Retirement communities and extra care housing Centre for Housing Policy University of York

CHP: Recent and ongoing and research Evaluation of Hartrigg Oaks Comparative evaluation of different models of housing with care – emerging findings Systematic review of the effectiveness of assistive technologies in assisting people with dementia remain in their own homes

Hartrigg Oaks: the concept CCRC Independence Attractive living environment Community and social activities Care and support Insurance based model – fit and frail Home for life

Hartrigg Oaks: development Many years in development Used 21acres greenfield site on edge of York, already owned by the JRHT 152 bungalows clustered around a central complex housing registered care home, and other amenities Development cost of £18M

Hartrigg Oaks Bungalows – spacious, designed to life time homes standards Layout and design creates sense of own space, just like a housing estate Central location, not within walking distance of shops and services for some residents, but within 1-2 miles of key services Residents: average age 78; women outnumbered men by ration 2:1; one third living with partner, two thirds living alone

Fee structure Two fees Residence fee –Fully refundable that is repaid without interest to estate –Non refundable (smaller) –Annualised (‘rent’) Community fee –Standard (£5,000 approx, single; £9000 approx couples) which will not increase, regardless of care service use –Reduced (as standard, but lower, in return for bigger residence fee) –Fee for care (not part of the insurance pool) pay for care services as you use them – appeals to some younger residents Not cheap

Care and support Services to bungalows - low level domestic support - home care (equivalent to those provided by social services) On site care home provides permanent places when residents can no longer live independently Also provides short term care and respite

What made Hartrigg Oaks attractive: residents’ views Very attractive to older people with the financial means to live there Combination of independence and security Many people fully independent but anticipating future needs By moving to HO were retaining control of future Not burdening families with responsibilities

Not just care and support…. Environment in which might live wholly independently for a decade of more Quality of accommodation Location Social activities Fees – value for money The Rowntree name

Meeting expectations? Half the residents “very satisfied” About one third “quite satisfied” About 10% neutral About 1% dissatisfied (rising to 5% in second survey)

Good things about Hartrigg Oaks

Findings High levels of satisfaction Concerns about social isolation of the frail Issues about resident empowerment Dementia care Managing expectations Dynamic nature of Hartrigg Oaks Concerns about affordability

Comparative evaluation of different models of housing with care Began in 2003/4, will finish 2006 Comparing eight different housing with care schemes: –Two RSL schemes –1 private sector (Retirement Security Ltd) –5 Charitable Trusts (including Hartrigg Oaks, Abbeyfield Integrated Care) Literature review of empirical studies

Literature Review: findings (1) Much speculation and great expectations about the role of housing with care, but less evidence of what it can achieve 11 recent empirical studies of housing with care schemes in the UK

Literature Review: findings (2) High levels of satisfaction of residents: related to independence and security Home for life? Cost effective? Fit and frail? Reduce social isolation? Dementia care?

Evaluation: emerging findings High levels of satisfaction across the board Scale Location Community formation Accommodation Build in capacity to change Home for life

Conclusions Housing with care is a positive choice for many older people Housing need as well as care need Diversity of provision Information sharing