Luxury care in Highgate: a Signature approach

Bishop’s Avenue in North London – better known as ‘Billionaire’s Row’ – runs from Hampstead Heath towards East Finchley and the A1. Famous for its eye-watering house prices (homes on the 66-house street typically sell for tens of millions of pounds) and rows of ostentatious mansions, it is perhaps an unlikely location for a brand new care home.

Walking down Bishop’s Avenue on a cold morning in late January to visit Signature at Highgate – Signature Senior Lifestyle’s latest luxury London care home – passing one mega-mansion after another, each with high security gates and unscalable walls, I couldn’t help but wonder “who lives here?” over and over. In fact, if press reports are to be believed, many – perhaps even a majority – of these enormous properties lie unoccupied – expensive investments invariably registered in offshore tax havens and left empty.
There is still plenty of activity on Bishop’s Avenue, however, albeit of the construction variety – not least next door to Signature’s latest, where retirement living provider Riverstone is hard at work building its Riverstone Bishops Avenue development of retirement apartments (and penthouses) for a 2025 opening, with a price tag that may even exceed that of Signature of Highgate.

Behind the façade.

Perhaps not the most likely place to find a care home, then, even if it is, at the time of writing, possibly the most expensive care home ever to be built in the UK, with a price tag of £50m being mentioned in various quarters (Signature will not be drawn on a specific figure). To be fair, Signature of Highgate does not number among the more vulgar properties lining the Avenue. Rather, its frontage is far more in keeping with the surrounding area (or the surrounding area as it once was, anyway). There is a good reason for this, as Wayne later explains, but I first ask him about the reasons behind the location of a care home in such striking (and expensive) surroundings.

“This road and this location are very prominent and very visible and serve this wider community of Highgate and Hampstead really well,” Wayne explains. “We’re looking at the catchment area for the home. We want to make sure that we’ve got enough potential residents to fill the beautiful buildings that we create and invest in … We think that this this area of North London has an undersupply of good quality care beds, and we’re here to meet the needs of the residents who live within a 20 minute drivetime catchment of this home.”

The catchment areas for Signature of Highgate, then, are the leafy residential streets of Highgate and Hampstead, with the home’s close proximity to both the North Circular and the A1 extending the catchment a little bit further. As is the case with the other 65 plots that make up Bishop’s Avenue, the site of Signature of Highgate was originally occupied by (in comparative terms, at least) a more modest dwelling.

“This was a single residential house,” Wayne tells me. “It was an old period house from the 1920s or 30s. It wasn’t listed, but the local authority was very interested in preserving it, and it was essentially ‘locally listed’. So, the front façade is a replica of the original house and, in fact, we’ve retained some of the brickwork at a lower level and in other elements of the building.”
Signature took this approach in order to get planning permission for a 70,000 square foot building on the 1.7 acre plot. Hence, then, the relatively modest frontage.

But as Wayne points out (and my visit confirms), everything behind the façade is unmistakeably contemporary.

Time and budget

Construction of Signature at Highgate took two years, courtesy of main contractor Wates Construction. Inevitably, with a project of this size and scale, there were delays and bumps along the road.

“As we came out of COVID, there was massive inflation in the construction industry,” Wayne explains. “So Wates were trying to procure their packages with their sub-contractors at a time of very high inflation, and that put a lot of pressure on the job … They were clearly trying to get the best price that they could in a very, very difficult market. It was a fixed price contract for us.”
Despite being a fixed price job, Signature did ultimately pay a little more than the original price, although Wayne tells me that this fell within allowed budgetary contingencies. The project was completed around six months late, but again, Signature were able to make allowances for this.

“We knew six months out that we were behind,” Wayne says. “As you can imagine, the day that you open, or [the day that] the building’s finished, you’ve got your CQC regulatory approval, so you need to be staffed, trained, fully fitted out, equipped, ready for your inspection. And that is a six-month lead-in program for Signature, for all of the recruitment and training and everything that needs to happen. So, when the CQC come in and inspect us, we won’t have a resident here but we’re absolutely ready to open. And, if a month before we’re due to get the building, we realise it’s going to be late, that’s a major problem. [But] six months before, we can reset our opening program.

“So, we did have visibility on the lateness and we were able to mitigate it. We got our CQC approval in late November and the first resident moved in early December of 2023.”

The importance of sustainability

Building in London comes with certain obligations, not least as regards sustainability.

“We’ve got the London Plan that we need to adhere to,” says Wayne. “We’ve got carbon offsetting that we need to provide, and we’ve got more robust sustainability measures than if we were building outside of London, which adds considerably to the cost.”
The Greater London Authority Act 1999 requires that the Authority produces a plan that includes within its scope the Authority’s commitment to sustainable development.

