New market opportunities: senior living East Housing LIN meeting, 9 July 2015

1. New market opportunities: senior living East Housing LIN meeting, 9 July 2015 Jeremy Porteus Director Housing LIN

2. Understanding the older people’s housing market • Public sector policy direction is still fostering new models of provision & new capacity in extra care to reduce costs and improve outcomes - • by a shift towards unregistered ‘housing’ accommodation with high levels of support to replace traditional care home placements & reduce hospital use for respite, assessment, rehabilitation and intermediate care • through new housing based & domestic style models for dementia care at all needs levels • a ‘de-institutionalisation’ of expensive health services for long term mental health & chronic illnesses • BUT, general housing need statistics suggest 220k – 295k new homes are required each year, just 118k currently being developed

3. Evidencing funding applications Understanding demand & capacity Housing LIN / ADASS SHOP analysis tool Draws on the IPC POPPI data from ONS, plus the EAC care & housing data

4. Useful guidance: funding & procurement • Current sources of funding Which of these may still be suitable for funding new extra care schemes? • How scheme characteristics influence access to funding sources Not all extra care schemes, providers or operators are the same • Evidencing and informing funding applications Understanding demand and capacity, making your case for funding, cost modelling • Appraisal types for extra care housing Not for profit and for profit approaches

5. Capital and revenue investment • HCA Affordable Housing Programme Guarantee – continuous market engagement • DH £315m specialised housing fund • DH £135m social care capital grant • £5,3bn Better Care Fund with £220m DFG to support reablement, more ahead? • Impact of welfare reform and Supporting People in England - new HB arrangements and commissioning within tighter eligibility criteria and increasing self-funder market (ADASS report) • Use of equity release to move to ‘downsize’ to purpose-built ‘care ready’ housing and/or to pay for personal care and support

6. Alternative funding sources: what’s new? • Institutional lending, pension funds, bond and/or social finance • LA grants, loans and/or Special Purpose Vehicle • Other procurement frameworks • Insurance-backed products • Public/Private partnerships • ‘Downsizer’ market - personal equity/individual asset management • Neighbourhood based solutions eg co-production/community led or co-housing • Other public capital/revenue eg learning disability/mental health trusts

7. From welfare to wellbeing • At Home Care • Make best use of technology and equipment – from 4th generation telecare/health to Ipad/internet • End of Life Care – avoid hospital admission • Preventing costly health interventions eg, as a result of a fall • Building effective social capital to enable greater community engagement/informal or family care/volunteering • Less dependency on high cost care • Designing for inclusion • Accessible and adaptable HAPPI homes • Providing meaningful housing choices and lifestyle aspirations to meet personalisation objectives

8. A new breed of extra care housing? • HAPPI ‘care ready’ to on-site 24/7 care • Supersized – developing at scale: retirement villages, vertical living • Hub and spoke/community hubs • Flexi-care • Making better use of sheltered housing • New urban living • Healthy living centres • Supporting people with long term conditions ie dementia or a learning disability Useful selection of resources on the Housing LIN extra care housing webpages at: www.housinglin.org.uk/Topics/browse/HousingExtraCare/

9. Age-appropriate mainstream housing • Age-proofing • Age-friendly cities • Lifetime neighbourhoods • Healthy places, healthy homes Useful selection of resources on the Housing LIN design hub at: www.housinglin.org.uk/Topics/browse/Design_building/

10. Private Rented Sector • Embryonic state (estimated less than 1500 units nationally) • Often used by leasehold sector in ‘hard to sell’ retirement properties, but • Also, rent to buy schemes as a ‘taster’ for ‘resizer’ market before committing to purchase • Growing interest in attracting older people in ‘general needs’ PRS but also some bespoke retirement housing PRS • More popular in US, Canada, Australia and mainland Europe Useful Housing LIN factsheets and viewpoints on PRS at: www.housinglin.org.uk/Topics/browse/HousingExtraCare/Commissioning/PrivateSector/

11. Co-housing/lifelong neighbourhoods • Co-housing communities are based on the following features: • they are set up and run by their members for mutual benefit • members live consciously as a community • they are democratically managed and controlled by their members • common space encourages shared activities like community meals and • where possible, physical design encourages ease of social interaction Specific section on the Housing LIN website on cohousing at: www.housinglin.org.uk/Topics/browse/Housing/HousingforOlderPeople/Cohousing/

12. Other initiatives • Use of NHS Estate/ public land disposal (NHF report, ‘Creative Use of NHS Estate’) • Local Enterprise Partnerships: regeneration and wider infrastructure. Extra care housing as s106 contributions • Community-led housing: • Residential care and care hotels • Homesharing/Shared Lives • Telecare/telehealth • Close care/continuing health care Useful selection of resources on the Housing LIN health & Housing Intel pages at: www.housinglin.org.uk/Topics/browse/HousingandDementia/

13. Developing your Market Position Statement Working with DH, DLCG, and ADASS on how might accommodation and care for older people change over next 20-30 years – use Housing LIN SHOP@ What impact will changing wealth and tenure on accommodation and services older people might want as opposed to might need. Estimated 5.5m people under-occupying What will the implications of levels of personal equity held (£873.77bn) Are you clear what your core business isin balancing choice and safeguarding housing for older and vulnerable people?

14. Opportunities or Challenge? • What scope is there for better planning, commissioning and/or access capital funding to promote innovation in lifestyle choices for older people or stimulate a housing with care market as an alternative to institutional provision? • Can Age Friendly communities help partners such as not-for-profit, churches and statutory health and social care services support more people in the community, meet growing demand of an ageing population, any targets / cost-benefits? • Is there the case for Extra Care for maximising independence for people with dementia or is the future more residential care and home based care and support? • Are there other market opportunities such as aids and adaptations, telecare, co-housing, homesharing, social capital? • What strategies and policies are in place to engage, involve and listen to the housing with care needs of older people and their carers? • Join the Housing LIN to stay connected with latest ideas

15. THANK YOU! www.housinglin.org.uk Jeremy Porteus Housing LIN Director c/o EAC, 3rd Floor 89 Albert Embankment London, SE1 7TP Email: j.porteus@housinglin.org.ukEmail: info@housinglin.org.uk Tel: 07899 652626 Tel: 020 7820 8077 Website: www.housinglin.org.ukTwitter: @HousingLIN

16. Workshop Discussion • What are the key barriers to delivering extra care developments? • What changes to your operations are necessary to your extra care schemes economic? • What market innovations will be necessary to develop new extra care schemes in the future?