Housing has an important impact on health and well-being: good quality, appropriate housing in places where people want to live has a positive influence on reducing deprivation and health inequalities by facilitating stable/secure family lives.  This in turn helps to improve social, environmental, personal and economic well-being.  Conversely, living in housing which is in poor condition, overcrowded or unsuitable will adversely affect the health and well-being of individuals and families.

The value of good housing needs to been seen as more than ‘bricks and mortar’. The Department for Communities and Local Government (DCLG, 2006) define a decent home as ‘a home that is warm, weatherproof and has reasonably modern facilities’. Failure to address the investment needs of poor housing conditions will have a detrimental impact on the occupiers’ health and well-being.

A decent, affordable home is an essential requirement for tackling health inequalities and reducing the burden on health and social care services and cost to the public purse.

This topic includes homelessness and fuel poverty.

This topic is most closely linked with:


Last updated: 2015-12-14 12:37:14
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1. What are the key issues?

Homelessness - a consequence of, and exacerbated by, the shortage of suitable affordable housing and the wider economic climate.

Addressing the housing and support needs of vulnerable and disadvantaged groups - including those with poor mental health, physical disabilities and long-term conditions, migrants, care leavers, families fleeing domestic abuse, troubled families, long-term unemployed people, vulnerable young adults, ex-offenders and people with substance misuse or complex needs.

Meeting the housing requirements of those with disabilities and older people.

Homes in disrepair, poor quality management and fuel poverty.

Last updated: 14/12/15

2. What commissioning priorities are recommended?

Provide housing and support services, including home adaptations, for an increasingly ageing population and people with disabilities
, including children with complex and/or serious inherited medical conditions, whose homes may require multiple adaptation as they become adults and their requirements change. Middlesbrough Council and its partners have successfully implemented a number of initiatives to tackle homelessness and housing needs, for example, Sanctuary scheme, emergency crash pad accommodation and a range of supported housing and supported housing services.  However, increased numbers are presenting as homeless with demand outstripping supply.  This is a continuing priority due to the increase in homelessness and the needs of vulnerable households to be supported into appropriate accommodation and services.

Provide high quality housing, advice and support services
to enable vulnerable individuals to meet their housing needs, develop or sustain their capacity to live independently and contribute to the economic and social life of their community.  This will include homelessness prevention and associated support services, with multiple and compelling pathways to help people engage with services. Since 2012, approximately 1,500 vulnerable households have benefitted from external wall insulation while a considerable number of additional households have had cavity wall/loft insulation and new boilers fitted.   A Selective Licensing Scheme has been proposed, which will play a key role in improving standards in the private rented sector and engage with tenants/landlords to tackle basic issues around health and well-being and poor conditions.  However, data shows that levels of fuel poverty and poor stock condition continue to be prevalent in the town centre areas and there is a continuing priority to address these issues.

Provide, secure, good quality, affordable and well managed homes
, including creative and innovative schemes to bring empty homes back into use, particularly for the benefit of the homeless and other vulnerable groups.  Effective regulation, targeted intervention and enforcement within the private rented sector will be a key component. Extra care housing, bungalows for older people and those with disabilities and specialist housing linked to a neuro rehabilitation centre are examples of developments completed in the past two years.  Middlesbrough’s Staying Put Agency administers the Disabled Facility Grants to provide adaptations to all residents to remain in their own home.  This will continue to be a priority as individuals/households present for appropriate housing and support.

Enable the most vulnerable and disadvantaged households to maintain safe, warm and healthy homes
.  This will include targeted intervention to improve the life chances of the most vulnerable households living in the poorest housing in the most deprived areas by engaging them with health, education and other services so as to achieve the same health outcomes as other people.  Effective regulation, targeted intervention and enforcement within the private rented sector will be key component. Middlesbrough has secured funding and is working with partners to bring empty homes back into use.  A Rent Bond Guarantee scheme and Stepping Stones are examples of providing financial support to access affordable housing for rent, or sale.  In 2014, the Council will consult on Selective Licensing to improve standards in the private rented sector and bring empty properties back into use while ensuring that good quality, well managed properties are available to those needing accommodation in the town.   These are long-term priorities that continue to be addressed through partnership working with local housing providers/partners, accessing available funding to complete the works and working with a number of agencies to improve overall management of neighbourhoods.

These remain the most important strategic housing priorities in 2015.


Last updated: 14/12/15

3. Who is at risk and why?

An ageing society poses great challenges for appropriate housing. Most homes and communities have not been designed to meet people’s changing needs as they get older. Inclusive housing and wider environmental design is key to people’s health and well-being, and the suitability of the built environment plays a critical role in the provision of social care and health services. This demographic change needs to be considered when planning homes and neighbourhoods.

