Proposals for sheltered housing for the elderly in Sidford > Inspector tells developers to pay full affordable housing contribution

At the beginning of the year, a controversial planning application was approved:
Futures Forum: Proposals for sheltered housing for the elderly in Sidford > third planning application approved, despite development 'potentially' generating increase in traffic

Now the Inspector has made clear what contributions the developer must make: 

Developers must pay full affordable housing contribution as demolition of former care home begins

An inspector rejected plans to reduce the off-site contribution

Daniel ClarkLocal Democracy Reporter
18:14, 8 APR 2019

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FORMER GREEN CLOSE CARE HOME

Demolition work has begun on converting a former care home into retirement apartments – but their bid to reduce the affordable housing contribution has been rejected.

Churchill Retirement Living’s plans to revamp the closed 23-bed former Green Close care home in Drakes Avenue in Sidford were finally given the go-ahead by East Devon District Council planners in December last year, after twice rejecting similar schemes.

The sheltered apartment plans would see the care home demolished and replaced with 40 apartments, with a guest suite, owners’ lounge, lift, office also be included, as would be 24 car parking spaces.

A financial contribution of £677,434 to the council towards the provision of affordable housing within the district is a condition of the application, which Churchill have agreed is acceptable.

The developers had appealed against a previous refusal by planners in May for a 39 one and two-bedroom apartments scheme as those plans only included an off-site contribution of £423,576, but no provision for on-site affordable housing. Councillors had voted by seven votes to five that this affordable housing offer was not policy compliant.

Planning inspector Rory Cridland has since upheld that decision, meaning that the council will receive the full affordable housing contribution of £677,434, which councillors at Tuesday’s development management committee meeting said was good news, when planning appeal statistics were discussed.

Mr Cridland’s report said: “The main issue is whether or not the proposed development would make adequate provision for affordable housing. The parties agree on the percentage of affordable housing required, that onsite provision is not appropriate and that a financial contribution towards off site provision is justified. They do not, however, agree on the amount or the means by which it should be calculated.”

The applicants had used a capitalisation rate at four per cent, considerably lower than the six per cent applied by the council.

He added: “The council’s six per cent figure is reasonably robust, and it is unlikely to be significantly out of kilter with prevailing market rates. In contrast, the evidence provided by the appellant to justify the four per cent rate is limited. Consequently, I favour the council’s evidence and conclude that the proposed contribution of £430,678 is insufficient to provide an off-site affordable housing contribution of equivalent value to on-site provision. As such, it would fail to make adequate provision for affordable housing and would, therefore, conflict with the requirements of the Local Plan.”

He dismissed the appeal, meaning the full £677,434 to the council towards the provision of affordable housing must be paid.

The Green Close care home was built in 1971 but closed in 2014 after Devon County Council cutbacks.

Developers must pay full affordable housing contribution as demolition of former care home begins - Devon Live
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A cashless Britain where over-55s and low earners are at risk of being left behind "further supports the case for the SW Mutual bank to open branches in the South West"

Last week, Sidmouth looked at an alternative way of banking:
Futures Forum: SW Mutual bank > "A new community high street bank for the South West could step in where the Big 4 have left...."
Futures Forum: SW Mutual bank > the region's first member-owned high street bank > a presentation in Sidmouth
Futures Forum: SW Mutual bank > a presentation in Sidmouth >>> >>> "The only thing that motivates people is this region and what it does."

And perhaps Sidmouth really does need such an alternative. As a correspondent says: "this report published in The Guardian features research from Accenture, and further supports the case for South West Mutual to open branches in the South West where communities have residents in the 55+ age group": 

Cashless Britain: over-55s and low earners at risk of being left behind

Study warns banks to adapt offerings to help consumers to use mobile or online banking

Rupert Jones
Sat 23 Mar 2019
Comments 935

With Britons increasingly turning to digital payments, consumers aged over 55 and those on low incomes “risk being left behind” by banks, according to new research.

The findings come in the wake of a major report earlier this month that says more than 8 million UK adults would struggle to cope in a cashless society.

According to the survey of 3,000 consumers, three-quarters (74%) of those aged 55-plus never use mobile-banking apps, while the figure for low-income earners was 57%. In addition, in both these categories, one in four (26%) of those surveyed said they never used online banking via a computer.

But at the same time, the research from management consulting company Accenture found that only 10% of UK consumers visited a bank branch at least once a week – falling to 7% of people aged over 55.

