Professional Documents
Culture Documents
APPENDICES
Appendices
A1: The residential care model and its
relevance
Pages 2 to 4
Pages 5 to 6
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Pages 9 to 11
Pages 12 to 13
Pages 14 to 16
Pages 17 to 23
Pages 24 to 25
Pages 26 to 28
Pages 29 to 32
Pages 33 to 41
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Accommodation i.e. the core costs of the property, as well as repairs and
maintenance.
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General social care things like assistance with daily tasks and help to get
out and about and access the community
Housing related support this can include things like support with money
matters and personal administration or support to use household
equipment
Health care for example, support with any health care need that has been
identified by primary health care consultation
Daily living costs and welfare benefits in residential care: Individuals living in residential care
are generally required to contribute from any money they have to help meet the costs of
their package of care.
Care services from a local authority are usually means-tested, so if the person is eligible for
local authority care, their finances will be assessed. Depending on their income (including
benefits) and capital (including savings), they may need to pay towards their care costs.
However:
DLA / PIP Mobility components are fully disregarded within the residential care
means test because they are not related to the provision of personal care and
support;
Individuals must be left with a minimum amount of money called the personal
expenses allowance (currently 23.90 per week). This is intended to cover items like;
Clothing, Personal items, Entertainment outside the Care Home and Transport if /
where it is not provided by the Care Home
For many people with a learning disability, their only or main source of income is through
their benefits. In reality many people in residential care will be left with an income made up
of their DLA / PIP mobility component and the personal expenses allowance, with the rest of
their benefits going towards the cost of their package of care.
Relevance in current market: The residential care model itself places restrictions on an
individuals ability to choose who they live with and who cares for them, even if the
residential care is of high quality. This restriction in practice however, may not differ greatly
from supported housing. In residential care, the restricted income has a major impact on a
persons income, ability to control their money and lead an ordinary life. This reason alone
means that the residential care model has become less desirable for people with disabilities
and in wider policy.
Personal budget use for Residential Care services: People who are eligible for social care
funding should be offered a personal budget, including a direct payment. This means
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Offer personal budgets to all older people who are eligible to receive council-funded
support services;
Personal budgets can be used to pay for care at home rather than residential care
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Living in a place that is rented through an assured or an assured short hold tenancy;
this might be a joint or an individual tenancy, in shared or self-contained
accommodation.
Living in an owned property, either outright or as shared ownership.
You might have all your support paid for. It might be for a few hours a week or it
might be 24 hours.
You might have a mixture of paid-for support and informal or natural support
from family, friends and/or community support.
You might not have any paid-for support, but some natural support.
You might have set up your supported living from scratch, by planning for and
getting your housing and support as you have designed it.
You might have moved into an existing service some accommodation with
support that had a vacancy.
If you live in your own home, you have the right to stay in the property for the period and to
the terms stated in your contract (usually 6 or 12 months for an assured shorthold tenancy,
which can be renewed, or indefinitely, subject to certain conditions, for an assured tenancy),
and to control entry in and out of the property (subject to the conditions in the contract) If
you own your own home you can stay for as long as you are able if you own it outright, or as
long as you pay your mortgage if you have one.
The separation of housing and support: Traditionally, residential care provides a full package
of housing, care and support. A common element of supported living is the separation of
housing and support. This means that as a tenant or homeowner, the person has a right to
choose who provides their support and can change support arrangements without moving
home or move home without changing support arrangements.
With supported living options, subject to their fairer charging procedures, social services and
health funding can pay for care and support that is needed. The welfare benefits system can
help pay for housing and everyday living costs.
(The model below is an example of how it might look, but there is no absolute rule about the
way these activities are carried out and managed)
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In this model, the Commissioner funds the care and support. This may be commissioned and
paid for by a Local Authority or a Health Authority (e.g. the CCG).
The Housing Provider provides the housing, unless the property is owned outright. If the
property is rented the tenant will pay this privately or, if they are eligible (see factsheet 1),
may claim Housing Benefit to help with the rental costs.
