Quality of Life Outcomes of Housing with Care for Older People in England

Housing with care has become increasingly popular in
recent years, and has been viewed by policy-makers and
commissioners as offering a more enabling, homely and cost effective alternative to care homes. However, most residents
enter with fewer care needs than those admitted to care
homes, and with different expectations. Although a previous
study (Bäumker et al., 2011) compared the functional outcomes for matched groups of residents, most comparative
studies have used unmatched groups. This paper will compare the social care related quality of life (SCRQoL) obtained using the Adult Social Care Outcomes Toolkit (ASCOT) for residents in housing with care and those receiving home care. The housing with care residents were drawn from the ASSET (Adult Social Services Environments and Settings) project, which was commissioned and funded by the Department of Health’s NIHR School for Social Care Research. The home care recipients were drawn from the OSCA (Outcomes for Social Care for Adults) project. Matched groups of 124 individuals in each were created using propensity score matching.
Residents in housing with care had less unmet need (current
SCRQoL) than people receiving home care (p<0.0001);
similar expected SCRQoL in the absence of social services
(p>0.05); and a higher gain (current compared with
expected) (p<0.0001). The improvements in outcomes were
achieved without increased costs in providing personal care.
Housing with care is relatively scarce, but this study adds
further evidence for the value of developing more specialized housing and increasing the choice available to older people wishing to move from unsuitable accommodation.