Standards Wise International - Blog

A Festival of Ideas - Day 2

Reimagining retirement living – a new look at older people’s housing?

Opening the session, Will Bax, Chief Executive Officer of Retirement Villages, said that the challenge is to age well. Over the next 15 years the median age will increase dramatically, and life expectancy is also increasing. Housing with care has failed to keep up with the ageing demographic, and this needs to be addressed quickly. Retirement Villages estimate that there are 3m people considering downsizing, but the availability of suitable housing gives limited choice.
The customer profile is changing, as baby boomers have more money and work longer (into their 70s). Their influencers are the 'squeezed generation' and millennials. Retirement Villages is conscious of both these changes.
Societal changes also play a part - conversations about sustainability, which Retirement Villages customers want them to respond to; the use of technology; and wellbeing, with an attitudinal shift toward personal health.
There is a stigma around retirement communities which is rooted in the past. It is time to put older people back at the heart of communities and remain purposeful for longer.
They want to support longevity by offering an integrated community, being easy on the planet, offering social connections, financial flexibility, life purpose, and promoting health and wellbeing. 
The Retirement Village approach is rooted in placemaking and community. Their developments are built for everyone, and engage with people of all ages in the local area. They call this idea 'Thrive Living'.
Wendy Griffin, Director of Nicol Thomas began her presentation by recalling a recent conversation with her mother, whose aspirations were choice, to be kinder, safer & healthier. The first choice is LOCATION - rural locations support smaller communities, but we are starting to see an increase in urban locations where there is an opportunity to regenerate the area. SAFER means being conscious of the quality of building standards on safety; and KINDER relates to climate change. HEALTHIER: We have never been more aware of how our environment can impact our health and quality of life.
Wendy said that design aspirations for retirement living include: making it person-centred (take into account life experience, gender, culture, etc); long term strategic aspirations; pavement appeal; making it viable and affordable for owners and developers; future proof design; sociable; community asset; and inclusive.
In the future we will see excellent retirement homes delivered as the norm rather than the exception.
Chris Jones, Executive Director of Development at EMH Group, then shared a case study of a scheme in Springfield, Ashby de la Zouch. It began with a need, and the Local Authority then identified land and funding was secured. Through a 'Virtual Cave' they were able to walk through the scheme before it was built. The EMH marketing campaign was 'Building a Feeling' as they were creating an integrated community.
Dr Paul Willis from the University of Bristol closed the session with information from a Study: ‘Diversity in Care Environments’ (DICE) at the University of Bristol.
DICE looked at how housing providers promote inclusive environments in different types of schemes, for social minority groups.
Social inclusion means an individual’s identities, beliefs; social environment and dynamics within schemes; the built environment and neighbourhood location; and wider structural and policy factors. The study used mixed method research, a combination of hard copy questionnaires and semi-structured and longitudinal interviews.
Factors which facilitated social inclusion included: shared identities (all new together), supportive neighbours, external connections, active participation in the life of the scheme, the presence of onsite staff, and a close connection with carers. The social significance of the physical design was also important: balconies and patios, communal spaces (formal and informal). These were vital during lockdown, but could become areas of conflict between sub-groups of residents. 
The barriers to social inclusion included the lack of social spaces and activities, some activities being more appealing to heterosexual women, lack of staff onsite (if residents needed support), and the formation of dominant resident groups.
Recommendations included: invest in staff onsite, provide continuous training on social inclusion, early and proactive engagement with residents from minority groups, support residents to contribute to the design, invest in communal areas and the social value of diverse activities, and ensure all schemes have a good digital infrastructure.