If the occupier needs personal care services, the provider of the services must be registered
with the Care Quality Commission as a domiciliary care provider. For more details about this
look here:
http://www.cqc.org.uk/content/services-your-home
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Property Rent this includes things like your core rent costs (i.e. the costs of the
bricks and mortar) and repairs and maintenance.
Service charges this includes things like the provision and servicing of communal
area furniture and fire safety equipment, as well as thing like communal heating and
lighting.
If you are renting your property you may be able to claim Housing Benefit to pay for these
costs.
(The Regulatory Reform Fire Order 2005 covers Fire Safety legislation in your own home
when you receive support. In broad terms this means that there are no prescriptive fire
safety procedures as such, but a responsible person needs to carry out a risk assessment
and recommend measures appropriate to the level of risk related to the specific property
and the specific occupier/s. If the occupier themselves are unable to carry out this
assessment, it is likely that any support provider that may be in place will be best placed to
carry out the assessment and make recommendations to the housing provider/owner. If
there is no support provider it will likely be the housing provider)
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General Social Care this can include things like assistance with daily living tasks
(e.g. preparation of meals) and getting out and about.
Housing Related Support this can include things like support with money matters
and personal administration or support to use household equipment.
Health Care for example, support with any health care need that has been
identified by primary health care consultation.
Personal Care (Regulated by Care Quality Commission) things like physical and
intimate personal care.
(Payment for staff expenses such as transport, staff meals, entertainment can vary according
to commissioning and/or support provider policies)
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The applicant is placed in a band according to the urgency and need to move. There
are usually 3 or 4 bands A, B, C and D. Those in Band A are often statutory
homeless and get highest priority
Medical or social care needs tend to put people with a learning disability in Band A
or B and thus get high priority. It is important to fill these parts of the application
form in thoroughly. There may be scope for adding in additional reports or
supporting letters
Properties are advertised as they become available each week. This may be on the
authoritys website and a newsletter. There may also be a folder or display in the
council offices
People on the housing register bid for properties that are suitable and in the right
area or that they like
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The highest priority bidders (perhaps 3 or 4) are invited to view the property
The successful person is the one who says they want the property and has been
waiting longest
Filling in forms
Pro-actively bidding
Viewing property quickly
Making a decision quickly
Application processes vary and particularly where the landlord is a housing association there
may be an interview. Local authorities usually have the right to nominate, (put forward)
applicants for a proportion of housing association property in their area although the actual
decision on who to let to is the housing associations.
Pros and cons
Pros:
Security of tenure; tenants of RPs usually have assured tenancies offering good
security and council tenants have a secure tenancy
Rents in social housing are nearly always met in full by housing benefit for those
who qualify. They are also only very exceptionally referred to a rent officer
Social landlords management and maintenance services and quality are monitored
and inspected and should be of a good standard
Local authorities and housing association are expected to assess the most vulnerable
people in housing need get housed despite the fact (surprisingly) there is not any
duty to them
Cons:
Demand for social housing far exceeds supply; long waiting list. It may therefore
take several years to get a suitable property
Housing associations are the only real way of getting new, purpose built social
housing
In some areas there may be very few properties like bungalows and other people
such as those over a certain age may be given higher priority. What is needed may
simply not be available in the social housing sector, in the short term, if at all
Some large estates may not offer a secure and welcoming environment for a
vulnerable person
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Charitable organisations letting out properties often to a particular needs group are, for rent
and housing benefit purposes, also considered as private landlords despite the fact they are
not trading for profit.
How to access
Private landlords compete in a market place for tenants and in principle any one can rent a
property from them.
If it is on the market, in principle, it is available to a disabled person who can meet the terms
of the letting. The usual ways of finding a property are:
Sometimes the only way of getting the right type of property in the right place
If available, can move in quickly, do not have to be on a waiting list for years
Some landlords will buy to order and have developed good relationships with
councils who regularly use the private rented sector to obtain housing for disabled
people
Cons:
There are some serious disadvantages for people with learning disabilities:
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The amount of rent eligible for housing benefit is limited by a Local Housing
Allowance. Often this is too little for the landlord so the tenant is faced with
topping up the rent from other benefits.
