HOUSING OUR AGEING POPULATION - LEARNING FROM COUNCILS MEETING THE HOUSING NEED OF OUR AGEING POPULATION - Local Government ...
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HOUSING OUR AGEING POPULATION LEARNING FROM COUNCILS MEETING THE HOUSING NEED OF OUR AGEING POPULATION
CONTENTS FOREWORD 4 EXECUTIVE SUMMARY 4 INTRODUCTION 5 HOUSING AND OLDER PEOPLE: THE DEMOGRAPHIC, MARKET AND POLICY CONTEXT 6 ISSUES AND BARRIERS AFFECTING HOUSING FOR AN AGEING POPULATION 17 HOUSING AN AGEING POPULATION: COUNCIL GOOD PRACTICE 21 BIRMINGHAM CITY COUNCIL 22 CENTRAL BEDFORDSHIRE COUNCIL 28 ESSEX COUNTY COUNCIL 32 MANSFIELD DISTRICT COUNCIL 36 NEWCASTLE CITY COUNCIL 40 NORTH SOMERSET, BRISTOL, BATH AND NORTH EAST SOMERSET COUNCILS 44 WORCESTERSHIRE COUNTY COUNCIL 48 THEMES AND LESSONS FROM THE CASE STUDIES 52 OPPORTUNITIES AND RECOMMENDATIONS 55 ACKNOWLEDGEMENTS 59
FOREWORD
We all know that there is an urgent need But while it is clear that councils can help
to better provide a range of housing enable partnership to deliver improved
options to meet the wide variety of housing outcomes through housing, it is not easily
circumstances, aspirations and needs of replicated. Local government needs the
people – our family, friends and communities – resources, the tools and, crucially, the buy-in
as they age. from all health and housing partners, to make
it happen.
With an ageing population older people are
now key players in the wider housing market. We look forward to working with our partners
They live in a third of all homes and population to develop solutions.
ageing will account for around 60 per cent of
Ultimately, the housing aspirations and needs
household growth, with the highest levels of
of people and communities themselves must
increase amongst those over 85 years.
be at the centre of our collective efforts.
The suitability of the housing stock is of critical
importance to the health and wellbeing of
individuals and the capacity of public services
to sustainably support healthy ageing over the Councillor Martin Tett
long term, delivering both improved outcomes Chair, LGA Economy, Environment,
and huge efficiencies. Housing and Transport Board
There is enormous, exciting innovation
underway across the country, as councils
Councillor Izzi Seccombe
develop and implement strategies leading
Chair, LGA Community and Wellbeing Board
the local public service response – this report
captures some of that inspirational work.
Within the diverse mix of different strategies
– from building new age-friendly homes, to
shaping and enabling the market, integrating
housing with health and care, and developing
new models for adapting and creating smart
homes – local leadership and collaboration
between local partners is critical throughout.
We will continue to support the sector to
innovate and advance, sharing excellent
practice that help councils in their ambitions for
meeting the needs of their ageing populations.
4 HOUSING OUR AGEING POPULATION
The number of people
aged over 65 is forecast
to rise over the next
decade, from 11.7 million
to 14.3 million by 2025,
a 22 per cent rise
HOUSING OUR AGEING POPULATION 5
EXECUTIVE SUMMARY
The number of people aged over 65 is forecast The policy context that affects the housing
to rise over the next decade, from the current options and opportunities that will address
11.7 million people, to 14.3 million by 2025, a the needs of an ageing population is complex
22 per cent rise. This means that one in five of and changing. In their role as housing
the total population will be over 65 in 10 years’ authorities, planning authorities, and health
time, which will become one in four by 2050. and care authorities, councils are at the heart
of solutions, and should be enabled with the
In the UK, the vast majority of over 65s tools, resources and certainty to realise their
currently live in the mainstream housing ambitions for people and places.
market. Only 0.6 per cent of over 65s live in
housing with care1, which is 10 times less than
in more mature retirement housing markets HOUSING AN AGEING
such as the USA and Australia, where over 5
per cent of over 65s live in housing with care.
POPULATION: COUNCIL
The suitability of the housing stock is of critical GOOD PRACTICE
importance to the health of individuals and also The case studies in this report demonstrate
impacts on the demand for public spending, how Birmingham City Council, Central
particularly social care and the NHS. Bedfordshire Council, Essex County Council,
Mansfield District Council, Newcastle City
Many retirees want to ‘rightsize’ and live Council, North Somerset, Bristol, Bath
in retirement housing in later life, but there and North-East Somerset Councils, and
is a chronic under-supply of high quality, Worcestershire County Council are playing a
affordable or desirable accommodation in the significant place-making role in shaping the
right locations. Age-friendly housing design current and future supply of housing for an
has been developed and promoted in recent ageing population in their areas.
years. The series of Housing our Ageing
Population: Panel for Innovation (HAPPI)
reports2 have proved influential in raising
awareness of the attractive design features
that can make ‘retirement housing’ a product
to be desired not dismissed.
1 Can be termed extra care, assisted living, very
sheltered housing or close care. It is housing for older
people that often includes personal and domestic
support, a dining service, communal facilities and
24 hour on site staff.
