessness in the year 2021/22. However, there are also significant success stories, ambitious plans and examples of good practice that clearly demonstrate the fundamental link between housing and health and wellbeing.

Key highlights recorded below, for more in depth summaries please see Appendix 2.

Spelthorne Borough Council:

• have recently completed two high quality housing developments within the borough which provides much needed emergency accommodation for residents who are facing homelessness. These are the White House and Harper House in Ashford
• is the lead authority for the set-up and management of a step-down project across North West Surrey to deliver an integrated ‘wrap-around’ intermediate care package to support timely discharge of older residents from acute settings.
• set up Knowle Green Estates (the Council’s privately owned housing company) to deliver affordable homes and increase move-on options available to residents in emergency accommodation. Since 2018, 82 affordable rented homes have been delivered; this includes the conversion of part of the council’s offices into 25 affordable homes of which Spelthorne is the first local authority in the country to do this.

Epsom and Ewell Borough Council:

• successfully operates a Private Sector Lease (PSL), where local landlords lease their property to the council for between 3 to 5 years for use as temporary accommodation thus increasing numbers of households placed within the borough and keeping temporary accommodation costs down.
• has employed a specialist single person housing officer to work alongside East Surrey Outreach Service (ESOS), to work with the borough’s most entrenched rough sleepers. This also includes sourcing funding to set up two ‘Housing First’ units in partnership with Transform Housing & Support.
• works closely with the Housing Benefit Team and social housing providers to identify and support households affected by the spare room subsidy, to downsize a number of households, which has resulted in 8 3-bedroom properties becoming available.

Reigate and Banstead Borough Council:

• commit in their ‘Five Year Plan’ to securing the delivery of homes that can be afforded by local people and which provide a wider choice of tenure, type and size and  make it clear in their Housing Delivery Strategy 2020-2025 that to achieve this they will work in partnership with housing associations, Surrey County Council, developers and Homes England
• since 2020 has directly delivered 61 new build homes, 32 secure tenancies, 4 housing first style units for homeless applicants with complex needs, 11 shared ownership homes and 14 market sale homes.
• are further increasing their local temporary accommodation stock through purchasing over 15 family homes and a shared house for single homeless applicants.
• jointly funds ESOS operated by Thames Reach. ESOS proactively work with rough sleepers and the LA to secure positive housing and health outcomes for service users.
• are also part way through an 18-month pilot with East Surrey Place part of NHS Heartlands, to deliver a Hospital Discharge Service concentrating on improving discharge times for patients that have housing issues on discharge.

Waverley Borough Council

• has committed to building homes to buy or rent for households from all income levels by harnessing the power of partnerships; aligning new supply more closely with need; ensuring synergy between services and creating homes for all out lives
• In the next 3 years plan to
  • ensure that the mix of affordable homes delivered includes rented homes which would be attractive to downsizers, to free up larger affordable homes
  • Enable at least one scheme per annum with wheelchair accessible homes (M43 standard) to meet the needs of older people or those with physical disabilities
  • Work closely with developers and Affordable Housing Providers at planning application and pre-application stage to ensure the location, size, type, tenure and design of new affordable homes meets need
  • plan strategically for the development of a range of housing options for older people, including Extra Care housing and dementia specialist care, working in partnership with Surrey County Council ASC Commissioning Team

Tandridge District Council

• work with ESOS to work with those who are sofa surfing or are rough sleeping.
• has identified that adaptions for disabled children can make the difference between a parent being able to care for their child at home or not and manage family life. As such adaptations for children up to £30,000 are not means tested.
• Have identified accommodation for older people as a specific need in Tandridge. As Surrey County Council transitions away from traditional residential and nursing care provision in the coming years, the need for extra care housing in the district is identified as critical as there are no affordable extra care units in the Tandridge District to either rent or buy, with all current provision being in the private sector which is not financially accessible to everyone.
• works with Social Services to identify at an early-stage vulnerable young people who are leaving care and who need their own accommodation by ensuring qualifying young people are registered on the Housing Register so they can be nominated to a supported housing vacancy before a crisis situation such as street homelessness occurs
• offers a Sanctuary Scheme to residents living in council property and in the private sector which enables victims of domestic abuse to remain in their own homes by providing security improvements such as the installation of spy holes in doors, improved door and window locks and security lighting. Housing Associations also offer this scheme to their tenants.  

Woking Borough Council

• has delivered two new self-contained, modern temporary accommodation schemes (providing 47 units), as well as renovating its existing temporary accommodation schemes.
• has also set up a selective licensing scheme in the Canalside ward to raise the standard of private rented accommodation. 865 licences have been issued under the scheme, with 52% of properties visited being improved following inspection
•  has a target to meet the need for 22 new gypsy and traveller pitches already identified in the Gypsy and Traveller Assessment up to 2027.
•  has developed Brockhill and Old Woking extra care schemes. The Brockhill Scheme provides 49 homes and is located in Goldsworth Park. Old Woking scheme is a Hale End Court and provides 48 apartments, 12 of which are for tenants needing care. These are designed to meet the needs of frail or vulnerable people living in Woking and provide 24/7 personal care to help those with additional support needs to remain as independent as possible.
• offers a range of support services designed to promote ongoing independence and wellbeing. The council’s independent support service works in partnership with other external agencies to offer support to anyone who needs it, regardless of tenure.

Mole Valley District Council:

• have identified the needs of older people as a specific area of concern and plan to enable and facilitate the development of extra care schemes for older people located close to facilities in the towns of Leatherhead and or Dorking.

Guildford Borough Council:

• have developed a number of additional supported living projects for people with learning disabilities over the past ten years, and are planning to build 12 flats next to Guildford Fire Station. The county council having nomination rights to four of these units, which will be used to house people with learning disabilities who are able to live independently but who require some level of support.
• provide two Extra Care housing schemes in the borough: Dray Court and Japonica Court. These cater for older people with higher support needs than those in sheltered housing, allowing them to receive the care they need whilst retaining their independence. An on-site social care team can provide care and welfare support for up to 24 hours a day where necessary.
• recognises that many older people, are still in housing need and under occupy large family homes and offers support and help to older tenants who are willing to downsize and will continue to consider ways in which they can offer more attractive housing options for their older residents including on new developments.
• aims to provide some new Traveller accommodation directly having received planning approval for five Traveller pitches at Ash Bridge and were successful in gaining a grant allocation of £432,000 from the Homes and Communities Agency.

Surrey Heath Borough Council:

• Delivered Surrey County Council’s Floating Housing Support Service which allowed the Council to successfully bid for an additional Support Officer within the service specifically working on homelessness prevention and resettlement with single people.
• To support the timely delivery of Disabled Facilities Grants and other adaptations Surrey Heath has secured Better Care Fund money to employ a Housing OT within the Housing Service. This will speed up assessment for DFGs as well as support housing needs work around housing allocations and homelessness where an applicant has a disability.
• have initiated a number of projects to address the needs of single homeless residents and rough sleepers. Following a successful project that led to the setting up of a local charity, the Hope Hub, providing crisis and day services, two accommodation projects have been delivered using developer contributions.
  • the purchase of a 10 bed former temporary accommodation scheme from a housing association. This is now run by the Council as a supported housing scheme for single homeless individuals.
  • the purchase of a 6 bedroom street property now leased to the Hope Hub to provide an Emergency Accommodation Scheme for single people, allowing a period of assessment and support to explore housing options.

Runnymede Borough Council:

• Is part of the successful StepDown scheme, using a number of Council properties to free up hospital beds when a patient is medically ready to leave hospital. 
• Have dedicated engagement and inclusion staff offering a range of methods to enable us to listen to the views of customers previously under-represented and lead diversity awareness and community engagement events.
• Built nine new Council apartments in Addlestone in 2022, launching a commitment to deliver 125 new council homes in 5 years.
• Significantly increased investment in council owned homes included solar panels and energy efficiency measures. 
• Support With Moving Policy offers practical support and financial incentives for tenants giving up larger, family sized properties who are willing to downsize to a smaller home.

Locations within Surrey

Housing deprivation is not evenly distributed within Surrey – See Fig. Below

Surrey’s Health and Well-being Strategy was refreshed in 2022 to include a particular focus on certain geographic areas of the county which experience the poorest health outcomes in Surrey. These areas were selected on the basis of the overall deprivation score established in the English deprivation indices 2019.

The “Key Neighbourhoods” for especial prioritisation are the wards which included the most deprived “pockets” within the county. These small areas are called Lower Super Output Areas (LSOA)s:

Table 9 shows these ‘Key Neighbourhoods’ and the decile they sit in for the Indices of Multiple Deprivation (IMD) overall and also for the barrier to housing decile. The deciles are calculated by ranking the 32,844 LSOAs in England from most deprived to least deprived and dividing them into 10 equal groups. LSOAs in decile 1 fall within the most deprived 10% of LSOAs nationally and LSOAs in decile 10 fall within the least deprived 10% of LSOAs nationally. Most are in the Lower 5 deciles for barriers to Housing.

Note: The Wider Barriers Sub-domain measures the financial accessibility of housing such as affordability; it is part of the Barriers to Housing and Services Domain of deprivation (Source: Department of Levelling Up, Housing and Communities English Indices of Deprivation 2019).

Figure 45 shows a map of Barriers to Housing Domain of deprivation (wider barriers sub-domain) at LSOA level in Surrey, which includes issues relating to access to housing such as affordability:

This shows that there is much geographical variation throughout Surrey for this indicator, but the North of the county is more likely to be more deprived when it comes to the wider barriers affecting housing.

Rural Housing

There are particular issues for those living in rural areas in Surrey. Around 50% of the land area in Surrey is rural, but it hosts less than 12% of residents.

Rural areas in Surrey have an older age profile than elsewhere, with almost a quarter of its population being over 65 years. In fact, the over 65 years age group is the only one that is growing in rural Surrey, with all younger age groups seeing a decline in recent years. Factors such as high housing prices and overall cost of living will inevitably lead to an increasing age and affluence profile of rural Surrey. Many of the older population live in large older properties and finding accommodation to downsize locally is a challenge. More traditional, smaller properties have often been extended.

Affordability and a lack of affordable and social housing is seen by many as a key issue for rural Surrey. Large areas of the county fall within the Green Belt, Areas of Outstanding Natural Beauty and Areas of Special Scientific Interest, many settlement areas are subject to conservation area regulations and land prices are high which drives up the cost of housing in rural areas.

Being within easy reach of London makes many of the villages an ideal choice for commuters; house prices are cheaper than London, whilst salaries in London are higher, this means local people on a median salary are finding it increasingly difficult to afford the current housing market. This together with the loss of council homes under Right to Buy, and the increased cost of private renting leaves some people with little choice but to move away, continue living at home with relatives or remain in the expensive and insecure private rented market. This impacts people feeling secure in their homes and feeling part of the wider community.

For village life to be sustainable there needs to be a mixture of age groups, incomes and household types to maintain services such as schools, local pubs, the post office and bus links. Lack of affordable housing results in rural communities having an unbalanced social and economic mix with mainly older or wealthy householders.

Creating affordable housing also has an economic benefit with the economy being boosted by £1.4 million and generating £250,000 in government revenue for every ten houses built.

There is a Rural Exception Policy, that is specific to rural areas that can be used to help. The National Planning Policy Framework refers to rural exception sites as “Small sites used for affordable housing in perpetuity, where sites would not normally be used for housing.” Rural exception sites seek to address the needs of the community by accommodating households who are either residents or have an existing family or employment connection. A proportion of market homes may be allowed on the site at the local planning authority’s discretion, for example where essential to enable the delivery of affordable units without grant funding or to enable a lower rate of rent to be charged.

Insight from the community

In order to add meaning to the findings outlined so far in this chapter through data and statistics it is important to reflect conversations, consultations and stories from the local community who live in Surrey, those who work in housing in Surrey and others with a vested interest. This is partly done through the case studies scattered through this document and found in more detail in Appendices 3-6. In addition below we have collated insight from relevant existing pieces of work and also conversations had in developing this chapter which can help us to develop our health and wellbeing recommendations in relation to housing.

Concerns of District and Boroughs

Whilst developing this chapter we asked Surreys Housing Enabling Officers what they thought the biggest issues for housing in Surrey are.

‘Truly’ affordable housing came out as the top concern with officers highlighting that the governments definition of ‘Affordable Housing’ includes housing that isn’t actually affordable. Lack of affordable housing is also tied in with supply and planning constraints meaning a lack of available land for development.

Officers also mentioned:

• Affordability of the private rented sector
• Lack of temporary accommodation (particularly for those with complex needs and large households)
• Lack of joined up policy
• Cost of living crisis
• Lack of social housing
• Lack of political will / political priorities
• Financial positions of councils impacting ability to deliver
• Lack of supported housing for people with complex needs
• Supporting refugees into appropriate housing

Consultation on A Housing, Homes & Accommodation Strategy for Surrey

Following the development of A Housing Homes & Accommodation Strategy for Surrey, Surrey County Council undertook a consultation. The consultation was open to the general public, and received 106 responses. The consultation aimed to gain insight from the local community as to which topics identified in the strategy they felt were most important. Of the respondents 101 lived in Surrey and 49 work in Surrey. Five people own a business in Surrey. Most respondents (68) own their home outright or with the help of a mortgage. Most respondents were employed full-time.

Responders were asked to say how important they felt the topics identified in the Strategy are. Figure 46 below shows the percentage of respondents who felt each topic was very important. Although this consultation was specific to the outcomes of the strategy it gives us some idea of what the community in Surrey thinks is important when it comes to housing.

Housing unaffordability had the largest percentage of people feeling it is very important (77.4%) followed by understanding public opinion. An aging population is the topic least respondents felt was very important (37.7%) and most respondents felt was not important at all (18.9%).

An explanation of each topic is below:

Partnership working – This refers to the need for greater partnership working in Surrey in relation to the provision of housing and accommodation.

Understanding Public Opinion – This refers to concerns about public opinion regarding growth and development as a barrier to partners confidently committing to long-term joint working on housing growth.

An Ageing Population & Under Occupation –  This refers to the issue of under-occupation (e.g. a house having more bedrooms than there are occupants) worsening housing supply problems and reducing availability for families.

Housing [Un]affordability  – This refers to higher house prices making it a less feasible option for growing families, graduates, essential workers or young professionals to afford to live in the county.

Supporting Vulnerable Residents –  This refers to multiple agencies and organisations working together to maximise what they have for the benefit of residents who need that support (e.g. high-needs families, migrants or individuals).

Public Sector Land (Collective action and taking greater control over quality, quantity & price of homes) –  This refers to identifying available public sector owned land for housing development and the need to pool resources and share the benefits to allow partners greater control over the type, scale, size and affordability of housing in their local area

More Councils, enabling more housing delivery – This refers to the opportunity for councils to prioritise housing delivery, addressing the challenges of funding, planning constraints, capacity, and working in partnership.

The Climate Crisis –  This refers to changing investment priorities away from new housing development and into retrofit and refurbishment of existing homes due to concerns over climate-based resistance to new housing.

Feedback to HealthWatch

HealthWatch have collated case studies on the condition of homes, impact on health and ability to get help which are reported below:

Case study 1 May 2023

I’ve had problems with my housing that why I’m [at the warm hub]. There’s a problem with the humidity and the place is just damp. I have a track record going back several years with the housing team at the council, which doesn’t help. It’s a battle trying to get someone to come out. I did talk get help in the end  – an organisation helped me write to the council and someone did come out in the end.

Case study 2 February 2023

Been living in UK since 2001. Rent house through a Private Registered Provider. There is mould in the kids’ bedrooms and in my bedroom. It is cold but I am having to leave the windows open to get some air in the room. My 5 year old has a cough and struggles with his breathing. I have a cough too. I have complained to PA Housing but nothing. I have to change the sheets a lot as they are damp and mouldy. It’s horrible. The children are squeezed into a room and are sleeping on mattresses on the floor pushed up right against the walls. It’s not nice for them.

It’s hard to get an appointment with the GP. I have 6 kids. When I try to get an appointment, I feel like I am fobbed off. I am worried. I want to change GP; I heard there is one in Hersham that is good but that there is a long waiting list. [another lady recommended Ashley Medical Centre to her]

I have arthritis and it’s getting more and more painful. [advised to contact GP again]

I took my 12 year old to St Peters [2022], there was a long wait in A&E but the service was good. It was a good experience overall.

I’m very stressed about the cost of living. It’s very hard when you have six children.

Case Study 3:

HealthWatch found that Ukrainian refugees main concern was housing. One refugee told their story:

I have been in Caterham since March last year. Living with Aunt initially and then we moved to a hotel and now a hostel with my sister and our children. We had to leave our partners behind in Ukraine. We have rooms opposite each other. Previously we had to share a bed which wasn’t ideal.

