Changing Accommodation

This resource looks at the situation where an adult relative or friend with a learning disability wants or needs to move from their current accommodation and what you can do to support them.

Wanting to move because their needs have increased

If a person with a learning disability wants or needs to move from their current accommodation because their needs have increased the first step is to consider what needs have changed. If the needs that have increased are primarily medical needs then you could look into whether a continuing health care assessment would be appropriate. If the continuing healthcare assessment found that your friend or relative needs nursing accommodation then it may be fully funded by the NHS under the continuing healthcare plan. However, you would not have a choice of accommodation in that situation.
If the increase in needs relates primarily to social care then you should request a new care assessment from their local authority.

During a care assessment the local authority looks at:

  • Whether the person in question has needs that arise from or are related to a physical or mental impairment or illness;
  • Whether those needs make them unable to achieve two or more specified outcomes which are set out in the Care Act (these includes being able to make use of their home safely and maintaining a habitable home environment);
  • As a result of being unable to meet these outcomes, there is likely to be a significant impact on the adult’s wellbeing. One aspect of wellbeing which is defined in the Care Act is the suitability of living accommodation.

So, if the local authority assesses that the living accommodation is not suitable because the person with the learning disability cannot make use of their home safely and/or they cannot maintain a habitable home environment then that person has an eligible need which the local authority has a legal duty to meet. This should be agreed and recorded in your friend or relative’s care and support plan.

Adult services should then look at suitable accommodation options for the person with the learning disability (and carry out a new financial assessment). They should find at least one suitable option. Whilst social care is not free and your friend or relative may be required to contribute towards their social care package, the personal budget for their accommodation should be sufficient to meet the cost of accommodation that meets their eligible needs. However, if the person with a learning disability chooses more expensive accommodation, then a top up payment from a third party (such as a relative or charity) may be required. The person with a learning disability has a legal right to choose their accommodation (which could be outside the local authority) provided that:

  • The care and support plan specifies an adult’s needs are going to be met by the provision of accommodation of a specific type;
  • The preferred accommodation is of that type;
  • The preferred accommodation is suitable for the adult’s needs;
  • The preferred accommodation is available; and
  • The provider (if not the local authority) agrees to provide the accommodation on the local authority’s terms.
  • The local authority must provide written reasons for refusal to provide or arrange the provision of preferred accommodation, although the legislation does not give you a specific right to appeal this decision.

The local authority says that the person with a learning disability has an eligible need but that the local authority cannot meet it because there is no suitable accommodation in the area.

If the local authority is saying that it cannot meet the need because it does not have suitable accommodation available then your options are:

  • Ask the local authority to look to see if there is suitable accommodation outside the local authority area; for funding purposes your friend or relative will remain an “ordinary resident” of the local authority which carried out the assessment and found the accommodation, rather than the local authority where the new accommodation is based; or
  • Try to source the accommodation yourself from a third party and ask the authority to fund it directly. As mentioned above, a person has a right to request that they are put into their preferred accommodation.

[If you find suitable accommodation which will be self-funded, and which is out of the current local authority then “ordinary residence” of your friend or relative will change. Whilst, in accordance with the Care Act authorities are meant to cooperate and there should be no disruption to a person’s care package when they move from one authority to another (although the new local authority will then usually carry out its own needs assessment), in reality changing authorities can have implications for a person’s care package.]

The local authority says that the care needs of the person with a learning disability have not changed

If the local authority says that your friend or relative’s care needs have not changed then you should consider whether the assessment has been properly carried out.

Factors to take into consideration are whether the person carrying out the assessment was suitably qualified – for example if the person being assessed is deafblind then a specialist deafblind guidance assessment should have been carried out by a suitably qualified person. If the person being assessed has complex needs then an experienced social worker with knowledge and experience of their condition should have carried out the assessment.

You should check that the assessment deals with all relevant aspects of the person’s condition and needs. For example, if the person with a learning disability is living independently but they cannot go to the toilet without support (which is not always available when they need to go) then this should be detailed in the assessment, as managing toilet needs is one of the eligible outcomes set out in the Care Act and arguably if a person cannot go to the toilet in their own home when they need or want to go then the wellbeing principles of personal dignity and physical wellbeing are not being met.