With banks increasingly focusing on their digital platforms, it is important for them to adapt their offerings to ensure certain groups of consumers “are not left behind in the digital revolution”, says Peter Kirk, managing director of financial services at Accenture. “Our research shows that low-income earners and those aged over 55 are using branches less, but they’re not using digital channels either,” he adds.

However, the survey indicated many of these people would like some help with using mobile or online banking. When it came to in-branch services that would appeal to them, 58% of over-55s and 55% of low-income earners would find in-branch education sessions appealing to help them improve their digital skills.

With bank branches and ATMs closing, a report published by the Access to Cash Review earlier this month said companies and organisations providing essential services should be required to ensure that consumers can continue to pay with notes and coins.

The review found that cash is still king across large parts of the UK economy, with more than 80% of people in Britain saying they pay taxi drivers, newspaper sellers, window cleaners and gardeners with notes and coins.

The report warned the country’s “cash infrastructure” – which costs £5bn a year to run – was on the verge of collapse because of its declining profitability, and said the government, regulators and banks all needed to take action. The review was funded by the cash-machine network Link, but was independent from it.

The report’s authors said the UK was not ready to go cashless and that despite the runaway growth of contactless and mobile payments, a “significant number” of people – about 2.2 million – were using cash for all their day-to-day transactions.

Last year, debit cards overtook notes and coins as the most popular form of payment in the UK for the first time, and the report predicts cash could fall to just 10% of all payments in the next 15 years.

Cashless Britain: over-55s and low earners at risk of being left behind | Money | The Guardian
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"Without any plan to tackle the financial crisis in the social care system, it’s hard to see how the vision in this 10 year NHS plan can be achieved."

If patients are either not treated in hospital or discharged at the earliest possible moment:
Futures Forum: The value of community hospitals

... there needs to be a better care system - which is not yet forthcoming:

Futures Forum: Doctors object to retirement village plans > they can't cope with the pressure of extra elderly residents
Futures Forum: Ensuring a sustainable future for social care > disrupt the market, and deliver greater supply, sustainability and fairness
Futures Forum: "Put more money into care services to help overflowing hospitals"
Futures Forum: "The loss of community hospital beds was intended to be offset by increasing the capacity of community care... Unfortunately there is not sufficient capacity in the home care services to do this job."
Futures Forum: Care Closer to Home: It's Not Working > new video from Save Our Hospital Services Devon
Futures Forum: By 2022, Devon will have the largest shortage in number of care homes places

With further comment today from ITV: 

Big questions left unanswered in long-term strategy for NHS

7 January 2019 at 11:10am
EMILY MORGAN HEALTH CORRESPONDENT

An extra £20 billion has been promised to the NHS over the next five years. Credit: PA

Today at last the long-term strategy for the NHS in England will be published. So long-term, it will take the health service right through the next decade, which is no mean feat.

NHS England’s Chief Executive, Simon Stevens, has written the plan at the request of the prime minister. He says it can save up to half a million lives by focusing on killer conditions and getting people to live healthier lifestyles. An extra £20 billion promised to the NHS over the next five years will be used to help achieve this. But how?

Well, we’re told diagnosis of major diseases will be made easier and quicker with technology, mental health provision will increase and patients will be looked after better in the community - keeping them out of hospital, ensuring they live longer and healthier lifestyles. This all sounds plausible when you take into account that GPs, local community and mental health will get a third of the extra funding.

So, less money you might say, going straight to hospitals.

The buzzword today is integration. Few really know what that means, but in essence it’s about the NHS working better with local authorities who control social care in the community. It might seem crazy that this isn’t joined up already, but it’s not, and while local authority funding has decreased, care in the community has had to be scaled back, putting huge pressure on hospitals.

That will change we’re told. It’ll all be joined up, hospitals will be able to discharge elderly patients more freely and community care will take over.

That’s all well and good but there remain some big unanswered questions. We’ve been waiting two years for a Social Care green paper, which will consult on the best way to fund and manage social care in England.

Without any plan to tackle the financial crisis in that system, it’s hard to see how the vision in this 10 year NHS plan can be achieved.

Health secretary Matthew Hancock. Credit: PA

That, along with dwindling local authority budgets, seems right now a fantasy. The health secretary Matt Hancock has promised the Social Care green paper will be published in the coming weeks so all eyes will be on whether it can deliver what the NHS needs.

It is also admirable to encourage healthier lifestyles and to offer healthy living programmes to those most at need, but that pledge is at odds with the massive cuts to public health budgets. 

Local authorities, in charge of those finances, have had to cut back on key services which ultimately help those with drink problems, drug problems and weight problems. How will the government achieve this pledge if councils aren’t given extra money to keep vital service?