There are additional problems when the tenant needs a second bedroom perhaps
for an occasional carer as Housing Benefit will only meet the rent for a one bedroom
flat if it is for one person
Adaptations where required may be difficult to get as the landlord may be very
reluctant to agree major changes to their property which does not add value
Legislation which in the past allowed people who need some care and support to get
a higher level of housing benefit to pay a commercial rent cannot be relied on
following a series of legal decisions referred to as the Turnbull judgement
It is common for the landlord to require a deposit equivalent to several months rent. Private
landlords may often require a working person to stand as guarantor before they let to
someone on benefits. Local
Authority may run a scheme to help pay for these deposits. A list of schemes to help with
rent deposit
can be found at www.privaterentedsector.org.uk
How the money works
Rent eligible for housing benefit is restricted by the local housing allowance (see
https://lha-direct.voa.gov.uk/Secure/Default.aspx) and subject to determination by a rent
officer.
Housing benefit departments have a small budget to make discretionary payments to cover
higher rents in exceptional circumstances. It would however be risky to rely on this for long
term housing.
Other issues
Despite reservations renting in the private sector can sometimes be a good option
particularly when someone wants a short term let, for example to try out living more
independently, and where long term security of tenure is less of an issue. There are
examples of commercial landlords buying property to order for disabled people and offering
an excellent service. There are also mechanisms where RPs lease properties from private
landlords and sub-let them. This provides better security of tenure and some assurance of
quality
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Excluded
As Exempt
As Exempt
Not required
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Cons
Excluded Tenancies
Pros
Cons
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General Issues
Having two different regimes achieving the same end outcome is confusing
There are widely fluctuating local differences in the interpretation and application of
what is quite loosely defined guidance
Particularly there is scope for widely varying interpretations of reasonable which is
referred to frequently in the guidance
The guidance hasnt kept up with many of the regulatory and good practice
developments in social and personal care and ordinary housing
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Other issues
The problem and risks with this option is the attitude of the local authority housing benefit
section. The key Statutory Instrument (SI) setting out the regulations is SI 3257. Broadly, the
Income Support Regulation seek to discourage renting between close relatives fearing that
arrangements will be set up to exploit the housing benefit system.
However, at the end of this SI it is explained that renting between close relatives is
permissible provided:
The property rented out is a separate, self-contained property. A close relative cannot for
example get HB to pay the rent on a room in their own home
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Outright Purchase
Better off relatives may be able to buy a property, without borrowing, for their son or
daughter to live in. This might be treated as a long term investment and the son or daughter
lives rent free or, if they have an income, might pay a modest rent. In the long term the
property could be:
Some of the issues which need to be thought about and dealt with in more detail are:
Why do people gift or lease a property to a third party: a Housing Association, relevant local
charity or not for profit housing provider? There are usually several reasons:
to maximise Housing Benefit entitlement if any rent being charged needed to be set
at a level above Local Housing Allowance (LHA) (see 5 Buy to Rent for more details)
as LHA is not the system used for assessing Housing Benefit entitlement in these
circumstances.
Gifts disposals or leases like this are usually made on the basis of various understandings
about what the recipient will endeavour to do and provide in the future. They will probably
agree for example that the gifted or leased property or an alternative more suitable
property will be provided, managed and maintained for life.
Shared Ownership privately financed
In the mainstream part-buy, part rent programme offered by some Housing Associations
part of the property is bought by the occupier and part rented from the association. Housing
benefit may be payable on the rent and the purchased share eligible for Support for
Mortgage Interest (SMI). Another option is for the part purchased to be funded by relatives
rather than SMI. It is also possible for parents to substitute their money for Social Housing or
Home Ownership Long Term Disabilities (HOLD) Grant from the Homes and Communities
Agency (HCA), which is used in combination with a loan by the housing association to fund
the part they retain. This creates a privately financed Shared Ownership option, which is
often more flexible than the HCA regulated model.
