'Designing extra care environments calls for a more considered approach' by Damian Utton

9 July 2020

While the Government’s announcement last week of renewed housing investment should be welcomed, accommodation for later living needs to play a key role in any future housing mix.

Given the right stimulus, the extra care sector will represent an increasingly attractive option for developers and operators aiming to address the challenges and opportunities presented by an ageing UK population.

The rationale is clear, with the number of over-60s in the UK set to grow by more than 7 million over the next 25 years. Nearly 60% of new households from 2008-2033 will be inhabited by someone aged 65 or over, inevitably seeking an age-friendly environment for their last major move.

Knowledge Sharing

Consequently, knowledge sharing across professional disciplines will be more important than ever, to ensure new entrants to the market continue the UK’s strong performance in delivering high-quality accommodation and care to residents over the long term.

That’s why Pozzoni Architecture has partnered with the Housing Learning and Improvement Network (HousingLIN), CPC Project Services and Rider Levett Bucknall to produce a report into the key drivers and challenges in developing for the extra care sector.

One of the core messages in our updated report, Design & Cost Considerations in Extra Care Housing’, which has been launched today, is that extra care environments cannot simply be built using a ‘one-size fits all’ approach. Lessons from the COVID-19 pandemic also need to be learned quickly, to safeguard public confidence in extra care housing.

Ultimately, there are numerous factors that will influence the success and financial viability of any extra care scheme, and the research team is pleased to share its valuable learnings, after more than 30 years designing for a variety of specialist care environments.

Defining Extra Care

Extra care environments (also known as assisted living, housing with care and supported housing) are usually distinguishable as self-contained homes, with design and support features aimed at enabling independent living.

Normally these homes are in the form of apartments, but they can also be bungalows or houses, generally with 24-hour care staff available on site and ranging in size from around 40 units to larger ‘village’ environments of up to 300 homes.

Extra care environments need to be flexible and adaptable to accommodate an individual’s changing needs and circumstances over time, allowing people to ‘age in place’ without facing significant disruption. These homes should offer independence and the opportunity to maintain a chosen lifestyle that includes connections with the wider community.

Design considerations

Providing extra care developments within existing communities is a positive approach that creates the opportunities for people to remain an active part of their community in later life. However, prime residential sites located near to local amenities and transport links may attract a high land value, so difficult decisions often need to be taken to find the most cost-effective solution.

Some developers may decide to build more and smaller apartments, in order to accommodate a greater number of residents on a site. The downside is that each home will need to be of limited dimensions and may not suit a resident’s changing needs over time.

Other developments favour a lower number of larger apartments, which can offer a more comfortable experience in later life – as well as commanding a higher value for rent or outright sale. Multi-bedroom apartments can however be an inconvenience to residents, as they might be impacted by the spare room subsidy (more commonly known as the Bedroom Tax).

Responding to the COVID-19 pandemic, many Registered Providers are able to maintain care and support by adapting their practices rather than changing their buildings. There are elements to the design of extra care housing which may ease pressure on building management in future; such as separate access for staff, residents and visitors - to reduce the risk of new infections at a scheme.

Communal Spaces

Most providers would agree that communal facilities are an essential ingredient in extra care environments, promoting shared experiences and tackling isolation, leading to improved wellbeing and independence in later life.

To ensure continued use of on-site facilities, our report suggests that developers focus on providing fewer, but more flexible communal spaces – that can be adapted based on the most popular usages among residents.

Larger and more flexible shared spaces will also help extra care operators reduce the risk posed by transmittable infections and viruses, such as COVID-19 and Norovirus. Circulation spaces should be able to accommodate social distancing, with alternative building entrances and access routes to communal areas, to limit the spread of infections and viruses.

The Future

Technology has a significant role to play in futureproofing the extra care sector; not just in providing safer, more engaging experiences within each home. Five years since the last edition of this report, the pace of technological change has advanced rapidly. We are seeing significant advances in the deployment of digital technology and the use of innovative materials and techniques across the industry.

There is a significant shortage of purpose-built housing for older people of all types; from sheltered housing to extra care. That’s why our report highlights off-site manufacturing as an increasingly important tool in delivering cost-effectively, to high quality standards and at scale.

Steel frame construction, more commonly associated with commercial buildings, is also beginning to be used for extra care housing schemes and is already reducing overall build schedules at some sites.

Technology also has an important role to play in future-proofing extra care environments in the wake of the COVID-19 pandemic; such as providing better social connectivity with relatives in the event of future lockdown measures, or potentially limiting the number of people able to access certain areas at one time.


The key challenge for anyone charged with delivering extra care housing is to create attractive, affordable homes so that people can make a positive choice for later life.

Our report aims to demonstrate that with careful consideration and the right tools, including practical new cost modelling, we can aim to make extra care a more exciting move for residents and developers, not merely a necessary one.

Extra care environments cannot simply be built using a ‘one-size fits all’ approach. Lessons from the COVID-19 pandemic also need to be learned quickly, to safeguard public confidence in extra care housing