My last point is who will deliver this? The staffing crisis in the NHS is not a joke. Around 100,000 doctors and nurses are needed and unions have warned that this figure will just keep rising. If there are no medics to deliver this, the plan is pretty much pointless. The government has promised to tackle staffing in the service at a later date, but until that happens there will always be a fear this plan can’t be delivered in full.

There is a lot of good in this plan. Of course there is. But until these questions are answered there will, I think, always be doubters.

NHS 10-year plan launched in bid to save 500,000 lives

Last updated Mon 7 Jan 2019

Big questions left unanswered in long-term strategy for NHS - ITV News

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Doctors object to retirement village plans > they can't cope with the pressure of extra elderly residents

We are to get a 'retirement village' at Knowle:
Futures Forum: Knowle relocation project: a summary of the issues
Futures Forum: Knowle relocation project: moving to Honiton...

And we are to get a 'retirement village' in Sidford:
Futures Forum: Proposals for sheltered housing for the elderly in Sidford > third planning application approved, despite the area 'not needing more sheltered accommodation'

With more media reports out today:
40 sheltered apartments to be built in Sidford - Radio Exe
Former care home will be demolished and turned into retirement flats - Devon Live

The problem is that we won't have enough health care provision for the incoming elderly:
Futures Forum: Knowle relocation project: a serious shortage of care workers in the Sid Valley area will mean that the new residents 'may experience problems' finding care provision

This is exactly what is happening just down the road and just around the corner: 

Doctors object to retirement village plans

Tuesday, December 11th, 2018 11:05am

By Ed Oldfield

An image from a consultation document in March of what part of the Sladnor Park retirement village could look like

They can't cope with the pressure of extra elderly residents

Doctors are objecting to plans for a retirement village in Torbay because of the pressure extra elderly residents will add to local health and care services “already close to breaking point.”

English Care Villages has submitted plans to Torbay Council for a 159-home “continuing care retirement community” at Sladnor Park, a former holiday park near the village of Maidencombe on the coast between Torquay and Shaldon.

Maidencombe Residents Association says the apartments would be too expensive for locals and the isolated site two and a half miles from the nearest urban centre at St Marychurch would bring in outsiders who would increase pressure on health and care services.

Objections to the plan include one from Torquay GP, Dr Roger Fearnley, who warned health services were already “close to breaking point” and said the Sladnor park development would attract people retiring from outside the local area.

He said in a comment on the planning application: “This influx of people would put significant further strains on health and social care services which are already close to breaking point.

“I am not aware of any meaningful conversations between the developers and local GP practices. There seems to be the assumption ‘we will cope.’ We may not.”

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Doctors object to retirement village plans - Radio Exe

And yet where further health care facilities were promised are not going to happen:

Newton Poppleford won’t be getting a new surgery

PUBLISHED: 16:30 11 December 2018

Beth Sharp

Newton Poppleford area for proposed development of 40 houses. Picture by Alex Walton. Ref shv 9458-16-13AW

Permission is being sought to build houses on land, previously set aside for a new doctors’ surgery in Newton Poppleford.

An application to build 40 new homes along with a new medical centre at King Alfred Way was approved by a planning inspectorate in March 2017.

At the time, the developers, Clinton Devon Estates, had been in discussions with Coleridge Medical Centre (CMC) which had a strong desire to secure the GP practice and had secured funding from the NHS for this to happen. But in May 2018, CMC withdrew as the funds were no longer available.

At the time, a CMC spokesman told the Herald that GPs had evolved with much more emphasis on innovative ways of working and broadening the range of co-located staff to provide specialist support in shared premises. The developers said they had approached others who might be interested in occupying the surgery but no one showed an interest.

Clinton Devon Estates have now submitted proposals to build two extra new homes at the development.

Newton Poppleford and Harpford Parish Council has slammed the proposals. A spokesperson said: “The council feels that it is disingenuous of the applicant, having been granted planning permission on the basis of the pledge of a doctor’s surgery, to now seek to walk away from their promises.

“The local community has strongly supported a new surgery for the village; through letters of support, a petition and the nascent Neighbourhood plan. CMC operate the current surgery in the village and has declared it inadequate for their purposes. Despite supporting a new surgery initially, they publicly declared it would no longer be viable for them. Residents in the parish will not be taken on by Sidmouth Beacon Centre, which leaves Coleridge, in Ottery, as the main medical centre for the village, despite there being no direct public transport links.”

