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Alternative models of housing with care and support


Co-housing communities are created and run by their residents. Residents come together to manage their community, share activities, and regularly eat together. Although co-housing has a strong focus on living communally, with shared spaces a defining characteristic, it is different from a commune as residents have their own self-contained homes and private spaces with residents deciding when and how they want to interact. Co-housing communities can also be known as community-led housing (CLH).

Starting in the UK at the end of the 1990s, the co-housing movement has gradually developed and there are now 19 built co-housing communities with a further 60+ co-housing groups developing projects.

Co-housing communities can be inter-generational, welcoming anyone of any age and any family structure. They can also be designed specifically to cater for communities of common interest, for example for women or LGBTQ+ groups. Interest in older people’s co-housing is growing as people increasingly see it as a way of living which can help to maintain independence and give a sense of purpose while also alleviating social isolation and loneliness. For some people, co-housing could be an alternative to housing with support.

Communities in the UK range from new, purpose-built developments with a strong focus on eco standards, to conversions of existing dwellings or buildings. They are in urban, rural and semi-rural locations, with some having very large areas of land and others having very little. Most of the initial co-housing projects were self-funded by the residents as there was no public funding available for co-housing. Increasingly, communities are working in partnership with other agencies to co-create their co-housing using a range of legal and financial structures to enable them to offer different tenure types including rental and mutual homeownership options. A Toolkit has been developed to help local authorities navigate issues related to co-housing schemes.

The common co-housing characteristics:

  • Co-housing is co-designed with intentional communities. The initial group contribute significantly to the design of the co-housing community and take an active role in creating the community.
  • Co-housing is a balance between privacy and community.
  • The size and scale of developments is appropriate, usually between 10 and 40 households to make interactions as easy as possible.
  • Residents are the decision-makers and decisions are often based on consensus, with all adult residents being encouraged to take part in decision-making. Residents manage their own community, looking after the maintenance and development of it, running the finances, tending the gardens and organising shared activities.
  • Co-housing communities are inclusive and part of the wider community and often host wider community activities in the shared space and common house.


Almshouses are self-contained, low-cost properties, mostly for older people who have a low income. Almshouses are managed and run by independent local almshouse charities which tend to be made up of volunteers. An almshouse charity is usually a charity for the relief of financial hardship by the provision of housing and associated services or benefits. They often cater for particular categories of people which the almshouse charity has a particular focus on, for example people who have worked for a certain trade or have been living in the area for a number of years. Today there are almshouses for retired fishermen, miners, retail workers and a host of other groups in addition to older people. Some almshouse charities have no age restrictions and are able to accommodate families, people with a disability and key workers. There are generally a small number of houses grouped together. Residents pay rent, usually called a maintenance contribution which is similar to rent but different in law, and less than a commercial rate.

The history of almshouses stretches back to medieval times when religious orders cared for the poor. The oldest almshouse foundation still in existence is thought to be the Hospital of St Oswald in Worcester founded circa 990. Today there are 30,000+ alms dwellings throughout the UK providing homes for approximately 36,000 people. The majority of almshouse residents are of retirement age, of limited financial means and living within the vicinity of an almshouse charity or have a family connection to the area in which the charity is located. Almshouses do not always have the word ‘almshouse’ in their name, they may be referred to by another title, such as ‘College’, ‘Hospital’ or ‘Homes’.

Some almshouse charities employ a warden or scheme manager to provide support to the residents and assist in the management of the charity and a small number of larger almshouse charities offer housing with care. However, generally anyone wishing to apply for accommodation at an almshouse charity needs to be able to live independently.


Homeshare matches someone who needs some help to live independently in their own home (householder) with someone who has a housing need (homesharer). In return for low-cost accommodation the homesharer provides a minimum of 10 hours of support per week to the householder. The matching is done by a homeshare scheme to whom a monthly fee is paid. A homeshare coordinator will select a householder and a potential homesharer who will then interview each other to try and ensure a good match. Homesharing can benefit and enrich the lives of both the householder and the homesharer. It is not usually suitable for the provision of personal care but can reduce the need and expense of traditional care services and can extend independent living at home.

The average homeshare match length is nine months and the longest current match is five years. There are more than 20 different homeshare schemes across the UK and Republic of Ireland, all of which are members of Homeshare UK.

Householders are often older people, or people who need support to continue to live in their own home. They will have some support needs or may have become isolated or anxious about living alone. The idea is that with reassurance and companionship, householders will continue to live full, happy and healthy lives. Householders will also be able to pass on their skills and experience to enrich the lives of those that share with them.

Homesharers are often younger people, students, or key public service workers who cannot afford housing where they work. They give time and support the needs of the householder in exchange for a place to live at a reduced cost. They can also benefit from developing a relationship with the householder, sharing interests and hobbies. The type of support offered over the 10-hour minimum is agreed between the householder and homesharer and may include activities like: cooking, shopping, cleaning, laundry, reading, administration, walking the dog and offering companionship.

The homesharer does not pay rent directly to the householder. Instead both parties pay a fee to the Homeshare scheme to cover the costs incurred in finding and supporting good matches. The homesharer may also pay a contribution to household bills. Fees paid to Homeshare schemes vary to reflect local economies. On average a homesharer will pay £160 per month and a householder will pay £140 per month to the Homeshare scheme which represents a significant saving on accommodation and similar domestic help.

Homeshare schemes are not regulated by an independent body. Schemes that join the Homeshare International Network (HIN) have to sign up to a Charter of good practice but HIN has no authority to inspect schemes for compliance.

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Promising practice examples

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Role of housing in the future of care and support

Commission report: A place we can call home

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