Extra care housing for older people – what research is out there?

The UK has an ageing population – it is estimated that the number of people aged 80 and over will increase, from three to six million, in the next 40 years. As people get older, their health and social care needs tend to increase. Making sure that homes are suitable to meet these additional needs will help people to remain independent for longer.

Extra care housing is a type of housing for older people (although it is sometimes designed for groups with other needs, e.g. adults with learning disabilities). Schemes share some key features:

• People have ‘their own front door’ – they live in a flat or bungalow (rather than having their own room, as in a care home).
• There are shared facilities, such as a lounge, café, and hairdresser. Some schemes may organise social events for residents too.
• Residents are in control of their care. Care should be flexible and personalised, and ideally, provided by a care provider that is separate to the housing provider.
• There are staff available on the premises 24/7.

This project was commissioned by the National Institute for Health and Care Research (NIHR) Health Services Delivery Research programme. Its purpose is to identify where there is research that could support the provision of extra care housing, and where there are gaps and more research needs to be done.

Reviewing published research

Once we started searching, we were a little surprised by how much research we found looking at extra care housing for older people. We included 98 publications in the review, though some of these were about the same study (e.g. they were a report and a journal article on the same piece of research).

Older people, as you might expect, were participants in most of the research (57 studies). Some studies included staff working in a scheme (24 studies), or other groups of people connected with extra care housing such as housing providers, local authorities, or architects (21 studies). Family members or informal carers also took part in research (10 studies). Most studies gave some information on the people taking part, such as their age and gender, but overall, they didn’t provide much detail.

Studies also didn’t give much detail on extra care housing, either what they thought extra care housing was (in comparison to our definition of extra care housing), often referring to it by other terms such as integrated retirement communities or assisted living, or features of schemes that were participating in the study. Of the 55 studies that provided a definition, most said that extra care housing should have self-contained properties (44 studies) and communal facilities (41 studies). However, they provided little detail on whether care and support was provided 24/7 (26 studies), or whether housing and care were contracted separately (8 studies).

Some of the features of extra care housing that we tried to find information on were:

• Whether a scheme was in a town or city, or the countryside. We found that studies that reported this were likely to include both types of scheme or schemes located in towns or cities. Two studies had only schemes that were in the countryside.
• The type of organisation that ran the extra care scheme. Forty studies gave details on this – in most of these (26 studies), the scheme was run by a non-profit organisation (e.g. housing associations, charities), one study included only a private provider, and 13 studies included both non-profit and private providers.

What we found

We were also interested in the focus of the study. We found that:

• Most studies (55 studies) looked at the experiences of older people, such as their views on the community in extra care housing, or how their care needs were changing over time.
• Some (18 studies) investigated whether and how living in extra care housing benefited older people (e.g. measuring their quality of life).
• Twelve studies looked at the costs of extra care housing.
• Forty-four studies looked at aspects of extra care housing that didn’t fit in any of these categories, such as how buildings were designed or the views of staff.

We also grouped studies so that they followed people’s journey through extra care housing, looking at moving into extra care housing, living in extra care housing, and moving on from extra care housing. Most studies looked at living in extra care housing, with only one focusing specifically on moving on from extra care housing (though other studies did touch on this).

How do these findings compare to the views of people living in extra care housing?

An important part of the review process is talking to people who have experience of the topic. We spent a morning sitting in the foyer of Exeter City Council’s scheme, Edwards Court (opens new window) chatting to residents and staff about the review and how they found living in extra care housing. People talked to us about a range of topics that also came up in the studies, such as their reasons for moving in and the importance of the care and support to help them live independently. They also identified research gaps (e.g. staff commented on the need for training to support the workforce).

Our conclusions

Lots of the research that has been done shows that living in extra care housing can be good for older people. However, we have some suggestions as a result of our review:

• Researchers should follow guidelines for the type of method they are using, and when reporting their results, to make sure studies are of as high a quality as possible.
• They should also give more detail on the people taking part in studies (and try to include views from a range of people, such as those from ethnic minorities or the LGBT+ community), and the included extra care housing schemes.
• There are some topics that need more research (e.g. how to support people as their care needs increase, how to help them transition to another care setting, and whether extra care housing can be a ‘home for life’).
• Providers should develop a standard definition for extra care housing, make sure that the design of buildings meets the needs of residents (e.g. those with poor eyesight), and that staff have suitable training.

---

If you found this of interest, Sian will be speaking at the Housing LIN annual conference in Bristol on Thursday, 12 March 2026.

For more on the findings from their review, download their four-page evidence briefing.

The Housing LIN also curates a dedicated page on extra care housing, which includes a topic page with further information on research and evaluation of extra care housing.