The Low Review: Personal Mobility in State-Funded Residential Care

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The Low Review reported back its findings in November 2011. This website provides links to the key information gathered by the commission and to its final recommendations.

On 1st December 2011 Maria Miller, the Minister for Disabled People issued a ministerial statement to Parliament announcing that the mobility component of Disability Living Allowance will not be removed from people living in residential care homes. Read the full statement here.

On 3rd November 2011 the Low Review reported back its key findings. The full report, executive summary and press release can be found below:

Low Review Report – PDF

Low Review Report – word doc

The Low Review Executive summary

The Low Review Executive summary easy read

Press Release

The Low Review was launched in July 2011 as an open and independent call for evidence, to complement the Government’s own internal review into the proposed removal of the mobility component of Personal Independence Payment, which will replace Disability Living Allowance from disabled people living in state-funded residential care.

Over the 12 week consultation period, the Low Review received over 800 submissions from individuals, disabled people’s organisations, disability charities, residential care providers, and local authorities, and held a number of oral evidence sessions with key witnesses.

154 Responses to The Low Review: Personal Mobility in State-Funded Residential Care

  1. pete blount says:

    my DLA ran out last Nov, we had filled out the claim forms yet again to renew it,initially we were told by letter that we would have a visit from an independant Dr who would examine me and send his report in to the DWP, he rang me on the 23rd Dec and said he would be coming to examine me at 10AM on Xmas Eve, when he arrived i was in my chair, he asked me some questions and when my wife tried to explain what effect my ailments were making to her ( she is my carer) she was told to ‘be quiet i am asking your husband’ and this was said on more than one occasion, he duly asked for me to stand up from my chair, my wife stood up to help, which was quite normal and he told her not to help, i did manage it but with quite a lot of pain and near breathless, he then told me to bend over as far as i could which i did try but was unable to move more that a couple of degrees, walk forward 3 paces and then it was ‘right you can sit now’ he filled in his forms asking me very little, after about 15 minutes he went and that was the last we heard until about 2 weeks later when we received a letter from the DWP which stated that i no longer qualified for DLA due to the doctors report saying basically there was nothing wrong with me, i did NOT need any help in getting in and out of bed, i was able to shower my self, and i could walk at least 800 mtrs, all this after i was asked just how do i manage when we do the family shopping, to which my answer was and i quote ‘ when we go to the superstore if there is NO electric trolley’s available then i will wait in the car until my wife comes out’ and yet he says i am able to walk 800mtrs just where does he come up with this figure, where i live my car is parked around 60 yds away and whenever we go out it takes meanywhere between 3 – 5 mins to get there i have to stop at least once and i always have to use my GTN spray, but he says i am capable of work, then o.k. give me back my HGV 1 licence and lets just see who is right and who is wrong, as far as the powers that be are concerned what there Independant Drs say is Gospel and we have to just sit back and take it, what recourse have we got, What right have they to tell ME what i can and can’t do when i have been ill for over 10 years and over that time i have developed other illnesses that will be with me for the rest of my life, as i now have to take Warfarin every day permanently because i have Atrial Fibrillation which i didn’t have 1o years ago, i am on Morphine for pain relief because i cannot bend due to spinal arthritis, these are just a couple ofd my ailments but i take each day approx 17 tablets and 2 sprays plus my GTN, so who is trying to play the system here, Certainly not me, so why is it that i am being penalised by the same system that tells everybody just how fair they are, i don’t know just who they are kidding but certainly NOT me…..

    • Tracy says:

      Hi Pete

      Reading about what you went through made me feel ill. It makes me so mad that when a ‘medical professional’ doesn’t believe/ hasn’t heard of a certain condition they screw you over (has happend to me but not in DLA claim). It might be an urban myth but I heard you have to claim 3 times before you are awarded DLA. Regardless of that keep fighting mate, chronic pain is not fun- tiredness, drug side affects, not being able to sleep properly or concentrate on anything on top of physical impairment- I know how hard it is, diff condition though. How wrong is the system when stuff like this happens???!!!!

  2. victor p parkin says:

    I am a severely disabled person and I am unable to walk more than 15 to 20 feet without the need to sit down because both my knees are shot due to a R.T.A back in 1982 my injuries were extensive because of the head injuries I sustained left my short term memory in a very poor condition I can not sit a highway code test I am aware of all road signs etc but questions on the highway code do not stick in my memory thus meaning I have to ride a motor tricycle on a provisional licence only if I am required to travel a further distance than a mobility scooter which has a very limited travelling distance and takes forever to get where you need to goth forms of to so I need both forms of transport to assist with travel it would help greatly if you could use a train to take mobility scooters on them but in the northwest our trains don’t allow this only on the eastern network as far as I know of. but it takes all my mobility money to get mot certs even on mobility scooters if you require insurance on them which any responsible person would take out plus the fact nearly every business dealing with mobility products rip the cash out of your pockets. so you see I’m not the only disabled person with his problem full disability access is still a futuristic dream too many disabled people who can not walk need these machines even those in nursing homes to grant them just a little independence. but remember this everyone disability can even happen to mp’s, councilors, and lords, and their families as well,illness takes everyone at some time of their life only a very few lucky ones will probably get away without illness and live a full life. but the odds are stacked well and truly against that happening, so politicians this may happen to you also remember that when you vote to cut our mobility allowance money you may just be cutting the throat of one of your friends or family members or even your own in the near future….

  3. James Duff says:

    I’ll wager these decision maker’s opinions would soon change should they suddenly find that they are the ones in need of state help.
    What has happened to the consideration once afforded to those less able to care for themselves that was once deemed an issue for this to be assessed through parliamentary processes and introduced in the first place? Why should this need suddenly not be a need now?
    I always thought during the cold war if we stopped spending money on the military we could spend this money on improving society instead, now we have stopped spending money on the military and there is still no money left for society! What are those politicians doing to us? None of them ever seem to end up in situations where they need to be cared for, and none of them seem to be able to connect with the constituents they are meant to be representing unless they happen to be rich or large conglomerates. It seems to me that the big society expects people to care for each other by voluntary means without any means of support in return. How are people meant to be cared for if there is no funding for this care and no funding for voluntary organisations with even the care homes closing because of cash flow issues?

  4. Josie Eans says:

    Hello . My initial reaction was it kind of makes sense on a basic level but residential care is by its nature a greater level of support . Does this mean that anyone is residential care is unable to go out in an independent manner . Most can walk and would be of great advantage for them to have mobility scooters y. I know certainly of 2 individuals in residential care with respiratory problems who use scooters to enable their mobility around the home as well as going out short distances . I think the mistake here is to assume residential care = end of active life in society . My experience in working in such envirions ( nurse before illness ) is those who get out out by whichever means are most happy . Mobility components are also used for having carers accompany the person on trips . I have to pay for the carers time and any admission costs . Getting some were is not the whole picture

    I am currently living independently with care support . The thought that i may need 24 hour support, not care as residential care in itself is not 24 hour care . Individuals vary in their level of independence .