“This building has 80 PV panels on the roof,” Wayne continues. “We’ve got Air Source Heat Pumps. The building’s electric. We’re BREEAM [Building Research Establishment Environmental Assessment Method] Very Good.”

“The majority of energy is generated by [the] heat pumps,” says Wayne. “Gas is only used to supplement domestic water temperature, increasing it from around 50°C to 60°C. The heat pumps generate about 85-90 per cent of the energy, while gas provides the remaining 10-15 per cent.

“It’s difficult to determine the exact energy usage for hot water, cooling, heating, and hot water generation, as it varies throughout the year. During the design stage, we need to ensure that the plant is sized for peak conditions that occur several times a year. A digital twin model can provide a more detailed assessment, but as we are dealing with a live project, the best approach would be to analyse real-time usage data.

“We would be very interested in looking into it once the care home is occupied by at least 80 per cent of its capacity as this would be the best way to assess the system performance from the energy point of view.”

Signature at Highgate has an EPC certification of B, with the home’s comfort cooling system (which enables the constant movement of cool, clean air around the home) slightly increasing the amount of electricity used, leaving the home a few points shy of an A rating.

Elasticity of care

There were around a dozen residents living in Signature at Highgate at the time of my visit in late January. In common with other responsible providers, the process of reaching resident capacity at the home will be a marathon rather than a sprint.

“As you would expect, we don’t move everybody in on day one,” Wayne confirms. “We would allow a year and a half to fill the home.”
Signature at Highgate is registered for 96 residents, and couples can share a suite if desired. There are 24 specialist dementia suites, which can be found at the rear of the building, which is arranged around an impressive, two-tiered, central outdoor space.

Signature takes a particular approach to the care it provides, as Wayne explains:
“We have elasticity of care,” he tells me. “The average age here will be around 85 years old. You have some relatively fit 85 year olds who will move in and they might just need some light residential-type care or very little care, and they just want to be in the right environment where there’s lots of activities and lifestyle and companionship and they’re in the right place to age further – all the way through to full residential, specialist nursing, palliative, and dementia care, all under one roof.

“Because we’re registered as a nursing home, we can care for our residents’ needs through that spectrum. We have elasticity of accommodation. We have the 24 specialist dementia units in a secure environment within the building, and then we have different-sized suites, from the more typical nursing home studio – which is still an industry-leading size of 25 square metres – all the way through to one bedroom suites which are 40 square metres. We might [even] be a bit bigger than 40 square meters – maybe up to 45 square metres – where it made sense as part of the design to have a slightly larger suite in that location.

“So, for example, if you have very high nursing needs, possibly a studio room is more appropriate. And you would pay for your care needs based upon the care that you need to be receive, so there are packages of care that we offer.

“If you’re more fit and active – maybe you’re single or maybe you’re with your husband or wife – a one bedroom suite might be more appropriate, and therefore what you’re prepared to pay for when you when you move in.”

Homely luxury

From the striking, art deco-inspired staircase that greets guests when they arrive at Signature at Highgate, there is no mistaking the fact that this is a high-end, luxury care home. Nonetheless, Signature is keen to emphasise that its new home should still feel like ‘home’ for its residents.

As Wayne puts it: “It’s a care environment, but we’ve worked really, really hard to make it feel homely and normal.”

Whether living in a £50m luxury care home on Billionaire’s Row could ever feel truely ‘normal’ probably depends on what your definition of ‘normal’ is, but there has clearly been an effort on Signature’s part to break up what could easily have been a rather imposing space into cosier, less-intimidating areas.

“It’s a large building, but we try to make everything domestically scaled in terms of lounges and seating areas,” says Wayne. “So, if you don’t want to go with family or friends to your private space in your room, and you want to sit in a quiet lounge or area, there’s plenty of little spaces dotted around.

“It’s the same approach with the restaurant as well – you’ll see it’s broken up into smaller areas, again to try and create a more domestic feel as much as you can.”

All the facilities and features one would expect from a care home like Signature at Highgate are present and correct. Feedback from residents at other Signature homes made it clear that having a choice of location for mealtimes is important. As a result, Signature at Highgate boasts a main restaurant and a secondary bistro, too. In addition, residents can enjoy meals in their own suites, many of which have separate lounge areas. Both restaurants have dedicated waiting staff.

There are various activity areas dotted around the home, as well as a hairdressing salon, therapy rooms, a beautifully designed cinema, and even a separate bar area, complete with full-time bar staff. The interior design and finish are exceptionally high throughout – the residential corridors may be on the long side, but they are punctuated with interesting things to see and touch, and places to rest. Wayfinding at Signature at Highgate is very much a visual concern – corridors are given ‘street’ names with local provenance, themed artwork distinguishes one area of the home from the next, and carpet and wall colours are designed to further aid wayfinding. Light wells and decorative backlit panels punctuate what could otherwise have been gloomier corners. Garden rooms lead out into the outside spaces. Signature has been careful to keep many of the original, mature trees, including one that sits at the heart of the home in the central garden space.

