Dorset's Extra Care Housing Strategic Statement 2024 to 2039

1.2.1 Extra care housing offers a home designed to adapt to changing care needs and to the needs of:

• people with disabilities
• people who are socially excluded
• people with long term health needs

1.2.2 Care and support is readily available, often through a dedicated support and care team providing help 24/7. To promote well being and inclusion a range of accessible community facilities and shared spaces are designed and provided, to meet the social needs of a broad range of people with care, support and health needs.

1.2.3 There is no single model of extra care housing.

1.2.4 However, there are defining features which distinguish it from other forms of housing or accommodation for older people, such as sheltered housing or care homes and general needs housing.

1.2.5 These are:

• it is first and foremost a type of housing
• it is a person’s individual home not a care home
• extra care tenants have their own flats usually provided under a tenancy or lease and have their own fully accessible bedroom, bathroom, kitchen and living room
• whereas a core care and support service is available on-site 24/7, tenants can still choose who provides their direct personal care
• in addition to the tenant flats, there are communal spaces (e.g. lounges, gardens, etc.) and professional areas (offices, meeting rooms, counselling and treatment rooms etc.) on-site to:
  • promote tenant wellbeing and good health
  • support their positive social interactions with other people to reduce isolation and loneliness
  • enable community development to support tenant participation in the communities they live in
• many extra care schemes provide well equipped shared kitchens, communal dining facilities and onsite meal services to:
  • promote tenants having access to good quality and nutritious meals
  • to support the positive social interactions of all tenants

1.2.6 How extra care housing differs from others forms of specialist accommodation with support for older people with care needs:

• care homes only provide a bedroom and en-suite bathroom facilities; residents have no tenancy rights and their care is provided with their accommodation by the same provider
• sheltered and retirement housing only provides a housing warden providing general advice; who may only be available part of the day and week and probably only during office hours
• sheltered housing does not provide support and help with personal care

1.2.7 Extra care housing is underpinned by three principles:

• promoting independence
• promoting empowerment
• accessibility as default

1.3.1 This Extra Care Housing Strategic Statement has been developed through partnership across housing, adult care services and planning, to take forward the priorities and themes set out in the council’s Commissioning for A Better Life as People Age Strategy.

The outcomes that this strategic statement and related plans will deliver against are:

• Dorset is a great place to grow older, with a range of vibrant community activity, giving people better days whether they have support needs or not, and keeping them well connected to the people around them and where they live
• people have access to excellent care and support in their home, both responsive short-term reablement and longer-term care, which always puts independence at its heart and helps people to continue to live independently for as long as possible, utilising equipment and assistive technology where appropriate

1.3.2 This statement sets out clear commissioning intentions, principles and proposals, to develop Dorset’s extra care housing offer for older people and people with long term support, care and health needs. This includes proposals covering:

• Dorset’s plans for well-designed and good quality housing for people with care and support needs, including people with complex conditions
• a model of support and care that is innovative and responsive and which makes the best use of extra care design features, new technologies and a highly skilled care workforce, to maximise the independence and choice of people with a range of support, care and health needs
• development plans that aim to:
  • prepare clear design briefs based on current planning policy and good practice guidance in relation to accessible and inclusive housing design
  • determine the level and type of extra care housing that Dorset will need in the medium and long term
  • review Dorset’s extra care housing provision, to address the following:
    • do schemes offer a contemporary, best practise and fully accessible standard of extra care design
    • do extra care services offer an effective approach to providing support and care
    • options covering the re-provision of services, where they cannot deliver an effective extra care housing offer
  • identify appropriate locations across Dorset that would benefit from the development of new extra care provision and which will deliver the strongest outcomes for people with long term support, care and health needs
• market stimulation to provide options for older homeowners and households and in particular for households who may benefit from housing with care and support but who are not eligible for council funded provision
• establishing effective partnerships with social housing providers to ensure that high quality and affordable extra care housing provision, is developed and commissioned in localities that achieve the maximum benefit for:
  • older tenants with care, support and health needs
  • people with long term conditions who need an accessible rented home, well designed to ensure their independence, choice and control
• opportunities for partnership with Health and other key partners to:
  • secure joint investment opportunities and access to all partner development sites capable of delivering new extra care housing
  • achieve person centred support and healthcare
  • utilise the accessible design features and facilities of extra care housing, to deliver seamless support and healthcare for both extra care residents and the wider community
  • through this delivering more efficient and responsive services that achieve substantially better outcomes for residents with support and debilitating health needs
• our proposals are underpinned by the following key principles:
  • housing with support and care developed and provided in localities with easy access to:
    • health, care and other similar amenities
    • shops, public transport, banks etc
  • extra care homes developed within the context of vibrant communities and alongside homes for families, young people and other household types
  • utilising this approach to promote the inclusion, community connection and wellbeing of residents, with long term care and support needs and offering opportunities for wider neighbour and community support
  • the local availability of a well-trained and skilled social care workforce or the capacity to develop this workforce
  • all housing with care developments minimising the need for travel by car and public transport, within the context of planning accessible neighbourhoods for residents with disabilities
  • innovation in building design that offers:
    • the maximum flexibility in meeting the full range of disability and health needs
    • promotes the wellbeing of residents with long term care needs, through the provision of attractive and fully accessible personal and shared spaces
    • supports the effective and efficient delivery of care and which supports resident choice and independence through new care technologies
  • sustainable development and housing management in line with Dorset’s Climate and Ecological Emergency Strategy, which reduces each scheme’s carbon footprint; promotes energy efficiencies and critically which significantly reduces the energy costs of older and disabled residents

1.3.3 A further aim of the strategic statement is to influence the council’s housing investment plans and regeneration programmes to secure:

• the capital investment needed to develop the range and level of older person supported and extra care housing Dorset needs
• housing and neighbourhood design that enables older people to live with dignity and independence in the communities they want to live in
• well-designed communities and neighbourhoods that enable older people with more complex needs and disabilities, including dementia, to easily access the transport, health services, shops, entertainment and amenities they both need and want to use

 

2.1 National and regional

2.1.1 There are a number of key Government policies and programmes that will influence the commitments and priorities set out in this strategic statement.

They will also influence the work programmes that the council will progress with it’s partners, to deliver it’s commitments covering the housing, support and care services for Dorset’s older residents and residents with long term care needs.

2.1.2 To deliver the very best extra care housing and related support and care services, we will incorporate the recommendations and lessons learnt from national and regional research and good practise in our work programmes and delivery plans.

2.1.3 The Government’s social care reform white paper ‘People at the Heart of Care’ (2021) emphasises that ‘every decision about care is also a decision about housing’.

The Government recognises the importance and benefits of housing, social care, health and planning working together through a coherent strategic system, to deliver homes for people with changing support and care needs including older people.

2.1.4 The intension behind this approach is to offer people choice as to where they live and critically more effective integration between well designed housing, the support and care services people need and new technologies. Ultimately the aim is to avoid:

• unnecessary hospital admissions
• people having to move into a care home prematurely without choice
• them not being able to recover in a home of their own

2.1.5 The Government’s Levelling Up White Paper published in February 2020 recognised that many older people are trapped in unsuitable accommodation, with the Government committing to increasing the housing choices and options available to older people.

To take this programme forward the Government plans to establish a Housing for Older People Task Force. The task force will work across Government including the Department of Health and Social Care and Department for Levelling Up, Housing and Communities and with leaders across housing and services for older people.

2.1.6 The Social Care Institute for Excellence (SCIE) is a leading agency recognised by the Government, Local Government and leaders across social care and health, which aims to improve the outcomes and standards achieved by social care.

Within this context SCIE produced the report ’A place we can call home: A vision and a roadmap for providing more options for housing with care and support for older people’

2.1.7 The report adopted the following vision for social care:

‘We all want to live in a place we call home with the people and things we love, in communities where we look out for one another, doing the things that matter most.’

