Written evidence submitted by L’Arche [EXA 071]
L’Arche is a small national ‘not for profit’ organisation (charity number England and Wales 264166 and Scotland SC038493). L’Arche Communities are people with and without learning disabilities, sharing life together in communities belonging to an international federation. Mutual relationships are at the heart of this shared life. Providing high quality, professional support and care services, housing and housing services represents a key part of how we live out our mission. We have a range of provision including care homes, supported living and day services. Currently we have 150 people with learning disabilities living in shared and self-contained accommodation that meets the characteristics of exempt accommodation. In line with the select committee requirements, we have addressed the areas that we are best placed to comment on.
What is the quality of exempt provision?
L’Arche is concerned that the inquiry is being driven by the attention drawn to a minority of arrangements where accommodation has not been of sufficient standard or the care and support provision has been lacking. We are also aware of the concern that unscrupulous landlords may manipulate the system for financial gain. L’Arche is amongst the majority of supported housing provision that aim to provides good quality housing and housing services for people who require and are provided with support and/or care.
L’Arche believes that the DLUHC National Standard of Expectations: Supported Housing (NSE) annex A Accommodation Standards provides a useful template to assess the quality of exempt provision. Ahead of requests from the Local Authorities we work within and those who commission care and support, we have recently undertaken an activity to assess all of our accommodation services against legislative minimum and best practice requirements. L’Arche is surprised that we have not been required to do this by Local Authorities as this would provider reassurance that the quality of all exempt accommodation meets appropriate standards.
Is the current model of exempt accommodation financially viable and does it represent value for money?
In line with other providers L’Arche believes that people with learning disabilities should be living the life they choose and as independently as possible. We have been working with commissioners where possible to move people into supported living where this is appropriate and needs can be met. In addition to the philosophy of person centred services where people have autonomy over their lives and homes we also believe this represents value for money. In cost benefit terms for the majority of our residents the alternative would be costlier care home provision that would suit their needs less well and give them less control over their lives.
Case study
In our Kent services John lived in a residential care home for nearly 30 years. He was often withdrawn, struggled to be part of the group and could be aggressive when too much change was imposed on him by busyness of life in a large household. 9 years ago he was able to move into his own supported living bungalow where his rent is paid through housing benefit and he is supported by a stable team of assistants. He now goes to the theatre and gym as well as regular outings across the country. John is rarely anxious; feeling in control of his life and things that he does.
John needs 24 hour support so lives in a 2-bed house with a sleepover room. He needs accessible accommodation, good space, and a range of adaptations to the property to make it safe and suitable. Wear and tear on the fabric of the house, the furniture and the white goods, is considerably above the cost of a non-disabled single person. He needs regular support to fulfil the conditions of his tenancy. L’Arche, as a non-registered provider, purchased the property without grant, drawing on our charitable reserves. Charity SORP rules require us to show depreciation of the property within our profit and loss account. These factors combine to give a rent and service charge well in excess of LHA. If only LHA was available, John would remain in a care home, unable to reach his potential and causing distress to himself and other residents.
This can only be done in recognition that the cost of supported living is not achievable within Local Housing Allowance Rates. Providing supported housing and services cost more than general needs services. In shared housing there are several households using facilities which means they need to be robust and require replacing more often. The physical and learning needs of our residents mean that we have to make costly adjustments to our properties. We work with people who are sensitive to their living environment alongside spending considerable amount of their time at home. Despite all this we are able to provide provision that is an alternative to other provision that weighs more heavily on the public purse. We would also be happy and would be confident in participating in any social return on investment or cost benefit activity carried out by the department.
Are there significant geographical and regional difference in the provision and problems of exempt accommodation.
Being a national organisation L’Arche experiences the full extent of different approaches which local authority housing benefit offices take to ‘exempt accommodation’. We only charge the cost of providing the housing and housing services, but unsympathetic and/or suspicious housing benefit teams have placed hurdles in the way of our in developing and sustaining provision. Current challenges we are experiencing include the housing benefit team refusing to classify properties as ‘exempt accommodation’, disagreeing with eligible and ineligible service charges and rent and service charges. These challenges impact on cash flow, reduce money available for housing and housing services ultimately affecting quality, take up staff time already overstretched due to the pandemic but most importantly cause stress for the residents and their families. We do have to take these issues into consideration when we are looking at developing provision, despite the fact this requirement is strategically driven by commissioners. There is a disconnect between housing benefit, housing and adult social care and not always because the area is two tier.
