Agenda item

To receive a presentation from Jemma Gumble, Strategic Partnerships Development Manager.

The Chair introduced this item on the Older People’s Housing and Care Project which he reminded members, had been discussed at Cabinet on 14 February 2018. 

Lia Markwick (Service Development & Strategic Commissioning Manager) and Jemma Gumble (Strategic Partnerships Development Manager) gave a presentation on this subject.

A video was screened which gave an example of a successful new development that follows a new approach for older people with the co-location of specialist housing and community services around a ‘vibrant service hub’ for residents.

The following points were highlighted:

• There are demographical challenges for Enfield with the number of people over 65 years forecast to increase 23% over the next 10 years.

People are living longer although often in poor health.

• Other challenges include the pressures on housing supply and on health and social care budgets which indicate new approaches are  needed in respect of the provision of ‘assisted living’. However there are often negative perceptions of Housing with Care for older residents.
• There are currently over 500 older people receiving intensive care packages in their own home. This number is increasing and there is a need for growth in various retirement housing and extra care housing. New choices for older people are required.
• One way to extend the choice for older residents is to co-locate specialist housing with community services which includes health and wellbeing and might also include co-location with education/ learning/ leisure and retail facilities.  All of this to be centred around a vibrant ‘hub’ where residents and the wider community would interact. 
• Contrary to some criticisms that older people would be centred in a ‘bubble’ the development would have an outward facing hub with the community. With the aim to promote healthy, active ageing.
• Feasibility studies are to be undertaken to look at options.  A development at Milton Keynes which provides facilities similar to those which we may wish to offer provides properties to buy or to rent.
• Advantages of having the co-location of housing and health services would mean that residents can be cared for at home rather than in hospital. The building quality would be high and more suited to the complex needs of older people. Other benefits expected include the reduction in temporary accommodation costs due to the subsequent increased supply of local housing.  Improvements for residents from an increase in their wellbeing, a reduction in loneliness, and improved dementia outcomes, there should also be a reduced risk of falls and a greater chance of couples being able to stay together.
• The current vision is to have a single development for approximately 200 to 300 homes. Financing may be possible through partnership funding such as NHS contributions, Mayors funds, charitable trust funds, and HRA contributions.

The following points were made:

• Cabinet had authorised officers to progress the strategic planning of an Older People’s Housing and Care Project.  Feasibility studies are to be undertaken.
• Councillor Smith said he had worked for a Housing Association and had experience in this field. He stressed the importance of ensuring that we establish the demand for this facility and whether older people wanted to live there.  He said, it should be remembered that there was not the demand for sheltered housing properties in the borough, which have been demolished and thought this could be seen as a warning for future developments of this kind. He suggested that a private developer be brought in to take this project forward which would minimise the risks to the local authority.
• Councillor Levy said he understands a feasibility study would be done and risk analysis undertaken.
• Councillor Smith went on to say there is an assumption that people brought together because they are old and frail wish to be together. He also suggested that we may wish to consider whether there is value in having this facility in Enfield or should it be undertaken in partnership with another local authority such as with Hertfordshire.
• Councillor Rye suggested that the concept of expecting old people to wish to live together may be wrong. Generally people of different ages live together in a road, and communities are built amongst a young and vibrant population. It is essential to see what the demand would be for the proposal, he thought in Enfield many older people on retirement would tend to sell their properties and move out to other areas.
• Councillor Smith thought that there would be some people who would wish to live in a development such as that proposed, however, he thought it was important that a private developer be used who is experienced in this field and who would make this a less risky venture for Enfield.
• Members commented on the large number of care homes already in the borough and the fact that other boroughs place their residents in Enfield.
• It was asked whether the usual criteria would apply for Enfield residents regarding nomination rights. It was thought there may be interest from other boroughs and it would not have to be exclusively for Enfield residents, but Enfield residents will come first.
• Councillor Levy stressed the need for the feasibility studies to include qualitative as well as quantitative assessments. 
• Doug Wilson spoke of the benefits of older people having choices which this proposal would provide. He spoke of the challenges that residential care homes sometimes have regarding nursing care provision. He thought extra care (nursing) provision may make a difference for people considering where they would like to live. It may also help to prevent social isolation. Friendship groups would hopefully grow and help in building proper communities here.
• Cllr Levy raised a number of questions –

a.    If officers had an approximate idea of costs involved? 

b.    If there were any sites we may consider suitable in the borough at present?

c.    What is the timetable for the project, - when would it be completed?

d.    Is there a possibility that a ‘do nothing’ option could emerge from the feasibility study?  - 

the following answers were given

a.    In Norfolk a similar project with 172 units cost approximately £18.9m. (it was acknowledged that land in Norfolk would be cheaper than in Enfield)

b.    It is too early to be able to determine any future site locations.

c.    It is anticipated that the project would be completed in 3 to 4 years’ time.

d.    The project indicated is the optimal idea, however, if space or finance does not allow this, then perhaps a smaller plan could be considered.

• It was thought that in order to achieve the diverse facilities suggested including education and retail services then an early dialogue with partners may be useful.

It was pointed out that a facility offering housing with care for people adds a further choice to the spectrum of options currently available for older people.

The Chair thanked Jemma Gumble, Lia Markwick and Doug Wilson for their report.