Covid-19: Effect on Retirement Communities

Liz Kendall Excerpts

Thursday 1st July 2021 Westminster Hall

[Liz Kendall (Leicester West) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Efford. I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate on this important subject, which has, so far, had too little attention during the pandemic. This is a prescient debate because retirement communities, which are sometimes called “housing with care” or “extra care housing”, should be an important part of the Government’s plans to reform social care—when they finally see the light of day.

Retirement communities enable older people to continue living independently in their own home with properly regulated home care services and other community facilities available on site. We have heard some wonderful examples from Members’ constituencies. Around 75,000 people live in such communities in the UK. Around 40% of residents are under 80 years old; almost half are between 80 and 90; and 15% are over 90.

As hon. Members have said, the pandemic has clearly posed real challenges to retirement communities, the people who provide them and the people who live in them. Residents faced increased loneliness and isolation due to the measures being put in place to control the virus’ spread, and communal areas and non-essential services have been closed and postponed. Many providers, although not all, struggled to get PPE at the beginning. They faced considerable staff shortages, and staff and residents reported real anxiety and stress. One of the issues raised with me was the lack of specific guidance for housing with care providers. I was told that they had to come up with a lot of that themselves. That is an important point, as we all know that we will have to live with this virus for some time.

Overall, as we have heard from the hon. Member for Strangford and the right hon. Member for Staffordshire Moorlands (Karen Bradley), research has shown that people living in retirement communities have been remarkably protected, compared with people of a similar age in the rest of the country. A smaller proportion died, and most housing with care providers reported no or very few covid cases in each of the months between March and December last year. Interestingly, some of that is due to the design and layout of retirement communities, and the self-contained nature of individual homes. One of the things we will have to look at in the future is whether capital investment is needed in residential homes to change their layout to make people less susceptible to the virus.

Although it is clear from evidence and research that many retirement communities did very well in protecting residents from the immediate impact of the virus, there are real concerns about the long-term implications of covid-19 on residents. Providers of housing with care fear that some residents may avoid seeking support from the NHS in the future because they are still worried about catching the virus if they go into hospital. The providers are also worried about the longer-term impact on the cognitive functions of older residents if they are cut off from family and friends, despite all the efforts to use Zoom and other technology.

Providers are also worried about older residents’ physical abilities, because they have been less mobile during the pandemic. That is part of a much wider issue. We have rightly heard about the huge backlog in operations and treatment in cancer care or acute-based care in the NHS, but we also have to think about the backlog and need in the community. As Age Concern and others have reported, we need to think about the support we provide for older people whose mobility has been reduced. Lots of older people report that they are not able to walk as far or feel less steady on their feet. That can have an impact on falls.

There are also mental health needs. It is not just about not seeing and hugging people—the friends and family they love—but living with the stress of fearing that they will catch this virus and die. As we think about the NHS recovery plan, I urge the Minister—I am sure she has already done this—to think about not just acute services but services in the community.

The benefits for the health of people living in retirement communities have been known about for quite a while. We know that older people in housing with care have higher exercise levels and fewer falls, and are less likely overall to suffer from anxiety and depression. That benefits not just them as individuals but the rest of the health and care system. Research has shown that those living in retirement communities are less likely to go into hospital and have fewer GP and nurse visits than comparable age groups. Indeed, some evidence suggests that the overall use of the NHS is about 30% to 40% less. That is really important not just because the people living there have better health but because there is a better use of taxpayer money. The health benefits of retirement communities are just one of many reasons why Labour is calling for an expansion of housing with care options in the future as part of our wider proposals to transform social care.

We live in the century of ageing. We have all heard about how the number of people aged over 65 will increase by more than 40% by 2040 to over 16 million. Most people want to stay in their lifelong family home for as long as possible, but having more options between care at home and a care home must be part of our vision for social care and housing in future, so that someone can be in their own home, living independently, but draw down those services and support as and when they need them. As the right hon. Member for Staffordshire Moorlands rightly said, other countries are way more advanced than us. Only about 0.5% of over-65s live in housing with care developments in this country, compared with 5% or 6% in New Zealand, Australia and America.

If we are to expand the options, three things need to happen. First, we need a clearly defined category of housing with care in the planning system, as the Housing, Communities and Local Government Committee, and the sector itself, have recommended. It is currently much harder to build housing with care properties than care homes due to a lack of definition in the planning system. It was a real missed opportunity when the Government did not include that specific definition in their “Planning for the Future” White Paper and the legislation. They need to think again.

Secondly, we need—the sector itself is calling for this—sector-specific legislation and regulation for housing with care, to give consumers greater confidence, spelling out residents’ rights and the nature of the relationship with care providers. It is also crucial to give investors long-term confidence. The legislation that has been introduced in Australia and New Zealand has really underpinned the development in those countries, which is why we need something similar here.

Thirdly, the Government need to seriously look at how we ensure that housing with care is an option for all older people, regardless of their means or housing wealth—in other words, not just available to those who have a lot of equity in their existing lifelong family home. Currently, around two thirds of housing with care properties are available for affordable and social rent. We are doing well at the moment, but cuts to local authority social care budgets over the past 10 years, including funding for complex services through such things as Supporting People, have meant that the creation of new affordable extra care housing has slowed, and in some cases services have been withdrawn. It is not good for older people, or the taxpayer, if people end up having to use more advanced and expensive care, or end up relying on the NHS.

I hope the Minister will set out what plans the Government have to support this important sector as we continue to live with the virus, and crucially what plans they have to support its expansion, so that all people have the choice, as the right hon. Member for Staffordshire Moorlands said, to live the life that they choose in the home that they call home, which will include these options in future.