Transcript Retirement communities and extra care housing

Retirement communities and
extra care housing
Centre for Housing Policy
University of York
CHP: Recent and ongoing and
research
• Evaluation of Hartrigg Oaks
• Comparative evaluation of different
models of housing with care – emerging
findings
• Systematic review of the effectiveness
of assistive technologies in assisting
people with dementia remain in their
own homes
Hartrigg Oaks: the concept
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CCRC
Independence
Attractive living environment
Community and social activities
Care and support
Insurance based model – fit and frail
Home for life
Hartrigg Oaks: development
• Many years in development
• Used 21acres greenfield site on edge of
York, already owned by the JRHT
• 152 bungalows clustered around a
central complex housing registered care
home, and other amenities
• Development cost of £18M
Hartrigg Oaks
• Bungalows – spacious, designed to life time
homes standards
• Layout and design creates sense of own
space, just like a housing estate
• Central location, not within walking distance
of shops and services for some residents, but
within 1-2 miles of key services
• Residents: average age 78; women
outnumbered men by ration 2:1; one third
living with partner, two thirds living alone
Fee structure
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Two fees
Residence fee
– Fully refundable that is repaid without interest to estate
– Non refundable (smaller)
– Annualised (‘rent’)
Community fee
– Standard (£5,000 approx, single; £9000 approx couples) which will
not increase, regardless of care service use
– Reduced (as standard, but lower, in return for bigger residence fee)
– Fee for care (not part of the insurance pool) pay for care services
as you use them – appeals to some younger residents
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Not cheap
Care and support
• Services to bungalows
- low level domestic support
- home care (equivalent to those provided
by social services)
• On site care home provides permanent
places when residents can no longer live
independently
• Also provides short term care and respite
What made Hartrigg Oaks
attractive: residents’ views
• Very attractive to older people with the
financial means to live there
• Combination of independence and security
• Many people fully independent but
anticipating future needs
• By moving to HO were retaining control of
future
• Not burdening families with responsibilities
Not just care and support….
• Environment in which might live wholly
independently for a decade of more
• Quality of accommodation
• Location
• Social activities
• Fees – value for money
• The Rowntree name
Meeting expectations?
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Half the residents “very satisfied”
About one third “quite satisfied”
About 10% neutral
About 1% dissatisfied (rising to 5% in
second survey)
Good things about Hartrigg
Oaks
Independence
86
Privacy
92
Help close by
92
Company
62
Social life
42
Amenities
79
Safe
70
Stimulating
42
Good care staff
63
No pressure to take
77
Residents have say
57
Like minded people
59
Differing needs mix
57
Meets frail needs
68
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% of bungalow residents
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Findings
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High levels of satisfaction
Concerns about social isolation of the frail
Issues about resident empowerment
Dementia care
Managing expectations
Dynamic nature of Hartrigg Oaks
Concerns about affordability
Comparative evaluation of different
models of housing with care
• Began in 2003/4, will finish 2006
• Comparing eight different housing with
care schemes:
– Two RSL schemes
– 1 private sector (Retirement Security Ltd)
– 5 Charitable Trusts (including Hartrigg
Oaks, Abbeyfield Integrated Care)
• Literature review of empirical studies
Literature Review: findings (1)
• Much speculation and great
expectations about the role of housing
with care, but less evidence of what it
can achieve
• 11 recent empirical studies of housing
with care schemes in the UK
Literature Review: findings (2)
• High levels of satisfaction of residents:
related to independence and security
• Home for life?
• Cost effective?
• Fit and frail?
• Reduce social isolation?
• Dementia care?
Evaluation: emerging findings
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High levels of satisfaction across the board
Scale
Location
Community formation
Accommodation
Build in capacity to change
Home for life
Conclusions
• Housing with care is a positive choice
for many older people
• Housing need as well as care need
• Diversity of provision
• Information sharing