What is influencing the design of retirement housing and care homes?

Dominic Morris: Hello I am Dominic Morris, head of the Senior Living team at Gowling WLG. Today in our Senior Living podcast series, I am joined by Jenny Buterchi from the Later Living team at PRP Architects. Jenny is a leading expert in the field of retirement housing and care home design and today we are going to be looking at the architect's perspective on some of the key trends and issues affecting the senior living sector. So, hi Jenny.

Jenny Buterchi: Hi Dominic

Dominic: To begin, do you want to tell us a little bit about yourself and your practice?

Jenny: Yes, thank you. Thank you for inviting me along today. I am an architect by trade and I am a partner at PRP, which is quite a large residential architectural practice. The team that I sit within is the later living team, with probably about 30 plus designers who work exclusively on older people's housing and care homes. We have had a team at PRP for over 20 years and we have delivered over 11,000 units in that time, which is fantastic. And we have designed everything from the bespoke care home right up to the larger retirement villages and lots of different types of intergenerational housing in between.

We have been lucky, or delighted I should say, to have won 10 Happy Awards since they had first come in over ten years ago and we have been shortlisted for a few more, including some this year. But I would say the one thing about our team is that not only are we passionate about what we do, but we look beyond the architecture continuously - we are looking always at policy, legislation, what affects our sector because that could be anything from planning legislation to building regulations and welfare reform. And we are obviously looking at ways of challenging how legislation does affect what we do on a day-to-day basis. We get involved in a lot of design [unclear 00:02:07] as well but ultimately we are always looking at any emerging trends and trying to keep ahead of what is happening in the sector, but as architects really for us it is about creating beautiful places where people can thrive in the later years of life.

Dominic: That is great. So I guess one of the key trends emerging in senior living is the growth of the urban settings, the growth of the urban models, a mixed-use scheme, a sort of increasingly complex scheme where senior living knits in as part of a wider mixed-use opportunity. Can you talk to us a little bit about what some of the key architectural trends you are seeing around that and the high street piece, the 15-minute neighbourhood, all these sort of concepts?

Jenny: Yes, we again go back to happy reports and some ten years ago, one of the big things that had come out of that was about considering location and making sure that older people were close to amenities and facilities. And it takes a little bit of time for that to filter through, but I guess before the pandemic a year ago we saw very much the high streets really struggling. That is something that is not going to look better unless there is serious change to how they approach. First, we are seeing a lot of clients now thinking that this is a fantastic opportunity for older people, so, if you think, a 15 minute neighbourhood for you and I is probably 25 minutes for the same walk for somebody who is in their later years. So it is even more important that they are actually at the heart of communities and that it is the communities they have lived in all their lives as they do not want to move somewhere else.

I think the exciting thing for us as designers is that looking at the town centres, about creating this sense of a destination in those places. It is not about shopping anymore, it is about experiences. We talk about sticky streets, which is when you create that public square that people want to visit and there are lots of different activities happening - it is leisure, it is eating out in restaurants, it is going to bars, it is doing a bit of shopping. We have got a number of skills in planning at the minute that are looking at exactly that model and I think it is really exciting, if you want to bring vibrancy back to the high streets, you need people to live there and if there are older people living there then they are less likely to be coming out to work every day so that means you have got constant foot fall, you have got immediate vibrancy to those spaces.

I think as a designer there are challenges. You have got to make sure that we respect thresholds between different usages, so being very clear about what is public, what is semi-public and what is private. The residents obviously want to have their privacy and there are also things around open space and having public squares where everyone, all generations, mix, which is absolutely what we must have. Equally for the older residents, they also need some outdoor space that is shared within their community or some individual open space such as balconies and roof terraces alike. With mixed-use there are practicalities that we have to look at too, there are so many things that happen back of house such as deliveries, getting refuse out, which impedes on people's day to day lives and also getting parking so that people can easily get to their apartments. Again, separating the residential parking from the public parking is also quite key so there are lots of challenges in it. This is actually a really exciting model and we are really looking forward to some of these getting built because I think it will start to set a new model for the high streets, which has to happen I think, so it is very exciting.

Dominic: That is great. I think particularly for retirement communities one of the key selling points is ability to invite the community in to use restaurants and health and wellbeing facilities. Are you seeing an increasing trend of that?

