TAC Response to “Establishing a 10-Year Strategy for Social and Affordable Housing”

Purpose

The purpose of this paper is to provide a contribution from the TAC to the “Establishing a 10-year Strategy for Social and Affordable Housing” discussion paper released by Homes Victoria on 9^th February 2021.

The submission offers shared learnings and specific ideas in response to the questions posed by the discussion paper and outlines opportunity for further discussion and collaboration between TAC and Homes Victoria.

Background

The Transport Accident Commission (TAC) is a Victorian statutory corporation established under the Transport Accident Act 1986 (TAA). The TAC is responsible for funding treatment and supports for people injured as a result of a transport accident as well as actively campaigning to reduce the incidence of road trauma.

In the 2019-20 financial year, the TAC provided support for 59,000 people with their transport accident claims. Each year the TAC provides support for around 3000 clients with significant and permanent disabilities, after sustaining injuries including Acquired Brain Injury (ABI) and Spinal Cord Injury (SCI). Often these clients will require ongoing support to help them return to participating in life roles such as working as well as increasing their independence and quality of life after injury.

The TAC is committed to supporting clients and their families to access appropriate accommodation and support services that are personalised, sustainable and facilitate client independence and participation.

TAC clients present with varied housing needs including:

• Private housing: The vast majority of TAC clients have access to private housing (either owned or private rental). The TAC funds home modifications and all reasonable supports to ensure a client can return to their home wherever possible.
• Specialist Built Environment required: A small proportion of TAC clients with extreme impairment or very high support needs require a specialist built form and significant supports, do not have a suitable home to return to.
• Highly Accessible Built form required: Clients with significant impairment who require an accessible environment, who may or may not need additional supports, but do not have a suitable home to return to; and
• Accessible Built form not required: TAC Clients with vulnerabilities and complex needs that may or may not be directly related to their transport accident. These clients may not require a specific housing build type but require social and affordable housing to be able to focus on recovery and getting their life back on track.

Like many parts of the general population, a proportion of TAC clients do not have access to a safe, appropriate and affordable housing. This cohort of clients requires the support of social and affordable housing to focus on recovery from their transport accident and get their lives back on track. When considering the built form and geographic location of housing options, TAC client preferences such as family, health, rehabilitation and cultural needs must be considered.

The TAC established Residential Independence Pty Ltd (RIPL), as part of its Client Housing Strategy in 2010. RIPL is a wholly owned subsidiary of the TAC, with the TAC being the sole unit holder.

The role of RIPL is to create purpose-built apartments, and units across Victoria, suitable for some of the TAC’s most seriously injured clients. Under the RIPL program, TAC currently owns and operates 34 units/apartments available for TAC clients across 7 sites, in metropolitan Melbourne and Geelong. RIPL tenants are TAC clients who have a significant and permanent disability (moderate – severe acquired brain injury and/or spinal cord injury) from a road accident and require suitable housing and supports to maximise their independence.

The TAC has invested significantly in research to support the TAC Client Housing Strategy and RIPL. Client focussed evaluation frameworks and design feasibility studies have produced insights into outcomes, matching disability needs to accessibility requirements as well as co-ordinating housing and support responses. International scanning has produced evidence of both housing and support considerations including exemplar models¹. In addition, the TAC has piloted and evaluated the impact of assistive technology in the RIPL housing, and found a range of positive outcomes, including the successful completion of pre-determined goals and a reduction in feelings of social isolation².

TACs responses to “10-Year Social and Affordable Housing Strategy” discussion paper:

People at the Centre:

The TAC strongly supports the priority identified within the Strategy to have “People at the Centre” in the design and development of future initiatives. This will ensure those who need and live in social, affordable and/or accessible housing are able to contribute to the success of the Strategy.

The TAC has a long history of benefiting from engagement with its clients and ensuring their voice is heard through longitudinal research, biannual customer experience and outcomes surveys, bespoke research, co-design service and product design, and contribution to selected staff learning and development programs. In 2018, the TAC formalised its approach to client engagement by co-designing a Client Voice Framework, which provides the TAC with a uniform approach to how it engages with clients to inform TAC strategy, policy and service design.