**What could make your life better** – right now, we don’t care about health, it’s all about living arrangements. We want to be settled in our own house and working and contributing to family life.

Other insights

Surrey County Council and Surrey Heartlands have carried out research to gather a deep and broad understanding of what is happening on the ground for residents, exploring resilience and support and identifying opportunities in the context of the cost of living crisis. The findings below are from research in the 5 most deprived wards in Surrey with a focus on those who are seldom heard but have been most impacted by the COVID-19 pandemic and the cost of living crisis. Research was done through community walkabouts, stakeholder engagement interviews, an online survey and ethnographic research (16 households). The findings related to housing are outlined below.

86% of residents have said they are cutting down on household bills. One woman in Court Ward said ‘Bills just keep coming which we both cannot pay. Council tax and heating are big ones. We work part time to be around for our kids, so if we paid all our bills back in full we would have no money to feed them or ourselves. My friend sends her kids to me when her fridge is empty and I do the same to her’,

The report highlighted the link between cost of living and poor health with examples such as

‘For me the cost of living crisis has just added and multiplied what I’ve already been going through. I have a chronic condition which stops me from working, and I’ve had to battle with housing to get back on the register since my ex left me in dept in the current housing association flat we are in. It feels like all the services are a bit inaccessible right now’

The report makes the recommendation that councils should not be pushing people further into debt and should find ways to consolidate debt and help with breaks in payment including working with housing and landlords to freeze council tax and rent.

Needs of Specific Groups

Age

Evidence shows that those who are youngest and oldest in our society are more at risk of housing-related health problems. For example, older people are more at risk of fuel poverty. Those aged over 75 are most likely to be living in homes that are too cold or lack modern facilities. Older people are also at greater risk of falls from housing related issues with many homes requiring adaptations. They are also more likely to live alone and be at risk of social isolation [9]. Children on the other hand are more likely to live in overcrowded housing which can impact social, mental and physical development. [10]

Nationally, young people are one of the worst groups being hit by the cost of living crisis and its impact on housing as mortgage rates increase making it harder to own your own home and landlords pass on the increase to renters. Affordability is a growing national issue and the situation is particularly pronounced for young graduates and professionals..

As shown in the key facts section, the younger someone is the more likely they are to be in social or private rented housing. The older someone is the more likely they are to own their home with a mortgage and those aged over 65 are most likely to own their own home outright.

For those known to adult social care, a person with a learning disability is less likely to be living independently the older they are. For those with mental health issues the 2023 general trend is for older age groups to be more likely to live independently, up to the age group of 45 to 54 and after that the percentages decline.

People experiencing domestic abuse

Experiencing domestic abuse is associated with a number of health risks including depression, anxiety, PTSD and substance. People experiencing domestic abuse are also more likely to experience homelessness compared to the general population.  Domestic abuse can lead to insecure housing and the issues described earlier in this chapter associated with that. There may also be health risks for children and others within the family, who witness abusive incidents.

Concerns on current or future housing options can make it difficult for those experiencing domestic abuse to leave their partners. The Domestic Abuse Report 2020: The Hidden Housing crisis, found that survivors are sometimes weighing up staying in a home shared with an abuser or leaving for another potentially unsafe situation due to lack of housing. There are also fewer housing options for those survivors who are not eligible for public funds (due to immigration status) as they are not entitled to housing related benefits or for housing help from any local authority.

Establishing a clear picture of the extent of domestic abuse in Surrey is difficult as it is often a hidden crime and under-reported. However it is estimated in the UK 1 in 5 adults will experience domestic abuse.

Surrey Domestic Abuse Partnership (SDAP) is a group of independent charities who work together across the whole of Surrey to ensure that survivors of domestic abuse are safe, and to build a future where domestic abuse is not tolerated. The service is open to anyone affected by domestic abuse regardless of age, gender, sexuality, religion, mental and physical health.

Between 1^st April 2022 and 31^st March 2023, the domestic abuse charity and refuge ‘I Choose Freedom’ (based across Surrey) supported 101 women and 129 children in Surrey (not all of whom were originally Surrey residents) who were fleeing their homes.  There are a variety of ways in which refuge can be sought. A person requiring refuge can make contact often by referring into the national domestic abuse helpline, or a professional supporting the family can also seek space and begin the referral by email or phone.

I Choose Freedom provided housing outcome data for 50 clients they helped to re-home in this period (the rest of the clients are still within service so outcome data is not yet available). Forty two percent were placed in unstable accommodation with most of these being in temporary accommodation, and 18% were in hotel accommodation. Further analysis of this data found that that once they leave the service refuge staff observed 75% of women experienced further harm and trauma due to their unsuitable housing leading to a feeling of insecurity, not belonging and also additional financial costs.

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Case study of a family that came into I Choose Freedom refuge in 2023

Client N (not originally a Surrey resident) – A woman with insecure immigration and mother to two children both aged under 5.

N was referred into refuge via a social worker after disclosing that she has been experiencing domestic abuse from her husband. N was being moved daily by Children’s services and was scared for her safety as she was still in the local area. N was often in hotels with no cooking facilities for her and her children and nowhere to wash her clothes. N advised she was experiencing low mood and felt exhausted and alone.

N was accepted by refuge and travelled to I Choose Freedom the next day. She was supported by her advocate to secure her immigration, offered counselling, and received therapy for her children. Five months into N’s stay at refuge N reported improvements in her mental health, feeling less anxious, reduction in panic attacks and feeling happy. During N’s stay her advocate begins the process of applying for housing however they don’t know when a property will become available so N has to be ready to move at any moment. The uncertainty began to make N feel low, and worried about and unable to plan for her children’s future.

N was placed in emergency accommodation, their Fifth move in six months. Unable to view the accommodation beforehand when they arrived, they find it is not suitable as it is shared with both males and females and is 45 minutes away from her children’s school. However, this is the only option available. N retreats into herself and struggles to get her children to school. 2 weeks later N is moved again to temporary accommodation which better suits their needs but is still one small room with her children. N’s mental health has declined she struggles with daily tasks like getting the children to school, shopping and getting to the laundrette.

N will still face more moves when suitable accommodation is found.

A fuller version of the case study can be found in Appendix 3 of the chapter.

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People experiencing multiple disadvantage

People facing multiple disadvantage experience a combination of problems concurrently. Multiple disadvantage (formerly known as complex needs) mainly originates in adverse childhood experiences; approximately 85% of people facing severe multiple disadvantage (SMD) have experienced childhood trauma. For many, their current circumstances are shaped by long-term experiences of poverty, deprivation, trauma, abuse, and neglect. Many also face racism, sexism, and homophobia.

These inequalities intersect in different ways, manifesting in a combination of experiences including homelessness, substance use, domestic abuse, contact with the criminal justice system and mental ill health. Other risk factors can include neurodiversity, physical disabilities, and learning difficulties.

Lankelly Chase’s 2015 report, ‘Hard Edges: Mapping Severe and Multiple Disadvantage in England’ estimates that approximately 31,000 people in England (2010/11) have a combination of homelessness plus contact with the criminal justice system; and around 34,000 have an overlap of homelessness plus substance use [11].

In order to tackle these issues in Surrey, the Changing Futures – Bridge the Gap specialist trauma informed outreach service has been put into place. The Changing Futures Programme is currently funded by the Department of Levelling Up Housing and Communities and the National Lottery until March 2025. It is a first step in supporting people experiencing severe multiple disadvantage, with the service offering each individual up to 8 hours per week of intensive, specialised, trauma-informed support. Both a local Surrey  independent evaluation and the national Changing Futures programme baseline report show that the programme is having a positive impact on tenancies [12], and improved outcomes for individuals relating to reduced offending, emotional and physical mental health, drug and alcohol use, social networking and relationships, self -care and living skills, motivation.

Gaps in current provision

In line with the Changing Futures programme, Surrey is funded to support around 120 individuals experiencing severe multiple disadvantage (i.e., 3 or more challenges concurrently). However, feedback from service providers and social and health care services indicates there could be as many as 3,000 people experiencing multiple disadvantage in Surrey, indicating a substantial shortfall in provision to meet the current need.

Feedback from stakeholders also suggests that there are gaps in the provision of appropriate specialist housing, shared housing, and independent housing to support the needs of adults, young people and families experiencing multiple disadvantage.

At present, evidence suggests there is a lack of supported housing contractors offering support provision for people with ‘high level’ needs, such as those experiencing multiple disadvantage.

The ‘Housing First’ approach provides permanent housing for homeless people who are dependent on alcohol and drugs or who have mental health issues, with wrap around relational support (such as the Bridge the Gap Trauma Informed Outreach Service), plus the social care and health services needed which is provided to them in their own homes or locally in their community. The intention is that housing should be available even if a homeless person refuses treatment for their substance use or mental health issues.

There are low numbers of Housing First or Housing Led units in Surrey (>20), by comparison, the Republic of Northern Ireland (an area similar in size to Surrey), aims to have around 1,800 Housing First Units by 2026, with 950 of those units currently in place. Public Health, in partnership with the Districts and Borough Councils, set up Housing First style Emergency Accommodation Cabins (these provided a temporary stay not a tenancy) during the COVID-19 pandemic which were occupied by 190 people. All cabin residents were housed by Local Authorities with the majority continuing to receive specialist Bridge the Gap trauma outreach support for several months.

In addition, trauma-informed training and person-centred care has been identified as a gap. For example, Tenancy Support Officers within the housing department could be better trained in trauma informed approaches and supporting people experiencing multiple disadvantage challenges such as mental ill health, substance use issues and neurodivergence.

Ordinarily, an area the size of Surrey would have the provision of ‘wet housing’ (i.e., temporary accommodation permitting the consumption of alcohol in a controlled environment). I-access provide advice, information, and signposting to other relevant services for accommodation and supported housing, however, through the eyes of service users there remains a gap, for example, Surrey does not currently provide ‘wet housing’.

In early 2024, Surrey will publish a separate JSNA chapter on Multiple Disadvantage which will provide significant data and insight into adults, children and young people experiencing multiple and concurrent challenges. The chapter will highlight specific barriers relating to housing and experiences of homelessness, as well as what is working well and recommended priority actions.

A case study outlining a positive lived experience of a surrey resident who experiences multiple disadvantage can be found in Appendix 4

People with Learning disabilities and /or autism

Learning disabilities

There are estimated to be 22,000 adults in Surrey will have a learning disability with only a proportion known to health and social services. This is expected to increase to around 23,000 by 2040. Information on the types of homes adults with learning disabilities live in can be found in the JSNA chapter on people with learning disabilities.

Supported independent living can be ideal for people with a learning disability. Tenants of supported independent living are provided with accommodation and support. This can include support to develop daily living skills and can sometimes include personal care. A list of supported independent living schemes in Surrey can be found on Surrey Information Point; Search results | Surrey Information Point

Access to appropriate housing for people with a learning disability and/or autism has long been identified as an issue. Valuing People, published by the Department of Health in 2001, noted that one of the key challenges for people with a learning disability and/or autism seeking to live as independently as possible is the limited housing options available and their lack of choice and control in regard to where they live and with whom [13].

The Adult Social Care Accommodation with Care and Support Strategy for Extra Care Housing for Older People and Independent Living Schemes for adults with a learning disability and /or autism outlines that due to a lack of alternative options Surrey County Council currently relies too heavily on placing older people and individuals with learning disabilities and/or autism in a residential setting. This approach limit’s the ability to support individuals to increase their independence, enable them to live healthy and fulfilling lives, and achieve their full potential in the community. This is especially true for a significant number of people who must be placed outside of Surrey due to the lack of suitable alternatives.

Reliance on residential and nursing care undermines an individuals’ choice and control and leads for many to high cost over provision. This needs to be addressed going forward in order to ensure a sustainable and resilient budget that operates within available resources and focuses on more efficient and person-centred forms of care within the community.

There are 1,075 (as of May 2019) individuals with a learning disability and/or autism in residential care and 2,896 older people that are placed in Surrey County Council funded residential and nursing setting. The average cost of placing an individual with a learning disability and/or autism in a residential setting is £77,000 per annum and for an older person it is £38,000.

In 2020 the Council outlined its strategic aim to reduce the number of people with a learning disability and/or autism in residential care by 40 to 50% over the next five years by expanding the development of supported independent living provision in line with the Community Vision for Surrey 2030.

Figure 47 shows a map of people with learning disabilities funded by Adult Social Care living in residential care, supported living, or living alone or with family / friends shown with locations of acute hospitals summarised by 2020 ward boundaries.

The independent living status of people with learning disabilities within Surrey is presented in Figure 48. In April 2023, 73.2% are living independently with the highest proportion of these people settled in mainstream housing with family or friends. Of the 21.1% not living independently, the majority live in a care home.

Figure 49 shows independent living status of people with a learning disability that are open to adult social care by ethnicity and shows that there are some existing inequalities.  over four fifths of ‘Asian / Asian British’ and ‘Mixed / multiple ethnic groups’ are living independently. The lowest percentage is for ‘Black / African / Caribbean / Black British’ at under two thirds.

Projected demand for Independent Living units for people with Learning Disabilities and Autism by local authority area by 2030 is shown on the map on page 16 of  ‘A Housing, Homes and Accommodation Strategy for Surrey’

Autism

In 2021, the autistic population in Surrey was projected to be 12,300 (3,200 children aged 17 and under, 900 young people 18 to 24 years and 8,200 people over 25 years of age). Only a relatively small percentage of these autistic people are open to social care services (circa 20% of those aged over 18 in 2021) and therefore many autistic people require access to mainstream housing as opposed to specialist supported housing.

In 2021, the Surrey ‘All Age Autism Strategy 2021 to 2026’ was published following a wide ranging and in-depth co-production and consultation process involving autistic children, autistic adults, family carers and professionals. Housing and Independent Living was identified as a key area requiring focus and improvement with autistic people and families struggling to navigate often complex social housing pathways and a lack of appropriate/autism accessible housing in Surrey.

The Strategy sets out aims to improve housing for autistic people in Surrey such as

• District and Borough Housing staff to understand autism and make reasonable adjustments so that housing processes are autism accessible.
• For borough housing stock to be autism accessible. Building Standards
• Autism accessibility is considered in all new buildings.
• Improve autistic people’s access to housing that meets their needs
• Increase the provision of supported housing.

The videos below provide insight into people in Surreys experience of Supported Independent Living

Surrey Supporting Residents to Live Independently – Tori’s Supported Independent Living Story

Surrey Supporting Residents to Live Independently – Shannon’s Shared Lives Story

Shared Lives – Michael’s Story (with BSL) – YouTube

People with physical disabilities

Surreys Adult Social Care Strategy for People with Physical Disabilities and Sensory impairment provides details on housing for people with disabilities in Surrey which have been summarised and updated below:

There are 14.1 million disabled people in the UK. Currently 3,300 individuals are known to Adult Social Care and have a Primary Client Category of Physical Disabilities recorded on LAS, Surrey County Council’s case management system, 66.4% of these people are under 65 years old.

Nearly 1 in 5 (19.4%) disabled people aged 16 to 64 years in the UK live in rented social housing compared with less than 1 in 15 (5.9%) non-disabled people, a significant difference. Disabled people were significantly less likely to own their own home (43.6%) or to live with parents (17.1%) than non-disabled people (55.9% and 19.1% respectively).

The housing situation of disabled people varies across age groups. Young disabled people aged 16 to 24 years were as likely to live with parents as non-disabled people of the same age, with similar proportions seen for each (74.6 % for disabled people, 79.3% for non-disabled people).  The largest disparity was seen for ages 45 to 49 years, where 46.4% of disabled people owned their own homes compared with 72.8% of non-disabled people, a percentage point difference of 26.4.

The housing situation of disabled and non-disabled people varied by sex. Disabled women were less likely to own a home (41.2% and 54.2%), less likely to live with their parents (12.7% and 17.1%) and more likely to rent social housing (26.8% and 9.2%) compared with non-disabled women. Similarly, disabled men were less likely to own their home (37.8% and 52.5%) and were more likely to rent social housing (22.5% and 6.6%) than non-disabled men.

Housing situation did not differ significantly between most impairment types. However, those with autism, or severe or specific learning difficulties were more likely than those with any other main impairment type to be living with parents (76.0% and 65.9% respectively). They were also less likely to own their own homes compared with any other main impairment type (3.8% and 8.0% respectively) [14].

The supply of private and social rented housing suitable for disabled people is very limited in Surrey. There is an acute shortage of social rented housing and many applicants on the (11) District and Borough council housing registers have long waits for rehousing.

