Housing innovation could benefit older people and the taxpayer
An independent evaluation of 19 extra care housing schemes has concluded that this innovative form of supported housing could improve older people's health and wellbeing and offer them improved choice and independence. It provides a potential viable alternative to residential care for some older people and can help reduce emergency hospital admissions - producing savings for both the NHS and social care services.
The evaluation, jointly published by the Housing Learning & Improvement Network (Housing LIN) and the University of Kent's Personal Social Services Research Unit (PSSRU), studied the impact of the Department of Health's £227m Extra Care Housing Fund.
Local authorities bid for money from the fund to kick start extra care housing schemes in their area. Between 2004 and 2010 it helped produce more than 5,000 units of accommodation - the single largest investment in specialist housing for older people in England.
The evaluation and associated research concluded:
- Death rates within 30 months of moving in were lower than they are for those moving into residential care
- Extra care housing can be cost-effective compared to care homes for some older people - it has slightly lower costs (for accommodation, living and social care) while residents have higher levels of physical and mental functioning
- The improved physical and mental health is likely to have helped reduce demand for health services - including costly emergency admissions - and delayed or prevented entry into residential care
- Residents reported enjoying a good social life and were happy with the independence, security and sense of community provided in their new homes.
Meanwhile, the Housing LIN, supported by the Association of Directors of Adult Social Services (ADASS), has published a resource pack to help councils and their partners - such as housing associations, NHS organisations and developers - deliver extra care housing and other accommodation options for older people in their area.
The pack, Strategic Housing for Older People: planning, designing and delivering housing older people want (SHOP) covers areas such as:
- The policy context
- Demand for and supply of supported and specialist housing
- How local authorities can encourage developers and investors by producing a market position statement
- The need to deliver housing that older people actually want to live in through an emphasis on design and quality.
It includes practical tools or resources to help local authorities, health organisations, providers, funders and developers. These tools cover everything from developing an accommodation strategy to planning issues and marketing individual new specialist housing schemes.
Extra care housing comes in a variety of models but it centres on self-contained flats owned or rented by people whose care needs are met round-the-clock through flexible care and support packages which can be adapted as the individual's needs change. The flats are intended to promote independence but they are normally sited within a scheme also offering communal facilities - including gardens and a café. Many schemes place an emphasis on quality design and include a mix of owner-occupier, shared ownership and rented flats.
New commissioning systems in the NHS and the arrival of health and wellbeing boards based in councils give local authorities and the NHS the opportunity to transform housing with care for older people.
Lord Best, Chair of the All Party Parliamentary Group on Housing and Care for Older People, said:
"This report highlights the value of extra care housing and shows how it can offer many older people a home for life with support available in response to their changing needs.
"But it comes at a difficult time for the development of this form of accommodation: housing associations are much constrained by shortages of grant funding and private developers are hamstrung by the problems facing older people who need to sell their homes before going into new forms of retirement accommodation.
"However while further growth may be very slow, this evaluation adds significantly to research showing that extra care housing has benefits not only for residents but for the public purse."
Jeremy Porteus, Director of the Housing LIN, called on local authorities, the NHS and their partners to use the reports published today to turn the promise of better lives for older people into reality. He said:
"Older people have retired from work - not from the world. Care and support should be shaped around people's lifestyles and housing choices - not the other way round.
"As the recent Dilnot report into long term care highlighted, we have to re-think how we plan and fund our old age and housing is a vital dimension of that.
"Now it is up to local authorities to learn from what others have done, develop realistic and comprehensive housing with care strategies and work with partners to provide housing that older people actually want to live in. The resource manual published today will help them do just that."
He added that in today's difficult financial climate local authorities should provide a particular lead in establishing partnerships and building the confidence to secure capital funding.
ADASS President Peter Hay said:
"Social care is focussed on helping people make choices around their care and support that suit their own wishes and circumstances. Where a person lives is one of the most personal choices they can make.
"We should be working with partners in health, housing and the voluntary and private sectors to ensure that a person's care needs no longer define their choice of accommodation, robbing them of their independence and frustrating their wish to enjoy their later years to the full."