A week ago (and many thanks to Donna Glover for pointing me
to this) the Government began an open consultation (responses in by 13thFebruary folks) on the future of funding for supported housing across England,Wales and Scotland.
This is a massive issue, particularly in terms of how much
housing benefit goes into supported housing landlords’ coffers when there is a
serious shortage of affordable housing for rent.
As part of the consultation, the government has published an evidence review conducted by Ipsos Mori, Imogen Blood & Associates, and the
Housing and Support Partnership, using a mixture of official statistics,
datasets, surveys, and extrapolation
Although it’s somewhat ticklish territory given the scale of
the cuts being scythed from public funding to support for people with learning
disabilities, it’s long been my contention that there is still a lot of public
money being spent to institutionalise people with learning disabilities rather
than to really support people to live the lives they want. And a big chunk of
money I haven’t known about is housing benefit – a chunk of money that has
recently probably been getting bigger as local authorities try and shunt some
of their social care accommodation costs on to housing benefit by
re-registering residential care as supported living.
Although there is in this blog my usual dose of finger in
the air calculation, so extreme caution is needed about this stuff, the
evidence review gives us some basic figures to work on. So – here we go…
The evidence review says that there are 38,500 working age
adults with learning disabilities in England (i.e. aged 18-64 years) in some
form of supported housing. This is almost a quarter (24%) of all working age
adults in England in supported housing. Of these 38,500 people, most of the
supported housing is provided by housing associations (24,500 people), followed
by charities (5,500 people) and local authorities (2,000) – ‘other’ (either
private landlords or housing where the commissioners don’t know who the
landlord is because the housing and support is so enmeshed) accounts for 6,500 people.
This doesn’t quite add up to the amounts reported by local authorities in
national statistics but anyway, let’s press on…
Information from private rented providers in England suggest
that, on average, people with learning disabilities in supported housing are
paying £104 per week in rent and £59 per week in service charges. If there are
38,500 people in supported housing, this adds up to a grand total of £208.2
million per year in rent and £118.1 million per year in service charges for
people with learning disabilities. If housing benefit is paying for this, then
this would add up to £326.3 million in housing benefit for supported housing
for people with learning disabilities.
The evidence review also asked as part of their survey how
much local authorities in England were funding for the support elements of
supported housing over and above rent and service charges, and they came up
with a total figure of £640 million per year for people with learning
disabilities (equivalent to £320 per person per week for support).
This is a very quick blogpost just really to alert people to
the report and the consultation so I haven’t had time to digest it, but some
very quick thoughts:
- For working age people with learning disabilities, this suggests that almost a billion pounds a year (£966.3 million) is spent on supported housing, with around a third of this coming from housing benefit.
- Even adding up the rent, service charge and support costs, supported living is still considerably cheaper to the public purse at £483 per person per week than residential care for working age adults with learning disabilities at £1,336 per person per week.
- Following on from point 2), Rochdale and other local authorities planning re-institutionalising routes take note.
- Also following on from point 2), and perhaps
heretically, it’s quite possible that supported housing support is too cheap,
meaning that for many people living connected lives that they want to live
becomes effectively impossible and people become prisoners in their own
homeshousing units. - Last thing – separating the funding sources of housing benefit from local authority funding of support has not resulted in the meaningful separation of housing and support for many people. It has also not stopped a commercially driven drift away from people living in their houses in the middle of their streets, to ‘specialist’ complexes promoted by organisations grabbing a bigger share of the ‘market’. The money needs to be meaningfully controlled by people who can put it to good use, rather than leaving people at the mercy of landlords’ interests while being blamed for their rents being expensive.
Thoughts on this would be very welcome – I may well have
made more mistakes than usual!
As a parent/carer for someone who still lives in the family home, I am completely bewildered by all this - but feel that nothing but good can come from a LOT more transparency about costs.
ReplyDeleteMy first thought is that £320 for support isnt going to buy a whole lot of support - surely that is the main reason for pushing people into residential care? I realise it is an average, but still find it low. (The recent CoP case where a private provider quoted close on half a million a yearfor care at home I found quite terrifying.)
The second thing is that I thought I saw a statistic that showed that a large number of people with LD were still living at home with their parents - the cheapest option of all, presumably, as the parents will be providing most of the support as well. And threatening residential care as the only other option is a pretty good way of ensuring that parents CONTINUE to do that, without daring to rock the boat.
My daughter has zero desire to live independently, and wouldn't, we feel, last a week in an ATU, so we will continue to be a very cheap option, and we can;t bee the only ones. Even in London, it is care/support which is the high cot, not housing.
