What makes extra care housing an appropriate setting for people with dementia? An exploration of staff decision-making

Abstract

Extra care housing facilities in the UK are intended to offer a community-based alternative to care home placement. However, little is known about staff’s views of the appropriateness of extra care housing for people with dementia. This paper describes a mixed-methods study which explored this issue using statistical modelling of frontline staff’s recommendations of the best care setting for care home entrants; thematic analysis of transcripts from a simulated Resource Allocation Management Panel meeting; and content analysis of care coordinators’ reasons for not considering extra care housing in actual care home applications. Frontline practitioners saw extra care housing as a valuable alternative for a significant minority of care home entrants. However, extra care housing was not recommended if people needed care at night. Social care managers expressed general support for the idea of extra care housing, but appeared overwhelmingly focused on maintaining people at home and unsure where in the care pathway extra care housing sat. More evidence is needed on whether extra care housing can be an alternative to care homes and how services should be arranged to meet the needs of people living in extra care housing.

Living with dementia in supported housing: A systematic review and thematic synthesis of qualitative research

“…Brown et al, 2017; Dutton, 2009), discussion papers (Dutton, 2010), and in quantitative research conducted in supported housing settings (e.g. Brooker et al., 2009; Twyford, 2016; Verbeek et al., 2019). These studies questioned if supported housing settings have the resources to support or care for people with dementia beyond the milder stages of the condition.…”

“…However, research also suggests that these outcomes are not universally experienced (Dutton, 2010;Verbeek et al, 2019). There is a need to understand the experience of living with dementia in supported housing, to surface the benefits and challenges of living within these settings.…”

“…Some evidence suggests that these housing models can improve quality of life, increase independence and autonomy, combat social isolation, reduce hospitalisations and defer entry into residential care for people with dementia (Brooker et al., 2011; Holland et al., 2015; Twyford, 2016). However, research also suggests that these outcomes are not universally experienced (Dutton, 2010; Verbeek et al., 2019). There is a need to understand the experience of living with dementia in supported housing, to surface the benefits and challenges of living within these settings.…”

Een huis, een thuis?

“…Het risico is groot dat je nog 'te goed bent voor verhuizing', maar wanneer je daadwerkelijk wil verhuizen, dan is de zorg te zwaar en kan deze niet meer geboden worden. 23 Een huis is niet automatisch een thuis, terwijl dat laatste wel voor iedereen het doel zou moeten zijn, ongeacht je hulpbehoevendheid. Ik bestudeer wat de zorgomgeving betekent voor het dagelijks leven en functioneren van ouderen, met name zij die intensieve zorg en ondersteuning nodig hebben, zoals mensen met dementie.…”

‘You have got to stick to your times’: Care workers and managers’ experiences of working in extra care housing

“…In 2003 the Department of Health introduced the ECH Fund to support the development of innovative housing with care options for older people (Department of Health, ). While there is no agreed definition of ECH, causing problems for older people and their families making decisions about future care (Verbeek et al, ), there is agreement that it is a distinct alternative to other, more traditional, forms of housing and care provision due to three principal characteristics (Evans et al, :20). First, is its focus on ‘supporting independent living in self‐contained accommodation for rent, shared ownership or sale’.…”