GrumbleSmiles

A Retirement Village is a complex operation of housing and care. To function well they need to be fully integrated with the wider community and fully understood by statutory services. They are also most effective when fully interwoven with local GP’s and the NHS.

The devil is in the detail. Each piece of the jigsaw matters. For the village model to be complete and operating at its best, all the pieces need to be in place.

So let’s look at some of the small but key steps in the operation :-

• WELCOME & INTRODUCTION. —- long before a new village is opened “friends groups” are established to explain all aspects of the lifestyle on offer and the opportunities to live an active life. Ambassadors from other villages are by far the best at explaining this. After a village has opened this welcome still needs to be made available to new arrivals and a friends club needs to continue to support prospective applicants on the waiting list for vacancies.
• RECEPTION DESK — on arrival visitors to the village you are greeted by resident volunteers which immediately signals the important role residents play in managing the village.
• VOLUNTEERS — the shop, the coffee bar, the drinks bar and several other functions are all run with the help of residents. Also the majority of the activities are totally organised and lead by residents with control over activity budgets.
• OPEN COMMUNICATION — is essential in a village of several hundred residents, otherwise gossip and misinformation fills the void. Monthly manager meetings open to all residents; smaller street meetings; newsletters and a suggestion scheme are key components. Open doors, the village manager walking the floor and regular directors visits are also important. So too is an elected Residents Association.
• TECHNOLOGY — has the power to collect and analyse data on the operation of the village. It can also facilitate research and future development of the village model. However it is not a substitute for face to face communication.

IT REQUIRES ALL THESE ASPECTS OF THE RETIREMENT VILLAGE TO BE WORKING IN HARMONY AS ONE BIG TEAM OF RESIDENTS AND STAFF FOR THE VILLAGE TO PROSPER AND REFRESH ITSELF AS NEW CHALLENGES ARISE.

My last three blogs have looked at the origins of ExtraCare’s Retirement Villages; the development rationale; and the model for care and support. The immediate question then posed was is this financially viable as the community ages. The simplistic answer is yes if residents pay for it themselves by trading equity in their property for care and support.

However, it is worth stepping back and looking at the bigger picture first. The model is intended to be an integration of four key elements :- ACTIVITY; HEALTH; SUPPORT; FINANCE. All need to be at play for the model to work well.

Let’s examine each one in turn :-

• ACTIVITY – the wide range of facilities available in a village is designed to encourage residents to live an active lifestyle. It draws on the skills of residents to participate in the running of the village and to socialise with other residents. Volunteering and taking an active part in managing the village, can give people a continued sense of worth and achievement. Way beyond the wrap around lifestyle of residential care.
• HEALTH – this starts with a proactive approach to wellbeing. Regular health checks and medication reviews with a well-being nurse and if required liaison with GP’s. Promotion of exercise linked to the fitness coaches. Healthy eating advice to combat obesity.
• SUPPORT – not everybody who moves into a village needs support and some will never need it. The lowest level maybe help with house cleaning. Next is assistance with care. For a few they may require nursing care. This could be paid for by Social Services or occasionally the NHS, but resources are increasingly limited. To access services more themselves residents will probably have to pay for it themselves. Hence the need to trade equity for care.
• FINANCE – waiting on Governments to adequately fund social care has been a decades long issue. Because they had not anticipated increased longevity nor significantly increased morbidity. Politically it has now become to difficult to resolve, so the only answer is for the vast majority of older people to accept they have to provide for themselves. The health insurance industry has exited this market because of the difficulty of predicting long term care costs.

If Retirement Housing operators truly believe their lifestyle model prolongs healthier active lives, then they should be confident enough to provide a model of funding for long term care and support. With the caveat that they may need stop/loss insurance to cover extreme risk.

THERE IS STILL MORE TO COMPLETE THE FINAL PICTURE.

See my next post.

This is a follow on from my two previous blogs.

The key issue is “Who pays ?”

The starting point is to acknowledge that later life can be expensive, especially if you need care and support.

