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The purpose of this paper is to explore the potential of housing with care schemes to act as community hubs. The analysis highlights a range of benefits, barriers and facilitators.

Data are presented from the Adult Social Services Environments and Settings project which used a mixed methods approach including a review of the literature, surveys and in-depth case study interviews.

Most housing with care schemes have a restaurant or café, communal lounge, garden, hairdresser, activity room and laundrette, while many also have a library, gym, computer access and a shop. Many of these facilities are open not just to residents but also to the wider community, reflecting a more integrated approach to community health and adult social care, by sharing access to primary health care and social services between people living in the scheme and those living nearby. Potential benefits of this approach include the integration of older people’s housing, reduced isolation and increased cost effectiveness of local services through economies of scale and by maximising preventative approaches to health and wellbeing. Successful implementation of the model depends on a range of criteria including being located within or close to a residential area and having on-site facilities that are accessible to the public.

This paper is part of a very new literature on community hub models of housing with care in the UK. In the light of new requirements under the Care Act to better coordinate community services, it provides insights into how this approach can work and offers an analysis of the benefits and challenges that will be of interest to commissioners and providers as well as planners. This was a small scale research project based on four case studies. Caution should be taken when considering the findings in different settings.

This paper provides an overview of the main results of a Department of Health‐funded research project which investigated the quality and costs of residential supports for people with learning disabilities. The main findings were that the adjusted costs of community‐based supports were higher than residential campuses and village communities; within community‐based provision there were no statistically significant differences between the adjusted costs of supported living, small group homes and group homes for 4‐6 people; community‐based provision and village communities offered better care than residential campuses; there appeared to be distinct benefits associated with community‐based provision and village communities; within community‐based provision there were benefits associated with smaller size and supported living arrangements.

Extra care housing enables older people to remain in their ‘own home’, while providing appropriate housing and access to health and social care services that are responsive to their needs. This type of provision is very much in line with the government policy of fostering people's sense of control and independence, and is a priority area for expansion. We explored the current levels of development and expansion of extra care housing in terms of the numbers of schemes and places and factors that contributed to and were problematic in its development.

This paper describes an evaluation of 19 extra care schemes allocated funding from the Extra Care Housing Fund.

Interviewers collected information about the expectations and experiences of 1,182 new residents, and demographic and care needs information for those who received a care assessment (817 individuals) to correspond to previous surveys of care homes. Follow‐up information was collected at six, 18 and 30 months. Comprehensive costs were estimated for individuals based on capital costs, care and support costs and living expenses.

Entrants to extra care were much less physically and cognitively impaired, on average, than entrants to care homes, although residents in several schemes had high levels of physical disability. Overall, residents appeared to have made a positive choice to live in a more supportive and social environment (“pull” factors) rather than responding to a crisis (“push” factors). Outcomes, in terms of physical and cognitive functioning, for residents with similar characteristics to care home residents were better, and costs were no higher, while mortality rates were lower.

Outcomes could not be measured for those who dropped out, and residents with deteriorating mental health were more likely to drop out.

Extra care can provide a positive option for people planning ahead, but appears to be less suitable for crisis moves. Further work is needed on supporting those who are more dependent.

To encourage downsizing, extra care needs to be sufficiently attractive to those making a lifestyle choice.

This was the first major study of costs and outcomes in extra care housing.

EVOLVE is a tool for evaluating the design of housing for older people. It is used to assess how well a building contributes to the physical support and personal well‐being of older people. Developed from research into extra care housing, it can be used for a variety of building types, including sheltered housing and individual private houses. The tool can be used by architects, housing providers, commissioners, researchers and individual tenants or home owners. EVOLVE can be used as a briefing document or an aid to design. It can provide a rational basis to the selection of proposals in a competitive procurement process. The EVOLVE tool can also be used to evaluate existing housing stock, including schemes where remodelling is under consideration.

The purpose of this paper is to explore whether relatives of care home residents are best placed to act as “champions” or advocates for their family members, as is often the expectation.

Focus groups and interviews were conducted with 25 relatives of residents in four care homes for older people in the South East of England. Two rounds of focus groups were held in each participating care home: the first was to discuss any issues arising from the care received, or concerns about the home itself; the second was to enable a deeper exploration of the key themes that arose from the first round and explore why relatives, in this case, failed to complain.

Thematic analysis revealed a complex range of emotions experienced by relatives that contributed to a conflict between what they believed to be the correct response and how they behaved in reality, which led to a culture of acceptance. Analysis revealed some relatives were reluctant to “interfere” for fear of possible negative repercussions, thus they downplayed issues in an attempt not to “rock the boat”.

This paper discusses the flaws in the policy emphasis on personalisation and the reliance on family members as advocates, and concludes with suggestions on how care homes may foster an environment where relatives, and indeed residents, feel comfortable to raise issues and concerns.

Providing housing with care may seem to be integration at its best. This paper investigates the workforce implications of this form of provision with a focus on older people with high support needs.

This article presents plans to evaluate the individual budget pilots in England. The setting up of the 13 pilot projects is described, and the evaluation's questions and approaches are outlined. The article outlines some of the central challenges being encountered as the pilots get under way.

Research in care homes requires the co-operation of care home managers. Noting the challenges faced by the care home sector, the purpose of this paper is to consider ways in which research studies can encourage care home managers and their homes to participate in research.

The discussion is informed by two research projects which are used to explore methods of encouraging managers of care homes to participate in research. One of the studies included interviews with care home managers to understand their reasons for taking part in research.

This paper outlines and assesses three strategies for encouraging care home managers to participate in research: working in partnership, providing payment and providing personalised feedback on findings. Whereas all the strategies have the potential to encourage care home managers’ participation in research, partnership working in particular was found to be fraught with difficulties.

This paper suggests that the research projects could employ any of these strategies to encourage managers of care homes to participate in research. It also suggests that proactive measures could help ameliorate the pitfalls of partnership working.

This paper shows the advantages and disadvantages of using a combination of strategies for encouraging the participation of care home managers in research.