最近的一份报告显示，随着“护理黑点”的出现，英国的老年护理系统正在崩溃. 英国老年协会的一项分析表明，在英格兰，多达四分之一的邮政编码地区是“黑点”，即没有养老院床位的地区, even for those who are able to pay. 养老院的床位更是令人担忧，因为养老院是为最虚弱的人提供床位的，超过60%的邮政编码地区没有床位.
Circumstances exacerbating care blackspots
There are many reasons leading to care blackspots. 它们的发展是因为提供者——无论是地方当局还是私人护理院——无法提供所需的能力, or because there is insufficient staff to deliver the care. 在过去的五年里，社会护理工作者的空缺职位增加了两倍。Age UK还估计，尽管需求不断增长，但在过去的五年里，社会护理的公共支出减少了1.6亿英镑.
For those who can afford social care and live in a town or city, the grass is marginally greener, however there are big variations by region. 护理费用昂贵，而且并不总是在他们的首选地点. Our own experience tells us that care homes, as well as retirement living developments, are generally being built outside city centres, in suburbia or smaller towns. Whilst there is nothing wrong with this approach per se, 这意味着每个开发项目的规模都受到可用场地大小的限制, 除了高度限制外，郊区或小城镇不太可能支持超过两层或三层的开发.
With around 3.目前65岁以上的人口有600万，预计到2066年将增长8%, 我们需要的是期待已久的政府绿皮书，该绿皮书提出了一种新的长期融资模式，以改革社会福利的提供. 国际上也有一些例子，说明更综合的代际生活模式如何有助于提供老年人的社会照顾.
Exploring the vertical care village
我们的一些客户正试图通过将经济适用房开发与养老院或额外护理相结合来解决合格员工的短缺问题, as well as providing a nursery on site, to the benefit of staff, care home residents and the wider community. Needless to say, this is not easy, 同样，这通常受到场地大小或可用性以及建筑高度限制的限制.
It is worth proposing and investigating models for high rise care homes, 以及将老年人公寓(额外护理)和经济适用房与城镇和城市中心的托儿所设施相结合的开发项目. 已经有一些高层办公楼被改造成额外护理开发项目的例子, as well as intergenerational developments, 但没有任何建筑提供护理和/或养老院住宿的例子, 为更多独立老人提供的公寓，以及为护理人员和他们的家人提供的住房，并在现场设有托儿所.
垂直堆叠的公寓和/或护理卧室也可以很好地满足痴呆症患者的需求, as there would be virtually no corridors, and communal areas would be located at the heart of each household. Outdoor space for each level could be provided by well-designed sunrooms. Needless to say, 该模型需要符合最严格的消防和疏散程序.
In a vertical village development model, residents and staff would benefit from being able to live in the city centre, 靠近所有设施，为养老院/公寓居民和托儿所的孩子提供代际互动的机会. 住在开发区的员工不必通勤，也不用担心照顾孩子, 哪些应有助于招聘和留住最熟练的护理人员. 将公寓和养老院与共享的公共设施相结合，确保了养老院居民的混合，使养老院保持活跃，并减少了养老院作为临终关怀场所的耻辱.
Vertical care villages, with or without housing for the care staff, are uncommon in the UK, however new build precedents have been set by Battersea Place, London which offers 1,2和3卧室的公寓和顶层公寓俯瞰巴特西公园，提供一系列酒店风格的设施和24小时护理; Nightingale Place by Audley Villages in Clapham, London; and the Extra Care Charitable Trusts’ Solihull Village, Birmingham with 260 apartments.
International precedents
垂直护理村的发展在加拿大是一个普遍的概念，Arcadis成功地与许多客户合作开发了各种垂直村庄的模式，其中老年人社区位于城市的中心. Whilst each offers a different model and experience for their residents, 共同的主题是，这些发展在提供独立生活的同时，也提供痴呆和护理服务, in essence combining care home and retirement living. The approach is similar to extra care developments in the UK, but whereas extra care is only available in the affordable sector in the UK, 加拿大的发展既迎合了可负担性，也迎合了私营部门，允许混合社区和老龄化.
Canadian developments consist of a minimum of 150 apartments, varying from studios to three-bedroom apartments. Often the unit numbers are in excess of 200, 确保建造电影院等公共设施所需的居民数量, cafes, bars and restaurants located in the development viable.
由于居民人数如此之多，这些开发项目通常比英国的开发项目要高. Located in city centres where the height is not an issue, unlike in suburbia, where the height of the development is often limited to three storeys, maybe four, limiting the numbers of the typical UK development to 60-80 apartments.
由于资金和人口压力，保健服务正在发生变化. Whilst this is alarming, 它还为克服这些问题提供了新的思维方式和新的方法的机会. 我们认为，可以从加拿大市场吸取宝贵的经验教训, 帮助向英国的护理提供者和开发人员提出新的想法，以解决英国特有的问题, 研究提供护理的不同方式并从经验教训中获益.
