The Cornwall case certainly illustrates how murky the funding of supported living can be, for both individuals and schemes. Even the Commission for Social Care Inspection (CSCI) and the Healthcare Commission (HC) report makes some unfathomable and significant errors when describing this funding.
For example, it says that “people who live in supported living houses have access to a range of benefits, including income support, mobility allowance, disability living allowance with a severe disability premium and housing benefit”.
In fact, mobility allowance was abolished 15 years ago and the severe disability premium is part of income support, not DLA. If the CSCI and HC can get such basic facts wrong, it’s not surprising that practitioners in the field can have similar problems if not properly advised.
It is significant that Cornwall is seen as a welfare rights desert, and I wonder whether the council or the health trust accessed specialist benefits advice when setting up their supported living schemes.
In many local authorities, in-house welfare rights services have been a crucial partner in helping to develop schemes that maximise income for both service user and provider while staying on the right side of the legislation as far as registration as a care home is concerned.
The benefits system does create perverse incentives in some respects because users generally have access to higher benefit income for their personal use if they live in “unregistered” settings.
Housing benefit and Supporting People money can also help providers decide to go down the unregistered route because those payments are sometimes more flexible (and even amenable to local pressure) than the funding attached to care homes. None of this should skew the decision to register or not, of course, but almost inevitably it is something that any local authority will consider when setting up schemes.
Handling residents’ benefits and other income is another area to which the report rightly drew attention.
But bad practice is not confined to Cornwall. I know of a number of establishments around the country, registered and unregistered, where the DLA (mobility component) belonging to individual residents, for example, is automatically pooled and used to provide and fund the home’s mini-bus or transport budget.
Not only is this unethical, it also illegal, as the home is, in effect, means-testing the resident’s DLA. I hope that the report will lead to that practice and the other examples of bad practice cited being abandoned across the country and not just in Cornwall.
Gary Vaux is Community Care’s welfare rights expert