They added the parish council didn’t believe all avenues had been exhausted with regards to the new surgery and would welcome an immediate discussion with all parties to find a potential solution.

The first homes which are a part of the scheme, that included 16 affordable homes, are due to be completed in winter 2018 and the whole development is hoped to be finished by winter 2019.

Newton Poppleford won’t be getting a new surgery | Latest Sidmouth and Ottery News - Sidmouth Herald
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Proposals for sheltered housing for the elderly in Sidford > third planning application approved, despite the area 'not needing more sheltered accommodation'

Back in October, developers pushed once again for their plans for retirement flats in Sidford:
Futures Forum: Proposals for sheltered housing for the elderly in Sidford > third planning application submitted

Planning officers said they had no choice but to approve the plans:
Churchill Retirement Living‘s plans for 40 retirement flats at Sidford Green Close site recommended for approval | Latest Sidmouth and Ottery News - Sidmouth Herald

And so this week, the District Council's planning committee have done just that:

Controversial plans to build 40 retirement flats in Sidford approved

PUBLISHED: 15:06 04 December 2018 | UPDATED: 15:06 04 December 2018

Sam Cooper

Green Close care home site in Sidford. Ref shs 43-16TI 0480.CR2

Controversial plans to build 40 retirement apartments on the former Sidford care home site have been given the green light.

The developers Churchill Retirement Living can now start works on demolishing the existing 23-bed care home in Green Close, ready to start building works.

As well as the sheltered apartments, the plans include a guest suite, owners’ lounge, lift, office and buggy store as well as a car park with 24 spaces and a landscaped garden.

As part of the scheme the developer will also pay £677,434 towards affordable housing.

This was the third time an application for the site had been put before the committee by the developers.

They application was approved by East Devon District Council’s (EDDC) development management committee today (Tuesday), despite concerns with the road access to the site and the increased strain it would put on local health services.

The developer has submitted two previous applications, the first was submitted for 36 apartments in 2017 but was rejected and went to appeal before being thrown out by a planning inspector. The second, for 39 sheltered flats, was refused by EDDC earlier this year. At the time the applicant proposed a financial contribution of £654,870 towards affordable housing however this wasn’t deem ‘adequate’. Recent changes to national policies mean the developer’s contribution of £677,434 meets the requirement.

During today’s meeting, councillors raised concerns with the road access.

Ward member Cllr Marianne Rixson said she was very ‘unhappy’ the entrance would be on South Lawn instead of Drake’s Avenue. She added many residents didn’t have garages so had to use the road for parking which meant it had to be single file traffic in both directions.

The other ward member Cllr David Barratt agreed saying the plans were ‘back to front’ and the entrance should be on Drake’s Avenue.

Cllr David Key said: “If it went to appeal I can’t see how it would be refused because Highways are happy with it. I certainly wouldn’t say it was adequate but I don’t think we stand a hope in hell [of rejecting]”.

Cllr Marianne Rixson added the area did not need more sheltered accommodation and that the development would result in even more pressure on the local health centre.

In total 12 councillors voted to approve the scheme and two abstained.

Controversial plans to build 40 retirement flats in Sidford approved | Latest Sidmouth and Ottery News - Sidmouth Herald
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Proposals for sheltered housing for the elderly in Sidford > third planning application recommended for approval

Plans for flats for the over-60s have been resubmitted:
Futures Forum: Proposals for sheltered housing for the elderly in Sidford > third planning application submitted

It had been the case that the developer's pleas over 'viability' could be ignored to some extent:
Futures Forum: Sidford and affordable housing > of 'viablity' and 'overage'

But the new planning law means this will be even more difficult to do:
The revised National Planning Policy Framework: housing focus - Lexology

And so the plans are likely to be approved later this month:

Fresh application for Green Close retirement apartments in Sidmouth

30 November 2018

Council’s development management committee to consider further planning application by Churchill Retirement Living for 40 sheltered apartments at Green Close/Drakes Avenue, Sidmouth

A third planning application submitted by Churchill Retirement Living for the construction of retirement apartments on land at Green Close/Drakes Avenue in Sidmouth will be debated and determined by East Devon District Council’s Development Management Committee at its next meeting on 4 December. The meeting starts at 10am in the Council Chamber at Knowle in Sidmouth.

The planning application proposes 40 sheltered apartments with 24 car parking spaces and follows two previous planning applications for 36 and 39 apartments respectively.