    So classifying between residential care , nursing home care , and EMI care may clarify matters . Though managing a family members needs on spending time in other places ( family homes) can feel overwhelming and adding a taxi being a cost that can not be met , may be a tipping factor for families and individuals adding to social exclusion with its implications to that individuals needs .

    Ultimately my DLA mobility component is used for a scooter now . I still need taxi’s , which I pay a premium because I need a wheelchair vehicle . I can’t use community transport often as my illness is unpredictable . I also tire quickly so need transport I can adapt to my needs . I have to do things when I can . I also need to use taxis home from appointments and for hospital appointments . Without my DLA my income was not sufficient to pay my rent top up and get back from hospital ( A&E admission ) None of my family drive . This caused me considerable distress and worry which aggravates my condition .

    If I need 3 calls a day morning , lunch , tea and bed call , My local authority will not fund all the hours . So I could end up in residential care but want and need to get out in a suitable vehicle . Without my DLA mobility this would not be possible . Would this be flouting my human rights ?

    So by removing this you could be trapping people in their own homes , increasing the risk of depression and increasing the effects of pre existing conditons . The money is not for families but by removing it you are reducing equality and increasing the gap between those who have and those who don’t . families may not be able to afford fuel for trips out , be embarrassed about this so avoid visiting and taking the person out .

    Christmas day in residential homes will be a lot bussier .


  5. Kevin Westall says:

    Is this another attack upon the disabled It seems that this government are discriminating against us, why ? because they have nothing but conempt for the disabled. And.this from a man who had a disabled child. Still, it won’t affect those with plenty in the bank ( about 1 pent ) the other (99 p cent ) can suffer Typical….

  6. Alison says:

    Well the government seem to want to cut benefits but they attack the ones most in need whether residential disabled or otherwise its about time they listened to thes people im a transplant patient yet my dla has gone to tribunal twice each time ive wone yet i get no mobility component and fatigue and arthritis in my back is not sufficient for them to allow me mobility let alone pain stopping me from getting around they juge you but couldnt live like you have to yet they give immigrants more than our pensioners when are we going to take care of british people !!!!!!

  7. Natasha Crist says:

    I am not in residential care, I live on my own. I have Mental Health problems and Heart disease.

    I am on the care element of DLA as I am on 24 hour supervision to try and stop me severely injuring or killing myself. I was detained under the Mental Health Act for just over a year, now have been left at home as Mental Health sufferers are rarely admitted to hospital. The supervision rarely works, as have done things to myself on many occassions – the Medics do not know why I’m still here inspite of what I have done.

    I am also on low level disability allowance, because my heart condition has made it difficult for me to get around. I can walk a certain distance for exercise or to get to my nearest supermarket, but then have to get a taxi home as my legs become week and painful.

    If the DLA is scrapped, we can only guess what will happen

  8. Robin Smith says:

    my 23 year old fragile-x son lives 50 miles away in residential care, he did not choose the location – a small remote town and the only house available at the time. he lived alone for many months while the house was finished and prepared for other residents. his timetable was the tv listings. there is no phone-line in the house so internet access is impossible. without mobility he’d go insane.

  9. chris lloyd vmsm says:

    wELL IF THE GOVERMENT TAKE AWAY MY DLA-MOBILITY then after being a disabled war veteran then i might as well do one of two things ,1. become a sitting muppet to wither away because goverment think I should not have any independancy because of my injuries which restrict me , or 2. should i shoot myself so i am of the books and be just another statistic crapped on disabled veteran and the disabled in general .
    You people in goverment and the ridiculus twerps who write comments,such as,” well if they live in residential establishments they dont need it”, should really find out what disability is about , . For gods sake life is hard enough as it is take this away then your disabling the disabled even more ,discriminating them as well . and condemming them to being house bound.

    Well thanks for all you anti disablement comments ,thanks for a goverment who couldnt give a toss really except line there own pockets and keep the fat cats in banks happy . wreck our countries Army by cutting man power ,so they can buy two bloody aircraft carriers we never needed and the money for them could of paid to help disabled or deaf ,deaf/blind .
    again many thanks from a veteran who is proud to be british , proud to have served my country,proud to have been a soldier even if i am know disabled . so to you armchair politicians and MP’s get a grip and get out of your little bubble and get into real world .

    • george herschel says:


  10. Mrs G. Owens says:

    Mobility allowance is granted to those people who need help to get around. They have to get through strict criteria to get this benefit. It should not matter where they live. To remove this benefit from people in care homes removes their right to independence,to choose where and when they wish to go, and it removes their dignity. Without it people in care homes would have to rely on transport arranged by the care home managers, their relatives(if they have any) to take them when it is convenient to them—not when they wish to go. Everyone has a right to personal choice. It is a disgrace to remove this benefit that gives disabled people a measure of independence.

  11. Michaela Allcock says:

    I think the proposals to take away higher rate Mobility allowance for those in residential care is disgraceful, by doing this you are taking away their freedom and valuable outside and much needed contact and change of enviroment necessary for their own quality of life.
    People with a disability already have their own physical limitations and we need to be making sure that they are provided for, they do not choose to be disabled and to deny them this allowance and the homes that care for them is to take away a valuable lifeline.
    I myself have a disabled daughter but am lucky enough to be able to care for her in our own home, we ourselves have the higher rate mobility allowance, life is hard enough when you or a loved one have a disability without being told you have no rights to a facility to help make life easier for their day to day well being, I do not know what we would do without ours.

  12. Philip Barton says:

    Surely the main objective of this exercise is to circumvent the existing legislation which prevents Councils from taking the mobility component of Disability Living Allowance into account when assessing the level of charges to be paid by those receiving social care? By removing the entitlement altogether, the mone (or, more likely, a fraction of it) can just be reallocated to Social Services. If this is the agenda, then debate should revolve around how to ensure that this money is ring-fenced to be spent on transportation and how individual choice can be built into the new arrangements.

  13. Karen Frere-Smith says:

    I support this campaign to keep the DLA

  14. purplewheels says:

    Once again cuts are directed at the most vulnerable in our society. If I had to go into residential care because my care needs could not be met within the community, it would not mean that I wouldn’t need a social life, perhaps I might need it even more!

    I currently get high rate mobility component and use it to fund a Motability car, which I use in conjunction with a powered wheelchair in order to get around. My life would be so severely impoverished should I no longer receive this vital money.

    I do not qualify for income support because of a tiny pension I get from my late husband’s employer. Therefore, I only receive Incapacity Benefit and my DLA care component at the Lower rate (even though I believe that I should be getting middle rate).

