The purpose of this blog post is to identify the high-level principles for the regulation of supported housing and for the assessment of the value generated by supported housing. Collectively we might call this “oversight”. The details of both systems are content for a future, longer published briefing (watch this space).
Supported housing accommodates between 600-700,000 people in the UK, some of whom have high levels of additional need. Supported housing providers receive over £4 billion annually in Housing Benefit/Universal Credit revenue together with contributions from the people they accommodate and, in some cases, statutory sector top-up funding as well.
No one is responsible for the oversight of supported housing. Some might argue that there are plenty of regulators in the supported housing sector: the various national social housing regulators, the Charity Commission in England and Wales, the OSCR in Scotland. To a greater or lesser extent these agencies might regulate supported housing providers, but they don’t oversee supported housing or what it does, and they probably shouldn’t try.
Supported housing accommodates a wide range of additional need and there is a need for oversight. I’ve made reference a number of times recently to Thea Raisbeck’s “Exempt From Responsibility?” Paper, part of which looks with concern the unregulated Exempt Accommodation sector.
There is a distinction between regulation on the one hand and the measurement of quality/assessment of value on the other, although there is a relationship between them as “oversight” functions.
Regulation & the Assessment of Value
Regulation might include the ongoing assessment of:
Financial security and stability (calibrated to accommodate a diversity of specialist supported housing providers)
Service delivery competence
Any system for “measuring” (assessing) the value of what supported housing does, separately from regulating the organisations that provide it, should be based on Value Generation principles:
Outcomes for people
Wider social/community benefit
We have the opportunity here to put something in place that works. Whilst the UK has increasingly divergent health and social care systems, the regulatory and value assessment approaches I’m setting out have potential applicability across the 4 nations.
Some of you may recall the QAF (Quality Assessment Framework), compliance with which was required for Supporting People funding, although not all supported housing providers had Supporting People funding. In addition to QAF compliance, supported housing providers had to submit performance returns (SPPIs). Over time, these returns became increasingly compromised by the “cost control” bias applied to them by local authorities seeking cost savings. This in turn encouraged some providers to describe the service delivery outcomes in unjustifiably positive terms in order to maintain their less than adequate funding.
Consider this example, which is true. Someone with a high level of additional need who lives in supported housing runs up high arrears, threatens other people and causes significant property damage. That person is then moved by the (regulated) supported housing provider into private sector accommodation without recourse to eviction (this was pre-Covid 19), and this is described as “planned move on”. The planned move on enables the supported housing provider to tick the “successful outcome” box in contractual compliance terms when what they actually did was to pass unresolved need to another part of the system.
Neither the system for assessing value (Value Generation) or the regulatory framework it sits next to should be operationally onerous for providers of supported housing. The oversight tail shouldn’t wag the operational dog on a day-to-day basis.
Smaller and specialist providers often struggle to comply with finance and governance regulation requirements. Regulation systems should adjust themselves to the safe operating parameters of all supported housing providers, not vice versa.
Systems for regulating supported housing providers and for assessing the value they generate should be developed independently by universities or other social policy research bodies as national frameworks (by which I mean separate frameworks to suit the particular characteristics of the health and social care system in each nation).
It would be appropriate for the body that develops the regulatory and value assessment frameworks to then operate them independently from but in conjunction with the agencies that commission and fund the supported housing. This would break the link between funding and the assessment of value, which needs to happen lest we focus on the cost of everything and the value of nothing.
Supported housing oversight is essential. It accommodates high levels of additional need and receives significant public and other revenue.
An oversight system comprised of regulatory and value assessment components should be independently developed and then implemented/managed by a university or social policy agency.
Regulation should accommodate diversity and specialism: it should not discriminate in favour of scale.
Oversight as a whole should maximise security and quality of outcome for people without impinging on supported housing providers’ service delivery resources.
There is change to the social and healthcare landscapes throughout the UK. The evolution of health and social care should include seeing supported housing as an integrated part of the different systems within the 4 nations. For this to occur it is important for supported housing to have the type of oversight I have described.
This blog post is the third in the “What is Supported Housing?” Series. To summarise so far I have suggested that supported housing:
Be defined other than by timescale
Is where someone with an additional needs lives, for the duration of that need, irrespective of who the landlord is
Should be regulated and overseen (see my next blog post)
Should be commissioned, funded and “measured” according to Value Generation principles
The UK Government is working on draft social care legislation for England and devolved governments have yet to integrate supported housing into the health and social care mainstream. Supported housing, not least its funding, should be part of the health and social care mainstream.
Supported housing revenue includes local authority and NHS administered funding for social and health care needs, and people’s own personal budgets.
Supporting People funding is now the exception not the rule. A significant amount of the value of the Supporting People budget (originally £1.8 billion) has been reallocated into (enhanced) Housing Benefit as Intensive Housing Management funding. It’s moved from the instability of local authority finances to the relative stability of the welfare benefits system.
The key question when it comes to recurring revenue for supported housing, however is “where will it sit in relation to the welfare benefits system?”. The UK Government gave a “Future of Supported Housing” policy commitment in 2018 to keep the funding of supported housing within the welfare system.