Although overall life expectancy has been increasing for both men and women, the number of years spent with a limiting illness or disability has also been increasing. In 2009-2011, life expectancy for men increased by 1 year (77.9 to 78.9 years). However, men could expect to spend 19% of their life living with a disability, which was an increase from 14.6 to 15.0 years compared with 2006-08.  Life expectancy for women increased by 0.9 years (82.0 to 82.9 years) and the expectation of living with a limiting illness or disability was 22.2% (17.5 to 18.4 years) compared with 2006-08. Such changes in life expectancy are anticipated to have an impact on the demand for care in later life (Office for National Statistics (ONS)).

An estimated 26.5% of people over 65 fall each year, and for those over 75, the rates are higher (32%).  Those being admitted to hospital following a fall are estimated to be 7.8% and 11.5% (65 and 75 years and over respectively) potentially reducing mobility and independence and increasing the risk of premature death. (POPPI)
There was a 29% increase in excess winter deaths (England and Wales 2012/13) with between 10,590 and 13,100 male deaths and 13,610 and 18,000 female deaths respectively.  The majority of deaths occurred among those aged 75 years and over (25,600 in 2012/13 compared with 5,500 in those under 75. (ONS)

There are few known gender-specific housing issues. Women have greater life expectancy than men and it is likely that any deficits in appropriate housing suitable for older single occupancy will affect more women than men.  Homeless statistics typically show more males to be affected by the issue than females, but that women face more barriers, and to face more barriers, when homeless.

Socioeconomic status
Households in relative poverty have a higher prevalence of living in a dwelling with damp problems (8%) more often than the general population (8%).

In 2012, damp problems occur in 4% of all households but there was a higher prevalence of damp (10%) in ethnic minority households.

Nationally, homelessness between January and March 2014 was 7% lower than the same quarter of 2013.  There were 58,590 households in temporary accommodation on 31 January 2014, a 3% increase from the previous year.

The life expectancy of homeless people is 30 years less than the rest of the population.  On average, homeless people live until the age of 47 years, and for homeless women, it is further reduced to just 43 years. They are consistently less likely to take up routine screening, health checks, and vaccinations and it is essential to engage this group with existing public health programmes.  Ill health is more likely within homeless households, including those in temporary accommodation.

School absenteeism is more prevalent amongst children in homeless households and they are more prone to delayed development of communication skills (Shelter, 2006b).  Homeless children are more likely to show signs of behavioural problems such as aggression, hyperactivity and impulsivity.  Nearly half of young male offenders on remand and 42% of young female offenders sentenced have experienced homelessness (Shelter, 2006a).

There is a strong overlap between experiences of more extreme forms of homelessness and other support needs, with nearly half of service users reporting experience of institutional care, substance misuse, and street activities (such as begging), as well as homelessness. Traumatic childhood experiences such as abuse, neglect and homelessness are part of most street homeless people’s life histories.  Most complex needs were experienced by homeless men aged 20-49, and especially by those in their 30s (Joseph Rowntree Trust, 2011).

Homelessness is linked to nutritional deficiencies, and obesity is increasingly common (Food Standards Agency, 2007).  Rough sleeping is accepted to be inherently harmful to good health, and either contributes to, or exacerbates, health problems such as physical and mental health issues, and drug and alcohol misuse (Crisis, 2011; Department of Health, 2010).

House condition and types
Much of this information is sourced from the English Housing Survey 2012.  In 2012, 4.9m dwellings (22%) failed to meet the Decent Homes Standard compared to approximately 2.8m in 2006.  13% of dwellings, primarily in the private rented sector, failed on Category 1 hazards, e.g. 19% private rented sector, 14% owner occupied and 6% social sector dwellings.  Private rented sector dwelling failures were more likely to be poor thermal comfort (15% compared to social rented of 5%) and disrepair (8% compared to social rented of 3%).

Around 4% of homes experienced problems with damp in 2012 compared to 8% (2009).   Households in relative poverty (8%) and ethnic minority households (10%) had a higher prevalence of damp, as did households containing five or more people.  Vulnerable groups and those with a long term illness or disability were no more likely to be housed in a damp home but, for all vulnerable groups, including those with young children, the likelihood of living in a damp home was greater within the private rented sector.

In 2012, the majority of homes, irrespective of tenure, had modern PVC wiring (97-98%) and 93% modern earthing, with the latter being higher in the social rented sector (96–97%). 
Since 2012, local authorities, homeowners and landlords have taken advantage of a number of Government initiatives to improve energy efficiency in dwellings that have had a positive impact on reducing excess cold hazards within the housing stock.

Census 2011 analysis stated that of 23.4m households (England & Wales) 1.1m (4.5%) were overcrowded (social rented 8.7%, private rented 8.6% and owner occupied 2.3%).  Of 1.1m overcrowded households, around 68% (724k) had dependent children (couples 28% and lone parents 5%).  16.1m were under occupied (owner occupied 82.7%, private rented 49.5% and social rented 39.4%). (ONS)

Poor housing conditions increase the risk of severe ill health, or disability (25% during childhood and early adulthood), with a likelihood of suffering respiratory problems and 10 times more likely to contact meningitis. Children in unfit and overcrowded homes miss school more frequently due to illness and infections, leading to a higher risk of low educational achievement and long term implications for economic well-being in adulthood due to an increased likelihood of unemployment, or working in low paid and insecure jobs (Shelter, 2006a).  An increased duration of living in overcrowded accommodation is significantly associated with children feeling unhappy about their own health and associated with being bullied in or out of school, getting into trouble with the police and having long-standing illness, disability or infirmity (Shelter, 2011).

