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