Supported housing

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Introduction
Types of accommodation available
Care homes (residential care homes)
Care homes with nursing (nursing homes)
Respite care
Outreach support / floating support
Assertive outreach
Hostels
Group homes
Supported housing (sheltered accommodation)Therapeutic communities
Deciding which type of housing is suitable
Points to consider
What level of support do you need?
Finding suitable accommodation
Funding for supported housing and residential care
Wales
Useful contacts

Introduction

This factsheet is targeted primarily towards users of mental health services, their carers, friends and family. It may also be helpful to students and professionals.

Housing is a basic human need. A comfortable home can enable people to feel safe; it affords them privacy and should allow them to spend time with friends or family. For many people, one of the most important aspects of having their own home is the independence which it offers. However, due to illness or disability, many people are unable to live independently in their own homes without the care and support of others. For some, the need for high levels of care and support means that they may have to move to some form of supported accommodation or residential care.

There is great variety in the types of supported housing and residential care available and different types of accommodation suit different levels of need. Apparently, similar types of accommodation can often vary widely in the facilities and degree of comfort they offer, as well as in their environmental features and household rules and conditions.

Types of accommodation available

Care homes (residential care homes)
These may be run by the private sector, voluntary organisations or local authorities. All care homes have to register with the Commission for Social Care Inspection, or the Care Standards Inspectorate in Wales, who have a responsibility for the registration and inspection of care homes.

Care homes are usually specific to a particular client group; for example, people with mental health problems, or elderly people. They can vary in size enormously, but the majority of them provide homes for between 8 to 20 residents.

Residents are entitled to have their own room, and share communal living areas. In some homes catering and cleaning services are provided. In others, aiming to foster independent living, residents are encouraged to take an active part in the activities of daily living.

Care homes generally offer long-term accommodation and support, however, short-term placements are sometimes appropriate.

Levels of care vary between homes and between client groups. Some homes provide 24-hour staffing with waking night duty staff or a worker sleeps in and is on call in case of an emergency. In others, staffing may be restricted to daytime and evenings. Many care homes provide assistance with personal care such as washing, dressing, bathing and taking medication.

Homes are managed by a registered care manager. Homes are usually staffed by residential social workers, care workers, or care assistants. At least 50 per cent of staff should be qualified to a minimum of NVQ in Care Level 2.

Most people in this type of accommodation will receive income support including the personal allowance, any premiums payable and also a residential allowance. They will keep their personal expenses allowance, but the remaining income support will be used to pay the home's charge. This together with a contribution from social services will usually be sufficient to meet the full cost. If a resident qualifies for Disability Living Allowance, the care component will be withdrawn after four weeks but the mobility component will remain payable.

Care homes with nursing (nursing homes)
These may be run by the private sector, voluntary organisations, local authorities or health authorities.

Care homes with nursing aim for residents to each have a room of their own. Generally, they offer long-term accommodation and support. However, short-term placements are sometimes appropriate, for example to provide respite care for carers, or in case of emergency or illness.

Care homes with nursing provide a higher level of support than those without nursing: they always have 24-hour staffing. Homes are usually staffed by a combination of qualified nurses and care assistants. At least 50 per cent of staff should be qualified to a minimum of NVQ in Care Level 2.

Most people in this type of accommodation will receive income support including the personal allowance, any premiums payable and also a residential allowance. They will keep their personal expenses allowance, but the remaining income support will be used to pay the home's charge. This, together with a contribution from social services, will usually be sufficient to meet the full cost. If a resident qualifies for Disability Living Allowance, the care component will be withdrawn after four weeks but the mobility component will remain payable.

Respite care
Respite care projects provide short-term supported accommodation for people who may be temporarily unable to care for themselves at home or a short break for carers. These projects are usually run very similarly to care homes; indeed, some care homes and nursing homes may have places set aside particularly for providing respite care.

Outreach support/floating support
This type of accommodation tends to consist of individual flats - usually housing association or council housing. There are usually a number of flats allocated to an outreach support project within a particular area.