The advantages of this model, apart from those that apply to all Shared Ownership, are
essentially freedom of restrictions that apply to HCA funded Shared Ownership which
include:
No grant limits allowing higher design standards, better location, size and type
No restriction because of the size of HCA programme only the associations ability
to borrow
No waiting for HCA allocations can move more quickly
Less bureaucratic - only association/charity rules to be met
No HCA tests of value for money
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Joint Ownership
Joint Ownership is where a group of people pool their resources to buy a property between
them. This could be a group of families coming together to acquire a property for their
children to share.
Anybody who buys a house with a mortgage in conjunction with a husband or wife or
partner is technically likely to be a 'joint owner'. This means they will be 'jointly and
severally' liable for loan repayments. That is to say if one ceases to pay the mortgage for any
reason the other remains liable for all the repayments, not just half.
Joint Ownership is therefore commonplace. It is usual for two people to be joint owners but
in legal terms it is equally simple for up to four people to be joint owners. There can be more
than four joint owners but this is much more complex.
It is possible if unusual, if they have the resources, for up to four disabled people to
be the joint owners rather than the parents (or other relatives).
Where the owners are parents, those who live in the property will be tenants.
The real question in a joint ownership model where parents are the owners is often 'how
can we get our money out? An issue that arises where groups share a single dwelling is
what happens if one person wants or needs to move on?
This needs agreement prior to setting up joint arrangements. All parties must go into the
arrangements on the basis this will be each persons permanent home. No one individual or
family must be able to undermine the living arrangements or make the other sharers
homeless. As a consequence all the parties should agree no family is able to withdraw their
funds unless three conditions are met:
There is another family/individual able to replace the funding which one of the
families is taking out
The individual who is to move in must want to share with those already living in the
house and be compatible
The person moving in must be acceptable to those already living there
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A vehicle for bigger developments - can be used for example to buy a plot of land
and develop a block of purpose designed flats.
Forming a company forces all concerned in the process of preparing objectives,
memorandum and articles of association to think through in some detail what the
purpose is and how matters will be managed in practice.
As a legal entity the company can borrow - although families may be asked to offer
guarantees.
The company has a life which extends beyond the life of any individual parent.
It provides a vehicle for managing and maintaining property, also possibly of
providing or managing care and support in the long term.
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Discretionary Trusts
Discretionary Trusts have increasingly been seen as a key mechanism for making long-term
financial provision for disabled relatives. Discretionary Trusts are a legal way of putting
assets - money, shares and property - aside for a 'beneficiary'. Advice of a solicitor with
expert knowledge of Trust law is required. To work in the way intended Trustees must have
discretion as to how funds are used, the beneficiary should not be the sole beneficiary and
must not have a right to either the assets of the Trust.
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Intentional Communities
What this option is - Intentional communities is a term to describe a variety of planned
residential communities from eco villages and housing co-operatives to Kibbutzim and
Ashrams. Typically members hold common social, religious or spiritual views and share
responsibilities and resources.
In the present context intentional communities refers to schemes of this type set up
specifically to house disabled people who live together as part of a supportive community.
Historically, intentional communities were often set up as small villages or farms in rural
areas but some are newer developments in towns like Milton Keynes or may consist of a
number of properties spread across an area.
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SL arrangements are part of organised SL Schemes that approve and train the SL
Carers, receive referrals, match the needs of service users with SL Carers and
monitor the arrangements
People using SL services have the opportunity to be part of the SL Carers family and
social networks
SL Carers can use their family home as a resource
SL agreements provide committed and consistent relationships
The relationship between the SL Carer and the person placed with them is of mutual
benefit
SL Carers can support up to three people at any one time (two in Wales)
SL Carers do not employ staff to provide care to the people that they support
In a Shared Lives arrangement that offers accommodation, the individual usually shares the
whole house and mealtimes whilst having the privacy of their own bedroom.
Shared Lives Schemes are registered by the Commission for Social Care Inspection. The
Schemes in turn monitor individual placements. Families offering Shared Lives
accommodation and care no longer have to register as small homes.
Matching is a key feature of Shared Lives arrangements. Matching of the individual and the
Shared Lives family is usually done by a Shared Lives Worker in close consultation with the
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For many disabled people this may be the first (only?) opportunity to live with and
share activities with someone who is not also disabled other than perhaps parents
It can be a very positive, genuine, friendship
It can be the key to making independent supported living economically feasible
It can play a part in linking someone with the wider community helping build a social
network
There is likely to be turnover; students may sometimes be attracted to doing this for a while.
