Housing with care for older people

Introduction

The growing interest and investment in models of housing with care for older people reflect high hopes for what they can achieve - the promotion of independence, reduction of social isolation, improvement in quality of life, and provision of a viable alternative to residential or institutional models of care. However, the evidence base in this field is still very limited, and JRF is committed to playing a role in addressing this through both research and demonstration.

These issues are hugely relevant to JRHT, with the recent opening of our housing with care schemes in Hartlepool and Scarborough, and the tenth anniversary of our continuing care retirement community, Hartrigg Oaks in York. These schemes will enable us to assess the new opportunities and challenges in the context of increasing public policy focus on choice, control and independent living.

Key issues

• Housing with care for older people is a significant area of growth: by mid 2006, there were 30,000 units of extra care housing in England.
• But the evidence base is still very limited - a JRF literature review (Croucher, 2006) found just eleven UK evaluations (as opposed to descriptive studies).
• Evidence tends to be stronger in areas such as satisfaction with housing.
• There are key gaps in robust research on the quality of stock - how specialised housing impacts on long term health and well-being outcomes, the extent to which schemes can support people with dementia, and the cost-effectiveness of different models.

Overview

Housing with care has been a key area of research for JRF since the establishment of our continuing care retirement community, Hartrigg Oaks, in the late 'nineties. While the earlier research focused on this particular scheme, later studies have explored aspects of the wider context, including a comparison of different models (Croucher, 2007) - the promotion of social well-being (Evans, 2007); and most recently, the costs and outcomes of moving into an extra care housing scheme (Baumker et al, 2008). JRF also funded a review of extra care housing and people with dementia by the Housing and Dementia Research Consortium. There are two further research projects in progress - one telling the story of Hartfields (our new scheme in Hartlepool), and another looking at social well-being in a number of new extra care schemes and villages.

A new programme of work on housing with care starts in Summer 2009, under the overall frameworkof 'A Better Life'. The aims of this programme are to influence: 

• the extent and way in which Housing with Care is promoted and commissioned, reflecting older people's own definitions of quality of life and informed by robust evidence.
• the quality of schemes, the outcomes they aim for and the capacity and skills of staff to deliver, focusing on older people who have/develop high support needs.