I recently presented at Lichfields' Newcastle Breakfast Seminar on the topic of elderly care accommodation. Or, as I have seen termed elsewhere, accommodation for those in their “extended middle age!”.
The older population, elderly people, those in their extended middle age, however termed, is growing. Indeed, the number of people aged 65 or over in England is projected to increase more than any other age cohort in future years.
Figure 1: Population projections by age cohort, England (2014=100)
Source: ONS, Lichfields analysis
As previously reported by Lichfields, this projection has wide-ranging implications as the country’s demographic profile is the foundation on which public finances are determined and major policy decisions are made. Another of the key implications of the population profile changing so markedly is that housing needs will change too.
In the same way that national policy is clear that local planning authorities (LPAs) must meet the housing needs of their local area, both for market and affordable housing (NPPF para 47), national policy is also clear that LPAs must meet the housing needs of different population groups, including older people (NPPF para 159). However, whilst the focus has been on building more houses in general (and rightly so), interventions have largely been concentrated on those at the start of their “housing career” (such as Starter Homes, First Time Buyer ISAs and so on). Significantly less focus has been placed on those in the later stages of their so-called “housing career”.
This is evident from the Housing White Paper which, in seeking to “fix our broken housing market” sets out some key targets, including:
225,000+ new homes to be provided per year (pg 9)
200,000 people brought into home ownership (para 4.21)
225,000 affordable homes to be built (para 4.26).
Yet there is no such target for meeting the needs of the older population. Rather, the Housing White Paper simply defers the issue, setting out the following:
Offering older people a better choice of accommodation can help them to live independently for longer and help reduce costs to the social care and health systems. […] To ensure that there is more consistent delivery of accessible housing, the Government is introducing a new statutory duty through the Neighbourhood Planning Bill on the Secretary of State to produce guidance for local planning authorities on how their local development documents should meet the housing needs of older and disabled people.
Whilst not tackling the issue head on, what the Housing White Paper does is reiterate the thrust of the NPPF - now in its fifth year – i.e. that LPAs are expected to have clear policies for addressing the housing needs and requirements of different groups, including older people. That said, some clear recognition of the severity of the current situation and an emphasis on the urgency required in introducing measures to start to address it would have been welcome.
This begs the question: do LPAs currently have clear policies for addressing the housing needs and requirements of older people? And in short, the answer is no.
Lichfields has analysed the 99 post-NPPF adopted Local Plans identified in its Planned and Deliver Of these:
29 do not have a generic elderly persons’ accommodation policy;
88 do not have a specific requirement for elderly accommodation; and
94 do not make specific allocations.
It’s a ticking time bomb.
As an industry, in both public and private sectors, we need to ensure that we understand, through robust evidence, what the housing need is for the growing ageing population. Alongside this, we need to understand what supply is currently available. Only then can we formulate clear strategies on how the residual need could be met.
To help evidence the need and in order to understand the opportunities to deliver housing for the ageing population, Lichfields has produced its Carepacity Toolkit.
Carepacity can assist in the planning process by:
objectively assessing the need for housing for older people and finding potential development sites;
understanding existing supply;
assessing the potential of development sites;
supporting the planning case by quantifying the range of benefits arising from the development of housing to meet the needs of the ageing population; and
enabling delivery through an understanding of the planning and financial implications of different typologies of elderly care provision, as summarised below.
Figure 2: Typologies of accommodation
Source: Lichfields analysis
To discuss Carepacity further, please get in touch: firstname.lastname@example.org
 Department for Communities and Local Government - Fixing our broken housing market (February 2017)
08 Aug 2017
Last week my youngest daughter graduated from nursery, ready to start primary school in September. I calculated that in the five years since 2012 we have spent over £76,000 on nursery care for our two children. Childcare is clearly a booming business!
Whilst the care my girls received during their time at nursery was fantastic there were two areas where I always thought it could be improved: firstly by the introduction of male staff; and secondly by the development of links with the community and in particular local care homes.
In 2000 the BBC reported that for every 100 people working in childcare, only two are men. The Children's Workforce Development Council (CWDC) questioned 1,000 parents about the issue of men working in nurseries. 59% of respondents said there was not a single man employed at the nursery to which they sent their child. The CWDC is calling for more men to consider working in early years settings. They say it is crucial for children under the age of five to have contact with a responsible male adult.
