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What is “Supported Housing” ? (Part 2): Defining it

Here is an opportunity to offer some definitions for supported housing based on peoples’ needs. Definitions that will support the integration of supported housing into the social care mainstream.

In my 1st blog post of the “What is Supported Housing?” series I said that supported housing is a victim of its own limiting misdescriptions. I also argued that this isn’t helped by the definitions of supported housing in the UK Government’s (now stalled) “Funding Supported Housing” policy agenda of 2018, which I’ll look at below.

Here is an opportunity then, to offer some definitions for supported housing based on peoples’ needs. Definitions that will support the integration of supported housing into the social care mainstream.

This blog post may be of interest to UK-wide readers, despite the policy focus being on England. Social care is a devolved matter but supported housing still isn’t, to the extent that it’s funded through enhanced Housing Benefit/Universal Credit. In addition, the revised definitions of supported housing I propose have universal applicability.

Formal Definitions

The Social Housing Rents (Exceptions and Miscellaneous Provisions) Regulations 2016 give definitions of supported housing in its widest sense (for England) as follows:

specialised supported housing” means supported housing—
(a) which is designed, structurally altered, refurbished or designated for occupation by, and made available to, residents who require specialised services or support in order to enable them to live, or to adjust to living, independently within the community,
(b) which offers a high level of support, which approximates to the services or support which would be provided in a care home, for residents for whom the only acceptable alternative would be a care home,
(c) which is provided by a private registered provider under an agreement or arrangement with—
(i) a local authority, or
(ii) the health service within the meaning of the National Health Service Act 2006(d),
(d) in respect of which the rent charged or to be charged complies with the agreement or arrangement mentioned in paragraph (c), and
(e) in respect of which either—
(i) there was no public assistance, or
(ii) if there was public assistance, it was by means of a loan secured by means of a charge or a mortgage against a property;

supported housing” means low cost rental accommodation provided by a registered provider which—
(a) is made available only in conjunction with the supply of support,
(b) is made available exclusively to residents who have been identified as needing support, and
(c) falls into one or both of the following categories—
(i) accommodation that has been designed, structurally altered or refurbished in order to enable residents to live independently,
(ii) accommodation that has been designated as being available only to individuals within an identified group with specific support needs;
“support” includes—
(a) sheltered accommodation,
(b) extra care housing,
(c) domestic violence refuges,
(d) hostels for the homeless,
(e) support for people with drug or alcohol problems,
(f) support for people with mental health problems,
(g) support for people with learning disabilities,
(h) support for people with disabilities,
(i) support for offenders and people at risk of offending,
(j) support for young people leaving care,
(k) support for teenage parents
(l) support for refugees;

So Specialised Supported Housing is for people who might otherwise be in a registered care home and is funded through the use of private capital. It’s also exempt from the Rent Standard.

Other “Conventional” Supported Housing defined above is subject to the Rent Standard and reflects a “typical” definition of mainstream supported housing.

Both definitions in the Social Housing Rents (Exceptions and Miscellaneous Provisions) Regulations 2016 specify the landlord as a Registered Provider. However, there are many supported housing services run by nonprofit agencies that have no registered provider involvement, and still other supported housing services provided by the private sector. Are these not supported housing?

The legal identity of a tenant’s landlord does make a difference to that tenant’s entitlement to enhanced Housing Benefit where additional needs are an issue (only social/nonprofit housing tenants/licensees are eligible). This is perverse in circumstances where additional need isn’t restricted to social housing. The regulation of all supported housing is more important than the legal status of a supported housing landlord.

Definitions Proposed in “Funding Supported Housing”

In addition to these two broad definitions above, the UK Government’s “Funding Supported Housing” policy consultation originally had the following definitions of supported housing:

  • Short-term supported housing: The UK Government has defined “Short-Term Supported Housing” as being supported housing that is accessed by people in crisis and with a maximum duration of two years or until a transition to “long term stable accommodation” is possible, whichever occurs first.
  • Long-term supported housing: Long-Term Supported Housing includes people with learning disabilities mental health needs and other groups whose additional needs are permanent.
  • Sheltered & Extracare Housing: the UK Government hasn’t defined this type of supported housing in its “Future Funding” policy agenda, apart from identifying its existence. It did accept the need not to be too prescriptive in how sheltered and extracare are defined.

I don’t believe that timescale or client group should define Supported Housing; it should be defined by the nature of the needs it meets. As I mention in previous blog posts, definitions of supported housing based on a timeframe are about the restrictive management of a pot of public money, not about meeting peoples’ needs.

The proposed definitions of Short-Term, Long-Term and Sheltered & Extra Care Housing do not reflect the diversity of supported housing services. For example, where do Shared Lives/Adult Placements, Respite Care, Housing First and Intermediate Housing fit in? No consideration is given to the sometimes high degree of overlap between Sheltered & Extra Care, Long-Term Supported Housing and Specialised Supported Housing.

Proper consideration will be given to funding supported housing in my next blog post, but for the sake of clarity all forms of supported housing should be funded, in part at least, through the welfare system as the UK Government has accepted.

Revised Definitions

So-called “short-term supported housing” should be redesignated as “Immediate Access Accommodation“. Within that definition refuges and other forms of emergency accommodation for which Universal Credit is not immediately appropriate should be funded by a ringfenced local authority fund for up to 6 weeks, after which Universal Credit including an enhanced housing component should fund it.

Intermediate Supported Housing“: which, by definition, applies to people who don’t need Immediate Access Accommodation, although they may have come from it, and don’t need Intensive Supported Housing, although they may have come from it. The duration of someone’s stay in Intermediate Supported Housing would depend on the duration and extent of their need within a system geared towards the maximisation of managed interdependence. If appropriate, Intermediate Supported Housing may be provided in the same building as Immediate Access Accommodation, for example a refuge. Funded through Universal Credit.

In the same way I challenged the appropriateness of the term “Short-Term Supported Housing” I believe the term “Long-Term Supported Housing” is inappropriate and should be replaced with the term “Intensive Supported Housing“. Within “Intensive Supported Housing” peoples’ needs can be of any duration but the point is that they’re intensive. This might be as a consequence of an addiction or as a consequence of a severe learning disability to give just two very different examples of many.

Specialised Supported Housing and Intensive Supported Housing are not dissimilar. If the requirement for Specialised Supported Housing to be privately funded by definition were removed, they would be practically identical.

Sheltered and Extra Care Housing is defined by the UK Government’s 2nd set of “Funding Supported Housing” consultation proposals. I agree that definitions of the people who live in sheltered/extracare shouldn’t be too prescriptive.

Wherever we are in the UK it is important that supported housing is an integrated part of the network of social and healthcare services that people need. Social care reform is on the agenda universally and it’s important that we inform the nature of change by putting supported housing front and centre.

Providing revised definitions of supported housing that focus on peoples’ needs is important in a context where such definitions are habitually geared to the management of a budget (“long-term”, “short-term” etc). I understand that money is important but it’s much better looked at as part of a Value Generation approach:

  • Outcomes for people
  • Cost benefit to the public purse
  • Wider social/community benefit

Cost alone is a very crude measure of the value that supported housing generates. Value Generation contextualises it better within a wider framework of measurement.

My next blog post in this “What is Supported Housing?” series will focus on funding supported housing.

Michael Patterson 18th May 2020

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