2.1.8 The report concludes the following:

• the current national policy, funding, regulatory and planning frameworks for housing with care and support are complex and fragmented
• the supply of many forms of housing with care and support is not keeping up with demand, with the gap in supply of extra care housing particularly acute
• there are significant regional disparities in supply and in many areas there is lack of choice in housing options
• there is a lack of supply for people of all economic backgrounds, including those who are eligible for social care and who are seeking ‘middle market’ options for purchase or rent
• the demographic and funding pressures on the system mean that this supply gap will worsen
• whilst the availability of new technologies continues to rise, there is a reluctance in parts of the sector to use them in social care, sometimes due to a lack of understanding about how these technologies work
• the range of regulation, both in terms of CQC and planning for new-builds, both hinders new developments and/or repurposing of buildings and also presents a major hurdle for consumer rights and informed decision-making
• there is a low level of public understanding of housing with care and support and people struggle to navigate the system
• advances in technology, new ways of working and collaboration between sectors occurring as a result of COVID-19 need to be ‘locked in’
• remaining independent is the most important consideration for people (51%) when thinking about needing care or support in old age

2.1.9 In 2008 the report ‘Housing our Ageing Population Panel for Innovation 10(HAPPI)’ was published. The report considered how best to address the challenge of providing homes to meet the needs and aspirations of older people of the future.

2.1.10 The report challenged Government, local government and housing providers to:

• build homes that will meet needs and aspirations as we all grow older
• plan ahead positively, creating demand for better choice through a greater range of housing opportunities
• ensure that housing for older people should become an exemplar for mainstream housing and meet higher design standards for space and quality
• ensure local planning authorities play a key role to deliver desirable housing in great places, tuned to local need and demand

2.1.11 The All Party Parliamentary Group on Housing and Care for Older People has carried out several reviews of the HAPPI report covering:

• HAPPI 2 (2012): What’s needed to scale up and deliver the level of new housing aimed at older people and people with long term care needs
• HAPPI 3 (2015): To ascertain best and innovative practise across planning policy; housing design and build and housing management and advice services, with the aim of ensuring that older people are supported with choosing the right home for them
• HAPPI 4 (2018): Planning principles and housing models aimed at improving the housing and support options for older people living in rural locations
• HAPPI 5 (2019): Improving the planning, supply and development of affordable housing designed for older tenants

2.1.12 The Housing LIN is a respected design network and advice hub covering housing for older people, which has supported the continued development of the HAPPI framework and principles.

Much of it’s work has been reflected in Government policy papers and guidance and in reviews of the statutory planning framework.

In response to the outcome of the HAPPI reports the Housing LIN have developed a comprehensive guide on the design, planning and development of extra care housing, "Factsheet 6 Design Principles for Extra Care Housing’.

This design guide and the outcome of the HAPPI reports are summarised by the following principles:

• space and flexibility
• daylight in the home and in shared spaces
• balconies and outdoor space
• adaptability and 'care ready' design
• positive use of circulation space
• shared facilities and 'hubs'
• plants, trees, and the natural environment
• energy efficiency and sustainable design
• storage for belongings and bicycles
• external shared surfaces and 'home zones'

2.1.13 The council’s Planning, Housing and Adult Care services are working together to incorporate the principles arising from the above guidance, good practise and research into Dorset’s planning and housing development frameworks.

Ultimately the aim is to reflect these principles in Dorset’s emerging Local Plan and Housing Strategy and the council’s adult social care commissioning plans.

2.1.14 These cover our local priorities and guidance covering future housing and other development.

We will also work closely with housing providers and developers across all sectors on using this guidance, to design and build the very best housing aimed at meeting the needs of disabled people and people with long term health conditions and in particular those who need care and support.

2.1.15 The robust population, need and demand evidence used to develop this statement and the key proposals that will drive our extra care housing plans, are in line with the 9 actions identified by the South West Directors of Adult Social Services.

These are set out in their ‘Housing with Care: Good Practice Guide’ and include:

• assessment of need for housing and supported accommodation for older people
• assessment of need for housing and supported accommodation for working age adults with care/support needs
• developing plans/strategies covering housing and supported accommodation for older people and working age adults with care/support needs
• encouraging and stimulating the market of housing and supported accommodation providers
• making best use of planning and housing policy
• resourcing and funding housing and supported accommodation
• housing and supported accommodation delivery
• managing the quality and value for money provided by supported housing
• provision of information and advice

 

2.2.1. The underlying message of the council’s commissioning strategy, is the council’s drive to support and enable the development of community resilience and social capital; ensuring residents understand the offer from the council and other system partners but also to support their own contribution to the communities they live in.

2.2.2. Key themes throughout are prevention, capacity building, evidence based interventions and effective integration between system partners and services to deliver seamless and outcome driven support.

2.2.3. The council’s Commissioning for Better Life Framework sets out an approach to working with the community in an integrated, joined up way; empowering people, families and the community to help themselves and each other.

Through capacity building and social capital the strategic framework aims to empower residents, to develop resilience and support individuals and families to better cope, manage and reduce problems that may arise in their lives.

2.2.4. At the heart of the strategic framework are the following key themes for Social Care:

• prevention of the need for more care
• supporting resilience and independence
• people being supported to remain in a home of their own for as long as possible
• avoidance of unnecessary admission to institutional care

2.2.5. Key Strategic Priorities focus on older people being supported to be healthy and remain physically active; being active members of their community; tackling loneliness and isolation and promoting the use and uptake of new technologies that enable greater independence and control.

2.2.6. A critical component of these plans are to prevent older people from being unnecessarily admitted to care homes and that care homes should only be used to address the most complex health and care needs.

Whereas care homes are a necessary provision for some people who can no longer live safely in a home of their own even with adaptation and support, it can be the most restrictive and costly form of care.

As stated elsewhere the aim of our plans are to support people with care needs to remain independent in a home of their own for as long as possible.

2.2.7. To deliver this the council is committed to developing and commissioning a range of resources and approaches that include:

• improved information/advice to self-funders
• improved care at home and day opportunities
• improved and additional extra care housing facilities
• increased capacity and therapy-led reablement
• equipment and technology-enabled care

2.2.8. Whereas this document is aimed at achieving the new and improved extra care housing, it will also address all the other themes through the development of well-designed housing aimed at meeting a wide range of long-term health and care needs.

The commissioning of highly skilled and readily available support and care services, which are able to take advantage of extra care design features and integrated care technologies are also a key part of our plan.

2.2.9. The council is preparing a new Local Plan and Housing Strategy.

The key planning themes and conclusions set out in this strategic statement, will form part of the evidence used to develop Dorset’s Local Plan.

The priorities set out in this statement will also be reflected in the council’s Housing Strategy.

3.1 The population profile for Dorset points to an older and aging population, with a significant projected growth in the over 65s by 2036.

At 113,703 older people Dorset has one of the largest older person populations in the country, representing nearly a third or 30% of Dorset’s population.

This compares to England where only 19% of the population are over 65. The population is projected to rise by 36,454 older people by 2036, which is a 32% increase but there will be a more significant 43% rise in the over 75s.

3.2 Dorset’s older people offer considerable resource in terms of their experience, knowledge and contribution to the life of Dorset.

A good outcome for this strategic statement will be enabling older people to continue this contribution, within the context of remaining active and healthy.

However, life limiting health conditions are a reality for many of Dorset’s older people and these can have a significant and debilitating impact on their lives.

Homes that can easily adapt at each key stage of a person’s life and support that develops their strengths as they develop care and support needs will overcome these impacts.