Circadian lighting

Signature has installed circadian lighting in the communal areas and bedrooms of the home’s dementia areas. Both the white
‘colour’ of the LED lighting and overall light levels have been programmed to adjust throughout the day in order to mimic sunlight/daylight, with lower-level warmer hues in the morning and evening, and brighter, more vibrant, blue-type white hues in the middle of the day, in order to promote the natural circadian rhythms of those residents living with dementia.

The intention is to help residents naturally regulate themselves, and thus better intuit when it is time to rise and be active, and when it is time to rest and be calm. Signature hopes to see residents achieve better sleeping patterns, as well as better cope with the changes of the day, mitigating behaviours such as sundowning.

Throughout the home, lighting in each bedroom and communal area can be programmed separately. Scene lighting can also be preset in all spaces, so that staff can quickly switch a bedroom to a calming level of light no matter what time of day it is.
Suites at Signature at Highgate are generous in size and can be furnished according to residents’ wishes (and the depth of their pockets), although they may bring their own furniture with them – fire regulations allowing. Televisions are networked, meaning that they can display daily menus, activities, and other useful information.

In terms of back-of-house, everything is again present and correct, with laundry rooms and kitchens all pleasingly high-spec. This being Billionaire’s Row, Signature at Highgate naturally boasts a basement car park (complete with ample EV charging), and this is the first Signature home to feature car park lifts rather than a ramp – another nod towards maintaining an approximation of a period façade. The home has its own minibus, and residents are welcome to bring their own cars.

Safety monitoring

Following a successful pilot at Signature at Reigate Grange, Signature has become the first corporate care group to commit to having CCTV safety monitoring for residents living with dementia in all its homes, courtesy of Care Protect.

Wayne explains how this works: “[Safety monitoring] is optional for families and for residents. It’s monitored by a third party, not by Signature … It is in this building, and it will be in all our buildings moving forward. We’re working through our existing portfolio of homes at the moment.”

Only Care Protect can view the live streams from the CCTV cameras. Audio is monitored by a combination of random human review and AI, with Care Protect employing a team of experienced carers and people who have worked in care regulatory roles. Flagged incidents are reviewed and, if appropriate, referred to the relevant care manager via an alert which will include an explanation of why the incident has been flagged. A recording of the incident will also be included.

Alerts can range from a resident displaying behaviours that the care manager might need to take account of, to training and PPE issues. While this could mean a carer being flagged for not wearing their mask in the correct way, it also means flagging up staff who have delivered exceptional care. The Signature at Reigate Grange pilot saw the introduction of a ‘golden moments of care’ program, where moments of exceptional care are used both as examples to help train staff but also so that the carer responsible gets recognition for their work. Signature is looking to roll this initiative out to all its homes.

All of which means that, as well as the obvious advantage of improving resident safety, Signature clearly sees the introduction of safety monitoring as a means of supporting staff training and coaching, and further driving the personalisation of care. Naturally, Signature staff expressed reservations at the start of the Signature at Reigate Grange trial – nobody wants to be ‘watched’ at work, after all – but Wayne points out that staff have been won over by reassurance safety monitoring can bring.

“Dementia is a very difficult disease, and if you have a dementia resident say: ‘she hit me’ or ‘he pushed me’, then the staff feel very vulnerable,” says Wayne. “[Safety monitoring] gives a degree of reassurance to staff that, if there is an incident, it can be reviewed.”

Blazing a trail

Signature has worked closely with campaigner Jayne Connery and her Care Campaign for the Vulnerable on the Reigate trial and subsequent safety monitoring rollout. After my visit, I asked Jayne about her successful experience working with Signature and its CEO Kay Cox, and she told me:

“It’s indeed a very positive time for CCFTV, working with providers including [Signature] who are implementing independent safety monitoring. It has been a privilege working with Kay Cox and her dedicated team … CCFTV are proud to collaborate with Signature Senior Living, as they have wholeheartedly supported our campaign to implement independent monitoring systems in all dementia care communities. Their commitment to this cause exemplifies their dedication to providing the highest standard of care.
“It is a privilege to work alongside Signature Senior Living, and we are confident that their proactive approach will inspire other providers to consider the benefits of implementing similar technologies in their care services.”

Wayne tells me that, following the Reigate pilot, staff and residents’ families alike have been won over by the benefits of safety monitoring, despite any initial misgivings. As Signature at Highgate grows its resident population, and more and more people come to live in and experience this truly impressive home, it will be interesting to see how many families opt in to safety monitoring, and whether Signature’s trailblazing adoption of this technology will set a broader care trend.