Extra care housing is often promoted as a break through model in the delivery of housing with care for older people. It offers a practical alternative to residential care, allowing older people to retain independence and control, with support and flexible personal care. Typically residents have a self- contained flat, access to communal facilities, with some meals provided. These core features are required as a condition of funding, although defining extra care isn’t clear cut.
I’ve just attended the excellent Institute of Housing annual extra care conference in Nottingham, which explored the prospects for extra care. The topics discussed included cuts to Supporting People budgets, welfare benefit reform, possible future changes to security of tenure, new local planning structures, and the delivery of health and nursing care to schemes. All these issues, and many others, will have an impact on the sector – although no one is certain about what they will be. The conference discussed positive opportunities, as a result of deregulation and localism, but had some apprehension over the instability of revenue funding for retirement housing in both the private and social sector.
My own conclusion is that extra care will increasingly depend on income, where you live and how far your local authority has a joined-up approach to older people’s housing. Pressures on funding will mean it will increasingly cater for the frailest groups, rather than offering balanced communities – an important selling point for many schemes. It may become more difficult to move into rented extra care, unless your costs are covered by welfare benefits. Escalating service charges could exclude many self funders from the sector. Buying an extra care flat will also become more expensive as prices and charges rise. It will still make sense for many older people seeking to transfer the equity in their home rather than pay for residential care. If the Government offers greater practical support to the use of equity to pay for housing with care, the extra care model could thrive.
A key question that struck me during discussion of flexible models of housing with care, is why it is economical to pay for 24 hour care in extra care but not for 24 hour cover in sheltered schemes with a similar or identical resident profile. Will more flexibility in the design of schemes and the levels of care, mean a move away from local authorities taking a blanket approach to existing sheltered scheme? Will they consider each scheme on its own merits and fund 24 hour onsite support where required?
Related to this debate Age UK is helping to promote the Joseph Rowntree Foundation ‘A Better Life’ initiative which aims to improve the lives of older people with high support needs – including those in extra care housing. This work reinforces the principle that policy decisions in this area must be informed by the views and experience of older residents themselves.