Jenny: Yes, and traditionally those are the parts of the retirement living schemes that can be difficult to make stack up financially. So if you can place them as any other restaurant for sure on the high street and show that the public are using them as well as the residents, that just automatically increases the viability of them. But they have to be designed from the outset to be that forward front facing facility that has to look like a destination that anybody in the community would want to go to and not feel like it belongs to the residents. So there is a bit in the design that has to be carefully thought through to make sure that you do get that feeling of somewhere that is attractive so that all parts of the community want to go to, but it is a very interesting model and I think it is one that we are going to see increasingly coming into our portfolio in the next few years.

Dominic: Yes there certainly seems to be some excellent examples emerging. And then turning to another growth trend, rental for later living - from a design perspective, what are the particular challenges that you have to grapple with?

Jenny: There are a few different forms of rental and you have got a lot of our private providers now looking at having a flexibility behind it. So you could either go and purchase your dwelling or you could actually rent it. I think that is probably a response to what has been happening at the community in the last year as well because there is people that have homes, very isolated in the communities suddenly thinking oh actually this is not where I want to be in my later years, I want that sense of community. So they quite often want to make that move quite quickly so to sell a house and buy another house is a bit of a difficult thing for them to do. So you need to just rent it and see if it suits them before they make the move, which is actually quite a good thing.

There are also other providers in the markets such as Birch Grove that are looking at just private rental, but when it comes to design often I think we looked at PRS when it first appeared as a form of housing and we could not help but feel it looked very much like a lot of the retirement communities we were designing. It is about the lifestyle, the facilities that are available to residents and the design of those and I think when we are looking particularly at rental you need to create that sense of community a little bit faster and there may be people staying in the villages for longer. You need an immediate sense of vibrancy when people walk in to look at the development for the first time, for them to walk in and think yes this is where I want to be. So those spaces do not have to be vast spaces but they need to be small, busy and attractively designed and feel like something that someone can slot into very easily.

I think the apartments are slightly different because we need to make sure that there is a robustness to the finishes that are going in to the rental sector. I do not really like the term, but there is a greater rate of turnover and when you have more people moving in than you would for a sale model you need to make sure that the apartments are sufficiently robust that whenever one tenant moves out and another moves in that the agency can get in and they change anything that needs changing quickly, because obviously the longer that it is going through a refurb then that is more downtime that you are not renting your apartment out for. So there is a bit a work to do around that and with regards to design specification, but I think it is something that the private rental sector are doing very well and something we have been learning from.

Dominic: It is very interesting you say that there is not that great a gulf between the mainstream BTR product and what the housing with care market is delivering in terms of the product you see, even with the for sale model.

Jenny: When we looked at some of the developments that we have worked on, when they first were on the drawing board we just thought oh that looks like extra care on steroids, because it was so much bigger than anything we had ever done. But the facilities were really similar, and the only thing that was missing was a care team onsite. So yes I think there is a lot to be learnt between the two sites.

Dominic: Very good. So that is more an urban focus, although there is obviously rental out of town as well. Turning to the more rural locations and the traditional retirement village setting, what are some of the design challenges for you and what are the distinctions in terms of the products that clients are looking to deliver in those settings?

Jenny: We have got suburban ones that are on the edge of towns and then you have got the really rural ones, and the really rural ones are difficult to get through planning these days. Believe me they both appeal to a certain market - obviously if you have lived in the rural or suburban setting all your life you are unlikely to want to move into a high street, somewhere in London really. So it goes back to there is no one size fits all, there has to be a choice there and definitely the edge of town developments need to standalone a bit more and need to be sustainable for that community itself. Having said that, a lot of the more suburban ones still very much look at opening their doors to the wider community and so again it is about considering the clubhouse facilities and how that really, it is existing communities that are there and actually really embedding in that community potentially.

I think the other thing that those sites have is they give us this great opportunity to be closer to nature and to have the landscaping be something that is that much more luscious than maybe an urban setting can offer. It gives people that potential to be closer to nature and we know again in the last year how important people's outdoor space has been, and in the slightly less dense settings you can really create some amazing landscape settings. We have one village that has been finished a few years now, and the allotments in it are absolutely to die for, and there are fantastic views. Allotments with plants like I have never seen in my life, little summer houses people have built, where they have their gin and tonics in the evening and they have got quite a little community within that retirement village. So I think it involves lots of things like woodland walks through it - if you go to that particular village first thing in a morning, everybody is out walking their dogs.