Consultation Feedback on this topic with professional stakeholders highlighted the following is required:

• Affordable, suitably designed and accessible homes in the right places, with supporting infrastructure, can extend independent and safe living for older people and working age disabled people and/or other long-term health needs
• More training for Occupational Therapists on different conditions
• More involvement from Occupational Therapist in the initial development and design of accommodation for people with disabilities

Refugees and asylum seekers

A wide range of agencies from across Surrey, convened and co-ordinated by the County Council, have been working with a number of refugees, asylum seekers and migrants in recent years.

[Note: Individuals who are granted asylum or resettled in the UK have refugee status and receive legal protection and access to public funds and public services, as a result of being forced to flee their country because of a well-founded fear of persecution. Asylum seekers are those who seek sanctuary in another country and the right to be recognised as a refugee, because of a well-founded fear of persecution in their home country. Asylum seekers do not have the right to work or claim benefits, social housing or temporary accommodation.

Since welcoming Syrian refugees in 2016, this effort has expanded in recent times with the evacuation of initially military personnel and those supporting them from Kabul, Afghanistan and then Afghan civilians and more recently, those arriving in the UK from the Ukraine. British Nationals from Hong Kong have also been welcomed into Surrey, under their national re-settlement scheme. In addition, there has been a significant build-up of people in the asylum accommodation system, and as a result, asylum seekers have been placed in hotels whilst they await a decision on their asylum application.

There are several hotels in Surrey being used to support national migration schemes:

Bridging hotels (commissioned by the Home Office until August 2023): Accommodation for those arriving on the Afghan Relocations and Assistance Policy (ARAP) or Afghan Citizens Resettlement Scheme (ACRS) scheme. The hotels are used to bridge the gap between arriving in the UK and moving into settled accommodation.  As of November 2023, there is just one hotel being used to accommodate Afghan evacuees in Surrey and it is anticipated that the final families will move out in early 2024 into settled housing.

Initial Accommodation hotels and Overflow Dispersal Accommodation (commissioned by the Home Office.): Accommodation for asylum seekers arriving via irregular migration routes such as via boats across the channel. In April 2023, over 1,650 people were being provided with temporary accommodation in Surrey, 55% hosted in initial accommodation, 34% in bridging hotels, 8% in overflow dispersal accommodation and 3% in emergency response hotels.

Once an asylum seeker receives a positive decision on their asylum application, there is just 28 days until they have to leave their Home Office provided accommodation. This leaves little time to find alternative accommodation, obtain a National Insurance number, find work, or establish a welfare benefits claim. They also usually lack the basic requirement to gain a tenancy in the private rented sector: a deposit.

Bridging accommodation is intended to provide a temporary interim solution while the home Office work with delivery partners to support the Afghan families in becoming self-sufficient, and able to resettle in communities. The Home Office ‘Bridging accommodation closures’ document provides an overview of Home Office policy on supporting the movement of guests temporarily accommodated within bridging accommodation, and managing further offers of temporary and settled accommodation when bridging accommodation is closed as a result of contract termination.

When individuals are asked to move on from Home Office provided accommodation, they may seek support from District and Boroughs Councils housing services. Despite advice and support, these groups find it very difficult to understand the landscape, legal framework and intricacies of the housing market and of renting or buying a property and may be more susceptible to the activities of unscrupulous landlords in the private rented sector.  Difficulty in communicating in English can render these groups even more vulnerable.

In addition to accommodation commissioned by the Home Office, Surrey residents have opened their homes to people fleeing Ukraine through national schemes such as the Homes for Ukraine Scheme and Ukraine Family Scheme. This generosity has been despite challenges such as the rise in cost of living and length of stays exceeding the initial expected 6-month sponsorship.

In July 2023, 3665 guests had arrived from Ukraine to Surrey. Figure 51 shows a breakdown by District and Borough.

Figure 51: Number of people welcomed from Ukraine residing in each of the Districts and Boroughs as in July 2023

In 2023, Surrey County Council led the delivery of a migrant health rapid needs assessment which included conducting semi-structured interviews with professionals providing and or commissioning services for migrants. They provided their insight in the housing situation for migrants.

A key theme was the lack of communication, coordination and forward planning from the Home Office. In many cases new hotels with vulnerable migrants would often be stood up and populated without any prior planning with the local authority or NHS who would be required to provide services for those being housed. This created a lot of frustration for staff looking to support this vulnerable group.

A source of anxiety for migrants in hotels is the temporary nature of their living situation, as it would not be uncommon to be moved to another hotel in another part of the county at extremely short notice. As a result, services users felt a lack of control over their lives. It also made it difficult to secure stable employment (where they were permitted.).

Staff interviewed noted that the hotels are situated in rural areas of the county, making it difficult for residents to access amenities and integrate into the community.

Surrey partners have been engaging extensively with the Home Office and the providers to ensure improvements are made to policy and practice of procuring properties and supporting refugees, asylum seekers and migrants. There are a number of long-standing factors that mean that housing is likely to remain a considerable issue and therefore, partnership work will continually be needed.

Gypsy Roma Traveller communities

In Surrey, a small proportion (0.2%) of the population (2,600 people) described themselves as White: Gypsy or Irish Traveller, and 1,673 (0.1%) described themselves as White: Roma in the 2021 Census. GRT communities have the poorest health outcomes of any ethnic groups, not only in the UK but internationally. Surrey’s GRT residents face both issues of inequality (lacking access to service’s) and being left behind (without basic standards of welfare and insufficient provision of residential sites to meet demand).  

A Gypsy, Roma and Traveller Rapid Needs Assessment was undertaken as part of the Surrey Covid-19 Community Impact Assessment. This highlighted that there is insufficient accommodation to meet local need; overcrowding and poor conditions on some sites. It also highlighted that there is widespread distrust of services, as such people often do not disclose health and wellbeing issues. There are ongoing and established systemic issues that impact the way in which the Surrey system is able to identify and respond to the needs of the GRT communities effectively.

Surrey County Council developed a Brighter Futures Strategy for GRT communities in 2014. The Brighter Futures Strategy and the Surrey Gypsy Traveller Community Forum have identified homelessness as the single biggest issue impacting outcomes for Surrey’s GRT population. However, bricks and mortar accommodation are not what the community is seeking so offering homes rather than sites under homelessness legislation can be a significant source of local friction in which travellers claim that their way of life is being undermined

In two-tier local government areas, the statutory responsibility to provide GRT facilities rests with the lower tier authority, so in Surrey this means District and Borough councils. Surrey County Council has supported this need by providing land, originally leased to D&B’s, for the establishment of GRT sites.

Over time Surrey County Council has taken on responsibility for managing 15 sites (out of a total of 17 public sites across Surrey) across 10 different D&B areas at an annual average combined cost estimated to require more than £3m in 2023/24 (reactive maintenance – see Annex 2). Two are managed by Guildford Borough Council. More information on the number and sites of plots can be found on the Surrey County Council website.

Surrey also has a number of unauthorised developments; these are developments on private land without the appropriate permission and are subject to the relevant planning laws. Occasionally there are Unauthorised Encampments in Surrey (UE). This is where land is occupied without the landowner’s consent. In this situation it is the responsibility of the landowner to evict.

The community is growing, overcrowded and requires new sites. The current county wide approach means there is a lack of coordination, agreed governance and funding arrangements which doesn’t deliver best value for money, nor the facilities required by the community. This is exacerbated by the fact that there are poor levels of rent payments resulting in significant arrears, however even if all rent was collected it would not cover the management and maintenance cost for each public site at current levels charges to tenants.

There is a need for an agreed position among public partners to consider how to best prioritise funding to reverse the under-investment and reactive maintenance, declining asset conditions, poorly managed sites and annually increasing costs.

People with substance use issues

Surrey’s JSNA chapter on Substance Misuse tells us that in 2016-17 (the most recent data available) there were an estimated 3391 opiates and crack cocaine users which is the equivalent of a prevalence of 4.6 per 1000 population aged 15-64. This is lower than England’s estimated prevalence opiates and drug users of 8.9 per 1000.

Housing instability and addiction have an inseparable relationship. Those lacking stable housing face hardships (as discussed earlier in this chapter) which can cause physical and emotional pain and lead people to turn to drugs or alcohol to distract themselves from daily challenges [15].

Additionally substance use issues may be the reason for someone ending up in unstable housing in the first place. Two thirds of homeless people cite drug or alcohol use as a reason for first becoming homeless, while people who use drugs are seven times more likely to be homeless than the general population [16].   

In 2021/22, the proportion of new presentations to adult drug treatment in Surrey who have no fixed abode (4%), or who have a housing problem (6%), was lower than the corresponding proportions in England (7% and 13% respectively). This could reflect Surrey’s relative affluence, compared with England as a whole, or it could indicate a health inequality – for example, if drug users with housing problems in Surrey find it more difficult to access drug treatment than drug users without housing problems.

The Substance Misuse chapter was published in April 2024 and describes in further detail the specific physical and mental health outcomes for people with substance use issues including those related to housing.

Looked after children and care leavers

Since 2020, the volume of children in care (recorded as a care status of: Section 20 (S20), Interim Care Order (ICO), Full Care Order (FCO)) has increased by 6.7% (66 children). Once young people who are relevant or eligible leave the care system at aged 16, 17 or 18; there are a range of legal responsibilities in place to support these young people into full independence up to the age of 25

 While the numbers of children requiring our care and support are rising, the volume and capacity of services easily accessible are in decline. The changing needs of our children, the impacts of COVID and an aging foster carer population have presented tremendous strain on our social care placement system creating a national call to arms.

Between late 2021 and early 2023, 3 national reports have been published highlighting the impacts of declining services, identifying central government support and addressing potential new ways of working to combat these challenges.

The CMA report published in March 2022 (Final report) focuses on central government support on developing local authority run services (in house provision). Reviewing the planning and regulatory barriers to support the private network in developing their services and review of the market oversight and contingency planning practices current in place.

The independent review of children’s social care (IRCSC), published by Josh MacAllister in May 2022 focuses predominantly on how local and central government address the structures around supporting young people to remain with their families, increasing support and funding in these ventures such as the likes of No Wrong door, though does present 80 recommendations.

In February 2023, the Department for Education (DfE) published their response to both the CMA report and IRCSC via a new strategy “Stable Homes, Built of Love”.  The DfE took serious consideration regarding the 80 recommendations presented by the IRCSC, recognising that full implementation would have incurred £2.6b of new spend over a 4 year period. As a result, government have announced plans that will present £200m of new spend over a 2 year period. The report does accept all recommendations from both CMA and IRCSC though cannot support the time frames suggested.

Once young people leave the care system at 18 there are a range of legal responsibilities in place to support these young people into full independence.

As of July 2023, 78% of our care leaver population are determined to be in suitable accommodation, which includes semi-independent, independent, former foster carers, parents, relatives and supported lodgings. Despite this, nationally at least one third of care-leavers are reported to experience homelessness within the first two years of leaving care. 25% of the homeless population are estimated to have been in care [17] [18] .

Accommodation support and options for care leavers in Surrey can be found here Your accommodation as a care leaver – Surrey County Council (surreycc.gov.uk)

As of July 2023, 56% of Surreys total care leaver population were living in Surrey, this is an increase of nearly 5% compared with the same period in 2022. 78% of our total care leaver population are determined to be in suitable accommodation.

For further detail on how Surrey are working to address the sufficiency challenges within children’s placement services, please see the full and updated Sufficiency Strategy.

Accommodation support and options for care leavers in Surrey can be found here Your accommodation as a care leaver – Surrey County Council (surreycc.gov.uk)

Surrey has developed a Joint Housing Protocol for 16 and 17 year olds – v8 FINAL.pdf (procedures.org.uk) which has been agreed by all Districts and Boroughs. A protocol for preventing homelessness in the care leaver population in Surrey is currently being developed.

The Armed Forces Community

The Armed Forces Act 2021 places a legal duty on local authorities to have due regard to the principles of the Armed Forces Covenant when exercising certain statutory housing functions.  More information on the Covenant Duty can be found in the Government’s statutory guidance.

This duty relates to the principle that it is desirable to remove disadvantages arising for Service people from membership, or former membership, of the armed forces.  The Duty applies to the following members of the Armed Forces Community:

1. Members of the regular forces and the reserve forces.
2. Members of British overseas territory forces who are subject to Service law.
3. Former members of His Majesty’s forces who are ordinarily resident in the UK.
4. Relevant family members [of those in (a) to (c) above].

There are approximately 6,000 Regular members of the Armed Forces in Surrey with 680 known service families with 1,224 service children, over 250 Reservists, 3,150 cadets and 32,500 veterans [19].  While local Census data on veterans’ families have not been published, applying national proportions to available local data suggests that spouses/partners and children could account for an additional 30,000 people.

This make the likely size of the Armed Forces community in Surrey over 70,000 strong, with veteran households present in every ward across the County.  More data from the 2021 Census can be found on Surrey-i, including data on veterans by electoral ward, age, disability, and economic activity. 

The following housing functions are in scope of the Covenant Duty:

1. Allocations policy for social housing.
2. Tenancy strategies (England only).
3. Homelessness.
4. Disabled facilities grants.

The 2021 Census data on living arrangement for veterans includes analysis of communal establishments.  Older veterans are less likely than the age-adjusted population to live in a care home; younger veterans are more likely to live in prisons, detention centres and approved bail and probation premises, hostel, or temporary shelters for the homeless.

Although evidence is lacking (particularly outside London) we know that nationally veterans are particularly vulnerable to homelessness.  Veterans who are rough sleeping tend to be older than the general rough sleeping population – a study in London found that 44% of veteran clients of CHAIN, a hostel referral service, were aged 50 or older compared with only 18% of all their clients.

There are a range of factors contributing to homelessness in the veteran group including risk factors that pre-dated their time in the Armed Forces, difficulties during their time in the Armed Forces such as mental health disorders and substance use which continued post-discharge, difficulties transitioning to civilian life such as finding employment. Studies have also found that veterans are a group who are less likely to seek help or advice.

Only a small minority of the Armed Forces Community will need to access housing services, but when they do, disadvantages are most likely to be experienced by veterans, Service personnel that are about to leave Service and become veterans, and Service families.  The latter includes cases of family break-ups when the non-serving spouse and dependent children could be evicted from Service Families’ Accommodation.

The following disadvantaged are those that can typically be experienced by members of the Armed Forces Community.

• A lack of knowledge about local social housing services.
• Not building up sufficient ‘local connection’ in accordance with a local authority’s allocation scheme, reducing access to social housing.
• Not being prioritised to receive suitable social housing, a lack of social housing that meets particular needs caused by physical or mental injury.
• Finding it difficult to communicate with a housing body while on a posting overseas.
• A lack of knowledge about how to navigate the civilian housing sector, welfare system and budgeting, increasing their likelihood of becoming homeless.
• A reluctance to seek early help to avoid homelessness, because of stigma or a belief that civilian bodies will not understand their experience.
• Requiring adaptations to be made to their home when they move to a new area, or lacking knowledge of what grants are available.

National schemes which are available to support veterans include Op FORTITUDE, a new service for veterans affected by homelessness.

To support the aims of the Armed Forces Covenant the Surrey Civilian Military Partnership Board (SCMPB) fosters closer working relationships with the armed forces. SCMPB is made up of lead agencies and military partners. Led by the Chair of Surrey County Council, the board considers key issues affecting the armed forces community across the county including housing.

Local schemes to support the Armed Forces community include the following:

• Regular meetings with Unit Welfare Officers from regular and reserve units across Surrey with key officers from the council to understand and help address local issues.
• Training of frontline staff, managers and councillors from local authorities, partner agencies and the VCSE sector to raise awareness of the issues facing the Armed Forces Community and where to signpost them to sources of help and support.
• Surrey manages the national Forces Connect App which signposts user to local and national sources of help and support within four easy clicks.
• There is a network of veteran hubs across the county supporting local veterans providing support and signposting information.
• Service charities within the county, including SSAFA and the Royal British Legion, provide specific welfare and financial support packages for members of the Armed Forces community in all areas of their lives, including housing. This could include funding for house adaptations, initial rent deposits and exceptionally act as guarantor for first rental payments and offer sheltered accommodation etc.

A health needs assessment for veterans in Surrey was completed in 2013 and has information on housing and homelessness, however this is now 10 years out of date. There are plans to produce a JSNA chapter around this key group.

People with Mental Health needs

The importance of safe and settled accommodation is well documented as a determinant of good mental health and wellbeing. Public Health England’s Joint Strategic Needs Assessment (2019) and the Five Year Forward View for Mental Health (2016) outline that housing is critical to the prevention of mental health problems and the promotion of recovery. Homelessness and poor-quality housing are risk factors for mental health problems. Stable, good quality housing is a protective factor for mental health and can be a vital element of recovery.

