MIDDLESBROUGH COUNCIL
EXECUTIVE REPORT
Meeting the challenges of an ageing population – older people’s housing needs
Executive Member for Regeneration and Economic Development: Charles Rooney
Executive Member for Social Care: Barry Coppinger
Director of Regeneration: Kevin Parkes
27 JULY 2010
PURPOSE OF THE REPORT
1. This report considers how the Council and its partners might meet the housing needs of Middlesbrough’s increasingly ageing population.
SUMMARY OF RECOMMENDATIONS
2. That the Executive Members approve a medium-term approach to meeting older people’s housing needs which focuses initially on the potential to create a Retirement Village at Greater Middlehaven.
IF THIS IS A KEY DECISION WHICH KEY DECISION TEST APPLIES?
3. / It is over the financial threshold (£75,000)It has a significant impact on 2 or more wards
Non Key / r
DECISION IMPLEMENTATION DEADLINE
4. For the purposes of the scrutiny call in procedure this report is
Non-urgent / rUrgent report
BACKGROUND AND EXTERNAL CONSULTATION
National priority
5. Responding to the needs of an ageing population is acknowledged as one of the biggest challenges of the 21st Century. Nationally, numbers of older people, and those requiring housing with care, are set to rise dramatically over the next two decades, with a significant increase in demand for specialist housing.
Local need
6. Across Tees Valley, there are around 140,000 residents aged 60 or over. By 2031, this group is projected to increase by more than 50% to 213,000, representing almost 30% of the population. By this time it is also anticipated that Middlesbrough’s population of residents aged 60 and older will amount to some 37,000, or just over 27% of the town’s population. Furthermore, more than one in every ten Middlesbrough residents will be aged 75 and over. It is also projected that increasing numbers of older people will have physical disabilities, those with learning disabilities will account for a larger proportion of the older population, and dementia and other long term conditions will be more prevalent. It is anticipated that demand for housing, social care and health services, including adaptations to enable older people to remain at home, will continue to grow. [1]
7. Whilst it will be important to develop a better understanding of the data around aspirations of older person households intending to move from their current homes there is already an indication as to the aspirations of older people in Middlesbrough and across the Tees Valley. The Tees Valley Strategic Housing Market Assessment (2009) suggests a strong aspiration towards two bedroom properties across Tees Valley (84% in Middlesbrough). In terms of property type, preferences were strongest for bungalows (53% of households across Tees Valley and 67% in Middlesbrough). This was followed by a preference for flats (27% of households in Tees Valley but only 15% in Middlesbrough). Around one-fifth of Tees Valley older person households would consider a house. There was also some interest in properties with three or more bedrooms (18.8% across Tees Valley). Overall, this data is consistent with national research with the majority of households seeking two bedroom properties; with interest mainly in bungalows and, to a lesser extent, flats.
STRATEGIC RESPONSE
National policy
8. The national agenda for addressing the housing issues facing older people focuses on:
a) improving the information and advice available to older people relating to housing options;
b) making it easier for older people to stay in their own homes, near their family and neighbours;
c) the introduction of rapid repairs and adaptations services;
d) increased funding for Disabled Facilities Grants;
d) ensuring that all public sector housing is built to Lifetime Homes Standard with an aspiration that all new housing will be built to these standards;
e) establishing lifetime neighbourhoods consciously planned for people of all ages and conditions; and;
f) strengthened relationships between housing, health and care services.
Local strategy
9. Middlesbrough’s strategic response is set within the context of the Older Persons Strategic Plan, a ten-year vision for the town’s older citizens. This is underpinned by the Council’s Older People’s Housing Strategy (OPHS), which aims to meet the housing needs of older people by ensuring:
a) they can stay in their own homes for as long as possible;
b) their housing needs are taken into account in future housing developments; and,
c) accommodation based services are enhanced so that older people have access to appropriate, high quality accommodation with support and care.
10. Whilst work is currently under way to refresh the strategy it is anticipated that the general direction of travel will remain constant. The following paragraphs, therefore, consider how the Council might look to meet the housing needs of older people within the context of the existing strategy.
DEVELOPING ADDITIONAL HOUSING PROVISION FOR OLDER PEOPLE
Enabling older people to stay in their own homes for as long as possible
11. The vast majority of older people want to stay in their homes for as long as possible. A substantial body of evidence points to older people doing better for longer in a setting conducive to maintaining their quality of life, which fosters choice and independence, as opposed to dependency. The Council and its partners place great store in helping people to live at home, safely and independently, for as long as they can. This is a central plank of the OPHS, and a range of initiatives help meet this primary objective, including:
a) The Staying Put Agency, which enables access to Disabled Facilities Grants and minor aids and adaptations, amongst a range of other services;
b) Telecare - a service which uses a range of electronic sensors in the home to automatically alert and organise an effective response should a problem arise;
c) Integrated Falls service – multi-disciplinary approach focusing on increasing appropriate exercise interventions for those at risk of falls, health promotion and education strategies; and,
d) a range of initiatives within Occupational Therapy services that have reduced assessment waiting times, including self-assessment for equipment and minor adaptations.
Older people’s housing and future housing developments
12. New homes can be built to accommodate the needs of older people now, such as bungalows and apartments. More generic provision can be designed from the outset to be more easily adaptable to changing needs as people grow older, increasing the probability of their remaining at home for longer.[2] There are a number of recent examples of specific development for older people in Middlesbrough, including:
a) St. Francis Close, Acklam Green;
b) Trinity Crescent, North Ormesby; and,
c) Tregarth Close in Saltersgill.
13. More recently, the Council has been allocated grant funding, subject to further evaluation, from the HCA to help build 20 apartments for older people at the site of Levick House, Cambridge Road.
