Introduction
Background
Everyone should be able to access housing that is accessible, meets their needs, supports their engagement and participation in the community, and is safe, affordable and provides security and stability to build life upon…
…Failure to grasp this challenge will see more people with a learning disability left without housing options for the future, experiencing homelessness, or languishing in hospitals, and a new generation of young people unable to realise their aspirations to be part of society and make their way in life.
Jon Sparkes OBE, Chief Executive, Royal Mencap Society
(National Housing Federation blog, 2024)
Where people live should be their choice, and this is equally so for autistic adults and adults with a learning disability. However, the Housing LIN (Learning and Improvement Network) estimate a shortfall of between 27,000 to 34,500 units of supported housing for autistic people and people with a learning disability by 2037, or around 1,800 to 2,200 units of accommodation per annum.
While there has been a focus on the national housing strategy, and the Government’s ambition to build 1.5 million new homes, at a local level there is an opportunity to plan for and deliver more accessible general and supported housing options as a part of that wider strategy.
Local strategies for housing for autistic adults and adults with a learning disability can help local areas to better understand where they are now in relation to housing options, where they would like to be, and identify their next steps and priorities in order to get there. They are essential for medium- and longer-term planning, focussing on a 5-20 year horizon as well as considering the current needs.
This toolkit is funded by DHSC and is designed to support local areas, strategically and methodically, in thinking about and creating their housing strategies for autistic adults and adults with a learning disability. It may additionally support local authorities to meet the anticipated requirements of the Supported Housing (Regulatory Oversight) Act 2023.
Considering the diversity of preferences and needs of autistic adults and adults with a learning disability
Autistic adults and adults with a learning disability are as diverse as any other group. When thinking about housing it is essential to understand people’s daily lives, goals and preferences as well as any support needs they may have, including a need for specialised design or adapted housing. In relation to the provision of housing options as well as care and support, there are differences in terms of funding streams, and in the housing options likely to be most suitable. As such, in this toolkit we will at times refer to the level of care or support needs of autistic adults and adults with a learning disability.
High needs
This group have a need for a high level of support and may be hospital inpatients or at risk of hospital inpatient admission.
The NHS is more likely to be involved with housing and support and NHS funding such as Continuing Healthcare (CHC) may be available.
High or moderate needs
This group have care and support needs that are eligible for support under the Care Act (2014) and so the local authority may provide this unless the person is a self-funder.
Moderate or low needs
This group does not have care and support needs that meet the criteria for local authority support under the Care Act (2014). While most autistic adults and adults with a learning disability are in this group, they may still benefit from suitable housing options that are difficult to find in the general housing market.
There’s no ‘one size fits all’
To develop housing options that people want and will choose to live in, housing options cannot only be about people’s support needs and the types of housing adaptations that relate to those support need. Rather, an understanding of the whole person in terms of their preferences, strengths, community, aspirations, family and the potential impact of what may be a significant transition.
A set of housing options are given below, with the ambition being that a range of options are available to meet preferences and needs, to support individuals, families and communities.
Housing options for autistic adults and adults with a learning disability
This section summarises the main models of housing with support for autistic adults and adults with a learning disability. These definitions are based on those outlined by LGA and ADASS in their housing pipeline resource. While these definitions describe a range of typical models that may be developed, in practice features may vary or overlap depending on individuals and the nature of the local area. Options may also be new build or adapted from existing buildings depending on the circumstance. There is more information in relation to design standards in step 6 – Drawing on best practice.
General housing: The majority of autistic adults and adults with a learning disability live in general housing, often with family. This housing may have some adaptations or be accessible. People may need to be supported in relation to accessing appropriate rental agreements, mortgages, shared ownership, etc.
Specialist bespoke supported accommodation: Accommodation built to higher accessibility standards, including considering the design needs of autistic people. Accommodation is either provided as single occupancy bungalows or clustered flats. Normally no shared areas are provided and there are staff facilities on site. New developments may be built to accessibility standards. On-site care is provided 24 hours a day with the number of carers to support each person varying to meet individual needs.
Bespoke single occupancy property: The property may need to be fitted with sound proofing and other design features to support the person living there. The location of the property may need to meet a range of requirements. They are normally a one bed property with another room/space for carers and can be a new build or renovation. On-site care is provided 24 hours a day with the number of carers to support each person varying to meet individual needs.
Purpose built supported accommodation – clustered flats: Mainly provided as single occupancy flats clustered together with some communal areas. The property would normally be built to robust standards and meet accessibility standards. They can be new build or renovation. The level of care and support can vary, with most providing on-site background support 24 hours a day, with the number of carers to support each person varying to meet individual needs.