3.3 However, these are some of the 13care and health challenges that need to be addressed through progressing innovative housing and support solutions for Dorset’s older residents:

• there are estimated to be about 22,258 older residents living in Dorset who have a life limiting condition, which significantly impacts their ability to manage the activities of daily living
• it’s projected that by 2038 8,946 more older people will develop long term conditions, which will significantly limit their ability to manage their own needs
  • this represents a 43% increase compared to a more limited increase for England of 38%
• 8,708 older people are estimated to have a dementia related condition, which is projected to rise by 3,989 or 49% by 2038 compared to a 44% rise for England
• 22,194 older residents experience significant challenges with their mobility, which will rise by 9,275 or 45% by 2038.
  • again this is higher than the rise for England, which is projected to rise by 41%

3.4 The care, support and health needs and future requirements of Dorset’s older residents are complex and will pose a significant challenge to local health and social care systems, unless the right housing and support solutions are developed.

3.5 The complexity in planning their housing, support and care needs are affected by the mixed types of housing Dorset’s older people live in, alongside significant variations in their socio economic profiles; life limiting conditions and their expectations with regard to the type and location of where they may want to live as they get older.

These factors significantly affect the locality, range and scope of the specialist housing development Dorset’s older residents may want and need.

They also affect the support, advice and care they may need to help them achieve their expectations, as well as helping them achieve sustainable and healthy independence.

3.6 These issues and the council’s plan to address them are set out in Appendix 3.

This covers the council’s approach to developing new extra care housing capacity across Dorset and which takes account of the differing housing, care, support and health needs, of residents living in each of Dorset’s localities.

3.7 The multitude of factors include:

• Housing Tenure and Socio-Economic:
  • 83.5% of the older person households in Dorset are homeowners, which is above the English level of older homeownership of 1480%
  • this is within a context that about 38% of Dorset’s older person households have incomes that are less than £15,000 per year and which are below the national average
  • most of these households are tenants
  • 47% of older person households are homeowners with low to middling incomes of between £15,000 and £30,000 per annum
• Locality Variations:
  • 83% of East Dorset’s older person households are middle to high income homeowners and only 17% are low income tenants or home owners
  • this is in the context that East Dorset has the largest older person population (27,905) and the most council commissioned home care packages (26%)
  • this contrasts with South Dorset where only 46% are higher income homeowners and 54% are low-income tenants or homeowners
  • however, South Dorset has the third highest older person population (18,795) and the second highest council commissioned home care packages (21%)
  • low-income households and tenants live mainly in the market and larger towns
  • there are significant numbers of older homeowners living in rural locations but they remain focused in and around Dorset’s key towns
• Health and Care Outcomes:
  • there are significant differences in the health outcomes between high, moderate and low income older people
  • 17% of Dorset’s high income homeowners experience challenges with the activities of daily living and 20% of homeowners with low to moderate level incomes
  • however, this increases to 27% for low-income tenants
  • about 60% of the council’s community packages are commissioned for older homeowners, most of whom have low to moderate level incomes
  • 40% of commissioned homecare packages are for low-income tenants
  • 55% of older persons OT assessments are for homeowners and 45% are tenants

3.8 These are illustrative facts that point to the following key extra care housing requirements:

• some older homeowners who may need to fund their own care will benefit from the housing market providing a targeted housing offer, which meets a design standard able to respond their changing care and health needs
• others will need the council and affordable housing providers to develop and commission high quality extra care housing for rent, designed for people with long term and complex care needs eligible for council funded care
• many of Dorset’s older residents who own their own home, who have emerging care, support and health needs but whose equity and income may not sustain their needs long term, will benefit from extra care developments that offer affordable shared ownership alongside other types of extra care and potentially general needs housing
• given the range of extra care housing options that will be needed, both the council and housing providers will need robust advice services, to ensure that all of Dorset’s older people have the right information on their housing with care options and how these might be financed
• some localities will benefit from a mixed approach to housing development offering well designed and accessible extra care housing, to meet the needs and aspirations of both higher income older homeowners and tenants.
• other localities will need equally well designed but focused affordable extra care housing for tenants and low income households
• given the need that older people will have to easily access health, shops, transport and other key amenities as they develop mobility and other health needs, developing and providing extra care housing in and around larger market towns and conurbations or as part of strategic development sites will be a principle consideration
• this also reflects that Dorset has one of the lowest populations of working age adults in the county, which adversely affects the availability of a social care workforce able to work in extra care housing

3.9 A key issue in terms of planning sustainable housing for older residents and the support services they need to maintain independence, is the fact that nearly 30% of people aged over 65 live alone in Dorset.

This will present adult care services with a particular challenge as this group of older people age, particularly in terms of those who may have limited local family and social networks making it more likely that they will need social care if and when they develop a life limiting condition.

3.10 Appendix 2 provides more detailed demographic, housing and health data and is intended to help with the development of more specific investment proposals and business cases that emerge from this plan. Appendix 2 is available on request.

 

 

4.1 Supply analysis

4.1.1 In 2021 Dorset Council commissioned a comprehensive housing needs assessment, covering housing development requirements and priorities up to 2038.

4.1.2 These are the key considerations arising from the housing needs assessment and demand modelling, which may affect the future development of extra care housing:

• there is a current deficit of 487 extra care housing units for rent and 416 extra care housing units for sale
• however, in addition to addressing this deficit Dorset will need to develop a further 397 extra care housing units for social rent and 505 extra care housing units for sale by 2038
• this equates to 1,805 additional extra care housing flats or 33 new (55 unit) schemes by 2038
• there are significant variations in extra care housing supply and shortfalls across Dorset, for both rent and sale
• benchmarking with other local authorities that share Dorset’s population profile and characteristics, indicate that at least Four (4) new extra care schemes (220 units) are needed to bring Dorset up to the benchmark average
• developing new extra care housing will be challenging for Dorset, within the context of:
  • the housing needs assessment highlights that 1,717 new affordable homes are needed per annum
  • however, approximately only 40% of the new affordable homes needed in Dorset are being delivered per year, equating to about 650 new homes
  • this significantly impacts the population of working age adults working in lower paid sectors such as care, adversely affecting the availability of care staff
  • the ready availability of a skilled and trained social care workforce able to access affordable housing, is a key consideration that will affect future extra care housing development

4.1.3 However, it’s important to note that there are currently too many older sheltered housing homes and schemes, which are unlikely to meet modern space and accessibility standards and which may not offer an effective housing solution for people with long term care and health needs.

Whereas the council’s housing needs assessment indicates a long term need to provide more well-designed and accessible homes for older people, there are estimated to be 1,048 older sheltered housing flats for rent that don’t meet the current needs of Dorset’s older population.

4.1.4 Therefore, the council will work in partnership with social housing providers to progress assessments of current sheltered housing sites to:

• determine whether and to what extent they meet a modern standard of accessible and good quality housing, aimed at older people and people with long term support and health needs
• the potential for current sheltered housing schemes to be cost-effectively remodelled, to meet the extra care housing design principles and requirements set out in the HAPPI framework
• where schemes are assessed to be incapable of remodelling to meet these standards, the potential to redevelop these sites to provide the additional extra care housing capacity needed as set out in this strategic statement
• this includes assessing each site’s potential to meet the key planning, development and design considerations set out under section 1.3 of this statement

4.1.5 Tables and analysis detailing the housing demand projections and benchmarking data can be found under Appendix 2 of this strategic statement, which also includes more detailed locality analysis. Appendix 2 can be provided on request. 