In evaluating this option it should be borne in mind:
there is turnover of staff in any residential home or care service this is not unusual
if the philosophy of promoting an 'ordinary life' is accepted then it is 'normal' to face
changes in relationships from time to time Having said this compared to living at
home with parents this is likely to be a more variable arrangement.
Supervision and monitoring of the support tenant is required to safeguard the resident and
get the most out of this arrangement.
What is the Status of the Support Tenant?
The learning disabled person will normally be the tenant or owner of the property. The
support tenant is likely to be a lodger. This means they have no security of tenure. This helps
to protect the more vulnerable, disabled resident.
The contract with the support tenant will provide for a period of notice if they want to leave
- say one month and indicate how long they are expected to stay in the first place - say
twelve months. However, neither is easy to enforce in practice.
The nature of the agreement with the support tenant will require careful thought and legal
advice. What you need to ensure is that you have a service contract so that if the support
tenant no longer provides the necessary support they have no right to continue living in the
property.
The support tenant would also be entitled to one months notice.
How Do You Recruit and Select Support Tenants?
Support tenants come from a variety of sources where the opportunity can be promoted or
advertised:
churches
GPs surgeries
recommendations from former support tenants/care workers
previous carers
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Involvement of the disabled person in selection is vital and often family, friends, previous
carers or advocates are involved as well.
The Role of Support Tenant
The support tenant will:
visitors
household emergencies
household management and maintenance
correspondence
personal and household security
daily living activities
encourage the individual to live as independently as possible and also develop their
self-confidence
be a good role model. For example, introduce friends and visitors, helping to extend
these networks.
agree house rules with the individual regarding smoking, visitors, music, telephone,
cooking, bills and tidiness of rooms
pass on any worries or concerns that the individual might have to the appropriate
person or support tenant co-ordinator
respect the individual's confidentiality and not discuss details with inappropriate
people
contact the individual's Social Worker if for any reason the support worker has not
arrived to support them at the specified time
inform the co-ordinator as early as possible if they cannot support the tenant due to
sickness or an emergency or any other reason
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Cons:
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Schemes are not universally available and depend on a local authority taking the
initiative to set up a scheme with Keyring and provide funding. About 40 authorities
currently have an established Keyring network
So far has most often been thought of as an option for people with more mild or
moderate disabilities
Require sufficient, suitable properties, fairly close together, being available at a
similar time
Renting
Housing Benefit is the only welfare benefit available to pay for rented housing. Housing
Benefit is paid to those on a low income to help cover their rent. It is possible to apply for
Support for Mortgage Interest to contribute to interest payments on a mortgage. The detail
behind these payments is explored in detail later in this factsheet. .
Types of Housing Benefit:
Standard lettings in the Social Housing Sector (Housing Associations and Local Authority) are
straightforward (unless Spare Room subsidy applies, see below); Housing Benefit will always
match the rental requirement as this is an affordable housing option
Social Housing is allocated on a priority need basis, based on an application to the Local
Authority
Where the rental is in the private sector Local Housing Allowance rules apply
Where property has been specifically obtained on behalf of an individual or group of people
and a higher level of rent(i.e. above the standard housing benefit amount) is required then
Exempt Accommodation or Excluded Tenancy rules may apply. For example, this may be the
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The landlord, (or someone acting on their behalf) has an obligation to provide care, support
or supervision to the tenant. On behalf of should be taken to mean that the care, support
or supervision if not provided by the landlord should be provided for them. There should be
some form of interposition for the landlord in providing these services.
The amount of care, support or supervision provided by the landlord can vary considerably
but it must be more than minimal. It could be the case that the tenant has a very intensive
package of care or it could be that the support is fairly minor, but, nevertheless goes beyond
that which is normally provided by a housing provider.
