GrumbleSmiles

For the first story on this subject, look up “PRINCETHORPE COURT STORY” in the TAG CLOUD.

Looking back, there were four key elements to the story and although they only clearly emerge with hindsight, they are perhaps the essential ingredients to many breakthrough projects.  Whether we knew it or not at the time, it was a breakthrough that was required.

The Project Team

The first key was the group of people involved in the project at the outset.  The leader and most significant player was Bill Martin, the Chief Executive of Coventry Churches Housing Association.  Bill was never satisfied with the status quo and always wanted to improve everything around him.  He encouraged, and at times, drove his team to do the same.  Second best was never good enough.  Boundaries, rules and regulations were there to be stretched.  What was good enough for everybody else was never a yardstick to be copied.  I’ll bet as a kid in winter, Bill was the one who always wanted to be the first to walk in fresh snow.  He was the hardest, most demanding boss I ever worked for and also the very best.  He remains a good friend to this day.

The second central player was the CCHA Housing Director, Stewart Fergusson.  Stewart was the son of an East End bookies runner with all the cheek, and 100-word-a-minute patter that you find on market trader stalls.  Stewart’s abilities went way beyond the market place.  He had a history degree from Cambridge University and an intellect capable of challenging any issue.  He was supported by one of his Team Leaders, Liz Taylor, who had a qualified background in housing management and considerable experience of managing sheltered housing schemes.  Both Stewart and Liz had a wholistic approach which looked beyond the immediate housing needs of the elderly and was concerned about the pressure that increasing frailty could bring.

My role at the time was as CCHA’s Development Director and I was charged with getting the design project off the ground and successfully constructed.  Whilst I did much of the pushing and shoving, I was more than ably assisted by my right hand man – Andy Hillier, who has worked alongside me for thirty years and is a master of project co-ordination and specification.

Whilst many others made strong contributions later in the process, it was this small group who initially developed the concept of what we then called Very Sheltered Housing.

On the outside of the team, we were fortunate to have Tom White as the Director of Social Services in Coventry.  Tom was very positive about the concept from the outset, even though he could see that in the long-term this housing and care provision would undermine the City’s much older stock of “old people’s homes”.  His support was vital because the referrals for care came from Social Services, at a time when many social workers felt that frail residents could not be looked after in housing and needed to move to residential care.

We were on the edge of legislation and regulation on several fronts and constantly had to argue our case for this new model.  The Housing Corporation felt we were over-sizing the communal facilities and straying into providing care, which was not the role of Housing Associations.  We had quite a few skirmishes with them but they did eventually capital- fund the project.    The planners and building regulators could not make up their minds whether this was housing or health care provision and were constantly trying to put us in an “institutional” box.  We didn’t give in and were adamant that this was housing, not residential care.   The health care regulators reluctantly left us alone because we were only providing domiciliary care.   This was outside their remit in those days.

You can see why the combined skills of the initial development team were so essential to the early negotiation of the project.  It very much challenged the conventional wisdom that frailer old people could not cope or be coped with in housing.

Thirty years on and extracare housing is a well liked and accepted model of housing and care provision.

MORE TO FOLLOW

Thirty years ago I was lucky enough to be in at the beginning of a remarkable project, which helped start a change in how housing and care for older people was perceived in the UK.  It’s physical expression was a retirement housing scheme called “Princethorpe Court”, which is still going strong today in a housing neighbourhood of Coventry.

The Background

It is important to understand the context in which this new form of provision was conceived, because many of the issues we faced then are still just as relevant today.  Furthermore, a lot of the lessons we learned on our journey have still to be learned by many current policy makers and providers.

In the 1970’s and 1980’s sheltered housing had become an established form of retirement housing and it endures as a very effective first move into retirement accommodation for the majority of elderly people who have to or choose to move out of their family homes.  Major specialist housing associations lead the way in developing this type of accommodation – Anchor, Hanover and Royal British Legion (now Housing 21).   McCarthy and Stone was the only significant house builder to develop this provision in the private sector.  Both were later copied by many other housing associations and house builders as the increasing size of the elderly population became more obvious. 

 There was a significant schism between the two types of providers.  Housing associations were heavily subsidised with capital grants from the Government via the Housing Corporation, which enabled them to provide low-cost rented accommodation.  The house builders didn’t have access to Government grants and therefore focussed entirely on housing for sale.

The key limitation of both types of accommodation was the need for care beyond emergency alarms.  Once care was needed it was assumed people would move through a series of types of housing as their health became deteriorated :-

Category 1    –     Sheltered Housing – Individual bungalows or flats sometimes with a communal lounge ;

Category 2     –     Sheltered Housing –  as above but linked by internal corridors and with slightly more communal accomodation ;

Category 3     –     Residential Care Homes ( or Local Authority Old Peoples Homes )

Category 4     –     Nursing Homes

Category 5     –    N H S Geriatric Hospitals

These types of provision were born out of the boundaries of Government Departments and their funding responsibilities.  They were a rough and ready solution to ending a lifetime.  The concept that elderly people could move easily from one category to the next in later life ignored the reality that moving home is a very traumatic experience.  What’s more the prospects of increasing frailty, more and more dependency, and less and less control over your life, were certainly not designed to offer a great outlook in later life.

More often than not, any move was forced upon people through increasing frailty, or driven by the concerns of relatives or Social Services.  Some elderly people  made a proactive decision to move to sheltered housing so that they could feel safer and more secure.  Virtually no-one moved to residential care or old people’s homes with enthusiasm – a small, single or shared bedroom, a shared toilet and a chair in the communal lounge were just not that appealing.   Absolutely no-one moved into a nursing home out of choice.   It was a decision made by professionals.   The ony way you moved onto geriatric wards was straight from an ambulance into a hospital bed, —–usually never to emerge again.

The social policy driver of all this provision was safety and security – the second lowest step on Maslow’s hierarchy of needs.   There was no lofty ambition to offer new opportunities to older people in retirement, just a desire to find more economic housing and care for those who could no longer cope on their own.   In the early 1980’s, a small Midlands based Housing Association – Coventry Churches Housing Association  (later called CCHA,  then Touchstone and finally Midland Heart), set out on a path that would go on to influence more recently developed retirement housing throughout the United Kingdom.

That is where the story of Princethorpe Court really begins.

SEE NEXT WEEK’S THRILLING EPISODE