    My friend lived in a London borough and had several DLA applications refused, then she moved to the West Country and her application was allowed. She gets High Rate on both components, yet works full-time. I on the other hand am unable to work at all! So do I think things should be reviewed, well yes, but not in order to knock off a great chunk of the budget, it should be to make sure it is being used in the best way for the people who are entitled to it.

  15. Barry says:

    This Low Review may well be to do with the people in residential care and the mobility component of Disability Living Allowance that they get for helping them retain there dignity! And mobility! For everyone concerned, but this talk of public transport witch is fine if you can use it as many people do but for those with special needs who find public transport more of a hinderers than useful haw are they to retain there dignity and mobility, I personally feel the government members involved in this Review should spend a week or two in a residential care home with ever young or old doing the work of a career that way they could see first hand the difficulty’s and indignity they would be imposing on these people that they say there helping by making the right chose for these people and for those yet to come into the system, think about it one day your loved ones will need dignity! And mobility! To help them or yourselves.

  16. Simon Stevens says:

    The review frustrates me in a few ways as someone on DLA living independently. Firstly, many of the comments here demonstrates how disempowered disabled people feel and how others still pity them, DLA is not a god given right but a tool to support people which I feel no longer works as its simply fuels dependency and poverty.

    I hear people talk about DLA like they are die a painful immediately death if they lost this allowance. Disabled people are rights but also responsibility, which is often sadly forgiving.

    This review seems to assume residential care, eg locking away disabled people, is okay and mobility allowance is seem as the visiting rights of people in prison. It saddens me how people talk about disabled people as permanently vulnerable and the if a carer ‘put their loved ones in a home’ they automatic decide how the allowance will be spent to put light into misery.. come on, this is 2011! Where did ‘free our person’ go?

    Everyone has its tough disabled or not, every parent/carer can say how hard it is as anyone else. I am fed up disabled people focusing on their ‘problems’ demanded other people pick up the pieces as they demand rights but expect charity. If you really want to do something, you will find a way of doing it!

    Providers of residential care are responsible for transport needs. Many of the charities complaining about the mobility allowances run homes where they are failed to deliver transport. Councils also charge day care users redicious amounts for transport, stealing the allowance from them,

    I feel as accommodation and care services split, this will be an non issue as residential care as it is now will cause to exist, as people become tenants of community living centres with add on packages. I also feel the whole anti-poverty measures and social care for low needs should be properly reviewed to empower people to be active citizens, not disempowering them in a model of dependency as they fight for a life on benefit which suits the charities which profit from it with well paid staff. And before someone asks, I have lots of difficulties, I am in chronic pain and I am a mental health user so I do know a bit about what I am talking about.

  17. michael anthony wilkinson says:

    richard you really have no idea as to how people living in residential care are funded. my 30 year old daughter now resides in a care home, she is not in an old peoples home, but are funded as though she is. being a younger person and has severe learning dificulties,she uses more clothing food toiletries footwear to name but a few, after her care costs are deducted from her income support she is left with only £22 per wek this is supposed to cover all of those things. it goes nowhere near, we have to subsidise this out of our old age pensions, so please have a thought for those of us who do have to suffer not only the financial side of this, but alson the heartbreak of our daughter having to live outside of the family daughter does not sleep at night only catnapse. my wife and i suffered 25years of very little sleep, you should try it and that is only part of it she has very challenging behaviour, she lived with us untill eventually it caused us both to suffer physically. would you really like to see her allowance cut?

    • Mr & Mrs J. Meakin says:

      We totally agree with the comments made by Michael Wilkinson as our daughter is very much in the same situation.Losing the mobility payment would create real hardship to us as pensioners if we have to subsidize our daughters travel expenses to travel home and to her social activities. The £22.00 left after fees does not even come close to covering her personal living which we now subsidize.

  18. george herschel says:

    if you are “rich” and can afford to self fund your residential social care you can keep the mobility allowance , but if you are “poor” and the state pays for all your residential care you lose the mobility allowance ,,surely regardless of the resident being “rich” or “poor” their mobility needs are the same .at least the war disabled pensioners are out of this argument= a war disabled pensioner who is entitled to the war pensioners mobility supplement W.P.M.S. will retain their mobility allowance which many use for the hire of a motability finance car, be they self funding or have their residential care paid for by the state ..can you imagine the war disabled within the Royal Chelsea hospital, the Chelsea pensioners being forced to give up their WAR PENSIONERS MOBILITY SUPPLEMENT…..

  19. John Welsh says:

    I am lot happy with the nloisey nuisance neighbour about get on at me now from
    19 Sycaome Close
    & What can you do about it for me day now
    & Will like a better good new safe home for me to live with a better good looking new life
    & A better good looing new social life for me in the community for me day now in
    Kettering Northamptonshire for me day now with a lot of Friend and Friendship for me to day now in
    Kettering Northamptonshire and better good choice for me day now in
    Kettering Northamptonshire now
    Yours sincerely
    John Welsh.

  20. JACQUIE KENT says:

    People living in residential care need the money to buy things such as powered wheelchairs so that they can continue their independence as there will be no staff or volunteers to take them out.

  21. A concerned person says:

    Some of my comments may have been posted already, but are important and need to be reiterated.

    People who live in residential care are there for a reason and often may not be able to speak out or voice their opinion fully; almost certainly not to the extent that they probably wish. I’m quite sure that many would much prefer an “ordinary” life, with choices and opportunities that most of us take for granted every day. Simple things like being able to choose what to eat, who to spend time with, where to go, with whom and for how long; a meaningful role in society, a loving relationship, their own house – even their own bank account are luxuries that so many people are unable to enjoy and probably never will.

    As if life has not been made painful and utterly difficult enough for many of these people (which in most cases is no-one’s fault, but is no easier to bare), repeated indignities only compound these struggles and it is shameful.

    Free money will never take away their struggles but it does help, in some small way, to open up just a few opportunities that otherwise would be simply unattainable.

    The social care system in this country is going through some major changes, but is still woefully underfunded, under resourced and often completely misunderstood. The proposed cuts will ruin people’s lives – this is a fact and cannot be argued otherwise, however eloquant the government makes their statements. It is shocking how a blind eye can be turned to the super-rich and their greedy actions, whilst those living on so little face having even that taken away.

    Not that I need to validate my comments, I will nevertheless add that I work with profoundly disabled people every day and I have multiple sclerosis. I have experienced everything written above first hand for a very long time and I am very scared for the future of these people and for myself, in Britain.

    It is a good place to live if you do nothing for yourself and need financial help.
    It is set to become a dreadful place to live if you cannot do anything for yourself and need financial help.

