It is an uncomfortable question which many people might prefer to overlook, but which large numbers will face as they approach later life.

The issue of how to help older people to lead happy lives in their senior years was firmly in the vision of North Yorkshire councillors as long ago as the late 1990s and led to the introduction of the county’s ground-breaking Extra Care service, which now marks its 20th anniversary.

That debate led to the introduction of the county’s ground-breaking Extra Care service, a vision which would see residents’ needs met in a network of new communities that would provide the support people needed, while maintaining the independence they desired.

The wisdom of the decisions made, by both councillors and their professional officers, can be seen with the clarity of hindsight.

It is now 20 years since the first complex welcomed residents through the door and Extra Care has proved to be a success beyond the expectations of those who mapped out the original strategy.

Partnerships with social housing providers, supported by Government grants, have allowed that expansion, providing a popular and cost-effective alternative to traditional care homes.

Extra Care sites provide mixed accommodation, apartments and bungalows, with varying levels of support available to meet the needs of residents, including those living with dementia.

Each has its own mix of facilities, which could include a shop, hairdresser’s salon, café or meeting room, which, crucially, the surrounding community are encouraged to use.

That helps to amalgamate Extra Care into the wider community, which is one of the reasons for its success.

Earlier this month, the first Extra Care development, The Orchards, at Brompton, Northallerton, celebrated 20 years of service, providing 34 self-contained apartments and bungalows for rent, with a range of support facilities for residents, but also the important asset of social inclusion, with activities including coffee mornings, craft sessions and a film club.

Extra Care has expanded more quickly than initially envisaged, when it was expected 25 developments would have been created by 2025.

That has already been exceeded and is expected to total 30 by the deadline year.

The success of the formula has been summed up by Nicky Cooper, manager of Sycamore Hall, Bainbridge, who left a career as a registered care manager in traditional residential homes for a career with Extra Care more than a year ago.

She was attracted by the formula, where residents retain their own independence – literally with their own front door – in communities with bonds reminiscent of neighbourhoods in a bygone era.

An opportunity at Sycamore Hall allowed her to move from a sector where she had become less comfortable: “I decided it wasn’t what I believed in anymore; I wanted to enable people.

“I looked at Sycamore Hall and decided it is what I was interested in, helping people look after themselves, with a little bit of help.

“Anyone needing care normally has to move out of the area. This keeps them within their place of birth, these are Dales people, born and bred there.

“Extra Care is enabling people to stay in their communities, near their families. We have done that time and again in the last year.

“People get the care they need, if they need it, but they don’t always need it. The people we look after have their own front door, and we respect that. It is their home, not ours.

“I see people enjoying life again, we have taken away the pressure of people being isolated. Many people have become isolated and here, they have neighbours again. We are a neighbourhood.

“I love the communal feel of it, it is bringing back how we used to live, 40 or 50 years ago,” she said.

Manager at the Filey Fields development, Gail Speight, found her way into that job as a direct result of the Extra Care ethos of integrating with the community.

She ran a hair salon in another Housing 21 complex in Bridlington, serving employees and the wider community in addition to residents, before becoming an assistant manager ahead of promotion to her current role.

“Sometimes, it is not just about the resident themselves, but their wider social network,” she said.

“Relatives can have more of a family relationship, as opposed to the worry of being carers. That can turn relationships around and build them back up.

“That is what we have seen with a lot of families, who have been carers and have struggled with it.

“For me, a positive is the fact that we create an inclusive environment. At Housing 21, the outside community is invited in, not just friends and families.

“We have community events and that helps to bring people together. Even if people cannot get out as much as they would like, people come in and residents are able to join in activities.”

They include monthly religious services, games sessions and more. Another advantage for residents is that they are allowed to take pets along when they move in, which is greatly valued by many people.

Resident June Slater moved to Filey Fields 14 months ago, with her husband, who sadly died a few months later.

But Mrs Slater, 68, praised the care he received and the support she has continued to receive as she has come to terms with her loss and the approach of the next chapter of her life.

“I am comfortable here because I know there is someone available all the time, if I needed help,” she said.

“I was here with my husband, though he has now passed away. We had 100 per cent care for him and not a lot of places provide that. It is now helping me, there are people here to talk to, if I need to and I have 24-hour care,” she said.

The Orchards at Brompton, Northallerton, set the pattern for Extra Care in North Yorkshire as the first development to open in the county, with care provider managers working in tandem with the housing managers.

Registered manager Claire Budd took up her role as care provider manager at The Orchards after working in conventional care settings.

She said: “When they have experienced it, some people wish that they had moved in sooner.

“People in Extra Care have the freedom to come and go and I think people enjoy living here. Some people put off moving because they automatically think it will be like residential or nursing homes, but it is not.

“Some people need no care at all when they move in, and people can be as independent as they want to be.

“But if the time comes that they need some help, then the support is available there in the building,” she said.

By 2025, all North Yorkshire’s major communities will have an Extra Care complex and by that time it is expected a clear plan will be in place for the next generation of accommodation.

North Yorkshire Council is now involved in work which will see new developments tailored to meet the needs of smaller communities.

A key ambition is to embed Extra Care further into communities, so, in the future, the council may look to provide accommodation on the same sites for people with different types of needs.

In addition, welcoming the wider community to use the facilities available in their local Extra Care scheme will help to keep smaller, rural communities thriving.

North Yorkshire Council’s executive member for health and adult services, Cllr Michael Harrison, said: “Extra Care has been a real success story and one which thousands of people have experienced benefits from.

“Developments like these cannot happen overnight and I am grateful to those who had the foresight and determination to take it from an idea to reality all those years ago.

“Changes to the population are likely to continue and services like Extra Care are likely to become increasingly important in future, with more people living longer.

“That is why we are already looking to the future, to make sure as many people as possible are able to live the independent lives they, quite naturally, want to maintain.

“We also want to do that in a way which helps communities remain buoyant, so future projects may look a little different to existing schemes. But they will help ensure North Yorkshire thrives as a whole and that smaller communities are able to prosper.”

North Yorkshire Council is now looking to the future for Extra Care, with proposed new schemes in various stage of development.

Planning is also under way for a new generation of Extra Care, to support people with more complex needs, in addition to smaller schemes which can support rural communities.

The role played by Extra Care in keeping people in the communities they know and love are typified by Alan Iveson, who enjoys the companionship and activities at Sycamore Hall since moving in permanently, following a stay for respite care.

“I was lucky, there was a farmer (living) in, just across the way from me and I knew him,” said Mr Iveson.

“We have been friendly ever since. It has made a big difference, a big difference, to both of us, because we could go and spend many hours talking about times back and times now.”