Both previous applications were refused on the basis that they failed to provide a sufficient contribution towards affordable housing. Initially, for the first application, a financial contribution of only £40,000 was offered towards affordable housing, on the basis that it was not viable for the scheme to pay more than that. The developer also refused to share any uplift in their profit from the site to address concerns that they may ultimately make more than was being estimated. That application was refused and that decision was upheld on appeal. A second application proposed a financial contribution of £654,870, but this was still less than was required and the developer again refused to share any uplift in profits and so this was also refused and is currently the subject of an appeal.

Following a change in Central Government Policy, through the publication of the new National Planning Policy Framework (NPPF) in July 2018, Churchill Retirement Living has submitted a third application offering a financial contribution of £677,434.

Due to a change of planning policy within the NPPF, planning officers are advising members that they can no longer require an applicant to enter into a legal agreement to secure a further contribution on this site. This is because the new NPPF advises that in order to support the re-use of brownfield land, local authorities should reduce any affordable housing contribution by an amount proportionate to the floor space of the existing building.

Planning officers are advising that this change to the NPPF means that the proposal now complies with current planning policy and as such there is no longer a justification for any further contribution towards affordable housing and therefore no need for any further legal agreement. In effect Churchill Retirement Living is now proposing to pay the full affordable housing contribution.

As the latest application is considered to be acceptable in all other regards, the application is recommended for approval subject to a number of conditions and is subject to a legal agreement to secure payment of a financial contribution of £677,434 to the council towards the provision of affordable housing within the district.

For further information read the agenda on the East Devon web site:

Councillor Mike Howe, Chairman of East Devon’s Development Management Committee, said:

"This development has a long and protracted history with this now being the 3rd application from Churchill Retirement Living, with a 2nd appeal also running. In the meantime, the site is now vacant and not providing the care homes places that are needed. Although now supported by officers the application has raised a number of concerns for the town council and ten residents remain opposed to the scheme. I look forward to a healthy debate of the issues at the committee meeting."

30 November 2018 - Fresh application for Green Close retirement apartments in Sidmouth - East Devon
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County Council rejects Devon Health Scrutiny report >>> "The care at home (Rapid Response) service is very stretched, especially since community hospital beds were closed."

Health and politics seem to go very much together, wherever you are:
Futures Forum: Health and politics in East Devon

A motion has come forward by the Devon authorities:
Futures Forum: County Council to consider "taking a strong position on protecting our community hospitals and a strong position on resisting any future plans to sell off the buildings"

The independent Councillor for Ottery has chaired a review on these issues:

No more community hospital bed closures, recommends Devon Health Scrutiny report

Monday, 19 November 2018 2 Comments by Claire

A scrutiny review into the system that’s designed to replace community hospital beds is recommending a raft of measures that will be debated at Devon County Council’s Health and Adult Care Scrutiny Committee, on Thursday this week.

I chaired the review, which took place during the summer and found that the care at home (or Rapid Response) service was very stretched and care of the dying in particular was highlighted as an area of concern, especially since community hospital beds were closed.

Over 200 Devon community hospital beds have been lost in the past five years or so.

We interviewed a range of witnesses, including Dr Paul Hynam, GP and Secretary of the Local Medical Committee, GP, Dr Mike Slot (whose concerns prompted the review), Ann Rhys, Assistant Director of Care at Hospiscare and Richard Westlake, Chair of Exeter Patient and Public Involvement Group. Also interviewed were various senior managers from Devon County Council and the local NHS.

I proposed the Spotlight Review after Sidmouth GP, Dr Mike Slot, attended the January Health and Adult Care Scrutiny Committee to outline his concerns about how care at home (or Rapid Response) was working. Dr Slot said that although he supported it in principle, there simply weren’t enough carers available to look after patients.

On Thursday (22 November) health scrutiny councillors will be asked to endorse 12 recommendations, including:

- No further community hospital bed closures
- Consideration of reopening some community hospital beds on a flexible basis to ease pressure on the system 
- A review of all intermediate (temporary bed-based) care provision across the county
- A standardised approach to Rapid Response across the county, including having GPs on the team
- A review of Hospiscare’s role in end of life care, with a view to providing more financial support

Sadly, the biggest pressure on the local healthcare system seems to be care of the dying. This outcome was predicted by some GPs before the community hospital beds were closed.

Hospiscare’s Assistant Director of Care, Ann Rhys, told councillors that since the community hospital beds had closed Hospiscare had seen a significant increase in pressure on the service and a resultant large increase of patients dying in their 12 bedded inpatient unit in Exeter.

In the last three months (reported over this summer) 40 patients have been unable to access Rapid Response. Worryingly, staff can make phone contact three to four times a day to the Rapid Response service because there is NOT support available.  This is very time consuming and has a significant impact on community teams.

