Assisted living and extra-care housing

Assisted living (also known as extra-care housing) is a type of ‘housing with care’ which means you retain independence while you’re assisted with tasks such as washing, dressing, going to the toilet or taking medication.

What’s assisted living?

Assisted living (also known as extra-care housing) offers more support than sheltered housing but still allows you to live independently.

You live in a self-contained flat, with your own front door, but staff are usually available up to 24 hours per day to provide personal care and support services. These are tailored to you and can include help with washing, dressing, going to the toilet and taking medication. Domestic help, such as shopping and laundry, and meals may also be provided.

Common features of assisted living accommodation include:

  • help from a scheme manager (warden) or a team of support staff 
  • 24-hour emergency help through an alarm system.
  • social activities arranged for the community.
  • a minimum age for residents, usually 55 or 60.
  • self-contained flats allow you to stay independent.
  • communal lounges allowing you to socialise as and when you feel like it.
  • Some extra-care housing is available to buy or rent privately and some is available from the local council following a care needs
  • assessment, but it isn’t available in every area.

Unlike sheltered housing, assisted living housing is regulated by the Care Quality Commission (CQC). They inspect the facilities and provide ratings.

Read inspection reports and ratings on the CQC website

How much does assisted living cost?

The cost of assisted living varies depending on whether you rent or buy your accommodation, the scheme you choose, the level of care you need, and where you want to live. As the services offered by extra-care facilities vary so much by site and individual needs, it’s impossible to guess how much it will cost for any one individual, but the costs should be lower than for residential care.

There will be ongoing charges for the care and assistance provided, as well as a regular ‘service charge’ to cover the management and upkeep of the scheme. If you are renting a property there will be rent to pay, and if you have bought a property on a leasehold basis (housing for older people is mostly sold leasehold), there will be ground rent.

On top of this, you have to pay council tax, water rates and energy bills. Some charges for water and fuel may be part of your service charge if they are for communal areas. This includes water to a communal laundry or fuel bills for lighting and heating the corridors or a communal lounge.

It’s important to be clear about all the charges you will have to pay, including any one-off fees such as administration or exit fees, before you make a commitment. Check how and when any regular charges, such as the service charge or the charges for care and support, can be increased.

You may be able to get help with your rent and/or service charges through Housing Benefit (if you are renting) or Pension Credit (if you own your home). Help with council tax and the cost of care and support may be available through the local authority.

What should I consider before moving to assisted living housing?

There are a few things you should consider before moving to assisted living accommodation, not only to ensure it is the right option for you, but also to ensure the specific site is going to meet your requirements.

If you like many of the features of extra care housing, but don’t need a lot of care or help with day to day tasks, then you may be happy living in sheltered housing. This is a type of ‘housing with support’, where a lower level of assistance is provided than in extra care housing. 

If you are struggling to live independently and would find it difficult to do so even with more care and support in place, you may need to consider residential care.

Assisted living is midway between these two options. Talk to your GP or social worker about having a free care needs assessment to figure out which option would be best for you. Remember that you may be able to get care and support services in your current home, or have it adapted so that it better meets your needs.

Think about the people you would like to be close to. Is it easy for them to visit? Is the site within easy reach of public transport and amenities such as local shops? Even if the community has its own range of shops and entertainment, easy access to a local town or village would give you the option of going out for the day if you feel like it.

What are the ongoing charges and will they be affordable for you? In addition to rent or mortgage payments and bills, you usually have to pay a regular service charge. Charges for care and support may be included in this, or you may pay for these services separately. This can be a significant expense, but help may be available through benefits or the local council.

Many assisted living apartments are sold on a leasehold basis, which usually means paying ground rent to a freeholder, and there may be other charges such as an ‘exit fee’ if you need to sell the property.

Make sure you are clear about all costs, including any one-off fees, and how you will meet these before making a commitment. Make sure you understand how and when any regular charges, for example for care, support or other services, can be increased.

Will the property be big enough for you (and your partner if you are moving with someone)? Think about any furniture that you would want to take with you. If you can’t fit it into the property, do you have a friend or relative who could look after it? Could you afford to place the items into storage?

Also think about how your needs may change over time. Are the doorways wide enough for a walking frame or wheelchair? Is there an lift or only stairs?

How do I rent assisted living housing?

Renting is an option if you don’t want or can’t afford to buy. There are benefits to renting, for example, it may be easier to move if your needs change and your landlord is responsible for certain repairs to your home.

You may be considering renting for the first time to free up equity in your current home. If so, think carefully about whether this money is enough to meet your ongoing rental costs and other needs for a long period of time. Seek advice about the impact of releasing capital on your entitlement to benefits and/or local council-funded social care services.

Some local councils don’t allow you to join their assisted living waiting list if you own a property, although they may make an exception if your current home does not meet your needs. If not, you may still be able to find a place in an assisted living facility through a private landlord.

If you’re considering renting privately, make sure you understand the terms of your tenancy and how easily you can be evicted. Most private tenancies provide very little security of tenure, although landlords may offer tenancies on more secure terms.

How do I buy assisted living housing?

Unlike sheltered housing, assisted living housing is inspected by the Care Quality Commission (CQC), the same organisation who inspect care homes, who provide each facility with a quality rating. You can browse inspection reports and ratings on the CQC website to find good quality local developments, before contacting them to see if they have any properties on the market.

Your local council should be able to tell you if there are local assisted living facilities, or you can visit the Elderly Accommodation Counsel directory.

Services and charges vary from scheme to scheme. Make sure you understand exactly what services are provided, how much they cost, and how you are going to cover these costs before making a commitment. Ask for a full breakdown of charges, including optional services and any ‘one-off’ fees.

Most assisted living housing is sold on a leasehold basis. There may be restrictions in the lease on what happens if you want to sell the property or leave it to a relative in your will. Make sure you check these restrictions and other lease terms and conditions before you buy.

You may need to pay an ‘exit’ or ‘transfer’ fee if you sell the property or if there is a change of occupancy, for example, if a carer comes to live with you. Make sure you ask about any exit fees before you decide to buy.