But should I stay or should I move?
Keynote address by John Galvin, CE of EAC, to the Housing LIN Conference 2016
- How well do we understand older people’s attitudes to moving home?
- What barriers deter some of those who wish to?
- What are EAC’s plans to improve our understanding and to help reduce barriers to moving?
- How could housing providers and commissioners work with us in this?
EAC’s mission and role is to help older people make informed choices to meet their housing and care needs. We do this though our HousingCare website, our national Advice Line and our network of local partners in the FirstStop Advice network – including Care & Repairs England’s growing number of local Silverlinks projects that bring in older volunteers to share their experiences with their peers.
We have been proud to be involved with the Housing LIN since the start, providing a support service by seconding staff – initially Alex Billeter, and latterly his nephew Jerome Billeter, to work with Jeremy:
- For us the potential synergies were too much to miss. The LIN as the leading ‘knowledge hub’ for a network of housing, health and social care professionals.
- EAC as the leading ‘housing and care options’ advice service to the public.
- The synergy bedded in a shared belief that in a complex and changing world, what the professionals are grapping with should be shared with the public, and what we learn from our involvement with thousands of older people should feed into and inform the thinking of professionals.
Today’s context, as I see it, is that you all have big issues to address:
- In the social sector pessimism about development continuing, services being maintained, the supported housing model being stifled by rent controls, slashed budgets for housing support services, benefits reform and a general lack of appreciation of sheltered housing’s preventative role. Some envisage extra care not reaching its 10th birthday.
- In both private and social sectors, continuing apprehension about the future for a product that is part bricks & mortar, part services. How secure is it financially and/or politically?
And of course in both sectors there is a legacy to deal with; a certain amount of poor public image:
- In the social sector: old buildings, some poor sites, ageing residents, introduction of other client groups, and support services reduced or withdrawn;
- In the ownership sector, some sharp practices / reputational problems from the 1980s heyday; also some outdated buildings with no prospect of major upgrades; residents & prospective residents wary if not downright suspicious about unfair charges and fees, and fearful of future costs; prospective residents unfamiliar with and wary of leasehold and shared ownership tenures; and overall confused about what it means to ‘go private’ at a time when the welfare state is undergoing radical change.
In addition there are many conundrums facing us as we try to understand what people really want from their housing and home as they age. Evidence seems confusing and contradictory, which perhaps helps further explain uncertainty amongst providers, funders and commissioners, and contributes to the slow pace of building later life housing.
So the four themes of my presentation are:
- Confusing evidence around attitudes to moving home
- Reflections on how to begin to make sense of the evidence
- EAC’s response – what we are aiming to do
- What we hope for from you – ‘the industry’
2. Confusing evidence around attitudes to moving home
2.1 Recent research
Centre for Ageing Better
I’m very interested in the findings of the research commissioned by the Centre for Ageing Better, which Anna presented. But this key graph confuses me:
Ipsus Mori found that (excluding don’t knows) around 79% (60-65), 83% (65-74), 97% (75+) said categorically they did not intend to move – to retirement housing or anywhere else.
However Demos (The Top of the Ladder, 2013), drawing on a range of sources including its own polling said that 25% (3.5m) of 14m over 60s would be interested in buying a retirement property and a full 58% said they were interested in moving.
Other recent research has produced different claims.
All can’t be right. So perhaps much depends on the context and way in which questions are framed?
2.2 EAC’s evidence of interest in specialist housing
In truth, much of EAC’s evidence is also rather inconclusive. We know that of our 4 million website visitors pa, around half (2m) are looking for information about retirement housing, as are two thirds of the 40,000 clients of FirstStop Advice services nationally & locally.
At first sight these figures seem to support the Demos findings on interest in moving . . . or do they?
- Our figures include 3 distinct groups – older people, their families and professionals. Perhaps families and professionals like the retirement housing option a lot more than older people themselves?
- And perhaps older people use our site and services to explore what specialist/retirement housing is, before concluding that it’s not for them?
We don’t yet know.
2.3 EAC’s evidence of potential drivers towards moving
Our upgraded and re-launched online housing appraisal and solutions tool (HOOP) was an immediate hit last year, with 3,739 users in first 3 months.
All factors that you’d imagine would lead many, most, to want to consider moving to somewhere where they had less responsibility overall, less rooms, a smaller or no garden, and more help available both in an emergency and with routine home management & maintenance.
So, given such strong drivers, why don’t more people move?
2.4 Evidence on who actually moves
We calculate that roughly a third of renting households (primarily social renters) currently live in retirement housing, but just 5% of home owners.
