Specialist and Supported Housing Needs Assessment

1. This assessment is intended to identify the specialist housing and accommodation needs of older people, some of whom will also have care/support needs. This assessment of need includes estimated need for specialist housing for older people, such as retirement housing, 'sheltered' housing, extra care housing, and residential and nursing care provision.
2. The assessment of need for specialist housing and accommodation for older people draws on a range of evidence, including:

• demographic context
• health and care context
• current provision of specialist housing and accommodation for older people
• socio-economic context
• local strategic evidence and local commissioner perspectives and intelligence
• the perspectives of older people and other stakeholders.

Contextual evidence: housing and accommodation for older people in Gateshead 

Demographic context

1. To produce an overview of the change in the older population in Gateshead, estimates for the 55+, 65+ and 75+ populations are used.
2. In order to produce demographic projections the following datasets have been used:

• ONS Mid-2020 Population Estimates for Census Output Areas in the North East region of England. (ONS Mid-2020 Population Estimates for Census Output Areas in the North East region of England by Single Year of Age and Sex -  Supporting Information; Table SAPE23DT10d.) This has been used to generate population estimates at ward level.
• ONS 2021 census population estimates. (ONS P02 Census 2021: Usual resident population by five-year age group, local authorities in England and Wales) The 2021 census population estimates have been used to provide an up-to-date estimate of the older population living in Gateshead.
• ONS 2018-based subnational projections for England. (ONS 2018-based Subnational Population Projections for England; released in 2020) This has been used to estimate the projected growth of the populations, at ward and borough-level, projected to 2040.
• This data is used to identify the current age distribution of the older population in Gateshead and to identify trends in the older population. It is also used as a basis for the estimation of net housing and accommodation need for older people in Gateshead to 2040. Table 1 shows the projected population at 55+, 65+ and 75+ for Gateshead to 2040, and table 2 shows the percentage change in these population cohorts to 2040.

Table 1. 55+, 65+ and 75+ population for Gateshead to 2040.

Source: ONS 2021 census and ONS 2018-based subnational population projections

1. Table 1 shows that both the 65+ and 75+ population cohorts are projected to increase to a greater extent than the overall 55+ population. This is significant because the 65+ and 75+ population cohorts are more likely to need specialist housing and accommodation.

Table 2. Percentage change in the 55+, 65+ and 75+ population for Gateshead to 2040.

Source: ONS 2021 census and ONS 2018, based subnational population projections

1. Table 2 shows the most significant growth is in the 75+ population in Gateshead, compared to the 55+ and 65+ populations. However, both the 65+ and the75+ population cohorts are projected to grow at a significantly higher rate than the 55+ population to 2040.
2. The estimation of housing / accommodation need shown later in this section is based on the projected growth of the 65+ population and the 75+ population cohorts which have been selected, based on previous research carried out by the Housing LIN indicating that these are the most likely population cohorts to need and to move to specialist housing and accommodation designated for older people.
3. To provide local context to the projected change in the 55+, 65+ and 75+ populations for Gateshead, changes in the same population cohorts are shown at Annexe 1 in relation to other councils in the north east of England region.
4. Using 2018-based ONS Subnational Population Projections data (ONS 2018-based Household Population Projections for England: detailed data for modelling and analysis - principal projections.), the older populations for Gateshead and other councils in the north east have been projected for the years 2023, 2025, 2030, 2035 and 2040. The tables in Annexe 1 show the population projections for Gateshead and other councils in the north east up to 2040 for the 55+, 65+ and 75+populations respectively.

Health and care context

1. Gateshead's average life expectancy at birth is 79.5 years, Public Health England (opens new window), which is higher than the North East regional average life expectancy of 78.9 years, but below the average life expectancy for England of 81.5 years (ONS: 2020 National life tables - England).
2. The demand for residential and nursing care is partly influenced by the local prevalence of dementia amongst the older population, as well as by other health and care needs. Table 3 shows the prevalence of dementia in Gateshead.