Welfare reform
The introduction of Welfare reforms produced predictions from a range of organisations on the impact of the changes to households claiming benefits, living on low incomes and residing in rented accommodation. These included:

  • significant increases in poverty among children and working age adults by 2013/14 from tax and benefit reforms, including Local Housing Allowance (LHA) (Institute for Fiscal Studies);
  • private sector tenants claiming LHA* would lose an average of £12 per week and between 136,000 and 269,000 would be unable to afford their rent, with half of these likely to be evicted or moved on voluntarily (Shelter / Cambridge Centre for Housing and Planning 2010);
  • those claiming traditional housing benefit for all rented sector properties would be affected by non-dependent deductions from April 2012;
  • working age families (deemed living in under-occupied social rented housing) would have their housing benefit cut; and,
  • a cap on benefits claimed by any individual working age household.

* the number of households in England giving the reason for loss of last settled home due to the assured shorthold tenancy has increased from 8,540 (18%) in 2011 to 13,560 (26%) in 2013.  Under LHA, housing benefit for private tenants was cut in 2010 with tenants only being able to rent a home in the cheapest third of the market.  In addition, with the introduction of the benefit cap, landlords might chose to evict or not renew the tenancy where they perceive that the tenant will struggle to pay the rent.

Fuel poverty
Living in cold homes affects both physical and mental health but the most serious is its contribution to Britain’s unusually high rates of ‘excess winter deaths’.  Many of these excess winter deaths could be prevented through warmer housing (Institute of Health Equity, 2011).

In the 2012, (using the low income high cost definition) the number of households in fuel poverty in England was estimated at around 2.28 million, representing approximately 10.4 per cent of all English households (DECC, 2014). This is a fall from 2.39 million households in 2011 (a reduction of almost 5%).  Key drivers behind fuel poverty are: the energy efficiency of the building; cost of energy; and, household income.  National Fuel Poverty figures for 2012 show the North East as having 128,971 households in fuel poverty, which is 11.6% of the total number of households (1,109,018).


Last updated: 14/12/15

4. What is the level of need in the population?

Nationally, homelessness has decreased by 7% since March 2013. In Middlesbrough, homelessness rose from 63 cases in March 2013 to 77 cases in March 2014.  In 2013/ 14, the rate of homelessness per 1,000 households in Middlesbrough is 1.32% on a par with the North East rate of 1.33%.  The average rate for other Tees Valley authorities, however, is much lower at 0.5%.  The main reasons for presenting as homeless in Middlesbrough are:

  • domestic violence accounting for 79% (highest proportion of any local authority in England and much higher than the North East rate (24%) or England rate (12%);
  • young people made homeless due to parental eviction accounts for 13% of all homelessness in Middlesbrough; and,
  • other homelessness with the majority due to eviction or fleeing harassment. 

There were 1,503 enquiries from households in housing need in 2013/14, and of those, 138 enquiries were from non-priority homeless households, i.e. those who are not deemed to be statutorily vulnerable and thus no duty is owed by local authorities (Homeless Database Monitoring Reports).  Market factors make it difficult to predict homelessness more specifically, but the following suggests that homelessness will continue to increase over the short to medium term:

  • homelessness has varied in consecutive quarters, but risen 22% overall in the past two years in Middlesbrough;
  • demand for social housing is significantly outstripping supply; there are presently in excess of 5,000 social housing applications on the Common Housing Register, and there were only 947 lettings of vacant stock carried out last year;
  • housing standards in some areas of the private rented sector are poor and affect the health and well-being of tenants.  Anti-social behaviour has an impact on the sustainability of the neighbourhood;
  • currently, there is a shortage of 189 affordable houses in Middlesbrough; and,
  • mortgage repossessions decreased by almost 50% since 2008, when they peaked at 136.

Older people
Middlesbrough’s population aged 65 and over is projected to increase by 11% between 2014 and 2020 (36% from 2014 to 2030).  Numbers of people aged 85-89 will increase by 44% and those aged 90 and over by 133% over the same period. 

Those aged 65 and over predicted to have dementia in 2014 is 1,523 people rising to 2,263 people by 2030. People aged 65 and over predicted to have a moderate or severe learning disability, and hence likely to be in receipt of services in Middlesbrough, is projected to increase from 62 to 83 between 2014 and 2030 (POPPI).  There is no specific, supported housing model for people with dementia in Middlesbrough and residential admissions and admissions to nursing care are projected to increase by 20% and 54% respectively between 2013 and 2017.  It is estimated that 67 units of accommodation will be required by 2016 and 81 units by 2025.