Lord Freud acknowledged in 2012 that people in exempt or specified accommodation would have the housing component of their Universal Credit administered by the local Housing Benefit team under the Exempt Accommodation rules. So effectively, enhanced Housing Benefit for Intensive Housing Management is paid as the housing component of Universal Credit on an uncapped basis.
I believe that this supported housing component of Universal Credit should be redesignated “Supported Housing Rent”, which should be payable to all supported housing providers regardless of legal identity, provided they are properly regulated/accredited and overseen (see my next blog post “The Regulation of Supported Housing”).
Whoever the landlord is, be it social, private, statutory, voluntary charitable; would it not be better for there to be a simple system whereby the costs of the building are met through a banded system to take account of different cost variables? In England these bandings would probably be regionally based. (See the “Lord Best letter” of 2017). The additional (non bricks and mortar) housing needs components can also be banded according to level of assessed need (low, medium or high).
This system has the advantages of reflecting variable levels of additional need and building/property costs whilst at the same time applying sufficient maxima to each band. It dispenses with the need for basing rent levels on wildly inconsistent Local Housing Allowance levels.
Within a Universal Credit claim Supported Housing Rent components would be therefore be awarded based on a banded regional basis to reflect the variable costs of the development and management of property in every and any given region of England, and whilst Universal Credit remains a non-devolved issue this model may also be of interest to NI, Scotland & Wales.
The housing based additional needs component of Supported Housing Rent could be paid at three levels: low medium and high. These are simple principles that allow for variable costs in both buildings and the needs of the people who live in them.
Recipients of Supported Housing Rent (landlords) will have to generate value:
outcomes for people
cost benefit to the public purse
wider community benefit.
They will have to comply with regulatory and oversight standards (see my next blog post). We really should dispense with the absurd and discriminatory notion that peoples’ entitlements to enhanced revenue (in this case Supported Housing Rent) as a consequence of their additional needs should be dependent on the legal identity of their landlord, which is the case now.
The capital funding of supported housing is a blog post in its own right. However, having given a view on supported housing revenue it seems sensible to make some summary comments on the capital position.
We are moving increasingly in the direction of private capital funded supported housing. This has been especially so in the case of Specialised Supported Housing (what I would refer to as “Intensive Supported Housing”).
There is a need to get the balance right between social motivation and profit. Put a different way, there is a need to be realistic about what percentage return on capital public revenue should be expected to return. Investors should generate value in what they do just as much as providers of supported housing are expected to do.
REITs (Real Estate Investment Trusts), which facilitate much of the investment in supported housing, need to evolve their structures in the light of the English social housing regulator’s judgements against some REIT-based housing associations and the associated trade press reporting.
Conversely, we should consider how well-placed social housing regulators across the UK are to oversee supported housing, a significant amount of which sits outside their sectors. I think there are strong arguments to make for the independent oversight of supported housing, arguments I shall attempt to make in my next blog.
Investment in supported housing is based on a viable revenue stream. This viable revenue stream, with its consequent impetus to investors, should be built into universal credit on a Supported Housing Rent basis.
The UK Government will also continue to deploy public capital (and revenue) in the form of targeted funding for specific outcomes. For example, it has recently announced that it is bringing forward £160m of its Rough Sleeping Services budget to provide 6000 homes with support for street homeless people in England. This is ambitious enough to be a game changer for street homelessness, provided the revenue for support is sufficient and stays in place.
We need to think about the funding of supported housing in the context of its outcomes (see my blog post on defining supported housing) and its regulation/oversight (watch this space!).
Supported housing needs revenue funding certainty for its day to day operation and in order to give investors confidence to invest and providers confidence to provide.
Supported Housing Rent builds revenue and confidence into the system and makes the relationship between needs and resources. It retains revenue for supported housing within the welfare benefits system.
Supported housing providers, “social” or not, should generate value and comply with regulatory/oversight frameworks in order to qualify for Supported Housing Rent.
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.
“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.
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.
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.
Supported Housing: A Victim of its Own Misdescription
As an advocate for supported housing I think it is important to think about what we actually mean when we think of “supported housing”.
In my experience it is certainly the case that supported housing has been and remains a victim of its own misdescription. We have allowed people and institutions, some of whom see themselves as advocates for supported housing, to impose their own limiting beliefs and definitions. We have allowed our vision of supported housing (and other preventative, enabling services) to be blurred by other agendas such as “cost control” in the commissioning of supported housing and the administration of public money. The preoccupation with the cost of everything and the value of nothing has led us to limit our own beliefs about what’s possible with supported housing and has helped to restrict its significance as an essential part of our social response to additional need.
Supported Housing, Health & Social Care
Supported housing is routinely seen as a disconnected, less important component of the social network of services people need. It’s not seen as an integral part of the wider social care agenda, which is its rightful place. Social care services throughout the UK are under immense pressure; there is both an opportunity and a necessity to talk about supported housing in a way that gives it the status it deserves but seldom gets as part of the solution to the UK-wide crisis in social care.