2 www.housinglin.org.uk/Topics/browse/Design-building/
HAPPI/
6 HOUSING OUR AGEING POPULATION
The key themes and lessons that emerge DELIVERING AND ENABLING
from their work are:
NEW HOUSING FOR OLDER
PEOPLE ACROSS THE PUBLIC
HAVING A CLEAR VISION: AND PRIVATE SECTORS
PROMOTING AWARENESS The disposal of public sector land presents a
AND CHANGING ATTITUDES good opportunity for councils to allocate sites
There are clear benefits where councils can in appropriate locations for housing for older
shape local housing markets to deliver good people – Birmingham; Newcastle; Essex
quality, well-located, inclusively-designed Encouraging and supporting private sector
housing for older people including: retirement housing development that is well
• Well designed, ‘care-ready’ housing will be designed is an important part of helping to
attractive to many older people who want create housing diversity and help meet the
to downsize before a care or health related future housing needs of older home owners –
‘crisis’ – Birmingham; Central Bedfordshire Worcestershire; Central Bedfordshire
• There is the potential for family homes to be
released back to the market – Birmingham; PROMOTING AN INTEGRATED
Mansfield APPROACH TO HOUSING,
• Efficiencies can be achieved in the delivery CARE AND HEALTH
of personal care and support at home in
The development of effective and integrated
developments exclusively for older people –
housing and health responses to an ageing
Essex; Newcastle
population supports older people to return to
their homes and provides practical assistance
to reduce the likelihood of falls by assessing
PLANNING FOR AN AGEING and removing hazards in the home to prevent
POPULATION hospital admission – Mansfield; North Somerset,
Using a sophisticated mix of demographic data, Bristol, Bath and North East Somerset
planning tools alongside localised contextual
information and what older people say is Sensitive and well-designed housing aimed
important is necessary to plan and deliver what at people with complex care needs and/or
is really needed locally – Central Bedfordshire people living with dementia can be a highly
effective housing alternative to registered
Using local plans to signal to the market what care – Worcestershire; Newcastle
is required across all housing tenures and
proactively engaging with housing developers
supports the delivery of well targeted and
considered housing proposals – Newcastle
Co-production with older people means
involving people in the specification, design,
delivery and review of housing offers.
HOUSING OUR AGEING POPULATION 7
EXECUTIVE
SUMMARY
SUSTAINING OLDER PEOPLE It is essential that a renewed national and
local effort to build more homes for older
IN MAINSTREAM HOUSING people is:
Commissioning and providing home
improvement agency type services across • intelligence led, including working with
council boundaries offers scope for older people to understand demand
economies of scale that can support and • enabled by a local planning, set within
foster innovation in improving existing housing clear national policy
– North Somerset, Bristol, Bath and North
East Somerset • collectively led by local housing and
health partners
• taking opportunities to increase supply
OPPORTUNITIES AND of a wide mix of housing supporting
RECOMMENDATIONS positive ageing
Given the scale of demographic change and • integrating housing with health and care
the centrality of this growing older population strategies and services
to many aspects of housing policy, there is an
• successfully adapting existing housing
opportunity for the Government to set out to
and providing older people that want to
comprehensively address the housing needs
‘rightsize’ the means to do so
of an ageing population for England, through
working with and supporting councils and • able to inform older people of their options
other stakeholders. for their current and future housing needs.
8 HOUSING OUR AGEING POPULATION
Between 2008 and 2039,
74 per cent of projected
household growth will be
made up of households with
someone aged 65 or older
HOUSING OUR AGEING POPULATION 9
INTRODUCTION
The Local Government Association (LGA) With an ageing population, older people
Housing Commission Final Report, Building are now key players in the wider housing
our homes, communities and future3 market. They live in a third of all homes and
recognises that there is a distinct and urgent population ageing will account for around 60
need to better provide a range of housing per cent of household growth with the highest
options to meet the wide variety of housing levels of increase amongst those over 85
circumstances, aspirations and needs of years. Councils are well placed to exercise
people as they age. corporate leadership and take a greater
strategic approach to enhance the housing
Between 2008 and 2039, 74 per cent of
and lifestyle choices for people in later life.
projected household growth will be made up
of households with someone aged 65 or older. Housing quality and suitability has a
The suitability of the housing stock is of critical direct impact on the health and wellbeing
importance to the health of individuals and of the occupants of a home. A suitably
also impacts on public spending, particularly designed and/or adapted home can extend
social care and the NHS. independent, safe living in later life and
thereby housing supply and the design
This report sets out in more detail what is
and stock condition can help manage more
required to meet the housing needs and
effectively the delivery of or, reduce or delay
aspirations of our ageing population drawing
demand for social care.
on work by councils that already have a clear
vision and/or are seeking to achieve this Integrated action in the fields of housing
objective. and planning can align some of the most
important policy areas currently challenging
The LGA recognises that councils play a
national and local government – how to
significant place making role in shaping
reform and integrate the NHS, social care
the current and future supply of housing in
and public health in the context of population
their areas. Whether considering a planning
ageing, and how to increase housing supply
application for a new leasehold retirement
delivery and build more resilient and healthy
housing development or commissioning a new
neighbourhoods.
extra care scheme, it is becoming apparent to
councils the extent to which housing for older
people can influence the housing market.
3 Building our homes, communities and futures, 2016,
LGA
10 HOUSING OUR AGEING POPULATIONMany retirees want to
‘rightsize’ (or downsize) and
live in retirement housing in
later life, but there is a chronic
under-supply of high quality,
affordable or desirable
accommodation in the
right locations
HOUSING OUR AGEING POPULATION 11HOUSING AND OLDER PEOPLE:
THE DEMOGRAPHIC, MARKET
AND POLICY CONTEXT
DEMOGRAPHIC CONTEXT The key shared factor of all retirement housing
is that occupiers own or rent their own
The number of people aged over 65 is forecast
independent property with a shared central
to rise over the next decade, from the current
core providing communal facilities which
11.7 million people, to 14.3 million by 2025, a
vary in size and provision according to the
22 per cent rise. This means that one in five of
development type.
the total population being over 65 in 10 years’
time, which will become one in four by 2050. In the UK, the vast majority of over 65s
currently live in the mainstream housing
Whilst people are living longer and the
market. Only 0.6 per cent of over 65s live in
number of older people is rising, the
housing with care4, which is 10 times less than
advances in healthy life expectancy are
in more mature retirement housing markets
not keeping track. Healthy or disability free
such as the USA and Australia, where over 5
life expectancy for those over 65 averages
per cent of over 65s live in housing with care.
