Care and Place (CAPE): the links between housing characteristics and condition and older people’s care needs, care use and care costs

Nicola Brimblecombe In progress  


Most older people wish to live in their own homes as they age and to have choice over their housing and care situation. However, currently many older people’s own homes are not accessible (for example, people cannot move around them or use all the rooms easily or safely) or are in poor condition. This may affect whether, how soon and how quickly social care needs such as difficulties with mobility develop. Older people’s housing may also affect whether they can receive care at home, who they receive this care from, and how long they can live independently in the community.

This study is looking at non-specialist (mainstream) housing which is where most older people currently live. It is exploring the different characteristics of housing in combination, reflecting the ways in which people live in real life, including type of housing (e.g. flat or house), how many rooms and how many people live there, whether the home is rented or owned, and whether the home is in good condition.


This study is looking at how these housing characteristics are linked to people’s social care needs, use of care services, and care received from family and friends. It focuses on people aged 50 and older in England.

Five main questions are being explored:

  1. What are the links between housing characteristics and when and how quickly care needs develop?
  2. What is the link between housing characteristics and people’s use of adult social care services and care from family and friends?
  3. If some of these housing characteristics were to be changed, would this change the number of older people who have care needs and how much we need to spend on social care for them?
  4. How do older people experience the links between housing characteristics and how their social care needs are met? What choices are available and how are these choices made?
  5. How can improvements in adult social care and housing practice help older people to have more choice over their current and future housing and care situation?

This project is also in receipt of further funding with regards to the rapid internal call, as of 01 August 2023.
The main objective of this work is to understand the experiences of older persons with care needs from the Bangladeshi Sylheti community on: 1) the link between housing condition and characteristics and when and how care needs develop, as well as use of formal or informal care; and 2) choices and preferences with respect to housing including how decisions are made, barriers to this and what would help increase choice.


To answer these questions, the study is:

  • Holding Theory of Change workshops and carrying out interviews with stakeholders to develop the theory of change for the study, help set priorities, provide valuable early insights, identify sub-groups who may have different experiences, and foster early engagement with stakeholders;
  • Undertaking secondary analyses of longitudinal data to investigate onset, level, and trajectories of (a) care needs as measured by functional capabilities (as defined by ability to perform activities of daily living (ADLs) and/or instrumental activities of daily living (IADLs)); (b) care utilisation (formal/unpaid) over time, how trajectories of care needs and utilisation differ and their association with housing conditions; and (c) geographical and/or socio-economic inequalities in these patterns;
  • Build a ‘simulation model’ to estimate and project (i) the number of older people with care needs currently living in various specified housing conditions based on existing housing practice and policy (i.e. base case / no policy change scenario); and (ii) the number of older people with care needs if a range of social care and housing practice changes aimed at improving housing for older people (practice change scenarios) were implemented;
  • Carrying out in-depth qualitative interviews with older people with care needs and unpaid carers about their experiences.

Further ‘rapid fire’ funding will allow further proposed work. The proposed work will be an add-on to the current data collection
(N=72 interviews, all completed), with the aim to interview people aged 65 and older with care needs and/or carers from the Bangladeshi Sylheti community (N=5-6). Sample selection will be consistent with the CAPE project and all participants will be recruited from our existing data collection site in Poplar in London, via the non-profit organisation we are in contact with, Neighbours in Poplar. Interviews will follow the format of the current data collection practices for the CAPE project using the same research materials, including the interview topic guide, although the information sheet, consent form and further support sheet will be translated into Sylheti. The interviews (in-person, phone or online) will be facilitated with the aid of a
professional interpreter who is fluent in both Sylheti and English. The additional interviews will be analysed using the same coding frame that has already been developed in NVivo. Adjustments to the existing coding frame will be made based on what emerges from these additional interviews. Ethical approval has already been secured for the currently funded study and will be utilising the same procedures, additional ethical approval to carry out this research activity will not be required. The proposed work would span six months: August 2023: Translation of research materials; identifying and contracting an interpreter. September 2023: Conducting
the add-on interviews. October 2023: Analysis of the add-on interviews. November 2023 to January 2024: writing up findings (as part of qualitative work package outputs).