If the assessment has not been carried out properly then you should request that the local authority does it again.

If the local authority refuse to carry out a further assessment then you could try using their complaints procedure to resolve the issue. If this is unsuccessful then you could go to the Local Government Ombudsman . Alternatively, you may be able to bring legal proceedings against the local authority for failure to carry out their legal duties – this option is very time sensitive and you should get legal advice as quickly as possible before pursuing this option.

If the assessment was properly carried out but you disagree with the conclusion that there are no eligible needs you can ask for the decision to be reconsidered. Alternatively, you could consider challenging the decision.

The person with the learning disability is unhappy with their current accommodation and wants to move to the same type of accommodation somewhere else

If there has been no change in their needs but they are unhappy in their current accommodation then the first thing to identify is why your friend or relative is unhappy with their accommodation. You should try to establish whether there has been a safeguarding incident that may have triggered their desire to move or whether in fact their needs have changed.

There may be a situation where safeguarding concerns are raised by or about a person with a learning disability. For example, it may be that they are at risk of or actually experiencing physical abuse by another resident or a care worker. If such concerns are raised then the service manager of the accommodation should be made aware of the situation and depending on the circumstances it may be necessary to report the matter to the police. The Care Quality Commission should be informed if they are living in a care home . Social services adult safeguarding team should also be made aware of the situation as if a local authority suspects that there may be some form of safeguarding issue it must carry out a safeguarding enquiry, which may involve a review of the care plan and the suitability of the provision.

Suitable accommodation would need to identified and available. However, as mentioned above, if the person with the learning disability has a preference for particular accommodation and it met the criteria set out above then your friend or relative should have some control over their placement.

As well as protecting an adult’s right to live in safety free from abuse and neglect, your friend or relative’s wellbeing should also be taken into consideration. Therefore, when making a decision about whether to move a person from their current accommodation due to a safeguarding risk, it is important that their view is heard. If you are deemed an ‘appropriate person’ by the local authority then you may be able to help your friend or relative to put their views forward. However, the local authority may want to appoint an independent advocate to help them to put their views forward if you are not able to adequately advocate for them, or if the local authority has differing views of what would be in your friend or relative’s best interests.

The mental capacity of the person with a learning disability will also be relevant in deciding whether they can make their own decision about whether to stay in their current accommodation or be moved somewhere away from the safeguarding risk.

If your friend or relative simply has not settled into their accommodation, perhaps because they are away from their friends and family, then you could contact social services to see if there are any other suitable placements that may be available to your friend or relative, which meet their needs and are within their personal budgets (unless you or another third party are able to top up their care costs.)

If your friend or relatives wants to move to accommodation in a different local authority, for example to be close to a relative, then voluntarily moving without any input from the local authority where they were living immediately before the move, may mean that the local authority is no longer responsible for meeting their eligible needs and their new local authority is not required to meet those needs. However, if the original local authority are involved in the care planning process and decision to move your friend or relative to new accommodation in another local authority area to promote their wellbeing by promoting and developing friendships and relationships then they may continue to be deemed to be responsible for your friend or relative’s care.
 

Your friend or relative’s needs have decreased and/or they want to live more independently

If your friend or relative wants to move accommodation so that they can live more independently (for example by moving from a care home to supported living accommodation) the first step is to request a new needs assessment.
One of the concepts promoted by the Care Act is that any restrictions on an individual’s rights or freedom of action that is involved in the exercise of a function should be kept to a minimum. Therefore, if your friend or relative can demonstrate the importance to their personal dignity and wellbeing of living more independently and can demonstrate that their other eligible needs could still be met through living in a less restrictive setting then the care plan should be able to support them moving to less restrictive accommodation.

For more information about this resource, please contact the Learning Disability Helpline.

Phone: 0808 808 1111

Email: helpline@mencap.org.uk

Contact the Helpline