roughly 10.5 years, whilst for those over 85
it falls to less than three years. Many retirees want to ‘rightsize’ (or downsize)
and live in retirement housing in later life, but
The number of older people that have some
there is a chronic under-supply of high quality,
form of care need is significant, with almost
affordable or desirable accommodation in
half of people over 65 currently living with a
the right locations. Recent mid to high end
limiting long term illness (LLTI) or disability.
schemes being developed across the UK are
It is forecast the number of over 65s with
being fully sold off-plan, with long waiting lists
an LLTI whose day-to-day activities are
for existing schemes.
significantly limited will reach three million by
2025, a rise of almost 30 per cent. Age-friendly housing design has been
developed and promoted in recent
years. The series of HAPPI reports5 have
OLDER PEOPLE’S proved influential in raising awareness
HOUSING SECTOR of the attractive design features that can
Retirement housing in the UK has evolved make ‘retirement housing’ a product to
over the last 30 years. The principal aim of be desired not dismissed; for example,
retirement housing is to provide an alternative HAPPI compliance has been built into the
to private residential housing and residential requirements to secure funding from the
care for older households. It targets those Department of Health’s Care and Support
older people requiring specialist housing Specialised Housing Fund6.
support or care (or will in the future) but who
4 Can be termed extra care, assisted living, very sheltered
also wish to maintain their independence housing or close care. It is housing for older people that
and can provide a community (with ongoing often includes personal and domestic support, a dining
activities and support provided), not just service, communal facilities and 24 hour onsite staff.
housing. 5 www.housinglin.org.uk/Topics/browse/Design-building/
HAPPI/
6 www.gov.uk/government/news/care-and-support-
specialised-housing-fund-phase-2-successful-bids
12 HOUSING OUR AGEING POPULATIONThe role of digital technology in relation to “People over retirement age, including the
housing for older people is also increasingly active, newly-retired through to the very
recognised as part of an effective building frail elderly, whose housing needs can
management solution to deliver smarter encompass accessible, adaptable general
and more accessible, adaptable and needs housing for those looking to downsize
environmentally friendly homes. In recent from family housing and the full range of
years, the emergence of the HAPPI design retirement and specialised housing for those
principles have also made the link between with support or care needs.”
better quality and management of housing
There is an emphasis on Local Plans being
for older and vulnerable people and healthier
underpinned by evidence of local housing
lifestyles and quality of life. The LGA’s Digital
needs of different groups including older
Transformation Programme will help inform
people and providing for the housing that they
smarter ways of working; for example, to
require.
deliver services that are better targeted and
more efficient. National Planning Practice Guidance, updated
in 20158, supplements the NPPF and seeks
to guide development on a number of more
POLICY CONTEXT technical issues. The importance of good
The policy context that affects the housing design is included within the ‘Design’ chapter
options and opportunities that will address and includes consideration of the improvements
the needs of an ageing population is complex to the well-being of people through good
and changing. In their role as housing design. This links with the chapters on ‘Health
authorities, planning authorities, and health and Wellbeing’. It is stated that the guidance
and care authorities, councils are at the heart should provide commissioners, providers and
of solutions, and should be enabled with the developers with the tools they need to engage
tools, resources and certainty to realise their with local planning authorities to promote
ambitions for people and places. healthy communities and support appropriate
health infrastructure. However, there is relatively
Housing and planning policy
little that specifically relates to housing and
The National Planning Policy Framework
older people.
(NPPF) (March 2012)7 along with the National
Planning Practice Guidance sets the The Housing White Paper 9 sets out the
background at national level for development intention for a proposed amendment to
in England. It contains a useful definition of the National Planning Policy Framework
older people within the glossary stating: that would expressly require all local plans
to include clear policies that address the
provision of suitable housing for older people
and how this is to be provided.
8 www.gov.uk/government/collections/planning-practice-
guidance
7 www.gov.uk/government/publications/national-planning-
policy-framework--2 9 www.gov.uk/government/collections/housing-white-paper
HOUSING OUR AGEING POPULATION 13HOUSING AND OLDER PEOPLE:
THE DEMOGRAPHIC, MARKET
AND POLICY CONTEXT
This would be supported by the provision Councils are required to have regard to
of new national planning practice guidance ensuring sufficient capacity and capability to
explaining to councils precisely how their local meet anticipated needs for all people in their
development documents should meet the area needing care and support – regardless
housing needs of older people. In effect, the of how they are funded with housing options
Government will explore ways to stimulate the now right at the centre.
market to deliver new homes for older people
The act places housing at the heart of the
and is introducing a new statutory duty
definition of wellbeing and requires councils
through the Neighbourhood Planning Act on
to be proactive in shaping and developing
the Secretary of State to produce, for the first
the market, particularly in alternatives to
time, guidance for local planning authorities
institutional care such as housing with care.
on how their local development documents
Through the process of producing market
should meet the need for accessible housing
position statement councils are engaging
for older and disabled people.
with the market to promote a variety of
Health and social care policy accommodation to match the needs and
The role of housing, including for older choices of the local population.
people, as a determinant of health has been
As part of the drive for more integrated
reflected in recent policy.
approaches, a pioneering Health and
The statutory guidance around the Housing Memorandum of Understanding11
implementation of the Care Act 201410 (MoU) to support joint action on improving
asserts that: health through the home was agreed between
government departments, agencies such
“Housing is therefore a crucial as Association of Directors of Adult Social
Services (ADASS), NHS England, Public
health-related service which is
Health England (PHE), and the Homes and
to be integrated with care and Communities Agency (HCA), and other
support and health services to housing and health sector organisations in
promote the wellbeing of adults 2014, including the LGA.
and carers and improve the
quality of services offered.”