The Emotional and Mental Wellbeing in Surrey Adults Chapter of the JSNA estimates that in 2020 182,747 people in Surrey had a diagnosed mental health problem. Demand for Adult Social Care mental health services is rising. Demand for mental health services has continued to rise following the COVID-19 pandemic. In January 2020, there were 1,621 open cases with a primary social care need of mental health, which has now increased by 71% to 2,779 in January 2023. This does not capture clients who have mental health as a secondary need.

The Emotional and Mental Wellbeing in Surrey Adults Chapter of the JSNA also gives details on the proportion of adults in contact with secondary mental health services who are in stable and appropriate accommodation. It shows that in Surrey (2020/21), less than half (48%) of adults who are in contact with secondary mental health services live in stable and appropriate accommodation compared to over 60% nationally. Over half of mental health service users lack housing security which could negatively impact their recovery journey. Stable accommodation in 2020/21 had declined significantly since 2017/18.

Supported independent living

ASC supports those with mental health needs through commissioning Supported Independent Living (SIL). As of August 2023, there were 19 supported living providers, with 80 sites offering 424 placements. ASC also commissions Housing Related Support from a variety of providers, which includes 272 units of lower-level supported living; 489 units providing night shelters, short and long term support for people who are or have been homeless.

However, market analysis has identified gaps in provision with a requirement of SIL specialisms to meet complex mental health needs including people who have multiple health needs, neurodiversity, forensic needs under part 3 of the Mental Health Act, behaviours that challenge, substance use and/ or self harm. There is also a requirement for more self-contained accommodation for individuals who would like to live in SIL and may be unable to live in shared accommodation due to certain risks or vulnerabilities. There is funding for a new team within Mental Health at Surrey County Council called the Supported Independence Team who are working with people living in SIL to understand if their current accommodation is still the most appropriate for them. More information on this work can be found on the Surrey County Council website.

Figure 52 shows the proportion of people known to adult social care with a mental health condition living independently or otherwise. 59.6% are living independently, with 18.4% social housing tenants, 13.1% are not living independently. There are high levels of missing data making it harder to draw conclusions from this data set.

Figure 53 shows the independent living status of people with a mental health condition by ethnicity that are open to ASC, ‘Asian / Asian British’ has the highest percentage living independently (70%) for 2023, with other groups at around 60%. ‘Black / African / Caribbean / Black British’ has the highest percentage ‘not living independently’ at around 20%. Comparing the number of people by ethnicity shows the ethnicity with the highest proportion of people is White (approx. three quarters), with an even split between the other groups. Please note the high percentage of missing data may impact these results.

SIL should:

1. Enable people to remain in the same accommodation as their needs change
2. Help people to self–care and promote independent living skills
3. Foster links with the local community and enable people receiving services to access the wider community and play an active part in community life
4. Be domestic in nature and not resemble institutional environments like residential care homes
5. Provide a level of on-site support and care by staff which can scale to changing needs
6. Technological infrastructure which helps people to maintain their independence, and which can be linked to assistive technology where needed

 Source: Annex 3 – SITE Criteria for Specialist accommodation Sites (surreycc.gov.uk)

Estimated Projected Demand for new Supported Independent Living units by 2030 is shown on the map on page 16 of  ‘A Housing, Homes and Accommodation Strategy for Surrey’.

There is anecdotal evidence from the frontline in Surrey that the absence of stable housing options in Surrey delays hospital discharges. In turn, there is an absence of escalation pathways to support housing officers to refer people back to secondary care services when required, which may have detrimental effects on recovery.

A Mental Health and Housing protocol has been developed between partners in Surrey which aims to ensure that accommodation needs, health needs and associated support in the community are identified at an early stage to prevent homelessness when a person with mental health needs is discharged from hospital.

Hoarding

A hoarding disorder is where someone acquires an excessive number of items and stores them in a chaotic manner, usually resulting in unmanageable amounts of clutter. The items can be of little or no monetary value. Hoarding disorder is now considered a standalone mental disorder and is included in the 5th edition of the DSM 2013. Hoarding can also be a symptom of other mental disorders.

Hoarding does not favor a particular gender, age, ethnicity, socio-economic status, educational / occupational history or tenure type.

Hoarding can pose a health risk in people homes because the clutter can:

• make cleaning very difficult, leading to unhygienic conditions and encouraging rodent or insect infestations
• be a fire risk and block exits in the event of a fire
• cause trips and falls
• fall over or collapse on people, if kept in large piles [20]
• lead to eviction and homelessness form both private and social tenancies

It is not clear how many people in Surrey Hoard and many people who hoard will not come to the attention of services. According to Hoarding Disorders UK between 2.5% and 6% of the UK population is affected by hoarding disorder, this would equate to between 30,140 and 60,281 people in Surrey.

A protocol is being developed between Surrey District and Borough Councils, Surrey County Council, Surrey Heartlands ICB, Fire and Services and other relevant agencies to work in partnership using an outcome focused, solution-based model to tackle hoarding. The protocol offers clear guidance to staff working with people with hoarding behaviours aiming for partnership working and a reduction in duplication of work by services.

Prison leavers/ ex-offenders

People who leave prison with strong foundations in place to make a success of their lives are less likely to re-offend. These foundations include a stable home [21]. Yet nationally, of the people released from prison between March 2020 and March 2021, only around half had access to settled accommodation upon their release Around one in seven were homeless or sleeping rough (Ministry of Justice, 2021). Added to this, 65% of those without settled accommodation after release from prison between February 2019 and February 2020 had re-offended within 12 months. This figure is significantly lower in those who did have settled housing at 44% (HMI Probation, 2020). Data from The Forward Trusts clients being released from Surrey prisons in the year 2022/23, suggested that 64.15% of individuals had no stable housing upon release.

There is a lot of work happening in Surrey to ensure prison leavers have stable homes. There are 3 tiers of Community Accommodation Services (CAS) outlined in the HM Prison and Probation Service Operational Accommodation Framework (July 2020)

The first tier CAS1 was formally known as Approved Premises and provides monitored accommodation for those leaving prison that require additional risk management oversight. MOJ have funded improvements to CAS1 to improve the quality of buildings and increased capacity across the country. In Surrey, a CAS1 premises has benefited from improvements. This provision based in Surrey provides accommodation for those requiring an enhanced level of risk management and supervision for the Kent, Surrey and Sussex Probation region.

The second tier is CAS2 accommodation service provided by Nacro (social justice charity). This provides accommodation for those subject to court bail, home detention curfew and can also be used as an alternative to recall in situations where accommodation is a factor. 

The third tier is CAS3 providing up to 84 nights of accommodation provision for prison leavers including those moving on from CAS1 and CAS2. The aim of CAS3 is to ensure that no one leaves prison without the offer of a place to live from their first night in the community. It provides a stable base for a person to access effective wrap around support and to provide a pathway into settled accommodation. In Surrey, approximately 20 units of both shared and self-contained accommodation has been utilised across Surrey including 4 units dedicated for female prison leavers. The accommodation is not intended to replace Local Authorities statutory homelessness duties but provides and additional provision when all other options have been explored. To date over 400 people from Surrey have been referred to the scheme.

The MOJ has also invested in a new prison based role of a strategic housing specialist. This role aims to assist in making a person’s accommodation journey more efficient and help increase partnership working between community agencies and the prison as well as assisting in unblocking any challenges. There are Strategic Housing Specialists in HMP Coldingley, HMP Send and HMP Bronzefield.

In addition, all people on probation are eligible to be referred into Commissioned Rehabilitative Services for support with accommodation if there is an identified need. For men, a contract with Interventions Alliance provides independent advocacy and support around accommodation including support with homelessness applications and support in becoming tenancy ready. For females, a holistic provision is provided by Women in Prison in Surrey which also provides accommodation support if identified as a need.

The Police and Crime Commissioner (PCC) commissions services in partnership with Surrey County Council’s Public Health team to improve community safety, reduce re-offending behaviour and support victims of crime to cope and heal from the harm caused. Examples of these which include housing support are:

• Grant funding to the Forward Trust Housing and Resettlement Service in Surrey which provides support to vulnerable adults with a history of drug, alcohol and mental health issues who are newly released from prison with nowhere to live. Support includes help to maintain tenancies. Between April 2021 and March 2024, 124 individuals are to be rehoused.
• Grant funding to The Hope Hub, to support ex-offenders with a short-term tenancy whilst supporting them to actively engage in life skills, training and services to empower them towards independence, maintain all appointments and reduce offending
• grant funding to Transform Housing for accommodation and support for people (single, 18-65) with a history of offending providing accommodation and support to 8 people.
• a grant to the Amber Foundation paying for supported bed spaces at their Surrey property, see more detail in the case study below

Amber’s mission is to transform lives by supporting marginalised young people to move on to sustainable and independent futures that are free from crime. They do this by providing a residential training programme focused on personal development, employability, and resettlement skills for homeless, out of work young people aged 17 to 30.

 ‘A’ returned to for the third time Amber in June 2022. His return this time followed a tragic car crash where they were the sole survivor. Due to the nature of his injuries he was unsure what work he would be able to perform (having been working prior to the crash as a carpet fitter), so self-referred to repeat the programme, and broaden his options of what he could possibly do with his life.

Since his return to Amber A at times found it hard to motivate himself to the programme, finding it repetitive as he had been through before and has unfortunately relapsed on substances a couple of occasions whilst on leave, notably over the Christmas period. Despite this A’s stay at Amber has been a success and A now has a job offer, which includes a 40 hour full time contract, paid for driving lessons, and onsite training at a place he had been volunteering. 

Gaps in Provision

Despite all the work going on above there are gaps in provision. CAS3 accommodation for example has light touch support and may not be suitable for those with complex needs and there is limited supported accommodation provision for those not ready to move on to private rented accommodation.  Additionally, CAS3 accommodation is meant to be for low and medium risk prison leavers only but often ends up being for high risk leavers because they are often harder to place in alternative types of accommodation because of their risk and complex needs. 

Despite all the work going on above there are gaps in provision. CAS3 accommodation went down to single occupancy in rooms over the COVID-19 pandemic to prevent the spread of disease and haven’t gone back up to capacity yet

Accommodation in the South East and Surrey is particularly expensive, as highlighted elsewhere in this report, and there is also a lack of available private rented accommodation in Surrey. These issues have caused and exacerbated the points raised by stakeholders below

Conversations with Stakeholders have highlighted There is a lack of housing provision for prison leavers who are deemed to be ‘high risk’. These are prison leavers deemed at higher risk of re-offending and may have sexual offences or arson convictions for example. The clients who Surrey Adults Matter and Bridge the Gap work with have told us this also. CAS3 accommodation is meant to be for low and medium risk prison leavers only but often ends up being for high risk leavers   because more important they do not end up on the street due to increased risk of re-offending.

Additionally, there are issues with finding suitable accommodation for women, 4 CAS3 accommodation beds are dedicated to women however in some cases women have returned to unsuitable circumstances / relationships and there is a need for more dedicated support.

Homelessness and rough sleeping

The key facts on housing in Surrey provides details on homelessness and rough sleeping prevalence and who is at risk.

Issues that may impact on housing services in Surrey

National

National Strategies and policy changes that may impact on housing in Surrey in the years to come are outlined below.

The Building Safety Act

Events in recent years such as the Grenfell Tower Tragedy which claimed the lives of more than 70 people and the recent death of Awaab Ishak in a property not fit for purpose have shocked the sector and led to calls for changes. This has led to renewed focus on consumer regulation the production the Building Safety Act which became an act of parliament in April 2022. In summary the Act bought in a number of measures intended to make buildings and residents safer. This included the formation of a new Building Safety Regulator to enforce a more stringent regulatory regime for buildings of 18 meters and over, as well as overseeing safety and standards for buildings of all heights. The Act also contains measures intended to ensure that most leaseholders do not have to cover remediation costs, by setting out routes of redress that instead would see contractors and developers pay for building safety work.

There were also some changes to fire safety laws that will place additional requirements on Responsible Persons, as well as introducing a New Homes Ombudsman scheme to help deal with complaints from home buyers against developers.

Social Housing (regulation) Act 2023

The Grenfell Tower tragedy was also the catalyst for the Social Housing (regulation) Act 2023. This became law on the 20 July 2023 and strengthens the Regulator of Social Housing to carry out regular inspections of the largest social housing providers, order landlords to carry out remedial works and power to issue unlimited fines to Rogue landlords.

The Government has also committed to bring in legislation in response to the tragic death of Awaab Ishaak  “the government also committed to introducing Awaab’s Law where all landlords must fix reported health and safety hazards within a strict time frame.”

Housing White Paper 2017

The last edition of Surrey’s housing JSNA chapter provided an overview of the Housing White Paper of 2017 “Fixing the broken housing market” and many of the issues highlighted in that report are still very relevant today. This paper is largely about housing delivery and seeks to speed up the planning framework, e.g. by shortening the life of planning consents and enabling homes to be built more quickly. The report recognised the challenges with both sides of the housing market – demand side, and supply side.

The White Paper proposed a new much wider definition of affordable housing that will include First Homes and other low-cost home ownership initiatives; it will also include some private rented accommodation as well as social rented housing let at affordable rents. However, feedback from stakeholders in the development of this chapter has repeatedly been that this definition of affordable housing is not fit for purpose and the housing is not truly affordable.

Despite calls in the 2017 white paper to diversify the supply market, it is still heavily dominated by private sector house builders motivated primarily through optimising shareholder value. While there has been some increase in provision of housing from all supply sources, including social landlords, small and medium size builders, and private financial institutions, this has not been sufficient to achieve the levels of new housing supply needed and the government has dropped its target of creating 300,000 new homes a year.

The levelling up plan and the Decent homes Standard

The Decent homes standard has been hailed a national success. It aimed to ensure that all social housing would comply with prescribed standards of decency by 2010. Although not every local council or housing association met this deadline, the initiative was largely successful. As part of the government’s  Levelling Up Plan, a similar initiative is to be introduced for the private rental sector. A big idea behind the Levelling Up agenda is reducing geographic inequality across the country, and it is key that housing policy is included in this.

The idea is to raise housing standards for private tenants and bring their rights into line with those of council and housing association renters. In June 2022, Secretary of State for Levelling Up, Housing and Communities Michael Gove announced a UK-wide mission to half the number of “non-decent” rented homes by 2030. In addition, all domestic private rented properties must meet the Domestic Minimum Energy Efficiency Standard Regulations.  

The Climate Change Act 2008

The Government has legally binding targets under the climate change act 2008 to reach ‘net zero’ carbon emissions by 2050. Meeting this target will require a range of actions across sectors of the UK economy that are responsible for emissions, Housing is one such area as it is currently responsible for around 14% of UK emissions.

The clean growth strategy was published in October 2017 and includes several targets to improve energy efficiency including to upgrade all fuel poor homes to Energy Performance Certificate (EPC) band C by 2030

The heat and building strategy sets out how the UK will decarbonise our homes, and our commercial, industrial and public sector buildings, as part of setting a path to net zero by 2050.

Homeless Reduction Act

The Homelessness Reduction Act 2017 is one of the biggest changes to the rights of homeless people in England for 21 years. It effectively bolts two new duties onto the original statutory rehousing duty.

It places new legal duties on local housing authorities and amends the existing homelessness legislation in the Housing Act 1996. These new duties apply to all eligible applicants (i.e. on the basis of immigration status) and are blind to intentionality and priority need. The prevention duty is also blind to local connection. [22]

Ending Rough Sleeping for Good Strategy 2022

The government published its Rough Sleeping Strategy Ending Rough Sleeping For Good September 2022. It commits the government “to end rough sleeping within this Parliament”. It includes initiatives such as: –

• Further investment in the Rough Sleeping Initiative – and continued support for the Housing First accommodation model.
• £200m for a new Single Homelessness Accommodation Programme. This is designed to deliver up to 2,400 homes by March 2025, including supported housing and Housing First accommodation. The new accommodation will be aimed at adults experiencing severe multiple disadvantage and specialist accommodation for young people (under 25) who are at risk of, or already experiencing, rough sleeping.
• £316m further funding to the Homelessness Prevention Grant to help local authorities support people before they become homeless.
• £550m to support access to accommodation and support for people leaving prison. This includes expanding the Accommodation for Ex-Offenders programme, continuing to expand the number of Approved Premises for high-risk offenders and doubling the number of housing specialists in prisons.
• Expanded the Rough Sleeping Drug and Alcohol Treatment Grant
• £3.2m funding for 69 local authorities to provide targeted support to young people at risk of sleeping rough and £36m to expand ‘Staying Close’, providing extra support for young people leaving children’s homes.

Rough Sleeping Strategy

The government have committed to ending rough sleeping within this parliament – as stated in the Government’s Rough Sleeping strategy ‘Ending Rough Sleeping for Good’.