Table 3. Number of people 65+ with dementia and dementia prevalence as a percentage of the total 65+ population (2020).

Source: NHS Digital, Recorded Dementia Diagnoses publications

1. Note that the figures for projected number of people 65+ with dementia in 2040 is based on projected growth rates from Wittenberg et al (2019). (Projections of older people with dementia and costs of dementia care in the United Kingdom, 2019 to 2040; Care Policy and Evaluation Centre, London School of Economics and Political Science)
2. The current prevalence of dementia among the 65+ population (6.1%) in Gateshead is higher than both the North East average (4.09%) and the English average prevalence (3.97%).

Table 4. Prevalence of dementia in Gateshead and north east region local authorities (2022).

Source: Gateshead Council

1. Table 4 shows that Gateshead has the highest rate of dementia amongst people aged 65+ in the north east (as at 2022).

Specialised housing and accommodation for older people

1. Data from the Elderly Accommodation Counsel's (EAC) housing data (Q4 2019) national database of older people's housing provision was reviewed to confirm the current supply in Gateshead. This includes social and private sector housing for older people.

2. The following definitions of older people's housing and accommodation are used to describe the different types of housing and accommodation for older people:
3. Housing for Older People (HfOP) Housing Care glossary (opens new window): social housing sector retirement housing and age-designated housing for affordable rent and private sector retirement housing for sale. The most common types of Housing for Older People are:

• ssheltered housing for social/affordable rent: These schemes typically offer self-contained accommodation commonly available for social rent. They are usually supported by a part-time/visiting scheme manager and 24-hour emergency help via an alarm. There are often communal areas and some offer activities. Most accommodation is offered for social or affordable rent, based on need, by local councils or housing associations.
• private sector retirement housing: This is typically similar to sheltered social housing, but it is usually built by private developers for market sale. Once all the properties have been sold, the scheme is sometimes run by a separate management company that employ a scheme manager and organise maintenance and other services.

   4.Housing with care (HwC) (Housing LIN - what is extra care (opens new window)): (often referred to as 'extra care housing' when provided by housing associations and local authorities and 'assisted living' by private sector providers). Housing with care is designed for older people, some with higher levels of care and support needs. Residents live in self-contained homes. It typically has more communal facilities and offers access to onsite 24/7 care services, which includes assistance with meal preparation, washing and other daily duties. Often includes a 24/7 alarm system, presence of a scheme manager and a team of support staff.

5. Residential care home (NHS care homes (opens new window)): a residential setting where a number of older people live, usually in single rooms, and have access to on-site social care services. 24/7 onsite personal social care services include help with washing and dressing. Residential care homes do not consist of self-contained units.

6. Nursing care home (NHS care homes (opens new window)): similar to a residential care home, but additionally providing care from qualified nurses. There will always be one or more qualified nurses on duty to provide nursing care. These are sometimes called 'care homes with nursing'. The Care Quality Commission states that in addition (to a residential care home), "qualified nursing care is provided, to ensure that the full needs of the person using the service are met." Nursing care homes do not consist of self-contained units.

7. The following table shows the current provision of housing for older people and housing with care in Gateshead compared to other north east region local authorities. The purpose of this comparison is to place the current provision of specialist and supported accommodation for older people in Gateshead into a regional context, for example, how the current provision of these types of accommodation in Gateshead compares to other local authorities in the north east.

Table 5. Housing for Older People (HfOP) and Housing with Care (HwC) in Gateshead and north east local authorities. Number of units.