11 www.gov.uk/government/publications/joint-action-on-
improving-health-through-the-home-memorandum-of-
10 Section 15.50, Care and support statutory guidance understanding
14 HOUSING OUR AGEING POPULATIONThe MoU details areas of improvement, Supported housing policy
and the action plan aims to ensure that On 21 November 2016, Department for Work
organisations work together to: and Pensions (DWP) and Department for
Communities and Local Government (DCLG)
• establish and support national and local
published Supported Accommodation Review:
dialogue, information exchange and
the scale, scope and cost of the supported
decision-making across government,
housing sector (2016)12.
health, social care and housing sectors
Specialist housing for older people in the
• coordinate health, social care, and housing
social sector, including sheltered housing and
policy
extra care housing, provides 70 per cent of all
• enable improved collaboration and supported housing across England, Scotland
integration of healthcare and housing in the and Wales in 462,000 units of accommodation.
planning, commissioning and delivery of
homes and services These housing services are facing potentially
significant change in relation to government’s
• promote the housing sector contribution
proposals for the future funding of supported
to: addressing the wider determinants of
housing.
health; health equity; improvements to
patient experience.
Health and wellbeing boards (HWBs) have
an opportunity to engage effectively to bring
together planning, health and care partners
to develop a collective strategic ambition
for delivering housing that enables healthy
ageing alongside health and care services.
12 Supported Accommodation Review: the scale, scope
and cost of the supported housing sector (2016),
www.gov.uk/government/publications/supported-
accommodation-review
HOUSING OUR AGEING POPULATION 15HOUSING AND OLDER PEOPLE:
THE DEMOGRAPHIC, MARKET
AND POLICY CONTEXT
Funding for Supported Housing: These proposals would in effect bring to an
Consultation13 contains the key elements of end the current housing benefit arrangements
the Government’s proposals for the future for all specialist older people’s housing at
funding of supported housing from April 2019 the end of March 2019. In its response14 to
including: the proposals, the LGA called for a separate
LHA rate that is just applied to the supported
• Councils will have responsibility for funding,
housing sector and a recent DWP and DCLG
commissioning and quality assuring all
select committee report explicitly stated:
supported housing in their areas from
April 2019.
“It is essential that the
• A ring-fenced budget for supported
Government’s funding
housing will transfer to councils from April
2019. It will be ring-fenced for supported proposals do not threaten the
housing, not for specific service user future supply of supported
groups. housing. The Government
• The new system as proposed would affect should undertake an assessment
all service users in supported housing from of the final funding proposal
April 2019. to assess its impact on the
• The new funding model will mean that core future provision of
rent and service charges will be funded supported housing.”15
through Universal Credit (or housing benefit
for pensioners and where Universal Credit
has yet to be fully rolled out) up to the level
of the applicable local housing allowance
(LHA) rate.
• The new model will devolve funding to
councils in England to provide a ‘top-up’
where necessary to providers – the ‘top
up’ being the difference between the
applicable LHA rate and the current cost
of rents and service charges in supported
housing; for instance councils will have
an ‘enhanced role’ in commissioning
supported housing in their area.
• If it goes ahead as proposed it will be the
largest change to the supported housing 14 www.local.gov.uk/sites/default/files/documents/
LGA%20Submission%20to%20consultation%20on%20
sector since 2003. the%20Future%20Funding%20of%20Supported%20
Housing%2013%20February%202017.pdf
13 www.gov.uk/government/consultations/funding-for- 15 www.publications.parliament.uk/pa/cm201617/cmselect/
supported-housing cmcomloc/867/86709.htm#_idTextAnchor028
16 HOUSING OUR AGEING POPULATIONISSUES AND BARRIERS
AFFECTING HOUSING FOR
AN AGEING POPULATION
Within this policy context there are a range This objective could be achieved through a
of issues and barriers that are affecting the specific planning classification and planning
ability of councils and their partners to plan regulations that require specific number of
for and deliver a range of housing solutions HAPPI style ‘care ready’ homes to be built
that will better support an ageing population. depending on assessed local need.
These are issues not solely about new build Financial uncertainty and risk
housing; it’s also about making best use of the The issues around the future viability of
existing housing stock, the wider age-friendly specialist housing for older people as a
built environment, age-friendly communities result of the proposed changes to funding for
and supporting people in their own homes to supported housing, in combination with the
have access to timely interventions, access to impact of rent reductions in the social housing
social networks and so on. sector, is resulting in significant financial
uncertainty in relation to planned and future
development of housing for older people.
PROVISION OF HOUSING
This impacts on capital funding, such as the
AND FINANCIAL RISK Government’s Care and Support Specialised
The Elderly Accommodation Counsel16 Housing Fund17 for housing associations,
(EAC) estimates that there are approximately which is stalling as a result as a result of the
520,000 units of retirement housing (including uncertainty caused by the funding proposals
some degree of support or care) in England. for supported housing, especially outside
EAC estimates a substantial shortfall in London and the South East where values are
housing and care provision by 2035 of nearly lower. Lenders have less risky markets they
400,000 units of purpose built housing for can invest their money in so making long term
older people. However, although specialist development plans and investment decisions
retirement housing is an important part of in the affordable older people’s housing
meeting older people’s housing needs it is sector becomes less attractive.
essential to look at all forms of housing.
However, there has been a substantial
The crucial driver for change in the older increase in non-grant funded private sector
people’s housing market is to bridge across retirement housing and housing associations
a niche market to the mainstream house rebranding and improving their older people’s
building sector. This will develop a greater ‘offer’ by developing more ‘mid-market’
variety of choice, support health and choices, in particular targeted at a more
wellbeing outcomes and unlock a key static affluent or ‘downsizer with equity’ market.
area of the housing pathway.
