I did much to promote the idea of Specialised Supported Housing via Support Solutions briefings. Specialised Supported Housing is privately financed supported housing for people with complex needs for whom the alternative would be a care home.
Specialised Supported Housing is an important concept that can generate value for the people it accommodates and supports, for the public purse and for the wider community. However, it is not (yet) regulated and the values base that motivates its development is variable.
For some people and organisations the priority is Value Generation (outcomes for people, cost-benefit to the public purse & wider community benefit), for others it’s more to do with the management of money.
Specialised Supported Housing exists in different forms. It may have originally been envisaged for people with significant levels of learning disability, or physical disability or significant mental health needs that are lifelong. However, it’s also a good concept for older people who might otherwise need hospital stays and are unable to live independently, for people with significant addictions who are in crisis but for whom addiction will not be a long-term situation.
Whoever it’s for, it needs to operate on Value Generation principles, and be regulated.
My interest in Specialised Supported Housing stems from 2 facts:
- the fact that I work with Support Solutions, which does a lot of work on the capital and revenue side of Specialised Supported Housing in addition to the work I did through Briefings and events to promote it as an accommodation and support concept for people with complex additional needs
- the fact that I have a teenage son who may well benefit from Specialised Supported Housing one day
Those 2 facts were cast in stark contrast for me recently after my son and his mother were prevailed upon by their local authority to consider a particular Specialised Supported Housing scheme.
My son is autistic, nonverbal, has severe learning disabilities and is physically disabled. He requires 1:1 support. This summer he will leave his school, which he’s attended since the age of 2.
His local authority got him and his mother to visit a building site that is to be a Specialised Supported Housing scheme within a few weeks. It’s a modest family home being converted to accommodate 5-6 people. It’s too small. My son’s allocated room (no, he hadn’t been asked about the Specialised Supported Housing scheme, never mind the room) had inappropriate bathing fittings, but “he can go upstairs and use someone else’s”. Apart from that inappropriate assumption, he’d struggle with stairs anyway.
“If you don’t sign up for it today, you’ll lose it” was the pressured advice from the guy responsible for filling the rooms. He’d need at least 6 months transition, especially as he’s leaving school this summer. “Two months, max” said the guy.
My son would be uprooted from the life he’s known his whole life and placed in a small room in a small house with 5 people he doesn’t know. He’d be entitled to Housing Benefit, which would be paid to the provider organisation/landlord and would part-subsidise the local authority’s commissioning costs. His PIP would be payable to the provider organisation/landlord, along with any other benefit entitlements he might have, in order to fund “day care” as they are required to do under their agreement with the local authority. He would have no choice about who provided day care, or necessarily what type of day care it is. He’d have no choice about how his money is spent or who he lives with and spends his time with.
This drives a coach and horses through the established principle of separation between housing and care.
This isn’t just a problem associated with a provider that’s more concerned about the generation of revenue than the generation of value. It’s also a problem associated with a local authority commissioning function that’s more concerned about the management of cost than the meeting of need.
Specialised Supported Housing is as yet unregulated, aside from the oblique organisational regulation applied by the Social Housing Regulator, Charity Commission or whichever other regulator, if any, happens to govern the landlord/provider. This is neither consistent nor sufficient. Large amounts of public and personal revenue are used to support Specialised Supported Housing, which caters for a wide range of complex needs; so why shouldn’t it be regulated?
With regard to regulation I suggest that quality is measured using Value Generation principles by an agency entirely independent of commissioners. Regulation shouldn’t be an industry in its own right either. Value Generation-based frameworks should be developed by university departments with appropriate expertise & independence from central and local government. They should be used for measuring the impact a Specialised Supported Housing service has on the people who live there, its benefit to the public purse and to the wider community. The actual process of assessing the value a Specialised Supported Housing service generates should be undertaken by an agency independent of commissioners. Perhaps the CQC, although obviously outside the framework of the the Care Quality Commission (Registration) Regulations.