Supported Living

Dimensions’ advice to families investigating different models of support is to concentrate on finding support that will enable your loved one to gain choice and control over his or her life, to remain healthy and happy and to maintain the things that are important to him or her.

This page on supported living aims to help families who are questioning their loved one’s living arrangements, particularly those thinking about a move away from the family home. In it, we answer common questions and discuss supported living and residential care options in detail to give you information to determine if supported living could be the right route for your loved one.


If you’d like to read some real life stories of Supported Living, then Maggie and Doreen, Barbara and Jackie’s stories will help set the scene.

 

What is supported living?

Supported living is a service designed to help people with a wide range of support needs retain their independence by being supported in their own home. People in supported living have their own tenancy and are responsible for their own bills and cost of living. This may include full or part furnishing and repairing any damage – exact details will vary locally. To afford these, the person may be entitled to a wide range of benefits and grants. In single person supported living, they will also have their own front door.

In Supported Living, support provision is not dependent on provision of housing (and vice versa.) So if the support provider changes, this doesn’t affect the tenancy. The person has security of tenure in line with their tenancy agreement – they can only be made to leave under certain circumstances, usually by order of a court.

 

What is registered care?

In registered care (also known as residential care, or a care home) the person has a licence to occupy a room – or occasionally a flat in a larger complex – and bills are covered by the care provider. The person can be made to leave relatively easily. The landlord is usually the same person or organisation who does the care and support. Few benefits remain available (see below for detail.) In both formats, the quality of the care and support and the pleasantness of the environment should be comparable. Also the care and support is commissioned by a Local Authority or health board and regulated by CQC (in England) or CIW (in Wales) in both formats – though in different ways, which we address further within the rest of this FAQ.

 

What is the difference between supported living and residential care?

People in supported living are responsible for their own bills and cost of living. To afford this, the person may be entitled to a wide range of benefits such as Housing Benefit (HB) – if they don’t work, Personal Independence Payments (PIP,) Employment and Support Allowance (ESA,) Mobility Allowance and Attendance Allowance (AA.) Grants to adapt a property may also be available.

In residential care, few benefits remain available. These include the mobility part of PIP and some of the daily living component. There are more marked differences to be aware of. For example, in residential care holidays may be included – though in our recent experience this is becoming less common. In supported living people pay for their own holidays, including additional staff costs. Like anyone else, people in supported living pay their own domestic bills and shopping costs, together with costs incurred by staff in the course of the support they provide – such as bus fares and activities.

Supported living isn’t necessarily more expensive overall but because families are often involved in seeing and managing the money for the first time, it can look quite alarming to those who have been used to the ‘all inclusive’ deal in a care home.

 

How can I tell if a living arrangement is supported living or care home?

You may not be immediately able to. In fact, it is an indicator of quality that someone’s home looks and feels like an ordinary home rather than a workplace, regardless of the technicalities of the living arrangement.

But some registered care homes stand out for the wrong reasons. If you’re considering something that looks roughly like a university campus, or which has many people with a learning disability living on the same site, our advice is to be very cautious. Surroundings like this can be photogenic but are they real life?

Ask yourself – and the management – some tough questions about how they support people to become independent, to make their own decisions and control their own lives. Lives – those that are really lived – are messy, in normal houses in normal streets. Good lives don’t happen in segregated communities.

 

What are the advantages of supported living?

The benefits of supported living are the choice, control and enfranchisement that come from holding one’s own tenancy and – in a single person service – one’s own front door.

In particular, by separating a person’s support and housing provider, the housing will remain constant even if a person’s support provider changes. That is essential; no-one should be forced to endure low quality support in order to keep living in their home. This is the case even with providers (such as Dimensions,) that provide both support and housing.

Supported Living arrangements, where the person’s rights are protected by his or her tenancy agreement, often offer greater security of tenure compared to residency in a care home which typically come with 28-day notice periods. That said, this security does depend on the terms of the tenancy agreement. With more and more supported living services being found through the private rented market rather than social housing, the old idea of a ‘home for life’ is dwindling.

 

What are the disadvantages of supported living?

The benefits of supported living are the choice, control and enfranchisement that come from holding one’s own tenancy. The resulting responsibilities include managing multiple costs, keeping to the tenancy agreement etc. For some people the benefits may not be meaningful or desirable and then the costs are an avoidable burden. So there are times when supported living may not be the right model of support.

That’s why all decisions about an individual’s support should always be made on person-centred grounds, not on any sort of ideology. For example, it may be that a registered care home is able to offer greater shared support. It may be that a tenancy becomes something of an anchor, if a person’s declining health requires considerable adaptation to be made to his or her living environment. It could be that a single person supported living arrangement leads to the person becoming more socially isolated (though note that in this case the issue is the ‘single person’ not the supported living per se.)

 

Who is supported living suitable for?

Supported living used to be thought of as primarily for more able people and those who wish to live alone. Whilst both those groups of people can certainly benefit from supported living, so can people with more complex needs, and those who prefer to live with housemates. Both supported living and registered care can provide support 24/7 support if required; we support many people with profound and multiple learning disabilities and complex needs in supported living environments.

We also support people in smaller care homes and larger supported living services as well as the opposite. The decision about whether someone lives alone or with housemates should be based on their assessed needs, personal wishes, compatibility and the opportunity to pool budgets to deliver shared support.

 

Is shared support a good thing?

In principle, yes. Sharing elements of someone’s support (for example, night support) can lead to more resources being made available for daytime support hours. However, it does incur some risk: There’s a risk that everyone will end up doing what the strongest personality in the house wants to do.

Conversely, excess compromise can leave everyone dissatisfied. And if someone needs to change where they live it can be laborious to carve up the shared hours, ensuring everyone retains the support they are individually assessed to need – notwithstanding the full reassessment that would occur naturally.

In austere times, there is always a temptation for local authorities to use shared support as a means of cutting individual budgets – this can occur equally in both supported living and residential care. Families can use the Care Act to challenge such decisions and Dimensions is part of a coalition offering a free legal support service to help families in this position.

 

Click the question to show the answer for these additional FAQs:

How can Dimensions help with supported living or other housing option needs?

Over 80 local authorities and numerous parts of the NHS trust Dimensions to support people with learning disabilities and autism to live fulfilling lives. We offer a mix of services to meet individuals’ needs. Why not speak to your local authority to find out if we are one of their preferred support providers?

And our housing brokerage team are experts at finding and securing homes for people.

Alternatively, use our postcode search to see where we currently work:

Our Transitions Guide

Dimensions has a range of helpful guides for families, including to transition. Find them here

 

Useful External Resources

NDTI guidance on the differences between supported living and residential care

NHS Guide on Supported Living Services

ChallengingBehaviour.org Pack – 8 Ways to Get a House