4.2 Analysis of key groups

4.2.1 Low income and social housing tenants:

• characteristics and issues
  • more likely to be dependent on state funded social care and welfare benefits including pension credit and less likely to have occupational pensions
  • will have a lower healthy life expectancy and so may enter the care system at an earlier age and need care for longer
  • highest risk of having multiple health conditions that may result in the need for complex care support
  • will require access to social housing for rent with limited options in terms of shared ownership or leasehold
  • more likely to be living in older social housing rented properties, including sheltered accommodation, which may offer limited potential in terms of adaptability and providing accessible housing
  • more likely to be dependent on local shops, amenities and public transport and so living close to main shopping and transport hubs will be key to maintaining their independence
• key themes:
  • the key driver is developing accessible, attractive and inclusively designed affordable housing that can easily respond to older residents as they develop life limiting conditions
  • this should include extra care housing for rent, which enables this group of older people to remain living in the communities they know well
  • a further key consideration is that their housing should be in surroundings that help them easily access good local amenities and public transport to maintain their choice and independence, and which is planned to take full account of increasing disability
  • this combined with the increased likelihood of their need for social care will require innovative approaches to delivering cost effective but person-centred support and care with accessible housing, particularly within the context of an already pressured adult social care budget
  • given the higher development costs associated with developing housing built to higher space standards for people with complex needs, including housing with care and support (extra care), effective partnership with housing providers across the private and social housing sector will be needed
  • this is needed alongside the development of mixed sites encompassing housing for other groups and owner occupiers in order to generate cross subsidies and to access a broader range of financing options
  • options to include the development of well-designed accessible housing for older people who may need extra care as well as other groups with life limiting conditions, as part of major housing regeneration programmes needs to be considered
  • existing social housing sites designated for older people (sheltered) but which don’t or are unlikely to meet modern accessible housing design (HAPPI standards) should be examined in terms of their potential to deliver new extra care housing or mixed development and housing provision to meet other key housing priorities

4.2.2 Older homeowners (middle income):

• characteristics and issues
  • this is Dorset’s most significant group of older person households
  • older people in this group may be less dependent on state funded support and care
  • however, they may become more reliant on council funded care as needs increase; as they get older and if they develop more complex life limiting conditions
  • households in this group are overwhelmingly homeowners with a significant capital value and for whom social housing for rent will not be an option or preference
  • their existing homes may become unsuitable for their needs or may not provide the adaptability or accessibility in the event that they do develop life limiting conditions and or require care
  • this group is likely to feature significantly in the projected increase in older person households over the next five years
• key themes
  • a key driver for this group will be maintaining their housing assets and the funding of their long-term care, as and when they may need this
  • they will need good quality and robust support, advice and financial assistance through financial products aimed at older homeowners
  • this includes advice on financing long term care and support alongside purchasing a new extra care home

4.3 Support and care model

4.3.1 The council has reviewed how it commissions support and care, across several current extra care housing services. The aim of the review is to help the council design with it’s’ system partners, a new commissioning framework covering the delivery of support and care services across both existing and new extra care housing provision.

4.3.2 In carrying out this review the council has benchmarked it’s approach with several local authorities who either share similar characteristics to Dorset’s population or who are delivering best practise in the provision of extra care housing support. The council has also taken account of guidance developed by key agencies such as the Association of Directors of Adult Social Services (ADASS) and the Social Care Institute of Excellence (SCIE).

4.3.3 The following principles have emerged from the review and will inform the development of the support and care model, the council will commission across all the extra care housing provision it develops and provides:

• flexibility in how this is developed and offered depending on:
  • the regular review of the need of tenants
  • delivering an effective crisis response, for people living in a home of their own (including extra care housing)
  • a crisis response that prevents a long-term escalation in the need for care and avoids unplanned hospital and care home admissions
• an extra care housing offer able to effectively respond to a range of scenarios including:
  • step down from short stay care home beds, as part of hospital discharge and reablement pathways
  • step up for residents who are still independent but who’s care and support needs are rapidly changing and increasing
  • a pathway for residents who suddenly become disabled through accident and other similar episodes, who need adaptive housing with support to help them regain their independence
• the model responding effectively and flexibly to multiple needs that include people with a learning disability, autistic people, people with dementia and residents with mental health needs, as well as people with more complex mobility and bariatric support needs
• nomination frameworks that focus on reablement opportunities and the avoidance of care home admissions
• multi-disciplinary reviews linked to complex care profiling, to understand the level of need extra care housing can address and to provide guidance to social care and health professionals, on the types and level of need that can be managed by extra care
• based on the above devising with social care professionals and providers, a risk framework categorising levels of need and risk and what an extra care housing service can reasonably and safely offer
• the effective and targeted use of new care technologies that support the more efficient delivery of care and which promote the independence, resilience, privacy and choice of residents with complex needs
• developing the understanding of social care and health staff; residents with care and support needs and their carers, of what well designed extra care housing can offer and the benefits it can deliver for people with long term conditions

4.3.4 The council’s initial modelling of the impact of applying these principles to how it commissions extra care housing, indicates it will help the council in mitigating pressures on health and social care resources and related council spending.

4.3.5 Based on the outcome of the review the council is progressing the development of a new support and care model for extra care housing. In developing this model the council will consider and prioritise the following Key factors:

• Dorset’s low working age population adversely affecting the availability of a skilled social care workforce
• progressing effective workforce plans with social care providers and other strategic partners to address this, including using Extra Care Housing as Hubs to deliver broader care services across localities
• developing a core competency and ‘values’ led Extra Care staffing and development framework that emphasizes:
  • doing with and not to
  • maintaining and building the skills and resilience of extra care residents, to support themselves and exercise more control over their lives
  • outcome focused and not task focused delivering flexible and responsive support, able to work with other agencies to measurably improve residents wellbeing, independence and control
  • a learning culture able to learn from residents, other professionals and good practise to improve how support is delivered
  • extra care housing providers having access to professional support and advice to improve service delivery and staff practice, which may cover OT, dementia, PBS etc.
• nurturing and progressing effective leadership across extra care providers, council adult social care and health to offer an integrated service approach that ensures
  • person centred, seamless, outcome focused and therapy led support is delivered
  • all agencies work effectively together to prevent crisis, escalation and the need for more long-term care and health support
  • opportunities for joint learning, staff and service improvement are maximised through utilising the staff skills, resources and specialist knowledge of all partner agencies
• the potential of extra care housing providing community hubs reducing provider costs, including travel costs and increasing the likelihood of attracting and retaining a permanent and sustainable workforce
• developing Extra Care Housing as part of developments that fund and promote key worker housing to ensure a localised Extra Care workforce

4.3.6 Appendix 1 sets out in more detail the council’s proposed commissioning approach and support and care model, covering the existing and future extra care housing schemes it plans to develop and provide. Appendix 1 can be provided on request 

4.4 Overall conclusions

Housing planning and development:

• forecasting models suggest that an additional 1,805 extra care housing units designed for people with long term care, support and health needs, will need to be developed over the next 15 years
• a key consideration will be developing extra care housing that can meet higher space and accessibility standards, aimed at people using wheelchairs and to meet the needs of the growing population of people with more complex care and health needs
• our needs and socio-demographic analysis suggests that the equivalent of two new extra care housing developments are needed within the next 5 years in or near Town A and Town B
• Appendix 3 details the options and benefit analysis highlighting the two localities, where new extra care housing development will deliver the most benefit
• this is in addition to the existing gateway developments that are being progressed at Bridport and Wareham (West Purbeck), which including new extra care housing provision
• however, any new schemes are unlikely to be completed before 2028 taking account of planning and building timelines
• based on the same demographic and need data the intention is to work with both private sector housing providers and housing associations to develop attractive and inclusively designed housing with support and financial options for older homeowners and tenants
• this will be coupled with commissioning advice services able to advise on financial options and products, to assist older homeowners to purchase housing capable of meeting their needs as they develop the conditions of older age
• there will be a clear focus on town based and mixed development sites, where more vulnerable older residents can be housed and supported in a broader community context alongside more active elders, families and younger households and where there is access to a social care workforce
• this also allows cross subsidies from private sales and fees to fund the development and provision of extra care housing for rent
• housing for older people and people with long term care and health needs, to be developed within neighbourhoods designed to allow easy access to key amenities, shopping centres and good public transport where local environments and ‘street scene’ take full account of the needs of people with mobility, sensory, cognitive and neurodiverse impairments
• to deliver the housing development programme envisaged by this plan within the context of accessible communities and neighbourhoods, robust and effective strategic partnership and leadership will be needed across the council’s Strategic Commissioning, Adult Social Care, Housing, Asset Management and Statutory Planning services and external housing development partners and vehicles

