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What can we do to improve the future of the Later Living sector ? An overview from the UK and Netherlands perspective.

24 April 2023

At the end of March 2023, our Care sector lead, Stephen Jones, sat down with Healthcare sector lead of Drees & Sommer Esther Akkerman, working with Vastgoedjournaal to discuss the similarities and differences of later living in the Netherlands and the UK.

Esther Akkerman has been with Drees & Sommer since August 2022 and has earned her spurs at Woonzorg Nederland and Syntrus Achmea, among others, where she was involved in devising and implementing residential concepts for the elderly and nursing homes. 'In recent years we have seen the separation between housing and care become ever greater. The elderly are being forced to live independently for longer and the supply of care is changing along with this. But how can we ensure that the elderly really can continue to live independently, even if they become dependent on care? This is a major challenge in the Netherlands. The phrase "100,000 new dwellings a year until 2030" is a dream for anyone working in real estate. A third of those homes should be created for the elderly, to help the flow to single-family homes. But what must such new housing for the elderly meet?

Stephen Jones, has been with Drees & Sommer UK for 10 years having formerly worked at AECOM and has worked in the residential and care sectors all his career. He sees a similar challenge in the UK in providing varied housing programs for the elderly.

‘The variety of later living accommodation forms is limited and is often seen as a necessity when health deteriorates, rather than an aspiration for a better life during retirement. In the UK this leads to many under-occupied family homes, often restricting younger families moving up the property ladder.

Beautiful and aspirational Retirement Villages constructed in rural England - which include a spa, cinema and other amenities are typically constructed in affluent areas where future residents can release income from owner occupied homes to fund the substantial purchase or rental prices, but not everyone can afford that.’

Is the UK also experiencing high land prices for developments like this?

“The public sector housing associations in the UK, funded by Homes England, are doing admirable work, delivering quality later living accommodation in the towns and cities that need it most and where home ownership is not as prevalent. But as with the private sector, increased, land, construction, borrowing and care provision costs, is hindering viability. As a result, Drees & Sommer UK's Cost Management division are working hard with clients to find innovative ways to continue to deliver the scale and quality of development required to meet demand.”

What is Akkerman's experience of building land for elderly housing in the Netherlands?

'With the current housing task, you see that the distribution of building land is becoming a battle between the target groups. After all, everyone needs a roof over their heads; starters, status holders, families, singles, the elderly, and students. Many choices have to be made in the Netherlands'.

That a suitable elderly home can only be in a city remains to be seen, according to Akkerman. 'One elderly person is not the other. Elderly people with geriatric problems can thrive just as well and perhaps even better in a quiet place outside the city.' The minister has indicated that he does not want to build any more nursing homes. Something Akkerman would regret if that really doesn't happen anymore. 'After all, there is still a target group for nursing homes. We now have to accommodate them somewhere else. That must be taken into account in the building plans.'

Care homes are still being built in the UK. 'We build nursing homes with an average of between 65 and 80 rooms. Here, care wings are sometimes used for a specialist care need such as those living with dementia, or to create small households where in the event of another pandemic, wings can be isolated rather than isolating the full home.’

Developers, contractors, and architects are working closely together so that today's care homes are built to be lifecycle-proof.' Jones does not see the need for a variety of accommodation forms disappearing any time soon. 'In the UK there is a shortage of hospital beds so providing other suitable care settings such as step-up / step-down accommodation unlocks capacity in the NHS (National Health Service), the UK's public health system. Drees & Sommer UK's Strategic Management team work closely with various NHS trusts across the UK on their estate strategy and often review what land they can unlock for new development or disposal.'

Akkerman: "There's no question for both the Netherlands and the UK that we need to focus anyway on forms of housing where residents can be there much more for each other. That can be people from the same age group, but also think, for example, of mixed residential forms with the previously mentioned different target groups, who can support each other.' To get and keep the necessary interaction going, appointing a community manager, according to Akkerman, is not an unnecessary luxury. "It only has a chance of success if everyone also sees the added value. Still, Akkerman wants to avoid residential forms with shared facilities being directed to perfection. 'There really is a need for residents' own input.'

In the Netherlands, intergenerational living is seen to have great benefits, is this mirrored in the UK? The UK has traditionally constructed retirement living as standalone developments but increasingly private developers and public housing associations are creating large mixed developments with family housing, bungalows, retirement living apartments and care homes with a variety of tenures. Drees & Sommer UK have recently taken practical completion of an intergenerational site in Lymm (built by McGoff Construction), which has a mix of retirement living apartments, a care home, and a childrens day nursery, allowing all ages to be enriched by each other’s company (see case study).

Embracing the available (care) technology is also extremely useful and badly needed, according to Akkerman. 'We are facing a shortage of care personnel in the Netherlands and on top of that increased personnel costs.' Jones agrees that this is also the case in the UK. The elderly housing market should try to take advantage of innovations already proven for other markets. Consider e-consults with caregivers, home automation in and around the home, smart technology and other innovations that can contribute and support living independently for as long as possible. 'The added value of a good senior living complex is in the facilities. Developing suitable senior living accommodation is much more than just supplying a pile of bricks.'

Akkerman wants to conclude with some tips: 'Define your target group well: make sure you know for whom you are developing and what that group cares about and needs. Develop projects with added value in an environment that suits that target group. The added value of the senior complexes is in the facilities around them. In the initiation phase, also look at the exploitation - aspects related to sustainability often pay off in the longer term. And finally: good cooperation with like-minded parties is the best basis of a successful residential facility for the elderly.'

Image from McGoff Construction from Lymm Case Study

McGoff Group