Those developed by RPs sit easily alongside schemes established by private developers, with both types of scheme undoubtedly addressing a key need within communities and providing a real choice of accommodation for those aged over 55. Such schemes are often an attractive option for individuals, their families and commissioners. But do we need more beyond the traditional Extra Care scheme?
There is a significant amount of statistical evidence in support of the idea of organisations providing services and support beyond Extra Care. This is particularly in relation to the ageing population and picks up on the correlation between housing, health and well-being. This evidence is reflected in the growing emphasis on maintaining independence and individuals living in their own homes for as long as possible, enshrined in the Care Act 2014.
The traditional Extra Care model usually consists of mixed tenure accommodation providing a range of affordability options, communal restaurant area, gym, services often that the wider community can access (perhaps a hairdresser), a programme of activities, together with support and care. To date Extra Care schemes have provided generic care and support, addressing a wide range of needs. Could this model be developed further to provide more specialist support and care services at particular schemes?
So, for example, could there be a scheme developed that just focuses on people diagnosed with dementia? From the very outset such a scheme and its facilities could be designed to provide the support and care packages, and the programme of activities, specifically tailored to address dementia needs. There is a range of research into how particular settings or services can delay the on-set of more severe symptoms of particular progressive diseases: so these type of schemes could actually assist individuals beyond simply providing accommodation and a sense of community. They may also be attractive to commissioners of services in areas where the instances of a particular diagnosis are high.
This is not to say that the traditional Extra Care scheme does not still have a place – demand clearly shows it does – but arguably more specialist schemes could also bring benefits in particular cases. To some extent this model has already been tested through specialist charities who address specific support needs: some have developed new schemes specifically for individuals with a particular diagnosis. These have, on the whole, worked well, although as with any new scheme created their own challenges.
The obvious challenge to this model is whether this type of scheme eliminates one of the benefits of Extra Care schemes currently in having a mix of people and needs requirements, generating a genuine sense of community. Perhaps the only way to explore this challenge is to test the model in reality?
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