Housing provision

focus on longer, healthier living and preventing ill health.

Recently, the media has increasingly focused on under utilised NHS land and estates and the relationship between acute, mental health and social services has been under the spotlight. NHS trusts need to use their estates to help achieve better value.

An independent perspective can help promote the reallocation and re-use of stretched assets. For example, Lancashire Care NHS Foundation Trust entered a joint venture with Ryhurst, the healthcare arm of Rydon, to make efficiency savings and invest in new facilities. The partnership led to £5 million in revenue savings for the trust and an improvement in the use of space of 39 per cent. This helped the trust to create a new 154-bed residential mental health facility to support frail and elderly patients, which better meets the changing needs of the local community. Having grown and expanded organically, the Isle of Wight NHS Trust’s main hospital estate at St Mary’s is now dispersed across the 52 buildings that form the 27.7 hectare site. A space utilisation pilot study was undertaken to review use of space and vacant accommodation was found to equate to 424.98 m2

. This represented an annual saving of £165,984.40 in terms of how land disposal could achieve capital receipts to reinvest.

It was suggested that the surplus land could be used to provide step down facilities for patients moving from an acute medical setting once their level of care need was reduced. Patients are often elderly and unable to return to their own homes, but do not need an acute bed. Waiting for home care is now the most common reason for delayed transfer of care and moving to a step down facility allows further time to be allocated to make arrangements for future care needs; it also cuts delays in discharge from an acute bed.

Meeting a need

Extra care and retirement housing provision has been steadily growing as a subset of the housing industry, making an important contribution to the housing mix in two ways. Firstly, by helping people to remain independent in later life with access to the care they need and secondly, freeing up larger homes for younger people with families. Extra care housing is specialist housing designed for people aged over 55 years. The facilities are often made up of self contained flats with shared


60 extra care homes were created in underutilised space at Hazelhurst Court

amenities such as a lounge, restaurant, health spa, hairdresser and garden. Care is available on site at a level that meets individual needs and residents have access to personal care services and assistance with a range of tasks, such as dressing, bathing, meal preparation and housework, if required.

Extra care facilities also offer different levels of support, with care workers available on site 24 hours a day for those who need them. There are many advantages to being in extra care housing, which include maintaining independence, security, flexible care and support as well as providing opportunities to socialise. In some cases extra care housing can delay the need to move into a care home. The RIBA award winning Hazelhurst Court extra care scheme in Lewisham for Phoenix Community Housing, provides 60 affordable homes for people aged over 60. Built in the grounds of a sheltered housing facility, these homes offer opportunities for social interaction and a range of communal facilities to help keep residents healthier for longer and reduce demand on social care and NHS budgets. These examples show how the market can innovatively use land to create viable, specialist facilities in locations that were previously not considered or thought possible. The question is, how many more spaces could be freed up throughout the country to deliver more? In addition to the social and development challenge, the ageing population of the UK is increasing and the so-called ‘grey pound’ is becoming more influential. Indeed, it could be argued that the wealth, income and needs of the elderly population are likely to shape the

built environment as much as those of the younger generation in years to come. There is a significant potential market for age appropriate housing and this demand is only set to rise in the future. The public and private care sectors therefore need to assess and understand what type of housing is needed for the growing ageing population. Offering older people a better choice of accommodation can help them to live independently for longer, reducing costs for the social care and health systems. Care can be delivered in a range of environments, which include home care, sheltered housing, care / nursing homes and extra care homes, although of course, there are benefits and limitations for all of them. For example, domiciliary care is flexible in that you can decide the frequency with which you receive care and care is delivered in a familiar environment, but it can be lonely at times, especially if family and friends do not live close by.

According to Age UK, 3.6 million older people in the UK live alone, of whom two million are aged 75 and over. One of the benefits of care homes, sheltered housing and residential homes is that they offer opportunities to socialise with people of the same age and to take part in organised activities and outings.4


It can be difficult to know how to prepare for the future, but we do know that it is essential that we begin discussing how we will deal with later life care needs. Care watchdogs have warned that the quality and safety of social care services received by elderly and disabled people in England are in danger because we • November 2018

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