Housing an Ageing Population : The Extra Care (Flexicare) Solution

Dr Tim Browntjb@dmu.ac.uk

www.dmu.ac.uk/cchr

Centre for Comparative Housing Research, Faculty of Business & Law, De Montfort University, Leicester, UK

Flexicare Conference 29 November 2011

Introduction & Topics • CCHR @ DMU – who are we and what do we do!• Ageing Population • ‘Laying the Foundations’• Future Policy Developments • Extra Care : The Neighbourhood Dimension • Learning Lessons from Abroad

• Topicality e.g. Older People Living in Under-Occupied Homes (Intergenerational Foundation Report)

Centre for Comparative Housing Research: What We Do!

Centre for Comparative Housing Research (CCHR) : Who we are!

• Established in 1996 and part of the Department of Politics and Public Policy in the Faculty of Business & Law.

• We have five staff and three Honorary Research Associates • Expertise in range of topic areas across the team

www.dmu.ac.uk/cchr

An Ageing Population

• Lots of Statistics – Proportion of the Population over 65 Years of Age

• 2009 : 16% • 2034 : 23%

– Fastest Increase : Population over 85 Years of Age • 2009 : 1.4 million • 2034 : 3.5 million

– Approximately 5% of Older Households Live in Specialist Accommodation

Implications e.g.

• Immediate and Long Term Challenges : There is No Quick Fix

• Housing, Health & Social Care • Importance of Existing Homes & Neighbourhoods

‘Laying the Foundations’ : A Housing Strategy for England [1]• Chapter 6 especially pp 48-50 : ‘A New Deal for Older

People’s Housing’ • Principles : Key Messages include:-

– ‘A Better Deal for Older People, with Greater Choice and Support to Live Independently’

– ‘Supporting the Most Vulnerable Households’– ‘Empowering Independence’

• Localism Act, 2011

‘Laying the Foundations’ : A Housing Strategy for England [2]• Details include:-

– Rolling out Personal Budgets within Supporting People – Information and Advice e.g. FirstStop – Funding Streams for Handypersons, Adaptations etc – Role of Home Improvement Agencies – Equity Release – Encourage Councils to Ensure Provision of a Wide Range

of Housing Types – Lifetime Homes & Neighbourhoods

Initial Assessment : Five Points for Discussion • What is Actually New - ‘Jam Tomorrow’ Agenda? • Is it Joined Up – the Potential of Community

Budgets? • Is it a Long Term Strategy? • Will Localism Work? • What about the Elephant in the Room – Public

Expenditure?

Future Policy Developments : Look Out For• Post-Dilnot on Funding Long Term Adult Care • Government White Paper: Spring 2012 • Health & Social Care Bill • Pre-Budget Autumn Statement – Today!• Cabinet Office and Public Service Reform • ….• My Key Message : ‘Be Proactive Not Reactive’

Extra Care : Principles

• ‘Laying the Foundations’ and Extra Care Provision : Part of a Range of Provision

• Definitions : Concept rather than Type of Provision • Key Features / Characteristics include:-

– ‘Home First’– Maximum Independence – Self-containment – Mixed Tenure – Community Facilities and Support Services

Current State of Play

• University of Kent Study on the Value of the Government’s Extra Care Housing Fund : December 2011

• Role of Extra Care in Addressing Health & Well-Being Agendas at the Local Level e.g. North Somerset & South Gloucestershire

• Importance of Overall Market Assessments and Strategies : Context for Extra Care e.g. Hull

• Funding Models

Neighbourhood Approach

• Housing our Ageing Population Panel for Innovation (HAPPI): Hub and Spoke Approach

• Hub:– Facilities for Residents and the Wider Community of Older People and

Specific Needs Groups • Spoke

– Connections to Local Neighbourhood – Existing Stock

• Moral, Social and Business Cases • Challenges: Project Complexity

Good Practice [1]

• Birmingham and Stoke-on-Trent – Innovation : Extra care village linked to telecare

and e-health – Integration with neighbourhood regeneration – Strategic policy framework – Multi-agency approach – Evaluation

Good Practice [2]

• Acocks Green, Birmingham e.g. – Fourth of Five Extra Care Retirement Villages– Extra Care including those with Dementia– Mixed Tenure – Wide Range of Facilities – Many Partners – Aligned with Many Funding Streams

Learning Lessons from Abroad

• Health Warning(!)– Economic, Political & Social Environments – Organisational & Policy Frameworks – Difficulties of Policy Transfer

• Common Issues : Ageing Population, Public Expenditure• Challenge Accepted and Conventional Approaches • Sources include:-

– Housing our Ageing Population Panel for Innovation (HAPPI) : Field Visits

– Housing Learning Improvement Network

Examples

• Multi-generational Housing e.g. Netherlands and USA

• Naturally Occurring Retirement Areas (NORA) e.g. USA

• Co-housing e.g. Denmark

Multi-generational Housing

• Political, Cultural and Business Cases• Lifestyle Choice • Innovation, Experiment & Evaluation • Little Consideration in England (So Far)• Part of a Neighbourhood Agenda

Naturally Occurring Retirement Areas

• USA and Canada • Definition: ‘Areas not originally defined for seniors

but that now have a large proportion of older people’

• Socio-demographic Trends • ‘Supportive Service Programs’• Outcomes include ‘Fewer residential care

placements’

Co-housing

• Denmark (and Netherlands)• Principle: Self-contained Homes with Community /

Shared Facilities • Empowerment • Mutual Home Ownership Model • ‘Senior Co-housing’ and Independent Living • UK Co-housing Network

– Nine Senior Co-housing Groups

Conclusions

• Don’t Rely on Central Government • Real Localism

– Innovation and Experiment – Learn from

• Elsewhere in England • Abroad