Extra Care Housing Gap Analysis

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Purpose

This page sets out the current position with regards to Extra Care Housing, drawing together information produced by the Strategic Housing and Investment Team, with information from Wirral Intelligence Service, and additional performance information. It aims to give indications of where investment in extra care housing may be practical and cost-effective.

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Background Information

The population of older people in Wirral is increasing. The 2022 based population data from the Wirral Intelligence Service shows the population of Wirral stands at 324,336, showing a population increase of 1.35% from 320,000 in 2015.

The Population is projected to increase by 4.1% by 2043. The largest increases are projected to be within the older age groups, with the 65+ age group estimated to increase by 33.3% by 2043. As of June 2022, older people aged 65+ made up 22.0% of the overall population, which is above the England average of 18.5%.

The Office for National Statistics (ONS) Projections show for the Wirral Area that population for age group 65+ in 2022 sits at 73,525 and by 2040 it is predicted to be 93,252.

The predicted demographic changes for Wirral (highest estimated increases in the 70-79 ages) will impact on housing, support, and health demands.  

The commissioning intentions as set out in the Market Position Statement of the Council are to:

  • move towards actively improving the outcomes for people who live in shared supported living settings by working with providers to promote independent living and operate a positive risk-taking approach
  • decommission shared accommodation services where they are not delivering the best outcomes for the people who live there
  • commission apartment style schemes where people live with ‘their own front door’ and can have access to background support when needed.

We will also work towards the vision set out in the Wirral Plan Our vision is to create equity for people and place and opportunities for our residents, communities, and businesses. The vision has been developed to build on five thematic priorities that focus on improving outcomes for whole population groups as outlined below:

  • Sustainable Environment – Working towards a clean-energy, sustainable borough that leads the way in its response to the climate emergency  and is environmentally friendly
  • Brighter Futures – Working together for brighter futures for our children, young people and their families by breaking the cycle of poor outcomes for all regardless of their background.
  • Inclusive Economy – Working for a prosperous, inclusive economy to help businesses thrive  and creating jobs and opportunities for all.
  • Safe and Vibrant Communities – Working for safe and vibrant communities where our residents feel safe and are proud to live and raise their families.
  • Active and Healthy Lives – Working to provide happy, active and healthy lives for all, with the right care, at the right time to enable residents to live longer and healthier lives.

Wirral’s All Age Disability Strategy provides the following details to supplement our analysis:

  • By 2030 it is estimated that around 64,000 Adults (18+) in Wirral will have some form of limiting long term illness or disability that would be around 1 in 4 of the projected adult populations; and
  • People in Wirral with a long-term health condition, on average have a lower quality of life score when compared with the rest of England.

Three priorities are identified:

  •  All people with disabilities are well and live healthy lives; 
  • All young people and adults with disabilities have access to employment and are financially resilient
  • All people with disabilities have choice and control over their lives.

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Population

Map. 1 & 2 (information obtained from the Local Insight) You can find out more here.

Population for Wirral as of 2022: 

Proportion of the population aged 65+ years for Wirral by Lower Super Output Area (LSOA); proportion is calculated as a percentage of all age population.

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Population density for Wirral by Lower Super Output Aea (LSOA). Population density is calculated using resident persons per hectare.
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Key to map above

 

 

 

 

Population for Wirral in the 65+ demographic as of 2022

Population density for Wirral by Lower Super Output Area (LSOA). Population density is calculated using resident persons per hectare.

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Proportion of the population aged 65+ years for Wirral by Lower Super Output Area (LSOA); proportion is calculated as a percentage of all age population.
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Key for above map

 

 

 

 

Population total by Ward (this is mid-2020 data from Wirral intelligence Team)

Location Population Total
Bebington Ward 15,669
Bidston and St. James Ward 16,256
Birkenhead and Tranmere Ward 16,926
Bromborough Ward 16,427
Clatterbridge Ward 13,986
Claughton Ward 14,201
Eastham Ward 14,195
Greasby, Frankby and Irby Ward 13,728
Heswall Ward 13,126
Hoylake and Meols Ward 13,451
Leasowe and Moreton East Ward 15,086
Liscard Ward 16,086
Moreton West and Saughall Massie Ward 13,958
New Brighton Ward 15,162
Oxton Ward 13,784
Pensby and Thingwall Ward 13,024
Prenton Ward 14,786
Rock Ferry Ward 14,751
Seacombe Ward 15,609
Upton Ward 16,924
Wallasey Ward 14,658
West Kirby and Thurstaston Ward 12,543

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Extra Care Housing – Current Position

There are Eight purpose-built General extra care schemes funded by the Council to provide 318 general extra care (65+), tenancies and 10 dementia related tenancies. The schemes provide a mix of on-site domiciliary support, catering, and care facilities to enable older people to lead active and independent lives for as long as possible. In addition to this there are 6 Specialist LD Extra Care Schemes (78 Units) now active with another 21 units due to be available in December 2022. 