These figures obviously reflect the historic pattern of retirement housing supply (heavily skewed to social rented) and permissible demand (owner-occupiers blocked) – but is there more to it than this?
- Do we still channel or bribe older tenants towards sheltered housing as was clearly the case back in the 1960’s and 70’s?
- Does the traditional sheltered/retirement housing model appeal more to people in lower socio-economic groups, and not so much to home owners?
3. Reflections on making sense of the evidence
3.1 Back to HOOP (“You can lead a horse to water . . “)
The HOOP online app I described earlier is a simple affair. It encourages older people to think about how they live in their home, identify current, or anticipate future problems, and think about the relative priority they attach to sorting each problem. It then makes a number of suggestions for tackling the problems in turn, staring with the priority ones.
It doesn’t do ‘artificial intelligence’. That is, it can’t match the human ability to interpret the user’s situation as a whole, and attempt to put forward ‘best fit’ suggestions for tacking as many issues as possible through a multi-stranded approach.
But if I cast my mind back to the development of the original HOOP tool in 1998-99, before online apps were popular or possible, our aim was to develop and test a script for housing options advisors to guide an extended discussion with their client, trigger the provision of detailed information about housing options the client was interested in, lead to further reflection and discussion (including with family and perhaps other professionals involved), and gradually help the older person identify a pathway towards a ‘best fit’ all round solution.
The project made us acutely aware of 3 things:
- The sheer complexity of decision making – the importance of the many push and pull factors that older people were having to deal with;
- The inertia this could lead to – we realised that for some clients, doing very little, perhaps just making small changes to the home, could provide a ‘good enough’ solution that felt preferable to dealing with the whole pandora’s box our involvement threatened to open;
- Linked to this, irrationality. In truth only around 10% of our 100+ project sample really took to the rigour they felt the HOOP approach demanded. Many preferred to work instead towards finding a consensus way forward that would please their partners, wider families and other interested parties, or to go for solutions that were already familiar.
The combination of skilled advisor and original HOOP tool was quite capable of helping uses towards a ‘best fit’ solution to tackling multiple issues – but a majority shied away from this.
The whole exercise taught us a lot, and strongly influenced EAC’s subsequent development of its current housing & care options advice service. Today HOOP is only one (albeit important) tool in our armoury. The exercise of developing it made us more aware that we needed to listen first, gauge where our clients were coming from, and adapt our response accordingly.
So we accept much more readily today that even if all the pointers suggest that a home move, particularly a move to specialist later life accommodation, may offer solutions to the issues our clients present, and whilst they may wish or have been persuaded to explore this option, they may also be predisposed not to choose to pursue it.
3.2 Current supply of later life housing (Is variety lacking?)
Our graph shows new supply picking up from a trough to reach its highest level for 13 years. But this still only amounts to 10k units a year (including remodelled older schemes). And unbundle the figures and we find the majority of new and remodelled provision is either:
- Extra care provided by RSLs – mixed tenure but half or more for social rent.
- Leasehold provision by two dominant providers (McCarthy & Stone and to a much lesser extent Churchill), largely of the traditional retirement model, with lesser numbers of assisted living (extra care) and a small but growing number of ‘luxury downsizer homes’.
People who move to all these new homes (and indeed those who move into re-lets and re-sales) seem to appreciate them very much (more later) – but:
- Is the range of models too limited to attract a larger fan base? Do they cater for the needs and ambitions of all potential customers?
- Is what we see nowadays in the statutory and not-for-profit sectors too driven by (or associated with) health & social care policy objectives, rather than older people’s more complex mix of needs and aspirations?
- Is the private sector confining itself to the upper middle and top end of the market – or indeed having to do this to make its models stack up financially?
Remember Anna’s slides profiling 6 segments within the older population. Does specialist housing successfully address the needs and aspirations of each of these segments?
3.3 Current EAC research (other barriers to moving)
Other help to make sense of the evidence is coming from work we’re doing with Bournemouth University to explore what impact our service has on outcomes for clients. Some of the early interviews flag up points that are particularly relevant to specialist housing:
- Hilda, 86: Independent, homeowner (3 bedroom house), now wants supportive living in a flat. Doesn’t want leasehold (service charges seen as undesirable) or to buy at her age, as it would be “silly”. So would prefer to rent – in the social sector if possible.
- Doris, 70: Relationship has recently broken down. Lives with former partner of 16 years (so has no current tenure). Wishes to move back to Lincolnshire where she came from and still has family members. Does not want to live in a rural location, but in a town with good transport links. EAC’s report on social rented schemes contained none with desirable locations or types of accommodation.
