York's commitment to create a city that is 'dementia-friendly'

York city council is planning for the future of elderly care to meet the demands of an ageing and increasingly frail population.

York has a large and growing older population: by 2020, the number of residents over 85 will increase by 60%. This means that those who enter residential care will be older, frailer and more likely to experience dementia.As part of our ambition to create a fair and equal city for all our residents, we are working to make York a "dementia-friendly" city. We aim to meet the changing needs of an ageing population, enabling elderly residents to live in their own homes and communities for longer.I took over health housing and adult social services after the May 2011 elections in York. Over the past four years, the major challenge facing the council has been managing an increasing service requirement in the face of a 28% reduction in government funding.Like many councils that continue to run elderly people's homes, our buildings were built in the 1960s, when expectations were different. We had nine excellently-run homes, but the buildings and many of the residents' individual rooms were not the right size and layout for the more frail or those suffering from dementia.The challenge was the provision of dementia beds. At the time, we had only 57 dementia beds and 33 ensuite rooms out of 276 rooms in total. Our homes were built when people with dementia were sent to large institutions – my grandmother ended her life at Exminster Hospital in Devon, in the early 1980s, with residents lived 30 to a room and shared clothes. While our homes were already a definite improvement on this, more changes had to be made. Since July 2011, we have gathered information and ideas so we can better understand the city's future needs. The consultations included seeking opinions on the following options to meet those needs:

  • Retain the current operating model and provision.
  • Extend and refurbish the existing homes.
  • Increase the proportion of beds purchased from the private sector.
  • Fund the design, build and operation of care homes on three sites, including a community village.
  • Fund the design and build care homes on three sites but enter a partnership with a commercial developer to fund and build new homes.

The fourth option, funding the design was the preferred option. However – as with all projects – challenges arose. In late 2012, when architect's plans were drawn up, the council was informed that one of the three sites we had identified was no longer suitable due to conservation issues . This resulted in a smaller area of developable land, and the change meant we had to reflect on need, finances and provisions.

We have drawn on many examples of innovative care and best practicein the UK and Europe, as well as significant work by officers to explore future demand for specialist residential care and the developing supply of local residential and nursing care provided by the independent sector.

Last month, the council announced its plan for the future of elderly care in York. I am proud that we will still be building a care home and a community village for older people. Evidence tells us a third home isn't required and, in any case, funding won't allow it.

However, the community village has been expanded and will provide at least 72 homes, a quarter of which will be affordable housing, providing residents with care support from independent living through to end-of-life care. The new care homes will be designed for those who are frail, elderly or have dementia. It will be based on the household model providing a "home within a home". Residents will live in self-contained households of six to 12 people with similar needs, and have a kitchen, living areas and enclosed garden.

These homes will be a key part of York's efforts to future-proof the city in line with the changing needs of our residents and the marketplace.

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