Over the past year, we carried out Enter and View visits to all five of the borough’s extra care schemes and held interviews with the on-site service providers.
We chose to look at this service because:
- there is not much information available about the quality and safety of these types of services.
- with an ageing population and increase in conditions like dementia, demand for these services is increasing.
We were interested in whether this type of service enables people to have a good quality of life and, in particular, whether it improves and maintains people’s independence whilst keeping them safe and decreases social isolation and loneliness.
We carried out our extra care review between April 2014 and May 2015, gathering information and experiences from a range of stakeholders.
What is extra care
Extra care housing is designed to support people who can manage independently with care and support. Care services are provided by staff in line with individual care plans. However, the facility is not a care home, as residents are tenants with associated rights, whereas residents in care homes do not have tenancies. The care provided is regulated by the Care Quality Commission (CQC) but the facility itself is not inspected, and residents can choose to make their own care arrangements.
Most residents (80-94%) received a care package, except at Helmi House, where just under half the residents were being housed temporarily while their sheltered scheme was being upgraded.
Of those receiving care packages, 6-18% of residents required support from two care assistants at a time. Between 5% and 25% of residents were living with dementia and there were several residents at each scheme who used wheelchairs, mobility scooters or walking aides.
Two relatives thought staff were not adequately trained.
We generally saw and heard about services that provided a good level of care. The premises were fit for purpose, although they were not fully dementia friendly. They provided suitable accommodation and space for recreation, but communal spaces seemed under-used. Most staff thought the service at the scheme where they worked was good. Ten out of 12 would recommend it, while ten out of 14 relatives rated the service overall as good. Residents were largely content with the service, but lonely. We would also encourage commissioners and providers to acknowledge the investment required in resourcing and facilitating activities and community life. This is particularly important given the significant care needs of most extra care residents and in light of local authority duties under the Equality Act 2010 regarding age and disability.