The Scottish Government has taken steps to integrate health and social care in both structural and funding terms, but supported housing seems to be a separate matter. The Welsh Government is also focusing on health and social care integration and makes the link with housing and education without being very specific. Northern Ireland has integrated Health & Social Care Trusts, which cover residential care but not supported housing. The UK Government, on behalf of the otherwise ungoverned English, has said it wants to solve the social care crisis, but we have yet to hear any specific proposals. In all 4 constituent nations of the UK it is important to identify supported housing as fundamental to any vision of the structure of health and social care.
The next few posts to the Supported Housing Blog will focus on how we should define, fund, review, “measure” and regulate supported housing. The intention is to offer a view of the nature, scope and purpose of supported housing and its place within the wider agenda of social care.
What is Supported Housing?
The most obvious, and least helpful, way to see supported housing is as buildings in multiple occupation, owned or managed by a social organisation that were designed and developed to temporarily accommodate people with additional housing and other needs. It’s certainly true that such supported housing does exist, and so it should, but not at the price of limiting our thinking and peoples’ choices.
I’ve always considered that it is less about the building and the landlord and more about the people and their needs. For me supported housing is somewhere that someone with an additional need lives. It is supported housing for the duration of that additional need (and the length of time that someone is supporting the person to live there). Sometimes it’s permanent supported housing, sometimes it’s temporary supported housing: it all depends on what its occupants’ needs are
It shouldn’t matter whether it’s “social” housing, rented, owned, multiply occupied or solely occupied; whether it was developed and built as “supported housing” or just an ordinary house or flat
Furthermore, we shouldn’t make the damaging mistake of limiting how people see the scope of supported housing through careless definitions of its purpose and of the people who live in it, for example, as describing it as for “…people who need a bit of support”. Supported housing is for such people, but it’s also for people who would otherwise be in hospital, registered residential care or prison.
Neither should we allow the tail to wag the dog by giving different “types” of supported housing definitions based on timescales (“long-term”, “short-term”). Such definitions are based on a discredited “cost control” approach to managing the administration of the funding upon which supported housing depends. When looking to commission or fund supported housing “lowest unit cost” should not be a reason to fund it, it should be a reason to scrutinise more closely its outcomes in the context of Value Generation, which is defined as follows:
Outcomes (for people)
Cost benefit (to the public purse)
Wider social benefit (community sustainment)
Then we can have a much more nuanced idea of whether it should be funded. A crude dependency on cost control and the preference for lowest unit cost over all else prioritises the management of a budget over the needs of people. And it’s an expensive way of doing things too: when we fail to invest in preventative services such as supported housing, we pay a much higher financial price to fund otherwise avoidable healthcare, criminal justice, homelessness and other interventions as a consequence. And that doesn’t include the calamitous human cost of a failure to invest in prevention.
The funding bias in favour of “social” providers is a reflection of the lack of any proper regulatory framework for supported housing. The lack of dedicated regulation forces us to take false comfort from the fact that “social” organisations are often regulated by some agency or other (although not as supported housing providers per se). To assume that supported housing run by a social landlord will necessarily be cheaper or better than any other form of supported housing is an assumption borne of a failure to imagine how supported housing regulation and funding should work.
So, the story so far is that we are having to work and live with a system the fundamentals of which are in error.
We haven’t thought deeply enough about supported housing to conceptualise what it is in order to describe it properly. In order to describe supported housing properly I’m going to devote my next few blog posts on how we should
measure the quality of what it does.
It is important to take the opportunity to think in depth beyond the restraints of the system that currently defines and funds supported housing from a cost control perspective, which fails to regulate and measure quality in any meaningful sense.
Watch this space for weekly Supported Housing Blog posts that develop a definition of supported housing as part of the wider health and social care agenda. Please do comment on this blog post and share it widely.
This was written in 2015 & remains relevant today.
The purpose of this Briefing is:
To explain what Exempt and Specified Accommodation is and to make clear my view that most “Specified Accommodation” is actually “Exempt Accommodation”
To explain the Welfare Reform Act implications of Exempt and Specified Accommodation
To give comprehensive examples of Additional/Intensive Housing Management tasks and functions
To examine the future for Enhanced Housing Benefit and Additional/Intensive Housing Management
In recent months there has been much discussion about Exempt Accommodation and Specified Accommodation and a great deal of confusion about the difference between “Exempt” and “Specified” Accommodation.
The purpose of this briefing is to define what these definitions really mean and to make the very important point that most supported and sheltered housing, hostels and refuges currently being defined as “Specified Accommodation” but not “Exempt Accommodation” are actually Exempt Accommodation. This is very important for providers and local authorities from a financial point of view and to tenants/licensees from a Welfare Reform protection perspective.
As you may know the UK Government had said in 2012 that tenants in Exempt Accommodation would have the housing component of their Universal Credit administered outside of Universal Credit according to the Exempt Accommodation rules and would be protected from elements of the Welfare Reform Act (described below). Lord Freud, the UK Government Welfare Reform Minister, also subsequently said (September 2012) that there are some supported and sheltered housing services that “don’t meet the precise definition of Exempt Accommodation”. Such schemes, it is argued, might include agency-managed services and services providing “insufficient care, support and supervision”. We believe very strongly that, in the vast majority of cases, agency-managed schemes may well be Exempt Accommodation, and certainly can be established as Exempt Accommodation with some minor adjustments to the documentary arrangements in place.