Evidence gathered for the Tees Valley Strategic Housing Market Assessment (TVSHMA 2012) pointed to the need for greater choice and support to live independently with new developments responding to the impact of demographic change and, in particular, providing an increased range of housing and support products for older people.

Housing requirements identified in Middlesbrough, 2012

Housing Options


Want to remain in current home


Alternative social rented accommodation


Considering rented sheltered accommodation


Buying in the open market


Renting extra care housing


Buying extra care housing


Residential care home


Source: Tees Valley Strategic Housing Market Assessment 2012


Older people identified a number of adaptations that were necessary for them to retain independence over the next five years.   Resources for aids and adaptations remain tight, particularly for households in the private sector and alternative sources of funding, for example, equity loans, are included in funding options to finance some works.

Requirements for adaptations in next five years, Middlesbrough

Adaptations Required


Adaptations to bathrooms


Better heating


Handrails – internal and external

10.9 and 5.7

Downstairs wc


More insulation


Double glazing


Adaptations to kitchens


Wheelchair access



The survey also gathered information on the range of help and assistance required by older people in Middlesbrough, with 40.6% needing help to repair and maintain their home, 39.7% for gardening, 30% cleaning, 23.7% other practical tasks and 15% personal care.

Extra Care housing is purpose-built accommodation in which varying amounts of care and support can be offered on-site, and where some services are shared.  Middlesbrough’s Older People’s Housing Strategy identified a shortfall of 184 additional units by 2025/26 as a major weakness in housing and support/care.  Middlesbrough presently has:

  • one purpose-built Extra Care scheme, Pennyman House in North Ormesby, (42 apartments);
  • 65 apartments and 22 bungalows being built in Thorntree by January 2015;
  • a further extra care housing development being considered in Hemlington Grange; and,
  • potential to explore two further 50 place extra care schemes, aiming to divert 15% of projected admissions to residential.

There appears to be a correlation between residential and nursing placements and the availability of extra care housing i.e. less extra care provision, higher dependency upon residential and nursing care placements.  In 2012/13, 1,035 people accessed residential or nursing care equating to 48.36 per 1,000 population (25% above our neighbours).  Middlesbrough has 29 contracted older people’s care homes offering 1,421 residential, nursing and respite beds.

Middlesbrough’s Older People’s Housing Strategy 2007 also identified a requirement for 1773 sheltered units by 2025/26, increasing 2014 provision by 462 units.  A number of sheltered housing schemes could be converted to an extra care model of service delivery with care commissioned on an individual basis. 

The Council has produced a report outlining anticipated increases in older people living in Middlesbrough and the various ways that their future housing and support options could be accommodated. 

Mental health
At 2013, Middlesbrough had 4,927 people with mental health issues (3.6% local population) known to Social Care.  These figures indicate a significantly higher prevalence of mental health disorders and depression than England and are attributed to high risk factors that include long term unemployment, chronic low pay, poor academic attainment, long term physical health conditions and high alcohol use. Middlesbrough has significantly high admissions to residential and nursing care homes for under 65’s with mental health problems (14 admissions equating to 16.3 per 100,000 of population, compared to the England average of 4.7 admissions: 2013/14).  Of the 14, 12 (86%) were subject to Section 117 of the Mental Health Act.  3 people (21%) were placed in homes in another local authority.  Middlesbrough’s rate of care home admissions is increasing year on year with 8 (2011/12) and 11 (2012/13). 

Learning Disbilities
At 2013, Middlesbrough had 828 adults with learning disabilities (aged 18 - 65+) known to Social Care and 186 with complex needs while those aged 0 - 17years were 193 and 25 respectively.  When compared with national figures, Middlesbrough has 10% more children with a learning disability and a higher proportion of those with a severe disability (known to Education services), both nationally and regionally.  There are 282 people known to Social Care with Autism (119 below 18 years and 163 aged 18 years and above).  In terms of autism spectrum condition, it is estimated that there may be as many as 1,210 people living in the Middlesbrough area.  Middlesbrough has 48 properties that offer supported accommodation and one autism specific facility for three people is available.  There has been reliance on out of area placements to support clients into appropriate accommodation.

Housing need, affordable housing and private rented accommodation
In Middlesbrough, there is an annual affordable housing requirement of 189 homes (Tees Valley Strategic Housing Market Assessment) (TV SHMA 2012).  Council Tax records indicated there were approximately 2,500 empty homes in Middlesbrough (June 2014), of which 800 had been empty for over 6 months.  The biggest proportion is in the private sector, where over 650 homes were long-term empties.

Fuel poverty
Stock condition data for Middlesbrough shows that 5,400 dwellings pose a hazard to health due to poor thermal comfort.  The problem of fuel poverty is most severe in the private sector in the town’s older housing area, as shown on the map below.  In Middlesbrough the problem is compounded by the proportion of private sector dwellings located in some of the most deprived wards, including Gresham and Middlehaven.  These are of solid wall construction, and, therefore, classed as “hard to treat” properties. In Middlesbrough 1,880 dwellings have a SAP rating of less than 30 (Private Sector Stock Condition Survey, 2008). A SAP of less than 30 is considered unacceptably low and represents a difficult and expensive dwelling to heat.  There are 5,650 dwellings with a SAP of less than 35. The Home Energy Conservation Act (HECA) 1995 has a SAP target of 65 for all dwellings.