Councillors were very concerned to hear that one East Devon Hospiscare nurse had reported that in just one month during the summer there were eight instances where no care was available. GP feedback revealed that the service has led to a lack of confidence of some GPs who say they spend a long time trying to find carers to support a patient at home, only to find there is no support available. The result is then an admission to the local acute hospital instead. Something the service was set up to avoid.

The NEW Devon Clinical Commissioning Group did not provide hospital readmission rates to the scrutiny review, despite being asked several times to do so.

A survey to GPs prompted responses mostly from East Devon. Some of the comments are below:

- “Sometimes it can take some time to get a call back informing you that they cannot get the care requested, meaning the patient needs to be admitted much later in the day.”

- “Since the closure of community beds and supposed reallocation of funds the service seems rather worse than better.

- “I take the view when with a patient that I won’t be able to access Rapid Response but if I can it’s a bonus.”

- “Sadly SPOA (Rapid Response) sounds great, but in reality, it’s a time-consuming referral with low probability of delivering the service you want.”

- “I have had three recent episodes where I have called SPOA (Rapid Response) in recent months and they have been unable to put in appropriate care. Patients have been sent to the RD&E for admission. It is a frustrating process – often not staffed well enough so details at the point of contact cannot be taken.  Most cases seem to involve two to four calls back to speak to the right person. GPs under pressure are tied up for too long by the service. So long in fact it has made me not want to use the service. It would be easier to admit patients than it is to call SPOA and arrange care – or try to arrange the care…. “

- “Our allocated care agency handed back their contract and we have been left with very little support for care… when we need Rapid Response to support patients and prevent admission we cannot link into subsequent long-term care packages. I had one chap with a neurological condition who had Rapid Response for over a year!”

I am really really glad this piece of work was carried out and I am proud to be the spotlight review’s chair. For years we have been told by senior managers that the system is working well, with just a few minor problems. This report and the conversations we have had with people who work at the coalface clearly shows a different picture. A worrying picture that needs fully examining.

I trust that councillors who sit on Devon County Council’s Health and Adult Care Scrutiny Committee will fully support the recommendations.

Here’s the link to the report, which will be debated and voted on Thursday (22 November) https://democracy.devon.gov.uk/documents/s22439/RR%20Report%20final.pdf 

Pic:  Ottery St Mary Hospital

No more community hospital bed closures, recommends Devon Health Scrutiny report - Claire Wright

Dr Slot had raised his concerns earlier in the year:
Futures Forum: "The loss of community hospital beds was intended to be offset by increasing the capacity of community care... Unfortunately there is not sufficient capacity in the home care services to do this job."
Futures Forum: "Put more money into care services to help overflowing hospitals"

The report was rejected on Thursday:
Halt on more community hospital bed closures proposal defeated by Conservatives - Claire Wright
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Ensuring a sustainable future for social care > disrupt the market, and deliver greater supply, sustainability and fairness

We need to be thinking about how to deliver social care:
Futures Forum: Hospital beds and social care: "The NHS will not be able to care properly for the growing population of frail older people unless the availability of social care increases in line with rising need."

For example:
Futures Forum: Social care for north east Dartmoor > "How the decision to get rid of beds at a cottage hospital in Devon inspired the launch of NEDCare, a social enterprise for people in later life."

There are very different perspectives on this:
Futures Forum: The poor state of our health and care system >>> who do we blame?
Futures Forum: "Take responsibility for your own health": naivety or convenient excuse?

The Adam Smith Institute has a few ideas:
Futures Forum: Innovation vs. The Nanny State: "How markets are solving the problems government can't" >>>

Including some from a paper which came out earlier this summer:

STABLE FOOTING 

Ensuring a sustainable future for social care

Eamonn Butler and Paul Saper argue that a long-term solution for social care requires older but wealthier people contributing more to their own generation's care costs.

Executive Summary:

The Problems:

Although the existence of the future funding crisis in adult social care is widely acknowledged, its scale is greatly underestimated. Factors in supply and trends in demand both fuel this crisis.

On the demand side, the demographic trends are understood. But care budgets cover not only the needs of the elderly; they also the needs of younger people with physical and intellectual disabilities, whose numbers are increasing.

More women participate in the economy, making it harder for them to care for relatives. Many family carers are themselves elderly and limited in what they can do. And families are more dispersed, with fewer people living near their elderly relatives. Meanwhile, inefficiencies and perverse incentives force more people with social care needs onto the NHS, leading to unsustainable budget pressures.

