Extra Care Housing: The Current State of Research and Prospects for the Future

Robin A Darton

doi:10.1017/s1474746421000683

Abstract

Extra care housing aims to meet the housing, care and support needs of older people, while maintaining their independence in self-contained accommodation. Evidence from several studies suggests that it has benefits for residents in terms of costs and outcomes, and can provide a supportive environment for people with dementia, although the benefits for residents with greater care needs are less clear. Budgetary pressures and increasing eligibility criteria are altering the balance of care between residents and resulting in more task-focused, less personalised care. An increasing shortfall in provision and incentives for developers to concentrate on ‘lifestyle’ provision raise questions about the long-term viability of the model for supporting local authority-funded residents. Responses to the coronavirus pandemic also raise questions about future housing and care arrangements, and these need to be addressed in the government’s long-delayed plans for social care.

Highlights

A long-standing principle underlying government policy in the United Kingdom, and internationally, has been to help people maintain their independence in their own homes for as long as possible, termed ‘ageing in place’ (Department of Health and Social Security, Scottish Office, Welsh Office and Northern Ireland Office, 1981; Department for Communities and Local Government, Department of Health and Department for Work and Pensions, 2008; World Health Organization, 2015; Department for Communities and Local Government, 2017b)
In another longitudinal study of residents in 14 extra care villages and schemes operated by a single provider, Holland et al (2015) found significant reductions in NHS costs, including in the duration of unplanned hospital stays, and significant reductions in the costs of providing the equivalent level of social care to that provided in the wider community
In the UK, and internationally, a wide range of specialist housing has been developed to cater for people whose home is no longer suitable

Summary

Introduction

Measures to improve and adapt ordinary housing and to enable downsizing to smaller, more manageable accommodation help older people remain in their own homes (Department of Health and Department of the Environment, 1997; Department for Communities and Local Government, Department of Health and Department for Work and Pensions, 2008; Department for Communities and Local Government, 2017b). Extra care housing aims to meet housing, care and support needs, while helping older people maintain their independence in their own private accommodation. Over the last 50 years the physical standard of housing has improved significantly (Department for Communities and Local Government, 2017a), but housing problems disproportionately affect older households. People aged 85 or over are most likely to live in non-decent homes, and households with people aged 85 or over are most likely to include someone with a long-term illness or disability (Department for Communities and Local Government, 2016)

Aims and methodology

Findings

Discussion