As with the provision of accommodation it should be the landlord that has ultimate
responsibility for providing care, support or supervision or provides a level of support that
the authority is satisfied is more than minimal. It is not sufficient for the landlord to simply
facilitate, co-ordinate or just be involved in the provision of care, support or supervision
either on behalf of others, ie social services, the NHS or within a joint responsibility.
The care, support or supervision does not need to make up the entirety of all care support or
supervision provided, that is additional services provided by a different provider can be in
place.
If the care, support or supervision is not directly provided by the landlord or by someone
acting on their behalf, for example if all the care, support and supervision are independently
commissioned by Social Services, then exempt accommodation status will not apply.
(HB/CTB Circular A22/2008)
If a local HB office is satisfied that the accommodation is exempt then eligible rent and
HB entitlement should be assessed under the old HB scheme rules (Housing Benefit
(General) Amendment Regulations 1995 (SI 1995 No. 1644, now revoked) which originally
introduced the Local Reference Rent (LRR) Otherwise the eligible rent will be calculated by
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This new specification applies to an individual exemption from the Universal Credit benefit
cap only. Any housing provider wishing to set rents at high levels will still need to satisfy the
provision of care, support and/or supervision test as exempt accommodation described
above as those regulations remain in place.
The DWP have indicated that longer term reform of the exempt accommodation regulations
within Universal Credit will be needed. It is anticipated that this may mean taking high
housing costs out of the benefit system altogether, probably by passing the responsibility to
meet these costs to Local Authorities. More detail on this is expected to be released in due
course.
Housing Benefit - Excluded Tenancies
Housing Benefit Regulations 2006 Schedule 2 Regulation 14 defines excluded tenancies as
those that are provided by a landlord who is a Registered Provider (ie registered with the
Homes and Communities Agency)
There is no requirement to refer an application (for HB in an excluded tenancy) to the rent
officer unless the accommodation is larger than reasonably required by the claimant and any
others who occupy that dwelling (it is important to bear in mind that the size criteria applied
by the rent officer are different from the test to be applied by the LA here. The test here is
whether the dwelling is larger than the claimant reasonably needs, whereas the rent officer
is simply applying a formula based on the number of occupants), or rent payable for the
property is unreasonably high (HB/CTB Circular A22/2008)
The decision to refer a registered Housing Association case to the rent officer rests with the
LA, but for the sake of transparency the LA should have a policy for determining whether a
referral is appropriate as a high rent or a large property is not wholly determinative: the test
is unreasonably high or larger than reasonably required. HB officers are encouraged to work
closely with their RSL partners and to create a Service Level Agreement between parties:
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If your rent payable is more than the appropriate room rate, you will need to top up the
difference from other income. If it is less you will receive that amount.
If a tenant occupies a self-contained one bedroom property but are under 35 years old they
will only be eligible for the shared room rate, unless they claim DLA Care at the middle or
higher rate, in which case you will be eligible for the one room rate.
A bedroom that is used overnight by an overnight non-resident carer can secure the 2 room
rate. A person who requires overnight care is someone who
o
if they do not receive either of the above, has provided the local authority (LA)
with sufficient evidence to show that this type of care is required
In addition, the claimant, will only meet the definition if the LA is satisfied that the claimant,
reasonably requires, and has in fact arranged, that one or more people who do not occupy
as their home the dwelling to which the claim or award for housing benefit relates should
i be engaged in providing overnight care;
ii regularly stay overnight at the dwelling for that purpose; and
iii be provided with the use of a bedroom in that dwelling additional to those used by the
persons who occupy the dwelling as their home.
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Any other child but not a foster child nor a child whose main home is elsewhere
Any rooms in a property over this allowance will be counted as 8under occupied and
Housing Benefit will be reduced by
The claimant needs an extra bedroom to accommodate a carer or a group of carers who
stay overnight to look after them
The Claimant lives in temporary accommodation organised by the council because they
have been homeless
The claimants child who would be otherwise expected to share needs their own room
because of the severity of their disability. Local authorities have to make individual
decisions in these circumstances.
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The applicant must be claiming DLA Care Higher Rate and one or more of: Income
Support, Incapacity Benefit, Employment Support Allowance (Support Group) Severe
Disablement Allowance, Pensions Credit
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