The Government has published data on fuel poverty at sub regional level at both low income/high cost indicator and 10% definition.  The most recent figures were published in June 2014 and give fuel poverty levels at 2012, reporting by local authority area.   Middlesbrough had an estimated 8,457 fuel poor households (low income/high cost), which is 15.1% of total estimated number of households (56,144).  Using the previously used 10% indicator, the estimated number of fuel poor in Middlesbrough is 11,003, or 19.6%.

Fuel poverty in Middlesbrough, 2012

The data also provides fuel poverty levels at Lower Super Output Area (LSOA).  The top 10 LSOAs with the highest levels of fuel poverty in Middlesbrough are:

Households in fuel poverty, ten Middlesbrough LSOAs with highest rates, 2012

Lower Super Output Area (LSOA)


Household in fuel poverty (%) Low income High cost

Household in fuel poverty (%) 10% indicator









































Source: DECC sub-regional fuel poverty statistics


Poor thermal comfort can pose a hazard to health and, for older people (65 +), it can contribute to excess winter deaths.  Annual figures can vary according to the extreme winter weather experienced in any one year.

Excess winter mortality, Middlesbrough, 2010/11 to 2013/14











North East










Source: Office for National Statistics



Last updated: 14/12/15

5. What services are currently provided?

Middlesbrough’s Homelessness and Housing Advice service in Middlesbrough is provided by Erimus Housing and partners, both statutory and voluntary.  Frequently asked questions on homelessness can be accessed on the Council’s website.   Examples of support provided are Sanctuary scheme, Social Lettings Agency (Rent Bond Guarantee scheme), Emergency Crash Pad Accommodation for young people and the Homeless Prevention Fund.

A range of supported housing and housing related support services for vulnerable people are available from Middlesbrough Council.
To look at options to accessing affordable housing are available from Compass

Middlesbrough Council Staying Put Agency (SPA)
The SPA provides support for older, vulnerable people and anyone person with a physical disability, offering financial assistance to make adaptations to the home that allows them to live more independently .  SPA services concentrate on supporting hospital discharge, re-ablement and rehabilitation, minimise premature or avoidable dependence on long-term care in an institutional setting, or those most isolated in the communities. SPA provides advice and assistance on repairs, improvements, energy efficiency measures and adaptations to the home, and information on financial assistance, offering practical help to investigate other sources of funding.  SPA provides a comprehensive hand-holding service through the complex Disabled Facility Grant (DFG) process and supervision for private works for home owners to prevent them being the victim of cowboy builders.  SPA core services include:

  • Disabled Facility Grant Programme – a mandatory grant that funds suitable adaptations for owners and tenants to enable them to stay in their homes and improves living conditions. Services are delivered within the local authority framework, aiming to ensure effective delivery to different/under-represented groups.  The Agency can access specialist assistance for working with clients with complex needs.
  • Telecare - encompasses a full range of sensors and other equipment that help to keep people safe in all parts of their home, allowing them to call for help and assistance when needed, or triggering an alarm. The Service is offered at no charge for up to six weeks following discharge from hospital and through intermediate care.
  • Middlesbrough Mobile Adapt and Mend Scheme (MMAMS) – the Agency’s Handyperson services centre on home repairs, adaptations, gardening services, installation of telecare monitoring equipment and the provision of further assessment, advice and guidance. The service predominantly supports older/ vulnerable people and people with disabilities.

The SPA ancillary services include:

  • Housing Options project – in-depth casework providing tailored advice to support client choice;
  • Loans – working with housing, partners and local businesses to develop packages of financial assistance for vulnerable clients;
  • Safely Home Scheme – hospital discharge service;
  • Comfy & Cosy – funding secured locally due to the success of WHHPF to aid in the purchase of fleeces, shoe grippers, carbon monoxide monitors and grit;
  • Older People’s Recycling – One Planet Living partnership and falls prevention;
  • Portable Heaters  - hold a stock of heaters which are offered out on loan;
  • Electrical Safety Council grant – essential minor electrical works;
  • Boiler Breakdown – enables speedy repairs to be carried out; and,
  • Kidz Home Zone / Play Zone – the scheme is to prevent unintentional injury within and around the home and is focussed on children under the age of 5 or a child with a disability.

Regulation of the private rented sector
Environmental Protection provides a service that encompasses inspection of private homes to ensure their compliance with statutory minimum standards and advice on any necessary works, for example, investigation of complaints about housing conditions and safety in privately rented accommodation and mandatory licensing of houses in multiple occupation.

