New market opportunities: senior living East Housing LIN meeting, 9 July 2015 Jeremy Porteus Director Housing LIN

Understanding the older people’s housing market Public sector policy direction is still fostering new models of provision & new capacity in extra care to reduce costs and improve outcomes - i)by a shift towards unregistered ‘housing’ accommodation with high levels of support to replace traditional care home placements & reduce hospital use for respite, assessment, rehabilitation and intermediate care ii)through new housing based & domestic style models for dementia care at all needs levels iii)a ‘de-institutionalisation’ of expensive health services for long term mental health & chronic illnesses BUT, general housing need statistics suggest 220k – 295k new homes are required each year, just 118k currently being developed

Evidencing funding applications Understanding demand & capacity Housing LIN / ADASS SHOP analysis tool Draws on the IPC POPPI data from ONS, plus the EAC care & housing data

Useful guidance: funding & procurement Current sources of funding Which of these may still be suitable for funding new extra care schemes? How scheme characteristics influence access to funding sources Not all extra care schemes, providers or operators are the same Evidencing and informing funding applications Understanding demand and capacity, making your case for funding, cost modelling Appraisal types for extra care housing Not for profit and for profit approaches

Capital and revenue investment HCA Affordable Housing Programme Guarantee – continuous market engagement DH £315m specialised housing fund DH £135m social care capital grant £5,3bn Better Care Fund with £220m DFG to support reablement, more ahead? Impact of welfare reform and Supporting People in England - new HB arrangements and commissioning within tighter eligibility criteria and increasing self-funder market (ADASS report) Use of equity release to move to ‘downsize’ to purpose-built ‘care ready’ housing and/or to pay for personal care and support

Alternative funding sources: what’s new? Institutional lending, pension funds, bond and/or social finance LA grants, loans and/or Special Purpose Vehicle Other procurement frameworks Insurance-backed products Public/Private partnerships ‘Downsizer’ market - personal equity/individual asset management Neighbourhood based solutions eg co- production/community led or co- housing Other public capital/revenue eg learning disability/mental health trusts

From welfare to wellbeing At Home Care Make best use of technology and equipment – from 4 th generation telecare/health to Ipad/internet End of Life Care – avoid hospital admission Preventing costly health interventions eg, as a result of a fall Building effective social capital to enable greater community engagement/informal or family care/volunteering Less dependency on high cost care Designing for inclusion Accessible and adaptable HAPPI homes Providing meaningful housing choices and lifestyle aspirations to meet personalisation objectives

A new breed of extra care housing? HAPPI ‘care ready’ to on-site 24/7 care Supersized – developing at scale: retirement villages, vertical living Hub and spoke/community hubs Flexi-care Making better use of sheltered housing New urban living Healthy living centres Supporting people with long term conditions ie dementia or a learning disability Useful selection of resources on the Housing LIN extra care housing webpages at: ngExtraCare/ ngExtraCare/

Age-appropriate mainstream housing Age-proofing Age-friendly cities Lifetime neighbourhoods Healthy places, healthy homes Useful selection of resources on the Housing LIN design hub at: n_building/ n_building/

Private Rented Sector Embryonic state (estimated less than 1500 units nationally) Often used by leasehold sector in ‘hard to sell’ retirement properties, but Also, rent to buy schemes as a ‘taster’ for ‘resizer’ market before committing to purchase Growing interest in attracting older people in ‘general needs’ PRS but also some bespoke retirement housing PRS More popular in US, Canada, Australia and mainland Europe Useful Housing LIN factsheets and viewpoints on PRS at: ngExtraCare/Commissioning/PrivateSector/ ngExtraCare/Commissioning/PrivateSector/

Co-housing/lifelong neighbourhoods Co-housing communities are based on the following features: –they are set up and run by their members for mutual benefit –members live consciously as a community –they are democratically managed and controlled by their members –common space encourages shared activities like community meals and –where possible, physical design encourages ease of social interaction Specific section on the Housing LIN website on cohousing at: ng/HousingforOlderPeople/Cohousing/ ng/HousingforOlderPeople/Cohousing/

Other initiatives Use of NHS Estate/ public land disposal (NHF report, ‘Creative Use of NHS Estate’) Local Enterprise Partnerships: regeneration and wider infrastructure. Extra care housing as s106 contributions Community-led housing: Residential care and care hotels Homesharing/Shared Lives Telecare/telehealth Close care/continuing health care Useful selection of resources on the Housing LIN health & Housing Intel pages at: ousingandDementia/ ousingandDementia/

Developing your Market Position Statement Working with DH, DLCG, and ADASS on how might accommodation and care for older people change over next years – use Housing LIN What impact will changing wealth and tenure on accommodation and services older people might want as opposed to might need. Estimated 5.5m people under-occupying What will the implications of levels of personal equity held (£873.77bn) Are you clear what your core business is in balancing choice and safeguarding housing for older and vulnerable people?

Opportunities or Challenge? What scope is there for better planning, commissioning and/or access capital funding to promote innovation in lifestyle choices for older people or stimulate a housing with care market as an alternative to institutional provision? Can Age Friendly communities help partners such as not-for- profit, churches and statutory health and social care services support more people in the community, meet growing demand of an ageing population, any targets / cost-benefits? Is there the case for Extra Care for maximising independence for people with dementia or is the future more residential care and home based care and support? Are there other market opportunities such as aids and adaptations, telecare, co-housing, homesharing, social capital? What strategies and policies are in place to engage, involve and listen to the housing with care needs of older people and their carers? Join the Housing LIN to stay connected with latest ideas

THANK YOU! Jeremy PorteusHousing LIN Directorc/o EAC, 3 rd Floor 89 Albert Embankment London, SE1 7TP Tel: Tel: Website:

Workshop Discussion What are the key barriers to delivering extra care developments? What changes to your operations are necessary to your extra care schemes economic? What market innovations will be necessary to develop new extra care schemes in the future?