The Strategy commits to:

• Increasing affordability and security of housing
• Empowering local authorities to better prevent rough sleeping – including fully embedding the Homeless Reduction Act
• Committing to working with stakeholders from local authorities and the service delivery sector to establish an operational risk assessment tool to assist with the prevention of rough sleeping,
• Supporting our ambition that no-one is released from a public institution to the streets

Considerable investment is going into ‘Rough Sleeper Initiatives’ – including Housing First properties designed to provided accommodation with no preconditions as an anchor from which to address other support needs – such as mental health issues, drug and alcohol dependency and poor overall health.

Local

Housing is an all-encompassing topic which effects everyone in the County. As such it is discussed in many policies, strategies and protocols for different population groups. These have been referenced where appropriate in this chapter. Below is a summary of the local Strategies relating specifically to housing.

The Housing, Homes and Accommodation Strategy for Surrey

Surrey County Council recently commissioned Inner Circle to develop its Housing, Homes and Accommodation Strategy for Surrey. This Strategy has been agreed by Cabinet. The strategy outlines the case that Surrey is in the grip of a serious housing crisis. While this is very different from the scale and severity of the housing crises that might be seen in large cities, it is a crisis nonetheless and action is required to tackle it.

The Strategy make recommendations such as

• Collaborative working to tackle the housing crisis in Surrey.
• Sharing best practice between partners in the county so the same good idea doesn’t have to be invented 11 times
• Making a call to Government for more power locally and more funding to tackle the housing crisis. 
• Making a case to Central Government or other funding bodies means telling a balanced and accurate story about the state of Surrey.
• Increasing the proportion of Social Rent housing, especially family-sized homes, recognising that Affordable Rent homes are increasingly out of reach for families in the greatest need.
• Providing a greater range of older people’s housing needs to be built
• Providing more step-down housing as an interim step between hospital and home care.
• Mapping public sector land, establishing an effective and dynamic One Public Estate partnership and working together to create common principles for land disposal and development
• Incorporating 20 minute neighbourhood principles into local policies and master plans for new sites.
• Improving the condition of existing homes, whether in private, council or housing association ownership

Health and Wellbeing Strategy

Surrey Priority 3 of Surreys Health and Wellbeing Strategy  is Supporting people to reach their potential by addressing the wider determinants of health and includes outcomes related to housing such as ‘peoples basic needs are met’.

Climate Change Adaptation and Resilience Strategy

Surrey’s Climate Change Adaptation and Resilience Strategy. Sets out an ambition to create low carbon, healthy homes for our residents that reduce emissions have lower running costs and improve the wellbeing of our community.

A target has been set for 66% emissions reduction in the domestic housing sector by 2035 against BAU as a minimum.

Surreys Greener Futures Climate Change Delivery Plan

Surreys Greener Futures Climate Change Delivery Plan sets out what Surrey needs to do to decarbonise including homeowners and landlords creating energy efficient buildings which use low carbon heat pumps, and maximise on-site renewable energy.

Surrey’s Greener Futures Climate Change Delivery Plan and the Surrey Climate Change Adaptation and Resilience Strategy should be considered as both will impact housing in Surrey.

District and Borough Housing Strategies

Each Local Authority is required to publish a Homelessness and Rough Sleeping Strategy setting out how it intends to reduce homelessness within their borough or district.

Local Authority	Strategy Link
Elmbridge	Housing, Homelessness and Rough Sleeping Strategy 2020-2024
Epsom and Ewell	Homelessness and Rough Sleeping Strategy 2022-2027. The homelessness review 2022 – Consultation Draft
Guildford	Proposed Homelessness Strategy 2018-2020
Mole Valley	Homelessness and Rough Sleepers Strategy 2021-2026
Reigate and Banstead	Homelessness Strategy 2022 to 2027 | Housing strategies
Runnymede	Homelessness and Rough Sleeping Strategy 2019-24
Spelthorne	Homelessness and Rough Sleeping Strategy 2020-2025
Surrey Heath	Homelessness and Rough Sleeping Strategy 2019-2023
Tandridge	Homelessness prevention and rough sleeping strategy 2019-2023 action plan update
Waverley	Affordable Homes Delivery Strategy 2022-2025
Woking	Preventing Homelessness and Rough Sleeping Strategy 2020-2024 draft

Evidence and Best practice

This Section describes the evidence and best practice in addressing the health harms of housing as described throughout this chapter.

Improving housing conditions

Housing Health Cost Calculator

It is possible to calculate the health benefits of interventions to improve housing stock conditions using the Housing Health Cost Calculator, which has been developed by the Building Research Establishment (BRE) in partnership with RH Environmental. This tool works out the costs to the NHS and society of HHSRS hazards and the savings where they have been mitigated or significantly reduced. This can be useful to build an understanding of the link between housing conditions and health and create a case for making changes.

NICE Guidance

The National Institute for Health and Care Excellence (NICE) has published guidance in 2015 on reducing excess winter deaths and the health risks of cold homes [23]. This included 6 evidence-based quality statements to improve the health and wellbeing of vulnerable affected groups, reduce the risk of fuel debt and improve the energy efficiency of homes. These are listed below:

• Local populations who are vulnerable to the health problems associated with a cold home are identified through year‑round planning by local health and social care commissioners and providers.
• Local health and social care commissioners and providers share data to identify people who are vulnerable to the health problems associated with a cold home.
• People who are vulnerable to the health problems associated with a cold home receive tailored support with help from a local single point of contact health and housing referral service.
• People who are vulnerable to the health problems associated with a cold home are asked at least once a year whether they have difficulty keeping warm at home by their primary or community healthcare or home care practitioners.
• Hospitals, mental health services and social care services identify people who are vulnerable to health problems associated with a cold home as part of the admission process.
• People who are vulnerable to the health problems associated with a cold home who will be discharged to their own home from hospital, or a mental health or social care setting, have a discharge plan that includes ensuring that their home is warm enough.

A case study of the Warmth and Wellbeing Service in Leeds which shows how these quality standards can be practically applied is available on the NICE website. Additionally there is a case study outlining the benefits of fuel poor households benefitting from decarbonisation grants in Surrey in Appendix 5.

In January 2020 NICE published guidance on improving indoor air quality in homes. [24] This recognised there are risk factors for poor indoor air quality such as physical infrastructure, standard of housing (damp and mould or physical disrepair including flood damage or poorly maintained fuel-burning appliances) and overcrowding. The guidance makes a series of recommendations such as:

• Prioritising indoor air quality in local strategies and plans
• Develop a structured process so that health and social care professionals and housing and local authority staff can use existing referral pathways to help people request a housing assessment if poor indoor air quality has been identified or is suspected
• Raising awareness of poor air quality in the home
• Advice and information for the general population, for example on using background ventilation to prevent mould.
• For healthcare professionals to explain to people with asthma, other respiratory conditions, or cardiovascular conditions that indoor air pollutants can trigger.
• For local authorities to use existing powers and cover both public and private rented housing to reduce people’s exposure to pollutants in their homes by ensuring identified problems such as damp and mould are fixed promptly

Tackling the affordable housing crisis

Surrey Housing Strategy

As mentioned above a  Housing, Homes and Accommodation Strategy for Surrey outlines the case that Surrey is in the grip of a serious housing crisis and puts forward recommendations to tackle it such as collaborative working and sharing best practice and making a call to Government for more power locally.

A Blueprint for addressing Global Unaffordability of Housing

A report by Mckinsey Global Institute from 2014 identified four necessary actions to improve housing affordability:

• unlock land supply
• reduce construction costs
• proper maintenance of homes once they have been built
• lower financing costs for buyers and developers.

It is clear that it’s not possible to achieve all the above through the local system and help from national government will be required.  Neither will this make up the reduction of social housing stock resulting from Right to Buy.

The crisis in the affordable housing sector can be described in terms of both quantity of new housing and quality of existing stock. In terms of new housing, we have seen increases in the provision of so called “affordable” housing over the last fifteen years but in England it falls short of assessed levels of need.

Tackling the undersupply of homes in England

A Government Research briefing produced in May 2023 covering trend in housing supply and barriers and potential solutions to delivering more homes in England found that supply was not meeting need. Around 233,000 new homes were supplied in 2021/22 when it is thought around 345,000 a year are required and 145,000 of those should be affordable.

The paper outline potential solutions including:

• The need for major public sector investment to enable local authorities and housing associations to build houses.
• Ensuring more land suitable for development is brought forward more quickly and at a reasonable price
• Properly resourcing local authority planning departments and addressing a planning system that is slow costly and complex.
• Encouraging SMEs building firms into a market dominated by a small number of large companies
• Funding is required for essential infrastructure is required to support housing development
• To provide training for the construction industry so they are in a fit state to deliver house building capacity

London School of Economics:

A 2017 LSE blog identified 6 innovative ways to increase housing supply.

• Using empty properties: Shelter Scotland – funded by Scottish Government – offers expert advice to local authorities seeking to expand housing supply through the use of empty properties. Shelter’s work focuses on enabling councils and their partners to bring empty homes back into use, by providing advice, tools and loans, and showcasing good practice. One strand involves the identification of empty properties and their owners and review of their property rights. Another relates to ensuring that standards relating to safety, hygiene, and the quality of accommodation are acceptable.
• Community-led housing: Commonly linked to the use of empty properties, community-led housing solutions such as housing cooperatives are increasingly being favoured in Switzerland and other countries. Factors that facilitate their growth are greater public awareness of their existence, robust governance structures, innovative mortgage packages, government support, and the willingness of individuals to consider collective solutions.
• New designs for affordable housing: In the UK, house-building tends to be dominated by a small number of large companies. This restricts opportunities for the design and development of more innovative affordable housing. In Canada, the Grow Home prototype was designed for low-income renters who would be willing to buy cheaper, well-designed, smaller properties, and to complete the construction themselves when their resources allowed.
•  New forms of temporary housing: These can play an important role in providing good quality short-term accommodation where there is urgent need, for example, following flooding, or in areas where seasonal employment is high.
• Community self-build projects: Access to land is a major factor in supporting community self-build, as well as finance and specialist advice. It is likely that more support and encouragement is needed to encourage local authorities to consider how their communities might obtain easier access to land, for example, through more proactive use of development plans.
• Social movements and public awareness: In countries such as Argentina and Spain there has been an emergence as a result of acute housing shortages. The success of these movements illustrates the potential for positive change once public awareness of the structural factors that contributed to the housing crisis in these countries has been raised.

Support for vulnerable residents

Social landlords do a great deal more than just providing and managing accommodation. A range of support is commonly offered to address the often significant health and wellbeing needs of their tenants – including jobs and training, learning and skills, as well as support to specifically address health needs and enable people to remain independent in their own home

Social landlords can play a pivotal role in improving the health outcomes and life experiences of their tenants. One example in the public housing sector of note is Poplar Harca in Tower Hamlets (London) who work in partnership with organisations across the Borough to connect residents to health and wellbeing activities in their community centres and other services nearby. This includes a Befriending Service and an online directory called WellOne connecting residents to local activities such as sports, music, cooking classes, women’s health and community events. 

It is harder to find examples of such support for vulnerable residents in the Private rented sector as landlords do not provide the same support however projects do exist. One such project is Knowsley Healthy Home Initiative. More information can be found on the NICE website. The initiative was led by Knowsley Council’s Public Health team in partnership with  local agencies. The service aimed to lower demand for council and other public sector services by taking a proactive and preventative approach to tackling housing and health related issues within the borough by facilitating access to existing support services for those currently not engaged.

The Healthy Homes Initiative targeted areas of poor-quality housing and health and a team of trained advocates gathers information and encouraged residents to be healthier, more financially secure, able to work, and to look after themselves and their properties.  By January 2015, over 3,200 homes had been visited as part of the initiative. This has resulted in over 1,100 referrals to other agencies that can provide solutions and support. Many residents have been referred for energy efficiency advice, smoke alarms and housing issues.

A second example of health support in the Private Rented Sector is Hackney Council who developed a network of 35 agencies and partners of two including frontline staff, fire services and charities who meet for regular workshops around issues affecting private rented sector residents. A newsletter keeps them all up to date, and there is a training programme for members curated from existing provision, such as NHS courses. This interconnected working enables them to share and store information across agencies about the environments their private tenants are living in, so they can act before problems become a crisis. The network is having impact on the ground as they do joint visits to residences in a new way of working to safeguard residents health.  More information can be found on the Design Council website.

Reducing homelessness and associated harms

NICE Guidance

NICE produced guidance last revised in July 2022 on integrated health and social care for people experiencing homelessness. They outline barriers to accessing health and social care in people experiencing homelessness as:

• Stigma and discrimination.
• Lack of trusted contacts.
• Inflexibility of services.
• Strict eligibility criteria.
• Lack of information sharing and appropriate communication.
• Specifically, the most common barrier to accessing primary care is absence of a fixed abode and therefore lack of identification documents.

The guidance outlines that ideally a person experiencing homelessness should be managed by a specialist primary healthcare centre for people who are homeless or a local homelessness multidisciplinary team which provides care across outreach, primary, secondary and emergency care, social care and housing service.

The guidance makes suggestions for GP practices such as appointing a homelessness lead and ensuring all members of the practice have appropriate training. The guidance makes suggestions for Primary care practitioners caring for people experiencing homelessness to provide care the same standard and quality as the others in the general population and to promote shared decision making. Furthermore, the guidance suggests that during contact with people experiencing homelessness, primary care practitioners should assess and manage specific health and social care needs and provide information on local authority services including housing services and social care.

The Social Care Institute for Excellence (SCIE) [25]

Housing options and advice are provided by local authorities to address homelessness, but often not until a family or individual has already become homeless. The best way to reduce homelessness is to prevent it happening in the first place. The homelessness charity Crisis commissioned SCIE to undertake a ‘Rapid Evidence Assessment’ of interventions to tackle/prevent homelessness.  The SCIE study found that based on a ‘best evidence’ approach:

• Sustained services, targeted to meet specific needs across time are effective. Effective services include those which provide Intensive Case Management, Critical Time Interventions and Housing First. Effective services incorporate Permanent Supported Housing elements, support for people into accommodation through the provision of housing vouchers and subsidies, and guidance on benefits and information about services.
• A number of features contribute to the effectiveness of services, including: adhering to particular aspects of models/designs of service that are found to be successful (fidelity); adapting and aligning services to local settings and context; developing and providing a range of person-centred responses that are attuned to reflect the personal circumstances of people, particularly with regards to their journey out of homelessness; integration and multi-agency working; a housing market that respond flexibly to the needs of homeless households.
• Challenges include a lack of services for people with complex needs such as mental health issues. People with complex needs can be more difficult to engage with in terms of assessing needs and providing flexible, responsive and sustained expert-led person-centred support. There were also challenges regarding access to housing in the local market and a lack of data and monitoring to inform service design.
• A lack of evidence about what works for a number of specific population groups, for instance with black and minority ethnic (BAME) groups and people living in transient accommodation (squatting, unsafe environment) who have rarely featured in studies and when they have, outcomes have not always been as positive as for other groups.
• The assessment suggests that involving and engaging people with lived experience of homelessness, and the wider community in service design would enable services to better access and engage harder-to-reach groups.

The Study also looked into the evidence to support people leaving institutions (such as care leavers and prison leavers) who are at risk of homelessness.  The report concludes that the most successful approaches to prevention are those that start as early as possible to identify people at risk of homelessness. It should not be left to local authority housing teams to start prevention work when people are at immediate risk (56 days). Those leaving institutions could have been assisted much earlier. Services within prisons, hospitals, asylum support services, local authority leaving care teams, and armed forces discharge teams must see homelessness prevention as a core part of their work.

The study looked at interventions such as Critical Time Intervention (CTI) which is a time-limited evidence-based practice that supports people vulnerable to homelessness during periods of transition. It is an empirically proven model, and the SCIE study identified a number of contexts and groups of people leaving institutions for whom tenancy sustainment is significantly increased through CTI. These included armed forces veterans, patients being discharged from hospital, young people, and prison leavers. Homeless Link in England has reported that CTI as a targeted approach ‘could arguably be transferred to any vulnerable group’.

It is a housing-led approach providing rapid access to housing. It also features an intensive case management approach to address the particular needs of people once they have security of accommodation. It should be noted that the evidence regarding its success is largely drawn from outside the UK, but reflects many elements of good practice seen in resettlement and move-on arrangements in this country.

Evidence for preventing homeless specific groups which has been briefly summarised below:

Care leavers

Evidence of what works to prevent young people exiting the care system into homelessness is relatively weak, given the regularity and prevalence of the problem. There is an urgent need to invest in evidence-based solutions, though good practical guidance is available.