Hi Liz. Yes, you're right - at least 50,000 adults with learning disabilities in England that social services know about are living with their families. This is (a) an underestimate and (b) likely to be a number that's getting bigger. Social and health services absolutely rely on families to do this (while not supported them or the person very well!). Maybe they a crisis-driven 'system' is a price worth paying?
DeleteA few thoughts,as you've cited me (see,I really do read your blogs). In no particular order:
ReplyDelete1) there are other costs to the public purse when people with a learning disability live in supported housing. Whereas residential fees cover everything apart from personal spending (for which people tend to keep around £30-£50 per week of their income from benefits), people in supported housing receive a higher level of income from benefits which is used to fund things such as food, activities and transport. This comes from the DWP rather than adult social care, still the public purse.
2) as alluded to above, people in residential care usually pay a higher client contribution to their care costs, often more than £100 per week. People in supported housing are often assessed as incurring more costs and pay less, or sometimes a nil contribution
3) a residential care provider is responsible for funding adaptations and equipment to meet residents needs. In supported housing this is often the responsibility of either the individual or the local authority. An occupational therapist, for example, is more likely to assess and arrange provision of equipment or more substantial adaptations, such as installation of wet rooms. Again, from the public purse but a different part of the purse.
4) supported housing does not promote independence if, as part and parcel of the tenancy, a minimum number of support hours must be purchased (from a specific provider).
5) I've seen some great example of RSLs (registered social landlords) who provide good support. I've seen others who purchase housing, immediately instigate a rent review, up the rent and then offer the absolute minimum in terms of updating, maintenance, adaptations and equipment. The only way to ensure value for money is to monitor closely what is being provided. Joint social care/health and housing reviews?
5) supported housing may appear cheap but the rent amounts quoted are usually on the basis of several people sharing. If you take the average amount of rent and service charge, multiply it by, say, 5, then the cost of the housing (and just the housing) suddenly seems much less cheap. £3,531 per month rent? A landlord could do worse.
None of the above leads me to conclude that residential care is better, by the way. It meets the needs of a small percentage of people, but not most.
Thanks Donna - this is brilliant and just the sort of information I strongly suspected I was ignorant of (have been having similar conversations with Naomi Harflett on email so thanks to Naomi too).
DeleteWonder if your comments suggest that part of a social care motivation for returning to residential care is to shunt responsibilities from them (for adaptations, professional input etc) on to providers, so they can not bother with/cut them? The number of adults with learning disabilities getting support from a professional plummeted from 2010/11 to 2013/14 (when it was last counted) - a way for councils to say they're fulfilling these responsibilities (via providers) while not having them themselves?
I'm not sure about that, Chris. In the residential care model ASC are paying for everything in the fee, much less is funded by DWP, housing benefit etc. They also have to put in place and monitor the contract with the provider and still have a legal responsibility to review each resident. For a small number of people, residential care is a) the preferred choice of them or their families, some people really want this option to be available b) offers a one stop shop for those who lack capacity, have complex needs and for whom supported living will offer no more real control over their lives. For this (again I emphasise very small) group of people supported living can, in some cases, feel like a 'mock up' of a 'normal' life, but with increased vulnerability and extra layers of complexity when, in reality, others are making all decisions in your best interests.
DeleteHowever....there's a danger that residential care may be seen as the default option. It's easier in many ways to arrange a residential care placement. No application to CoP for DOL (for 24/7 care) or tenancy if no capacity. No complicated mapping of support hours across all tenants (which has to be revisited for everyone every time a tenant changes support hours or moves), no issues around money management (bill paying, risk of financial abuse, splitting costs between several tenants) etc etc
Thanks again Donna. I suspect you're right about this depressing drift back towards residential care
DeleteI'm interested in this issue but sadly rather ignorant. However, I can't see any good economic or social reason for cutting the funding for supported housing, as it is both more appropriate and cheaper than the dreadful ATUs. And it's all very well for the State to rely on parents to do the caring, but (1) such parents make a huge commitment, long after they would otherwise be free of such responsibility once their (non-disabled) children leave home; (2) how is the adult with learning disabilities going to be looked after once their parents have become too old to care or indeed have passed away?
ReplyDeleteHi Jane. Liz has made a similar, excellent point about families in her comment too. Social care relies on huge numbers of families doing with with little/no support. Much bigger numbers of adults withl learning disabilities live in supported living and residential care (again, approaching 50,000 people) than in patient services (3,000ish people?) but inpatient services mainly exist because people and families aren't supported properly in the first place?
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