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Extra care housing is seen as a popular option for older people by families, some older people, policy‐makers and practitioners. Some new build is being provided but another option, for which grants are available, is to remodel existing outmoded buildings. This research reports on recent attempts from 10 case‐study areas in England to remodel sheltered housing and residential care homes to extra care housing. The results are mixed, with satisfaction reported by many new tenants, anger by some existing ones, challenges at every stage of the project for design and construction teams, and issues over the provision of assistive technology and care. Nearly all the schemes experienced unexpected problems during the course of construction. Remodelling is not necessarily faster or cheaper than commissioning a purpose‐designed new building. Nevertheless, remodelling may be the only viable option for some unpopular or outdated schemes. The research showed that remodelling is not a quick fix, but that it did have considerable advantages for many of the older people and support staff who were living and working in the remodelled buildings. The research concluded that remodelling should only be undertaken when other options have been carefully examined. Drawing on the research findings, advice to policy‐makers and practitioners who are considering this course of action is outlined in the discussion.

Extra care housing has developed from sheltered housing and has increasingly been seen as a popular option by policy‐makers for a number of reasons. These include the inability of conventional sheltered housing to be an adequate solution for a growing population of very old people, the decline in popularity and high costs of residential care and perceived problems with older people staying in mainstream housing. There is, however, no agreed definition of extra care housing, even though a growing number of government grants are becoming available for this type of housing. This is causing confusion for providers and for older people and their families who are not sure exactly what is provided. This lack of clarity means that this form of housing has become an erratic and piecemeal form of provision.

Extra care housing (ECH) is housing for older people that aims to provide flexible care while fostering independence. The purpose of this paper is to examine the impact that some of the successes and failures in improving accessibility during remodelling had on care provision, in order to offer advice to social housing providers planning to remodel existing properties into ECH.

The data consisted of an inventory of accessibility features and assistive technology (AT) items in flats and common areas. The data were drawn from ten ECH schemes in different regions of England.

Most of the AT found was low-technology supporting independence, such as grabbers; some was specific to care provision, such as hoists. Even after remodelling, the design and layout of most buildings did not fully comply with accessibility standards, leading to increased provision of care for some tenants: a care-negative situation.

This multidisciplinary, original research on remodelling into ECH presents successful examples of accessibility, AT and care integration that required active tenant involvement and creative design input from care staff, architects and builders who were AT and accessibility aware. It is argued that for new and remodelled ECH buildings to be care-neutral, designers need to work towards the most inclusive model of ECH.

This is original research that has produced guidance for builders, developers, policy makers and other stake holders.