    To anyone who feels that vulnerable and physically or learning disabled people do not deserve financial assistance; you must hope that you never find yourself in their situation.

  22. Louise says:

    I write on behalf of my foster son who now, aged 40, lives in residential care. He is severely physically disabled and can move only his left arm, slightly. He is therefore unable to work and any quality of life comes from being able to get out and about, see things, meet people…… he lies in a moulded shell in a reclined position and is tall, so his wheelchair only fits on some buses. His DLA pays for some taxis to enable him to get out, and also for the fares of the two carers needed to support him on trains and the few accessible buses. Without it he would be confined to his home and likely to suffer from isolation and subsequent depression / mental ill health.

  23. Angela Cavill-Burch (@onmybiketoo) says:

    My brother is now 44yrs old has severe learning difficulties (i hate that phrase) plus mobility issues requiring use of a wheelchair. The lack of suitable specialist nursing care facilities in Lincolnshire means that he lives over 80miles away from my disabled aged mother. The mobility component of his DLA pays for his visits once a month to see my housebound mother with his specialised carers in tow to make sure he is safe. It also pays for his annual holiday.

    I can’t transport either to see each other because I am a 24/7 carer of my severely disabled tetraplegic husband. This means that I don’t get to see my brother or mother very often either, and love to hear my mum’s joy over the phone when she has had a visit from her eldest son.

    This is why Jonathan needs his mobility part of his DLA.

    Angela his sister.

  24. Robin Boucher says:

    I help to run an organisation which supports adults with learning disabilities in a rural area in the Midlands. Some of our services are registered homes and we also work with people who live in their own places. Many of our service users are unable to use public transport and, being a rural area, it is often not available to go when/where people need to go. We have invested in substantial provision of vehicles to get around this problem, and invite our service users to contribute to the cost using their Mobility Allowance. My understanding is that many other provider organisations make similar arangements. Through this we are able to help people go to their doctor, go to college and other daytime activities, visit their families and to expand their social horizons. The local authority who funds most of our service users makes no mention of transport (or transport costs) in contracts etc. and they are aware of the arangements we make. We are very concerned that, if the plan to remove Mobility Allowance from registered home residents is carried through, it will seriously impact on the lives our service users can live, as we will have to cut back on what we provide. It is easy to say that “the provider should fund and provide” but in the current economic climate this is not likely to happen.

  25. Louise says:

    Similarly I work for a service provider and we have the same arrangement. The local authorities who fund our service users quite specifically say that transport should be paid for through mobility component DLA and do not fund it.
    We are a charity. We do not make a profit. There is no other money available to fund this. If the allowance is withdrawn or reduced it will have a serious negative impact on the lives of our service users, many of whom have profound and multiple disabilities – not only on their leisure but on their education, health care, and mental health.

  26. Kevin says:

    Louise hi,

    As you didn’t state whaich charity you worked for, so I have linked the main two associated published accounts for this review and consideration.

    RNIB 2010 accounts its income was £135 million

    Leonard Cheshire 2010 accounts its income was £155 million

  27. Louise says:

    I’m not sure what these links were for? I know perfectly well the situation in the charity I work for. There is simply no money available from elsewhere – other than the mobility component of DLA – for people with severe disabilities to get around when they are unable to use public transport.

  28. Kevin says:

    Louise hi,

    I have provided the links so people acessing the website/blog, can see for themselves the trading accounts of the RNIB and LC and other charities to make an informed decision on the collected information, views, data and experiences which are listed.

    Like HM Government currently reviewing it accounts, so should every one else. Most charities probabably receive about 50-60%+ income, which is from a statotary source (HM Government) either through PCT, Central Government, Dept of ………. These budgets are being cut by 9% year on year for the next 4/5 years, income will still be there.

    I know from my own expereince that outside trusts and charities have supported me and help is at hand from different resources.

  29. Andrew Barton says:

    I am very unhappy with this Government policy and have now set up an e-petition aimed at challenging it. We need 100,000 signatures to trigger a commons debate. Please take the time to add your signature. Thanks.

    • Kevin says:

      Andrew hi,

      A similiar petition

    • Tracy says:

      Send this on to organisations eg Disabled Motoring UK and anyone who has signed it copy the epetitions address and email it to people- have you thought about putting it on face book or twitter?

      I don’t use those things but a lot of people do

  30. Sindy says:

    The Government need to stop picking on the most vulnerable people in society – leave DLA as it is!

  31. Kevin says:

    Paul the current ILF budget is some £333 million pounds, about 1% is taken up in administration and on average cost £15,000 per person. For the most highest need, for which I have seen should receive this support. On average those receiving ILF receive about £50,000 net in income to support its needs. 770,000 disbaled children are in the UK. 3.2 million claim DLA of the estimated 10 million disbaled people in the UK.

    The current ILF program supports at March 2011

    Aids related disease 110
    Arthritis (osteo-rheumatoid-still’s dis) 658
    Blood disease (inc leukaemia) 3
    Brain damage (inc head injury) 961
    Cancers-tumours 70
    Cardio-vascular(inc heart disease) 80
    Cerebral Palsy 2981
    Cerebro-vascular (inc stroke) 747
    Dementia (inc Alzheimers) 86
    Down’s syndrome 1045
    Epilepsy 435
    Friedreich’s ataxia 173
    Huntington’s Disease 119
    Hydrocephalus 55
    Lung or respiratory disease (inc asthma) 61
    Mental illness 123
    Motor Neurone Disease 84
    Multiple Sclerosis 2642
    Muscular Dystrophy or Atrophy 534
    Osteoporosis 55
    Other 1577
    Parkinson’s disease 123
    Physical malformation limbs-Thalidomide 30
    Polio damage 104
    Severe learning disability 6099
    Spina bifida 341
    Spinal injury 1314
    (blank)  169
    Grand Total 20610

  32. Grace Kent says:

    A person in a residential care do need mobility payments. They should not stay indoors or walk, you have no idea what you are talking about. Independence is a word that maybe you have not heard of. If you are in residential care, it does not mean you are a not a person, What if they wish to go out, they should have some money to allow them to do this. Or are you saying that they have to stay at the home all day and evenings. i have seen some families with children in care using the mobility vehicles for those in care, i think who ever dealing with the mobilty funds needs shooting in their heads as they allowed things like this to happen.

  33. Richard Sanders. says:

    The issue here is that people cared for in residential homes, in receipt of the mobility component of DLA, spend their money in a variety of ways, but not necessarily on aids to mobility, or transport, but because they need to, to make their life humanly tolerable. The amount of this component is also assessed by the purchasing authority when the contribution people make to the cost of their care, is assessed by means testing. Remove the mobility component, and the purchasing authority is left with more tough decisions about who to exclude from services it can then not afford by having to pay more to purchase residential care, – without the additional contribution from people assessed for, but no longer receiving the mobility component. With apologies to people shot in the foot, the policy to kick out mobility components of those entitled in residential care will irreparably damage the policy maker when he answers for that action to every purchasing authority in England and Wales. Richard.

