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Supporting health and social care providers in Devon

MPS: Extra care housing

MPS: Extra care housing

What do we want from this area in the future?

The service outcomes which are key business drivers for the Extra care housing (ECH) programme are shown below.

The outcomes to the individual are to:

  • offer an alternative to residential care and sheltered housing
  • provide flexible on-site discrete care and support
  • enable people to maintain their independence in their own self-contained accommodation
  • improved quality of life in terms of financial wellbeing, reduced social isolation, continuation of community life, and potential for continued role for carers and families
  • provide an affordable solution so that ECH can be a home for life
  • provide high-quality, fit-for-purpose dwellings with low-running costs in local communities
  • promote wellbeing and social inclusion.

The system-wide outcomes are to:

  • reduce admissions to residential care homes
  • reduce admissions to hospital
  • provide opportunities for early discharge from hospital and rehabilitation in a domestic environment
  • create a resource for the wider community
  • give older people greater choice, independence and control over their housing and care options
  • develop greater availability of suitable housing for respite use.

All ECH schemes must be capable of accommodating people with complex care needs, including dementia, at their initial point of occupation and support people with those conditions as they develop.

 What is the assessment of need?

Each ECH scheme should have approximately 60 plus units of accommodation to achieve maximum economies of scale. Approximately a third of the people living in ECH housing are anticipated to have social care needs equivalent to those of people living in care homes without nursing

At mid-September 2019 we were providing financial support to circa 90 people in 251 ECH apartments. The number of people financially supported in ECH, and the total costs, fluctuates as individual needs change

Demand for extra care housing comes from:

  • Devon County Council commissioned activity – with upward of 30% of this as a direct alternative to care homes without nursing
  • local housing authorities
  • NHS
  • self-funding individuals.

ECH is a relatively new housing with care option in Devon, so it is difficult to accurately state how many of the available units we would directly commission over time. However, based on experience, approximately 2/3rds of the units would be occupied by people requiring state-funded care or support and the majority of the remaining 1/3rd would purchase care privately. We anticipate that approximately half of the people receiving state funded care and support would be at a level of need equivalent to those in a care home without nursing. As an average people in care homes without nursing need 35 hours of care per week. The Council will seek to secure the right to refer older people we support and have funding responsibility for into 75% – 100% of the total supply of Extra Care Housing as it is developed and becomes available.

 

What is the assessment of supply?

In operation
OkehamptonCastle Ham Lodge50 units social rented
IvybridgeDouro Court32 units social rented
Newton AbbotHayden Court50 units affordable rented
BidefordMoreton Court

41 units affordable rented

18 units shared equity

TotnesQuayside

30 units – affordable rented

30 units shared ownership

Planned

Exeter

(Due to complete Sept 2020)

St Loyes53 affordable units for rent

Tiverton

(Due to start on site in 2019)

Alexandra Lodge45 affordable units

 

In addition to the above an application for outline planning permission has been submitted for a site in Barnstaple which includes the provision of approximately 60 Extra Care Housing flats.

 

Net demand for ECH, taking into account the current or planned supply

A detailed needs analysis in 2009, using a nationally recognised methodology, identified the population at risk; which is the population of older people most likely to need ECH. Not all those in the population ‘at risk’ will need ECH so the model further identifies the population in need, which does provide an estimated demand for ECH.

The population identified as at risk are people aged over 75, living alone with a limiting long-term illness.

The population in need was calculated on the basis of the number of older people who could potentially be diverted from moving into residential care and those who have intensive regulated personal care in the home which could be provided more efficiently in an extra care setting. We also recognised that there is likely to be a need for ECH from other older people who may be receiving regulated personal care services, or who are at risk in their current housing situation.

Since 2010, the Council has successfully enabled the development of new extra care housing schemes in Newton Abbot, Bideford and Totnes, with new Schemes in development or with planning permission in Exeter and Tiverton. Sites have been identified for 2 further schemes in Barnstaple and Kingsbridge.

The needs analysis was refreshed in 2015 and remains current. Refer to the PDF here: Extra Care Housing: Refresh of the Commissioning Strategy for Extra Care Housing (2009), August 2015

LocalitiesCurrent Unmet Commissioned NeedProjected commissioned demand at 2033
Exeter151252
Exmouth121189
Newton Abbot / Kingsteignton87195
Barnstaple85150
Teignmouth3970
Sherford043
Dawlish3258
Kingsbridge3659
Seaton3758
Sidmouth5383
Tavistock4894
Crediton3161
Axminster4265
Cranbrook055
Cullompton4179
Ilfracombe / Braunton / Lynton / Lynmouth58103
Dartmouth2033
South Molton2544
Honiton4672
Ashburton/Buckfastleigh2240
Great Torrington2652
Moretonhampstead1425
Holsworthy2551
Okehampton635
Ottery St Mary3655
Tiverton1063
Ivybridge3559
Totnes-1417
Bideford/Northam570

 

What changes are we looking for from this service in the future, including any market opportunities, and what can Devon County Council do to help to move towards these changes?

Given the increases in the older population Devon County Council and other community partners need to significantly increase the supply of extra care housing to offer an extra care service as an alternative to a care home without nursing.

Extra care housing is predominately offered to older people, but we are keen to hear from providers willing to offer extra care housing to adults of a working age who require social care support and/or older people with dementia. This may be as a part of a wider extra care scheme for older people or as a stand alone service.  Specialist dementia extra care schemes capable of providing an alternative to care homes without nursing will, most likely, require new, smaller scale, and innovatively designed schemes in the future.

We want to commission good-quality care and support within robust quality assurance systems. This should fit around people’s individual needs and circumstances, and support family carers. In recognition of cost implications, a core well-being service providing a registered personal care crisis response service, along with nutrition, activity and general health and well-being services will be offered to all residents on a standard chargeable basis.

The well-being service, and the personal care packages to individuals, will be regulated by the Care Quality Commission, and operate to national standards.

The increasing challenges in developing a financially viable extra care housing model means that we are always seeking to work with the market to consider new and innovative approaches to achieve affordable extra care schemes.

Market opportunity - extra care housing

We want to work with providers who can:

  • facilitate the design and construction of extra care housing (ECH) in areas of need
  • secure a significant proportion of the funding to finance the construction and operation of ECH – including the servicing of any debt
  • operate ECH and provide or arrange facilities management services
  • provide or arrange core care services
  • provide or arrange personal care and support services
  • engage with communities and partner with other services.

(Return to the Market Position Statement)

Last updated: 29/01/2020


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