The DWP then proceeded, in consultation with parts of the sector, to devise a widened definition that would capture both Exempt Accommodation and also those schemes that it claimed “don’t meet the precise definition of Exempt Accommodation”. This widened definition is known as “Specified Accommodation”.
So What Is Specified Accommodation?
There are 4 categories of “Specified Accommodation” as follows:
Category 1: Exempt Accommodation.
The term “Exempt Accommodation” came into being in 1995 as a means of identifying types of accommodation that were exempt from what was known at the time as “Local Reference Rents”, which capped the amounts of rent that private landlords could charge.
For an Exempt Accommodation scenario to exist ALL of the following 4 criteria must be fulfilled:
The landlord must be a non-metropolitan county council; voluntary organisation, charity or Registered Provider (housing association)
The landlord must have legal interest in the properties concerned (ownership or lease)
The tenants concerned must need “care, support & supervision” (in case law terms this means “more than normal property management functions)
The additional services to meet those needs (“Additional/Intensive Housing Management”) must be provided by the landlord or an agent on its behalf
Entitles a social landlord to recover the costs of providing additional services to tenants/residents with additional needs via Housing Benefit.
Enables local authorities to fund enhanced levels of Housing Benefit, subject to a properly evidenced claim which shows that the money claimed equates to the cost of eligible additional services provided.
Enables local authorities to reclaim the money from the DWP via their Subsidy Claim. 100% where a Registered Provider (Housing Association) is involved but less where one is not.
Exempt Accommodation protects tenants from Welfare Reform Act provisions such as:
Spare Room Subsidy (“Bedroom Tax”)
Direct payment of rent
Exempt Accommodation applies, subject to the 4 qualifying criteria above, to:
Most supported Housing
Most sheltered Housing
General Needs Housing where the tenant has additional needs (Tenancy Sustainment)
Category 2: Supported housing where a third party (not the landlord) provides the “care, support & supervision”
Typically this would include agency-managed supported housing and schemes where tenants have personal budgets and purchase care packages from a third party provider.
As a consequence of this definition and some of the advice that has been provided within the sector, many providers have assumed that agency-managed schemes and accommodation within which tenants use personal budgets to buy care packages from third parties are not Exempt Accommodation. However, this assumption is very often incorrect.
We have to ask ourselves the question “what is care, support and supervision”? The case law definition (see Bristol City Council vs. AW  and CSH/250/2104) is “more than normal property management functions”. So where a tenant has additional needs that require additional/intensive housing management and the landlord or an agent on its behalf provides the additional/intensive housing management, it is Exempt Accommodation, not Specified Accommodation category 2.
When we think about, it in most of the schemes wrongly classified as Specified Accommodation category 2, the landlord and/or the agent on its behalf provide Housing Benefit eligible additional/intensive housing management services in addition to and irrespective of any Housing Benefit ineligible care and support services that might also be provided. The fact that these additional/intensive housing management services are provided by the landlord or by an agent on the landlord’s behalf means that the scheme/service is Exempt Accommodation.
Such additional or intensive housing management services include, but are not limited to:
General needs housing management functions that are more intensively provided as a consequence of the additional needs of tenants
Additional or intensive housing management functions and tasks that would not be provided in general needs accommodation where no additional needs exist. Such tasks and functions include but are not limited to:
The provision of an alarm (even though alarms are not HB eligible) or the Housing Proactive system (which is HB eligible and is also entirely free to providers and tenants who are HB eligible)
Controlling access to the premises (concierge type services)
Ensuring rent is paid regularly and on time.
Explaining the occupancy agreement and assisting people to abide by it.
Organising inspections of property and arranging for any repairs or improvements to be carried out, including the replacement of furniture.
Ensuring that people are aware of their rights under their occupancy agreement.
Offering advice and guidance on keeping property to a reasonable standard of hygiene.
Assisting people to access other support providers as required.
Liaising with all relevant agencies, both statutory and voluntary, on the tenant’s behalf.
Assisting people to reduce rent arrears.
Dealing with nuisance issues.
Ensuring that people know how to use equipment safely.
Providing people with advice and facilitating a move to alternative accommodation as required.
Assisting people to claim Housing Benefit and other welfare benefits.
Helping to keep people safe by monitoring visitors, including contractors and professionals, and by carrying out health and safety and risk assessments of property.
Please see Appendix 1 for the technical definition of what constitutes an HB eligible service charge where people have additional needs. This is very useful where you are told “there’s no such thing as “Intensive Housing Management”, which of course misses the point by focusing on an informal phrase that describes services that people with additional needs might require in connection with the provision of adequate accommodation.
Category 3: refuge provision
Refuges for people subject to domestic violence and abuse are in an identical situation to Category 2 Specified Accommodation (above), which is that in the significant majority of cases they are Exempt Accommodation and not Specified Accommodation category 3.
The fact that people in refuge accommodation don’t also need to be in receipt of “care, support or supervision” by way of 3rd party funding is immaterial in this context as they will almost inevitably be in receipt of “more than normal housing management functions” anyway and therefore fulfill the case law definition of “care, support and supervision” for the purposes of Exempt Accommodation compliance.
