Housing with Care (Extra Care Housing)

Market Context

Extra Care Housing (ECH) schemes are defined as accommodation that provides access to 24-hour, seven day (24/7) on-site care and support for adults, many of whom may also have care and support needs met by Adult Social Care as part of our duties under the Care Act 2014.

ECH schemes are for adults who want to live in their own home with access to on-site care and support 24/7, if and when they need it. It means living in a safe property, with self-contained accommodation in a well-maintained scheme in the heart of the community that is purpose built and tailored to the needs of older adults and adults with disabilities.

Extra care schemes are an important part of a wider accommodation pathway of care, support and housing solutions, enabling independence and positive outcomes for adults. They can prevent and delay a move into less independent settings such as residential care.

Market Rating

The market for care provided within ECH schemes in Somerset is evolving as Somerset Council works to implement new arrangements from April 2025, which the ability to ‘step up’ from a sleep-in to waking night to enable care delivery overnight where required. The arrangements for ECH are currently evolving as Somerset Council transitions from arrangements that varied between schemes depending on the predecessor council that they were located within.

Market Quality: Good

Market Supply: Stable

Demand: Evolving

Commissioner ambitions: Increase usage

Market workforce: Stable

Market maturity: Evolving

Current market status

Somerset Council retendered contracts for the 24/7 provision of on-site support and the primary provision of individual packages of support within ECH schemes during the 2024/25 financial year, split into three lots. These contracts commence on 01/04/2025 and are for 5 years with the option to extend for a further 2.

The providers in each lot are as follows:

• Lot 1 (East and South): Way Ahead Care
• Lot 2 (West): Agincare
• Lot 3: (North): Agincare

Market Data

ECH schemes range for the largest scheme of 66 accommodation units to the smallest with 24, and a mean average of 36. The size of the ECH schemes reflects the population for each area and the rurality of Somerset.

Each ECH scheme has a commissioned provider for the 25/7 support, which is also the primary provider for any individual packages where individuals have been assessed as requiring additional care and support.

There are Extra care housing schemes in the following areas:

North:

• Bridgwater: 2 schemes
• Burnham-on-Sea: 1 scheme

South:

• Chard: 1 scheme
• Crewkerne: 1 scheme
• Ilminster: 1 scheme
• Yeovil: 2 schemes

East:

• Frome: 1 scheme

West:

• Minehead: 1 scheme
• Taunton: 2 schemes
• Wellington: 1 scheme

All data is as at 24/03/2025

* Based on 2024/25

** Based on the commissioned providers for ECH schemes and excludes circumstances where an individual has chosen to receive their individual package from a different provider.

Distance from desired commissioning objectives

Somerset Council wants ECH to be a vibrant model that meets the needs of local people and reduces the number of people requiring residential care over the next 10 years as a result of non-nursing and overnight needs by increasing the level of need supported and availability of care delivery overnight within ECH schemes.

Prior to the new arrangements commencing on 01/04/2025 this was only available in 3 locations, however, it is expected that, over the lifetime of the contracts, most ECH schemes will move from having staff asleep on site and available to respond to emergencies, to having staff awake and providing care to those who have been assessed as requiring it throughout the night. This is expected to result in the overall spend on ECH increasing over the lifetime of the contracts, but also have the effect of reducing the number of residential care placements that are required while enabling people to live as independently as possible within their communities.

Market Risks

• The quality of the housing stock that is currently utilised is variable, with some older schemes being less favoured by prospective tenants even though the locations are generally good in terms of accessing local infrastructure (in some cases better than newer developments), and the commissioned care and support being of the same standard.
• Issues with recruitment and retention of carers, although ECH can provide an attractive working environment.

Current areas of focus for commissioners

• Embedding new arrangements from 01/04/2025
• Maximising referrals into ECH schemes to optimise usage
• Beginning work to review the physical environment offered by all our existing ECH Schemes recognising that, in terms of timescales, any reprovision is likely to take around three years from land being identified through to the first residents moving in.