As the number of people living with a disability rises in the UK, Sabrina Nash of Fenwick Community Support discusses the importance of reforming supported living…
…And we’re not just talking about simply putting a roof over their heads.
According to figures from Mencap – calculated using learning disability rates from Public Health England and data from the Office for National Statistics 2024 – there are approximately 1.5 million people in the UK living with learning disabilities and autism.
That equates to roughly one in 50 of the population and the demand for quality supported living has never been greater. Yet the sector finds itself at a crossroads, struggling to move beyond reactive crisis management toward sustainable, person-centred care that truly transforms lives.
Current projections paint a bleak picture: the need to double supported housing units by 2040 just to meet existing and anticipated demand. But quantity alone won’t solve the deeper challenges facing individuals with complex needs and their families. The real question is whether the sector can evolve to deliver care that promotes genuine independence, community integration, and long-term wellbeing.
The reality of complex needs
A 2023 paper from Housing Lin – Supported housing for people with learning disabilities & autistic people in England – cites statistics from Mencap in 2018 highlighting 78% of specialist supported housing units are occupied by individuals with learning disabilities and/or autism who have complex needs.
These are not people who simply need accommodation – they require sophisticated support that understands trauma, behaviour, and the intricate relationship between environment and outcomes.
The health inequalities facing this population add urgency to the challenge. People with learning disabilities experience significantly lower life expectancy and more avoidable deaths, highlighting systemic failures that extend far beyond individual services. The NHS Long Term Plan acknowledges these disparities, committing to increased health checks, keyworker support, and reduced reliance on inpatient care.
The crisis cycle
For too long, supported living has operated in reactive mode. Services emerge when hospital discharges loom or existing placements break down, creating a perpetual cycle of instability. This pattern traps people in inappropriate settings while communities scramble for alternatives. It’s a system that prioritises filling beds over building lives, managing crises over preventing them.
Learning from tragedy
The tragic death of Oliver McGowan in 2016 rightly brought learning disability and autism care into sharp national focus. Oliver, a young autistic teenager with a mild learning disability, died after having a severe reaction to medication which he and his family had asked for him not to receive. His story has since driven fundamental changes across health and social care, with the Health and Care Act 2022 introducing statutory requirements for mandatory training that bears his name.
Oliver’s legacy demands more than training compliance. It calls for a complete reimagining of how we deliver care and support, moving from services that merely manage to services that empower.
Pioneering new approaches
Against this backdrop, innovative providers are pioneering different ways of working. Rather than accepting the traditional cycle of short-term placements and frequent moves, some are focusing on creating genuine homes for life through lifetime tenancies and deep community integration.
I’ve seen first-hand what works and what doesn’t over 20 years in this sector. Too many individuals get stuck in services that don’t meet their needs, or worse, in long-term hospital placements that take them away from their communities. The sector needs providers willing to go beyond ‘good enough’ and focus on creating stable, values-driven care that lasts.
This emerging model centres on several key principles:
Trauma-informed care that recognises many individuals have experienced multiple placement breakdowns. Staff are trained to understand how past experiences shape current behaviour and needs.
Embedded expertise in positive behaviour support and active support methodologies that actively promote skill development and quality of life.
Community integration that goes beyond physical location, helping individuals build meaningful relationships and access the same opportunities as any other community member.
Housing security through partnerships with housing providers that separate tenancy rights from care provision, giving residents genuine security while enabling providers to focus on delivering excellent support.
The economics of excellence
Critics might argue that comprehensive approaches are unaffordable, but evidence suggests otherwise. The cost of repeated placement breakdowns, emergency hospital admissions, and crisis interventions far exceeds the investment required for stable, high-quality services.
When individuals thrive in their communities, the broader social and economic benefits are substantial. Reduced reliance on crisis services, improved health outcomes, and genuine contribution to community life represent significant returns on investment.
A sector in transition
The real test lies in whether providers can move beyond compliance to create services that truly transform lives.
For commissioners, this means looking beyond cost per placement to evaluate long-term outcomes. For providers, it requires courage to invest in different models. For families, it demands advocacy for services that prioritise dignity, choice, and future aspirations over convenient placements.
As we prepare to launch new services launch across areas like Swindon, Gloucester, and Wiltshire, the onus of responsibility is on us to prove that community-based alternatives can deliver both excellence and sustainability.
The path forward
The question isn’t whether we can afford to innovate, but whether we can afford not to. Every person with learning disabilities or autism deserves more than ‘good enough’, they deserve homes, communities, and futures built around their unique potential.
We’re no longer talking about incremental change, that period has passed. The sector needs fundamental reimagining that honours both individual dignity and collective responsibility for creating a truly inclusive society.
This article was written by Sabrina Nash, managing director of Fenwick Community Support.
Images: Shutterstock and Sabrina Nash.
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