14. It will be important for the Council to continue to work with partners to provide a range of opportunities in terms of purpose-built homes for older people. This has been achieved in the past by working with the HCA, housing associations, and/or through private sector contributions secured through planning obligations. In addition, it will be important for the Council to consider how new homes can be better enabled to accommodate changing needs over time. However, in moving forward, the Council must have regard to the economic viability of such an approach and its capacity to deliver the necessary step change in older people’s housing provision.
15. In this regard, the problem facing Middlesbrough is a combination of comparatively limited supply of housing land, which is often subject to a number of planning constraints and obligations as the Council seeks to meet the town’s diverse needs, including that for family and affordable housing. In addition, there is the broader economic impact of the recession on the capacity of the housebuilding industry, and the limited availability of, and increasing need to target grant funding from the HCA. In such an environment the Council and its partners may need to adopt a more proactive and pragmatic approach. There is clearly the potential to overload housing development sites with additional costs which cannot reasonably be borne and which could ultimately reduce the new housing supply so critical to the town’s future, as land owners may choose not to release sites and/or developers look to more favourable conditions elsewhere. This could have the effect of severely limiting new house building activity as the fragile economic recovery continues. In effect, then, it will be very difficult for the Council to insist on both affordable and specialist housing on some sites, particularly space-consuming provision such as bungalows. Given the challenges faced by the Council it may be more appropriate to move away from a relatively piecemeal approach where a very small percentage of units might be secured across a range of sites and look instead to develop more substantial provision on specifically allocated sites. This approach is considered further in paragraphs 20 onwards.
16. Whilst new developments for older people in Middlesbrough have more recently been aimed at the affordable/social rented market it will be important, in addition, to develop a better understanding and plan for the needs of older people who are currently accommodated and wish to remain in the private sector. There is currently only very limited provision for this increasingly significant market sector in Middlesbrough. If the needs of this group are not adequately addressed then it will increasingly require social care/health assistance to remain at home. In developing options for this group it will be important to enable homeowners to reinvest capital from the sale of their home. In this regard it is also a group which has the potential, for example, to release under-occupied private sector dwellings, including those at the higher end of the market.
17. In recent times the private sector has developed minimal provision for older people and has tended to focus on specialist provision, such as the McCarthy and Stone supported housing scheme at Constantine Court, Linthorpe Road. It will be important for the Council to work with the sector to consider how the needs of this important group can be met. This approach is considered further in paragraphs 21 onwards.
Accommodation based services
18. Whilst it is clearly desirable, it is not always possible to efficiently and economically provide services in the longer term to people in their existing homes. The OPHS, therefore, recognises the essential role of specialist accommodation-based services. In this regard the OPHS espouses Extra Care Housing, which is purpose-built accommodation in which varying amounts of care and support can be offered on-site, and where some services are shared.[3] It can provide the majority of residents with a home for the remainder of their life, regardless of changes in their care needs.
19. The OPHS identifies a shortfall in Extra Care Housing provision as a major weakness in housing and support/care in Middlesbrough. Middlesbrough has only one purpose-built Extra Care scheme, Pennyman House in North Ormesby. Demand for places in this 42 apartment, affordable housing scheme exceeds supply resulting in some admissions to more costly residential care which are unnecessary, but are the safest option. The Strategy estimates the town may need as many as 184 additional units of Extra Care by 2025/26. Whilst it may be possible to meet a relatively small proportion of this need by reconfiguring existing sheltered schemes, work already undertaken confirms that many current schemes cannot be economically adapted. Activity in this area continues with housing association partners focusing on the potential of a small number of schemes.
20. It seems clear that the Council should look to develop additional Extra Care provision. This could be a stand-alone scheme on a specific site, or within a wider, residential or mixed-use development. An Extra Care Housing scheme could also be a core component within a Retirement Village (see below). How such provision might be delivered is considered further in the following paragraphs.
Retirement Village
21. A Retirement Village would appear to provide an ideal response to the issues raised in the preceding paragraphs. The proposed model for Middlesbrough is what the Department of Health describes as an all-embracing, comprehensive alternative to both sheltered housing and residential care, providing for a whole range of individual needs and circumstances. Such a model would enable Middlesbrough to meet a range of older people’s needs in a setting conducive to maintaining their quality of life and fostering independence, as opposed to dependency.
22. This form of development, which it is suggested in Middlesbrough will be predominantly for owner-occupation, can be anything from a small estate to a full blown “village-sized” development of bungalows, apartments or houses, intended for occupation by older people, with Extra Care provision a key component. It can often include a number of recreation facilities and a range of property types and tenure. [4] The facilities offered should also be designed to benefit the wider community, thus ensuring integration. A landscaped open setting is also considered highly desirable, but this may be dependent on location.
23. Research carried out for the Joseph Rowntree Foundation (JRF) indicates the great potential of such provision to expand the choices of living arrangements for older people, offering the opportunity not just for decent age-appropriate housing, but also for enhancing older people’s quality of life, health status, and sense of social well-being and security. [5]. The research has also highlighted the opportunities for health and social care providers to deliver community services more effectively and efficiently.
24. Whilst this form of development is relatively new in the UK, there are a number of examples which the Council could look to as it develops its response, including Hartrigg Oaks, operated by the JRF Housing Trust in York. More locally, Hartlepool has developed the Hartfields retirement village with the JRF. It comprises 214 one and two bedroomed apartments and 28 cottages - all designed for people in later life and including homes for rent, shared ownership and sale. In planning for any such development in Middlesbrough it will be critical to determine future sales values with regard to the Middlesbrough market and to engender confidence in the sustainability of any investment in such a development. Older people looking to trade-down will not be looking for something more expensive, and, as already mentioned, will be looking to capitalise and/or safeguard their assets.