17 www.gov.uk/government/publications/care-and-support-
specialised-housing-fund-phase-2-prospectus
16 www.eac.org.uk/ISSUES AND BARRIERS
AFFECTING HOUSING FOR
AN AGEING POPULATION
Size and scale of development There is an opportunity to address the
As the size of the local catchment population particular difficulties that many general
for a viable extra care scheme increases housing related planning policies cause for
due the increased financial risk described the retirement living sector – such as the
above, the product has increasingly become relatively blunt distinction between the C2
an urban environment solution and more and (residential institutions) and C3 (dwellings)
more rural areas will not be able to access use class categories and attempts to apply
these essential developments, without grant affordable housing policies to retirement
or subsidy. Indeed, even within larger towns communities.
there may be communities with strong local
identities which will result in the majority
of its older people wishing to stay within HOUSING DESIGNED FOR
established family and community support OLDER PEOPLE
mechanisms. To address this issue of viability Consideration needs to be given to several
linked to scale, as a minimum, greater design related issues in order to secure
housing choice is required across the market housing better suited to an ageing population.
by providing age-friendly housing built to the
‘care ready’ HAPPI design principles.18 Lifetime homes
The lifetime homes standard (LHS) had
assisted with creating a new supply for
PLANNING ISSUES ageing ready homes but that standard is
AND CONSTRAINTS no longer mandatory. Local plans could be
Councils are increasingly seeking to ensure required to specify a percentage of homes
that they fully understand and promote to be built to these standards, for example
the anticipated future housing needs and drawing on the recommendations set out for
aspirations of older people. both LHS and wheelchair accessible housing
in the London Plan20.
Council planners require robust accurate data
HAPPI design standards
beyond the use of ONS data which models
The HAPPI principles for both new mainstream
future need at community level.19 Use of more
housing and specialist housing developments,
specific and detailed assessments of the
as featured in the All Party Parliamentary
housing needs of older people in a local area,
Group (APPG) on Housing and Care for Older
across all types of housing and tenures, will
People inquiry reports, provide excellent
facilitate a more consistent implementation
guidance for quality design and development.
locally of agreed planning priorities and plans
for housing an ageing population.
18 www.housinglin.org.uk/Topics/browse/Design_building/
HAPPI/ 20 www.london.gov.uk/what-we-do/planning/london-plan/
current-london-plan/london-plan-chapter-3/policy-38-
19 www.housinglin.org.uk/Topics/browse/ housing-choice
HousingExtraCare/ExtraCareStrategy/SHOP/SHOPAT/
18 HOUSING OUR AGEING POPULATIONThe University of Sheffield’s DWELL research IMPROVING HEALTH
report21 provides robust evidence how the
design of houses and neighbourhoods can
AND WELLBEING
facilitate mobility and wellbeing for current and There is both growing evidence and a
future generations of older people. clear policy steer towards recognising and
strengthening the role of housing in relation to a
Sheltered housing range of health and wellbeing issues including
Much of the design and construction of how well designed housing for older people
sheltered housing, especially in the social can help reduce the need for adult social care
rented sector, but also older leasehold and demand on NHS services (eg reducing
retirement housing, is outdated and no longer residential care admissions, preventing hospital
an aspirational choice for many older people. admissions/reablement, combatting isolation or
Social housing providers, when undertaking loneliness, better at home care coordination, a
asset management reviews to ‘futureproof’ wider community resource, and opportunities
these schemes, should assess the feasibility for greater personal and community resilience).
of making better use of existing sheltered
stock or to decommission and invest in There is a growing body of evidence to
new facilities, such as ‘care ready’ housing. support this including:
Some social landlords and councils have • A longitudinal study by Aston University22
recognised the wider ‘system’ efficiencies for The Extra Care Charitable Trust which
the latter can bring into the housing system; identified savings to councils in relation to
providing an attractive, aspirational housing social care of £4,500 per annum for high
offer can free up under-occupied general care customers and £1,700 for low care
needs housing which in turn can be allocated needs customers. In addition, the study
to families in housing need, including people suggests a reduction of GP visits of almost
in temporary accommodation. 50 per cent.
Owner occupier market • A BRE23 studies which suggests poor
In relation to the mainstream owner occupier quality housing costs the NHS £1.4 billion
housing market, many more homes are now per annum with £500 million directly related
occupied by older people than previous to older people.
generations and are therefore not ‘available’
• A Housing Learning and Improvement
for younger generations. Every unit of
Network (LIN) study24 for Trailway Court
specialist retirement housing built and sold
in Dorset which compared wellbeing after
helps to reduce the overall demand for
entering the scheme to before moving into
general market housing as a property is
an extra care housing scheme.
released for rent or sale to families/couples/
single persons etc. This helps to stimulate the
22 www.housinglin.org.uk/_assets/Resources/Housing/
market and can unlock housing chains for the Support_materials/Aston_ECCT_research.pdf
wider housing market.
23 www.bre.co.uk/healthbriefings
24 www.housinglin.org.uk/Topics/type/Blazing-a-trail-Extra-
21 http://dwell.group.shef.ac.uk/ Care-Housing-in-Blandford-Forum-Dorset
HOUSING OUR AGEING POPULATION 19ISSUES AND BARRIERS
AFFECTING HOUSING FOR
AN AGEING POPULATION
• Another Housing LIN study from North East Housing advice services need to be much
Lincolnshire25 which evaluated their new more widely available and marketed so that
extra care scheme using a control group older people and their families can make
of residents which as concluded savings informed choices in a timely manner prior to
of £4,000 per annum per extra care unit in when a crisis decision is required.
terms of care cost savings to councils.
Support to ‘rightsize’
Technology enabled housing and care can Research by Demos29 has shown that many
also play a role in maintaining independence people are interested in moving in later stages
and promoting wellbeing. Much of the of life to support wellbeing and reducing
emphasis on older people’s housing is on future care costs. However, ‘help to buy’
the future supply, however consideration is incentives such as removal of stamp duty for
also needed on developing more innovative older people buying retirement housing and
technology enabled solutions26 and use of ‘help to move’ or de-cluttering services30 are
digitally enhanced construction techniques. not always available to make the transition
The Government’s recent Digital Strategy27 easy, although some retirement housing
provides an overarching framework but is providers are increasingly directly providing
housing ‘lite’ on the sector’s digital capability. some of these types of services to assist
older people to move.