Support is provided by a team of workers, often called outreach support workers or floating support workers. These workers usually visit residents in their own flats. They can provide practical support with managing budgets, ensuring rent and bills are paid, planning shopping lists and so on. They can also provide emotional support and refer residents onto other services, for example, counselling.

Mutual support between tenants is often encouraged. This type of accommodation is usually appropriate for people with fairly low support needs, and is designed to encourage independence.

Residents are usually tenants and live fairly independently, but many receive community care services. Most residents will receive Housing Benefit to meet some or all of the rent and perhaps some services provided by the warden. They will also receive the same benefits as they would in ordinary accommodation.

Assertive outreach
This type of accommodation is very similar to that of outreach support projects. The difference lies in the type of support provided. Assertive outreach projects tend to be suitable for people who need a little more support and encouragement to engage in activities than would be appropriate for ordinary outreach support projects. Residents are visited regularly by support workers. The overall aim is to enable people to live as independently as possible in the community, and to prevent people being admitted or re-admitted to hospital.

Residents are usually tenants and live fairly independently, but many receive community care services. Most residents will receive Housing Benefit to meet some or all of the rent and perhaps some services provided by the warden. They will also receive the same benefits as they would in ordinary accommodation.

Hostels
These may be run by the private sector, voluntary organisations or local authorities. These offer varying degrees of support but do not have to be registered homes as they do not provide board or personal care. 

Hostels frequently offer short-term accommodation, and are usually specific to a particular client group; for example, people with mental health problems, or homeless people. They can vary in size enormously, but the majority of them provide homes for between 8 to 20 residents. Residents are entitled to have their own room, and share communal living areas.

Most residents will receive Housing Benefit to meet the cost of their rent and sometimes some of their care costs. They can also claim other benefits as they would in ordinary accommodation.

Group homes
These may be run by the private sector, voluntary organisations or local authorities. They offer varying degrees of support but do not have to be registered homes as they do not provide board or personal care. 

Group homes are usually specific to a particular client group; for example, people with mental health problems, or homeless people. They can vary in size enormously, but the majority of them provide homes for between 8 to 20 residents. Residents are entitled to have their own room, and share communal living areas with other residents who provide mutual support and are usually preparing to live independently. The accommodation is not registered and residents claim their usual benefits with housing benefit to cover the costs of rent.

Supported housing (sheltered accommodation)
There are many different types of sheltered or supported accommodation. These range from low to medium levels of support. Most of the sheltered accommodation available is designed with older people in mind. The majority of the accommodation is in the form of individual flats or studios within a block equipped with communal facilities. Some sheltered accommodation schemes have a resident warden and some have visiting wardens. Residents often have direct access to the warden via intercom or alarm facilities in their flat. People may be eligible for further support, such as visits from home-helps or domiciliary care workers.

Residents are usually tenants and live fairly independently, but many receive community care services. Most residents will receive Housing Benefit to meet some or all of the rent and perhaps some services provided by the warden. They will also receive the same benefits as they would in ordinary accommodation.

Therapeutic communities
Therapeutic communities provide a supportive environment with a focus on rehabilitation. Residents usually have their own room and share communal areas. There tends to be a focus on communal living, with regular house meetings and group activities. Therapy is usually available, whether it is on a one-to-one basis, or group therapy. Stays in therapeutic communities tend to be limited to an agreed time period. (At present there are no therapeutic communities in Wales.)

Most people in this type of accommodation will receive income support including the personal allowance, any premiums payable and also a residential allowance. They will keep their personal expenses allowance, but the remaining income support will be used to pay the home's charge. This, together with a contribution from social services, will usually be sufficient to meet the full cost. If a resident qualifies for Disability Living Allowance, the care component will be withdrawn after four weeks but the mobility component will remain payable.

Deciding which type of housing is suitable

Points to consider

• You may wish to request an assessment of care needs from your local social services department. A social worker or care manager will come and do a Community Care Assessment to look at your care needs and how to meet them.
• You can obtain details of what accommodation is available locally from social services, the Commission for Social Care Inspection, or the Care Standards Inspectorate for Wales. You can also obtain brochures from particular supported housing schemes.
• You could visit a number of care homes or housing schemes to see what they are like and what facilities they have to offer.
• All homes should produce written information (a service-users guide) to help you make a choice about the home you want to move into.
• Ask to see copies of policies and procedures, particularly complaints procedures.
• Consider carefully whether the supported accommodation can meet your needs now and in the future.
• If the home you choose has no vacancy, you could accept a temporary place in another home until there is a vacancy in the one you want.
• A short stay in respite care will give you an insight into how a home is run and whether you would like it.