Category 4: local authority hostels
Support Solutions UK has recently undertaken a lot of work with local authorities that have their own direct provision. Most local authorities are registered as registered social landlords with the appropriate regulatory bodies depending on which UK nation they are located in.
The fact of being a registered social landlord (and assuming compliance with the other 3 of the 4 Exempt Accommodation criteria, which is likely in the case of hostels and other accommodation for people with additional needs) means that local authority hostels are exempt Accommodation, not Category 4 Specified Accommodation.
Specified Accommodation categories 2, 3 and 4 means:
Protection from Benefit Cap & direct payment of rent but NOT Spare Room Subsidy (unlike Exempt Accommodation, which protects tenants/licensees from Spare Room Subsidy).
No guarantee of enhanced Housing Benefit if the rents are deemed “unreasonably high” as the local authority may refer the rent to the Rent Officer (unlike Exempt Accommodation, with which the local authority has to have regard for the costs of suitable accommodation elsewhere on a like for like basis if considering a restriction on rent or service charge)
Rent levels restricted to Local Housing Allowance where no Registered Provider is involved
If it is the case, as we strongly believe, that services that really are Exempt Accommodation (or “Specified Accommodation Category 1”) are being misdefined as Specified Accommodation Categories 2, 3 or 4 then we are guilty of failing to challenge an incorrect view of services that “don’t meet the precise definition of Exempt Accommodation” and consequently restricting Welfare Reform Act protection from tenants with additional needs and we are guilty of foregoing the opportunity to properly fund services for tenants with additional needs.
The Future for Enhanced Housing Benefit
I have worked since 2005 to assist organisations to allocate Additional/Intensive Housing Management costs into Housing Benefit where it is right and proper to do so. Most commonly this occurs where provider organisations have lost revenue from Supporting People but also where providers have not recovered their full eligible costs from Housing Benefit, irrespective of whether they receive Supporting People funding.
When I first introduced this idea with Support Solutions and reintroduced the concept of “Intensive Housing Management” it was treated by some with opposition and suspicion but has now become the default position for local authorities and providers, especially where Supporting People funding is being reduced or withdrawn. We were told that it wouldn’t survive the Welfare Reform Act but, on the contrary, Exempt Accommodation and Additional/Intensive Housing Management has become the gateway to proper levels of funding for services for people with additional needs and provides protection for such people from elements of the Welfare Reform Act such as:
Spare Room Subsidy (“Bedroom Tax”)
Direct payment of rent
Enhanced Housing Benefit applies to supported and sheltered housing and to general needs social accommodation where tenants have additional needs (Tenancy Sustainment services). But we have to ask the question, as many do, “how long will it last”?
When Lord Freud said in September 2012 that there are services that “don’t meet the precise definition of Exempt Accommodation” as a precursor to the introduction of Specified Accommodation, he also suggested that funding for Exempt Accommodation would be “localised” at some point in future.
We believe that this is likely to happen at some point in future so it is important for providers who are entitled to claim Enhanced Housing Benefit for Additional/Intensive Housing Management services to do so. It is also important for local authorities to agree well-founded and reasonable claims, as these are likely to contribute to local authority legacy funding going forward. To the extent that local authorities discourage such claims is the extent to which they may well limit the size of their own funding pot at the point at which the Exempt Accommodation budget is devolved. The UK Government might consider devolving Exempt Accommodation funding in the same way that it devolved Council Tax funding to local authorities (i.e. by taking the amount each local authority had claimed from the UK Government by way of Council Tax Benefit subsidy in the financial year 2012-13, deducting 10% and then devolving it to local authorities from April 2013).
There is a General Election looming of course, so things may change; however, our belief is that funding for Exempt Accommodation will be devolved to local authorities in England, which doesn’t have its own Government, and possibly to national Governments in Northern Ireland, Scotland and Wales.
We know that the DCLG & DWP have commissioned a review of the scale, shape and cost of the supported housing sector. We hope that it also considers its value! This review has yet to report and the forthcoming General Election will doubtless impact on the timing of its publication and possibly its outcomes. We will keep you posted as to developments when we are made aware of them.
Whatever the nature of any change please consider your organisation’s position, whether you’re a provider of services or a local authority Housing Benefit or commissioning colleague. Providers, both statutory and non-statutory, should ensure that they have reviewed their Housing Benefit revenue and their rent structures to ensure that their claims match the costs of the Additional/Intensive Housing Management services they provide to people with additional needs in supported, sheltered, hostel, refuge and general needs accommodation. I will help you do this and negotiate your claims for you on very, very favourable commercial terms as I always have (i.e. if we don’t successfully increase your housing revenue, you don’t pay us). Local authorities should also consider their strategic positions in relation to the payment of enhanced Housing Benefit for well-founded and reasonable claims and their ability to reclaim through subsidy what they pay by way of Enhanced Housing Benefit; again, I will be pleased to assist in this.
If and when funding for Exempt Accommodation is devolved it is likely to become a cash-limited pot, which may then be paid according to a limited set of eligible tasks. We believe that this is the wrong approach but inevitable whilst government at both central and local level prioritises cost over value and persists with separate funding pots for different types of additional needs (e.g. intensive housing management, support, social care, personal care etc.).