SUPPORTING HOUSING Support for people in existing housing
There is a need to also consider creating
CHOICES a better housing ‘offer’ for older people in
Information and guidance about existing poor quality or unsuitable mainstream
housing options housing (eg in disrepair/poor condition, lack
Research by Age UK and Independent Age28 of accessibility/in need of adaptation, costly
shows that that older people and families face to heat, fuel poverty, technology enabled etc).
considerable problems accessing information Responses to these issues will be able to draw
on housing and care options as they age. on the evidence review of the role of home
adaptations in improving later life commissioned
by the Centre for Ageing Better31.
25 www.housinglin.org.uk/Topics/type/Evaluating-extra-
care-valuing-what-really-matters-The-case-for-taking-
relationships-seriously/
26 www.housinglin.org.uk/Topics/type/Technology-enabled- 29 www.demos.co.uk/files/TopoftheLadder-web.
housing-with-care-Scenarios/ pdf?1378922386
27 www.gov.uk/government/publications/uk-digital- 30 www.lofty-heights.org/
strategy/uk-digital-strategy
31 www.ageing-better.org.uk/get-involved/current-
28 www.independentage.org/policy-research/research- opportunities/invitation-tender-understand-role-home-
reports/shining-a-light-on-care-helping-people-make- adaptations-improving-later-life/
better-care-home
20 HOUSING OUR AGEING POPULATIONHOUSING
AN AGEING
POPULATION:
COUNCIL GOOD
PRACTICE
A series of detailed case studies which
demonstrate good practice in how
councils are addressing the housing
needs of an ageing population.
HOUSING OUR AGEING POPULATION 21BIRMINGHAM CITY COUNCIL
STIMULATING THE MARKET
PROMOTING DOWNSIZING AND HOUSING DIVERSITY
THROUGH DIVERSE AND INNOVATIVE HOUSING MODELS
Birmingham City Council has an ambitious Housing and older people context
plan. It will have 150,000 additional people
At the last census there were just under 50,000
and 89,000 additional households by 2031.
people aged 75 and over within Birmingham.
Birmingham is a city of growth. New homes
Aligned to the national trend, Birmingham’s
are needed to accommodate a growing
older population will see a sizeable increase.
population and to help drive and support the
By the year 2030 one in 10 of the city’s
economic development of the city and the
predicted population of 1.23 million residents is
city region. The council estimates that 89,000
likely to be aged 75 or older (123,000 people).
new homes are needed from 2011 to 2031,
including a growing the market for housing In this context, the council recognised the
for older people. pressing need to plan ahead, refresh and
refocus what the market offers with regards to
The Birmingham Development Plan32 seeks to
supplying and managing specialist housing.
encourage housing growth. The council uses
planning powers positively to enable and Some key features of the local factors that have
accelerate delivery. The council plans influenced the council’s response to addressing
to build at least 51,000 new homes in the city the housing needs of older people include:
by 2031. Including completions to date, it
has identified sites with capacity for 46,247 • Life expectancy in Birmingham is 76 for
new homes. males and 81 for females – both below the
average for England, with the gap greater
However new homes completions in for the local male population.
Birmingham have fallen from 4,000 in 2005/6
• The number of people with dementia is
to 1,809 in 2014/15. As a result of a focus
expected to double over the next 30 years.
on increasing the delivery of new homes,
Appropriate new housing solutions are
Birmingham City Council (BCC) now builds
sought to meet demand for quality, joined
over 25 per cent of all new homes across the
up housing and care, not only for residents
city – for social and affordable rent, sale, and
diagnosed but for those who will be live-in
now private rented sector housing.
carers.
• Tenure of older households:
◦◦ 68 per cent social rented
◦◦ Seven per cent private rented
◦◦ 25 per cent owner occupied.
32 www.birmingham.gov.uk/info/20054/planning_
strategies_and_policies/78/birmingham_development_
plan
22 HOUSING OUR AGEING POPULATIONRadnor Road bungalows
• Over half of older people who would benefit How is it innovative?
from living in specialist housing will need The council’s approach
some form of financial support with their
To address the need for additional housing
housing costs.
in the city, both for older people and other
• The vast majority of both the affordable and groups, the council has intervened directly
market supply is sheltered housing. There and established its own housing trust.
are relatively small amounts of other types of Birmingham Municipal Housing Trust (BMHT)
specialist older person’s housing, and this is is Birmingham City Council’s brand name
especially true for the council’s own stock. for building new homes across Birmingham,
• Under-occupation in older people’s housing by working in partnership with private
is a growing issue across all tenures. Of developers. With over 2,500 homes already
those older people currently renting homes delivered or under construction, BMHT is
from the council, 56 per cent are registered providing high quality new homes across
as having excess bedroom space, or are Birmingham. In recent years Birmingham has
under occupying. Affordable housing led the way amongst large councils to build
providers at present only have a limited new council owned homes for affordable rent,
supply of properties that are appealing to through BMHT.
these under occupied households.
Addressing the requirement to develop
The council’s market position statement and deliver an attractive ‘rightsizer’ housing
for housing in later life33 summarises key offer has been a core component of the
requirements in the city in terms of improving council’s approach:
older people’s housing choices that are
• around 41 per cent of BCC stock is
reflected in this case study:
under occupied, mainly by older tenants
• addressing under occupation – help find (38 per cent)
innovative and affordable solutions to • up until now, the housing offer has been
tackle the issues associated with the high poor and/or limited to flats or one bedroom
numbers of older people occupying homes bungalows. Some older stock has been
not suitable to their needs inappropriately converted
• increasing the supply of specialist housing • there needed to be a better quality offer
for older people. In particular, to help to incentivise older residents to ‘rightsize’.
meet the demand for enhanced sheltered
housing and housing with care.