Source: Elderly Accommodation Counsel (2019)

Note that prev. denotes prevalence rate - the number of units per 1,000 population aged 65+ (for HfOP) and 75+ (for HwC)

*Affordable and social rent

1. Gateshead's prevalence of housing for older people is below the North East comparator average prevalence, however, it is above the English prevalence.
2. With respect to housing with care, Gateshead's prevalence is below the North East comparator average, however it is higher than the English average prevalence.
3. Further details about the supply of Housing for Older People and Housing with Care is shown in Annexe 2 including quantity of units, provider, tenure and location.
4. Table 6 below shows the how specialist housing provision for older people is distributed across the five neighbourhood areas in Gateshead.

Table 6. Specialised housing for older people provision (units) by tenure and neighbourhood within Gateshead.

Source: Elderly Accommodation Counsel

Table 7. Current provision of residential and nursing care beds in Gateshead and north east local authorities

Source: Gateshead Council/Care Quality Commission (2022)

1. Table 7 shows the shows the current provision of residential care and nursing care in Gateshead compared to other north east region local authorities. It should be noted that local intelligence from Gateshead commissioners is that residential and nursing care beds can be used flexibly to meet the changing needs of older people (i.e. at any given time, for example, the beds in use as residential and nursing may be different to the figures in table 7). The prevalence of residential care in Gateshead is above both the North East comparator average and the England prevalence rate.
2. With respect to nursing care Gateshead's prevalence rate is significantly below both the North East comparator average and the English average prevalence rate.

Socio-economic context

1. At the most recent census, home ownership among 65+ households in Gateshead was 65.6% (Office for National Statistics / Nomis (2011 census). Tenure by occupation by age - Household Reference Persons. Nomis Table DC4604EW (released in 2013).), which is significantly below the equivalent English home ownership rate of 80%. The table below shows the tenure distribution in Gateshead amongst 65+ households.

Table 8. Tenure for 65+ households in Gateshead.

Source: ONS/Nomis 2011 census

1. The Income Deprivation Affecting Older People Index (IDAOPI) (Local Government Association: LG inform IDAOPI score (opens new window) - based on data from MHCLG) score is a measurement of people aged 60+ living in relative poverty; a higher score for a local authority implies a higher level of relative poverty.
2. Gateshead's IDAOPI score is 19.4% and it is ranked sixth most deprived out of north east region local authorities. The comparison between Gateshead's IDAOPI and other local authorities in the north east is shown in table 9 below.

Table 9. IDAOPI score for Gateshead and north east local authorities, ordered from least deprived to most deprived authorities.

Source: DLUHC (2019; updated in 2022)

1. In comparison to the English average deprivation (IDAOPI) amongst older people, Gateshead is relatively more deprived compared with the English average level of deprivation of 14.2%.

Local strategic evidence and intelligence

Housing strategy (PDF, 815 KB) A key objective under the category 'Housing Supply' in the council's Housing Strategy is: 

"Securing the right mix of housing (tenure and type) in the right locations, to meet population projections, support independent living of older people, disabled and vulnerable residents, and deliver our targets for sustainable economic and housing growth"

The Housing Strategy also states a need for:

"A range of aspirational and affordable mainstream homes that provide for our growing older population, and households that include people with disabilities, that will allow them to live independently and cost effectively for longer."

Specialist and Supported Housing: Supplementary Planning document

The Specialist and Supported Housing: Supplementary Planning Document  (Image, 97 KB) states:

"In identifying the requirement for extra care, the council is seeking to ensure there is sufficient to reduce demand on higher cost services whilst avoiding oversupply that could destabilise the market."

"The council is seeking to reduce reliance on residential nursing and care homes by ensuring a sufficient supply of alternative support and supported accommodation."

"Having a range and sufficiency of this form of accommodation [Independent supported living for example, Sheltered, Promoting Independence, Respite] is important in reducing over-reliance on residential and nursing homes, reducing pressures on the number of very high-cost home care packages."

Market Position Statement

The Council's Market Position Statement (MPS) states: 

"The demand on Older Person's services has been increasing year on year due to the increase in life expectancy and the number of people diagnosed with dementia. The council's approach is to increase resources in enablement and preventative services to reduce future demand on long term statutory services in the next 3 years. It is expected the number of older people who are eligible for long term services will decrease with an increase in the number accessing low level support."