The map below shows the location of General Extra Care settings for those aged 65+ years together with Specialist Learning Disability Extra Care settings for those aged 18-64 years.

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Map shows the location of General Extra Care settings for those aged 65+ years together with Specialist Learning Disability Extra Care settings for those aged 18-64 years.
Reference Type
Purple General Extra Care (65+) 
Orange Specialist LD Extra Care (18-64) 

The current Strategic Housing Market Assessment (SHMA) Report for Wirral stated, that given the ageing population, the need for specialist older people accommodation is set to increase.

As of July 2022, all 328 general extra care are occupied and waiting lists are in operation. There are currently 9 vacancies within Specialist LD Extra Care. Analysis of current tenancies and the corresponding levels of support indicate increasingly high levels of frailty and dependency with a need to enhance core contracted support as there are now greater levels of those with high support needs. 

Due to open in 2023 there will be 102 general extra care (65+), units at Spinnaker house in Rock Ferry and 53 at Sycamore House in Liscard, which will give an overall older people supply of 483. In early 2023 there will be two specialist extra care schemes opening providing an additional 21 apartments.

The below table gives our overall total for Wirral as of 2022 and the overall total for the new schemes.

Type Units New 2023 Total units
General ECH 328 155 589
Specialist LD ECH 85 21 589
Total 413 176 589

As of October 2022, there were 335 people living within a Wirral Extra Care Housing Scheme. Below shows the increase in placements since January 2021. Some of the apartments are habited by couples.

As of November 2022 there are 130 people who meet the eligibility criteria and are currently on the waiting list. 130 of these individuals are waiting for General Extra Care Housing and 11 are waiting for Specialist LD Extra Care Housing in Wirral.

We have the following residents waiting for extra care housing in Wirral. The below shows Older People 65+ waiting for placements.

Extra Care Housing waiting list by locality of current address

Birkenhead 20.18%
South Wirral 30.27%
Wallasey 39.34%
West Wirral 24.21%

In Wirral, we aim to ensure that all our extra care schemes are filled with a range of dependency levels, as set out below: 

•    30% of residents who require low levels of care and support (0 up to 5 hours per week)
•    40% of residents who require medium levels of care and support (5 up to 15 hours per week)
•    30 % of residents who require high levels of care and support (alternative to residential care) (15+ hours per week)

Depending however on the number of cases and the priority of applicants, this remains flexible to respond to demand.

Following assessment and eligibility Criteria applied for individuals to meet the need for extra care housing are banded as below: 

Banding Class Time
1 Low 0-30 minutes
Low 30 minutes - 5 hours
3 Medium 5-10 hours
4 Medium 10-15 hours
5 High 15 hours or more

The current bandings within our general extra care (65+), which demonstrates a mixed level of acuity within extra care housing.

Current Extra Care Housing Benefit by band

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Current Extra Care Housing Benefit by band

Home Care need and cost

The below map provides a geographical overview of current commissioned packages of home care in Wirral. It indicates a higher concentration of home care packages within east Wirral particularly the North East.

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Overview of current commissioned packages of home care in Wirral

Current Homecare packages 65+
(November 2022 from Wirral Business Intelligence Team - Power BI Report)

Male Clients make up 34.4% of packages with female at 65.6%.

Current Home packages 18-64
(November 2022 from Business Intelligence - Power BI Report)

Male Clients make up 39.6% of packages with female at 60.4%.

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Residential need and cost

This map shows an overview of the locations of all Wirral care homes and indicates particularly clusters of homes within the North East and centre of Wirral: 

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Locations of all Wirral care homes

There could be a correlation between the lower levels of residential care available in the west and southwest of Wirral and the higher cost packages of homecare in those areas – on the assumption that people are receiving more support at home rather than accessing residential care.  There could be potential for extra housing in these areas to reduce these packages. Development wise South Wirral is of interest.

We are constantly reviewing the community care market and working with providers as part of the commissioning process to develop more extra care schemes where need is greater. As part of the Market Position Statement, which is now combined with the Liverpool City Region (LCR), it outlines more in relation to extra care housing.

