Accommodation and associated services for older people in Northern Ireland: future need and demand Chris Paris, Emeritus Professor of Housing Studies, University of Ulster CARDI International Conference: Ageing Globally – Ageing Locally Session: Housing, Technology and Living Environment Wednesday 2 nd November 2011, Dublin

Background  Focus on older adults’ housing need & demand 2006 to 2016  Wider than last review of older adults social housing needs (1997)  Research objectives relating to older people’s housing To analyse demographic and policy trends to support informed decision making regarding future housing need assessment To identify existing supply of accommodation relative to the distribution of the older population To draw up a ten-year projection of the future housing needs of older people  Three main research methods: Wide-ranging literature review Analysis of census and other data, including official household and population projections, for NI overall and spatially disaggregated by proposed RPA LGDs Interviews with a range of key stakeholders

LGDs proposed in the RPA

Key findings  NI projected to have highest rate of growth in older population in UK Growth of over-55s low in Belfast, much higher elsewhere, especially south and west  Strong evidence that older people wish to stay in their homes as long as possible  Access to suitable housing not perceived a major problem of older people  Health-related frailty is a major reason for needing to move  Next cohort of over-55s has much higher level of ownership than earlier cohorts Lowest in Belfast and Derry-Strabane, other areas had lower levels of social renting  Older households more likely to occupy unfit homes, despite less unfitness overall  Specialised social housing for older people mainly in Belfast and Derry-Strabane So should extra supply be focussed elsewhere? But is there demand elsewhere?  Possible mis-match between policies relating to deinstitutionalisation and probable rapid increase in number of older adults suffering from dementia  Glaring lack of age-related data on housing expectations and preferences

Literature review  We mainly looked at UK and Ireland, plus some EU material  Wide range of material on older people’s future housing and preferences: academic, professional, government & private  Strong emphasis on preference to stay in own homes  No evidence that access to housing is perceived as a major issue  But a theme of limited information regarding other possible options  A mix of ‘push’ and ‘pull’ factors affect choices about staying/ moving ‘Positive’ pull factors inclining people to remain in current home include ties with family & community, familiarity with home and neighbourhood, and retention of ownership of asset ‘Negative’ pull factors include lack of knowledge of other options, few realistic options, fear of upheaval and change, fear of losing asset and moving into rented accommodation, possibly at high cost ‘Push’ factors necessitating a move include deteriorating health, safety or security concerns, physical deterioration of dwelling, fuel poverty or inability to make ends meet more generally.

Housing models and solutions  Useful ideas of a ‘triangle of intervention’ and a ‘continuum of care’  Triangle of intervention: from broad measures for all older people (information on benefits) to resource-intensive action for a minority The Older Population Residential care/Care Homes Specialised housing - Close care - Extra care/housing with care - Sheltered housing - Park homes -Retirement villages Mainstream housing - Home care/domiciliary care - Repairs/adaptations/grants Mainstream housing - No inputs Complex needs Substantial needs Low-moderate support needs No current need - Provide information - ‘Preventive’ intervention for entire older population

Future need & planning issues  Age in itself is not necessarily a good indicator of housing needs But the availability of care is crucial in cases of long-term ill-health or illness  Impossible to provide a single estimate of demand Demand and need levels depend on variable factors: People typically only look to change at times of crisis Demand and supply are inter-related, not in a single cause-effect relationship  Waiting lists for sheltered housing show ‘visible’ demand But may be ‘insurance policies’ for people who do not actually want to move  There were no specific planning policies relating to older people’s accommodation  Demographic trends show significant changes in the NI population to 2016 Older overall, with many more older 1- and 2-person households  Overall projected population growth: 121,000 or 7.3% With most net growth is in older age groups, especially and 85+  The projected growth of over-55s has a strong geographical bias by LGDs Belfast had largest number in 2006 but has very low projected growth to 2016 Much higher rates of growth projected elsewhere, especially in the south & west