So I think there is a lot to benefit from those slightly more out of town settings, but the quality of development needs to make it sustainable.

Dominic: So it is pretty clear from what you have been saying, there is a huge diversity of product that is on the market and we have not even touched on care homes. But I guess in delivering any of this you have to overcome the very many challenges of our planning system. I wondered if you could share a few thoughts about how you engage and what your contribution is in helping client's navigate those, let us say, choppy waters.

Jenny: I guess we see, because we work with lots of different clients on lots of different tenures and lots of different products, on lots of different sites, we see quite a variety of approaches. I would say to any client to do your homework first, to look at the planning authority were you are thinking of building, as some are much more open to these types of buildings or communities than others. But the national Planning Policy Framework has made it very clear that local authorities should be considering what is the offer for older people in their communities. It does not always happen, and where it does not happen, we should really be challenging that. We have some local authorities we have gone to who say they do not need any housing or care homes for older people, that they have got enough, and yet their demographics are like spiking in this direction and they do not have enough relevant housing that is coming forward.

By engaging with planners at the earliest possible time you will ease the way through planning. We have got one client who looks at all the site stages, considers how they can get sites into it to actually put in straight to the local authorities minds that they should be thinking about what is for older people. Recently we have had the National Design Guide come out and there is a lot of mention in that of older people, which is really welcomed. Planning performance agreements are something a lot of clients are doing now and that is a really good way of bringing the planning authorities along that journey with you so there are no big surprises when the project goes into planning.

One of the things that I have really enjoyed in the last year has been looking at community consultation in a very different way. We went through a phase some years ago where we had community consultation before a project goes into planning and there was a one day event in the church hall and somebody is angry and they turn up and they do a bit of shouting at everybody and then everybody else gets a bit riled up. The clients tick the box, says we have done our community consultation but actually has it really worked, has the local community had their say, have those people who are not so vocal been able to ask the questions they want to ask - and the answer is really no.

In the last year we have had a project that we have worked on that has redesigned a town centre and the consultation of it has been a really empowering journey that we have been on with the client and with the local community. The client employed a PR consultant that had biweekly and fortnightly meetings with the local community and we have presented the design process the whole way through that. So if it has been early sketching, we are sharing early sketches. The local community has been able to send in questions in advance, they can also ask questions in the chat and then as the design developed before it went into planning, we have actually been able to share our 3D models with them and walk around the models so they get a better sense of where we are with the design and the sense of the place that we are trying to create. And actually they can also see that there are bits of that model that have not been finished yet because there are walls that do not link or something and they see that we are not sure and we are actually short on something that is in progress.

So that has been a really positive one and I really hope client's take the lessons learnt from those consultation events and progress with those. That site has gone into planning and it has had minimal objections to it considering the size of the development. So it has to be a positive way forward and I really hope that is one of those things that we definitely change the way we work into the future.

Dominic: Excellent, that does sound very positive. If we could look at wider COVID-19 learnings - I know your firm has done quite a lot of work around this, you have issued certain papers, your "Safe, Happy and Together" paper on safer design I guess in response to COVID-19 and similar diseases. If you would like to share some of your thoughts around that.

Jenny: We have produced two papers now, the second one has just been launched, both of them called "Safe, Happy and Together". Both looking at slightly different things, one is very much looking at the later living sector and one is looking at the care home sector because they are quite different in the way they need to control infections at the different models. What we did in advance to produce those papers is we actually went back and spoke to our clients, we tried to find out how buildings have worked during COVID-19 from the early stages and how they have managed to keep people safe within the buildings and controlling infection. But what has become apparent is that it is not just about controlling the infection, it is about people's mental wellbeing, it is about their physical wellbeing and we wanted to understand how well the buildings have actually performed in supporting the staff.

I think overall the feedback we have got has been very positive, and that staff, particularly in later living, have said that if a lot of our residents had been living outside of the community, they would have had nobody looking in on them, they would have had nobody making sure that they have had a meal each day. But we have looked at the design aspects of it, and I think that wellbeing is one of the key things that has come out. Outdoor space has been huge in that and we always look at how our gardens are designed, how they relate to the building, making sure everybody has got a bit of outdoor space that is theirs and they can be safely outside, in some instances being able to talk to a relative in the garden and keep that distance.