Getting switched on to technology: the big insights

The afternoon session began with an introduction by Susan Kay, CEO of the Dunhill Medical Trust. Susan Kay said that the Dunhill Medical Trust noticed they were getting grant applications related to technology, but with little focus on the users. Covid brought this issue to the fore.
The first panellist was Vic Rayner, CEO of the National Care Forum. She said that there has historically been a very limited use of technology across social care, meaning it was an immature market both for users and providers of technology. As a result some people were creating their own systems. There were low levels of data, and skill sets of staff were not recognised. There was a huge amount of caution and concern about what innovation in technology might bring - would it take people away from care?
Digital Social Care is a partnership between members of the Care Providers Alliance funded by the NHS and is a dedicated space for information, support and guidance. Covid has been a digital accelerator in terms of data, tech adoption, secure email, rollout of iPads etc. The Hubble project brought together three different types of housing and showed their digital journey.
What next? Alongside the funding announced in the White Paper there will be a rationalisation of collection of data, 80% of care providers will be able to access the Shared Care Record, broadband upgrades, integration with a focus on IG and cybersecurity, and training (digital skills and leadership).
What is missing? It doesn't feel like there has been a lot of co-production, market development needs to accelerate, skills acceleration, clear vision and funding for transforming care & role of digital in the workforce, and a greater emphasis on the built environment.
Professor Roy Sandbach, Chair of the TAPPI Inquiry, then spoke about the Inquiry. He explained that the purpose of TAPPI was to establish what was needed with what was possible for the use of technology in care. TAPPI had 4 hearings and 4 sector events and linked with 3 other commissions.
The population becomes more heterogeneous as we age, so uncovering individual needs takes time and effort. The White Paper speaks about this. What's needed: Something to make life easier, technology is an enabler not a driver, integrated approaches are vital, design is critical, don't underestimate the older generation!
Processes can easily be siloed and collaboration is difficult. There is a complex eco system for care.
Simple principles can be part of every conversation about technology and care, we don't need to wait for big policy to change it.
The 10 TAPPI Principles are: Adaptable, quality focussed, preventative, person-centred, outcome-focussed, co-produced, cost-effective, choice-led, interoperable, inclusive.
Alyson Scurfield, CEO of TSA (TEC Association) then spoke, explaining that TSA’s priorities were: being the voice of authority, a knowledge hub, and to set and maintain professional standards.
Their recommendations are: technology enabled services need to be proactive; digital skills and infrastructure must improve; people must own and control their own data; and more collaboration is needed.
TSA has seen pockets of great innovation but not developments at scale. Professionals need to collect, coordinate and deliver individual outcomes.
Angus Honeysett, Head of Market Access at Tunstall Healthcare outlined the TAS and ADASS recommendations: The importance of integrating health & social care, and shared common goals.    
If we get things right and outcomes are improved there are less visits to primary care. Low cost technology can reduce the need for residential care.
We need to move forward together working in partnership, but technology has historically been seen as a barrier. There is a challenge with the move from analogue to digital services. Ai and machine learning are valuable developments.
Angus Honeysett then posed questions to Steve Rawson, Chief Operations Officer at Beyond Housing. He explained that on a visit to his parents he found them arguing about the best technology, showing that you should not underestimate older people’s ability to embrace it.
Steve Rawson explained that Beyond Housing launched its 'Reach & Respond' service on 1st December 2021, which brought together 3 legacy services which serve 8.8k customers.
The challenges: will they meet the target of 2025, the future - can they reassure staff that they will have a job? This is a once in an era opportunity to get it right. Covid showed that things can be done at pace when required. Technology - will we have transferrable data?
How can Beyond Housing apply the TAPPI Principles? He said that most housing organisations would recognise themselves in them. 'Co Production' is very pertinent to the Housing White Paper - how can we involve our customers? Technology gives us the opportunity to consult with customers.
The integration of services which became Reach & Respond involved consultation with lots of customers. They said that they wanted it to be beneficial but not intrusive. They wanted to be able to trust Beyond Housing when they needed them, through the Reach & Respond service.
Research shows that 93% of Beyond Housing customers have access to the internet, which gives them real opportunities to use technology enabled care in the future.
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