The TAC continues to invest in strengthening the ability to hear and learn from clients with next evolution in client insights to involve feedback from clients in real time. A pilot to test this approach is to be delivered in 2021. The results of the pilot will inform future organisation-wide implementation.

The TAC would welcome the opportunity to share further detail about our Client Insights initiatives and structure to support this essential objective of the Strategy.

What are the most important features of affordable housing?

The TAC invests in the:

• development of purpose built accessible housing, via RIPL,
• extensive review of RIPL properties, through client feedback, quantitative and qualitative surveys, and extensive international literature reviews,
• home modifications to support approximately 1500 clients annually to maximise independence and safety in their own home; and
• Integration of appropriate housing and supports with ongoing client engagement to maximise client experience and independence outcomes.

Evidence presented in these recommendations is based on a combination of insights from the fields of architecture and health care which has investigated how housing design and disability support can best work together to improve independence and outcomes for clients. Clients requiring a specialised housing response, such as disability housing, have a number of unique accommodation needs; however, their desire for homely, personalised and comfortable housing located in communities of their choosing does not differ.

The TAC welcomes the opportunity to share this and other evidence and learnings with Homes Victoria, translating key findings to benefit the development of future disability social and affordable Housing.

Through research and learnings the TAC has identified several critical features to consider in the development and success of disability housing including:

1. The location of the housing.

The proximity of the housing to a tenant’s support networks, including family, friends and community groups/interests has been found to be a critical factor in client preference and achieving outcomes. For all housing pathways, both interim and long term, TAC clients exhibit a strong preference to return to their pre-injury community. For those who move outside of their community, significant support is required to assist them to establish community connection and participation.

Furthermore, location within reasonable walking/wheeling distance to facilities and amenities, including shops, supermarkets, cafes, take-away food stores (ideally a large, modern and accessible indoor air-conditioned shopping centre), accessible public transport (particularly the train), health services, social/community groups (e.g. clubs, churches, neighbourhood houses), places of employment/training, and leisure/sports facilities (e.g. movies, swimming pools, gyms) are all important features of the location of the accommodation.

Feedback from RIPL tenants and other stakeholders is that being close to accessible shops was more important than being close to public transport. Being close to accessible shops gives the person the opportunity for independence and social interaction (e.g. being able to do their own grocery shopping, buying take-away food or meeting friends socially).

2. The design of the housing.

The TAC is a strong advocate for the inclusion of minimal accessibility standards for all new Social and Affordable Housing properties, enabling the future needs of all Victorians, including those recovering from transport accidents, to be met. TAC’s funding of modifying existing homes evidences the economic benefits of future proofing the design of all new builds to support installation of disability related equipment/modifications, such as ceiling hoists, handrails etc., if required.

The 2010–2020 National Disability Strategy Report to the Council of Australian Governments (COAG) 2012 included a target of 100 per cent of new dwellings to meet the silver level of the Liveable Housing Design Standards by 2020.

The TAC acknowledges that progress has been made in this area, particularly in relation to the voluntary uptake of the Liveable Housing Design Guidelines by state and federal government agencies, however believes there is an opportunity for the Victorian Government to be the leaders in this area and mandate a minimum standard for all new builds as part of the “Big Housing Build”.

Many TAC clients and other Victorians with accessibility needs require levels of accessibility higher than Silver to maximise and sustain independence. An opportunity exists to strengthen and diversify accessible housing delivered through the “Big Housing Build” initiative by requiring rather than preferring higher standards than Silver (e.g. Gold +, Platinum) for all those properties dedicated to Victorians with a disability.

RIPL’s design brief is set at a Platinum Plus level, as the intention is to provide accommodation that is suitable for a very broad range of clients. The overwhelming feedback from RIPL tenants was that, in addition to meeting accessibility needs, their house should look and feel like any other house or home, not an institution. Furthermore, the design of the property should accommodate a wide range of individual preferences and abilities. Flexible or robust places are those that can be used for a number of different purposes and therefore offer more choice in the use of that space. In personalising a place, clients are both confirming their tastes and values to themselves, and communicating them to others. The TAC has found this to be a fundamental element to achieving a quality outcome.