There is provision for a Selective Licensing Scheme, which will be introduced in a phased approach across eligible town centre areas, playing a key role in improving standards in the private rented sector. The scheme will be part of an overall approach to early help services and intervention.  The scheme is intended to improve the overall management of the sector, encouraging stable and responsible tenancies while working closely with other agencies in a neighbourhood approach.  It will tackle basic issues around health and well-being and poor conditions.
Empty domestic dwellings (brought back into use) - Empty properties can be an eyesore and create a negative impact upon the local environment. The Council has a long-term commitment to bring properties back into use, thus adding new housing supply, creating affordable housing that meets decent homes standard, improving the appearance of neighbourhoods and contributing to the reduction of vandalism and anti-social behaviour.  (Middlesbrough’s Empty Homes plan).

Illegal eviction and harassment issues are managed by the Community Protection Service, who has a responsibility to ensure that tenants are not illegally evicted or harassed by their landlords. Ensuring landlords act responsibly and within the law protects the most vulnerable tenants.

Private sector leasing is managed by Endeavour Housing. Private sector properties are leased to the scheme manager for a prescribed period and these are then used to house homeless households.  Erimus Housing also has a small number of units.
Rent/Bond Guarantee Scheme is delivered by Erimus Housing on behalf of the Council. The scheme assists households threatened with homelessness to access private rented accommodation. Voluntary sector organisations (DISC and Hope North East) also deliver rent bond schemes aimed at specific groups, namely offenders and single homeless people.

Tenant Referencing Scheme enables individuals and families to access good quality private rented sector and social housing that they might not generally be offered, due to previous rent arrears or problems. To help maintain a positive tenancy, both peers and professional staff offer each client a package of support.

Services which support independent living
Connect provides a connect unit and emergency pendent linked to a 24 hour Contact Centre providing an emergency response.

Telecare (see Staying Put Agency) provides a service to people, who meet the Fair Access to Care (FACS) criteria and would be referred via a Social Worker, or Occupational Therapist.

Both of the above services (depending on assessment criteria) are offered at no charge for up to six weeks following discharge from hospital and through intermediate care.

Integrated Falls Team focuses on providing help to those at risk of falls.  It continues to develop appropriate services, including health promotion; an education and training strategy; appropriate exercise intervention; and liaison with Telecare and Carelink.

Occupational Therapy (OT) Team assesses individual clients for a range of equipment, minor and major adaptations within the SPA.  It has introduced self-assessment for minor equipment and adaptations, which does not need another referral to the OT team and can be carried out whilst similar work is being carried out at the property.

Intermediate Care Service provides a range of complementary and interlinked health and social care services that support the client in their home setting, or help them to move back home after a period in hospital, or a residential setting.  The service has a number of teams within its area, including Residential Rehabilitation Team, Mobile Rehabilitation Team, Re-ablement Team and Rapid Response Team, whose aims are to prevent hospital admission, expedite hospital discharge and prevent admission to long-term residential care.  The teams refer clients to the SPA, who offer additional support services, aids and adaptations to help clients remain in their home.

Independent Living Centre is the result of a partnership between Middlesbrough Council Department of Social Care and the NHS.  The Centre provides occupational therapy assessment, information, equipment demonstrations and help with disability issues to all.  Only residents living in Middlesbrough, or Redcar and Cleveland can access equipment; no referral is required and self-assessment is accepted.

Affordable Warmth 
In 31st March 2013, all local authorities were required to publish a Home Energy Conservation Act (HECA) Report with progress update reports at two yearly intervals.  The report contains Middlesbrough’s plan to identify and target the most vulnerable households and assist those in need of help to improve the thermal comfort of the home for all members of the household, prevent illness and excess winter deaths and reduce hospital admissions.  The 2014/15 Stay Safe and Warm initiative (Fire Service) aims to prevent accidental fires fatalities, injuries and health issues resulting in cold conditions.  Present Steering Group members represent Middlesbrough Environment City (MEC), Tadea, Fire Service, CDV/RSVP, SPA, Five Lamps, Thirteen and Accent.


Last updated: 14/12/15

6. What is the projected level of need?

The following factors point to the increasing likelihood of adverse effects on the groups at risk highlighted in Section 3 and increasing levels of need in the areas covered in Section 4.