Support and care model:

• appendix 1 sets out the key aims, principles and features of the council’s proposed support and care model, which it plans to commission across all the extra care housing services it currently uses and plans to develop. Appendix 1 can be provided on request 
• the model aims to deliver a responsive and flexible 24/7 onsite support and care service, able to effectively respond to a range of care, support and health needs and which is focused on promoting independence and resilience; the prevention in the escalation of care needs and the avoidance of admissions to institutional care
• the core service will underpin and sit alongside the individual personal care, commissioned by the council for each extra care resident
• based on this model the four new extra care sites the council plans to develop, will require an annual revenue investment of between £430,000 and £530,000 per scheme to pay for the onsite core support services but this will provide good value given the net savings that could be achieved and the reduced on-going pressure on social care resources
• if an effective and focused strategy is adopted to use both existing and proposed extra care developments to avoid the use of more complex and costly institutional placements, including using extra care housing for people with dementia, a learning disability and mental health needs, then it is not unreasonable to plan for an annual saving of between £200,000 and £255,000 per scheme
• this is based on the council’s review of best practise across several local authorities, with similar demographic, socio-economic and health profiles to Dorset
• the review highlights that it’s reasonable to assume that between 40% and 60% of extra care tenancies, can be used to address the needs of residents with higher and more complex levels of care, support and health needs and who are the most at risk of losing their independence that may result in a care home admission

5.1 The implications and conclusions that arise from this strategic document, point to the following key strands and priorities:

• housing development focused on delivering more well designed, attractive and fully accessible housing:
  • aimed at people with changing and increasing care, support and health needs
  • located in accessible neighbourhoods with good access to public transport, major shopping hubs, health and other community amenities
• a well-designed housing with care offer able to flexibly respond to:
  • Dorset’s older residents particularly as they age or develop long term care needs
  • Dorset’s residents of all ages with disabilities and multiple needs, where good quality and accessible housing with support will help them:
    • thrive
    • be happy
    • be healthy
    • be in control
    • be resilient
    • be independent
• a focus on developing new extra care housing as part of strategic housing developments or in and around larger towns
• the incorporation of extra care design principles in the Planning Framework and Local Plan, to ensure that the very best design features are reflected in both extra care housing developed by affordable housing providers and private sector developers
• the Local Plan reflecting the long term need to develop further extra care housing alongside the medium-term plan to develop four new extra care housing sites over the next five (5) years
• this includes the council’s commitment:
  • to continue developing the gateway extra care housing schemes on council owned sites at Bridport and West Purbeck
  • to commission and develop a further two new extra care schemes at Town A and Town B, in line with the outcome of the options appraisal set out in Appendix 3
• developing strong strategic partnerships with housing providers, health and other key partners to secure investment and appropriate landsites, to develop the extra care housing capacity Dorset needs in line with the key principles set out in section 1.3 of this statement
• to include evaluations and reviews of existing social housing sites aimed at older people to understand;
  • to what extent they meet these principles and
  • whether these sites can be remodelled or redeveloped to provide an effective extra care housing offer
• developing a robust and outcome driven extra care commissioning model that;
  • delivers a highly skilled, sustainable and values driven support and care workforce
  • effectively uses key extra care design features and new technologies
  • utilises these to deliver cost efficient support that helps residents with support needs to achieve increasing independence and resilience
  • supports strong leadership that achieves effective integration across extra care housing providers, the council, health and other partners to deliver outcome and solution driven support and care

1 Purpose

1.1 This document forms part of the council’s Extra Care Housing Strategic Statement and sets out the evidence to support the council’s medium term (next 5 years) plan, to develop and commission new extra care housing schemes and services.

1.2 The council is already committed to continuing it’s development of extra care housing as part of two 1gateway development sites at Bridport and West Purbeck (Wareham)

1.3 However, the housing demand projections set out in the 2021 council commissioned assessment of housing needs, highlight the need to increase Dorset’s supply of extra care housing over the next 15 years.

1.4 Within this context the council is also committed to developing a further two extra care housing sites, in localities where the maximum benefit for Dorset’s residents with long term care, support and health needs can be achieved.

1.5 The council wants to develop these sites to maximise the opportunities for continued independence, choice and control for all it’s residents who may develop support needs, including homeowners and people who fund their own care.

1.6 However, the primary focus and priority for extra care development across all four sites will be on affordable homes for residents who’s support is commissioned and funded by the council. This is a key factor in the council determining the localities where it will directly develop and commission new extra care housing.

1.7 This does not preclude the council working in partnership with housing developers and contributing it’s own land and other resources to develop larger extra care housing developments, which provide both high quality and affordable extra care homes for rent and an effective market option for homeowners.

2 Locality factors

2.1 Key provisions set out in the strategic statement concern developing extra care housing in locations, which offer easy access for people with long term care needs to shopping hubs; public transport; health and key community amenities.

2.2 Ideally this should be part of accessible neighbourhoods that enable people with long term conditions such as dementia or who have mobility support needs, to remain independent, in control and fully connected to the communities they live in.

2.3 Within the context that Dorset has one of the lowest populations of working age adults that significantly affects the availability of a social care workforce, developing extra care housing in localities that can more easily attract skilled social care staff is a key consideration.

2.4 The council’s climate change obligations and the fact that Dorset is home to several areas of outstanding national beauty and scientific interest, highlight the need to;

• develop extra care housing in localities that reduce carbon impact through fewer car journeys and
• the impact of people on sensitive sites

2.5 Therefore, the council is committed to developing the new extra care housing it wants to commission in town locations, which fully meet the criteria set out above.

3 Key considerations

3.1 Appendix 1 of this document sets out the key considerations the council has taken into account, to understand the localities where the council will directly plan and commission new extra care housing and which will achieve the most benefit for Dorset residents, who rely on the council for support and help.

3.2 This offers a wider context to the population, health and housing data set out in Appendix 2 of the council’s Extra Care Housing Strategic Statement, which has been used to inform the evaluation detailed under section 4 of this document.

3.3 This doesn’t preclude the council including in it’s evaluation, the benefits that may be achieved for residents who fund their own support and care and residents who may not currently need support but who want to plan in the event their needs may change.

4 Evaluation

4.1 The purpose of this evaluation is to identify localities across Dorset, where the development of additional extra care housing capacity will achieve the most benefit.

Whereas, the council’s overall aim is to improve the housing with care options for all Dorset residents who may need highly adaptive housing and targeted care either now or in the future, the council has statutory obligations to ensure that the needs of it’s most vulnerable residents are met.

Within this context the council will work through it’s Housing Strategy and Planning Framework to deliver the good quality extra care homes Dorset needs, for both homeowners and residents needing affordable homes.

4.2 However, in terms of the council directly developing and commissioning new extra care housing using it’s own landsites, investment and resources, the council will prioritise and focus on residents who are Care Act eligible and who need and are eligible for affordable housing.

This criteria will be a key factor in the council’s evaluation of the two localities where it will plan and develop new extra care housing.

This does not preclude the council using it’s landsites and resources in partnership with housing developers and providers, to deliver mixed tenure sites offering extra care housing for rent; sale and shared ownership.

This approach will particularly apply where a mixed development approach will;

• maximise best value
• achieve financial viability and sustainability
• deliver better outcomes in line with the council’s key strategies and plans

4.3 A further consideration is to what extent current extra care housing schemes, meet a modern standard of accessible and well-designed housing in line with:

• design guidance and standards established through the HAPPI framework
• key principles set out under section 1.3 of Dorset’s Extra Care Housing Strategic Statement

4.4 The council has evaluated all the affordable extra care housing schemes across Dorset, which offer low cost rent and shared ownership.

The evaluations were led by occupational therapists, who evaluated the schemes in line with the standards and principles referred to in 4.3 of this document. Within this context the council’s evaluation concluded that some schemes don’t meet these standards and principles.

