Identifying tenants with care and support needs
Guidance for frontline housing staff and contractors
Adult safeguarding is the process of protecting adults with care and support needs from abuse or neglect.
What do you need to know?
- How to identify which tenants may have care and support needs.
- How to identify who might be at risk of abuse or neglect.
- People can be abused by anyone: rogue traders, family and friends, paid workers, people in a position of trust and people with anti-social behaviour.
- Older people or people with disabilities are more likely to be abused or neglected.
- People can develop care and support needs at any stage in their lives.
Who might be at risk?
A person who:
- is elderly, with poor health, a physical disability or cognitive impairment
- has a learning disability
- has a physical disability and/or a sensory impairment
- has mental health needs including dementia or a personality disorder
- has a long-term illness/condition
- misuses substances or alcohol
- is a carer, providing unpaid care to a family member or friend
- is unable to demonstrate the capacity to make a decision as defined by the Mental Capacity Act and is in need of care and support.
What causes people to be at risk?
Older people or people with disabilities are more likely to be abused or neglected. They may be seen as an easy target and may be less likely to identify abuse themselves or to report it, for fear of the consequences. They may also be subjected to hate-motivated harassment or domestic abuse. Research shows that disabled women experience more abuse than those who are not disabled. 
People may become vulnerable to abuse at any point due to physical or mental ill health, acquired disability, old age or environmental factors, such as poverty and anti-social behaviour. Furthermore, people with care and support needs may have difficulty escaping abuse due to their reliance on the abuser, adapted accommodation or the lack of suitable alternative accommodation and care provision.  Many people with care and support needs live in sheltered, supported or extra-care housing but a high, and increasing, proportion of people with care and support needs live in general needs housing. 
Lessons from the North Yorkshire serious case review concerning ‘Robert’
Robert’s situation dramatically demonstrated the problems caused by different definitions of vulnerability. He was a young, long-term rough sleeper. He asked for help with his housing due to ill health. Two weeks later, in January 2012, he died from morphine intoxication. Staff at the voluntary homeless shelter had continually stressed Robert’s level of vulnerability but this did not appear to have been fully understood or acknowledged by the out-of-hours housing service. His care needs were overshadowed by a focus on his eligibility under homelessness legislation. Both housing and social services failed to sufficiently acknowledge the concerns of the homeless shelter and primary health care staff. Duties to assess vulnerable people in need of care and support under both housing and community care legislation were not fully considered. The response by housing and care agencies was very focused on eligibility for service and there was no evidence of a joint approach to meeting Robert’s needs. 
As a result of this case the following recommendations have been implemented: 
- ensuring that the emergency duty team has an up-to-date knowledge of eligibility criteria, thresholds for assessment, safeguarding procedures and services available for adults
- ensuring that cover over extended holiday periods is sufficiently robust
- strengthening working relationships between the housing authority and local homeless project
- increasing awareness of the needs of street homeless people among health services
- improving call handling with the police and the housing authority
- additional joint training on rough sleeper related issues for housing, health and social care staff.
Department of Health fact sheet 3: The Care Bill – Assessments and eligibility