  • The growth in single person households together with continuing affordability issues and indications that many view the private rented sector as longer-term housing option is likely to result in growing demand and pressure on the stock.
  • In 2013/14, 1503 household, made enquiries to resolve their situation and, of those, 138 were from non-priority homeless households (Homeless Database Monitoring Reports).  
  • The number of people over 65 years will increase by 9,600 by 2032 while over 85 years will double to 5,200 at the same year (Tees Valley Unlimited).  This will create a huge challenge in adapting housing stock to cater for this client group.
  • It is predicted that the rate of mental health problems in under 65’s will remain fairly stable because the population rates will remain fairly stable.   Therefore, demand for mental health services should remain largely unchanged.
  • For the 18-64 age group, the numbers with moderate or sever learning disabilities will remain steady, i.e. 471 in 2020 and 465 in 2030 while for 65 years and over, there will be an increase of 68 (10%) from 2014 to 2020 and 83 (34%) by 2030 (POPPI, 2013).  Middlesbrough Council Social Care and will support a policy of bringing people home from out of area placements and work towards preventing those placements in the future.  This will require the development of housing and accommodation with support to live independently for specific age groups, e.g. independent living/shared houses and housing with extra care.
  • Middlesbrough has been receiving increased numbers of asylum seekers, far in excess of agreed cluster numbers.  Middlesbrough’s population is approximately 138,000 and, with a quota of 982, is presently 142% over the prescribed cluster limit.  Along with the increase from economic migrants moving into the older housing areas where rents are cheaper, this has placed a greater demand for private rented properties and local services in those areas.
  • The demand for the services of the Housing Protection Team has increased over each of the last five years. Some landlords operate outside the regulatory framework, often out of ignorance rather than intention, and it is important that such landlords are educated about their responsibilities to ensure that decent housing standards are met. However, there are also some unscrupulous landlords who give others a bad name and it is important that appropriate action is taken.
  • Middlesbrough has a higher rate of child poverty than national average: 34% (2011) risen to 37% (2012) compared to UK 21% in 2011 and 20.2% in 2012 (below poverty line before housing costs) (Barnardos, 2012).
  • Unemployment for Middlesbrough is 12.9% compared to 9.8% (North East) and 7.2% (UK) for 2013/14.  (ONS local authority North East HI01)
  • Regionally, the impact of public sector cuts coupled with a stagnating growth in private sector employment impinges on householders’ ability to improve their income.
  • The wide range of welfare reforms is known to affect over 5,000 households in Middlesbrough, resulting in an average weekly income loss of £8.40 per household, and particularly affecting single homeless people.  Middlesbrough’s Welfare Rights Unit assisted 1,302 clients in 2012/13 and a further 1,726 in 2013/14 with debt issues.  In Revenue and Benefits, the number of customers seen for revenue queries was 7,935 (2012/13) and 10,025 (2013/14) and for Benefits, 34,056 and 33,407 respectively.
  • Massive reduction in available funding for affordable housing. Middlesbrough has an annual requirement of 189 homes (TV SHMA 2012).


Last updated: 14/12/15

7. What needs might be unmet?

Homelessness and other vulnerable groups – emergency and medium term accommodation and associated support services for chronically excluded adults, young people with intensive support needs and access to health care at point of contact in supported accommodation facilities.

Unsuitable homes - in particular those which fail to meet the needs of older people and people with physical disabilities.  Projected demand for disabled facilities grants far outstrips available resources and there is a projected £600,000 shortfall in 2013/14.

Housing requirements of older people, those with disabilities and those who are otherwise vulnerable – although the additional Extra Care housing being built in Thorntree will provide 87 units, it does not meet the shortfall identified for this client group.  The numbers of older people with dementia are rising from 1,523 (2014) to 2,263 (2030) presenting an increasing need for specialist housing and support.  The reduction in public funding for affordable homes will impact on the ability to deliver specialist housing.

In 2013/14, 75 people (18 – 64 years) were living in supported housing specifically for those with mental health problems and, approximately, 154 people were receiving commissioned support to maintain independence at home.  Middlesbrough has reported significantly low numbers of people in contact with secondary mental health services in settled accommodation (ranking 142nd out of 149).  The needs of those struggling to live independently might not have been identified and factored in to future funding requirements.

Housing for people with learning disabilities should be fit for purpose allowing people to live independently with appropriate support.  Housing with extra care, similar to the type offered to older people, offers the support required for an increasing number of older people with learning disabilities that need supported housing.

The Council’s Private Sector Stock Condition Survey (2008) found that:

  • 38.7% of homes within the private rented sector (PRS) in Middlesbrough are deemed to be non-decent dwellings.
  • 35.7% of dwellings within PRS have category 1 or 2 hazards within premises.
  • 41.2% of dwellings are in need of some repair.
  • 49.4% of dwellings in PRS have a poor degree of thermal comfort.

Disrepair is an issue for many economically disadvantaged and vulnerable owner-occupiers living in older, more run down properties, unable to afford to repair/refurbish their homes. Those private rented sector properties in disrepair will need to be improved to meet Decent Homes Standard.  An effective regulation and enforcement regime is required to ensure that all housing in the private rented sector meets legal requirements. Selective Licensing will provide a mechanism to engage in proactive inspection and enforcement activities to attend to disrepair issues for those who are most vulnerable.

Access to the required number of affordable housing units across all neighbourhoods, at current annual build rates and given public spending cuts, would not be achievable to meet demand.  Affordable and decent homes will be at a premium as demand rises.  The costs will increase putting private rented properties beyond the reach of the some of the more vulnerable groups. However, this is set in the context of some significant vacancies and lack of demand linked to popularity of stock/areas, or Welfare Reform implications.

