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Extra care housing enables older people to remain in their ‘own home’, while providing appropriate housing and access to health and social care services that are responsive to their needs. This type of provision is very much in line with the government policy of fostering people's sense of control and independence, and is a priority area for expansion. We explored the current levels of development and expansion of extra care housing in terms of the numbers of schemes and places and factors that contributed to and were problematic in its development.

In this article we first give the facts on what extra care is. Second, we make a few points on what really helps improve commissioning. The article draws on innovative and up‐to‐date material developed for the Department of Health's Housing Learning & Improvement Network by Moyra Riseborough from CURS at the University of Birmingham and Peter Fletcher of Peter Fletcher Associates. To see more about the Housing LIN and its work, readers should go to its website at www.doh.gov.uk/changeagentteam/housing‐lin.htm.

In July 2007, Housing 21 began an exploration of how changes to the system of social care called personalisation might impact on specialist housing provision in England. Personalisation now forms the basis of English social care policy focusing the delivery of public services on what people might want or choose, in the context of eligibility criteria and means testing. It is designed to promote greater choice and control of the support that people receive.However, there have been concerns that the views of older people living in extra care housing settings have not been heard in the implementation of personalisation. In 2008‐09 Housing 21 engaged older people and other groups with an interest in sheltered and extra care housing to debate the implications of personalisation for current and future housing, care and support services. This article discusses what arose from this consultation and its relevance to housing providers and commissioners.

Extra care housing has developed from sheltered housing and has increasingly been seen as a popular option by policy‐makers for a number of reasons. These include the inability of conventional sheltered housing to be an adequate solution for a growing population of very old people, the decline in popularity and high costs of residential care and perceived problems with older people staying in mainstream housing. There is, however, no agreed definition of extra care housing, even though a growing number of government grants are becoming available for this type of housing. This is causing confusion for providers and for older people and their families who are not sure exactly what is provided. This lack of clarity means that this form of housing has become an erratic and piecemeal form of provision.

Extra care housing is increasingly prominent as a strategic solution to the issues presented by an ageing population and low demand in traditional sheltered housing and (in some cases) as an alternative to residential care. However, it is proving difficult to assess rigorously its long‐term benefits and cost‐effectiveness compared with other housing and care models ‐ a task which must be undertaken in preparation for the Supporting People regime. This article reviews Anchor's own research on extra care housing and is intended to stimulate a wide‐ranging debate on the methodological difficulties that such an agenda represents.

This paper aims to describe the RE-COV study and to summarise its findings. It focuses particularly on the implications of lessons learned for national, operational and building design policy and practice.

Invitations to take part in a RE-COV study survey were emailed to the operators of 270 retirement villages and older people’s extra care housing schemes in England which were known to the Elderly Accommodation Counsel. Completed questionnaires were returned from 38 operators, online or electronically, between December 2020 and February 2021.

Survey findings evidenced the breadth and depth of the operators’ responses, the effects these had on residents’ lives and worthwhile changes which could be made. Outcomes demonstrated included higher levels of protection for residents from the COVID-19 virus compared to older people living in the general community, and high levels of residents feeling safe, supported and reassured.

The findings are used to offer evidence-based recommendations for housing operators, building designers and policymakers which could enhance resident, staff and operators’ health and well-being, both going forward and during possible future pandemics.

There is evidence that retirement villages and extra care housing provided safe, resilient and supportive environments during the first year of the pandemic which were highly valued by residents.

This study addressed a knowledge gap regarding how the COVID-19 pandemic had impacted housing-with-care stakeholders, evidencing specifically how operators had responded, and what their response achieved.

The purpose of this paper is to review the recent literature on housing with care in England where a longitudinal approach has been adopted and to identify possible new research projects that focus on gaps in the existing literature.

The review of the relevant research literature draws in part on an earlier overview of the broader literature on housing with care, part of an NIHR School for Social Care Research project, Adult Social Services Environments and Settings (ASSET).

The literature review suggests that the findings from longitudinal studies on housing with care in England have usually been based on administrative sources (such as assessments) rather than the primary focus being on the voice of residents and frontline staff. It is therefore suggested that further studies are required to reflect the views of everyday life in housing with care settings.

This literature review and the longitudinal qualitative framework for undertaking further inquiry forms the basis for a major bid for funds from the NIHR School for Social Care Research. This is a collaborative endeavour between the University of Bristol’s School for Policy Studies, the Association for Dementia Studies at the University of Worcester, the Personal Social Services Research Unit at the University of Kent and the Housing and Learning Improvement Network. The limitations of this paper reflect the paucity of past investigations on the contribution of social care to the quality of life of elderly residents in extra care housing.

As noted above, the reviews of this draft paper have helped to determine the form of the bid for research funds. Informal discussions with commissioners and providers of extra care housing for older people indicate that access for fieldwork along the lines proposed should not prove to be a major barrier. One of the important implications is to add to the weight of evidence about the working conditions of care staff in extra care housing. The research is likely to highlight both good and poor practices, not least with consequences for the quality of life of elderly residents.

As indicated above, the paper draws attention to the need for a longitudinal qualitative study on the contribution of social care to the quality of life of older residents in extra care housing. Such a study would focus both on the details of everyday lives experienced by residents and the interaction in this setting between frontline staff and residents. In the context of major demographic change in the UK and planned further substantial cuts in public expenditure, this research is of high relevance for both policy and practice in this field of social care.

The review indicated a reliance on administratively derived information about residents rather than focusing on the voice of residents and frontline staff. Future longitudinal research should pay attention to the latter.

Extra care housing is seen as a popular option for older people by families, some older people, policy‐makers and practitioners. Some new build is being provided but another option, for which grants are available, is to remodel existing outmoded buildings. This research reports on recent attempts from 10 case‐study areas in England to remodel sheltered housing and residential care homes to extra care housing. The results are mixed, with satisfaction reported by many new tenants, anger by some existing ones, challenges at every stage of the project for design and construction teams, and issues over the provision of assistive technology and care. Nearly all the schemes experienced unexpected problems during the course of construction. Remodelling is not necessarily faster or cheaper than commissioning a purpose‐designed new building. Nevertheless, remodelling may be the only viable option for some unpopular or outdated schemes. The research showed that remodelling is not a quick fix, but that it did have considerable advantages for many of the older people and support staff who were living and working in the remodelled buildings. The research concluded that remodelling should only be undertaken when other options have been carefully examined. Drawing on the research findings, advice to policy‐makers and practitioners who are considering this course of action is outlined in the discussion.

Extra care housing is an increasingly popular form of housing with care for older people, largely because of its potential for maximising independence by providing flexible care and support. However, far less attention has been paid to another important aspect of quality of life, social well‐being. This article reports on a research project that explored good practice in promoting social well‐being in extra care housing. We identify several key factors in supporting the social lives of residents and present recommendations for good practice.