As chair of an extra-care housing provider, I have seen first-hand how single-minded ministers are prepared to be in cutting costs and driving better performance. When chancellor George Osborne announced in his July budget a surprise 1% annual rent cut for four years for tenants of social landlords, the English housing sector was stunned. Local government take note.
Ministers remain convinced they can get more bang for the taxpayer buck. I would like to propose to Osborne a solution in care of older people that has been proven to do exactly this – and to cost less.
For more than 20 years, as a director of social services and beyond, I campaigned for extra-care housing as the model of provision that should replace residential care for older people. Almost two decades later, I am even more convinced that housing must play a bigger role in supporting older and disabled people to live independently. Why? For me it’s simple. Housing is “their territory”. Supported housing operates in, and provides its services in, the territory over which service recipients have ownership or control. No other model of UK social care as currently configured – be it residential, nursing or domiciliary care – can deliver on that.
We must start from where older people are: their aspirations, their potential to contribute, their desire to pursue a lifestyle should be what drives our thinking, planning and service delivery. This is the approach we take at The ExtraCare Charitable Trust – and not only does it work, but it saves money in the public purse.
A three-year study by the Aston Research Centre for Healthy Ageing, published in June, showed savings of 38% in NHS costs for our residents; a 46% reduction in routine or regular GP visits; a reduction in length of unplanned hospital stays from an eight- to 14-day average to one-to-two days; and a 26% reduction in higher-level social care costs to councils compared to costs in the wider community. In addition, when you consider the economies of scale that can be realised through people living in 200-home, well-designed retirement communities, with support services provided on-site, the case becomes, in my view, irrefutable.
Other countries have already grasped this potential. In the US, 5.6% of people aged 65 and over live in retirement communities, while in Australia and New Zealand some 5% make this choice. Yet in the UK, less than 1% are able to access such a lifestyle.
I am not suggesting that extra-care or supported housing is the magic bullet to resolve the chronic underfunding of social care. However, I do believe that, faced with a greater need for pooled funding and integrated service provision than ever before, extra-care housing is the vehicle and the territory for facilitating the change in behaviours that are required.
Martin Shreeve is chair of The ExtraCare Charitable Trust and former director of social services in Wolverhampton.