4.5 Appendix 2 of this document sets out the challenges these schemes present, which strongly indicate that they do not provide an effective extra care housing offer. This applies to scheme 1 and scheme 2.

4.6 Therefore, these schemes have not been included in the council’s evaluation of the number of additional extra care housing units needed across Dorset.

This has informed the priorities for new extra care housing development directly led by the council, which are set out in this document.

4.7 Within this context and taking account of the evidence and considerations set out in section 3 of this document, the evaluation factors set out in Table 1 will be applied to the council’s evaluation with weighting to indicate the level of priority of each factor.

4.8 In addition each locality will be scored against each factor to indicate to what extent the council directly commissioning new extra care housing will achieve the most benefit, based on the scoring set out in Table 2.

Table 1: Evaluation Factors

Factor number	Factor	Weighting %
1	Locations with the highest need for additional affordable extra care housing	60
2	Locations with the highest level of care and health needs	20
3	Locations with the highest need for additional extra care housing all tenures	10
4	Locations with the highest populations of over 65s	10

 

 

Table 2: Scoring

Description	Score
Exceptionally High	6
Very High	5
High	4
Moderate	3
Low	2
Very Low	1

4.9 Locality Scoring

Table. Locations with the highest need for additional affordable extra care housing

Locality	No of additional units needed	Score	Weighting %	Weighted Score
East Dorset	212	5	60	3
North Dorset	168	4	60	2.4
West Dorset	126	2	60	1.2
Mid Dorset	97	1	60	0.6
South Dorset	217	6	60	3.6
South East Dorset	137	3	60	1.8

Table. Locations with the highest level of care and health needs

Locality	Level of Care/Health demand	Score	Weighting %	Weighted Score
East Dorset	6,217	4	20	0.8
North Dorset	7,831	6	20	1.2
West Dorset	3,325	1	20	0.2
Mid Dorset	3,707	3	20	0.6
South Dorset	6,841	5	20	1
South East Dorset	3,369	2	20	0.4

Table. Locations with the highest populations of over 65s

Locality	65+ Population	Score	Weighting %	Weighted Score
East Dorset	28,346	6	10	0.6
North Dorset	25,475	5	10	0.5
West Dorset	13,226	2	10	0.2
Mid Dorset	13,208	1	10	0.1
South Dorset	19,731	4	10	0.4
South East Dorset	13,717	3	10	0.3

Table. Overall Weighted Scores

Locality	A	B	C	D	Overall Weighted Scores
East Dorset	3	0.8	0.4	0.6	4.8
North Dorset	2.4	1.2	0.6	0.5	4.7
West Dorset	1.2	0.2	0.2	0.2	1.8
Mid Dorset	0.6	0.6	0.1	0.1	1.4
South Dorset	3.6	1	0.5	0.4	5.5
South East Dorset	1.8	0.4	0.3	0.3	2.8

 

Outcome of locality benefit analysis

4.10 The evaluation set out under Tables A – E clearly highlights that over the next five (5) years, the council should focus it’s direct planning, development and commissioning of new extra care housing across the following locations:

• South Dorset
• East Dorset

4.11 Given the councils Extra Care Housing Strategic Statement highlights the benefits of developing and providing new extra care housing in major towns and conurbations, set out below are further factors that the council has considered in terms of which towns across East and South Dorset should be prioritised.

South Dorset

4.12 Weymouth is Dorset’s largest town with a population of 53,046. This is larger than the whole population of Mid Dorset that includes Dorset’s second largest town of Dorchester. The town makes up over 70% of South Dorset’s population.

4.13 Within this context it benefits from a large town centre and shopping hub encompassing major supermarkets; other retail; banks; larger medical centres and health amenities and access to good public transport.

4.14 The key consideration is that 11,368 older households live in Weymouth, which is 70% of all older households living in South Dorset. This includes 5,546 low-income households making up 64% of South Dorset’s low income older people.

4.15 Weymouth has a much more significant working age population than other localities across Dorset at 30,329. This significantly increases the opportunity to recruit a local support and social care workforce, able to work in any new extra care housing services commissioned by the council.

A larger local workforce also reduces the risk and impact of excessive car journey’s, contributing to the council’s aims to reduce Dorset’s carbon footprint.

4.16 These factors and key considerations strongly point to the council developing, planning and commissioning new extra care housing in Weymouth.

However, there are higher numbers of both low income older tenants and low income homeowners living in Weymouth and South Dorset, when compared to other Dorset localities.

This provides a strong case for the council to use it’s available landsites and resources, to develop a mixed extra care housing offer providing affordable rent, shared ownership and outright sale.

East Dorset

4.17 East Dorset’s main towns and their population sizes are as follows:

• Ferndown: 21,488
• Verwood: 14,105
• Wimborne: 7,755

4.18 Critically Ferndown has the largest number of older person households in East Dorset with 5,054 households (25%) compared to Verwood with 2,764 households (14%) and Wimborne with 2,231 households (11%). 4,019 older households living in and around Ferndown are high or moderate level income homeowners, with 1035 low income older tenants or homeowners living in Ferndown.

4.19 As the largest conurbation in East Dorset Ferndown has a significant Town Centre with major supermarkets; other retail and health and community amenities. The town also has East Dorset’s largest population of working age adults at 10,668 compared with Verwood at 7,900 and Wimborne at 4,264.

4.20 These factors indicate that Ferndown is an optimum location in East Dorset, where the council directly planning and commissioning new extra care housing will realise the most benefits.

North Dorset

4.21 Whereas the council wants to prioritise two (2) new extra care housing developments across South and East Dorset alongside the existing gateway sites at Bridport and Wareham, it’s recognised that North Dorset has one of the largest and fastest growing older populations.

Even though the level of additional 4affordable extra care homes needed is lower for North Dorset than South and East Dorset, the locality has a significant overall need for more extra care housing over the next 15 years.

4.22 Therefore, the council will work with it’s housing partners and developers to identify opportunities, to maximise new extra care homes in and around North Dorset’s major towns including:

• Gillingham
• Blandford
• Sherborne
• Shaftsbury

East Dorset

Demographic:

• the single largest population of older people at 28,346
• this is projected to increase by 5,318 by 2036, a 19% rise
• there are 14,559 over 75s living in East Dorset, which will rise by 3,629 by 2036
• the larger towns of Ferndown and Verwood are located in East Dorset

Socio-economic:

• estimates highlight that 7,919 older person households are high income
• homeowners with annual incomes above £40,000
• this is 39% of all older person households living in East Dorset
• 8,835 older person households or 44%, are homeowners with moderate annual incomes between £20,000 and £30,000
• an estimated 2,583 older households or 13% are low income tenants on less than £15,000 per annum, with 795 households or 4% who are low income homeowners

Health and care:

• homeowners with moderate to high incomes are less likely than low income tenants, to experience significant challenges with conditions that limit their ability to manage their own needs
• estimates suggest that only 17% of high income homeowners have conditions that limit their ability to manage their own needs, compared to 27% for low income tenants
• this combined with the high number of higher income older homeowners living in East Dorset, suggests that fewer older people will need council commissioned and funded housing with care
• however, given the higher older person population, the highest number of council commissioned homecare packages (26%) and OT assessments (32%) are delivered to East Dorset’s older households
• furthermore, East Dorset has one of the highest prevalence rates for council funded homecare packages for older people, which is an indicator of the potential need for council commissioned extra care housing
• the prevalence rate is based on the number of homecare packages per 1,000 head of East Dorset’s 65+ population

Supply:

• East Dorset has the second highest supply of extra care housing, with 174 market units for sale and 51 social housing units for rent
• overall this represents 15 extra care units per 1,000 head of the 75+ population
• notwithstanding the higher levels of older homeownership, the private market has already responded in developing one of the highest number of extra care units for sale
• within this context and albeit that levels of older rented households are much lower than other parts of Dorset, there is a need to develop a higher number of affordable extra care homes for rent than for sale
• overall housing need projections highlight that an additional 376 extra care housing units will be needed by 2038, with 212 for rent and 164 units for sale