What level of support do you need?

Supported housing and care homes can vary widely in the levels of support provided to tenants. It is important that you find a placement that is suitable for you. Too little support could mean that some of your needs may not be met, and too much support could mean that some of your independence is taken away.

Different individuals have different needs, so it is important that you have your needs assessed. If you feel you would like to have your support needs assessed, you will have to contact your local social services department and request an assessment. This would be carried out by a health care professional, such as an occupational therapist.

Following an assessment, an individual should receive a written care plan detailing the type of support they can expect to receive. It should be noted that although local authorities have a duty to assess people's needs for social care and support, they do not necessarily have to provide services (unless the person is subject to Section 117 of the Mental Health Act). The provision of services is dependent on the outcome of the assessment.

(For further information, see Mind's Community care factsheets.)

Finding suitable accommodation

The Commission for Social Care Inspection (England) or the Care Standards Inspectorate for Wales should be able to provide you with details of all the supported housing projects within your area. Your local social services department should be able to provide you with a list of care homes in your area, and a list of local nursing homes should be available from your local health authority.

If you wish to move away from your current area, you should contact the local social services department or health authority for that area for local information. If, however, your own local social services or health authority is funding your placement, any move outside their area would have to be negotiated with them.

If you have a social worker, keyworker or care coordinator, they may be able to help you find appropriate supported housing.

There are a number of national organisations that can provide advice and information about supported housing and residential accommodation. There are also a number of national organisations that provide supported housing and residential accommodation. For further information, please see the Useful contacts section at the end of this factsheet.

Funding for supported housing and residential care

If you have had a Community Care Assessment, your social services department will also carry out an assessment of your financial situation. It will look at your savings and income to see how much you can pay towards the fees of a home.

The facts and figures below were valid at 31 March 2005, but they are subject to change.

If you have savings and capital of less than £12,250, you will not be expected to spend any of it on your home fees. However, you will have to contribute all of your income (with a few exceptions) except for £18.10 a week, which you can keep for yourself. This amount is called your personal expenses allowance.

If your savings and capital are worth between £12,250 and £20,000, the local authority will help with paying the fees of a home, but you will have to contribute all of your income (with a few exceptions) except for your personal expenses allowance.

Anyone with savings and capital worth over £20,000 has to pay all the fees of the care home themselves. Also, if your capital is less than £20,000 but your weekly income is more than your home fees and the personal expenses allowance added together, you will have to pay all of the fees.

If you have savings over £20,000 and need to live in a care home that provides nursing care, the NHS will pay for the nursing part of your fees.

If you have particular nursing needs you may be entitled to full NHS funding for your care home place. This is called NHS Continuing Care.

If you have been detained in a psychiatric hospital on Section 3, and you are discharged to a care home, you may be entitled to Section 117 Aftercare. This means that the local authority will be responsible for meeting the fees of the care home.

Wales
Please note that for people in Wales there are two funding streams: the Supporting People Grant (SPG) and the Supporting People Revenue Grant (SPRG). SPG services will be administered by local authorities, SPRG services will be administered by the Welsh Assembly and will be free of charge.

For details of organisations that provide information and advice on funding residential care placements, please see the Useful contacts section at the end of this factsheet.

This factsheet was written by George Stewart. Updated February 2005.

Useful contacts

Abbeyfield Society
186-192 Darkes Lane, Potters Bar, Hertfordshire, EN6 1AB
tel: 01707 644 845
email: enquiries@abbeyfield.com
web: www.abbeyfield.com
Provides sheltered housing for older people.

Advance Housing and Support Ltd (formerly Guideposts )
2 Witan Way, Witney, Oxfordshire OX8 6FE
tel: 01993 772 885
email: support@advanceuk.org
web: www.advanceuk.org
Provides housing for people with mental health problems or learning disabilities.