Purpose built supported accommodation – hub and spoke: The ‘hub’ is usually long-term accommodation that provides on-site background support. On-site care is provided 24 hours a day with the number of carers to support each person varying to meet individual needs. The ‘spoke’ refers to dispersed one bedroom accommodation which would receive background support from the hub for those people with lower needs. The spoke may also provide some small, shared units. This accommodation can be new build or renovation.
Designated general needs housing with support – clustered flats: A cluster of designated general needs housing with support flats. Normally this would be a new build development but could involve existing general needs units let outside the normal lettings process. There may only be background support, or it could be combined with one-to-one support.
Community living networks in dispersed housing: This involves support being provided by a combination of paid workers and volunteers to a number of dispersed properties. Dispersed general needs social housing is allocated through the normal council processes, with private rented sector lettings also accessed. Dispersed accommodation can include shared ownership units.
Extra care housing – generic: Extra care housing that is for a mixture of needs and ages. Often it is mainly older people that live there, but also younger adults with disabilities, including people with a learning disability with lower needs. 24-hour background support is provided to all, with individual care based on an assessment of need. These are purpose-built developments that meets accessibility standards. Rental, shared ownership and leasehold may be available.
Extra care housing – older people (also known as integrated retirement communities): Extra care housing for people aged 55 and over. These developments can include older people with a variety of needs, including people with a learning disability who require low-level support. 24-hour background support is provided to all, with individual care based on an assessment of need. These are purpose-built developments that meet accessibility standards. Rental, shared ownership and leasehold may be available.
Shared Lives: offers people who require care and support the opportunity to live independently in the community and can be an alternative to living in supported housing. The Shared Lives scheme matches people with an approved carer. The carer shares their family and community life. Some people live with their Shared Lives carer, while others are regular day-time visitors. Some people combine day-time visits with overnight stays.
How to use this toolkit
This toolkit is designed to be flexible around the needs, context and existing strategies, policies and structures within a local area. It can be taken as a whole, or different steps can be used to guide individual activities. We have suggested an order for each activity or ‘step’, but this too can be flexible.
Population or housing types
Local areas should decide which population they will focus on. While the main intention for the toolkit is for it to be inclusive of all autistic adults and adults with a learning disability in a local area, it could be used to focus on those who draw on care and support or a sub-group within that. The toolkit should be used for the groups and housing types that are most helpful to that area and the process and steps are also appropriate to other groups such as physically disabled people.
Steps
The steps outlined are those identified as needed to create an outward facing strategy for a local area. As outlined in the following sections on leadership and vision and co-production principles, these should be grounded in strong partnership working and co-production with autistic adults and adults with a learning disability and their families. This will enable organisations and funders to understand the key needs and attributes of a local area in relation to housing for autistic adults and adults with a learning disability and what the priorities and expectations are of that local authority. An outward facing strategy can encourage greater engagement with organisations and funders and provide them with the information they need to guide decisions about potential investment. We highlight which steps relate to which section of a strategy and vice versa.
It may be that a fully detailed strategy is not yet achievable, but a combination of steps will still provide helpful insights to guide and prioritise local activities. Local areas should dip into the toolkit as they find helpful, using the steps to build on what they already have, or as a way of getting started.
Related strategies and reports
Local authorities, as well as other organisations may already have other related or relevant reports and strategies, either relating specifically to autistic adults and adults with a learning disability or to wider housing, health, social care and community. The aim is not to try and encompass them all in one plan, but to build on, signpost and make all those involved in a local plan for housing for autistic adults and adults with a learning disability aware of the range of activities that may be happening across groups and departments.
In the future, one such related activity within local authorities relates to the Supported Housing (Regulatory Oversight) Act 2023 which gained royal ascent on 29 August 2023 with formal consultation on the draft regulations running from February to May, 2025. The Act relates to supported exempt accommodation (supported housing that is exempt from the usual caps of housing benefit level), some of which is housing for autistic adults and adults with a learning disability. The Act includes obligations on local authorities to develop strategic supported housing plans quantifying existing supply and local need.
From strategy to delivery
This toolkit supports the creation of a strategy and is not a guide for the delivery of that plan. However, by bringing together a housing partnership and developing a strategy, issues in relation to the delivery of that plan will certainly arise. There is an opportunity to be discussing and moving forward with changes within local planning policy and within local health and social care planning that would better support the delivery of the strategy. That will be more likely if the relevant partners have been involved in the development of the strategy from the outset.