The other thing I suppose is the importance of home in the last year for us all has become more and more something that we are all focusing our minds on, looking at what works well in our house and what does not. Our dwellings always need to be designed to be spacious, to have good daylight in them. Ventilation has been one point that has been huge on the agenda, somewhere looking more at potential for putting access in so you get dual aspect dwellings so it increases and maximises the potential for ventilation in those. We have looked at the daylight and views out you would never be in a care home for, but you are not so able to get out so having that visual connection at least to outside is really important. Then also looking down to the nuances around how common spaces have been designed, making sure that deliveries can come over safely and not through necessarily the same entrance as the member of the public is coming through or a member of staff is coming through.

Thinking about things like where your staff accommodation is located so ideally a member of staff can come in from the outside, shower, get changed into their work uniform and then go into the building and then vice versa on the way home so you are not carrying infections into the building. And I think a lot of those are things that we will see embedding more so into our designs as time goes on and I am sure there will be more thinking around it. But I have to say for me, ventilation and garden space have been the two big key things that we have always promoted but now they are more important than ever and I do not think we will get anybody that would say that they are not important anymore, I think we all appreciate just how essential it is to us, particularly this market.

Dominic: Both of which seem like quite easy wins you would hope.

Jenny: They do, but you would be surprised at how often that they are challenged.

Dominic: I think for our listeners I definitely recommend you going onto the PRP website and having a look at those "Safe, Happy and Together" papers, they are thought provoking and very interesting. If we could then turn Jenny to look at the use of technology in property. This is growing exponentially and beyond the bricks and mortar it is all about how your space operates and performs and how you can monitor it. But from your perspective, it is right from the get go that new technologies and digital twins, use of BIM are at play, and particularly in later living space be it care homes or housing with care, benefits that can be driven from the clever and appropriate use of technology I think are going to be vast. Could you characterise it a bit from your perspective as to (a) how you are adapting to the uses of these technologies and (b) some examples of how they are being used in some of the schemes.

Jenny: That's true. I guess it is three‑fold to this… the first bit is really designing, using technology and yes we use technology across all our projects. We implemented it in Prague some ten years ago and it is in everything we do from the outset of designs right through to construction. It is an amazing way to design and we are working on much more complex buildings I would say these days compared to 10/15years ago. So it gives us the ability to build everything in 3D, to look at everything in 3D from the constitutional events I was talking about right through to the construction. And when we are doing the technical design you can see very quickly working with other consultants where all the clashes might happen and you design right before it gets to site. That is incredibly beneficial.

We build these models and they are quite intense, they are quite heavy going bits of software that we need for them. And they can actually look at things like modern construction and how you actually design, you can show how they all fit together and like. It is a different way to design. I think architects have always thought that way in their heads but actually being able to draw that way completely using the technology is amazing.

The next bit is how your buildings are then managed and some clients are getting to grips with that now, you know taking those build models and continuing with them. I think with the onus on building owners now to keep digital records, we are going to see that increasing dramatically over the next few years. And we do have a lot of clients, a lot of bigger landlords who already have a system that they run their facilities management on and it is a big shift to go into these 3D models, but fire safety records are the one thing that is driving it for a lot of them.

So we are getting a lot of clients that are actually looking at creating digital records for existing buildings and the fire safety behind those, how that information is relayed to their staff, to their residents through these models is actually is beneficial. So I am hopeful that the facilities management teams will start to pick it up and let them start to run with it because I think it is sophisticated. I think in the long run if they can wrap their heads around it, it will help.

I would say the third thing is the resident's perspective. We knew that our buildings are becoming more complex and more so with all these sustainability measures that were brought into it.

I think for our residents we are expecting them to make quite a big leap because sometimes the different systems that have been put into the buildings, if they move in they do not necessarily get quite the level of information that they need to be able to understand how lots of systems work. I think we go back and put sensors in, they have gone back and put sensors in to peoples apartments and done interviews with them about how to use their apartment and then when we have checked the sensors after a year of the building you can actually see quite clearly what has been working well and what has not been working well, and then we needed to re-educate people about why. The classic is a lady who said I have always opened my windows even in the winter time and we are going yes but that is why your bills are a bit high because you get electric under floor heating that is trying to heat up the space. I think the heating system is actually already ventilating your space, so as soon as you open your window those two things are going a bit out of kilter and there are trying to overcompensate from the fact there is an open window.