Age Concern England
Astral House, 1268 London Rd, London SW16 4ER tel: 020 8679 8000
email: contact by telephone or post only
web: www.ageconcern.org.uk
Provides information and advice about residential care including funding.

Anchor Housing Association
Anchor House, 269 Banbury Rd, Oxford OX2 7HU
tel: 01865 311 511
email: housing.enquiries@anchor.org.uk
web: www.anchor.org.uk
Provides sheltered housing, supported housing and help for older people wanting staying in their own home.

Arbours Association (London only)
6 Church Lane, London N8 7BU
tel: 020 8340 7646
email: info@arbourscentre.org.uk
web: www.arbourscentre.org.uk
Sponsors three long-term therapeutic communities and a short-stay crisis centre.

Asian Resource Centre
110 Hamstead Road, Handsworth, Birmingham B20 2QS
tel: 0121 523 0580
email: asian.resource@btclick.com
web: http://home.btclick.com/asian.resource/ 
Provides advice, a hostel for Asian women experiencing domestic violence, and sheltered accommodation for elderly Asian people.

Asra
239-241 Kennington Lane, London SE11 5QU
tel: 020 7820 0155
email: community@asra.org.uk
web: www.asra.org.uk
Provides sheltered accommodation to meet the cultural needs of older Asian people.

Association of Therapeutic Communities
Barns Centre, Church Lane, Toddington near Cheltenham, Glos. GL54 5DQ
tel: 01242 620 077
email: post@therapeuticcommunities.org
web: www.therapeuticcommunities.org
Provides information on therapeutic communities.

Camden Chinese Community Centre
9 Tavistock Place, London WC1H 9SN
tel: 020 7388 8883
email: info@camdenccc.co.uk
web: www.camdenccc.co.uk
Provides support, advice and information on housing and welfare benefits issues.

Care Council for Wales (Cyngor Gofal Cymru)
6th Floor, South Gate House, Wood Street, Cardiff CF10 1EW
tel: 029 2022 6257
email: info@ccwales.org.uk
web: www.ccwales.org.uk
Oversees standards of conduct, practice and training for all care workers in Wales.

Care Homes Information Network
The ALG, 59.5 Southwark Street, London SE1 0AL
tel: 020 7934 9999
email: info@alg.gov.uk
web: www.alg.gov.uk
Provides local social services with information on residential homes.  

Care Standards Inspectorate for Wales
Heol Billingsley, Parc Nantgarw, Nantgarw, nr Cardiff CF15 7QZ
tel: 01443 848 450
email: from website
website: www.csiw.wales.gov.uk
Responsible for registration and inspection of adult care services in Wales.

Carers Wales
River House, Ynysbridge Court, Gwaelod y Garth, Cardiff CF15 9SS
tel: 029 2081 1370
email: from website
web: www.carerswales.org
Advice, information and support for carers.

Carr-Gomm Society
Duke House, 6-12 Tabard Street, London SE1 4JU
tel: 020 7397 5300
email: info@carr-gomm.org.uk
web: www.carr-gomm.org.uk
Provides housing, care and support to vulnerable people with a range of needs.

Cheshire Foundation Housing Association
8 Summer Road, East Molesey, Surrey KT8 9LS
tel: 020 8398 9060
email: info@cfha.demon.co.uk
web: www.cfha.demon.co.uk
Provides supported housing for people with disabilities including mental distress.

Citizens Advice Bureaux
Myddelton House, 115-123 Pentonville Road, London N1 9LZ
web: www.citizensadvice.org.uk
Adviceguide website: www.adviceguide.org.uk
Provides advice and information on a wide variety of subjects including benefits and housing advice. Has a nationwide network of local CAB offices.
To find your nearest Citizens Advice Bureau, you can either search www.citzensadvice.org.uk , or look in your local phone directory under CAB.

Commission for Social Care Inspection (CSCI)
33 Greycoat Street, London SW1P 2QF
Tel: 020 7979 2000
email: enquiries@csci.gsi.gov.uk
web: www.csci.org.uk
Responsible for registration and inspection of adult care services in England.

