Voices from the frontline: care managers' insights on quality of life in extra care housing environments

Purpose This study explores care managers' perspectives on how extra care housing (ECH) environments in the UK address the needs of older residents' quality of life (QoL). Design/methodology/approach Semi-structured interviews with 14 care managers across 10 UK ECH schemes were analysed using an inductive thematic analysis followed by deductive alignment with established QoL domains. Findings Care managers identified eight interrelated QoL themes: independence, care, health and safety, community, sense of place, choice and control, general satisfaction and mobility, sensory and cognitive stimulation, and highlighted tensions between operational constraints and residents' autonomy. Practical implications Findings emphasise the need for design standards that support navigability, sensory engagement and flexible adaptation, alongside policy measures to address funding inconsistencies and staffing pressures. Originality/value By centring care managers' operational perspectives, this study fills a gap in ECH research that has prioritised resident viewpoints. It identifies an “implementation deficit” between ECH policy aspirations and systemic barriers; establishes mobility, sensory and cognitive stimulation as a distinct QoL domain and provides actionable insights for design and policy while challenging simplistic narratives about ECH effectiveness.