It is estimated that the U.K. government saves up to £1,540 per year for each person moving into senior living, according to Jones, Lang, LaSalle (opens new window) (JLL) and there is an appetite for something that bridges the gap between general needs and residential care homes.
However, among the key findings from the 2022 National Housing Federation (opens new window) (NHF) supported & older people’s housing development survey, there were some significant barriers to new development, including low levels of capital grant; planning & shortage of land; and the reduction in commissioned support.
This is not a new phenomenon - ever since I have been working in the sector we haven't been able to build specialised housing quickly enough or at sufficient scale to meet the demands of an ageing population. It seems to me that one of the ways of mitigating this is to make optimum use of existing sheltered housing blocks that are under-used and in many cases unlettable due to deterioration and failing to meet the expectations of the modern pensioner. I believe they can be modernised & remodelled in order to help meet demand both now and in the future.
For a number of years I commissioned Older People’s Supported Housing in a local authority. One of our projects was in partnership with a Housing Association who were modernising one of their sheltered blocks. The scheme consisted of outdated bedsits with off-corridor bathrooms; and a programme of updating them to one bedroom flats with integral bathrooms, was underway. The residents were not moved out while the building work was undertaken. Voids were held as they became available and people were moved to an empty flat while their flat was being refurbished. The number of units (34) remained the same despite the modernisation as the design made better use of the space. The council were moving towards subsidising housing with care, rather than accommodation-only services and a model that came to be known as “sheltered plus” was developed. This enabled people to continue to live independently behind their own front door with care available when needed, preventing a move to a more institutionalised setting such as a Care Home. 17 of the 34 flats are nominated by Social Care. The Landlord’s Housing Support team then carry out a lifestyle assessment and in the vast majority of cases, agree to the allocation. Voids are kept to a minimum.
Currently, day time care cover is provided by an on-site care team, delivered by a contractor based at a nearby Extra Care scheme. The Landlord reports that on the whole the original residents have appreciated the opportunity for them to age in place. They had previous experience of people having to move into Extra Care or a Care Home when their needs increased. Assimilation between the previous tenants and the people moving in and receiving care has generally been very good, with support being provided by the HA’s Housing Support team & Resident Engagement Team as well as the Council’s Extra Care Officers. The Landlord has also provided a shed and greenhouse as well as a range of activities which have broken down barriers. The Care Commissioner reports that it works really well for those customers who have lower level needs than usually associated with Extra Care but higher than could be supported in the wider community. It prevents the deterioration that sometimes occurs as a result of isolation. As needs at the scheme increase, the council will look to commission night time cover but it is not needed at the moment. The service is linked to the care contract at nearby Extra Care and is therefore financially viable even though a relatively low level of care is being funded.
Another project involved redesigning a sheltered accommodation- based warden service to “floating” support. When I joined in 2011 the Supporting People (SP) programme was coming to an end. Although the ring fenced Supporting People Grant ended in 2009, a number of Local Authorities continued to protect budgets in subsequent years. However, we recommissioned support in Sheltered Housing away from its traditional “cup of tea” approach and replaced it with more cost effective needs-led floating support. Whilst the change was not without opposition, the consultation we undertook with residents was overall encouraging. Comments received included that wardens favoured their “clique" and excluded those with non-conforming lifestyles. Also that:
“we don’t need a warden on site all the time as long as we’ve got the phone number of someone to call if we need help”.
The new support service was tenure-neutral and benefitted all older people in the community, it was also free at the point of delivery. In fact, the cost to the authority was approximately one third of the amount previously contracted to sheltered providers for wardens’ salaries. The service was extremely successful and due to a flexible provider who no longer had to work within the constraints of the SP Programme, a wide range of support was delivered, thus preventing hospital admissions, facilitating hospital discharge, preventing homelessness and reducing poverty and debt.
Another initiative that we implemented, optimised lettable space within Extra Care schemes, by repurposing under-used guest rooms. Extra Care schemes have often been designed with more than one guest room available for overnight visitors. Invariably we found these were under used, with 1 guest room being sufficient for tenants’ friends / family. With the cooperation of a number of Landlords these spaces were kitted out at the expense of social care for use as short-term accommodation. A “rent” being paid to the Landlord, including covering void periods. They are typically used for hospital discharge or in some cases emergency care home closures. I believe this is similar to the “Neighbourhood Apartments” in Manchester described in the recent Housing LIN case study.
I was therefore really pleased to learn about the new APPG Inquiry into the Regeneration of outdated Sheltered Housing recently announced by Lord Best and with the Secretariat provided by the Housing LIN. While the focus of the government’s recently announced Older People’s Housing Task Force will be on the supply of new, purpose-built retirement housing for an ageing population, this new Inquiry will look at how best to regenerate our existing supply of outdated sheltered housing – from modernisation and extensions to repurposing and replacing older stock and service models – for 21st century expectations. It will report back in spring 2024.
I look forward to following the progress of the Inquiry and to learning from it’s findings next year.
Sue Weston is a Specialised Housing Consultant and Owner of Housing & Support Solutions. She is formerly a Supported Housing Commissioner in West Sussex, leading on services for Older People.
And if you would like to contribute to the APPG Inquiry, last week it opened its’ Call for Evidence. Deadline for submissions is Friday, 24 February 2024