There may also be a relationship between the lower concentration of residential care homes in the southwest of Wirral and the cluster of sheltered schemes in the Pensby & Thingwall and Heswall areas

As of November 2022 there were 1568 clients in receipt of care within Wirral Residential and Nursing Homes. The forecast by April 2023  is that this will decrease to 1528.

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Housing Property Pool Plus, Sheltered and Supported Housing

As of 24 November 2022 there were 2,355 households aged 60+, who were registered with Property Pool Plus, in order to access affordable housing.  Of these, 715 are aged 70-79 and 268 are aged 80+. The majority of the need is for 1 bedroom accommodation (97%) with the remaining needing 2-bedroom accommodation.  Whilst a general assumption cannot be made that all of these applicants are in need of or would choose to live in extra care accommodation there is the potential for some of these individuals to live both now and in the future in extra care housing. 

Between 1 July 2019 and 24 November 2022 there has been an 82% increase in Property Pool Plus registrations by households where the age of the youngest household member is 80 or over. This is slightly lower than the overall increase in registrations (84.6%).

There are clusters of sheltered accommodation in areas where there is currently no extra care provision.  There could be potential for extra care provision in these areas, aimed at both ‘new’ customers and people currently living in sheltered accommodation who may wish to access extra care housing in the same area if their support needs increase.  There could be potential for adaptation / remodelling / extension of existing sheltered schemes to provide extra care.     

New extra care provisions since 2015 for older people have opened in Saughall Massie, Bidston Village and Pensby.  Specialist LD Extra Care have opened 6 new schemes in that time, with more due to open in 2022 and the coming years. Specialist LD Extra Care schemes are linked to an active decommission plan.

As of October 2022 782 clients were living in a Wirral Supported Living Schemes. This is a decrease of 25 since October 2019.

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Future Extra Care Housing Provision

The best use of Councils assets and those which may be available through its partners will be fundamental to the delivery of additional extra care provision. For the Council this will include the use and availability of its land and building assets.  

There are several opportunities which the Council is already aware of that could assist in meeting future provision.  These include:

  • Capital funding available through registered provider partners along with land which the Council currently owns which are subject to Development Agreements to deliver new homes.
  • A land asset which is owned by the Council but is the subject of a Development Agreement with a private partner to deliver new homes.
  • Land/Building assets owned by the Council which will be the subject of disposal in the future.

Wirral Council will continue to work to identify opportunities for new Extra Care schemes within both Wirral Growth Company developments, such as the proposed scheme in Moreton town centre, and on other developments where the Council has influence, particularly as part of the Birkenhead Regeneration Framework.

These potential opportunities need to be aligned with future demand and commissioning requirements which the Council wishes to pursue.  The disposal and use of Council assets could be used more effectively for the commissioning and development of extra care provision.  This may not necessarily be the whole site which could be available and could be part of a wider plan for disposal and redevelopment.  The use of any council assets could ensure that provision is met in areas where future commissioning is required, and available land opportunities are scarce.

It is beyond the scope of this document to detail all potential development opportunities; however further exploration with the Asset Management Team may identify future / emerging opportunities.

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Analysis based on the above

The below tables look at the demand and supply for Extra Care Units on  Wirral. Ages 55-70 – Modelling Overview:

Demand Supply Variance %Difference
295 328 267 45%

Estimated Future Needs for Extra Care Housing: 

Extra Care 2022 2024 2030 2035
% Increase 1% 2% 12% 32%
Units 595 607 666 785

The above modelling reflects the assumed level of Extra Care Housing aligned to demographic projections, but as the demand and supply analysis illustrates, we are starting from a low level of current provision which increases market challenge to build such capacity and capability to afford greater choice to promote and sustain independent living with associated care and support.

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Recommendations

The information presented within this document indicates potential for additional Extra Care provision to have an impact in a variety of locations; most notably where:

  • there are high numbers of older people
  • there is no current provision
  • there are high-cost packages of homecare
  • there are both high concentrations of and / or limited residential provision 
  • there is existing sheltered housing 
  • there is existing supported housing
  • there are existing development opportunities

Based on the conclusions drawn above, it is recommended that development of extra care provision is targeted in the following areas, in this priority:

  • South Wirral
  • West Wirral
  • Birkenhead and Tranmere
  • Wallasey

The council recognises that opportunities to develop this type of accommodation could be available across the borough and will consider this on a scheme-by-scheme basis. 

In relation to Specialist LD Extra Care, we will continue to work with providers to review their existing properties and look to develop new ones, that decommission existing not-fit-for-purpose properties.

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