33 www.birmingham.gov.uk/downloads/download/41/
market_position_statement_housing_in_later_life
HOUSING OUR AGEING POPULATION 23BIRMINGHAM
CITY COUNCIL
The council has developed its own unique The housing solution in response to this is
specification for this older person’s housing a two-bedroom ‘dormer style bungalows’,
model through research and consultation each with a ground floor bedroom and shower
with older people in the city. Feedback from room, a lounge and kitchen and also
older people identified a desire for bungalow a second bedroom and bathroom upstairs.
accommodation, of which there was a very The design is in summary:
limited supply, but this needed to incorporate
design features that provided maximum • based on HAPPI principles.
flexibility as well as making it a build model • dormer style bungalow – category 1 on
that could make the most efficient use of ground floor with second bedroom and
available development site opportunities. bathroom upstairs – equivalent to former
Code for Sustainable Homes Level 4
Research with older people identified the
following requirements: • bespoke design with good space
standards including the ability to dry
• two bedrooms: either through household clothes in vented spaces or outside
need or quality of life requirements
• Lifetime Homes standard enabling
• decent space standards and storage adaptation as needs change
• economic to run and easy to maintain • smaller gardens or balconies provide
• flexible to cater for changing needs manageable outside space.
• manageable outside space • The council has used some of its own sites
to develop this downsizer housing model.
• rightsizing needs to be an aspirational
move.
24 HOUSING OUR AGEING POPULATIONThe design is intended to make it possible for Outcomes
people to use the property like a traditional
To address the requirement to develop
smaller house, but if their mobility becomes
attractive housing that will encourage older
restricted, they can simply live downstairs,
people to downsize, to date, BMHT have built
leaving the upstairs accommodation for visitors
16 dormer bungalows across two sites with
or a live-in carer. The design of the dormer
more being planned. So far this has been
bungalow helps people to stay as independent
successful at encouraging older people
as they can and each home also has plenty of
to relinquish tenancies of large, family size
storage and access to its own private garden.
homes, another housing resource greatly in
The design of these new homes is intended
demand within the city.
to be attractive and aspirational in order
to encourage people who currently under The feedback from people who have
occupy larger houses to move to a smaller downsized to this new housing model has
home, releasing their house for a family. In been overwhelmingly positive. From a survey
addition, the council has developed downsizer of people who have downsized to this new
apartments for people aged 55 plus. housing, most people rated it with an overall
score of 10/10. When asked what were the
Modelling of future need for specialist housing
best features of the properties, the reasons
by the council indicates a requirement for an
given were:
increase of 2,457 housing with care and 515
enhanced sheltered units by 2029. • “the amount of natural light and
accessibility around the home”
Housing choices for older citizens have been
greatly enhanced through the development • “the look of the property from the outside”
of a number of extra-care villages in the • “the way the patio doors open onto the
city. These provide an attractive offer that back garden”
encourages people to down-size from
their current home. As well as providing an • “the properties are spacious, light, and
attractive housing option, the ability to access in an excellent location.”
care and the ethos of keeping mentally and The villages are large enough developments
physically active deliver wider health and to act as community hubs for older people
wellbeing outcomes. within their vicinity and Birmingham has five
To support the delivery of this specialist villages currently in operation. There are
housing, the council has worked closely with currently an additional 1,224 units of older
other housing providers, particularly the Extra people’s specialist accommodation in the
Care Charitable Trust, to deliver five extra pipeline, with four schemes going through
care ‘villages’ each with approximately, 250 planning and a further four currently on site.
units, across all tenures (social rented, shared These developments offer both market and
ownership and full leasehold sale), across the affordable accommodation.
city. This size and scale of retirement village
development is the largest of any city in the UK.
HOUSING OUR AGEING POPULATION 25BIRMINGHAM CITY COUNCIL An independent evaluation of the extra care villages provided Extra Care Charitable Trust by Aston University34 demonstrated the benefits that housing with care bring: • The Extra Care model is likely to offer significant potential savings in the cost of social care for local authority commissioners. • The cost of providing lower level social care using the Extra Care model was £1,222 less per person (17.8 per cent less) per year than providing the same level of care in the wider community (on average, with variation by local authority) and the cost of higher level social care was £4,556 less (26 per cent less) per person per year). The Extra Care Charitable Trust model can result in significant savings for NHS budgets – over a 12-month period costs total NHS costs (including GP visits, practice and district nurse visits and hospital appointments and admissions) reduced by 38 per cent. • The Extra Care Charitable Trust model seems to ‘level the playing field’ by successfully removing differences in self- perceived health differences which are initially related to social class. Contact Clive Skidmore Head of Housing Development, Housing Investment and Development, Birmingham City Council clive.skidmore@birmingham.gov.uk Mike Walsh Head of Service, Intelligence, Strategy and Prioritisation, Commissioning Centre of Excellence, Birmingham City Council michael.walsh@birmingham.gov.uk Radnor Road bungalows 34 file:///C:/Users/housi/Downloads/final%20report1%20(1).pdf 26 HOUSING OUR AGEING POPULATION
Only 0.6 per cent of
over 65s in the UK live
in housing with care,
10 times less than
the USA and Australia
HOUSING OUR AGING POPULATION 27CENTRAL BEDFORDSHIRE
DEVELOPING AN ATTRACTIVE PROPOSITION
PROMOTING INVESTMENT IN HOUSING
SOLUTIONS FOR OLDER PEOPLE
Central Bedfordshire is an area of The effect is most significant in the 85 and
considerable growth. The council has over age range where the population is set to
ambitious plans for new homes and new rise by 2.5 times from 5,400 in 2015 to 13,700
jobs in the area by creating new, vibrant, by 2035.
sustainable communities, while also
enhancing Central Bedfordshire’s picturesque As people live longer many are living with
setting. Accommodation for older people will one or more long term conditions, and for a
be an integrated part of its plans. significant number, advancing age brings
frailty. Currently in Central Bedfordshire
Central Bedfordshire’s economy is growing there are over 15,000 people aged 65 and
fast. Central Bedfordshire is generally an over who are unable to manage at least
affluent area, with only 13 per cent of older one personal care task and by 2030 this is
people living in income deprived households predicted to rise to over 24,000 people. There
and three quarters of older residents owning is a similar rise in the number of people living
their home. with a limiting long term condition, which in
2015 equated to roughly 20,000 and by 2030
To address the housing requirements of its
will be over 32,000.
older population the council has developed a
comprehensive and sophisticated approach
to using a detailed qualitative and quantitative How is it innovative?
evidence base to produce an ‘investment The council’s approach
prospectus’ to set out its vision for the range
From this detailed evidence base, the
and mix of housing and accommodation
council’s vision is to:
required and to invite investment to deliver
housing solutions.