“There is no exhaustive list of what can be defined as an eligible service charge. To be an eligible charge for HB purposes the charge must be connected with the provision of adequate accommodation having regard to the personal needs of that tenant group. Authority for this can be found in the DWP Adjudication Circular A22/2008, which was published in December 2008. Page 18 within Appendix A of that circular states that ‘The Commissioner’s decision in CIS 1460/1995 is authority for the proposition that the individual needs of the residents are relevant to the question of what is adequate accommodation. Arguably the special needs and problems of the residents of the home cannot be ignored in relation to paragraph 1(g)’ Paragraph 1(g) of Schedule 1 is of the Housing Benefit Regulations and relates to the service being connected to the provision of adequate accommodation. This is therefore suggesting that a service can be eligible having regard to a resident’s personal circumstances. The general population within supported housing are vulnerable people all in receipt of care and support and thus encompass a specific set of needs therefore the provision of an intensive housing management service is probably essential to the general tenant population of this specific type of accommodation.
Supported Housing is provided to primarily tenants who are disadvantaged with a wide range of complex and changing needs. There are a significant proportion of tenants whose high support needs, poor housing management awareness and lack of practical skills, mean that there is a requirement for a much more enhanced housing management provision to ensure that the tenants can sustain their tenancy whilst at the same time ensure that the landlord is providing reasonable and adequate accommodation for all tenants”
Please contact Michael Patterson if you’d like help with Exempt Accommodation, Specified Accommodation and enhanced Housing Benefit.
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This Briefing seeks to provide information about Covid 19 to landlords and providers of social and supported housing.
It identifies “at risk” groups, explains why people are at risk and sets out (and adds to) the recently published “Social Distancing” guidance.
You can get the most recent daily updates on Covid 19 within the UK, EU & EEA here.
It identifies the specific responsibilities that landlords and providers need to be thinking about and the actions you need to be taking.
It identifies Housing Proactive and Housing Proactive Plus as value generating interventions that are usually provided, installed and maintained, at nil cost (subject to welfare benefits eligibility) and that enable landlords and providers to increase human contact with tenants with additional needs whilst minimising infection risk and optimising staff deployment.
I’m writing this Briefing whilst in self-isolation as a consequence of Covid 19 infection. Covid 19 impacts different people in different ways. For me my head throbs like a bell tower, my limbs ache, my voice strains through a throat that feels like I’ve swallowed a cheese grater, my chest is tight, and I am tired, really tired. But I’m writing this Briefing so I’m one of the more fortunate Covid 19 victims, and to be honest what bothers me more is the thought that my 96-year-old mother, or my son with learning disabilities might fall victim to it.
Being involved in supported housing, it is natural that the impact of Covid 19 on people with additional needs occupies my thoughts. People with a variety of additional needs are vulnerable to the physical effects of the virus, and also to the societal effects. Providers are struggling with the sheer enormity of what we are facing.
Part of the purpose of this Briefing is to suggest a solution that will genuinely help people. I’m a believer in things that generate value. Value Generation has 3 components:
Positive outcomes for people (with additional needs)
Wider social/community benefit
But before we look at a solution, let’s take the measure of the problem.
Who is Most at Risk?
Emerging data show clearly that the people at most risk from Covid 19 infection are older people, and people with lung, heart and immunological problems of any age. The UK Government/Public Health England guidance on social distancing (see below) lists a much wider community of “at risk” groups.
The primary cause of Covid 19 mortality is lung infection, and this isn’t limited to older people although they are more susceptible to such infection and also to general immunological weakness.
The second most common cause is cytokine storm, which is the technical term for an overreaction of the body to infection and is most common in people over 75. At that age peoples’ immune systems are less effective and can overreact to infection potentially resulting in fever and organ failure.
Older people generally suffer more than their younger peers from one or more chronic illnesses. Findings from China, Italy and the USA show that it is a combination of age and pre-existing chronic illness that makes people especially vulnerable to the worst consequences of Covid 19 infection.
being seriously overweight (a body mass index (BMI) of 40 or above)
those who are pregnant
How do we Respond?
Social landlords, their agents and provider organisations that operate accommodation-based (and other) services to people with additional needs should be mindful of the social distancing guidance document. Judging by our engagement with them they are very mindful of their obligations to people they house and support, but in common with society in its entirety they’re struggling with the enormity of the situation.
People are being told to self-isolate. People over 70, and those under 70 with a “chronic condition” (see the social distancing guidance) are being asked to do so for a period of 12 weeks.
Social isolation is harmful, especially for older people. It can result in high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease……..”. None of these conditions are good at any time, but with Covid 19 risk many of them become cast into sharper, more urgent focus. Social isolation exists, and is dangerous, without Covid 19 so any solution to help with it should be present after the Covid 19 threat has gone.
According to Age UK “…..more than 2 million people in England over the age of 75 live alone, and more than a million older people say they go for over a month without speaking to a friend, neighbour or family member.” Many of these people will be social housing tenants in general needs and sheltered accommodation, much of the latter is now physically unstaffed.