  34. Alison says:

    Hi Richard-i’m not even going to read your reply because you are so full of your own self importance you cannot seem to see past your own nose…

    • Richard Sanders. says:

      Quite Alison, because this blog is not about the self indulgence of some inflated egos, but about the relevance of an allowance to a system set up by government, which now relies on the funding that families have won for their dependants, to afford their care, and make a meaningful contribution to their lives. My reply to Anne-marie above, explains the background of my understanding. When you have chilled out, and decided to make a contribution less insulting to this topic, and more relevant to the facts, of which you seem to have little knowledge, we can continue to share our concern for the fact that a coalition is using its apparent strength to smooth out the wrinkles on the face of disability, and the benefits it attracts, without acknowledging that care providers can not enhance a person’s dignity, without the person’s means for self-expression and esteem.

  35. Kevin says:

    Police and council ‘investigated’ scandal hospital concerns six times

    Police and council officers had at least six chances to investigate concerns about the safety of disabled people in a private “hospital” in the two years before the abusive regime was finally exposed by the BBC.

    The Panorama investigation uncovered serious allegations of abuse at Winterbourne View, a private hospital for people with learning difficulties, near Bristol.

    But it emerged this week that there were at least seven “alerts” notifying the authorities of safety concerns at Winterbourne View between October 2009 and August 2010, nine months before the documentary was aired in May this year.

    Six of the alerts were dealt with by the council’s safeguarding team and investigated by Avon and Somerset police, while a seventh was investigated by Castlebeck, the company that ran Winterbourne View. At least three of the alerts reportedly related to the use of restraint or physical abuse by hospital staff.

    South Gloucestershire Council has already faced criticism for apparently failing to follow-up concerns raised by a whistleblower in October 2010.

    But the new evidence raises fresh questions over why the council failed to uncover the alleged abuse that was later exposed by Panorama, despite the number of safeguarding concerns raised during those two years.

    A South Gloucestershire Council spokesman admitted that the referrals go back even further than October 2009.

    He said the council received 19 safeguarding referrals between the opening of Winterbourne View in 2006 and 12 May 2011, when it learned about the Panorama programme.

    Of these 19 referrals, 17 came from managers at Winterbourne View and two from charge nurses, while 15 concerned the behaviour of members of staff.

    The council spokesman said a serious case review set up in the wake of the Panorama documentary would “look in detail at each of these alerts and consider the appropriateness of the multi-agency safeguarding response to them”, while the council had also launched its own internal investigation.

    Avon and Somerset police declined to comment because of its ongoing investigation into the alleged abuse at Winterbourne View, as well as the serious case review, which is examining the actions of all the organisations involved.

    The Care Quality Commission (CQC), which regulates health and adult social care in England, said it was passed details of all seven of the alerts.

    A CQC spokeswoman said it was “the job of the local authority or the police to investigate these incidents and to hold the provider or staff to account if necessary”.

    But she added: “The issue at Winterbourne View was not what was known and reported, but what was concealed – the horrific abuse of vulnerable people which was exposed by weeks of secret filming by Panorama.”

    CQC said that these kind of safeguarding referrals were “shocking but sadly not atypical” of such facilities. Last year, CQC received 11,000 “notifications” of serious injury, and nearly 3,500 notifications of police investigations.

    Castlebeck has now announced the closure of three of its care facilities for people with learning difficulties, including Winterbourne View.

    This week, the company agreed to close Arden Vale, near Coventry, another “hospital” that provides “care” for people with learning difficulties and mental health conditions, after CQC served a legal notice proposing to remove Arden Vale’s registration.

    CQC had raised “serious concerns” about care standards at Arden Vale, including the inappropriate use of restraint, and took action when it saw no evidence of the necessary improvements.

    Last week, a Castlebeck residential home on the edge of Bristol, Rose Villa, was closed following a string of concerns about care standards and the suspension of four staff members.

    Castlebeck said it was “vigorously addressing concerns that have been raised about some of our services”.

    It has also received formal warning notices relating to two other care facilities, Croxton Lodge in Melton Mowbray and Cedar Vale in Nottingham, where CQC has again raised concerns about the potential safety of people with learning difficulties.

  36. roger sowersby says:

    I am wheelchair bound due to motor neurone disease. Last year, due to marital breakdown, I found myself homeless. For 3 months I was placed in a residential nursing home until the social services found me a place in extra care housing. It was the worst 3 months of my life. I was cooped up in a small room [no room to even turn my wheelchair]. The communal lounge was a no go area as it was full of dementia patients shouting, endlessly repeating senseless phrases etc. What saved me from depression was the ability to escape from the environment due to mobility component of the DLA. Unfortunately, due to progressive nature of MND, at some time in the future I will probably have to return to residential care. I have been able to accept the inevitability of MND but what fills me with dread is residential care without the ability to escape to the outside world.

  37. Neil Crowther says:

    In 2009 the UK Government ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). Article 19 of the Convention ( concerns the right of disabled people to live independently in the community and requires government to put in place legal and practical measures to enable disabled people to exercise choice about where and with who they live and to overcome isolation through increased participation in community life. Clearly DLA/PIP as a key plank in the means by which the UK meets its obligations.

    Personal mobility is not an end in itself. It is the means to a wide number of other ends. Having control over one’s own mobility is not simply about visiting family and friends. It’s about being in control, being spontaneous and free. Its about coming and going as one pleases. It’s about pursuing a life rather than just living. Its about having the flexibility to go to work, to go for a drink after work and to stay out all night if you want to. It’s about liberation. It’s why young people aspire to own a car. It’s why Thelma and Louise was such a popular film.

    It’s also about being safe. Does government not recognise the relationship between power and what happened at Winterbourne View? Does it not understand that taking the power of free mobility away renders people vulnerable to abuse by dent of the simple fact that their tormentors know they cannot escape?

    Hence, if we look at the proposed reforms through the lens of the UNCRPD, then our question concerns the effect of any proposals on enjoyment of the rights set out in the Convention, to which the UK is bound in international law. In doing so we should look beyond Article 19 at the effect on the enjoyment of other rights, whether general principles such as the right to dignity, autonomy and to full participation and inclusion in society or specific articles including freedom from torture, cruel, inhuman or degrading treatment, freedom from exploitation, violence and abuse, personal mobility, access to education, health and employment, adequate standard of living and social protection and participation in cultural life, leisure and sport.