The second thing is that living longer is a great blessing, but we, none of us has saved enough to cover the cost. Nor has the Government.

The NHS ideal of health care being free for all is an illusion which is becoming more and more obvious and elderly people are at the back of the queue. Social care has also been starved of Government funds for years. Leading to bed blocking in hospitals. It has been a familiar story for years.

Politicians are paralysed to take action for fear of upsetting elderly voters.

At the same time elderly people don’t want to hear that they will have to pay for themselves.

STALEMATE.

There is however a trillion £ pot of gold tied up in homeowners property which they accumulated through house price inflation, rather than hard work.

So the KEY to the future of ageing retirement communities is to unlock home owners housing equity and trade it for care and support.

However that is not a simple answer.

Current equity release schemes could facilitate this approach, but, they are expensive and only release maybe a third of the value of your home. Nor would they work easily in a retirement village where the lease is tied to service charges and restricts resale options.

Village landlords could offer a reverse staircasing model of ownership which would allow residents to sell back shares in their homes for care and support. Rent could be charged on the share of the property not owned, which would offset some of the cost of raising finance for the buyback.

This would be a start, but it doesn’t explore the full picture.

My next blog will attempt to do this.

This is a continuation of my previous post, which looked back to our earliest thinking about extra care housing at Princethorpe Court, which opened its doors in 1986. That then was later followed by a much larger scheme which embodied the same ideas but was called Berryhill Village. It opened in 1998, with 148 flats and a wider range of communal facilities.

ExtraCare Charitable Trust was set up in 1987/88 to provide for frailer residents who were languishing in hospitals unable to be looked after in their own homes and too frail to move to Residential care homes. A situation which continues to this day! In conjunction with Coventry Health Authority we started to develop Nursing Homes. This is a whole separate story, but its relevance is that it gave us a much better understanding of the support needed by some elderly people in later life, especially dementia. This had a significant influence on our later development and staffing of Retirement Villages .

In the next eight years, we went on to develop and manage more ExtraCare schemes with Coventry Churches Housing Association ( later called Touchstone ) and also to open more nursing homes in Coventry and elsewhere with other Health Authority’s.

But the breakthrough into Retirement Villages came after the opening of Berryhill. Initially with an aborted village project at Abbey Park in Coventry and then with a bigger project ( 243 flats) at Ryefields in Warrington. This was an all singing, all dancing housing for sale and for rent with a full range of care and support and a comprehensive package of communal facilities.

It began a whole new generation of villages which explored the key features of ACTIVITY, HEALTH, SUPPORT and FINANCE.

You can find the thinking behind these issues by clicking on “ Community Retirement Villages “ in the TAG cloud.

ExtraCare Charitable Trust has gone on to develop many villages using this approach. Elements of the model have been copied in the private retirement field, but to a much more upmarket sector. Sadly the public sector has largely given up on this type of provision because of the lack of grant funding.

All of which underlines the importance of answering the question:-

“Is the model of Retirement Village developed at Lovat Fields sustainable financially, if the average of the residents continues to increase ( to90 )?”

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Last week my regular correspondent to this blog posed a challenging question about the future of retirement villages. David Freeman and his wife Molly have been residents of the ExtraCare retirement village at Lovat Fields in Milton Keynes since it opened in 2007.

Over the next few weeks we will try to answer/explore the question:-

“Is the model of retirement village developed at Lovat Fields sustainable financially, if the average age of the residents continues to increase ( to 90 ) ?.”

It’s worth taking a step back to see how the thinking of extra care first emerged nearly 40 years ago. The early ideas were a move beyond sheltered housing to include care support, but crucially they stopped short of the social services model of Old People’s Homes and the private sector’s residential care homes.

Our thoughts were first brought together in 1986 with the opening by Coventry Churches Housing Association of Princethorpe Court in Coventry.

(I wrote a series of blogs in 2012 about the project which you can find by clicking on “ Princethorpe Court Story” in the TAG cloud.)

Many of the building design ideas were born in this scheme and equally importantly the first care and support ideas were established.

In my next blog I will look at the step up to Retirement Villages.