Transcript Document
Better care, better life
Keynote 4
Nicky Hodges
Associate - URS
- South West Conference 2014 -
Research on behalf of DCLG
into the provision of housing
for older people
Nicky Hodges, Associate, URS
Housing LIN South & South West Conference
08 October 2014
Outline
Research context, key questions and approach
REA – Benefits and costs of provision
Case study - North Somerset
Older people’s views
Stakeholder views
Overall research findings
Housing requirements
Different types of new housing
Demand for adaptations – and bottlenecks
Demand for specialist housing – and barriers to
supply
Questions
Context of study
Filkin
Report 2013 - Select Committee on
Public Service and Demographic Change
All Party Parliamentary Group on Housing and
Care for Older People
Research commissioned by Housing Minister
Part-funded by Contestable Policy Fund
Parallel DEMOS policy project
Findings presented to Housing and Planning
Minister
Research key questions
What types of specialist / adapted housing
do older people want and need, and what
do they see as the barriers to securing
these?
What is the nature and extent of the gap
between supply of and demand for
different specialist/ adapted housing types
wanted by older people, both now and
projected for the next 20 years?
What is the reason for any under supply of
specific specialist/ adapted housing types
wanted and needed by older people?
Research approach
Rapid Evidence Assessment
Quantitative
research
• Assess robustness of research
studies
• Focus on evidence of demand,
supply, gap, reasons for under Qualitative
supply.
research
National level
• Market
assessment –
current housing
circumstances
of older people
• Model of future
demand set
against supply
• 2 expert focus
groups
• Expert interviews
3 Study Areas
Policy options
development
• Older people focus
groups
• Local stakeholder
interviews
REA Themes
Benefits and costs of ageing in
place / specialist provision
User and customer perspective
Gap between supply and demand
and need
Sub-themes
Information and advice
BME older households
Equity release
Housing and dementia
Under-occupation, overconsumption and mobility
Benefits and costs of new provision
Extra Care v care homes
Improving body of evidence
Extra care provides a cost-effective solution compared to
care homes (PSSRU, 2011)
Extra care delivers better services and an improved quality of
life (various)
But more costly for social care?
Increase in short term costs of care – needs identified
Health costs decrease – proactive, more immediate response
Extra Care v mainstream housing
Little robust evidence on cost-effectiveness
Beneficial health outcomes compared to mainstream
housing (Kneale, 2011)
Benefits and costs of adaptations
Context
Most people want and need to stay put
Incomplete evidence
Provision of services not as good as it could be
Benefits to older people
Falls prevention
Mental wellbeing
Ability to self-care
Cost savings
Mixed evidence re adaptation costs v. social care savings
Stronger positive evidence re health cost savings
North Somerset
- views of older people
Thoughts on planning ahead
There isn’t actually much
support really if you begin
to lose your faculties.
‘It’s like bereavement. You
get so used to your house,
you invest a lot in it.’
‘The
underlying
factor is fear’
‘When I move again I’ll
get rid again. It’s really
important to move on to
the next stage of life’
‘We need to plan
ahead and think
positively’
Views on sheltered / retirement
housing
‘It
[sheltered housing] worked very well in
Bristol until wardens were taken away.’
‘I don’t think we want to go back to the
sheltered housing that we had’
‘It’s not good to live in this sort of isolation
with only people in your age group whose
outlook you share.’
Family attitudes - ‘Where are we going to stay
when we come and visit?’
Views on Extra Care and
retirement villages
‘It’s a living community’
‘If we are going to move it will be to something like
extra care housing, but then, how are we going to
get there?’
Money would soon be ‘eaten up’ by service charges
‘You have to be very careful in these closed
communities that people are being treated how
they deserve to be treated’
Transport links in rural areas
Want long-term guarantees for care arrangements
Case Study Area – views of
stakeholders
Understanding of context
Very high growth in numbers, especially over 85s
Oversupply of care home beds
‘We don’t have
Park Homes to Retirement Villages
enough of it
that’s affordable
Diversity in ‘older’ age group
and in the right
Elderly frail – extra care housing
location’
For younger age groups
‘What is available in the middle that older people would like?
Between independent living and extra care?’
‘If only they would build more bungalows, but they’re not so they
stay put’ (Older person, Somerset)
Local authority views
‘It has got to be about the private sector and how
we persuade them to do more for older people.’
‘It is about proactive engagement with providers
and using the JSNA and market position statement
to identify the gaps’
We need alternatives to residential homes. Want
Extra Care Housing rather than care homes.
One of the most significant things [adult social care
commissioning] have done is engage with planning.
Social care
On moves
‘By the time my service is involved it’s generally when
there has been a hospital admission or there has been
a big life event or a crisis.’
On MOTEX centre
Provides demo equipment and adaptations centre
‘If they have got the money they might as well get on
with it themselves rather than wait for the council.’
Overall research findings
Housing requirements
Diverse preferences and needs amongst growing
population of older people
The majority of people will continue to live in
mainstream housing
Wellbeing preferences
Health and wellbeing – public purse savings and
individual wellbeing benefits
Future considerations for housing options
Future generations will be more demanding than post-war
generation
Reduced pension provision
Growing prevalence rates of diabetes, dementia, obesity
Demand for adaptations
in existing housing
Rented sector demand could grow by 49%, from 1.2
million households in 2012 to 1.8 million households
in 2032
Owner occupier demand could grow by 39%, from
677,000 households in 2013 to 941,000 in 2032
Demand could outstrip supply by 292,000 in rented
sectors
Projected future mismatch (excess supply of 236,000
adaptations) in owner occupier sector where low
income households unable to afford adaptations
Bottlenecks to accessing adaptations
Inadequate
funding
relative to
need
Complex/
disjointed
process
Poor user
awareness of
DFG or
suitable
options
Limited offer /
provided too
late to
maximise
effectiveness
Need for impartial, independent advice
Need for shift from provision on release from
hospital to preventative investment to maximise
cost-effectiveness and impact on quality of life
Demand for specialist housing
Projected Growth in total demand for specialist housing
Rented sector demand could increase by 48% over 20
year period, from 44,000 in 2012 to 659,000 units
Owner occupier demand could increase by 37%, from
78,000 to 107,000 units (by 2032)
Projected Gap between supply and demand in 2032
Combined gap of 135,000 units
Rented sector 164,000 units in excess of supply
Owner occupier 29,000 units in excess of demand due
to affordability barriers
Constrained demand
Limited choice of
feasible specialist
housing options
Poor awareness of
newer options that
are available
Limited customer
demand to generate
delivery of increased
supply of attractive,
realistic choices.
What limits supply of specialist
housing?
Poor consumer demand to drive supply
Lack of pro-active planning
Competition for suitable sites
Higher costs of provision with significant communal
space and services
Need for stronger business case for developing
housing with on site care
Issues regarding Use Class
Public sector funding constraints
Research delivered by
URS Team,
led by Doug McNab
Philip Leather, PSL Research Ltd
Sheila Mackintosh , Mackintosh
O’Connor Associates
Dr Tim Brown, Centre for
Comparative Research at
DeMontfort University
Any Questions?
Nicky Hodges, URS
[email protected]
0117 917 1179