    Those living in residential care generally face the greatest barriers with respect to the enjoyment of such basic freedoms by virtue of the fact that the support they require for daily living itself lacks mobility, is located in one place, behind closed doors and very often without the means to access the outside world freely.

    Hence, justice dictates that those living in such situations have the greatest case to receive the support they need to overcome such barriers and to redress the lack of power they face.

    This point is not simply a matter of having the means, it goes to the heart of how one accesses the means. Replacing a nationally defined entitlement to the mobility component of DLA for those living in residential care homes with a 21st Century form of Parish Relief can only be considered retrogressive. Mobility without choice and control is a dead end, not the means to the end it should be to accord with the rights set out in the UNCRPD.

    Further, it is unclear how the government proposes to square its commitment to localism with a guarantee that disabled people living in residential care homes will receive mobility support from their local authority, especially when all evidence indicates that local services will soon resemble a skeleton at best. And if such a guarantee can be given, then why does it matter where the money comes from? Surely the (not negligible) costs of reform are then avoidable?

    A key principle of international human rights law is non-regression. This does not mean that the UNCRPD prevents government from reforming public policy – indeed their may be aspects of the PIP proposals which accord more closely with the UNCRPD than the present DLA. And at a time of fiscal retrenchment such as now it also doesn’t prevent government reducing the amount it spends on particular programmes or benefits. What the UNCRPD does demand however is proportionality and transparency. Why is the proposed reform a proportionate means of achieving a legitimate aim? What impact will it have – both positive and negative – and what mitigations will be put in place in relation to any negative effects?

    The Low review has been launched precisely because the government has failed these tests. Hopefully the review itself can draw on the Convention as a key point of reference in its deliberations.

  38. pineapple says:

    If my mother did not receive Mobility allowance then there is no way she could get out to family and friends on a once or twice weekly basis due to the cost of transporting a wheelchair bound person about. She would be stuck in the carehome 7 days a week as the taxi fair to my house is £30 return. It costs £10 return just for a trip into town for a couple of hours. As her family, we could not afford to pay for this out of our own money and so contact would be reduced somewhat. My mother is only 65 but has a spinal injury and so the only place the social could think for her to live was in a carehome. Cutting off her social contact would be detrimental to her wellbeing. BUT we know carehomes and the government operate on a £bottomline basis only.

  39. Alan Doyle says:

    I am a tetraplegic and currently live in a care home after my wife was taken seriously ill and am now a permanent resident as my wife needs as stress free a life as possible. I have had all of my benefits except the mobilty element plus half of my compulsory police pension, which was not a full pension, the other half goes to my wife, taken from me by Social Services, which I don’t object to. We struggle to keep our family home going. I am allowed £20 a week pocket money allowance of which I try to use as little as possible.
    The nearest bus service to the residential home is approximately two miles away. I use the mobility element of DLA on the frequent occasions I go out to pay for adapted taxis to travel to my home and shopping centres etc..
    As the government said they would protect the most vulnerable in our society this is a complete reversal of that statement. It will prevent myself and others from going out to visit my wife at ‘our’ home, leisure trips, also meeting friends and socialising in the local community as often as I would like to, in other words we will be confined to the four walls of the care home with £20 ‘pocket money’ to cover clothing toiletries and the cost of a telephone coming under serious consideration. Its clear that, the coalition definition of “fairness” and “dignity” and being part of ”The Big Society”. Regardless of your political belief. Is not extended to disabled members of our “civilised society”.


  40. Barry says:

    prosily southygirl1 there are people out there getting DLA and using that money for drugs or alcohol and it should be stopped DLA on any element should only be for people in real need of it, I can see the government one day making the NHS very much like the dentist where if you work et you pay for the treatment you get, its about time the government charged these people that come here on holiday instead of getting NHS FREE TREATMENT secondly once upon a time if you emigrated to this county you couldn’t get jobseekers aliens or DLA for up to 10 years but these days they more or less get it ASP witch is outrages to the British tax payer.

  41. Colin says:

    We recently had a meeting with our local MP Mrs Maria Miller, Disability Minister, who assured us “we had nothing to worry about”. We are not convinced.
    We are the parents of a thirty-one year old daughter with severe learning difficulties who is wheelchair dependant. She has lived in a small group home for the last 11 years situated 20 miles away from the family home. We currently own a wheelchair accessible vehicle which is used every weekend for home visits in addition to regular hospital and other appointments. The use of public transport is not an option as she has epilepsy and frequent seizures and requires support at all times from a familiar person.
    The Higher Mobility Allowance has assisted with the purchase of the vehicle and helps with the running costs. Although the home has a minibus, there are six other clients who all go home on a very regular basis. It would be totally impracticable to expect the residential home to be responsible for home visits. Even if the home could arrange to bring our daughter home she would then be housebound and unable to visit anywhere else. This would greatly restrict her freedom of choice and is totally unacceptable in a civilised society.

  42. Welsh Lass says:

    Once again the government is targeting the weak and the vulnerable to make cuts in spending. This would have a detrimental effect on the disabled persons who rely on those payments; for instance, when a young person goes into residential school, college or a care setting they automatically lose the care component of the DLA, which leaves only the mobility allowance. This allowance enables the disabled person to afford a taxi, and generally get out and about and do more things than just being stuck in a residential home every evening, week-end and holiday.

    Many young disabled persons, because of their specific and specialist needs have to attend a residential school as all this ‘integration into mainstream’ does not work if a person has a considerable disability (totally blind/high spectrum autism). From experience I know only the basics are provided for at these schools, any extra curriculum activities have to be funded by the parents, such as music lessons, horse riding etc. Then there are the countless appointments the disabled person has to attend, often miles away from their home, to see specialists. Meeting up with friends in the holidays too is expensive, as young people who attend these schools are never local but come from all over the country.

    The residential school week usually only lasts four and a half days, then return home mid-day Friday to return to school once again on the Monday morning, plus they have all the school holidays at home. How can the government even think that they do not need this benefit because they are in residential care? Why not go the whole hog and take it off every disabled person? This could even force some hard-up families take their child away from a specialist residential school and put them in a local mainstream school where their needs would not be properly addressed.

    What if a person is older and has no parents? Will they be stuck in a residential setting, like a prison, with no means of getting out and about? Would relatives who live many miles away regularly come and take them out for the weekend? Probably not, therefore they need this mobility component, it is a lifeline. Taxis are expensive, but busses are not a suitable form of transport for most severely disabled persons. In fact, removing the mobility component would be like going back to Victorian attitudes towards disability:- ‘they are safely ensconced in a home, out of sight and out of mind.’ It is treating this vulnerable group the same way as prisoners, given a bit of ‘pocket money’ for sweets only.

