Care and support at home for people with disabilities

Social services must assess the needs of a disabled adult who has care and support needs under the Care Act 2014.

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

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

Disabled people may be able to claim benefits to assist with paying for care.

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 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 is invited to claim PIP when their DLA claim ends.

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 is not available if the claimant lives 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]

Reporting changes 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 they are better or worse than when they were 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 cannot 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.

The Independent Living Fund (ILF) was a non-departmental public body, financed by the Government and administered by independent trustees. Its aim was 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.

Where a disabled person needs adaptations or extra facilities in order to remain in their home, they may qualify for a disabled facilities grant to pay for the work required. Adaptations are works that can be carried out to a property to make it suitable for a person who has a disability or other needs, such as making it accessible for wheelchair users.

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 Which: Home Improvement Agencies for further 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.

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 have 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.

If a needs assessment says that a disabled adult is in need of services to enable them to remain living at home, the local authority could disagree and say that they must move into a care home (for example, because it believes their needs are too complex or too great to be met at home).

It may be possible to challenge the local authority decison on the grounds that:

• the assessment has not been carried out properly or it has not identified whether it is possible for the disabled person to stay in their 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. It must consider, for example, whether its actions affect the disabled person's right to respect for their home, family, and private life, and therefore whether it is necessary for the disabled person to move into residential care given their situation

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

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

Find out more from the Care Quality Commission about making a complaint about an adult social care service.

The Equality and Diversity Forum provides a 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 to find sources of support and information available to them locally.