Fuel poverty can only be addressed by a combination of improving economic circumstances, lower fuel prices and improvements to the energy efficiency of the worst affected homes.  Registered Providers have invested in appropriate energy efficiency measures, such as, external/cavity wall insulation, with approximately 1,500 properties benefitting from external wall insulation and many more receiving loft/cavity insulation and new boilers.  However, there are approximately 6,500 private sector properties still needing works.  Costs to complete the works are high and those living in the worst affected homes are often on low incomes, or are vulnerable, and unable to fund the works without assistance.  Early schemes were fully funded but recent changes to Government initiatives have reduced the financial incentives and made it unaffordable to many households.  This emphasises the need to maximise the potential of energy efficiency funding programmes.


Last updated: 14/12/15

8. What evidence is there for effective intervention?

9. What do people say?

This JSNA topic has been prepared in consultation with a range of stakeholders, including:

  • Middlebrough Housing Forum
  • The Tees Valley Strategic Housing Market Assessment has also informed the Housing topic.  It is a major research study, which will help shape future planning and housing policies; provides an up-to-date analysis of the social, economic, housing and demographic situation across Middlesbrough and the Tees Valley and includes a major household survey and interviews with stakeholders.
  • a recent community survey has identified problems associated with poorly managed, private rented sector, concentrated anti-social behaviour and street condition, including level of crime and, for some older people, social isolation.  A community based response has been identified that will draw in cross service resources over an eighteen month period, to include licensing, proactive inspections, addressing housing standards and experiencing greater enforcement and incentives to deal with the overall deterioration of the housing and the surrounding environment.


Last updated: 14/12/15

10. What additional needs assessment is required?

  • Street and Health audit of the homeless population and specific health facility for homeless people.
  • To map the existing resources for addressing the needs of households in private rented housing and to explore cost-effective interventions for improving health and lifestyle.
  • Housing stock condition survey update.
  • Regular strategic housing market assessment including household survey.


Last updated: 14/12/15

Key Contact

Name: Lynda Harrington

Job title: Senior Housing Needs and Enabling Officer

e-mail:  Lynda_Harrington@middlesbrough.gov.uk

Phone number:   01642 729153


Local strategies and plans

Tees Valley Unlimited (2012). Tees Valley 2012 Strategic Housing Market Assessment.

University of Salford (2009). Tees Valley Gypsy and Traveller Accommodation Needs Assessment.

Middlesbrough Council (2014), Preventing Homelessness Strategy


National strategies and plans

Department for Communities and Local Government (DCLG, 2011). Planning Policy Statement 3.

Department for Communities and Local Government (DCLG, 2010). Local decisions: a fairer future for social housing.

Department for Communities and Local Government (DCLG, 2009) The English Housing Condition Survey – Housing Stock Report 2009

Department for Communities and Local Government (DCLG, 2008) Lifetime Homes, Lifetime Neighbourhoods – A National Strategy for Housing in an Ageing Society

Department of Energy and Climate Change (2008). The UK Fuel Poverty Strategy: 6th annual progress report.

Department of Health (2011). Cold weather plan for England.

HM Government (2011). Localism Act 2011.

HM Government (2008). The Housing and Regeneration Act 2008

HM Government (2004). The Housing Act 2004

HM Government (2002). Homelessness Act 2002


Other references with dates

Cambridge Centre for Housing and Planning Research for Shelter, (2010) Housing benefit changes and their effects on the private rented sector.

Care Services Improvement Partnership (CSIP, 2008a). The Extra Care Housing Toolkit.

Care Services Improvement Partnership (CSIP, 2008b) Commissioning housing support for health and wellbeing.

Chartered Institute of Environmental Health (2008) Good housing leads to good health.

County Durham and Tees Valley Public Health Network (2006). Cold kills.

Crisis (2011). The Hidden Truth About Homelessness.

Department of Energy and Climate Change (DECC, 2012a). Annual report on fuel poverty statistics 2012.

Department of Energy and Climate Change (DECC, 2012b). Fuel poverty sub-regional statistics 2010.

Department of Health (2010). Healthcare for Single Homeless People.

Food Standards Agency (2007). Homelessness and food poverty.

Housing Learning and Improvement Network (2011). Living Well and Home Inquiry.

Institute for Fiscal Studies (2011). Children and working age poverty from 2010-2020.

Institute for Health Equity (2011). The Health Impacts of Cold Homes and Fuel Poverty.

Joseph Rowntree Trust (2011) Tackling homelessness and exclusion: understanding complex lives.

National Centre for Social Research (2008). The Dynamics of Bad Housing: the impact of bad housing on the living standard of children.

National Housing Federation (2011). News article (login required)

Northern Housing Consortium (2011). A foot in the door: a guide to engaging housing and health.

Office for National Statistics (ONS, 2011). Measuring unmet needs for social care amongst older people. (in Population Trends, No. 145)

Shelter (2011). Improving outcomes for children and young people in housing need: A benchmarking guide for joint working between services.

Shelter (2006a). Chance of a Lifetime.

Shelter (2006b). Against the odds.

West Midlands Public Health Observatory (WMPHO, 2011). Excess Winter Deaths in England Atlas.

World Health Organisation Health Evidence Network (2004). What are the main risk factors for falls amongst older people and what are the most effective interventions to prevent these falls?