What is the proportion of exempt accommodation that is provided by registered compared to non-registered providers and is an appropriate balance being struck?
L’Arche housing provision is currently on a multitude of arrangements: owned by us; leased from Registered Providers private landlords, religious bodies and individual private landlords; managed on behalf of registered providers or through service level agreements with registered providers. L’Arche believes that exempt accommodation has grown through a market driven by commissioner and resident choice. We have been able to provide housing that meets the needs of prospective residents who have unique requirements that Registered Providers have not been able to satisfy. Whilst we are a national organisation our communities have worked at developing relationships at a local level with the most appropriate housing provider to meet the needs of the group or individual requiring housing. We provide a choice in the market where we can act quickly using a variety of arrangements to respond to demand. We often find that registered providers properties are taken up with nominations to local authorities and development of supported housing through the affordable housing programme has been woefully lacking
What is the proportion of exempt accommodation provided by commissioned compared to non-commissioned providers and is an appropriate balance being struck?
L’Arche services are all commissioned by Adult Social Care or other statutory agencies we do not provide non-commissioned services.
How does whether a provider is registered or non-registered or commissioned or non-commissioned, impact the quality of provision?
In L’Arche we work to the same standards whether the property is owned by or leased from a registered housing provider or owned by ourselves as a non-registered provider. Any proposals to limit the definition of exempt accommodation to registered housing providers would greatly reduce the diversity and scope of the supported housing sector. We do however understand the desire to limit the profits made by non-commissioned, non-registered, poor quality providers. As detailed above, we suggest that some form of quality framework, such as the NSE standards, should be put in place.
How should exempt accommodation be provided and what should the service cost
The current mechanism has grown reactively responding to different government policies that have directly and indirectly impacted on providing supported housing that meet needs that is recognised by providers, commissioners, national government, those who use services and those who love and care for them. It is an area that has not been strategically developed and there has never been a mechanism for covering the ‘true’ supported housing costs of supported housing and housing services. L’Arche believes that an honest conversation regarding funding the costs of providing supported housing and services is long overdue, rather than resources and energy being expended on moving costs around different departmental budgets
L’Arche believes this should be commissioned and paid for locally in line with local need but also taking into consideration those who may want to move into area to be near family.
Case study
Paul lives in a self-contained flat in our London service which L’Arche purpose built for him. This has improved his quality of life from residential care where he was sharing with four other people with support needs. Due to Paul’s significant mobility needs, he requires direct one to one support to do any meaningful activity in the community or in the home – he cannot get around by himself. He needed a property that was big enough, with wide enough doors for his wheelchairs and specialist equipment. This enables him to live safely and happily in his home. Because of the space Paul now has, he is able to help with the cooking and cleaning and he can access the local and wider community with ease. L’Arche is confident Paul’s quality of life would be significantly lower and his health would be significantly worse if he lived in care provision. Paul has had no major illness for several years and his pre-existing conditions are monitored and managed extremely well, such as his epilepsy. He has not had a seizure for several years and we believe that this is due to reduced stress and a happy environment that is suited to his needs.
The type of provision that Paul required plus the housing services to enable him to continue to live there would not be able to be delivered in a property not specified as exempt accommodation. His only option would be unsuitable and costlier registered care.
How should the regulatory oversight of exempt accommodation be organised?
What should be the regulations governing exempt accommodation and how should these regulations be enforced?
L’Arche believes that the current legislative and regulatory landlord requirements for registered and non-registered providers e.g. health and safety, HMO etc in conjunction with the NSE provides appropriate local oversight and scrutiny of exempt accommodation. L’Arche would welcome a register of supported housing provider in each local authority area, environmental health, planning, housing, housing benefit and adult social care working together to strategically monitor current provision and agree future need for new developments. There should however be funding for local authorities to provide specific staff with expertise and skills to monitor this provision.
There should be more guidance for Housing Benefit offices, tightening up what is meant by ‘above minimal support’, and clarifying that if the provision meets the definition, then exempt accommodation regulations must be followed: it is not at the discretion of the individual officer.
Is there sufficient publicly available information about exempt accommodation?
L’Arche employs a national housing manager the role of which encompasses navigating the ‘exempt accommodation’ regime and the way it is interpreted by different housing benefit providers. There is little government provided information that is available to the public and also the information provided to Housing Benefit offices is lacking. L’Arche often feel that we are expected to work within a framework, the criteria for which is not available to us and often those administering it, leaving all involved in the unenviable position of second guessing what information is required from us and why.
January 2022