Extra Care Housing

Extra care housing developments also called very sheltered housing or assisted living apartments are a growing and popular part of the housing with care market. Most ‘extra care’ consumers are older people and they often find it attractive because it offers them independent living in a home of their own with other services on hand if they need or want them.

What is extra care housing?
It is a concept rather than a housing type and while for simplicity’s sake we use the term extra care throughout there are many different kinds of housing and services that come under this label (see later in the factsheet). They are aimed at people with different kinds of incomes and aspirations. Some are for rent only and are aimed at ‘social’ tenants while others are aimed at people who can pay market rents. There are developments that are purely for sale or leasehold and others that are mixed rental and leasehold, often called shared ownership.

Until quite recently most extra care in the UK was developed with public subsidy by housing associations and was only for social rent. This is no longer the case. Many housing associations now provide mixed tenure developments. There is a thriving commercial sector as well. It is likely that this will begin to outstrip the level of social extra care provision over the next few years, in line with tenure patterns in ordinary housing, where around 70% of older people own their own homes.

The most important fact is that extra care housing is housing first. People who live there have their own self-contained homes. They have legal rights to occupy that are underpinned by housing law. This means there is a clear distinction between extra care housing and residential care as recognised by the Care Quality Commission. Further information can be found by going to www.cqc.org.uk

What is it for?

Mainly to provide well-designed housing that enables people to self-care for longer and give them access to care and other services, which help them, retain their independence.
Some properties in a development might also be used for providing intermediate care or rehabilitation services. Facilities might be based in a development to provide day centre activities, ageing well and keep fit for people living in and outside the development. These are usually separated from accommodation units in a development, to ensure privacy for the people who live there. Some developments also have office facilities for communitybased teams of domiciliary care or housing related support and health workers.

What does extra care housing look like?

There isn’t an easy way to describe the buildings because they are so diverse. They can look like a:

  • Purpose built retirement village
  • Large block of apartments with a restaurant or other linked buildings
  • Leisure complex
  • Development of bungalows and a mix of apartments and a central resource building that houses community health services or other facilities serving the occupants and local people
    • Sheltered housing scheme
    •  Hotel

You can find photographs and even plans of many developments detailed on the Elderly Accommodation Counsel extra care website www.extracarehousing.org.uk

Buildings may be new and purpose built or they may be older buildings that are re-used. Sometimes buildings are ‘remodelled’ so that each occupant has better facilities such as walk-in showers.
Extra care developments can contain a laundry for residents (or each apartment has a washing machine and dryer), lounges, meeting rooms, hobby rooms, and space for health or care staff. They may, but don’t have to have a specially equipped bathroom for assisted bathing and a restaurant. Extra care developments that have been built with public funds tend to make support and care accessible 24 hours a day. This doesn’t necessarily mean that it is all on site, although this may be subject to conditions of some capital and/or revenue arrangements. The level of support and care required is
something that has to also be addressed by commissioners. For example, if people need waking night cover it is likely that support and care staff will have to be based at, or close to, the development. More information on this subject is given in Essential Short Facts: Extra Care Housing, Factsheet 2 Commissioning Housing Based Models for Care at www.icn.csip.org.uk/housing

Care homes
Care homes (with nursing)
Specialist care
Care villages 
Virtual Care
Close Care

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