    Why does the government want to target disabled people to help the country’s deficit? Surely the obvious thing that no one dares speak about is immigration – the government would save an absolutely fortune if they did not give benefits and houses to the somewhat 200,000 per year economic migrants who come to Britain

  43. Anne Richmond says:

    I think it is unbelievable to think that the mobility part of DLA should be taken off people that have to stay in residential care. They have the same rights to be able to get out and socialise and get to shops etc. just the same as the rest of us.

  44. Chris says:

    Individuals have a right to get out and about. The days of care homes being institutions where individuals do little more than sit in an armchair and watch TV should be long since passed. Even the most generous of care services can only achieve so much before they have no choice but to think of the bank balance. As managers we may feel that every person has the right to go out and so we will have to ensure it happens but where the funds are not available what is the point of seeing them out and about for the short period before the company goes bust and individuals who were previously happy, settled and secure have their whole lives turned upside down. The idea of cancelling DLA for those in care settings could easily be seen as discrimination against those individuals on a national level. The government is quick to jump on other forms of discrimination are they forgetting that the law also protects the disabled from discrimination? Any leader(s) in the past that has committed mass discrimination has not been thought well of after and there is a very good reason for this. . . . It is just plain wrong and no amount of supposed justification can change that. Unless the government is going to look at all benefits, and in one go not just saying that they will look at another one in a couple of years, then they should not do so to those without a clear voice of their own. It is easy to dismiss providers as ‘money grabbing’ and most of those in care homes these days really cannot speak up for themselves on these matters and be heard. It has taken a great deal of legislation and white papers to bring care to a level where it helps individuals to be precisely that, individuals, and the thought of going back to the dark ages in such a supposedly enlightened time is absurd. Social services will not review care fees unless there is a change in ‘need’ not finances or preferences. Care homes are generally not paid the fees for transport and so without the money to get out how are service users supposed to? What means will be put in place to ensure that disabled people in care can still go out as much as they want to? And if another means will be put in place to ensure this then why change from DLA in the first place?

  45. des says:

    prisoners are treated least they get day release and home visits

  46. Kevin says:

    Government U-turn on scrapping mobility allowance expected

    The government looks set to back down from controversial plans to remove up to £50 a week in mobility benefits from disabled people in care homes.

    Charities are cautiously optimistic that the government will not now take away the mobility component of disability living allowance from 78,000 residents funded by the NHS or councils as envisaged in the Welfare Reform Bill, which is currently being debated in the House of Lords.

    It is thought the government will announce its U-turn next month, though it is uncertain precisely what concessions the government is prepared to make on the mobility component.

    The news follows disability rights campaigner Lord Low’s inquiry into scrapping the mobility component, which called for the benefit to be retained.

    The government is holding its own internal review into the proposal, which would come into force in 2013 with the replacement of DLA with a new benefit, personal independence payment.

    Steve McIntosh, policy and public affairs officer at Carers UK, said: “There are a number of areas, which the government is looking at again around the Welfare Reform Bill. We would welcome any move that the government would make to continue the mobility component in residential care and hope this represents a positive sign the government is looking to reconsider the decision.”

    Simon Shaw, parliamentary manager at the deafblind charity Sense, said: “Over a year on, we continue to hope that the government listens to the concerns raised by deafblind and disabled people to reconsider its position, so that people living in residential care do not lose an essential lifeline.”

    A Department for Work and Pensions spokesperson said: “We have always been clear that we will not make any changes that stop disabled people in care homes from getting out and about.

    “Our officials have spent the last few months gathering information and evidence, including visiting disabled people in care homes to find out from them and their families about their mobility needs.

    “The Low review also looked at some of the same issues and so we will be reflecting on the outcome of this work before we announce the final decision shortly.”

    What do you think? Join the debate on CareSpace

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    Related stories

    Charities launch review of disability benefit cut

    Government threatened with legal action over disability benefit cuts

    Ministers press on with disability benefit cut despite opposition

    • Andy says:

      This year alone the Government have attacked the disabled no less than five times each time removing bital and essential elements of care, for those in care homes they have a majority of what is required to give them a comfortable standard of living, for those in the general populus it is becoming harder after each attack to services and financial benefits.
      Although people think that disabled people get more than enough I strongly feel that unless they are fully aware of the Government scandle of Incapacity Benefit where the victim is the disabled person, they must pay towards everything including vital medication that people on income support get for free. As a result of this we need to fight the Goverment cutbacks by demanding the Government stop giving alchoholics extra money to get drunk and stop giving drug takers free Methodone before attacking the disabled any further, disabled are people too we deserve more respect than what we are getting……..

      • Kevin says:

        Ministers announce U-turn on mobility benefit cut
        BBC news item

  47. Kevin says:

    Secretary of State for Work and Pensions v Slavin [2011]

    Court of Appeal decision

    This was the Secretary of State’s appeal against the decision in CDLA/3638/2010. The Court of Appeal decision affirms that, in certain circumstances, claimants who are living in a care home wholly funded by the NHS may be entitled to the care component of Disability Living Allowance (DLA).

    The decision also discusses whether such an arrangement is considered a hospital for the purposes of DLA mobility component.

    The claimant was diagnosed as having the following medical conditions: severe learning disability, Fragile X Syndrome (autistic traits), challenging behaviour, hay fever, gingivitis, sensitive skin and epilepsy.

    As a result of his condition his behaviour could be extremely challenging, such that he needs to be continuously supervised by at least one, and sometimes two care staff, who needed to be ready to intervene in order to attempt to prevent him causing damage to property or injury to himself or others.

    He lived at home until his behaviour eventually became too challenging for his parents. On 26 November 2007 he moved into a privately owned and run care home -“The Lodge”. Although it was staffed by appropriately experienced and skilled care staff, it did not have any staff with medical or nursing qualifications.

    The fees for the claimant’s accommodation and care there were paid by the Health Authority i.e. in effect by the National Health Service. The Health Authority agreed to pay the whole of the cost of the Claimant’s accommodation and care following assessments under the National Framework for NHS Continuing Healthcare and NHS Funded nursing care.

    The claimant was in receipt of the higher rate of the mobility component and the highest rate of the care component of DLA while living at home. However, on 18 February 2008 a decision was made that neither component of DLA was payable from 26 December 2007 on the ground that he was –

    “being maintained free of charge while undergoing medical or other treatment as an in-patient ……. in a hospital or similar institution under the [National Health Service Act 2006]”

    – within regulations 8 (care component) and 12A (mobility component) of the Social Security (Disability Living Allowance) Regulations 1991 (“the 1991 Regulations”).

    The claimant appealed against the decision, contending that the fact that The Lodge did not have qualified nursing staff meant the claimant was not in a “hospital or similar institution” and therefore that neither reg. 8 nor reg. 12A applied.

