Extra care housing provides a direct alternative to residential care for older people with increasing and/or complex needs who want to be as independent as possible. It enables local authorities to make revenue savings at the same time as fulfilling people’s needs and aspirations more effectively.

The Care Act 2014 requires local authorities to make sure that people receive services which prevent their care needs becoming more serious or which delay the impact of their needs. It requires local authorities to do this by having a range of providers which offer a choice of high quality and appropriate services. If this is to happen, commissioners, developers and providers need to create a more diverse market and ensure that there is a greater diversity of choices for people who need support.

Extra care housing has the potential to help people stay independent for longer. Quite simply most people prefer to live in their own homes. Specialised supported housing can also help local authorities deliver transformational change in challenging times. It can forge innovative and effective collaboration between public and private sectors for the benefit of citizens.

Extra care housing provides high quality buildings which put people’s complex and changing needs at the forefront of design. When assistive technology is integral to this design, there is a real opportunity to promote people’s independence and reduce dependence on paid support.

Extra care housing can offer a quality of life that is quite simply unachievable in even the best care homes. As a review of care homes in Wales concluded: “When older people move into a care home, too often they quickly lose access to the things that matter to them and give their lives value and meaning and are an integral part of their identity and wellbeing, such as people, places and everyday activities. Older people are often not supported to do the things that matter to them but instead have to fit into the institutional regime often found in care homes, losing choice and control over their lives” (The Older People’s Commissioner for Wales 2014).

Extra care housing provides a direct alternative to residential care for older people. At the same time it can play a vital role in helping central and local government reconcile the tension between rising costs and burgeoning demand.

We know the factors that lead to older people entering residential care. Therefore, if extra care housing is designed and staffed to address these factors, it can undoubtedly offer a realistic alternative to people who want to remain as independent as possible. Admission to a care home is often precipitated by a critical event, e.g., a fall or sudden illness (which may or may not lead to hospital admission) or a carer is unexpectedly unavailable. It may also be triggered by a chronic problem, e.g., the impact of dementia or social isolation. Because of concern about these older people often enter residential care at the instigation of other people.

When properly specified, designed and commissioned extra care housing can address the specific factors that may precipitate admission to a care home. The availability of 24-hour support in extra care housing reduces the demand on carers at the same time as enabling them to remain a big part of people’s lives within an accessible environment. People in extra care housing enjoy a good social life, which reduces the risks of social isolation and promotes better health. For example, lower than expected numbers of falls are recorded in extra care housing.

Extra care housing can provide a good quality of life for many people with dementia, even though changing needs – e.g., challenging behaviours and conflict with others – can sometimes lead to a move to nursing care. However, the number of these moves can be reduced by ensuring that support is more effectively planned and delivered to respond to largely predictable events. There is evidence that targeted programmes which respond to these events can help achieve better outcomes.

Extra care housing enhances the quality of life of both older people and their family carers. It addresses the specific needs and circumstances which would otherwise lead to residential care.