Supported living explained

Supported living is one of the most successful ideas in social care. People who would once have lived in institutions have their own front door, choose who supports them and have the rights of a tenant. It is also one of the most legally delicate models in housing, because everything rests on keeping two contracts apart.

How the model works

A typical supported living scheme has three parties:

1. A landlord, usually a housing association or charity, which grants each resident a tenancy.
2. A care provider, registered with the Care Quality Commission for personal care, which delivers care under a separate agreement.
3. A commissioner, usually adult social care, which assesses needs under the Care Act 2014 and funds the care.

Housing Benefit pays the rent and eligible service charges. The council or the person's own funds pay for care.

Why separation matters

The CQC's guidance is clear that a supported living provider can only register for personal care, not for accommodation with personal care, if there is a real separation between the care and the accommodation. If the same organisation controls both, or a person would lose their home by changing care provider, the CQC may decide the service is in fact a care home.

Signs that separation is weak:

• One organisation is both landlord and care provider, with no clear divide between the two roles.
• The tenancy says the tenant must accept care from a named provider.
• Care staff decide who moves in.
• Residents were never offered a choice of care provider.

Tenancies and mental capacity

Residents in supported living should have proper tenancies, usually assured tenancies. A tenancy is a contract, so the tenant needs the mental capacity to understand and agree to it.

If someone lacks capacity to sign:

1. A deputy with authority over property and affairs can sign for them.
2. If there is no deputy, an application to the Court of Protection is usually needed to authorise the tenancy.
3. Where care arrangements in a person's own home amount to a deprivation of liberty, authorisation also has to come through the Court of Protection, because the Deprivation of Liberty Safeguards only cover hospitals and care homes.

Landlords who grant tenancies to people without capacity, with no authority in place, risk the tenancy being unenforceable.

Lease-based landlords

A lot of supported living is owned by investment funds and leased for 20 years or more to a registered provider, often with rent rising each year in line with inflation. The registered provider grants tenancies and collects Housing Benefit to cover the lease payments.

In April 2019 the Regulator of Social Housing published an addendum to its sector risk profile about this model. Its concerns included the concentration of risk in long, inflation-linked leases as a single source of finance, thin margins, and the risk sitting with the social landlord rather than the investor. Several lease-based providers have since been found non-compliant with governance and viability standards, although at least one has been upgraded after changing its lease terms.

If you are considering a lease-based arrangement, look closely at:

• the rent review mechanism and whether it is capped
• who carries void and repair risk
• break clauses and what happens if Housing Benefit is cut
• whether the rent can be justified to a council as reasonable

Variables that make or break a scheme

A handful of variables decide whether a supported living scheme works for the people in it and stays viable.

The CQC's guidance for services for autistic people and people with a learning disability, Right support, right care, right culture, favours small, community-based settings where people have choice and control. Large clustered schemes face harder questions at registration and inspection.

Who does what

• Landlord: tenancy, repairs, property safety, rent setting, intensive housing management where provided.
• Care provider: CQC registration, care planning, staffing, safeguarding in care.
• Commissioner: needs assessment, funding, reviews.
• Managing agent, if used: day-to-day property management under a written agreement with the landlord.

Write these roles down in one place, and give a copy to every party. When something goes wrong, unclear roles are what turn a repair problem into a safeguarding one.