    A tribunal dismissed the claimant’s appeal, finding that The Lodge was a “hospital or similar institution”.
    The Upper Tribunal decision

    In reaching his decision, Upper Tribunal Judge Turnbull identified the issues in the appeal as:

    (1) is the fact that the Claimant’s accommodation and care in The Lodge is paid for by the Health Authority, and that The Lodge employs appropriately experienced and skilled carers, sufficient to cause regulations 8 and 12A to apply, notwithstanding that The Lodge has neither medically qualified nor nursing staff?

    (2) if not, do regulations 8 and 12A apply:

    (a) on the ground the claimant received treatment from doctors, nurses and other healthcare professionals elsewhere than at the Lodge?

    (b) if the claimant received treatment from doctors, nurses or other healthcare professionals at The Lodge, but who are not employed or engaged by the Lodge?

    Judge Turnbull held that –

    a claimant is not in receipt of “medical or other treatment as an in-patient in a hospital or similar institution”, within the meaning of Regs. 8 and 12A of the Social Security (Disability Living Allowance) Regulations 1991 merely because his accommodation and care in a care home without medical or nursing staff is funded by the NHS by way of NHS Continuing Healthcare, and he is cared for there by appropriately skilled care staff.
    the fact that, in addition, the claimant receives what is undoubtedly medical treatment or nursing elsewhere than at the care home makes no difference (save possibly in exceptional situations where there is some strong link between the care home and the institution where the treatment does take place).
    it may be sufficient if (i) the claimant receives a significant level of treatment from a doctor, nurse or other healthcare professional on the premises of the care home, notwithstanding that the relevant professionals are not employed or engaged by the home and/or (ii) the care staff at the home can be said to be acting to a sufficient extent under the supervision of doctors or other healthcare professionals (e.g. in giving medication, applying restraint procedures etc).

    Judge Turnbull therefore set aside the tribunal decision and remitted the case to a new tribunal to investigate the type and nature of care provided to the claimant at The Lodge.

    The DWP appealed to the Court of Appeal.
    The Court of Appeal judgement

    The Court dismissed the DWP’s appeal. Lord Justice Richards held that:

    “55. The Lodge is registered as a care home only, not as a nursing home, and it does not purport to provide nursing care. Its staff are trained to handle challenging behaviour and to support in other ways the particular needs of residents; they are given an initial induction and ongoing training and are encouraged to work towards NVQs. But they do not have professional qualifications or training as nurses, nor do they work under the supervision of qualified nurses. It is true that they look after residents who, in the case of the respondent at least, suffer from a disability of the mind amounting to “illness”, but it does not follow that the care they provide is nursing care; and in my view it can fairly be described as domestic care (or “personal” care, within the meaning of s.3(1) of the Care Standards Act 2000) rather than nursing care. There is nothing in the nature even of the “palliative treatment” referred to in the Leamington Spacase. The management of challenging behaviour is no doubt a demanding aspect of the care provided, but of itself it does not seem to me to constitute nursing. The support of residents in the administration of their medication is not sufficient to give the care a nursing rather than domestic or personal character. The situation is therefore materially different from that considered in the three main authorities.

    56. If I am right that the care provided at The Lodge does not amount to nursing, it follows on the analysis above that the respondent is not undergoing “medical or other treatment” by reason of his residence there. Even if, contrary to the view expressed above, “medical or other treatment” has a wider scope than medical, dental and nursing treatment, I still do not think that the care provided at The Lodge amounts to “treatment” within the meaning of the expression.

    58. … If the respondent is not undergoing “medical or other treatment” by reason of his residence at The Lodge, no useful purpose is served by separate consideration of whether The Lodge is “a hospital or similar institution” within the meaning of the regulations. I do not think that it is, but that is largely because it is not providing medical or other treatment to its residents (and for much the same reason I do not think that its residents can sensibly be described as “in-patients”). I might, however, have taken a different view of the matter if I had concluded that it was providing medical or other treatment to its residents. I stress in any event that, as indicated above, the issue falls to be considered on the assumption that the respondent does not receive treatment from doctors, qualified nurses or other healthcare professionals at The Lodge.

    59. That leaves the question whether the receipt of medical or other treatment from healthcare professionals away from The Lodge can bring the respondent within the scope of the regulations. In my view, it cannot. The whole tenor of regs. 8 and 12A is that the person is undergoing treatment “in” the institution where he is maintained free of charge. That is underlined by the words “as an in-patient”. Treatment away from the institution would be treatment as an out-patient. I reject Mr Buley’s contention that the words “as an in-patient” should not be read as qualifying “medical or other treatment”. They are an integral part of the condition and qualify “medical or other treatment” just as much as they qualify “maintained free of charge … in a hospital or similar institution”.

    Lord Justice Davis also held that:

    “60. In my view it is legitimate to stand back and ask oneself, on the facts as found or as are required to be assumed, whether one would expect the answer “yes” to the question: “Is the respondent undergoing medical or other treatment as an in-patient in a hospital or similar institution?” I do not think one would expect such an answer.

    67. In my view, on the wording of the Regulations and consistently with the authorities, for there to be medical or other treatment provided to the respondent, an element – which must be not insignificant – of care provided by, or under the supervision of, professionally qualified doctors or nurses at The Lodge is required. There is no doubt that the respondent suffers from a mental disorder or disability. Quite possibly, in times gone by, he would have been placed in a mental hospital. There is no doubt that he needs, and is being provided at The Lodge with, skilled and specialist care. But that is not enough. Mr Buley emphasised that the staff, whilst not professionally qualified, were trained in management of aggression and violence. Skilled physical restraint undertaken by a mental health nurse in a hospital or similar institution would be capable, I accept, of amounting to part of the “treatment” provided. But it does not follow that applying such restraint techniques is “treatment” for all purposes. It is not difficult to think of institutions – certain educational establishments, for example – where some staff are trained in such techniques; but no one would style use of those techniques in such a context as “treatment”.

    68. Since, as is my view, the respondent is not “undergoing medical or other treatment” it also really follows that he is not “an in-patient…in a hospital or similar institution.” In truth, it is very strained to describe the respondent as an “in-patient”. Further, The Lodge plainly is not a hospital; and by reason of the complete lack of treatment being provided by or under the supervision of professionally qualified doctors or nurses at The Lodge, in my view it is not a “similar institution” either. But all this really underlines the need to consider the wording of Regulations 8 and 12A as a whole and not to break it down into separate or prioritised parts.”

    The case was largely concerned with the mobility component and whether the Lodge counted as a hospital. However, the Court of Appeal highlights the fact that the definition of care home in Reg 9 of the DLA Regulations excludes “services provided pursuant to the National Health Service Act 2006”, and accordingly the claimant would be entitled to the care component as well, despite being in a care home.
    More information

    secretary of state for work and pensions v slavin – BAILII website