Extra Care25th June 2015

Sue Knox

Sarah McCarthy

Issues Covered• What is Extra Care?

• What is the vision for Extra Care?

• Evidence regarding the impact of Extra Care on promoting health and well being

• Current level of provision in Lancashire

• Green Brook and Brookside – what do they offer?

• Case study

What is Extra Care? ADASS and LIN Guidance

“Extra Care takes a number of different formats and styles, but primarily it is housing which has been designed, built or adapted to facilitate the care and support needs that its owners/tenants may have now or in the future, with access to care and support twenty four hours a day either on site or by call. It is generally based on the following principles

What is Extra Care? (contd.)• To promote independence – the provision of self-

contained accommodation designed to enable individuals to live independently within the community, and promote their well-being and quality of life.

• To be empowering and enabling – the availability of flexible, person-centred care and support services which empower and enable individuals to maximise their independence and promote health and wellbeing.

• To promote social inclusion – services and buildings designed to promote social inclusion and alleviate social isolation”. ADASS and LIN

Models of Extra Care

• Purpose built scheme without community resources• Purpose built schemes with community resources• Core and cluster (including virtual models)• Remodelled Extra Care• Retirement village • Extra Care schemes for people with specialist needs e.g.

dementia, learning difficulties• Extra Care linked to care home provision

What is the Vision for Extra Care?• To provide a home for life • To provide a viable alternative to residential care • To improve health and well being• To provide onsite care which delivers cost savings• To provide a wider community resource and support

place shaping • To benefit wider housing market and regeneration

activity/free up family housing

Reducing Admissions to Residential Care

Permanent admissions of older people (aged 65 and over) to residential and nursing care homes, per 100,000 population (2013/14)

•Lancashire 818.9 •Average NW 776.6 •Average comparator group 690.7 •Average England 668.4

High numbers of people moving into residential care when compared with comparator authorities

Extra Care Housing in Blandford Forum, Dorset

ASCOT Measure Pre-measure Post-measure (after 6

months)

Difference

Accommodation cleanliness and comfort

81.75 94.02 +12.27

Personal cleanliness and comfort 84.92 97.44 +12.52

Food and drink 86.51 91.45 +4.95

Personal safety 61.90 94.02 +32.11

Social participation and involvement 57.94 85.47 +27.53

Occupation 56.35 78.63 +22.28

Control over daily life 69.84 88.03 +18.19

Dignity 73.33 78.79 +5.45

Collaborative Research between Aston Research Centre for Healthy Ageing (ARCHA) and the ExtraCare Charitable

Trust• Over a 12 month period total NHS costs (including GP

visits, practice and district nurse visits and hospital appointments and admissions) reduce by 38% for Extra Care residents who were in the sample across the period.

• NHS costs for ‘frail’ residents had reduced by 51.5% after 12 months.

• 46% reduction in residents’ routine or regular GP appointments in year one

• A significant reduction in the duration of unplanned hospital stays, from an average of 8-14 days to 1-2 days.

• A significant number (19%) of Extra Care residents designated as ‘pre-frail’ at baseline had returned to a ‘resilient’ state 18 months

• At baseline new residents had more difficulties with cognitive functions, independence, health perceptions, depression and anxiety than controls, but after 3 months these differences have reduced and some have disappeared, with significant improvements in psychological well-being, memory and social interaction for Extra Care residents.

• After 18 months Extra Care residents in general showed a reduction in depression – and those with low mobility, showed the greatest improvement (from their lower initial levels).

Current Level of Provision in Lancashire

Purpose Built Extra Care Schemes

•Brookside

•Green Brook

Sheltered Housing Based Extra Care

•Care team within sheltered housing schemes

•14 schemes

Sheltered Housing Based Extra Care SchemesSheltered housing schemes generally don't have 24 hour staff cover; however there are around 13 schemes which have 24 hour care on site. North•Beck View, Lancaster •Parkside Court, Lancaster •Torentum Court, Wyre •Stanner Lodge & Croft Court, Fylde  

East •Kirk House, Hyndburn •Hyndbrook House, Hyndburn •St Ann's Court, Ribble Valley •Plessington Court, Longridge

Central •Molyneux Court, Preston•Bannister Brook and Greenwood Court, South Ribble•Marlbrough Court, West Lancs•Ainscough Brook, Preston

Green Brook House• Purpose built extra care scheme opened in April 2010 in Whitworth• Landlord – Greenvale Housing, Care and Support Provider -

Willowbrook• The scheme consists of 6x1 bedroom flats and 36x 2 bedroom flats. • Facilities include communal lounges, laundry, bistro, shop, hairdressing

salon, consulting room, buggy store and assisted bathing.• Care provider Willowbrook - core and add on model• Bingo, coffee mornings, cinema, day trips, nails, botcha, chair

exercises, strollathon, any activities requested

Brookside• 111 apartments which are of mixed tenure, 33 shared ownership/outright sale,

73 rental & 5 rehabilitation in Ormskirk• Landlord – Your Housing, Care and Support Provider - HICA

• Balanced community: general needs, moderate care & substantial care

needs.

