Housing Choices Integrated Discussion Paper

The National Development Team for Inclusion (NDTi) has a vision of a society where all people, regardless of age or disability, are valued and able to live the life they choose. This includes people having choice and control over where they live and the support that they receive. Through our work across the UK with older people, people with learning disabilities and people with mental health problems it has become clear that despite the range of housing options that exists for people with support needs, there is still an over reliance on traditional forms of housing and support such as residential or nursing care.

Although current health and social care policy and legislation emphasises person-centred approaches and use of community based options (e.g. the Care Act 2014), and discourages residential settings which are segregated from family and communities, this does not appear to be having a significant impact on current patterns. Indeed, it appears that we are currently seeing a shift away from options that offer choice and control, towards more traditional residential care – with these developments being implemented on the rationale that residential care is lower cost.

In order to stimulate debate about the continued over reliance and possible increase in use of residential care, and to encourage more serious exploration and consideration of alternative options, NDTi conducted work to scope, define and describe the different housing and support options available for older people, people with learning disabilities and people with mental health problems. From this, we produced a series of short discussion papers which were shared between January and May 2017 and have now been drawn together in this document.

They were as follows:

• Paper 1: Cost and cost-effectiveness of housing and support options (January 2017) – a summary of the evidence available on the cost and cost-effectiveness of residential care compared to other housing and support options, including highlighting significant limitations in the evidence available
• Paper 2: A proposed typology of housing and support options (February 2017) – acknowledging that a lack of common understanding of terms and definitions can limit understanding of alternatives to residential care, we proposed a typology identifying and describing the different housing and support options
• Paper 3: Characteristics of housing and support options (April 2017) – in response to feedback and comments on the proposed typology, this paper set out the different characteristics of the housing and support options identified in terms of choice, control, rights and inclusion
• Paper 4: Policy Recommendations (May 2017) - drew policy and practice recommendations from the discussion and debate generated from the previous papers.

To assist readers, we have now drawn all four papers into this, consolidated document.