On the supply side, it is difficult to induce people to save for something that only one in four of them will need. And insurers are unwilling to step in because of the ‘long-tail’ risk that some individuals may need many years of expensive care.

The system is a lottery and widely perceived as unfair. The old mechanism by which self-pay residents subsidised public provision is, increasingly, no longer working.

Care at home often flouts employment and wage legislation, and many of those hired as live-in carers have low skills and few qualifications, risking poor quality care. A crackdown on this seems inevitable, meaning that other care options will have to be provided.

The Solutions:

Nearly all care homes with local authority-funded residents are at least 20-25 years old and no longer up to standard. We need a new mechanism to encourage pension funds, insurers and other long-term investors to invest in this segment of the market. If this were combined with efficient management delivered by independent for-profit or non-profit providers, chosen by the investing institutions and the local authorities, the latter would have access to lower-cost and better-quality provision than is currently available and allow them to phase out obsolete stock.

We recommend that government creates the conditions for a long-term care insurance market by the state agreeing to pick up the long-tail costs of those who insure themselves after, say, six years. This would make insurance products viable and affordable so that individuals would be able to pool their risks and insure themselves, just as they do in other areas of life. Moreover, bringing in the insurance sector would bring more order into the market, as the insurers would be responsible for meeting the costs.

At present, care at home is contracted on the basis of hours or number of inputs, with the focus on price rather than outcomes, and with no encouragement to integrate health and social care. This cannot continue in its present state and local authorities should look in future to contract with the new providers (who are waiting to come to the UK) who have developed technology platforms and more sophisticated caregiver recruitment, along with training plans that are the stuff of transformational change. Developing insurance products for long term care will also be a catalyst for network building and increased use of technology in this sector. We foresee that commissioners, who currently know what they are getting elsewhere in terms of quality standards, will want the same level of knowledge for the home care sector.

Older people enjoy a number of benefits, from free TV licences and Winter Fuel Payments, to lower rates of National Insurance before they reach pensionable age. These, and the pensions Triple Lock, should be reviewed, and the Personal Income Tax Allowance adjusted, so that older but wealthier people make more of a contribution to their generation’s care costs.

A more rational and affordable care system will involve disrupting the market, but deliver greater supply, sustainability and fairness. Tinkering with the present system will not solve the looming crisis. What we need are new partnerships in a new market.

READ THE FULL PAPER 

Stable Footing: Ensuring a sustainable future for social care — Adam Smith InstituteStable+Footing.pdf
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Social care for north east Dartmoor > "How the decision to get rid of beds at a cottage hospital in Devon inspired the launch of NEDCare, a social enterprise for people in later life."

North East Dartmoor Care "is a new social enterprise set up to provide a range of support and personal care to people in the North East Dartmoor area."
NEDCare – Social care for north east dartmoor

Here's a video about NEDcare made by the Design Council. "The project's aim is to inspire and support other communities to help build social care where they live":

How the decision to get rid of beds at a cottage hospital in Devon inspired the launch of NEDCare, a social enterprise for people in later life.


Watch: Transform Ageing – Discover the impact of NEDcare

Transform Ageing is a design-led initiative that aims to change the experience of ageing for people in the south-west of England. 

We challenged social ventures to find solutions and create lasting change through the initiative, breaking down barriers and supporting ageing societies.

NEDCare is delivering a lasting solution for ageing communities and providing a better solution for people in later life. NEDCare supports communities to build the capacity for care locally. It aims to help other communities create the same level of engagement locally by meeting GP services, pharmacies, parish council and community groups like the Women’s Institute.

Transform Ageing is a pioneering programme taking a community and design led approach to improve people’s experience of ageing. It brings together people in later life, their friends, family and carers, social entrepreneurs and public sector leaders to define, develop and deliver new solutions that better support the needs and aspirations of our ageing communities.

Transform Ageing is brought to you by:

Watch: Transform Ageing – Discover the impact of NEDcare | Design Council
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Proposals for sheltered housing for the elderly in Sidford > third planning application submitted

An application for a retirement housing complex in Sidford has been rejected - twice, the last one being in May this year:
Futures Forum: Proposals for sheltered housing for the elderly in Sidford > refused as it still did not include ‘an adequate amount of affordable housing’ or a ‘provision of an overage clause’.