Whilst it appears to be difficult to persuade men of the benefits of working in the nursery care sector the benefits of regular interactions between children and older people are widely accepted. In 1976, a Japanese man named Shimada Masaharu trialled the operation of a nursery and care home on a single site in Tokyo. By 1998, sixteen such intergenerational facilities were operating in Tokyo alone. Around the same time similar facilities were developed in the USA and Canada. One particularly successful example is the Intergenerational Learning Centre which opened in Seattle in 1991 where a nursery is located within the campus of a care home. Children are taken to visit the residents on a daily basis and residents can visit the nursery, with both taking part in a programme of structured joint activities such as singalong time, craft activities and cooking.
In Singapore childcare facilities and senior centres are to be co-located in ten new projects in the next decade to provide opportunities for intergenerational bonding, as part of a £1.69 billion national plan to help Singaporeans age confidently and lead active lives. The Singapore government is also encouraging existing operators of elder care facilities to introduce innovative programming that allows the young and old to interact.
Numerous studies by the US National Institute on Aging have linked social interaction with decreased loneliness, delayed mental decline, lower blood pressure, and reduced risk of disease and death in older people. Socialising across generations has also been shown to increase the amount of smiling and conversation among older adults, according to one Japanese study . This seems to be borne out by a new Channel 4 documentary ‘Old People’s Home for Four Year Olds’ aired recently, which sees pre-schoolers swap their nursery for a nursing home as they join a group of pensioners at a care home for six weeks. The researchers noted an almost immediate improvement in the mood and emotional state of the elderly residents and, more surprisingly, an unexpected improvement in their mobility.
Whilst the benefits to the elderly of spending time with young children are well known, the impact this intergenerational interaction has on children has been less researched. It is suggested that children who are able to spend regular time with older people are more likely to develop a positive view of them, be less likely to view them as incompetent and leave them less likely to exhibit ageism. This can only be a positive influence on their early development.
The first nursery in the UK to share the same site as a care home and where children and residents will meet daily for activities will open in September in Clapham, London. ‘Apples and Honey Nightingale’ are to operate a 30-place nursery in the grounds of Nightingale House, a residential care home for serving the Jewish community. Nightingale House has around 200 residents at the site and the average resident is in their 90s, with 10 per cent of them aged 100 or older. The nursery has been running a weekly baby and toddler group based at the care home since January 2017 and prior to that Apples and Honey had been visiting the care home for about 15 years twice a term. The intention is for the elderly residents and the children to eat their meals together and for residents to become involved in many of the Early Years curriculum activities which are organised for the children. The operators are looking at how best to make the curriculum intergenerational, with children and residents spending time together every day, cooking and baking, doing exercise and movement classes, music and arts and crafts.
The idea of intergenerational care in the UK is being pioneered by ‘United for All Ages’, a think tank and social enterprise developing new ‘all ages’ approaches to key social and economic issues. They have been actively meeting with nursery groups, care providers and local authorities to develop the idea of co-locating nursery and elder care. Whilst some care homes invite children in from nurseries for visits this is very much a one-off and the aim of United for All Ages is to make co-location part of everyday life. Whilst this will likely be a slow process there is evidence that some operators are embracing the idea of intergenerational care. UK nursery group Busy Bees is opening a new nursery in Chichester next door to an Anchor care home, and Torbay Council in Devon has plans for an intergenerational care site. Lorraine George, a childminding development worker at Torbay has recently been awarded a Winston Churchill Travelling Fellowship to look at intergenerational learning and is to visit successful sites across the USA. Summing up her enthusiasm for intergenerational development Lorraine George said:
It’s such a simple idea. We have a lot of children who have very little family, or who are removed from their extended family. Most families are time poor; elderly people have plenty of time and there’s such a good exchange of skills.
In my opinion intergenerational care appears to offer significant benefits for everyone involved, including the operators of such facilities who could undoubtedly benefit from cost savings in terms of design and operation of shared facilities. Hopefully with the support of pioneers such as United for All Ages, the development of facilities such as Apples and Honey Nightingale will become more widespread across the UK, bringing benefits for generations to come. In light of the recognised shortfall in nursery provision across parts of the UK there is a potential opportunity for care home operators to diversify their standard product to provide intergenerational facilities which not only maximise profitability but offer significant benefits for all their customers, both young and old.
 Morita and Kobayashi; licensee BioMed Central Ltd. 2013