Barnardo’s and homelessness charity St Basil’s have produced specialist guidance – an invaluable resource – for local authorities and housing providers working with care leavers at risk of homelessness. It details a number of best practice examples, and provides a framework for improvements in local areas. The framework is based on some key principles, stating that young people leaving care are:

• given as much information, choice and control as possible
• able to make mistakes and never ‘fall out’ of the framework
• helped to succeed
• offered flexible support that adapts to meet their needs
• offered supportive and unconditional relationships
• the shared responsibility of their corporate parent.

Prison leavers

Social Exclusion Unit reported that aside from CTI, there is no single evidence-based programme for the prevention of homelessness for prison leavers, although of course much good practice exists.

Housing-led solutions, coupled with specialist advice and preparation before release are solid principles of success. A good Housing Options approach will include this and will involve going into prisons to prevent homelessness for people long before their release.

The St Giles Trust, a charity helping people facing severe disadvantage, operates a scheme to provide peer mentors in prison and community settings. The scheme provides tailored specialist advice and has shown strong success in improving access to and sustainment of housing.

In Scotland, the Scottish Prison Service has produced the Sustainable Housing on Release for Everyone (SHORE) standards. The SHORE standards are a multi-agency approach. They are specifically designed to ensure that ‘people leaving prison can access services and accommodation in the same way as people living in the community.’ There is strong evidence that Housing First and CTI approaches not only resolve homelessness in the vast majority of cases, but also successfully reduce re-offending rates. We strongly recommend that these housing led approaches, including the key elements of the Housing Options approach described above, are scaled up across Great Britain to prevent homelessness for prison leavers.

Veterans

The reduction in homelessness among armed forces veterans is a good example of public policy success. The reduction in veteran homelessness is a good example of responses to homelessness being co-ordinated across government departments, and not simply requiring local authorities to take responsibility. Veterans deemed vulnerable through leaving the armed forces became a ‘priority need’ group under homelessness legislation in 2002. At this time the Ministry of Defense also expanded its own ‘pre-discharge resettlement service’. This service requires those at risk of homelessness (and other vulnerabilities) to be assessed and for housing advice to be provided to people before leaving the armed forces.

Despite such success there is a frustrating lack of evidence about how the reductions in veteran homelessness have been achieved. There are clearly good services and approaches to the issue but a lack of data about them. The SCIE study again identified CTI as an effective model for this group, referencing data from the US.

Refugees and asylum seekers

The SCIE report found there are no evidence-based interventions to reference for this group.

People experiencing domestic abuse

Homelessness prevention for survivors of domestic abuse must be tailored to the needs and choices of people involved. There are some common approaches to providing help, but no identified programmes with a strong evidence base.

Sanctuary schemes offer survivors help to remain in their home. They provide additional security measures within the home, with details provided to local police to ensure the fastest possible response should further abuse take place. The SCIE study found some evidence of the effectiveness of sanctuary schemes, alongside cost saving data.

Provision of refuges has been a traditional approach to assisting people escaping domestic abuse and relieving one of the most acute forms of homelessness. This kind of emergency accommodation is often the immediate response to provide safety away from a perpetrator. There is no one model of refuge provision, and they can range from individual units of self-contained housing to congregate buildings more akin to hostels.

An All Party Parliamentary Group on Ending Homelessness (APPGEH) inquiry into homelessness and domestic abuse heard evidence of some innovative practice at local authority and housing association level. These included schemes to provide reciprocal access to housing for survivors of abuse across local boundaries. Other evidence included housing associations seeking to identify people at risk of homelessness and abuse through their own property management and training of staff. Once again this shows how homelessness prevention can and should be started well before issues reach a local authority housing team.

Services in Relation to Need

The Needs in Specific Groups section of this JSNA chapter outlines many of the services working with different groups of people in the County. This section provides a brief overview of some of the more generic services although acknowledges that it has in no way been possible to capture all of the work being done in wider Surrey and its smaller localities to tackle housing issues in Surrey.

Improving Housing conditions – what’s available?

The Council must monitor housing issues in the area This includes private rented properties, council and housing association homes and owner-occupied housing. One way of monitoring property condition is through the HHSRS.

For those living in social housing the owner (be that Council or Housing Association) provide a range of services to maintain and improve the condition of homes. The extent of these services will vary depending on the landlord/provider but include repairs services and systems to supply water, gas, electricity and sanitation.

Each Local Authority in Surrey is also responsible for regulating the Private Rented Sector and protecting tenants by ensuring landlords and agents comply with relevant obligations. Each borough and district in Surrey works closely with owners and landlords to ensure properties are fit for occupation. Their work includes holding forums to advise landlords of changes in the law and to promote the availability of loans and grants each Local Authority is also required to manage the statutory Mandatory Licensing Scheme for larger HMOs, which ensures that fire safety, housing management and housing conditions in the private rented sector meet prescribed standards. The Housing and Planning Act 2016 now provides additional measures that authorities can use to deal with rouge landlords e.g. to apply for a banning order to prevent a landlord operating in the area.

Cold homes can give rise to health issues and there are initiatives being implemented in Surrey to prevent fuel poverty. The Fuel Poverty Programme was introduced in Surrey in 2022 as a critical response to the escalating national cost of living crisis, particularly the burden of energy costs on households. The programme  aimed  at simultaneously delivering on two critical fronts to enable Surrey residents them to live in warm and comfortable homes:

• Resident Support: Providing comprehensive assistance to residents facing fuel poverty, ensuring they receive the support they need.

• Domestic Energy Efficiency and Generation: Focusing on improving energy efficiency in homes and promoting clean energy generation to reduce fuel poverty and contribute to our Climate Change Strategy & Delivery Plan.

Physical spaces called ‘Warm Hubs’  were set up run by community groups or Councils so people having trouble heating their homes to come to warm up, have warm drinks, social interaction and access advice. In 2022 there were 101 warm hubs across Surrey and over 21000 visitors hosted. This initiative will run again in 2023 but is being reviewed to maximise the offer to residents and has been renamed ‘Warm Welcome’.

A pilot scheme for fuel vouchers was also run in 2022 with 13 community venues. Vouchers could be redeemed at the Post Office and PayPoint with options to get funds added to prepayment meters or cash.  Residents have so far received over £5000 in Fuel Vouchers and feedback has been positive.

Disabled Facilities Grants are part of a national fund, applied for through Districts and Boroughs used to provide means tested grants adapt the homes of older and/or disabled residents. They can be used to cover changes to home such as widening doors, installing ramps, stairlifts or adapting heating and lighting controls. There are also handyman/person services available for those who need them and depending on the Local Authorities policy a range of works required to prevent falls and accidents such as installing grab rails, may be provided free of charge.

Improving Housing conditions – what’s missing?

Despite the work ongoing to maintain and improve housing conditions in the housing stock in Surrey as outlined in the Key Facts on Housing section there are still homes in Surrey which require improvements and the focus on improving housing conditions needs to be continued. It is known some homes in the private rented sector do not comply with the Domestic Minimum Energy Efficiency Regulations. The Greener Futures Steering Group is working on a pilot to raise awareness of the regulations and encourage compliance.

There is a clear link between housing condition and energy efficiency and therefore the climate change agenda. Services like warm hubs are plugging gaps where fuel poverty exists and while these are currently essential, there is a need to solve the root causes of fuel poverty including making sure Surreys homes offer energy efficiency. New homes can be built today to have very low energy bills and increase resilience to both cold and the extreme hot weather we will experience more frequently in future, preventing poor health outcomes. However new homes continue to be built in Surrey which lock-in instable energy bills, fuel poverty and risks to health. There is a need to increase the energy efficiency and climate resilience of new house-building in Surrey to prevent fuel poverty.

To tackle the quality and energy efficiency of existing housing, there are competitive Government funds for decarbonisation of low-income and vulnerable households which Surrey County Council, other Local Authorities and Private Registered Providers are applying for. Residents themselves can apply for ECO4 or the Great British Insulation Scheme through select large energy providers. However, the limited scale of funding committed by the Government and the competitive, time-limited nature of the projects, means that many fuel-poor households in Surrey won’t be reached.

The net zero agenda to improve energy efficiency will drive up property standards,  reducing fuel poverty and leading to healthier residents and climate resilient homes. However, long-term investment and changes in policy are required to unlock these benefits.

Housing related support services – what’s available?

Each of the Surrey district and boroughs provides funding to adapt existing homes to make them suitable for occupation for people with disabilities. These works are often facilitated by Home Improvement Agencies who provide stair lifts, level access showers, extensions to homes and handy-person schemes. Technological solutions such as Careline, Telecare, falls/bed detectors, smoke alarms etc are also being provided by agencies in Surrey. These are valuable measures that help people to remain independent, reduce the risk of trips and falls, and facilitate the early return of patients from hospital.

Supported Independent Living (SIL) can be ideal for people with a learning disability, physical disability or mental health need who want to live as independently as possible and need some support to do so.

Tenants of supported independent living are provided with accommodation and support. This can include support to develop daily living skills and can sometimes include personal care. Examples of daily living skills include but are not limited to planning and completing meal preparation and accessing the community.

Tenants make choices and decisions about their own lives; and can access the practical assistance and support that they need to participate in society and live active lives. SIL arrangements can be delivered:

• in self-contained owner-occupied or rented accommodation, which might be in small schemes
• in shared accommodation – for people who may require a greater level of care and support and/or who prefer a group living environment but want to exercise a greater degree of choice and control over their daily lives than would be possible in a care home setting
• through the Shared Lives scheme, which supports the matching of people with carers who wish to share their home in the long term

People in supported independent living have their own assured tenancy which secures them the right to remain in their home and to change their support provider if they wish.

SIL is available to those who have had an assessment and are eligible for funded care and support for ASC services.

A case study outlining the benefits of new SIL accommodation in Surrey which is being built so tenants have very low energy bills, helping them to stay resilient against changes in energy costs can be found in appendix 6.

Figure 54 shows examples of different types of housing support and where they are distributed throughout Surrey.

Extra care housing

Extra care housing describes a form of retirement living in Surrey, usually individual self-contained flats with their own front door. The level of personal care available to someone living in Extra Care Housing is much higher and can be arranged according to individual needs. Staff are available 24 hours a day to respond to emergencies. There are also a range of social and leisure activities provided and communal facilities. This aims to offer a supportive environment where people are able to live safely and well as they age. 

Housing related support services – what’s missing?

Currently there is not enough Extra Care Housing in Surrey and particularly not enough affordable Extra Care Housing. Trends have shown a indicate a declining demand for residential care, a growing popularity of Extra Care housing and an increase in people being supported to live independently.  Surrey Council have committed to increasing the availability of affordable Extra Care Housing by 725 units by 2030 and work is underway identifying new sites and acquiring planning permission.

The housing with support system in Surrey is under significant strain and is facing long and sustained financial challenges. This is due to firstly a rapidly growing population and particularly older population,  In addition the number of adults with a learning disability and/or autism in Surrey is projected to rise in line with the general population. Secondly there is insufficient specialist accommodation provision for both older people and working age adults with a learning disability and/or autism, and additional capacity is required urgently to support them to remain in their communities. National benchmarking suggests that, for accommodation options for older people, Surrey’s biggest gap in provision is extra care. It also shows that Surrey County Council funds a much higher percentage of people with a learning disability and/or autism in residential care than most.

 Surrey need to be able to offer residents the right accommodation options to meet their health and wellbeing needs, in a way that supports them to live as independently as possible. We need to look more creatively at how care and support can be integrated into accommodation. Surrey’s accomodation with care and support strategy outlines how this will be done

Projected Demand for Extra Care Housing by 2030 is shown on the map on page 17 of  ‘A Housing, Homes and Accommodation Strategy for Surrey’.

Helping the homeless – what’s available?

Each of the Surrey districts and boroughs have their own strategy for preventing and reducing homelessness in their locality. Each of the Surrey districts and boroughs provide a free housing advice service for those threatened with homelessness. This is a crucial high volume area of work that impacts on levels of homelessness.

There are also a range of other services provided for the homeless:

1. Rent deposit’, and ‘rent in advance’ schemes are provided in many areas to those in priority need and non-priority cases, many LAs also offer landlord incentives and rent top ups.
2. Local Authorities in Surrey put considerable resource into negotiating with landlords, family members and mortgage companies to prevent homeless and secure new accommodation options. They carry out referrals to supported housing as well as allocations via the Housing Register to prevent homelessness.. Additionally Local Authorities provide emergency accommodation for applicant that they have reason to believe have a ‘priority need’ and are homeless.
3. Valuable advice services, such as Citizens Advice, and local voluntary agencies, are available and often help to prevent homelessness. This includes proactive money advice services which promote financial inclusion, improve budgeting, reduce housing and other debts, prevent eviction, provide employment advice and support benefit claims.
4. Three domestic violence support services are available, geographically spread across the County. These services are very effective at assisting people to both obtain and maintain their tenancies.
5. Family mediation services are provided in many areas.
6. Single homeless and rough sleeping outreach services are now established in Guildford (HOST), Woking & Waverley (YRP outreach), Reigate and Banstead, Mole Valley, Epsom and Ewell and Tandridge (Esos).
7. Severe Weather Emergency Protocols (SWEP) ensure that emergency accommodation is available for rough sleepers during the winter when temperatures fall below zero. Additional winter shelters or bed spaces also normally operate in a number of areas, although the arrangements are not yet sufficient to offer a sustainable solution across the County.
8. Public Health Agreements are in place with some GPs and help to improve screening and outreach referrals for homeless people.

One particular programme of note in Surrey (and mentioned earlier in the chapter) is the Changing Futures – Bridge the Gap service. It is a first step in supporting people experiencing severe multiple disadvantage, with the service offering each individual up to 8 hours per week of intensive, specialised, trauma-informed support. Both an independent evaluation and the national Changing Futures programme baseline report show that the programme is having a positive impact on tenancies.

Helping the homeless – what’s missing?

A lot of work is being done in Surrey to prevent homelessness and rough sleeping in the county and support those who are at risk.

Colleagues in Districts and Boroughs have highlighted a need for more temporary accommodation. It is recognised however that this is not a solution to homelessness. More affordable permanent accommodation is required.

In the current climate of reduced funding and increasing numbers of homeless people there is a need for more innovative solutions to the homelessness crisis in Surrey to offer residents greater security in their accommodation.

Increasing affordable housing supply – what’s available?

All of the districts and boroughs work with local Registered Providers to increase the supply of affordable housing through their enabling role. Many LAs have their own stock building programmes.

Affordable housing repeatedly came up as the biggest threat to Surrey residents health throughout conversations and insights captured looked at in the development of this chapter.

There are many barriers to providing this however as consensus among colleagues is that Local Government needs more power and more funding to tackle the supply of housing and unaffordable housing in Surrey.

There is a need to challenge the common perception of the ‘Surrey Brand’ to make sure funding opportunities are maximised by giving an accurate reflections of the housing issues in Surrey.

There is a need to recognise that homes often defined as ‘affordable’ are not truly affordable.

Spotlight on a service – Amber

Amber is a charity housing and supporting young people dealing with complex challenges such as homelessness, mental health issues and long-term unemployment. Amber has four supported housing centres in the south of England (Kent, Surrey, Wiltshire and Devon) accepting young people, aged 16-30, from across the country. The average length of stay with Amber is 6 to 9 months but is flexible with young people staying as long as they need to up to a maximum of 2 years. Farm Place, based in Surrey accommodates up to 30 young people, providing the space and facilities for young people to rebuild their lives away from the pressures of their previous environment. They work in teams under the guidance of Team Leaders and take part in community projects, leadership courses, personal fitness and outdoor activities. They participate in art, drama, music, sport and many other simple enjoyable activities that fill their days and evenings with positive confidence building experiences.  There are four key themes that are central to the approach of the charity which includes:

1. Employment readiness
2. Health and wellbeing
3. Independent living
4. Personal Development

Independent living looks and supporting young people to manage a tenancy and accommodation. Amber – Transforming young lives (amberweb.org)

Figure 55: Impact of support by Amber – 2022

Key Findings and Recommendations

Key Findings

Housing is a fundamental wider determinant of health. Housing affordability and availability (supply) of housing is considered to be the biggest factor that could have an impact on those health issues related to housing.

The housing with support system in Surrey is under significant strain and is facing long and sustained financial challenges. The local system does not have the powers or funding required to rectify this situation.

There are some homes in Surrey which are in poor condition. Improving the condition of these homes would get to the core root of some of the issues we see in Surrey such as fuel poverty.

There are high levels of under-occupancy in the County which could provide housing opportunities for those in need. There need to be desirable options to encourage people to downsize.

There are groups of people within Surrey who have particular housing needs and currently there is not housing available to meet all of these needs. These groups include; prison leavers, people with mental health needs, people with physical disabilities, a growing older population, Gypsy Roma Traveller community, people with learning disability and autism; people who experience multiple disadvantage, the armed forces, People with substance use issues and refugees and asylum seekers.