“Secure the best quality of life
The council has established a thorough
we can for our older residents
evidence base to underpin its strategic
approach to identifying the range of both now and in the future.
opportunities to grow and develop more This means delivering a
refined housing choices for older people. range of accommodation that
Like much of the rest of the UK the council enables older people to
is forecasting an increase in its population live fulfilling lives and
of older people. This rise represents both an enjoy good health in attractive
increase in the number of older people and homes that meet their needs
the proportion of older people in the local
population. In 2015 people over 65 made up
and allow them to retain their
17.2 per cent of the population, by 2035 they independence as they age.”
will be 23.3 per cent. The reasons for this
trend are increasing life expectancy coupled
with baby boomers starting to reach later life.
28 HOUSING OUR AGEING POPULATIONPriory view, Dunstable
The detailed evidence base and this vision • By the end of 2020 reprovide the capacity
forms the basis for a highly attractive and in the seven council-owned care homes
sophisticated ‘investment prospectus’35 (249 places), in homes that have modern
document which the council is using to physical and environmental standards.
invite investment in a range of housing and
• Work with current care home operators
accommodation options for older people.
that wish to improve the physical and
The original plan was to produce a more environmental conditions in their homes
‘traditional’ market position statement by remodelling or reproviding.
document, however the investment
The council’s investment prospectus
prospectus was produced to provide a
specifically identifies the range of
more attractive and engaging approach to
opportunities that will, collectively, address
stimulating the market.
the identified demographic, housing and care/
The investment prospectus, based on support needs, as well as the aspirations and
evidence of housing need and this vision, requirements of older people. These reflect
sets out clearly the council’s market shaping the scale and type of local communities as
and housing delivery objectives in the form of well as older people’s aspirations:
development opportunities:
• Develop innovative housing solutions for
• Facilitate the development of six affordable older people, ie signalling to architects
extra care schemes by the end of 2020. and house builders who want to take the
One scheme of 80 apartments or more opportunity of a more innovative approach
in each locality area and two additional to designing attractive and aspirational
schemes in areas of high demand. housing.
• Encourage the development of open market • Developing small scale housing for older
extra care schemes to provide apartments people in smaller towns and villages.
for sale and private rent. • Develop dementia friendly buildings
• Encourage developers to build mainstream that help people living with dementia
homes that are suitable for and attractive to orientate themselves and live more
to older people as part of new residential independently.
developments, including changes to the The impressive investment prospectus
design and layout of homes that can make identifies in more detail the housing and
a big difference to ‘future proofing’ for older accommodation options that are required in
people without jeopardising the viability of each of the council’s four ‘localities’.
the development.
35 www.centralbedfordshire.gov.uk/housing/independent-
living/dev-accom-older-people-bedfordshire.aspx?utm_
source=website&utm_medium=shortcut&utm_
campaign=opip
HOUSING OUR AGEING POPULATION 29CENTRAL
BEDFORDSHIRE
Alongside its understanding of the • Most of the respondents, if they did move,
demographic and potential care/support would release a larger property than the
characteristics of its over 55 population, one they were taking up.
and the evidence from its strategic housing
market assessment (SHMA), the council This is a detailed and very thorough approach
commissioned extensive qualitative research to generating a qualitative evidence base
in order to better understand the ‘drivers’ to complement the existing demographic
and motivations behind older people’s and quantitative housing need evidence. It
propensity to move. provides more sophisticated intelligence to
guide the range of development opportunities
This research was specifically designed to set out in the council’s investment prospectus.
cover the same period as the emerging local It also produces a numerical estimate of the
plan, 2015-2035, and it used the SHMA as a impact of rightsizing and offers a methodology
starting point of estimates of housing need for doing the same in other areas.
for older people. The research sample was
selected to be a representative cohort of
residents over the age of 55 years across Outcomes
all housing and tenure types. Six hundred The council is responding to this evidence
short and 80 in-depth surveys were carried through directly developing housing for older
out along with focus groups with stakeholder people itself as well as inviting both private
organisations. and social housing providers to develop
housing and accommodation ‘offers’ that will
Key findings include:
be attractive to older people.
• Twenty seven per cent of respondents
Delivery outcomes
would consider moving to more appropriate
• A council developed extra care housing
housing before they needed care and a
scheme of 83 units in Dunstable.
further 25 per cent would be prepared to
move if the need arose. • A private sector ‘rightsizer’ housing scheme
of 32 units in Dunstable.
• Location was by far the most important
factor for those people planning or • Two new care homes with 141 beds in
considering a move, followed by design Dunstable enabling the council to close
and size, tenure and cost, and facilities. some of its in-house outdated care home
provision.
• Most people planning or considering
a move wanted a similar tenure to their • A housing association extra care housing
existing arrangements, ie most owner scheme of 81 units in Leighton Buzzard.
occupiers (80 per cent of current 65 plus • In developing its Local Plan, consult with
population in Central Bedfordshire) wanted residents to explore the opportunities for
to remain in the owner-occupied sector if community-led housing such as co-housing
they move. for older people.
30 HOUSING OUR AGEING POPULATIONYou can also read