It isn’t just supported housing that contains a multiplicity of vulnerabilities to Covid 19 infection. The population of so-called “general needs” social housing exhibits very significant levels of additional need. According to the ONS: “One-quarter (24.7%) of disabled people in 2019 rented social housing, compared with just 8.2% of non-disabled people.”
We should be mindful of the “at risk” groups identified in the social distancing guidance, for example, age, respiratory disease, heart and kidney disease, “neurological” issues such as Parkinson’s Disease, Motor Neurone Disease, Multiple Sclerosis, learning disability, cerebral palsy, diabetes. Also sickle cell and spleen-related conditions, HIV/AIDS and other immunological deficiencies and obesity.
In addition, people with mental health needs, substance misuse needs and other conditions where self-care may be compromised may be susceptible to Covid 19. Homeless people, people at risk of domestic violence & abuse, asylum seekers and refugees and other needs groups are also more likely to slip through the medical/social net as well.
Housing Proactive/Proactive Plus
Housing Proactive is a telephone/tablet-based system that, at its most basic level requires users to press a button on their ‘phone or device that says, “OK Each Day” (supplied free) by a specified time of day, assuming everything is OK with regard to their property and tenancy in general. If a tenant doesn’t press that button by the agreed time, they get a ‘phone call from a real person asking them if everything’s OK at home. If they don’t pick up the call then a call is immediately made to the landlord, provider, family member or whomsoever has been agreed as the point of contact in such circumstances.
With Covid 19 the challenge for landlords and providers is to increase two-way social contact without infection risk. Housing Proactive does this by providing a telephone and/or tablet-based communication service that enables social landlords to communicate directly to individuals and groups of tenants verbally or by message. Similarly, tenants can contact you. In addition to letting you know they’re OK by pressing their “OK Each Day” button by an agreed time/times, they can also let you know they’re not OK.
Given the many changes in procedures required and challenges with staffing, the need to communicate quickly and effectively with people is critical, especially for higher needs and more at-risk groups.
Housing Proactive has an add-on capacity (known as Housing Proactive Plus) in the form of what’s called “Envosense”, which is a sensor that detects changes in temperature and humidity and alerts you when either or both are not what they should be.
As temperature falls in a home, blood pressure goes up – putting people at greater risk of stroke, heart attack or other cardiovascular problems. Furthermore, as temperature falls susceptibility to influenza, colds and other viral infections such as Covid 19 increases.
Housing providers may have a duty of care, particular in sheltered and supported housing where it is understood that tenants have higher needs and greater health challenges to ensure temperature ranges are in appropriate ranges.
Furthermore, excessively high temperatures in a property can be an indicator that someone is unwell (as they have turned their heating up in response), or might be an indicator that the tenant is at higher risk of energy related arrears.
Public Health England reviewed the literature on the impacts of temperature and humidity on people, older people in particular, and their findings are given sharper focus given the risk factors associated with Covid 19 infection discussed above:
“The evidence from the small number of epidemiological studies identified suggests an association between raised blood pressure with exposure to indoor temperatures of around 18°C or colder in the general adult population.
When the effects of cold in older people were compared with those in younger people, the studies showed in general that the changes in outcomes such as blood pressure, clotting factors, cholesterol and in core and skin temperature were more profound, with slower recovery, in older people. Several studies also demonstrated reduced thermoregulatory control and thermal perception/discrimination with ageing.
There are a number of quite serious health issues related to living to excess moisture. A relative humidity of 60 per cent or above provides optimum conditions for microorganisms and airborne allergens, such as dust mites or mould spores to thrive. Black mould in particular is highly toxic and can cause respiratory infections.
Our homes also suffer if humidity is too high. Excess moisture will rot wood, corrode electronics and appliances, spoil instruments or books, cause food to go stale, and trigger the proliferation of mould and mildew, which can damage wallpaper and soft furnishings, and even compromise the structural integrity of a building.
Maintaining a relatively constant humidity level indoors, between 40 per cent and 50 per cent, can bring great benefits.
Below this, and influenza and other air-borne viruses can thrive – and are more easily transmissible, above this – mould, and other bacteria begin to thrive which can cause significant respiratory and allergic issues, impair the immune system, increase illness and begin to physically damage properties. Wood also rots faster at these higher humidity levels.”
More efficient staff deployment is a necessity at times like this. Social housing and provider organisation staff are stretched at the best of times. Covid 19 adds the additional challenge of a social distancing requirement to reduce infection risk and higher staff demand. Using Housing Proactive enables social landlords and providers to deploy staff in a different way. They can focus on those people who they know are in difficulty for whatever reason because they didn’t press their “OKEachDay” button and they didn’t respond to the call from Housing Proactive’s call centre that would result from a failure to press their button. Similarly, tenants have the ability to call you if all isn’t well with their property or tenancy in general. Being part of an integrated system drastically reduces the necessity for face-to-face contact whilst actually increasing the level of other human contact and the mutual reassurance that goes with it.
That mutual reassurance is in place 24 hours every day, every week all year round.
