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DLC and supervised living
Trawling for opinions really.
Client has schizophrenia and lives in supported (24 hours) accommodation. Refused PIP and FTT also unsuccessful. SOR now received. Client does appear to be coping pretty well with daily living with minimal intervention. His meds are administered to him on a weekly basis and he receives some help with budget planning so he attracted points in these areas, but he prepares meals unassisted, washes, dresses, socialises with other residents of the unit, etc. The issue is that he manages to do this only because he lives in such a supported environment (he knows someone is on call 24 hours if he needs help and this gives him sufficient mental security to cope. If he was living independently it would almost certainly be quite a different story). We’re struggling to find anything upon which to pin a request for leave to appeal to the UT but if anyone can think of a potential approach we’d be most grateful for ideas.
Has he had any recent flair ups of his condition or periods when he stopped taking medication and the condition kicked in as it can
Any issues with behaviour or avoiding others or is he a (would be be good) example of someone who the medication works for 100%
any side effects to the medication ?
Long shot I know but said with a smile on a similar client (DLA) who seemed to have no chance at all but then who regailed a re sit tribunal with a story that led to his getting DLA ( about hissi dreams and how he would sit on railway bridges and plan how to cause the least annoyance to any people going to work) as he looked down at the railway line below
Thanks JF
From the sound of it, he’s pretty stable. It’s one of those ironic ones where if it wasn’t for the support he wouldn’t be stable (and would then easily meet the PIP criteria).
I think it’s a bit of a perennial problem for people with mental health problems who have managed to have their conditions stabilized and are living in the community, certainly going back to when I was advising in a psychiatric unit a good few years ago. As above, the risk of relapse approach used to be helpful for DLA but in terms of PIP, i think the arguments have become even harder to make.
It’s been a discussion point on quite a few PIP training courses I’ve done, in particular the lack of any obvious approach to the need for supervision to prevent the risk of harm to self or others that can secure entitlement to DLA. I have wondered whether, because of living in 24-hour supervised accommodation, there might be an argument in relation to descriptor 3, managing therapy.
Therapy is defined as therapy to be undertaken at home which is prescribed or recommended by a registered doctor, nurse, pharmacist or health professional - presumably, he does have some form of regular medication prescribed by the CMHT (don’t even know if that’s what they’re called now), which I would imagine would be supervised to some extent at least in the supported accommodation?
If so, is there any means by which you could pull down some points here, to add to the budgeting points perhaps? Would there be a risk of him failing to comply with the medication if he wasn’t supervised and then relapsing, or overdosing? I’m thinking of reliably and safely arguments here.
Thanks Paul
Yes, that’s more or less what we had argued. His meds are given to him on a weekly basis but other than that he takes them unsupervised and whilst there are staff on call 24 hours per day his key worker only knocks on his door twice daily to check he is OK. The FTT didn’t accept that Activity 3 (c, d, e or f) was satisfied.
I don’t know if this helps but I have a client with schizophrenia who is in 24 hour supported living on a supervised treatment order. I, along with his approved mental health practitioner, am intending to argue that this is therapy for the purposes of descriptor 3f, and to test this through to the UT if necessary.
It most certainly does help, Nevip.
My feeling is that we should bung in a request for leave to appeal on the same basis for our case and see what happens. Thank you and please do let us know how your case progresses.
Is there any scope for arguing ‘prompting’ descriptors (alongside Regs 4 & 7)? Clearly this will also depend on the facts of what client actually receives / requires / requests.
Perhaps the meaning of “prompting” in relation to the kind of 24 hr support provision in this type of accomodation requires testing before the UT? It is difficult see how it could be argued the mere presence of a person in the buiding amounts to “prompting” but maybe some amount of interaction in a particular case between the claimant and the person(s) present could amount to “prompting”. That there is 24 hr provision would suggest (at least in general terms) that a degree of “prompting” is part of thye duties of the persons providing 24 hr support to residents.
I agree with Paul that there must be a concern that PIP does not provide an equivalent qualifying route to DLA ‘continual supervision’ and that many current DLA recipients may not qualify for PIP on migration as a result.
Thanks for your input Peter.
And yes indeed- I don’t think we would have had any difficulty at all with obtaining MRC for him had it been DLA.
I don’t know if this helps but I have a client with schizophrenia who is in 24 hour supported living on a supervised treatment order. I, along with his approved mental health practitioner, am intending to argue that this is therapy for the purposes of descriptor 3f, and to test this through to the UT if necessary.
This my thinking on the issue, too.
It might be that the support workers are giving 1964’s client his meds only once a week - but I would have thought it arguable that his health condition is, at a minimum, being monitored during each and every interaction with staff (and with other residents when staff are observing). Although it’s only good for one point, that might make a difference in some cases.
But there’s also an argument that the definition of ‘therapy’ should include things like any art therapy etc provided within the supported accommodation - i.e. if it’s part of the care plan/package and has been recommended by one of the health professionals responsible for the claimant’s treatment/care.
Appeal heard and allowed. Tribunal made it clear at the outset that it was thinking on precisely these lines.
Ooh- that’s very useful to know Nevip!
Our case is currently sitting at the UT awaiting decision as to whether leave to appeal has been granted.
Appeal heard and allowed. Tribunal made it clear at the outset that it was thinking on precisely these lines.
Excellent news. - well done.
Have to admit to a personal stake in this one as my sister has significant long-term MHPs - but has this year moved into supported accommodation (sounds very similar to that outlined in the o/p) after years in a care home. Coping well - in fact coping even better now that the underlying entitlement to DLA has changed to actual payment - but wasn’t looking forward to the change over to PIP once it happened (or the likely impact of loss of income on her MHPs). Thinking what I’d argue on her behalf informed my input above, but good to have it confirmed there’s some mileage in it…
I also had a client who at FtT got 6 points for managing therapy on basis of support worker visiting him at home for over 7 hours per week - it was supported housing but no support worker within accommodation. The client was quite delusional and the ‘therapy’ was helping him to manage day to day life - interact with people etc
I had a similar case with a ‘stable’ claimant in a Supported Accom. I asked to see his care plan and risk assessments which indicated that he needed prompting across a range of the descriptors. Point also made about absence of prompting leading to likelihood of relapse.
We’ve just been granted leave to appeal on our case so fingers crossed….