Housing with support as a model for housing with care and support
What is housing with support?
Housing with support, also be known as retirement housing, is an umbrella term which includes sheltered housing, retirement flats, retirement bungalows and warden-assisted housing.
Housing with support offers older people independent living in self-contained housing with the knowledge that support is available if required. The accommodation consists of purpose-built, self-contained homes, usually flats or bungalows or occasionally luxury apartments, for sale, shared ownership or rent. The support offered is usually limited to help from a scheme manager (warden), or support staff and 24-hour emergency help through an alarm system which can be activated by pulling a chord or pressing a button on a pendent. Staff are not usually available 24 hours, and do not assist with personal care or carry out tasks like shopping or housework.
Generally, the scheme manager is expected to:
- manage the scheme and respond to the emergency alarm when on site
- get to know the residents and provide individual support, for example emotional support and make sure they know about local services;
help with welfare benefits and social care, encouraging residents to ask for additional support from statutory and voluntary organisations when appropriate.
However, there is variation in terms of the role of scheme managers and the support offered to people living in the scheme.
Housing with support offers a stepping stone between living completely independently and moving into housing with care or a care home. Facilities often, but not always include communal areas, such as gardens or lounges and there may be social activities for the people living there. Schemes may also have a guest bedroom which visitors can use for an overnight stay.
Schemes usually consist of between 15 and 60 self-contained homes which may be bedsits (studios), flats, bungalows or luxury apartments.
Number of units
There are approximately 363,000 housing-with-support units in England and Wales although the figures on this can vary depending on the definitions used.
Who lives in housing with support?
There is a minimum age for residents, usually 60, sometimes 55 and occasionally 50 years old. The accommodation is usually suitable for older people who are able to live independently and need a low level of support. Where more support is needed, this would typically be arranged via a home care (domiciliary care) provider in the same way that it is for people living in mainstream or general housing.
Funding
Housing with support for rent is usually managed by local authorities or housing associations and demand can be high in some parts of the country. Some people are eligible for the housing benefit part of Universal Credit to help pay the rent. Housing benefit can also cover some or all of the service charge, provided the person's income and capital is low enough, and as long as the payment of service charges is a condition of occupying the accommodation, rather than an optional extra. Council tax, water rates and energy bills are usually additional costs.
The cost of some or all of a person’s care and support may be available through the local authority or sometimes via NHS funding.
Regulation
Unlike care homes, housing with support is not inspected or given ratings by an official body. Those who manage leasehold housing with support may be a member of the Association of Retirement Housing Managers (ARHM) and follow their Code of Practice, but this is entirely voluntary.
Any homecare (domiciliary care) provided by an external provider will be registered with the Care Quality Commission (CQC).
Commissioning and provision
Housing with support is primarily provided by housing associations, local authorities, voluntary sector or charitable providers, that is, typically not-for-profit organisations. However, some private sector ‘for-profit’ organisations do provide supported housing, either as landlords and/ or as support providers.
Many schemes have complex operational models in which buildings are leased and services (such as support, care or housing management) are subcontracted or commissioned to other organisations (sometimes referred to as ‘agency managed’ supported housing); for example, a supported housing scheme may have a housing association landlord but a voluntary sector organisation may provide the housing management and support services.
Housing with support units by sector and tenure type
Sector |
Total |
Private |
Public |
---|---|---|---|
Leasehold |
107K |
80K |
27K |
Mixed tenure |
10K |
4K |
6K |
Rent |
271K |
0K |
271K |
Other |
14K |
7K |
7K |
Note: Mixed tenure includes a mix of rent and leasehold. Other tenures include shared ownership, for example.
Case study
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Priory View Open
Model of housing or service: housing with support
Principles of excellence: community connectedness; person centred and outcome focused; adopting innovation
Promising practice examples
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Waterton Green Open
Model of housing or service: housing with support
Principles of excellence: community connectedness; person centred and outcome focused
Waterton Green is a private sector retirement development in Yorkshire. It comprises 129 homes including two- and three-bedroom bungalows, houses, dormer bungalows, cottage flats and luxury apartments, exclusively for over 55s. The development offers a range of personalised enabling services and the ‘lifelong’ homes are easy to adapt, which avoids major works and allows people to more easily age in a place. Innovative technology, such as interchangeable level worktops in the kitchens and a hidden capacity to enable single-transfer hoist from bedroom to bathroom, has been included in the design.
