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Forum Home  →  Discussion  →  Disability benefits  →  Thread

What is a care home?

Jacky Philipson
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Housing and Benefits worker Manchester Mental Health Assertive Outreach Team

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My client is moving into a residential home which is registered with the Quality Care Commission as a care home. This particular home is for clients with mental health needs and provides accommodation, meals and there are RMN nurses on site who would provide prompting and encouragement etc re daily living skills rather than hands on care.

How can I find out whether the home is a “care home” for the purposes of social security law i.e. suspension of payment of care/daily living component of DLA/PIP and 13 week trial run re housing benefit on previous tenancy?

I have looked for some other supported housing projects in the Quality Care Commission Register and they are listed as care homes but I know that clients who have places there are still paid DLA/PIP care/daily living in full so not sure how best to advise this client.

Can anyone advise

Jacky Philipson
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Housing and Benefits worker Manchester Mental Health Assertive Outreach Team

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Should add to above that home would be funded by an Individualised budget from Social Services. Cl has been in hospital for aprox 9 months already and still holds a tenancy with social housing provider. He is reluctant to give up tenancy so want to properly advise him as to the possibility of a 13 week trial and loss of DLA/PIP care/daily living so he can make an informed consent.

Paul_Treloar_AgeUK
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Information and advice resources - Age UK

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See p.918-919 of CPAG 2017/18.

A care home is an establishment that provides you with accommodation as well as nursing and personal care, if provided under ‘specified provisions’. Specified provisions are Part III of the National Assistance Act 1948 and the Mental Health Act 1983, amongst others, and essentially encompass situations whereby the local authority are paying an amount towards the cost of the care home. There are circumstances when these rules don’t apply, usually to pure self funders, and also when accommodation is provided under housing legislation.

Presumably, his DLA or PIP care payments have stopped already due to being in hospital for 9 months?

In terms of your reference to 13 week run-on, I can’t see how this would apply. He’s already been absent from home for 9 months, and at the point he moves from hospital to a care home, the 52 week absence rules would no longer apply (as he’s out of hospital) so his HB would cease. At least that’s how it looks to me.

Dan_Manville
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Mental health & welfare rights service - Wolverhampton City Council

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If the LA are paying for it then that will cause further suspension of the Care Component.

Dan_Manville
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Paul_Treloar_AgeUK - 13 June 2017 10:31 AM

In terms of your reference to 13 week run-on, I can’t see how this would apply. He’s already been absent from home for 9 months, and at the point he moves from hospital to a care home, the 52 week absence rules would no longer apply (as he’s out of hospital) so his HB would cease. At least that’s how it looks to me.

I was just looking at this and for the res’ care temp absence rules, reg 7(12) looks to apply and the 13 weeks looks to start from the first day they enter res’ care.

Paul_Treloar_AgeUK
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Dan Manville - 13 June 2017 10:34 AM
Paul_Treloar_AgeUK - 13 June 2017 10:31 AM

In terms of your reference to 13 week run-on, I can’t see how this would apply. He’s already been absent from home for 9 months, and at the point he moves from hospital to a care home, the 52 week absence rules would no longer apply (as he’s out of hospital) so his HB would cease. At least that’s how it looks to me.

I was just looking at this and for the res’ care temp absence rules, reg 7(12) looks to apply and the 13 weeks looks to start from the first day they enter res’ care.

Nice one Dan, I missed that one, very helpful to know about, thanks.

Dan_Manville
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Paul_Treloar_AgeUK - 13 June 2017 10:36 AM
Dan Manville - 13 June 2017 10:34 AM
Paul_Treloar_AgeUK - 13 June 2017 10:31 AM

In terms of your reference to 13 week run-on, I can’t see how this would apply. He’s already been absent from home for 9 months, and at the point he moves from hospital to a care home, the 52 week absence rules would no longer apply (as he’s out of hospital) so his HB would cease. At least that’s how it looks to me.

I was just looking at this and for the res’ care temp absence rules, reg 7(12) looks to apply and the 13 weeks looks to start from the first day they enter res’ care.

Nice one Dan, I missed that one, very helpful to know about, thanks.

I learned something too; it’ll be handy for mine post discharge.

HB Anorak
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Absolutely: for HB purposes, the 13-week trial period in a care home can form part of a longer absence from home of up to 52 weeks.  It is designed for exactly this scenario: long term hospital patient contemplating moving to care home when discharged from hospital, but not ready to commit to that yet so keeping options open.  Meanwhile HB continues.

Jacky Philipson
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Housing and Benefits worker Manchester Mental Health Assertive Outreach Team

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Thanks for all of your responses. Yes my understanding was that if the residential home is a “care home” then he could take advantage of the 13 week trial hb payment and that this is paid in the context of an overall limit of 52 weeks absence from home so actually since he has been in hospital since Sept he would be entitled to most of the 13 weeks available.

I think the care provided in the home can be defined as “qualifying serices” i.e. inlcudes accommdation and is provided under the “specified provisions”  but the issue is whether “personal care” is also provided.  Having looked further into the definition of personal care I am minded to think that prompting and encouragement that may be provided in respect of meeting care needs is not the same as personal care which seems to be more about hands on assistance with bodily functions. If that is the case then it would seem that this particular establishment is not a care home?

Dan – when you say that payment by the LA would cause further suspension of the care component do you mean only in relation to “care homes”?  I am only really familiar with clients who are placed in supported housing projects where – I think -  IBs pay for the majority or all of the support and the client pays a small amount for utitilities etc but retain full payment of AA or DLA.

Simon@Nottm
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Jacky Philipson - 13 June 2017 11:56 AM

Dan – when you say that payment by the LA would cause further suspension of the care component do you mean only in relation to “care homes”?  I am only really familiar with clients who are placed in supported housing projects where – I think -  IBs pay for the majority or all of the support and the client pays a small amount for utitilities etc but retain full payment of AA or DLA.

What matters is the funding arrangements for the cost of the accommodation, if is it being funding by the LA under S117 of the MHA or part 3 of the National Assistance Act it is a care home and payment of DLA care/PIP DL is suspended.

If the cost of their accommodation is being met from HB and care is funded by an individual budget then they are not in a care home and DLA/PIP is not affected.

Hope this helps

nevip
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