Developing an extra care housing resource pack, Greater Manchester Health & Social Care Partnership

Greater Manchester H&SC Partnership decided that a resource pack would be a useful resource to create to promote innovation, best practice and improve commissioners understanding of workable models of housing with care.


Greater Manchester H&SC Partnership wanted to develop innovative models of accommodation with care in order to create a wider range of housing options for older and disabled people to allow increasing numbers of people to live in the community for longer, instead of moving into residential care.

Developing innovative models of accommodation with care can be challenging for commissioners. They decided to develop an extra care housing resource pack in order to help commissioners with this change.
The pack developed for this project contains 18 housing examples (extra care housing and others) covering national/international contemporary developments and guidance regarding how these examples can be applied to the councils in the Greater Manchester (GM) area, as well as, a financial model specific to the GM context.
The pack provides a practical legacy resource for Greater Manchester partners, as well as for other local authorities and stakeholders.

The challenge
Developing innovative models of accommodation with care can be challenging for commissioners. Greater Manchester H&SC Partnership decided that a resource pack would be a useful resource to create to promote innovation, best practice and improve commissioners understanding of workable models of housing with care.
The key challenge for councils in developing a pack was ensuring any resource included the breadth of research needed for commissioners which included:

  • national and international examples of service models of housing with care and related housing models suited to older people
  • analysis of how these models could be applied to the GM context, or how they could be adapted to work within the GM ‘landscape’, taking into account the demographic and economic profile of the conurbation
  • exploration of the funding and payment models, both capital and revenue, including demonstrating approaches to charging and contracting
  • cost benefit analysis impact and evidence of economic impact (including regeneration, economic growth and employment) in relation to extra care housing
  • a financial model which can be used to identify the potential for cashable savings which could be realised from the use of extra care housing as an alternative to residential care.

The solution
The GM&HSC Partnership team and a small group of Greater Manchester commissioners worked with the Housing LIN team to develop and refine an extra care housing resource pack.
Consequently, a comprehensive pack has been produced to provide commissioners with a wide range of examples of extra care housing that can be drawn on to inform future development as well as a range of practical ‘tools’ that can be used to inform the local business case for the development of extra care housing.
Specifically, the resource pack contains:

  • A mix of contemporary extra care housing and other housing models for older people that can be drawn on to influence the further development of extra care housing in Greater Manchester. These are intended to show the increasing diversity and quality of housing with care schemes and retirement villages, as well as other types of housing aimed at older people. As much as possible the following information is provided for each case study in the resource pack:

- Name/Location
- Developer/landlord
- Scheme overview
- Tenure mix/affordability
- Regeneration site applicability
- Housing/care provider arrangement
- Type of local area/demographic characteristics
- Commissioning arrangements/affordability
- Mix of support/care needs accommodated
- Dementia friendly components
- Availability of scheme to wider community 
- Link to further information

  • 13 case studies from the UK are provided and 5 international examples. These are not all necessarily equivalents of extra care housing but are intended to provide additional housing models and inspiration for Greater Manchester commissioners.
  • The evidence of the wider benefits that extra care housing can deliver for Greater Manchester such as supporting economic growth, regeneration or increasing employment benefits. It is intended to provide additional evidence to support the case for development of extra care housing being a relevant part of a strategy across Greater Manchester to deliver urban regeneration, promote economic growth and create jobs.
  • The circumstances in which extra care housing provides a feasible and practically realisable way to deliver financial cost-benefits for local authorities and their health partners compared to, for example, the use of residential care. This includes a link to the Greater Manchester extra care housing cost benefit analysis (CBA) tool, (developed in partnership by the GM Health & Social Care Partnership and the GM Combined Authority Research Team.) This helps commissioners explore the financial costs and benefits of extra care developments over a five-year time frame. To complement this tool, the Housing LIN has drawn on work with other councils to develop a model for assessing the extent of any cashable savings/cost avoidance from the use of extra care housing compared with other options.The development of this model has been informed by work with other councils where a similar approach to determining the cost effectiveness of extra care housing was successfully used.
  • The pack also includes further resources to help commissioners including:

- advice about revenue streams to fund extra care housing and the different ways to commission care/support services
- tips on whether to commission integrated or separate care and housing services
- clarification of the roles and responsibilities of housing and care/support providers in extra care housing
- capital funding considerations in extra care housing.

The impact
The resource pack is a relatively new tool for Greater Manchester commissioners so its hard to measure the long-term impact, however, commissioners who have seen it so far have said the following components were particularly helpful:

  • the range of scheme models, demonstrating what works in certain communities/locations/sites
  • the economic impact and financial cost-benefit analysis tools
  • links to other information and resources
  • the commissioning considerations.

It is hoped that the resource pack will:

  • stimulate the development of additional extra care housing across Greater Manchester which reflects contemporary practice and design whilst fitting into the Greater Manchester context
  • provide commissioners with evidence of the wider economic benefits of developing extra care housing
  • lead to the Greater Manchester extra care housing cost benefit analysis tool becoming more widely used by commissioners to evidence the positive impact of developing this housing and care model
  • give commissioners a consistent way of assessing the likely cashable savings/cost avoidance from the use of extra care housing compared with other care options.

How is the new approach being sustained?
A workshop was held with colleagues from across GM with an interest in extra care housing to ‘sense test’ the content of the resource pack and offer the opportunity to utilise the knowledge of Housing LIN for a more detailed look at specific schemes and approaches to extra care.  This was also intended to encourage use of the resource pack and sharing of approaches and practice between localities in relation to extra care housing. The final version of the resource pack and financial models has been shared with strategic housing and social care commissioning colleagues across all 10 GM localities, and with the GM Housing Provider Partnership. It’s hoped that there is continued use of the pack in future commissioning, design and development of extra care housing in Greater Manchester. 

Lessons learned
Regional work is complex, so a collaborative and iterative approach is needed. The amount of time needed for regional engagement and co-ordination is more than if a single council is involved.

Developing a comprehensive financial cost benefit model for extra care housing that is relevant to a large group of councils requires a significant amount of council financial data in order to generate a useable model.

More capacity was needed than anticipated to develop case studies that are sufficiently detailed for commissioners to be able to make practical use of them.

Contacts
Helen Simpson, Strategic Relationship Manager (Housing), GMHSCP helen.simpson11@nhs.net
Housing Lin

Links to relevant documents
Extra care Housing Resource Pack for Greater Manchester Health & Social Care Partnership Housing Lin December 2019