The MPS states a number of commissioning statements, which include:

"To reduce the number of long term general residential care placements"

"To maximise the use of reablement to minimise the need for long term home care packages"

"To support new extra care developments across the borough."

"To increase our Shared Lives provision for older people as an alternative to building based respite provision"

It additionally states that the market opportunities are:

"Planning of up to 3 new extra care services in the borough which will include those with dementia needs to be in operation by 2025"

Perspectives of older people and other stakeholders

1.The evidence regarding the housing perspectives of older people has been drawn from:

• a sample of local older people
• local community organisations such as Age UK
• local providers of Housing for Older People and Housing with Care such as Home Group, JJH, Thirteen Anchor, Karbon.

2. The evidence from these sources is summarised below.

3. Older people are seeking housing options that enable them to live independently for as long as possible.

4. Older people are a diverse group with different views, experiences and opportunities about where they might live in later life. The range of housing types available needs to reflect this diversity.

5. The majority of older people would prefer to remain living in their existing homes than move to specialist accommodation. People are seeking support to remain living where they are now such as with adaptations, aids, technology to support independence as well as care/support staff.

6. There is currently a crisis in relation to recruiting and retaining the care workforce which is likely to limit the specialist housing and accommodation options for older people.

7. However, some older people are interested in and willing to 'rightsize/downsize' provided that an alternative home is sufficiently attractive and meets their requirements.

8. People are seeking properties that:

• adapt to their changing needs across the life-course
• provide good quality, affordable accommodation with less maintenance and upkeep requirements
• provide spacious, modern accommodation with a good sense of community

9. Moving to properties with an age-designation is a 'marmite issue'; for some people it is their preference whereas others would prefer to live in a mixed-age community.

10. The majority of people would prefer a property with 2 bedrooms although 1 bedroom is preferred by others.

11. More people are likely to consider moving to specialist accommodation if it is affordable, aspirational and accessible and meets the requirements at 2.47.

12. The majority of existing sheltered housing in Gateshead is not attractive enough to encourage people to consider moving before they need it. Existing sheltered housing typically lacks well designed communal spaces that are attractive and that have the flexibility to be used for a variety of purposes

13. A local example of best practice in relation to contemporary housing for older people is Home Group's Watergate Court. Many research participants see this as an attractive place to live although affordability is a concern for some. This housing scheme has a variety of communal spaces that are ergonomically designed with communal areas being used for multiple purposes, including the use of different colour schemes and flooring, and appropriately designed and attractive seating, to maximise the flexibility and use of these communal areas.

14. Older people are seeking better access to information and advice about their housing and support options. People need help to weigh up the cost implications of moving and to understand what options are available to them. The majority of people would prefer to use offline for example, in person methods of communication.

15. The evidence of need based on Registered Provider and other housing provider insights is:

• There is a need for flexible housing with care models that enable people to transition easily should they need care; for example Watergate Court extra care housing scheme which includes a dementia 'wing'.
• There is considerable interest amongst RPs in developing new older person's accommodation that is attractive and 'aspirational'. There is interest in a dialogue with the council about different housing models that are suited to older people.
• There is a recognition that older sheltered stock will need to be reviewed and updated where this is feasible and cost effective in order to provide a more contemporary housing offer.
• Registered Providers are seeking a dialogue with the council in relation to the impact of the analogue to digital switch over in 2025 and how technology can better support the independence of older customers.

16. The evidence of need based on commissioner insights is:

• There is a need for an increased range of choices for older people, including modern age designated housing without care and large communal facilities but there is also a need for further provision of extra care housing.
• There is a need to improve existing sheltered housing so that it provides a contemporary offer that is more fit for purpose.
• There is a need for shared agreements with neighbouring local authorities about movement across local authority boundaries for specialist housing.