This page is targeted at housing professionals. Our main site is at www.shelter.org.uk

Disabled people: care and support at home

This content applies to England

A disabled person may be able to remain in her/his accommodation and avoid moving into specialist housing if s/he can access appropriate care and support services.

Services range from 24-hour care to help with domestic chores, transport to recreational facilities and respite care.

Access to services

Social services must assess the needs of a disabled adult who has care and support needs under the Care Act 2014. For detailed information, see Access to housing with care and support.

Types of service

A local authority may meet the needs of a disabled person through:[1]

  • accommodation in a care home or other premises
  • care/support at home
  • counselling / social work
  • goods and facilities
  • information, advice and advocacy.

Paying for services

Social services will carry out a financial assessment to assess the contribution, if any, a person should make towards the cost of any service provided.

For detailed information on charges for services, including information on direct payments, see Charges for care and support.

Welfare benefits

Disabled people may be able to claim benefits to assist with paying for care. Some of the benefits available are outlined below.

Personal Independence Payment / Disability Living Allowance

Personal Independence Payment (PIP) is a non-means tested benefit for a disabled person who needs helps getting around and/or with managing daily life.

PIP was introduced in April 2013 to replace Disability Living Allowance (DLA) for people between the ages of 16 and 64. Regulations specify when existing DLA claimants can claim PIP.[2] From October 2017, anyone in this age range who is still receiving DLA will be invited to claim PIP when their DLA claim ends. Further information on PIP and its phased introduction is available from Gov.uk.

Components of PIP/DLA

DLA has two components: care and mobility. The mobility component is paid at two rates and the care component at three, depending on the extent of the applicant's disability.

For PIP, the two components are:

  • a daily living component, for help participating in everyday life
  • a mobility component, for help with getting around.

Each component in PIP is payable at two rates: a 'standard' rate and an 'enhanced' rate depending on whether the applicant's ability to carry out daily living or mobility is 'limited' or 'severely limited'.

It is not necessary for the applicant actually to be receiving help with care or mobility to get DLA or PIP, and the benefit does not have to be used to pay for care or mobility needs.

The care component of DLA or the daily living component of PIP will not be available if the claimant is residing within a funded care home. In a case where the claimant had been wrongly paid the care component of DLA while living in a funded care home, it was held that it was not recoverable as the claimant had no appointee at the time and because of his condition he could not reasonably have been expected to realise that he was being overpaid.[3]

Change of circumstance

When claiming DLA or PIP, the claimant has a duty to report a change in his condition. It is not for the claimant to make a judgement as to whether s/he is better or worse than when s/he was first awarded mobility allowance. That is for the decision maker to decide.[4]

Employment and support allowance

ESA is a benefit paid to people over 16 and under state pension age who have an illness or disability that limits their ability to work. Contributory ESA is paid to claimants who satisfy the national insurance contribution conditions, or who have been transferred from IB to ESA. A person who is otherwise entitled to ESA but who does not satisfy the national insurance conditions may get income-related ESA.

From October 2013, a person who comes under the Universal credit (UC) system will not be able to receive income-related ESA and must claim UC instead. A claim for ESA will be for contributory ESA only.

Incapacity benefit

Incapacity benefit (IB) is a benefit for people aged 65 and under who are unable to work due to sickness or disability for at least four days in a row, unable to work two or more days out of seven consecutive days, and receiving specialist medical treatment.

IB was abolished for new claimants on 27 October 2008 and replaced with employment and support allowance (ESA). IB can still be paid to people who were already getting IB when it was abolished, but most people getting IB will be assessed to see if they can be transferred to ESA.

There are three different rates of IB: short-term (lower) IB is paid for the first 28 weeks, short-term (higher) IB is paid for weeks 29 to 52 of a claim, and long-term IB is paid from week 53 of the claim onwards.

Attendance allowance

Attendance allowance (AA) is available for people aged 65 and over who need help with care at home or who need supervision. It is payable at two rates: a lower rate for people who need help either during the day or during the night, and a higher rate for those who need help during both day and night. It is not necessary for the applicant actually to be receiving help with care to get AA, and the benefit does not have to be used to pay for care needs. AA is not available if the claimant is residing within a funded care home.

