Is Delivering Healthy Homes More Of A Cultural Change Than A Technical Challenge

If we have the technical knowledge to deliver healthy homes, what is stopping us? Is this more of a cultural challenge that requires an organisational mind shift

Some of the solutions and knowledge needed to deliver a healthy home already exist and have been demonstrated to work. What is harder to shift is how organisations think about and prioritise health.

This is influenced by several factors. The financial headroom to invest, the quality of data the organisation holds, the governance culture and the ability of the organisation to deploy solutions at pace and scale.

The sector has access to the knowledge to deliver healthier homes. The challenge comes from creating the right conditions around finance, culture and organisational ability to ensure this knowledge is used everywhere, and for everyone.

Why does it pay to move from reactive responses to proactive prevention?

Reactive models respond once a resident has already reported an issue - damp, mould or a repair by which point the health impact may already be under way.

Proactive prevention through using stock condition data and early intervention helps to catch problems before they affect a resident's health or escalates into costly disrepair claims. Prevention can be viewed as being cheaper than cure.

The financial case is well evidenced. The human case for avoiding harm and ill health rather than remedying it becomes a strong moral argument for making the shift. It is important we consider both.

What leadership thinking needs to change to become a proactive provider of healthy homes?

For any change to succeed it requires strong leadership to guide, and a strong culture forged on trust in an organisation to implement.

In this respect, leadership needs to treat health as a strategic outcome, not an operational risk to manage. This means setting organisational targets for health impact alongside targets for repairs and compliance and giving teams a shared health objective to achieve. It should become the overriding strategic objective of the organisation.

This ties into what for many is the purpose of social housing, to provide healthy, safe and dignified homes to people who need it.

It is also a question of mindset because the technical capability to be a proactive provider of healthier homes does exist.

Is there a skills challenge to overcome in moving from reactive to proactive providers?

Yes. This shift will require broader workforce development, investment in systems and a commitment to continuous learning.

Frontline and asset teams are highly skilled at diagnosing and fixing problems once they are identified, but proactive working requires a different approach. It involves reading and understanding data to spot risk before it materialises. It demands confident conversations with residents about health rather than just repairs.

These are learnable skills, but it can take time and money to get there.

The skills gap is not just a technical qualifications challenge. It is also about behaviours, attitudes and systemic capability across a whole workforce, from top to bottom.

It is also about managing a change programme, and a different way of thinking and delivering.

Is this fundamentally a question of breaking down silo approaches from housing providers? Can placing health at the centre of every lens build a collective approach and outcome?

Siloed working is a barrier to progress. Damp and mould, retrofit and resident engagement are often run as separate workstreams with separate data, even though they help shape the same outcome for the same household.

Finding a common strategic denominator could be the answer. Placing health at the centre of all outcomes does not mean creating another department, it creates that strategic goal. It means using it as the shared lens that connects the existing ones, so decisions in one area account for their effect in another.

Silos when they are internal and systemic can be damaging and costly. But the reason to break them down should not be focused solely on creating greater operational efficiency. Rather it is because a resident’s health cannot be managed by a single team, a single visit or indeed a single organisation. It requires collaboration and partnership working.

Does the resident need to be more involved in the co-design of health solutions? Are we providing the homes that residents want today, or are we still answering questions from years back?

A vast majority of social housing stock was built in a different time to meet different challenges. The population that lives in social housing today has more complex and more health-related needs than the stock was originally built for.

Many current standards and specifications were set some years ago, often in response to problems that have since evolved. It is one of those ongoing challenges, legislation tends to address something that has happened and we must be prepared for what might come next.

Residents' expectations, and the way they use their homes has moved on, not least from the pandemic with the home becoming a place of work for many as well. Involving residents in co-design helps housing providers to understand what is really happening in a home, not what a specification assumed would happen. It is in this gap where health risks often sit.

The resident should not be simply seen as the end recipient of healthier homes. They are in fact the most important source of knowledge of how a home is performing, because they are living with the consequences. Therefore, they have an invaluable view of what a healthier home should look like, to respond to their circumstances today.

We ignore their voice at our peril.

Do we listen to residents enough?

Listening is the most underrated communications skill.

Many formal engagement processes exist across the sector, but the everyday feedback residents give, through repair calls, complaints or casual comment, often is not captured in a way that reaches the ultimate decision-makers.

Listening well means treating that information as core data, not just anecdotal feedback. It is invaluable and should be used in how homes are designed and maintained.

There is also a challenge here. You have to actually want to hear what a resident has to say. And once you have listened it is important to make sure something is done about what has been shared.

Why does culture determine the deployment of technical solutions, and how can we encourage prioritisation of health outcomes?

The technology to build healthier homes exists. Data capability to find the most-at-risk residents exists. There is evidence for what already works.

What is needed from leadership is the organisational will to use all of these components to ensure a better outcome for the residents that live in these homes and the ability of the home to adapt with its residents, and to their needs.

This becomes a cultural choice.

How do we enable greater collaboration on sharing learnings and health outcomes from housing interventions and upgrade programmes?

Individual housing providers are running valuable retrofit and intervention programmes, but the learning from them is rarely shared beyond the organisation that ran it.

Efforts are being made to improve this, but it is a long journey. And it can be again linked into the culture of organisations.

A collective approach, through shared data standards, common outcome measures and forums for comparing results, would allow the sector to learn faster than any provider can alone, and avoid different organisations solving the same problem in isolation.

We need to start solving problems once, together, and then all build on what is proven to work.

Why should improved health be the driving focus of housing providers?

Many would argue it is a question of responsibility and is a core reason why social housing was created.

Housing providers are already responsible for the physical home residents live in every day, and the condition of that home will have a direct and measurable effect on health outcomes.

For many residents their health needs are shaped by the housing they live within. Therefore, making health the driving focus does not add a new responsibility to a housing provider instead it makes explicit an effect that already exists.

It also gives providers a clearer basis for prioritising investment, those interventions with the greatest health benefit.

By Daniel Little, Sales Director, Aico.

Image credit: Aico