- Gerald, 81: Homeowner, but due to health problems and age, his 3 bedroom house is becoming unmanageable. Is in early stages of deciding what’s best and doesn’t really know what he wants. Is not keen on buying a leasehold property, and not keen on engaging with ‘private based’ options.
- Phillis, 91: Already living in housing association sheltered housing, but wants to move nearer a daughter in a different area. Quite frail, uses a walker and has carers. Was recently offered a social sector rented sheltered flat, but turned it down because it wasn’t on the ground-floor. Other providers in the area have told her she doesn’t have high priority with them.
- Harry, 65: Homeowner. He and his wife sold their house and began to look for shared ownership. However, the process is taking longer and proving more complex than they anticipated. 3 months later he is trying to arrange a short term market rent solution while still pursuing shared ownership.
Five issues identified here:
- Owners wanting to relinquish responsibility and move to renting;
- Waryness about leasehold tenure, and about service charges;
- Lack of choice in social sector for people regarded as low priority;
- Some lack of trust in ‘private’ sector management companies;
- Owners interested in trading down to shared ownership, but finding it complex and in short supply.
At the least, these raise questions about the extent to which the current supply of later life housing fully addresses the needs and aspirations of a very diverse older population. Separately, they also raise some questions about EAC’s current advice service (more on this later).
3.4 The views of people who have moved (what makes for successful outcomes?)
Over 6 years EAC has canvassed the views of 20,000 residents in 1,400 developments managed by 240 landlords and management organisations. We’ve asked residents to reflect on key questions under the broad headings of MY HOME, WHERE WE LIVE (the scheme as a whole), the SERVICES PROVIDED and LIFESTYLE (social dimensions).
The results show two things:
- A majority of residents are satisfied or very satisfied overall;
- There are wide variations between schemes in terms of which aspects they perform most strongly on.
We conclude that if prospective residents are round pegs in round holes – if they have been able to find (or are lucky enough to find themselves in a scheme whose strengths match their priorities) – then specialist housing really works for them. As residents, they then say many of the things the Centre for Ageing Better wants all older people to be able to say.
[Highlighted in red are aspirations that specialist housing can help meet]
4. EAC’s conclusions and forward plan
Our FirstStop Advice service has until now could be characterised as a high volume, low cost one. That’s not to say not knowledgeable, informative and (we believe) the best available. But we have concluded that we need to do more to counter the intertia and apprehension so many of our clients display, and up our offer in ways that help particularly around moving home options.
- A HOOP-light approach to understanding their priorities;
- More detailed information about individual housing schemes and their specific offers and strengths, including building on our Resident Consultations to also capture and present the views of families and staff;
- Working with our clients to identify schemes whose strengths match their needs and aspirations;
Much more information about leasehold and shared ownership tenures, including lease terms, costs, charges and fees;
- Much more information about eligibility and access routes (CBLs) in the social rented sector;
- The capacity to offer to support some clients throughout their individual journeys;
- Exploring connecting potential movers to settled movers.
We also intend to deliver market intelligence for the industry by building our capacity to distil what we learn from this deeper engagement with potential retirement housing residents to strengthen the evidence base for what would encourage more older people to consider moving, including what new models of later life are needed and how obstacles to a successful move can be reduced.
5. And what do we hope you will do?
Three weeks ago EAC hosted (and the Housing LIN, Legal & General and others sponsored) the 6th National Housing for Older People Awards in Manchester, with 300 guests including 175 residents celebrating where they live.
So our headline plea is – don’t give up! There is a very important place for specialist and age friendly housing in the range of housing options that should be available to older people. Here in Manchester, in a very graphic way, was the evidence – and the emotional payback!
- Don’t be afraid of differentiating your offer – and being open about what it is and does. Work with us on this.
- Listen to what we will publish this year on potential residents who don’t succeed, and think how to address the obstacles they face.
- Innovation – go for it! There are many ways of making specialist housing work in tough times – examples of which the Housing LIN is sharing in recent publications. In Manchester we could feel the power of so many able and willing older citizens who could contribute to new solutions.
- Think as laterally as you can about tenure options even in older rented schemes. A lot of older owners who don’t want to buy again would be interested in market rented or shared ownership.
Overall, continue to be part of what EAC and the Housing LIN are trying to do, which is to bring residents and prospective residents in on the re-thinking we’re all doing, and in on the envisaging and delivery of special (as well as specialist) housing for a good later life.