There is no ‘wet housing’ provision and a lack of suitable housing options generally in Surrey to support those with substance use issues. There is not enough Extra Care Housing in Surrey and particularly not enough affordable Extra Care Housing. Involving specialists such as occupational therapists in building design could help make sure homes are fit for purpose.

There is a lack of suitable accommodation for people leaving prison especially for those with complex needs and women. CAS3 accommodation in particular is often not used for the purpose intended due to a lack of alternative options.

There is insufficient accommodation to meet the needs of the GRT community and the current approach to managing this amongst public partners is not allowing for sustained changes.

The absence of stable housing options in Surrey delays hospital discharges.

There is a lot of work happening in the County to improve the lives and living conditions of homeless people. More could be done by working together to share best practice and resources. There is a need for more secure accommodation options for this cohort who often have complex needs such a Housing First accommodation.

Trauma-informed training and person centred care has been identified as a gap for those working to support people who have experienced multiple disadvantage

Learning from best practice examples elsewhere showed that opportunities to achieve joint goals in improving residents’ health and wellbeing could be identified through close working between Public Health and Adult and Children’s Social Care and housing colleagues. 

Recommendations

Housing affordability and availability (supply) of housing is considered to be the biggest factor that could have an impact on those health issues related to housing by Surrey residents, staff who work in housing, staff who work in the health sector, businesses, public service providers and others in Surrey with an interest in housing. This will continue to pose significant local challenges for the foreseeable future and is significantly affected by regional, national, and international influences beyond local control.

There are opportunities for health, social care, land agents, developers, Local Authorities, house builders and housing professionals to work closer together to improve outcomes for local residents. Those working across the housing and planning professions are key players in protecting and improving the health of Surrey residents.

The recommendations below recognise opportunities which have been identified during the development of this chapter to address Surrey residents’ health and wellbeing needs through housing.

Affordability and Availability

1. All those involved in or having an interest in housing in Surrey should work to influence the Government for policy changes, resources, and powers to enable partners in Surrey to tackle the housing crisis.
2. All available opportunities to increase affordable housing supply suitable for the needs of the community should be identified with a focus on increasing social rented supply e.g. by using public land and assets to provide new schemes.

Homelessness

1. Build on work in the Districts and Boroughs Homelessness and Rough Sleeping Strategies by sharing best practice between teams regularly aiming to reduce homelessness and the use of emergency and temporary accommodation, including for immigrants, refugees and asylum seekers
2. Offer residents greater security in their accommodation, such as offering them assured shorthold tenancies where appropriate.
3. Ensure a continued focus on the housing situation, its implications for health and the actions needed to address it amongst all partners in Surrey.

Condition

1. Ensure a continued focus on improving housing standards in Surrey including energy efficiency to reduce levels of fuel poverty.

Meeting the needs of residents

1. Key Health and Wellbeing Board and related strategies should include measures to reduce homelessness and improve housing and social care related health outcomes. biggest issue posed to people’s health related to housing.   
2. Seek opportunities to promote/ better advertise and develop schemes already in place in Districts and Boroughs which reduce under-occupancy and empty homes in Surrey. This could include delivery of specialist housing schemes for older people including new extra-care schemes in order to have options to motivate those who may be willing to downsize and community led housing
3. Tenancy support officers and housing management should be trained to deliver a trauma-informed approach to residents to be able to better support resident groups such as those who’ve experienced multiple disadvantage, domestic abuse and the associated trauma
4. People who misused substances or require support with mental health issues should have access to housing which accepts them while they are in treatment and have a period of stabilisation before permanent support
5. Increase ‘Housing First’ units where housing is available for homeless people who have significant substance use and/or mental health issues, to give them an opportunity to seek treatment.
6. In collaboration with probation increase suitable accommodation for Prison Leavers, in particular women.
7. Review and develop pathway plans for different client groups (including those experiencing multiple disadvantages, prison leavers, care leavers, those who have experienced domestic abuse, those with physical disabilities, learning disabilities and mental health needs, those with substance use issues and the armed forces community) to help prevent homelessness, meet housing need and to identify and address potential ‘barriers and constraints within the system including at hospital discharge.
8. Increase the availability and accessibility of new and appropriate specialist housing options for disabled people, people with learning disabilities and/or autism, people with mental health needs, people with drug and alcohol dependencies and older people with care and support needs across Surrey. This includes the provision of ‘wet housing’ accomodation options.
9. With regards to the Gypsy Roma Traveller community a common aligned approach between all public partners needs to be agreed if a sustainable improvement is to be made to efficiencies and outcomes across the residential sites.
10. Providing residents with specialist needs accessible housing information, advice, and guidance to support them to access appropriate housing and maintain their tenancies. This should include easy read tenancies that are easily accessible.
11. Ensure involvement from appropriately qualified specialists e.g. Occupational Therapists in the initial development and design of accommodation for people with disabilities, people with learning disabilities and/or autism, people with mental health needs, and older people with care and support
12. The wider workforce in Surrey including those who work in Housing and those working for housing associations should be trained to be able to identify and support the health and wellbeing of their clients through signposting and/or brief advice (for example Making Every Contact Count). This may include awareness training in relation to particular conditions such as autism and drug and alcohol dependencies which will enable those professionals to interact with people more effectively.
13. Public Health and Adult and Children’s Social Care should work more closely with housing teams and with housing associations, including those in districts and boroughs to identify opportunities to achieve joint goals in improving residents’ health and wellbeing.

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Appendices

Appendix 1 – Key terms and acronyms

Definitions

Allocations Policy: An allocations policy sets down the rules for allocating (i.e. offering) housing, and should ensure that those most in need get offered a home first. Most allocation schemes give applicants for an allocation either a certain number of points or place them in a group or band, depending on their circumstances. 

Affordable Housing: Low-cost housing provided on a rented or shared ownership basis for those unable to afford a home in the private sector. Since the introduction of Affordable Rent, the meaning of ‘affordable’ has been debated by housing professionals. 

Affordable Rents: Affordable Rent is the main type of new housing supply. Affordable rented homes will be made available to tenants at up to a maximum of 80% of market rent and allocated in the same way as social housing is at present. Landlords will have the freedom to offer Affordable Rent properties on flexible tenancies tailored to the housing needs of individual households. 

Bedroom standard: where the number of bedrooms is allocated to each household in accordance with its age/sex/marital status composition and the relationship of the members to one another (definition of statutory overcrowding uses the ‘room standard’, which is deemed to be too strict and rarely used). 

Category 1 Hazard: part of the HHSRS (see below) inspection categories. Serious hazards are labelled category 1. If there are risks to the health or safety of occupants that the officer thinks should be dealt with, owners and landlords will have to put matters right.  

Cost of living crisis: refers to the fall in ‘real’ disposable incomes (that is, adjusted for inflation and after taxes and benefits) that the UK has experienced since late 2021. 

Cuckooing: the practice of taking over the home of a vulnerable person in order to establish a base for illegal drug dealing, facilitate sex work, as a place for them to live, or to financially abuse the tenant.   

Decent Homes Standard: a target set by Government for all social housing providers to meet set standards of design for their homes by 2010. In brief, a

 will have to pass four tests: 

• It has to meet the current statutory minimum standards for housing 
• It needs to be in a reasonable state of repair 
• It needs to have reasonably modern facilities and services 
• It needs to provide a reasonable degree of thermal comfort. 

Dwelling: A house, flat or other place of residence. 

Energy Performance Certificate (EPC): a rating scheme to summarise the energy efficiency of buildings

Gypsies Romas and Travellers’ (GRT): Persons of nomadic habit of life whatever their race or origin, including such persons who on grounds only of their own or their family’s or dependents’ educational or health needs or old age have ceased to travel temporarily, but excluding members of an organised group of Travelling Showpeople or circus people travelling together as such. 

Household reference person (HRP) A person who serves as a reference point, mainly based on economic activity and age, to characterise a whole household. The person is not necessarily the member of the household in whose name the accommodation is owned or rented 

Housing Association: A non-profit making organisation which provides homes either for people who cannot afford to buy their own or who need special types of housing, for example elderly people. Associations usually have paid workers and are managed by a voluntary Management Committee. 

Houses in Multiple Occupation (HMO): A single property divided into flats. 

Extra Care Scheme: A term used to describe housing that is rented to older people where an element of care is provided to residents by the landlord. 

Surrey Key Neighbourhoods: the “Key Neighbourhoods” are the wards which include the most deprived “pockets” within the county experiencing the poorest health outcomes in Surrey. These areas were selected on the basis of the overall deprivation score established in the English deprivation indices 2019.  A full list of the Key neighbourhoods can be found: Key Neighbourhoods | Surrey-i (surreyi.gov.uk)  

Private Rented Sector (PRS): – housing that is owned by a private individual, company or organisation, and rented to tenants. Other housing arrangements include social renting (from a council or housing association) and owner-occupying temporary accommodation – interim housing used to support residents while their homelessness application is being investigated or where they are awaiting suitable permanent housing. 

Rough-Sleeper: Rough sleepers are defined for the purposes of rough sleeping counts and estimates as 

• people sleeping, about to bed down (sitting on/in or standing next to their bedding) or actually bedded down in the open air (such as on the streets, in tents, doorways, parks, bus shelters or encampments) 
• people in buildings or other places not designed for habitation (such as stairwells, barns, sheds, car parks, cars, derelict boats, stations, or ‘bashes’). 

Tenure: the conditions under which land or buildings are held or occupied. 

Travelling Showpeople: Members of a group organised for the purposes of holding fairs, circuses or shows (whether or not travelling together) 

Acronyms

Adult Social Care – ASC  

Community Accommodation Services – CAS

Disabled Facilities Grant – DFG

Department for Education – DfE

Disabled Facilities Grants (DFGs)

East Surrey Outreach Service (ESOS)

Full Care Order (FCO)

Gypsy Roma Traveller – GRT

House of multiple occupation – HMO

Indices of Multiple Deprivation (IMD)

Interim Care Order – ICO

Lower Super Output Areas (‘LSOAs’):

Metropolitan Thames Valley Housing – MTVH

Supported Independent Living – SIL

Appendix 2: Highlights from Districts and Boroughs

Spelthorne Borough Council have recently completed two high quality housing developments within the borough which provides much needed emergency accommodation for residents who are facing homelessness.

The White House, Ashford, opened in October 2021 and provides specialist accommodation for single homeless people with multiple and complex needs. The development comprises of 27 en-suite rooms with shared kitchens and four self-contained studio flats. There is also an on-site learning suite / communal space for helping to prepare residents for move-on. Metropolitan Thames Valley Housing (MTVH) were appointed to manage the facility, providing a specialist support service with 24-hour on-site cover. Harper House, Ashford, opened in January 2022 and provides self-contained emergency accommodation for up to 20 homeless families whilst they await move-on to settled accommodation. MTVH also manage Harper House and have on-site presence 10am to 4pm daily.

Spelthorne Borough Council is also the lead authority for the set-up and management of a step-down project across North West Surrey to deliver an integrated ‘wrap-around’ intermediate care package to support timely discharge of older residents from acute settings. It’s a temporary solution whilst their existing home is made habitable, new accommodation is found, or to support temporary mobility issues and care needs that patients have following discharge from hospital.

The service is a partnership between Spelthorne Borough Council, A2Dominion, Elmbridge Borough Council, Runnymede Borough Council, The Whitely Homes Trust and Woking Borough Council and is commissioned by the NHS.

The service takes place in extra care / sheltered settings across 9 units (of which 4 are in Spelthorne) and provides a pathway for residents who are medically ready to leave hospital but are not able to return to their home as it is not fit for purpose. Referrals to the service are made by Discharge Health Coordinators or ASC and then the patient is discharged to the agreed temporary step-down unit where they are provided with a wrap-around service for up to 6 weeks to enable them to return home or find a suitable alternative.

Furthermore, in response to the lack of affordable housing being delivered locally, Spelthorne Borough Council set up Knowle Green Estates (the Council’s privately owned housing company) to deliver affordable homes and increase move-on options available to residents in emergency accommodation. Since 2018, 82 affordable rented homes have been delivered; this includes the conversion of part of the council’s offices into 25 affordable homes of which Spelthorne is the first local authority in the country to do this.

Epsom and Ewell Borough Council successfully operates a Private Sector Lease (PSL), where local landlords lease their property to the council for between 3 to 5 years for use as temporary accommodation. The scheme enables the council to increase the number of households placed within the borough boundary, to keep temporary accommodation costs down and to give those households more security whilst they await permanent housing. The council is looking to bring additional resource in order to expand the scheme.

The council has employed a specialist single person housing officer to work alongside East Surrey Outreach Service (ESOS), to work with the borough’s most entrenched rough sleepers. This also includes sourcing funding to set up two ‘Housing First’ units in partnership with Transform Housing & Support. The units will enable the council to house and work with individuals who would otherwise remain street homeless due to the complexity of their needs.

The housing department has worked closely with the Housing Benefit Team and social housing providers to identify and support households affected by the spare room subsidy, to downsize a number of households, which has resulted in 8 3-bedroom properties becoming available. The council continues to work with social housing providers to standardise and improve the offer to households, to encourage them to downsize, in order to expand the number of larger properties which is an area of high demand.

Reigate and Banstead Borough Council commit in their ‘Five Year Plan’ to securing the delivery of homes that can be afforded by local people and which provide a wider choice of tenure, type and size.

The council make it clear in their Housing Delivery Strategy 2020-2025 that to achieve this they will:

• Work in partnership with housing associations, Surrey County Council, developers and Homes England
• Maximise the delivery of homes through planning policy
• Explore innovative ways to deliver the right housing in the right places
• Develop our own housing delivery programme
• Support housing developers to provide housing to meet local needs
• Make best use of housing development opportunities
• Take commercial decisions to secure more housing choice

Since 2020, the council has directly delivered 61 new build homes, 32 secure tenancies, 4 housing first style units for homeless applicants with complex needs, 11 shared ownership homes and 14 market sale homes.

At the time of writing (October 2023) the council are further increasing their local temporary accommodation stock through purchasing over 15 family homes and a shared house for single homeless applicants. The council has also recently partnered with Transform Housing & Support, Surrey County Council Public Health to delivery other homes for homeless singles and young parents.

As well as increasing much needed housing stock, the council through an East Surrey Local Authority Partnership, jointly funds ESOS operated by Thames Reach. ESOS proactively work with rough sleepers and the LA to secure positive housing and health outcomes for service users.

The council are also part way through an 18-month pilot with East Surrey Place part of NHS Heartlands, to deliver a Hospital Discharge Service concentrating on improving discharge times for patients that have housing issues on discharge.

A scheme to offer support to social housing tenants that want to downsize is also being piloted. This provides officer time to help tenants make the move, deal with practical issues like setting up utilities, the actual move, providing a handyman service for small jobs like hanging curtains etc. The aim is to ensure residents are provided an opportunity to live in properties that are right for them and their needs, whilst at the same time freeing up family homes for local homeless families.

Waverley Borough Council has committed to building homes to buy or rent for households from all income levels by:

• Harnessing the power of partnerships. Building upon our strong relationships, levering in experience, expertise and funding to deliver what our communities need
• Aligning new supply more closely with need. Developments will be informed by a better understanding of changing needs across the borough. Planning decisions on type and tenure of new supply will be informed by robust, up-to-date evidence
• Ensuring synergy between services. Forging stronger links with Health, ASC, our Town & Parish Councils, housing providers and neighbouring councils to better understand what is working and what needs to change, to create homes that work for the whole community
• Creating homes for all our lives. New development must reflect the diverse needs of our residents at all stages in their lives. Collaborate more closely with ASC partners to build the right homes for older people and those with specialist needs.

The council’s ambition is to see all of its older residents housed in accommodation that is safe, secure and affordable trying to achieve this in a number of ways, working closely with health and social care partners. The council’s Careline service, run locally by Waverley officers, in partnership with Chichester Careline, provides assistive technology to enable older residents to stay in their own home for longer and the council helps older residents who need affordable housing to move to suitable senior living or Extra Care accommodation.

Over the next 3 years the council plans to:

• Ensure that the mix of affordable homes delivered includes rented homes which would be attractive to downsizers, to free up larger affordable homes
• Enable at least one scheme per annum with wheelchair accessible homes (M43 standard) to meet the needs of older people or those with physical disabilities
• Work closely with developers and Affordable Housing Providers at planning application and pre-application stage to ensure the location, size, type, tenure and design of new affordable homes meets need
• To plan strategically for the development of a range of housing options for older people, including Extra Care housing and dementia specialist care, working in partnership with Surrey County Council ASC Commissioning Team

Tandridge District Council works with East Surrey Outreach Service to work with those who are sofa surfing or are rough sleeping. While numbers of people rough sleeping in the district have remained consistently low for several years, the Council strongly believes that no one should have to sleep rough on the streets.