So I think the systems themselves need to push forward a little bit so some of them are a bit more intuitive to use, but there is an education for the residents as well. I would say one thing about technology in this sector, again in the last year has been amazing. We are seeing hotel style systems and tablets coming in to a lot of the buildings now instead of the old ward and call system where everybody was pulling cords, and because of what has happened in the last year our residents are getting to grips with them a lot better than they have ever done. But equally a lot of the health professionals also are getting to grips with them a lot better and they are using them and encouraging the residents to use them.

We have heard some lovely stories from some clients saying things like they have had a number of villagers for example, who have never met, and they're now taking part in virtual choirs across the villages and virtual crafting sessions, they are creating a social life online that these residents would never had experienced before so I think that is just absolutely amazing. A lot of our clients are saying they are going to keep that going definitely as time goes on so I think that is great news.

Dominic: One of the positives from the last 12 months definitely. On the wider issue of sustainability and ESG, what are you seeing from your clients? For me the senior living sector, particularly retirement housing, housing with care is absolutely ripe for delivering zero net carbon and meeting these sustainability targets.

Jenny: Yes definitely. Unlike housebuilders for example our clients are not in it to build a house and sell it. They are in it to build, operate and manage - they are there for the long term so they are always looking at it in the long term and we are probably seeing more buildings in our team than others across the practice looking at the net zero carbon targets. We have gotten quite a few of them in planning already and some of them looking at the lifetime of the building, some are looking at in-operation, so we are seeing a variety in the approach but it is definitely in there that the buildings are looking at net carbon zero in some form, which is great.

But design wise we have to start to looking at everything from a passive perspective to start with, from the edge of design and then looking at a lot of the systems, the technologies that are coming in and how you can actually make them part of the building and the building fabric. You are looking either at the body carbon which is quite interesting, so recycling materials of something that has been demolished where you can, it is not that easy but you can. But actually looking at the specification of materials to look at the body of carbon and manufacturers are completely getting this, and they are expecting us now to ask the question which is great because we are asking the questions, we have to make sure that we specify that the carbon used in production is kept to a minimum and that actually that the item can be recycled afterwards.

Then clients are also looking at what do they do to offset what carbon is used and that is really interesting because you start looking at offsetting measures you can do. That can be anything from planting forests to actually cutting money from one department and investing it in an existing community to try and prove its carbon footprint, and also looking at how they use transport, so making sure they have got electric vehicles as taxis in the scheme. There are a lot of things that need to go into to getting that net carbon zero target but again I would say education of ongoing existence is huge and all those things need to be really there. A few different technologies are needed to manage these things, to educate the staff that are running the building so they understand how they work, educating their residents so they understand how they work. And the residents will actually want to know these things before they buy, so actually saying not only have we achieved this but when you move in you we will expect you to do this, this and this, it is a good part of the journey as it empowers them to understand what sustainability means - it is exciting.

Dominic: It is very exciting. Also an awful lot for everyone to do isn't there.

Jenny: ….complicated but necessary.

Dominic: So if we can wrap it up I think with a bit of future gazing on your behalf. Say in ten years' time, what will a typical retirement village and a typical care home scheme look like? Not that there is any typical but have a go.

Jenny: I hope in ten years' time there will not be a typical one. I think we will see an increase in supply definitely, because in the last year our clients are already telling us that despite what might be in the press, quite often they are actually getting more and more enquiries to move into both care homes and to later living schemes. I think with care homes we will probably see quite a few close, some of the older ones. If you think of a care home that maybe has bedrooms without en-suites, that is really difficult to actually be able to control any sort of infection and it is actually what people just do not want anymore.

So I think we may see older care homes close and you may then see not an increase in the number of care homes, but that the new ones coming in will at least compensate for those that end up closing. I think in later living we will see an increase in the number of units coming forward, but for me I think there is a lot coming through the legislation and seeing an open letter to the Prime Minister this week really calling out for a setting up for taskforce to look at this sector. It would be amazing if that happens because there are lots of bits of legislation I think that need to really be amended or brought in to the sector. I think the one thing I would really like to see as I head that way myself in about 15 years' time is that divergence of models because there is no one size fits all, so what you want in your retirement will be very different to I want in my retirement and at the minute there just is not enough choice. So I hope to see more choice in ten years' time.

Dominic: Excellent so to conclude more products, more choice, more technology, more sustainability.

Jenny: And better legislation.

Dominic: Better legislation, which is probably where I come in. That is great. Thank you very much Jenny that is really interesting.

Jenny: Thank you Dominic it has been great to talk to you today thank you.