Carer's allowance

Carer's allowance is available for people who are looking after someone receiving either AA, the higher or middle-care component of DLA, or the daily living component of PIP. The person must be unable to work because they are providing care, and they must spend at least 35 hours per week providing the care.

Independent living fund

The Independent Living Fund (ILF) is a non-departmental public body, financed by the Government and administered by independent trustees. Its aim is to provide financial support for severely disabled people to enable them to remain in their home. In October 2007, the ILF replaced two separate funds: the Independent Living (Extension) Fund and the Independent Living (1993) Fund.[5]

The ILF was closed to new applicants in December 2010, but continued to fund existing users until 29 June 2015, after which funding was transferred to local authorities.

Adapting the home

Where a disabled person needs adaptations or extra facilities in order to remain in her/his home, s/he may qualify for a Disabled facilities grant to pay for the work required.

Where only minor repairs or adaptations are needed, the disabled person may benefit from the assistance of a specialist agency who can give advice on getting repairs and improvement work done. See Grants for improvements and repairs; Handyperson grants for more information.

Social services may be able to help a person apply for a grant, or pay for works not covered by a grant. In some situations social services can also provide help with adaptations, provided the adaptation is to assist with nursing at home or to aid daily living, and provided that the adaptations required do not cost more than £1,000.[6]

The Equality and Human Rights Commission has published an adaptations toolkit for local authorities on housing and disabled people.

Carers

Disabled people may receive care provided by family members, friends or neighbours instead of or in addition to the options outlined above. The services received by a disabled person has an impact upon the ability of these carers to provide care. Carers are entitled under the Care Act 2014 to an assessment of their ability to provide care.

Avoiding moving into a care home (or moving back into the community from a care home)

If a disabled adult has had a needs assessment which says that s/he is in need of services to enable her/him to remain living at home, but the local authority says that s/he must move into a care home (for example, because it believes her/his needs are too complex or too great to be met at home), it may be possible to challenge the decision on the following grounds:

  • the assessment has not been carried out properly or it has not identified whether it is possible for the disabled person to stay in her/his home with services or adaptations
  • if the assessment shows that the disabled person needs services at home, the local authority cannot just ignore this and only consider a care home placement: it must consider whether to provide services at home and should give reasons for its decision, and must take into account the views of the adult concerned.[7]
  • a local authority must also take into account the disabled person's human rights (see Disability discrimination and human rights). It must consider, for example, whether its actions affect the disabled person's right to respect for her/his home, family, and private life, and therefore whether it is necessary for the disabled person to move into residential care given her/his situation.

Similar arguments apply where a disabled adult who is in a care home wishes to live in the community.[8]

Complaining about home care

A person with a complaint about their care should initially complain to the care provider or social services. See Complaints about social care.

Specialist advice

The Equality and Diversity Forum provides a searchable list of voluntary, statutory and umbrella organisations that may be relevant to advisers working with clients who are disabled. In addition the Directory of Deaf and Disabled People's Organisations provides information about organisations, mostly but not exclusively based in London, that support disabled people.

Elderly or disabled people and their advisers can search LASA's socialcareinfo.net website to find sources of support and information available to them locally.

Wales

The information on this page applies only to England. Go to Shelter Cymru for information relating to Wales.

[1] s.8 Care Act 2014.

[2] Personal Independence Payment (Transitional Provisions) Regulations 2013 SI 2013/387 as amended.

[3] Brown v Secretary of State for Work and Pensions [2007] EWCA Civ 79.

[4] Ombudsman complaint, 23 November 2006, CDLA/2328/2006.

[5] Independent Living Fund (2006) Order 2007 SI 2007/2538.

[6] regs 3 and 4 Care and Support (Charging and Assessment of Resources) Regulations 2014 SI 2014/2672.

[7] ss.25(6), 9(4)  and 1(2) and 1(3) Care Act 2014.

[8] see Local Government and Social Care Ombudsman Investigations into complaints (15 020 256) against Warwickshire CC and (16 005 249) against Nuneaton and Bedworth BC

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