The council has identified that adaptions for disabled children can make the difference between a parent being able to care for their child at home or not and manage family life. Adaptations for children up to £30,000 are not means tested. For example: The council installed by crane, a prefabricated, ready for occupation, wheelchair accessible room pod, into the garden of one of its council properties. The pod was installed within 6 hours. This adaptation provided a large bedroom for a disabled child with sufficient room for specialist equipment such as a nursing bed and hoist, alleviating overcrowding in the property and enabling the family to stay in their community, close to their network of support and children’s schools. The cost of the works also provided excellent value, with the total cost being £26,000.

The council also provides floating support and supported housing and the range of clients that are supported through specialist accommodation and advice services including for people those with mental health issues, learning disabilities and rough sleepers amongst others.

The council has identified that over 20% of its population is aged over 65 years compared to 17.8% nationally with this trend set to continue over the next 20 years with this age group forecast to grow by over 50%. There is an anticipated 59% increase in those aged over 65 and a 136% increase in those aged 85 and over. As people age, increasing incidents of ill health, disability or other vulnerability make it more difficult for people to live independently and safely, in their own home.

The council identifies that the Surrey County Council’s Accommodation with Care and Support Strategy^[1]contains specific analysis of the support and care needs of our aging population and will be a key reference in informing their decisions on the delivery of supported housing in the future.

Accommodation for older people has been identified as a specific need in Tandridge. As Surrey County Council transitions away from traditional residential and nursing care provision in the coming years, the need for extra care housing in the district is identified as critical as there are no affordable extra care units in the Tandridge District to either rent or buy, with all current provision being in the private sector which is not financially accessible to everyone.

The council also notes that Surrey County Council’s analysis also shows that there is a need for a larger quantity and range of accommodation with care and support for those with mental health/ substance use issues in both the district and county wide. This includes all supported accommodation types, from more short term, step down accommodation from hospital settings which enables an individual to continue their recovery journey. A need for supported living has been identified in East Surrey as well as a need for small developments of accessible, self-contained units with 24-hour support to meet the needs of people with complex and/or additional needs such as autism, substance use, long term health conditions, physical impairments and personality disorder.

It is the council’s aim that those with a learning disability should be able to access mainstream housing as much as possible and be supported to make choices about where they live and with whom, in the setting that promotes the most independence for them.

The council sets out that it will work with Surrey County Council to identify the level of accommodation need in the Tandridge District and will also take steps to ensure that access to the Housing Register is promoted to those with a learning disability so that those who need access to supported housing can be identified.

Tandridge recognises that some young people have to leave their homes due to a variety of reasons, including relationship breakdown or the end of a care placement. The council’s aim is to enable young people to plan their housing future, obtain advice and access supported housing to give them the skills needed to live independently.

The council currently works with Social Services to identify at an early stage vulnerable young people who are leaving care and who need their own accommodation. The council works with Social Services to ensure qualifying young people are registered on the Housing Register so they can be nominated to a supported housing vacancy before a crisis situation such as street homelessness occurs

The council supports the vision in Surrey County Council’s Domestic Abuse Strategy which is: “to ensure that all those affected by domestic abuse have the right information, services and support, at the earliest opportunity, to live free from domestic abuse and gain the personal confidence to build healthy relationships for themselves and their dependents.”

The council works in partnership to share information on households affected by domestic abuse at the local Multi Agency Risk Assessment Committee (MARAC) to ensure victims of domestic abuse are protected and supported. The Council also works closely with East Surrey Domestic Abuse Service (ESDAS) to refer those affected for specialist support and advice and for referral to a refuge where necessary.

The council also offers a Sanctuary Scheme to residents living in council property and in the private sector which enables victims of domestic abuse to remain in their own homes by providing security improvements. Enabling victims to remain in their own homes minimises the disruption caused, particularly to children and significantly reduces the costs associated with providing alternative accommodation. Examples of the type of security improvements are the installation of spy holes in doors, improved door and window locks and security lighting. Housing Associations also offer this scheme to their tenants.

The council recognises that no single agency has the responsibility for tackling domestic abuse and therefore has developed a close working partnership with ESDAS to focus on the safety of those most at risk and to raising awareness through publicity campaigns and training and also to continuing to ensure its staff receive appropriate training to recognise all types of domestic abuse, acknowledging that abuse is not just about physical violence but also about emotional, sexual and economic abuse and controlling behaviour and affects men, women and children.

The support available through ESDAS is wide ranging from advice on housing, access to legal advice, the needs of children, emotional support and help to plan to leave an abusive relationship when the person is ready to do so. ESDAS also offer a “Stepping Up” programme which is an intervention programme for anyone who acknowledges that their behaviour towards their partner or ex-partner has been abusive and want to work towards stopping it from happening again.

Woking Borough Council has delivered two new self-contained, modern temporary accommodation schemes (providing 47 units), as well as renovating its existing temporary accommodation schemes.

The council has also set up a selective licensing scheme in the Canalside ward to raise the standard of private rented accommodation. 865 licences have been issued under the scheme, with 52% of properties visited being improved following inspection.

The council also has a target to meet the need for 22 new gypsy and traveller pitches already identified in the Gypsy and Traveller Assessment up to 2027.

Extra Care housing has been developed in Woking with Brockhill extra care scheme being a unique housing scheme, located in Goldsworth Park, designed to meet the needs of frail or vulnerable people living in Woking. Brockhill provides 49 homes and is currently the only extra care housing scheme in the Borough, resulting in a continual waiting list. Due to the high demand for extra care housing, the Council also commissioned a new scheme in Old Woking, Hale End Court and this new scheme provides an additional 48 apartments, of which 12 are for tenants needing care. Unlike other schemes, both Brockhill and Hale End Court provide 24/7 personal care to help those with additional support needs to remain as independent as possible. These schemes enable residents to also benefit from services such as on-site meals, a hair salon, day activities and chiropody.

As well as the designated housing schemes, the council offers a range of support services designed to promote ongoing independence and wellbeing. The council’s independent support service works in partnership with other external agencies to offer support to anyone who needs it, regardless of tenure.

Mole Valley District Council have identified the needs of older people as a specific area of concern and plan to enable and facilitate the development of extra care schemes for older people located close to facilities in the towns of Leatherhead and or Dorking.

Guildford Borough Council have developed a number of additional supported living projects for people with learning disabilities over the past ten years, and continue to review opportunities for future developments with Surrey County Council where there is clear evidence of need and access to appropriate support. The Council are planning to build 12 flats next to Guildford Fire Station, with the county council having nomination rights to four of these units, which will be used to house people with learning disabilities who are able to live independently but who require some level of support.

The Council provide two Extra Care housing schemes in the borough: Dray Court and Japonica Court. These cater for older people with higher support needs than those in sheltered housing, allowing them to receive the care they need whilst retaining their independence. An on-site social care team can provide care and welfare support for up to 24 hours a day where necessary.

The Council recognises that many older people, are still in housing need and under occupy large family homes. This is of concern in the social housing sector as there is strong need such family homes for younger people and does not make best use of the limited stock available. The Council offers support and help to older tenants who are willing to downsize and will continue to consider ways in which they can offer more attractive housing options for their older residents including on new developments.

The Council also aims to provide some new Traveller accommodation directly having received planning approval for five Traveller pitches at Ash Bridge and were successful in gaining a grant allocation of £432,000 from the Homes and Communities Agency.

Surrey Heath: Surrey Heath Borough Council have initiated a number of projects to address the needs of single homeless residents and rough sleepers. Following a successful project that led to the setting up of a local charity, the Hope Hub, providing crisis and day services, two accommodation projects have been delivered using developer contributions.

The first was the purchase of a 10 bed former temporary accommodation scheme from a housing association. This is now run by the Council as a supported housing scheme for single homeless individuals. The scheme includes 2 self contained units that can also be used for couples.

The second project saw the purchase of a 6 bedroom street property now leased to the Hope Hub to provide an Emergency Accommodation Scheme for single people, allowing a period of assessment and support to explore housing options.

Delivering Surrey County Council’s Floating Housing Support Service allowed the Council to successfully bid for an additional Support Officer within the service specifically working on homelessness prevention and resettlement with single people. This was possible due to the structure of the contract with Surrey County Council, and at the same times adds value to that contract.

To support the timely delivery of Disabled Facilities Grants and other adaptations Surrey Heath has secured Better Care Fund money to employ a Housing OT within the Housing Service. This will speed up assessment for DFGs as well as support housing needs work around housing allocations and homelessness where an applicant has a disability.

Runnymede Borough Council

RBC’s Climate Change Strategy promises to deliver carbon net zero for all Council operations by 2030.  RBC have expanded CCTV and Careline monitoring to reach more residents in Runnymede and beyond.  The Council has given a range of support to Ukrainian families, and hosts in Runnymede.

Only 16 households were accommodated in Bed and Breakfast establishments for more than 2 weeks in 2022/23, achieved through leasing properties, working with the provide sector and RBC’s in-house Magna Carta Lettings Agency. Three properties were purchased under the Rough Sleeping Accommodation Programme and are now home to individuals using Housing First principles, with more in the pipeline. A number of Council owned properties leased to partners to provide a range of supported housing schemes.

RBC is part of the successful StepDown scheme, using a number of Council properties to free up hospital beds when a patient is medically ready to leave hospital.  Residents stay in a supported living flat for up to 6 weeks, with a range of assistance to prepare them to live at home again. A joint family support service with Surrey Heath supports families who are vulnerable and may need a helping hand to enable them to remain functional and sustainable.

Dedicated engagement and inclusion staff offer a range of methods to enable us to listen to the views of customers previously under-represented and lead diversity awareness and community engagement events. In-house dedicated tenancy sustainment teams for private sector and council tenants.

Nine new Council apartments were built in Addlestone in 2022, launching a commitment to deliver 125 new council homes in 5 year

Independent EROSH accreditation demonstrates that Independent Retirement Living schemes (sheltered housing) are affordable and provide quality services to residents.

Significant increased investment in council owned homes included solar panels and energy efficiency measures.  The Support With Moving Policy offers practical support and financial incentives for tenants giving up larger, family sized properties who are willing to downsize to a smaller home.

Innovative use of RBC’s Discretionary Hardship Fund supports vulnerable tenants including those in crisis and those suffering poverty, domestic or racial abuse and in particular people who are disabled, those whose circumstances raise safeguarding concerns or where intervention can prevent family breakdown.

Appendix 3:  Case Study -Family that came into I Choose Freedom refuge in 2023

Client N – A woman with insecure immigration and mother to two children both under 5.

N was referred into refuge via a social worker after N disclosed that she has been experiencing Domestic abuse from her husband. The refuge advocate completed an assessment where N advised that she was being moved daily by Children services and didn’t know from one day to the next where she was going, often being left in hotel reception areas until the next hotel could be confirmed. N was scared for her safety as she was still in the local area, no cooking facilities for her and her children and nowhere to wash her clothes. N advised she was experiencing low mood and felt exhausted and alone.

N was quickly accepted by refuge and travelled to I Choose Freedom the next day. At this point in N’s journey this was the fourth time she had moved.  On arrival, N had a few plastic bags and little else to call her own, she had fled with the clothes on her and her children’s back. When N came to refuge, she was supported by her advocate to secure her immigration, offered counselling, and received therapy for her children. Five months into N’s stay at refuge N reported improvements in her mental health, feeling less anxious, reduction in panic attacks and feeling happy. During N’s stay her advocate begins the process of applying for housing. Advocates are aware of the housing crisis and so they start to prepare N for the next stage in her journey. N is accepted as homeless by the local authority, and now begins the process of moving on. N and her advocate do not know when a property will become available and so N has to be packed and ready to go on the days leading to her move which is upsetting. The uncertainty began to make N feel low, crying daily and worried about her children’s future. N cannot plan for the next week as her advocate is not aware of where she will be placed.

The day finally comes, and N is placed in emergency accommodation, this marks N’s Fifth move in six months. Unable to view the accommodation beforehand, N and her advocate arrive at the accommodation. It is shared with both males and females and N immediately feels scared. Often women fleeing abuse do not want to share accommodation with males. The advocate supporting N tries to explain to N’s housing officer the accommodation is not suitable and is advised this is all they have but they advise N is a priority to move out. N retreats into herself and struggles to get her children to school as the journey to school is 45 minutes away and has no help financially to get them there. N can’t move schools as this is emergency accommodation and she does not know how long she will be there. Daily calls into the housing officer by the advocate and 2 weeks later, move number six takes place. The next type of accommodation is better, shared again but an improvement. N has a kitchen but shared toilet and shower room with another family. N’s new accommodation is temporary accommodation.

N is now eight months in and six moves in total, living in one small room with her children. At various stages in her housing journey N’s mental health has declined. She struggles every day to get children to school, get to a launderette to clean clothes and shopping daily as there are no facilities to store a weekly shop.  All these daily tasks have additional cost impacts.  N’s mental health gets worse and visits the G.P resulting in N being put on medication for depression.

N will still face more moves when suitable accommodation is found.

Appendix 4: Case Study – Changing Futures Bridge the Gap prison leaver support

Positive client outcome from April 2023 to August 2023

X has just come out of prison.  Bar two weeks, he has spent a year in custody in the past two years.  We have continued to have weekly video links for him and engaged the psychologist from the team who also had regular contact whilst he was in prison.  He has a long history of offending and substance use.  His release this time was totally different from all others in the past.  The BTG worker engaged with the prison throughout and through the psychological work he made decisions about where he wanted to live and what he needed for a good transition. Supported accommodation was secured and he was collected from prison and all his items which had been in storage delivered to him the next day.  A timetable of support was produced by the BTG worker so firstly he had contact each day, but also so all of the practical issues such as meeting with iaccess, attending probation and job centre were all covered.  He has stated that he feels more relaxed now than ever and described his mood and motivation as 20/20 to his iaccess worker. Usually, he relapses upon release and gets recalled.  We have had daily contact, and he is smiling, contacted his sister who he has not seen for a long time and spent a day with his family, again, something he has not done for years.  What has worked so well is the co-ordination from the BTG worker, the joined-up approach with the prison and the regular contact and him knowing and trusting those around him for the first time ever and of course he had a safe place to be released to.  He has totally directed his support and at one point said he did not want to work with us, but we persisted to let him know we are still here and available whenever he chooses. He is happy, looks great and when I asked him if he was hopeful, he said he has never been this hopeful.

Appendix 5: Case Study – Decarbonisation grants for fuel poor homes

W from Reigate & Banstead received external wall park home insulation and his EPC increased 2 bands from G to E. This is expected to save 1.7 tCo2e, 6467 kW of energy, and £274 on energy bills annually.

“I am very pleased to provide feedback on the work carried out by/on behalf of Action Surrey at my Horley home recently.

The process of applying – handled on my behalf by my sister, as I do not have internet access – was simple to understand and the application forms relatively easy to complete.

The work carried out to the exterior of my home caused minimal disruption and on any occasion of interacting with the contractors carrying out the work, they were respectful of my property and the surrounding garden and courteous in their dealings with me – even asked if I wanted to have the opportunity of removing plants out of the way, apologising that they would need to walk/stand on that area in order to carry out the work.

Although since completion I’ve not experienced a winter to be able to judge the impact the work has on my energy bills and heat retention indoors, all in all I am very pleased to have been a part of the scheme and to have had the work carried out and I am happy for you to attribute my feedback to me, by name/location as you described.

Thank you for including me in the programme.”

Appendix 6: Case Study – Supported Independent Living Project – designing Net Zero and addressing fuel poverty

A Supported Independent Living scheme is designed to accommodate residents with care and support needs including complex needs arising from physical and/or learning disabilities, including autism, brain injury or mental health issues. Three new SIL sites have been designed according to the LETI Climate Emergency Design Guide to achieve Net Zero operational emissions, and prevent fuel poverty through reducing energy bills for tenants The design included a high standard of energy efficiency measures, heat pumps for heating and solar PV to generate on site renewable energy for each site. Energy bills for tenants are estimated to be 60-100% reduced, saving them money and increasing their resilience against increases in the cost of energy.

Sites

• Former Coveham Hostel in Cobham
• Former Horley Library in Horley
• Former Manor School in Byfleet

Number of residents = 34 residents

Benefits

Negative emissions during operation

Energy savings

60-100% annual energy bill savings

Solar PV to provide electricity needs for the site

Air Source Heat pumps to provide heating needs

EV Charge points

Cycle store

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Data Sources

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Contacts and Acknowledgements

Contact:  jsnafeedback@surreycc.gov.uk

Acknowledgements: Chapter delivery group with particular thanks to Poppy Middlemiss, Charlène Carayol, Katie Owens, Rebecca Matthews, Graham Tomlinson, Andy Vincent, Minerva Lemonidou

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