• All allocations go through the allocations panel which consists of a

representative from Your Housing Group, Hica Care, & West Lancs

Housing Options Team.

• Hair salon, Bistro, Music Room, Library, Leisure suite (used for tai chi,

yoga, keep fit, chair based exercises)

• Merebrook day centre for people with dementia and support for families.

• Alzheimer's society run carers information & support programme,

dementia advisors at Brookside.

• CMHT Memory Assessment Service,

• Smart recovery group (people with addictive behaviour)

• Diabetes clinic

• Podiatrist

• Buddhist meditation group

• Singing for the brain, activity groups

• Age UK coffee afternoons

• Staff team s on site heavily involved in fund raising for various charities

Brookside

1

1:30-2:30pm

Age UK

tea/Coffee &

Cakes

Function

Room

  2

Card Making

2pm

Craft Room

3

Bonmarche

1pm

Reception

 

Tai Chi 7pm Leisure

Suite

 

Bingo7.30pm Bistro

4

Yoga 10:30am

Leisure Suite

 

Bingo 2-3pm

Library

 

Table Top Games 2-

3pm Games Lounge

5

 

 

Tai Chi 

10am

Leisure Suite

£3

6

 

Bingo 8pm

Bistro

8

1:30-2:30pm

Age UK

tea/Coffee &

Cakes

Function

Room

9

Tia  Chi

10am, Leisure

Suite £3

Oswaldtwistle

Mill Coach

Trip

Skylarks 

630pm

Function

Room

£3

10

Knitters 2:30pm

Garden Room

 

Tai Chi 7pm Leisure

Suite

 

Bingo7.30pm Bistro

11

Yoga 10:30am

Leisure Suite

 

Bingo 2-3pm

Library

 

Table Top Games 2-

3pm Games Lounge

 

Classical Music on

DVD  7:15pm

Garden Lounge    

12

Tai Chi 

10am

Leisure Suite

£3

13

Queens

Official

Birthday

 

15

1:30-2:30pm

Age UK

tea/Coffee &

Cakes

Function

Room

 

16

Tia  Chi

10am,Leisure

Suite £3

 

Card Making

2pm

Craft Room

 

17

Knitters 2:30pm

Garden Room

 

Tai Chi 7pm Leisure

Suite

 

Bingo7.30pm Bistro

 

Old Fashion Sweet

Stall 10:30-3pm

Reception

18

Yoga 10:30am

Leisure Suite

 

Table Top Games 2-

3pm Games Lounge

 

Bingo 2-3pm Library

 

  

19

Tai Chi 

10am

Leisure Suite

£3

20

Bingo 8pm

Bistro

22

1:30-2:30pm

Age UK

tea/coffee &

cakes  

Function  Room

 

Body Shop

Pamper

Afternoon

Function Room

2 - 3:30pm

 

 

23

Tia  Chi

10am, Leisure

Suite £3

 

 

 

Skylarks  630pm

Function Room

£3

24

Knitters 2:30pm

Garden Room

 

Tai Chi 7pm Leisure

Suite

 

Bingo7.30pm Bistro

25

Yoga

10:30am

Leisure Suite

 

Table Top Games 2-3pm

Games Lounge

 

Bingo 2-3pm Library

 

Classical Music on DVD 

7:15pm

Garden Lounge    

 

 

 

 

26

Tia Chi  10am Leisure

Suite £3

29

 

1:30-2:30pm

Age UK

tea/Coffee &

Cakes

Function Room

 

 

 

30 

Tia Chi 10am,

Leisure Suite £3

 

Card Making 2pm

Craft Room

 

 

 

   

Case Study

OutcomesFor the person•Autonomy over her life•Tenancy•Access all of her home and her local area•Better quality of life•Better relationships with family

In respect of policy•Choice & control•Care Act 2015•Reduced admission to hospital•Carer Support•Less formal care