The developers, LIFEstyle by ENGIE aim to create communities that revolve around the principles of wellbeing, health and enriched lifestyles. They aim to support residents to be fit and healthy and to live life to the full. If mobility restrictions or other age-related issues affect residents, there is a range of services which can be purchased directly and added to the service charge. A Lifestyle Coordinator is also available to facilitate support services from within the wider community, which can help with everyday living.
Waterton Green is an example of an inclusive development that not only integrates with the local and wider community but reaches out and has provided much-needed facilities where few are available. Its dementia-friendly community hub, which houses a library, is open to locals. Social events such as Christmas parties and meet-your-neighbour events, baking or cooking classes are organised to help those living in the development to get to know each other better. Opportunities are also created for younger people in the community to socialise with the residents, allowing for an intergenerational dimension. Residents themselves also have the opportunity to be involved in volunteering to benefit the wider community.
In 2020 Waterton Green won What House? Gold Award winner for best retirement development.
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TONIC@Bankhouse Open
Model of housing or service: housing with support
Principles of excellence: person centred and outcome focused; community connectedness; co-production and shared decision making
Tonic Housing Association Limited is a community-led not-for-profit housing association for LGBT+ people over 55. It is focused on creating vibrant and inclusive urban LGBT+ affirming housing with support where people can share common experiences, find mutual support and enjoy their later life. Tonic was established in 2014 to address the issues of loneliness and isolation of older LGBT+ people and the need for specific housing and support. It has become the UK’s first provider of LGBT+ affirmative housing following the purchase of 19 properties at Bankhouse, a One Housing older living scheme in Lambeth. The properties were purchased after Tonic secured a £5.7 million loan from the Greater London Authority Community Housing Fund, agreed by the Mayor of London. The properties are a mix of one- and two-bedroom shared ownership homes which first opened in September 2021.
Tonic has been working towards making this vision a reality for several years, with a community panel of volunteers actively involved in shaping the specification of the scheme and services that they wish to see. Tonic@Bankhouse will create a unique offering of housing with care that celebrates LGBT+ identities. It will co-create events and activities with residents based on their interests, including collaborations with other LGBT+ organisations and support providers. Tonic has provided training for all the staff at Bankhouse to equip them with the knowledge and skills to provide quality care and support to older LGBT+ people. Bankhouse has an on-site restaurant, a bar, a community space overlooking the Thames, a floating garden and a roof terrace with views of central London. Amenities on-site include a spa room, bike storage, a launderette, an overnight guests’ suite for visitors and guest parking. All areas are fully accessible to wheelchair users. Bankhouse has 24-hour on-site staff and optional care packages are available.
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Horizons, Poole Open
Model of housing or service: housing with support
Principles of excellence: community connectedness; person centred and outcome focused; adopting innovation
Horizons in Poole is a flagship housing with support development by McCarthy and Stone which caters for those 70 years of age and over. Built in 2017 it consists of 80 one- and two-bedroom apartments, was designed by Glen Howells architects and embraces the HAPPI principles, as seen in this video.
With Poole Harbour, bus and train stations and Poole High Street close by, the location of the development enables those who live there to maintain their independence and remain connected to their local community. The inclusion of communal grounds and a wellbeing suite also promotes interaction amongst residents.
Described as offering ‘retirement living Plus’, staff are on-site 24 hours a day and there is one hour of domestic assistance available each week. Care can be arranged via Your Life, Poole, and is overseen by an estates manager. Meals can also be delivered direct to homes if residents are unable to visit the restaurant due to illness.
The development won the Best Retirement Scheme title at the National Housebuilder Awards in 2018.
View more about the Commission and its findings
- Commission on the Role of Housing in the Future of Care and Support
- Commission report: A place we can call home: A vision and a roadmap for providing more options for housing with care and support for older people
- Promising practice: Examples and case studies from across the sector that exemplify the seven principles of excellence
- Population survey: Findings from online survey of understanding and perceptions of housing with care options
- Cost-benefit tool: Tool to understand costs and benefits of residential care homes, retirement housing, extra care and Shared Lives