The Retirement Village and Extra Care Housing in England: Operators’ Experience during the COVID-19 Pandemic - RE-COV Study

Ground-breaking research into the impact of COVID-19 last year on retirement villages and extra care housing, undertaken by St Monica Trust in partnership with the Housing LIN and funded by the Dunhill Medical Trust, highlights how housing-with-care sector’s response to coronavirus pandemic benefitted residents.

The RE-COV Study report’s findings make essential reading on how the sector mobilised quickly to respond to COVID-19 related deaths in their schemes last year, especially when much of the spotlight was on the crisis in care homes at that time.

Launched at the Housing LIN’s HAPPI Hour webinar on 29 April 2021, the RE-COV Study reveals:

• The overall lower than expected proportion of RE-COV survey participants’ residents who died from COVID-19 in comparison to people with the same age profile living in the general population in England.
• The positive effects of the lengths that operators and staff took to help support residents’ activities of daily living, social engagement, community and personal activities.

Some of the measures adopted in Retirement Village and Extra Care Housing that operators felt were the most effective in protecting their residents and staff during the pandemic were found to be:

• Closing communal facilities, suspending activities or restricting residents’ access to areas.
• The issuing of full Personal Protective Equipment and its correct use.
• Restricting and closing Retirement Villages and Extra Care Housing to visitors and family when necessary.
• Regular and increased cleaning.
• The design and external and internal layout of schemes, plus the self-contained nature of individual apartments, enabled residents to isolate and keep their distance

Principal researcher on the RE-COV project , St Monica Trust’s Rachael Dutton said:

“In order to keep their residents physically, mentally and emotionally well, operators and staff demonstrated great commitment, ingenuity and resourcefulness. As well as offering constant COVID-19-related guidance and support, they provided an extensive amount of additional help, facilities and resources. Such activities and support would have helped to alleviate some of the negative effects of the pandemic, which older people in the general community also were experiencing, such as loneliness, worry and boredom.”

The study highlighted the favourable experience of many residents living in Retirement Villages and Extra Care Housing during the pandemic. Positive outcomes for residents included high levels of feeling safe, supported, and comforted knowing other people were around, plus enjoyment from organised outdoor activities.

However, the huge strain that the COVID-19 pandemic placed on operators was also acknowledged by all the research participants. These included:

• The financially damaging impact of the pandemic for Retirement Villages and Extra Care Housing Operators, with many of the additional costs and losses are still on-going. The estimated overall losses up to February 2021 for the group of 38 operators who participated in the study was -£12.5 million.
• That operators experienced similar pressures to care homes (such as difficulty accessing PPE and financial support, anxiety, stress, staff burn out, numbers of staff off work self-isolating or shielding) but received less guidance and support.
• The low visibility of the sector, with more than half of operators saying they had encountered issues due to local health and social services not fully understanding what retirement villages and extra care housing offer, or how they operate.
• Lack of consideration and support from central government including no guidance specific to housing-with-care until very late on and barely any testing available for staff until November and December 2020.
• Managing the balance of risk and independence to strike a balance between maintaining the individual rights and freedoms of residents, whilst maximising the safety of those living and working in the village and scheme communities.

The Housing LIN, Jeremy Porteus, said:

“With much of the national and trade media reporting on the crisis in care homes last year during the coronavirus pandemic, these important findings show how the retirement village and extra care housing sector mobilised quickly to introduce measures to protect lives. The evidence from the RE-COV research is clear, the sector's immediate actions to counter the rapid spread of COVID-19 safeguarded the lives of many thousands of older residents and the lives of frontline staff. The results reveal that, even without universal access to emergency government funding and faced with significant challenges in obtaining PPE, operators’ finances were put under considerable strain but they were still able to limit the spread of infection, significantly reducing the risk of COVID-19 related deaths in their schemes.”

The recommendations made in the study as to how some of the major challenges and difficulties faced by operators could be overcome included:

• A shared awareness and understanding of the housing-with-care model (including a widely publicised and consistently used legal definition), which reflects its important role in the broader care sector and the extent of the frailty, health and care needs they provide for.
• The inclusion of the housing-with-care sector in all relevant policy and guidance.
• Government rules and guidance being developed in consultation with experts, communicated clearly and consistently, with realistic and practical notice periods to implement them.
• The provision of better access to funding to support large financial deficits incurred by Retirement Villages and Extra Care Housing due to the pandemic as well as consistent processes for funding across local authorities.
• Flexibility built into contracts for commissioned services so that they cover essential costs of additional staffing, if need arises.

CEO of the Dunhill Medical Trust, Susan Kay concluded:

“We’re really pleased to have been able to support this work. It’s vital that organisations have the opportunity to share their experiences and successes – as well as the challenges – so that systemic improvements can be made in the future.”

Update:

On 1 July 2021 there was a Westminster Hall Debate with Parliamentarians on the COVID-19 pandemic experience of retirement communities. A House of Commons Library Briefing Paper (see below) drew attention to the RE-COV study.