3. Integration of appropriate housing and supports with on-going client engagement.

TAC research with clients has identified the critical role of an integrated, appropriate housing and support response with ongoing client engagement to maximize successful client outcomes^3,4.

Research has additionally shown the importance of engaging clients at all stages of the design, development and transition to new or modified housing⁴.

Further evidence demonstrates the importance of engaging clients early in the transition process and one method of doing this is via the appointment of an accommodation transition planner to work individually with client’s pre-move⁵.

The planner can develop a person centred approach to understand what is important to the client and undertake ‘discovery’ or ‘orientation’ activities with the client as required. Activities undertaken can include visiting the new accommodation, familiarising the client with their new neighbourhood, developing daily routines, building capacity to live in a rental property, such as budgeting, connecting utilities etc. Specifically, it has been shown to be useful to engage clients with local services (GP/dentist/church etc.), discuss and plan recreational activities, and become aware of community groups prior to the transition into the new accommodation. In moving into RIPL properties, the TAC has effectively engaged clients during their transition to new accommodation through activities such as allowing early visitation to their new apartment/neighbourhood, supporting client selection of furnishing, and where required, the hiring of support staff.

Research has also identified that even after the initial completion of disability housing design, it is critical to maintain client engagement and to reassess and modify housing to match changing client needs⁶.

TAC has experience and evidence to inform best practice in accessible housing and support model design.

4. Assistive technologies

There is evidence that some assistive technologies, such as environment control units, can benefit people with physical disability. The evidence is mixed in regard to the benefit of assistive technologies for people with cognitive disability, or a combination of cognitive and physical disability. While there is a limited evidence base that evaluates individual assistive technologies, the great potential for the use of smart phones, home hubs such as SofiHub and other home-based technologies to increase the independence of clients with disability has been identified in TAC research².

Assistive technologies have also been recognised as creating opportunities to build social networks for people with disability², which may help minimise social isolation, a factor which has been linked to poorer health outcomes, which in turn generate an increased need for other government funded supports and services.

Assistive technologies can assist clients to increase their independence and minimise the need for intensive, in-person support. The evaluations of RIPL developments suggest that although the technology has been well integrated into these developments, there have been some issues with reliability and clients not fully utilising the technologies. This is an important consideration when building new housing accommodation. Key barriers to greater use of these technologies in supported accommodation were identified as insufficient planning, limited ongoing support, and lack of reliable internet access⁶.

The TAC recommends strategies to improve use of assistive technologies include planning the integration of technology into builds/modifications, providing training and ongoing support to workers, clients and families in the use of technologies, and integrating technologies into housing transition and daily routines.

Partnerships:

The TAC welcomes the development of a partnership agreement with Homes Victoria to support:

• exchange of data, information and research findings to inform investment planning, policy settings and future initiatives; and
• exploration of co-funding opportunities to achieve mutually beneficial outcomes for both organisations

References

1. Calloway, L., Tregloan, K., Bowen, D. & Bonyhady, B. (2020). Research to support the TAC client housing strategy.
2. Fernando, N., Vouliotis, A. & Calloway, L. (2018). Pilot Evaluation of the effectiveness of a new activity sensing technology providing cognitive support in housing for people with acquired brain injury.
3. Tregloan K, Callaway E, Meyer B, Wood R and Iannello N. (2014). RIPL Project One: Post-occupancy built and technology design evaluation: Report. Faculty of Art Design and Architecture and Faculty of Medicine, Nursing and Health Sciences, Monash University.
4. Tregloan, K. & Callaway, E. (2016). RIPL Project Two: Post-occupancy built and technology design evaluation. Melbourne: Monash Art Design & Architecture, Faculty of Medicine, Nursing and Health Sciences, Monash University.
5. Bertram, N., Harry, H. & Board, H. (2017). Towards a holistic home modification process; 3 cases studies Melbourne: Monash Art Design & Architecture.
6. Jamwal R., Callaway, E. & Winkler, D. (2017). Using technology in supported accommodation to improve outcomes following neurotrauma. Melbourne: Department of Occupational Therapy, Monash University, Summer Foundation Ltd.