The District Council has pushed each time for affordable housing at Sidford - although it has not pushed the same criteria at Knowle:
Futures Forum: A tale of two developments > affordable housing in Sidford ... but not at Knowle
Futures Forum: Knowle relocation project >>> and comparisons with other proposals for sheltered housing for the elderly in Sidford >>> A planning officer recommended the application be refused as it still did not include ‘an adequate amount of affordable housing’ or a ‘provision of an overage clause’.

Meanwhile, builders of retirement housing complexes have been having a few problems:
Futures Forum: Knowle relocation project: and retirement home developers in trouble

And they have been trying to extricate themselves from these problems:
Futures Forum: Sidford: and developers lobbying to exempt retirement complexes from affordable housing obligations

And so we have the third planning application:
Renewed bid to develop Sidford’s Green Close site submitted | Latest Sidmouth and Ottery News - Sidmouth Herald

The Express & Echo reports this weekend:

Third bid submitted to turn former care home into retirement apartments

Two previous plans for the former Green Close care home in Sidford have been rejected

Daniel Clark

Local Democracy Reporter
18:22, 19 OCT 2018

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FORMER GREEN CLOSE CARE HOME

A third bid to demolish a former care home and replace it with retirement apartments has been revealed.

A planning inspector in 2017 rejected Churchill Retirement Living’s plans to revamp the closed 23-bed former Green Close care home in Drakes Avenue in Sidford, while a revised scheme was rejected by East Devon District Council planners in May as its affordable housing offer was not policy compliant.

Now, a new application, that would see the care home demolished and replaced with 40 retirement apartments for older persons including communal facilities, access, car parking and landscaping, has been submitted to planners.



Former Green Close care home in Drakes Avenue, Sidford (Image: Daniel Clark)

Documents submitted with the application say: “The proposed development is an excellent opportunity to provide the redevelopment of an underutilised site within Sidford and would make better use of a previously developed site in a sustainable location.

“It would provide much needed housing for older people in an attractive and safe environment and provide accommodation within the area, further adding to the vitality and vibrancy of the area. The proposal would contribute to the council meeting their housing policy objectives in respect of delivery private retirement housing.”



Former Green Close care home in Drakes Avenue, Sidford (Image: Daniel Clark)

The previous scheme was rejected as its affordable housing offer was not policy compliant, but the documents says: “Current policy acknowledges that an off-site contribution, provided as a commuted sum, is an acceptable method of achieving an affordable housing contribution and the affordable housing need is better met through this sum that can be directed to priority needs identified elsewhere in the district.

“The commuted sum should be directly related to the development and reasonably related in scale and kind to the development, and the council’s proposed method for calculating it meets neither of these criteria. The sum that meets the National Planning Policy Framework is based on the developer subsidy that would have applied had the affordable housing been achieved on site. This amounts to £346,663 and is the maximum amount that the council should request.”

The previously rejected plans included an off-site contribution of £423,576, but no provision for on-site affordable housing.



Former Green Close care home in Drakes Avenue, Sidford (Image: Daniel Clark)

READ MORE
Bid to demolish former council care home and build retirement flats refused

The Green Close care home was built in 1971 but closed in 2014 after Devon County Council cutbacks.

East Devon District Council planners will determine the fate of the application at a later date.

Third bid submitted to turn former care home into retirement apartments - Devon Live
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Rural communities ‘could die out by 2050’ unless health and care system improves

The South West has a problem:
Futures Forum: The ten local authorities with the highest percentage of the population over 65 are on the coast, with five being in the South West region. Within 20 years it is estimated that 40 per cent of the population of west England will be over 65.

The Rural Services Network quotes councillors in the region warning of the demographic trends:

17.09.2018

RURAL COMMUNITIES IN DANGER

VULNERABILITYCOMMUNITYOLDER PEOPLEFUTURE OF RURAL AREAS

Experts have warned that rural communities are ‘in danger of dying out’ unless they are given more help to cope with ageing populations, according to an article by iNews.

Trudi Grant, director of public health at Somerset County Council - an area with a median age of 53 compared with the UK average of 39 – highlighted the danger of ‘very unsustainable communities’ in which the population is dominated by those not of working age. 

Anne Marie Morris, MP for Newton Abbot and chair of the All-Party Parliamentary Group on Rural Health and Social Care, was quoted saying that a ‘one size fits all system’ for healthcare is better suited to urban communities. 

She said that in rural areas more specialist doctors and fewer general consultants are needed. She added that many nurses and medics ‘will have spent their training in urban areas so we need more training and experience taking place in rural areas,’.

Rural communities in danger - Rural Services Network

With the full piece from the i newspaper here:
Rural communities 'could die out by 2050', public health experts warn - i newspaper
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