Provision of Housing for Older People: Research Findings and Recommendations

1. Keynote 4 Nicky Hodges Associate - URS

2. 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

3. 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

4. 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

5. 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?

6. Research approach • Rapid Evidence Assessment • Assess robustness of research studies • Focus on evidence of demand, supply, gap, reasons for under supply. • Qualitative research • National level • 2 expert focus groups • Expert interviews • 3 Study Areas • Older people focus groups • Local stakeholder interviews • Quantitative research • Market assessment – current housing circumstances of older people • Model of future demand set against supply Policy options development

7. 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, over-consumption and mobility

8. 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)

9. 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

10. North Somerset - views of older people

11. 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’

12. 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?’

13. 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

14. Case Study Area – views of stakeholders

15. Understanding of context • Very high growth in numbers, especially over 85s • Oversupply of care home beds • Park Homes to Retirement Villages • Diversity in ‘older’ age group • Elderly frail – extra care housing • For younger age groups ‘What is available in the middle that older people would like? Between independent living and extra care?’ ‘We don’t have enough of it that’s affordable and in the right location’ ‘If only they would build more bungalows, but they’re not so they stay put’ (Older person, Somerset)

16. 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.

17. 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.’

18. Overall research findings

19. 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

20. 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

21. Bottlenecks to accessing adaptations • 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

22. 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

23. Constrained demand

24. 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

25. 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

26. Any Questions? Nicky Hodges, URS Nicky.hodges@urs.com 0117 917 1179