North Dorset

Demographic:

• North Dorset has the second highest population of older people at 25,475
• however, this is projected to grow by 8,344 (33% rise), with North Dorset projected to have the highest older population by 2036 of 33,819
• there will be a much more significant 44% rise in over 75’s when compared with East Dorset, with the population increasing from 12,426 to 17,955 by 2038
• North Dorset includes the larger town of Gillingham, which is identified as a key housing development location and the towns of Blandford, Shaftsbury and Sherborne

Socio-economic:

• there are fewer high income homeowners than East Dorset, with 5,297 households with annual incomes above £40,000 or 34% of all older households
• there are also far fewer older homeowners with moderate incomes between £20,000 and £30,000 per annum, with 22% or 3,386 households in this category
• North Dorset has much higher numbers of low income older households with annual incomes less than £15,000, with 5,451 (35%) older social housing tenants and 1,378 low income homeowners

Health and care:

• 19% of all council funded homecare packages and 22% of council OT assessments, are delivered to older households living in North Dorset
• with a higher number of low income older households than East Dorset, there maybe a case to provide a higher level of extra care housing for rent

Supply:

• however, whereas housing need projections highlight that North Dorset requires the highest level of extra care housing development with 506 additional units needed by 2038, there is a much greater need to develop extra care housing for sale than rent
• there is a need to provide 168 additional extra care homes for rent but 338 more extra care homes for sale
• this reflects the fact that there are currently no market or private sector extra care schemes or homes for sale in North Dorset
• there are 95 extra care homes offering affordable rent, including a new 55 unit scheme under development in Gillingham that will be ready to let by October 2023
• this also includes Trailway Court located in Blandford, which is the only council commissioned extra care housing scheme offering 24/7 onsite support and care

Mid-Dorset

Demographic:

• has the lowest current population of older people at 13,208 but projections suggest that Mid Dorset will see the greatest rise in older people, with a 52% increase by 2038
• this will increase the number of older people living in Mid Dorset to 20,105
• the greatest rise will be amongst the over 75s, with a 65% increase by 2038 from 6,549 to 10,827
• Dorset’s second largest town and main administrative centre of Dorchester is located in Mid-Dorset

Socio-economic:

• estimates suggest that 2,877 low income older household that rent (36%), live in mid Dorset alongside 779 (10%) low income older homeowners
• there are 2,646 (33%) higher income older households who own their own home and 1,713 moderate level income older homeowners
• these are relatively low numbers of both high income older homeowners and low income households that rent, within the context that Mid-Dorset has one of the lowest proportions of households that are over 65 at 37.9% of all households
• this compares with localities with higher populations of older people such as East Dorset and South Dorset, where the proportion of older households compared to all households is 49.7% and 45.5% respectively

Health and care:

• Mid Dorset has one of the lowest number older households receiving a council commissioned homecare package, representing only 11% of all homecare packages
• critically when the number of packages is considered as a proportion of each localities over 65 population (packages against 1,000 head of 65+ adults), Mid-Dorset has the lowest prevalence rate
• this is within the context that Mid Dorset has one of the lowest rates of council commissioned occupational therapy assessments for older people
• whereas these are proxy indicators and may not reflect the full picture in terms of the levels of support and care needed across Mid-Dorset, they do indicate a relatively lower need for extra care housing for the most vulnerable older residents who may rely on council funded care

Supply:

• has the highest level of extra care housing supply with 172 extra care homes for sale and 63 affordable extra care homes for shared ownership and rent
• housing demand projections based on extra care housing prevalence rates set out in the council’s housing needs assessment, suggests that Mid-Dorset requires only 131 additional extra care homes by 2038
• this is the lowest rate of projected increase
• this combined with Mid-Dorset’s lower older person population and number of households when compared to other Dorset localities, highlights that Mid Dorset may not be a priority in terms of council led new extra care housing development

West Dorset

Demographic:

• has the second lowest population of older people at 13,226, which is projected to grow at the lowest rate of 25% to only 16,525 by 2036
• furthermore, the population of over 75s is the lowest with one of the lowest rates of projected increase of 28%, growing from 6,275 to 8,657 by 2036
• West Dorset encompasses the market town of Bridport

Socio-economic:

• has the second highest proportion of higher income older homeowners at 36% or 3,324 household, with a further 1,956 (22%) older homeowners on moderate level annual incomes of between £20,000 and £30,000
• there are 3,823 low income older households (42%) living across West Dorset, of which the overwhelming majority are social housing tenants

Health and care:

• only 11% of council commissioned homecare packages for older people are provided in West Dorset but with a relatively lower older population when compared to other Dorset localities, the prevalence rate is one of the highest
• however, there are relatively few council commissioned occupational therapy assessments (8%of the total) carried out on older person households living in West Dorset, which may indicate a higher number of older people living in homes that meet their needs or who have relatively lower levels of disability and long term health conditions requiring adaptations to their homes

Supply:

• West Dorset has no significant extra care housing supply with only 6 enhanced sheltered housing units provided
• this combined with older person population estimates for West Dorset, indicate the need to develop 281 new extra care homes by 2038
• this is based on the supply prevalence rates included in the council’s 2021 housing need assessment

Bridport Gateway Development:

• the council is already committed to and progressing plans to use one of the landsites it owns in Bridport, to commission a xxx unit extra care scheme as part of a larger gateway development
• the site conforms to a number of the extra care housing development criteria set out under section 2 of this document, including:
  • located in a major market town
  • adjacent to a major shopping hub and supermarket with good public transport links
  • the site may offer easy access to the main high street, which is very near to the site
  • the high street offers banks, other shopping outlets, health, leisure and community amenities
  • the egress from the site to the main high street is level via a local park and options to open up safe access for residents with mobility support needs can be made a requirement of development proposals
• a detailed evaluation is needed to determine how much affordable extra care housing can be sustainably delivered on the site, including rented and shared ownership and whether some market extra care housing for sale can be delivered
• other than delivering some of the market capacity needed in West Dorset, developing extra care housing for market sale may provide subsidies to develop the affordable units and thereby contribute to the sites financial viability

South Dorset

Demographic:

• there are 19,731 older people living in South Dorset, which is Dorset’s third highest older population and which includes Dorset’s largest town Weymouth and Portland
• South Dorset is projected to see the second highest rise in the number of older people, with a 42% increase by 2036 taking the population to 28,093
• critically it’s projected that there will be a much more significant 60% rise in the number of over 75s living in South Dorset, with this population growing from 9,120 to 14,634 by 2036

Socio-economic:

• the highest number of older low income households live in South Dorset, with 4,956 low income tenants and 3,668 low income older homeowners
• these represent 31% and 23% of all older person households living in South Dorset
• the second highest number of older homeowners on moderate incomes also live in South Dorset, with 5,567 households or 35% of all older person households living in South Dorset
• however, South Dorset has the lowest number of high income older home owners with only 1,776 households representing 11% of South Dorset’s older households

Health and care:

• given that older low income tenants experience the greatest challenges with health conditions that impact their ability to manage their own needs, it’s highly likely that South Dorset will have higher numbers of older residents whose poor health affects their ability to support and care for themselves
• this is within the context of the higher number of low income older tenants living in South Dorset compared to other localities
• the second highest number of council commissioned homecare packages for older people are provided across South Dorset, with 231 support packages representing 21% of all council funded care packages provided to older residents
• these indicators suggest that well designed extra care housing will need to be a key element of the council’s delivery of support, which prevents the escalation of care needs across South Dorset

Supply:

• supply data indicates that South Dorset has 102 affordable extra care homes for rent
• however, the OT led building assessments described under section 4 of this document, identified several key and significant challenges with some of the existing rented extra care housing offered across South Dorset
• the challenges are sufficient for the council to determine that some rented extra care housing, does not satisfy the accessible and contemporary design standards and principles referred to in section 4
• therefore, these schemes are not included in council’s evaluation of where new extra care housing planned by the council, should be prioritised and developed
• the challenges are set out in Appendix 2 of this document
• within this context South Dorset has the highest need, to develop more affordable extra care homes
• this needs to be considered alongside the fact that South Dorset, has the highest number of older residents living in affordable rented housing
• South Dorset offers no extra care housing schemes and homes for sale, within the context that the locality has the highest number of low income older homeowners (3,668 households) and the second highest number of moderate level income homeowners over 65 (5,567).