The fundamental principle of Housing Proactive and Envosense is to enable the housing provider to manage their properties, tenancies and facilities more effectively and efficiently. As such it is Housing Benefit/Universal Credit/Pension Credit eligible, so people entitled to those benefits don’t pay for it and neither does the landlord/provider. The equipment is free; the installation is free (above a certain number of units) and there are no servicing or other costs. This is a Value Generation proposition that has a great deal of value to offer in a time of significant challenge. In addition to the direct benefits it brings in this time of unprecedented challenge it also provides important byproducts: a reduction in social isolation, more efficient staff deployment and the detection of changing needs. These factors will remain after Covid 19 has gone.
Please Get in Touch
Housing Proactive has an established track record and is deployed by 40+ housing providers across the UK for a variety of needs groups. We didn’t anticipate the Covid 19 emergency, but the fact is that Housing Proactive is in the right place at the right time to be part of your integrated approach to managing this unprecedented situation.
Remember that, subject to welfare benefits, eligibility it’s effectively free of charge. Even where people aren’t eligible for Housing Benefit/Universal Credit/Pension Credit it generates huge value for a minimal weekly cost.
Please click here to email us an inquiry or call Alertacall on 0808 208 1234 and mention this Briefing.
Many of you will know what “Intensive Housing Management” is. It’s a term that the old Housing Corporation in England used to describe the additional housing management services that people in supported housing often need. Intensive Housing Management services were funded by the Housing Corporation through a revenue grant known (latterly) as SHMG (Supported Housing Management Grant) some of which was often paid on by RSLs to their specialist agency partners that typically manage the RSL’s supported housing.
The set of prescribed intensive housing management services was defined in hardcopy in the Housing Corporation’s “Guide to Supported Housing”, before the age of the Internet. There is a similar list you can gain access to online here: in Scottish statutory instruments 2002 number 444 with its list of “Prescribed Housing Support Services” in Regulation 3.
The revenue funding streams for intensive housing management were put into the Supporting People pot in 2003, to help fund what became known as “Housing Related Support”. And that, you might think, was the end of that.
Except that it wasn’t. Supporting People begin to retrench very quickly. In 2005 Michael Patterson and Danny Key teamed up to identify and promote a regulatory means of mitigating providers’ losses of Supporting People revenue, by claiming the cost of eligible Intensive Housing Management tasks from Housing Benefit. This involves the use of the Exempt Accommodation route to enhanced levels of Housing Benefit.
Over time this led to a substantial number of eligible providers (housing associations and voluntary agencies namely) being able to claim enhanced levels of Housing Benefit for the costs of the eligible housing management tasks Supporting People no longer funded.
Michael Patterson renamed these eligible housing management tasks as “Intensive Housing Management”, a term which has returned to the language of supported housing, bringing with it a substantial pot of revenue known as enhanced Housing Benefit, which continues to exist to this day.
We are cautious who we work with, especially given the large numbers of new, unregulated supported housing services being set up. As someone with a values base I commend the “Exempt From Responsibility?” report written by Thea Raisbeck in November 2019 for Spring/Commonweal Housing, which identifies problems over the lack of regulation of supported housing, and the oversight of the system through which some landlords claimed enhanced Housing Benefit. To put it more bluntly: some unregulated supported housing providers are claiming Housing Benefit but apparently not providing adequate housing or intensive housing management services.
Not all supported housing providers are eligible for intensive housing management funding, but most social supported housing providers are. Rather than go through the criteria for Exempt Accommodation compliance here (but watch this space) just ask yourself these questions:
Are you a genuinely social organisation? (For the purposes of enhanced Housing Benefit this means nonprofit)
Do you generate value?
Outcomes for people
Wider social benefit (Community Sustainment)
Do you own or manage supported housing?.
If you can say yes to the above questions you’re likely to be eligible to claim Intensive Housing Management and Maintenance funding. It’s a complex process that requires you (or me on your behalf on a ‘no increase, no fee’ basis) to audit your supported housing and provide a properly optimised rent structure that can be used to support an enhanced Housing Benefit claim.
If you represent a social supported housing provider and you’d like to discuss claiming enhanced Housing Benefit, please contact me.
It’s also important to consider the likely future funding of Intensive Housing Management and Maintenance, and supported housing in general for that matter. I’ll keep the wider context for a future blog post/briefing but what about the Intensive Housing Management components of supported housing revenue, currently paid as enhanced Housing Benefit?
We should bear in mind both the implementation of Universal Credit and the UK Government’s (stalled) “future funding of supported housing” policy agenda.
Universal Credit allows supported housing claimants to have the housing component of their Universal Credit paid by local Housing Benefit teams as enhanced Housing Benefit. The future funding of supported housing policy agenda originally intended to pass supported housing revenue, of which Intensive Housing Management funding is a substantial part, to local authorities but that idea was parked.
Nothing much has happened on the supported housing policy agenda due to the UK Government’s preoccupation with Brexit and the current Covid 19 pandemic. But the UK Government is working on a Social Care Bill, and they would be remiss to omit supported housing from it.
It seems opportune therefore to remind the UK Government and the wider sector that Intensive Housing Management funding needs to stay exactly where it is now – as a flexible component of Universal Credit.
Going back to the “Exempt From Responsibility?” report, and my own briefings going back some years, it’s not just about the future funding of supported housing, important though that is. It’s also about supported housing regulation, it’s about how we define supported housing and it’s about what values base we apply to supported housing.