What actions need to be taken?
1. Increase availability of capital funding for housing for people with a learning disability
The right housing is crucial to enabling people with a learning disability to be able to live good lives. Not being able to access the right housing, and the impact of this on (for example) behaviours that challenge, can lead to people with a learning disability being detained in inpatient units under the Mental Health Act because it is not possible to find anywhere else for them to live.
Conversely, according to NHS Digital data, “lack of suitable housing provision” is the main barrier to discharging people with a learning disability and autistic people from these inpatient units. As well as being the main barrier to discharge, the percentage of people for whom this is a barrier (56% in December 2023) has increased significantly since March 2015 (29%) and rose by 12% over the previous six months alone (in June 2023, the percentage was 44%).
Recent research by the Learning Disability and Autism Housing Network and HousingLIN found that £340m of capital investment from public and private finance is needed per year to meet the need for supported housing for people with a learning disability and autistic people. Around 87% of the capital funding used by housing providers to develop supported housing for people with a learning disability and autistic people since 2017 came from private and non-public finance – compared to ~8.5% from NHS England, ~3.5% from Homes England, and 1.5% from local authorities.
The Government needs to:
Increase the availability of capital funding available to develop housing for people with a learning disability and autistic people
Work with local authorities and housing providers to strategically plan for how to increase the supply of supported housing for people with a learning disability
2. Ensure that all areas have developed strategic plans for housing for people with a learning disability
In order to properly plan for how they can meet the housing needs of people with a learning disability within their area, local authorities need to develop a clear understanding of their a) current and b) future housing needs. This should include analysis of the number of children and young people within their area that will require housing in future, as well as the number of people with a learning disability currently living with family or friends who may require alternative housing in future. Developing this understanding of housing need needs to be done in conjunction with assessments of health and support needs – these parts of the system need to be joined-up in order to successfully meet needs in a person-centred way.
The Department for Levelling Up, Housing and Communities and the Department of Health and Social Care need to:
Work with local authorities to support them to conduct research and analysis of their local population, and to use this to develop housing that will meet these needs
Work with local authorities to support them to join up housing, health and social care
3. Change policy and practice so that if someone with a learning disability is admitted to an inpatient unit, they do not lose their existing housing
One of the issues that people with a learning disability face is that, if they are detained in an inpatient unit under the Mental Health Act, they can lose access to benefits. One of these is Housing Benefit, which stops after 52 weeks in hospital (the current average length of stay in an inpatient unit for people with a learning disability and autistic people is over 5 years). Because of this, if you have a learning disability and are admitted to an inpatient unit, you can lose your home.
With housing the main barrier to being discharged back into the community, maintaining existing suitable housing – or carrying out adaptations to existing housing that requires them – is crucial to ensuring that people with a learning disability do not get ‘stuck’ in inpatient units.
The Government needs to:
Take steps to ensure that the withdrawal of benefits does not result in housing being lost
Introduce ring-fenced funding to cover ‘double-running costs’, including the cost of maintaining a house while someone is detained in an inpatient unit
Increase funding for the Disabled Facilities Grant to support adaptations to be made so that people with a learning disability can be discharged back into their homes without delay
4. Access to short breaks
Children, young people and adults with a learning disability need to be able to access short breaks and/or alternative accommodation when it is necessary. Currently, provision of short breaks and alternative accommodation is limited – many areas do not have these in place and where they do, there is not enough provision to ensure that they can be used by people who need them, when they need them.
Local authorities and Integrated Care Boards need to:
Identify what alternative accommodation is needed to support children, young people and adults with a learning disability in their area, and take steps to develop alternative accommodation and short breaks services within their area
The Department of Health and Social Care needs to:
Provide ringfenced funding for the development of short breaks services and alternative accommodation
5. Access to ‘emergency’ accommodation
Not being able to access alternative accommodation in crisis situations or in cases of emergency is a major reason for people with a learning disability being admitted to inpatient units. People with a learning disability should be able to access these ‘crash pads’ when they are needed, including if they are needed to prevent admission to inpatient units.
Local authorities and Integrated Care Boards need to:
Ensure that they have a sufficient supply of ‘emergency accommodation’ available to meet the needs of people with a learning disability
The Department of Health and Social Care needs to:
Provide ringfenced funding to local authorities and integrated care boards to enable them to develop ‘emergency accommodation’
6. ‘Future-proof’ housing
Many people with a learning disability will, if it is possible, live in the same house for a long period of time. This means that, if they are growing older in a particular house, they might need new or additional adaptations to support them as age. For example, people with a learning disability, and people with Down Syndrome in particular, are more likely to develop dementia at an earlier age – meaning that they might need adaptations to enable them to continue living in their homes.
The Department for Levelling Up, Housing and Communities and the Department of Health and Social Care need to:
Publish guidance on the need to consider whether housing for people with a learning disability can be adapted in future if needs change
Work with local authorities and housing providers to develop housing for people with a learning disability that is adaptable
Ensure that the commitment (made in 2022) to mandate the M4(2) requirement in the Building Regulations as a minimum standard for all new homes is carried out without delay
As well as the ability to adapt housing to meet changing needs, environmental factors need to be taken into account when developing housing for people with a learning disability. Anecdotal evidence suggests that in some cases, housing for people with a learning disability is being developed in areas that may be prone to flooding if sea-levels rise in future, as the land can be purchased more cheaply. It is crucial that the safety and long-term security of housing for people with a learning disability is not jeopardised by environmental factors.
Local authorities and Integrated Care Boards need to:
Work together with housing providers to ensure that housing for people with a learning disability will not be developed in areas that are e.g., at risk of flooding
We have worked to co-produce these actions and asks, building on years of work that has gone before it. We are happy to engage with policy makers at a local, regional, and national level about how we can get things right for people with a learning disability whose behaviour challenges. If you would like to talk about any of the actions in this plan, or any work you are planning on doing, please email actionplan@thecbf.org.uk