Southeast Dorset

Demographic:

• 13,717 older people live in South East Dorset that includes Wareham and West Purbeck. This will grow by 31% by 2036 taking the population to 17,952
• there will be a much higher 42% in the over 75 population, increasing the population from 6,593 to 9,381 by 2036
• Southeast Dorset includes the small towns of Wareham and Swanage

Socio-economic:

• there are 3,922 low income older households (39%) living in SE Dorset of which 3,125 are low income tenants. This compares to South Dorset’s low income households of 8,624
• 61% of older households are high to medium income homeowners, which is the second highest proportion
• however, this only represents 6,105 households compared to East Dorset at 16,754 older homeowners; North Dorset at 8,683 households and South Dorset at 7343 households

Health and care:

• 135 older households living in SE Dorset receive a council funded care package (12%) and 38 households received a council funded OT assessment
• this places SE Dorset at the mid-point, in terms of the delivery of council funded community care. As a comparison 264 over 65 homecare packages, are delivered across East Dorset and 231 across South Dorset

Supply:

• South East Dorset has no extra care housing, either for sale or rent. Within this context and the demand projections detailed in the council’s housing needs assessment, 314 new extra care homes may be needed by 2038. This includes 137 for rent and 177 for sale

West Purbeck Gateway Development:

• to address this need and the complete lack of extra care housing options for East Dorset’s older households, the council is seeking development partners to develop a new xxx unit affordable extra care housing scheme
• the council proposes to achieve this through using one of it’s own landsites and is actively procuring a partner

Extra care housing (ECH) Scheme

Scheme 1

Evaluation conclusions:

• a critical challenge identified with this scheme, is it’s relatively isolated location
• there are no pathways from the scheme to the main road, making it impossible for residents with mobility support needs to safely and easily access public transport, local shops etc
• this is within the context that all access roads to the scheme are narrow and steep
• residents are entirely dependent on online shopping orders or a limited community action bus service that’s only available three (3) times a week. There are no accessible leisure and community amenities located near the scheme, although the scheme is located next to a GP surgery
• there is a high risk that residents with any level of mobility support needs, may become socially isolated and increasingly dependent on support staff to arrange shopping and other basic needs.
• what’s important to note is that despite the fact that residents maybe more dependent on community transport, there is insufficient drop off space and lack of space to allow the safe turning of ambulances
• there is a lack of accessible external pedestrian walkways around the scheme, including dementia friendly pathing and signage that promotes easy wayfinding

ECH Scheme

Scheme 2

Evaluation conclusions:

• the nearest bus stop, local shops and key health and other amenities are some distance from the scheme
  • Bus stop 300yrds
  • nearest GP 1 mile
  • small local shop and nearest chemist ½ mile
• however, a key issue is that tenants need to navigate a steep and long incline to get to the main road, to access the above facilities
• this is likely to cause challenges for residents with significant and multiple health need and people with mobility support needs
• the internal corridors are only wide enough for two people, which will present challenges for people using wheelchairs or mobility aids who may need more than one person to support them
• this may also cause challenges for emergency services where two health staff are needed with equipment
• a critical challenge is that none of the flats have reinforced ceilings capable of supporting ceiling tracking hoists
• this significantly limits the schemes capacity, to support residents with multiple health and care needs and who need a hoist supported by care staff, to safely transfer from a bed to wheelchair and similar scenarios

ECH Scheme

Scheme 3

Evaluation Conclusions:

• the scheme offers an effectively designed and attractive living space with communal and circulation areas (corridors), able to accommodate residents with mobility support needs; their carers and paramedics with equipment
• highly accessible corridors and circulation areas on all main floors, allow residents to circulate unimpeded and there are various visual aids such as differentiated colour schemes on each floor and signs to support wayfinding
• there’s a variety of accessible communal living spaces and rooms that could be used for a range of purposes on each floor
• however, the flats were not developed to M4(3) standard and may offer limited access to residents who use wheelchairs and motorised chairs full time
• the location of the scheme presents challenges for residents with mobility support needs, as the scheme is not located close to local shops, bus stops/routes or amenities
• notwithstanding some of the challenges highlighted above the scheme does provide an effective extra care housing offer
• this includes:
  • wider internal corridors and internal amenity space, wide enough for two (2) workers to support a resident with mobility needs
  • this also allows unimpeded access for paramedic and health staff with equipment
  • strengthened ceilings and walls in all flats able to support the installation of ceiling tracking hoists and support grab rails
  • wet room bathing and level access toilet facilities, with dual access from the hall and resident bedroom

ECH Scheme

Scheme 4

Evaluation conclusions:

• located in one of Dorset’s larger towns, with easy and level access to major local shops; health; leisure and community amenities
• the paving and roads have been designed and laid out with the needs of people with disabilities in mind and there is good access to local bus stops with connections to Dorchester town centre
• the immediate local environment provides a dementia friendly neighbourhood, which supports wayfinding
• whereas the scheme was not developed to provide flats based on the M4(3) wheelchair standard and so there maybe some challenges in supporting residents who permanently use wheelchairs, the scheme does offer a good standard of accessible housing for people with mobility and other complex needs
• this includes:
  • wider internal corridors and internal amenity space, wide enough for two (2) workers to support a resident with mobility needs
  • this also allows unimpeded access for paramedic and health staff with equipment
  • strengthened ceilings in all flats able to support the installation of ceiling tracking hoist
  • wet room bathing and level access toilet facilities, with dual access from the hall and resident bedroom
  • accessible and well laid out across all floors, supporting effective wayfinding for residents with dementia and other similar neurological conditions

5.1 There is a need to develop more extra care homes across Dorset to reflect its significant and growing population of older people.

This is within the context of a faster growth rate in the number of over 75s over the next 15 years and what is likely to be significant growth in the number of older people with complex care and health needs. These issues are considered and explored through Dorset Council’s housing need assessment (2021) and its Extra Care Housing Strategic Statement.

5.2 However, the council recognises that with a lower working age adult population than the rest of the country and pressures on land use across Dorset, it needs to balance the requirement for additional extra care homes with other critical housing development priorities.

This includes more affordable homes for economically active households in order to retain and attract working age households.

This also reflects the fact that Dorset has several areas of outstanding national beauty and scientific interest, which impacts the availability of viable and sustainable landsites capable of housing development.

5.3 To address these issues the council has adopted a balanced approach, to achieving the sustainable growth in the new extra care homes Dorset needs.

It will achieve this through prioritising locations for new council led extra care housing development, which have the greatest need and where the maximum health and well being benefits can be realised for Dorset residents, who most need the council’s help to remain independent.

5.4 Within this context the council has used a comprehensive range of evidence covering demographic, socio-economic, housing need and health issues, to evaluate where it should focus it’s resources to provide more extra care homes.

This evaluation has concluded that the following locations should be prioritised:

• Weymouth in South Dorset
• Ferndown in East Dorset

5.5 Whereas the council will prioritise developing affordable extra care housing across these locations, it will work with housing developers and other key partners to progress mixed development that also offer options for homeowners. Equally development that will achieve new extra care homes across the whole of Dorset that realise the maximum benefit.

This particularly applies to further extra care development across North Dorset.

This strategy was last reviewed in 2024. 

The next expected review date is 2038.