Growth of 55+ to 2016 by LGDs

A changing housing market context  Massive overall change in the NI housing system, especially tenure, % growth in number of households, greatly exceeding population growth (13%) Major shifts in the pattern of tenures  Huge expansion of home ownership between 1981 and 2006 From 50 to 70% of households; number of home owners up by 50%  The social housing stock fell overall with a changing set of providers HE housed 40% of households in 1981 but just 14% in 2006  Reversal of long-term decline in private renting & growth of buy-to-let  Significant geographical variations (all households) Owner-occupation low in Belfast (56%) and Derry/Strabane (63%); all others 70-76% HE rental highest in Belfast (26%) and Derry/Strabane (25%); all others 14-19% Other social – primarily HAs – highest in Belfast (5%) with others 1-3% Private renting highest in Belfast (13%)  Similar (but lower) variations for pensioner households Owner-occupation lowest in Belfast (55%) and Derry/Strabane (60%); others 61-69% HE rental highest in Belfast (30%) and Derry/Strabane (25%); all others 17-24% HA tenants concentrated in Belfast (9%), low Mid Ulster and Fermanagh & Omagh (3%)

Implications for future needs  These trends have mixed implications for future needs/demands for older people  Together with current uncertainties due to the housing market recession Can we distinguish short-term fluctuations from possible new longer-term trends?  But home ownership is not likely to increase generally at same rate to 2016 Fewer HE homes to sell and changed sales scheme ‘Shock’ of housing market recession and problems for 1 st time buyers May imply expanded need for rental housing in social & private sectors  And increasing numbers of people reaching 65 will own their homes outright Cohort effect from higher ownership among current generation of year olds They are not likely to want to move into social housing Though lower values since 2007 may affect perceptions regarding other options  There probably will be fewer older potential clients for specialised social housing The number of HE tenants moving into older age groups is falling We need carefully to assess likely patterns of future vacancies and demands But there may be more need for other forms of health-related care  Future social provision is highly policy-dependent

Suitable/specialised housing  The study considers ‘suitable’ and ‘specialised’ social housing for older people  Difficult to enumerate ‘suitable’ accommodation: was defined by dwelling types But many are occupied by non-pensioner households (e.g. one-bedroom flats)  Decent data exist on HA specialised accommodation for older persons Showing growth from <6,000 in 1991 to 11,000< in 2009/10  But poor data on bed places in nursing homes & residential care homes No consistent and systematic source of data, figures are a bit rubbery We think the number of places has grown from <14,000 in 1991 to 15,000 in 2009/10  We analysed the spatial distribution of specialised & suitable accommodation Using ‘location quotients’ showing share of such accommodation compared to the 2006 distribution of older population (55 and over) If the shares of older people in an LGD is the same as its share of specialised accommodation, it will score an LQ of 1 Thus LQs of are ‘average’, <0.8 is relatively low, and 1.3< is relatively high This is a purely a descriptive method – no implication of ‘under’ or ‘over’ supply

Geographical variations by LGDs  ‘Specialised’ social housing for older people Comprising HA sheltered & with support: 10,300 in 2006 Very high LQ in 2006 in Belfast (2.0), high in Derry/Strabane (1.3), low in south and west If supply stays constant, then by 2016 differences will become more marked  ‘Appropriate’ social housing for older people Mainly HE bungalows & ground floor flats: 28,400 Less variation: highest LQ in Derry/Strabane (1.4), all others NB much HE ‘appropriate’ not occupied by older people If supply stays constant, by 2016 only significant difference would be higher LQ for Belfast  Contrast with projected growth of 55+ population Very low growth expected in Belfast: < 3% Much higher east and north: 20-24% Higher still in south and west: 25-29%

Projected housing needs to 2016  An increasing % of older people will be home owners In most cases requiring little or no public policy response  The number of HE tenants entering older age groups will fall to 2016  No strong case for expanding age-specific social housing provision And we need to consider where any such provision might best be located And to think carefully about how best to use the existing stock  Strong case for expanding other age-related accommodation with care Due to probable rapid increase in number of older adults with dementia Possible mis-match with policies relating to deinstitutionalisation  High proportion of 55+ in unfit housing: may be an ongoing ‘pool’  Lack of age-related data on housing expectations and preferences