Given the demographics of our ageing population, the issue of accommodation and care provision for older people has often been a neglected aspect of housing and planning policy. Yet the statistics should be of great concern.
The recent spotlight on provision for older people in the housing green paper is both welcome and timely, as is the forthcoming publication of a national strategy for housing in an ageing society. Unless the issue is urgently tackled and given a similar level of strategic priority as affordable housing, we are likely to be faced with a shortfall in appropriate accommodation that amounts to crisis proportions.
The national trend over the past few decades has been towards a very significant increase in the proportion of people over 65 and falling birth rates. Today, 30 per cent of households are headed by someone more than 60 years old. Statisticians calculate that the number of people over 85 is set to increase at six times the rate of the rest of the population over the next 20 years.
Government policy to support older people in their own homes in the community is consistent with what most people would choose for themselves. However, the national survey of English housing has suggested that at least 1.4 million people living in private and social accommodation require specially adapted homes.
With almost three-quarters of those in their 90s living in private households, social isolation is a growing concern. The capacity of home care and support agencies for our older population will become increasingly stretched. Meanwhile, we are still building housing unsuited to our changing needs as we get older. Major urban regeneration and extension projects frequently proceed without specific provision for this very significant and growing sector of our population.
As one of the leading architectural practices specialising in housing for older people, we fully endorse the green paper. It promotes accessible housing through the wider implementation of lifetime home standards in new developments and the increasing availability of more attractive options for downsizing from family homes.
If these aims are to be met, a number of issues need to be confronted:
- Insufficient funding availability.
- The misconceived application of VAT to remodelling existing buildings.
- The absence of statutory requirements for broader application of lifetime home standards.
- High land costs and low availability.
- Perhaps most importantly, the lack of a cohesive and integrated approach to housing and planning policy where older people's housing and care provision is concerned.
With the baby boomer generation now reaching retirement age, aspirations for lifestyle retirement options have opened up new markets. The private sector has recently seized this opportunity and is now actively developing a range of attractive retirement housing options that offer lifestyle alternatives. These are marketed under different labels such as retirement villages, assisted living, senior living and continuing care retirement communities.
Housing schemes encounter limitations
A number of models have originated overseas. They derive from the US, Australia, South Africa and Scandinavia where they have become well established. The level and nature of care provision, the range of communal and support facilities and the mixture of tenures vary from model to model, as do approaches to integration with the wider community. But there is a surprising paucity of definition and guidance in these models and a lack of understanding at local authority level as to how developments should be classified for housing and planning policy purposes.
Alongside the Department of Health and the CSIP Housing Learning and Improvement Network, the RTPI is championing an extra care tool kit as a best practice guide for planners and developers. But the knowledge and skills gap still needs to be closed. Some private housing developments for older people are considered with suspicion by planning authorities and regarded as seeking housing consents by the back door.
The Use Classes Order draws a clear distinction between class C3 housing and class C2 institutional developments. Sheltered housing has historically been classified as C3 while residential care homes have been classified as C2 developments. Many of the current generation of housing schemes for older people take the form of supported housing with extra care provided to residents in their own apartments, thus falling between the two categories.
This has given rise to inconsistency and confusion, leading to similar schemes being categorised as either C2 or C3 (see panel). Alternatively, they may be classified as sui generis, although this does not settle whether affordable housing quotas should be applied to these schemes or whether lower levels of provision would be acceptable.
This is often critical to viability, given the cost of provision of extensive communal and support facilities, and we have seen development initiatives fail as a result. Perhaps the first issue to be resolved lies in clear classification of the range of housing and care models currently being developed. Beyond that, policy could be developed around provision for the different categories.
In our view, housing provision for older people could be effectively grouped into three types:
- Appropriate general needs housing in the community, built to lifetime homes standards and hence accessible and inclusive in details and layout.
- Supported housing where, as a minimum, domiciliary care is offered to residents as a flexible package and a range of communal facilities is on offer to residents.
- Continuing care facilities including the provision of 24-hour on-site nursing care in addition to flexible domiciliary care.
This classification is comparable to the definition set out in the Housing Corporation's newly published design and quality standards.
Clear targets should then be set for the provision of each of these categories in every local plan in the country, in the same way that targets are set for affordable housing. Housing provision for older people could be linked to, and interchangeable with, affordable housing targets. Indeed, there are indications that this approach is now being adopted by some local authorities.
Planners tackle viability of development
Another major obstacle to the development of appropriate alternatives to living in the community lies in the availability and affordability of land. Due to the cost of providing a substantial amount of communal facilities and circulation space - typically about 40 per cent of total floor area in extra care housing - it is hard for developers of older people's housing to compete in the open market against volume house builders.
As a result, the land that tends to be targeted for larger housing schemes for older people often falls outside the development envelopes defined by local plans and is on the margin of or within the green belt. Our clients must therefore make a planning case under the exceptions policy on the basis of need. Often, sequential testing is required to demonstrate that there are no alternative sites in the development envelope of a settlement.
This is difficult to prove without carrying out extensive research and preparing detailed cost models. Understandably, planners tend to exercise a presumption against development of these sites in the absence of policy guidelines that provide a basis for departures from the local plan. Clear allocation targets for housing older people in conjunction with land specifically designated for this purpose could reverse this position.
To plan for our future, the profile of the issue facing every one of us must be raised. Housing provision for older people should be elevated to a far higher level of priority than it has today. The private sector has little incentive to build homes to lifetime standards unless there is a statutory requirement to do so. It also needs incentives to incorporate specific provision for older people in developments in addition to or as an alternative to affordable housing.
These obstacles are not insurmountable but will require a step-change across government, local authorities and the industry in how, where and what we provide for our ageing population. As Abraham Lincoln said: "It is not the years in our lives that count, it is the life in our years." If we fail to take steps to rectify our approach and strategy for housing older people, what life are we building for ourselves in the future?
PRP Architects managing director Roger Battersby has worked in the specialist housing sector for more than 20 years.
USE CLASS DISORDER
As part of a larger initiative, we sought planning permission for an extra care village of just over 100 flats with a range of communal and support facilities. The development was to be mixed tenure with varying proportions of the flats allocated to private leasehold sale, shared ownership and affordable rental.
There was a moratorium on new class C3 housing development in the borough. In response, the planning authority imposed a condition on the scheme in the form of a C2 classification. Our housing association client objected on the basis that the C2 institutional label would make the private sale and shared ownership elements less marketable. After protracted negotiations and a further application, the C2 classification was lifted.
On another occasion, we submitted a planning application for a continuing care retirement community for outline consent. This model, which is relatively untested in the UK, differs from extra care in that it includes a nursing home incorporating dementia care provision. Our client, a private developer and care provider, argued that the development should be regarded as class C2 on the basis that it included a care provision package that each resident would be required to buy into.
It was our client's intention to register the whole of the development, which was intended for private sale, with the Commission for Social Care Inspection. The local authority argued that the development fell into class C3 and that our client should be providing the same level of affordable housing as any other house builder in numbers of more independent apartments.