Counsel and Care
Twyman House, 16 Bonny Street, London NW1 9PG
tel: 0845 300 7585
email: advice@counselandcare.org.uk
web: www.counselandcare.org.uk
Provides advice, information and factsheets.

Family Welfare Association
501-505 Kingsland Road, London E8 4AU
tel: 020 7254 6251
email: fwa.headoffice@fwa.org.uk
web: www.fwa.org.uk
Offers community services and residential homes for people who have experienced long-term mental health problems.

Grace Consulting
35 Walnut Tree Close, Guildford, Surrey GU1 4UL
tel: 01483 304 354
email: enquiries@graceconsulting.co.uk
web: www.graceconsulting.co.uk
Provides help with finding residential or nursing homes within the private sector. 

Help the Aged
207-221 Pentonville Road, London N1 9UZ
tel Seniorline: 0808 800 6565
email: info@helptheaged.org.uk
website: www.helptheaged.org.uk
Run Seniorline, a free welfare benefits and housing advice line, and produce a factsheet on paying for residential care.

Housing Corporation
149 Tottenham Court Road, London W1P 0BN
tel: 020 7393 2000
email: enquiries@housingcorp.gsx.gov.uk
web: www.housingcorp.gov.uk
Provides information on housing associations. 

IFACare
37-38 The Old Woodyard, Hagley Hall, Hagley, Worcs DY9 9LQ
tel: 01562 881 888
email: info@ifacare.co.uk
web: www.ifacare.co.uk
Organisation that focuses on advice about paying for long-term care.

Innisfree Housing Association
190 Iverson Road, London NW6 2HL
tel: 020 7625 1818
email: info@innisfree.org.uk
web: www.innisfree.org.uk
Provides a housing service for the Irish community.

Kush Housing Association
98 Stoke Newington High Street, London N16 7NY
tel: 020 7275 8449
email: from website
web: www.placesforpeople.co.uk/kush/index.aspx 
Provides supported accommodation for African and Caribbean people with mental health problems.

MACA (Mental Aftercare Association)
1st Floor, Lincoln House, 296-302 High Holborn, London WC1V 7JH
tel: 020 7436 6194
email: info@maca.org.uk
web: www.maca.org.uk
Provides a range of community services for people with mental health needs including sheltered housing and information on residential care.

MARCH (Mental Aftercare in Registered Care Homes)
Silverwells House, 1 Old Mill Road, Bothwell, Glasgow G71 8AY
tel: 0800 783 4261
Has a helpline offering advice on all aspects of mental health care. Also runs a national bed vacancy register for professionals looking for placements for clients.

Mind
Some local Mind associations run housing projects.

National Care Homes Association
45-49 Leather Lane, London EC1N 7TJ
tel: 020 7831 7090
email: info@ncha.gb.com
web: www.ncha.gb.com
Provides information on private residential care homes.

Philadelphia Association (London only)
4 Marty's Yard, 17 Hampstead High Street, London NW3 1PX
tel: 020 7794 2652
email: office@philadelphia-association.co.uk
web: www.philadelphia-association.co.uk
Manages two adult therapeutic communities.

Registered Nursing Homes Association (RNHA)15 Highfield Road, Edgbaston, Birmingham B15 3DU
tel: 0121 454 2511
email: info@rnha.co.uk
web: www.rnha.co.uk
Provides information on private nursing homes.

Relatives and Residents Association
24 The Ivories, 6-18 Northampton Street, London N1 2HY
tel: 020 7539 8136
email: advice@relres.org
web: www.relres.org
Advice and support for people helping someone to move into residential care.

Richmond Fellowship
8 Addison Road, London W14 8DL
tel: 020 8603 6373
email: enquiries@richmondfellowship.org.uk
web: www.richmondfellowship.org.uk
Has a network of therapeutic communities.

Stonham Housing Association
235-241 Union Street, London SE1 0LR
tel: 020 7401 2020
email: stonham@homegroup.org.uk
web: www.stonham.org.uk
Provides a variety of housing, care and support including registered care homes, shared and independent housing. Some housing is permanent, others temporary.