Factors affecting quality in supported living: a variable picture

Care Quality Commission
4 min readFeb 27, 2024

In the latest in our series reflecting on the learning from the Supported Living Improvement Coalition, Stefan Kallee, Senior Specialist for People with a learning disability and autistic people, looks at the first of 4 key factors that affect quality in supported living.

A person holding a piece of puzzle in their hands
Photo by Vardan Papikyan on Unsplash

In the first blog of this series, I talked about continuing the work of the Supported Living Improvement Coalition.

The Coalition was a group of many different stakeholders that came together with the aim of understanding and improving supported living services. Members included people with lived experience, as well as people who run or commission supported living services.

In this blog, I’ll start to share some of the detailed learning about the 4 key factors that Coalition partners said affected quality in supported living.

How did we arrive at the key factors?

After we finished our convening role for the Coalition, we wanted to review and evaluate our work to understand what factors are important in supported living in the view of Coalition partners.

We analysed Coalition meeting notes, findings from a dedicated inspection programme, and held additional focus groups and interviews with 31 Coalition partners. From this, we identified 4 key factors that affect quality in supported living:

  • A variable picture of supported living — Good and bad services
  • Sharing, learning, and working together
  • Choice, independence and equality — Being able to choose the care and support you want
  • Relationships compromised by workforce issues — Support staff getting to know people

I want to first focus on the factor that perhaps sets the scene best: variation.

A variable picture of supported living

Some family members said that they felt fortunate when their relatives could find suitable accommodation and get support to do the activities that they enjoy. This implied a belief that provision among services was variable, and the quality of service that should be expected was seen as ‘lucky’ instead.

Families felt there was a ‘postcode lottery’ of services. Coalition partners highlighted a need for collaboration between stakeholders to find holistic solutions within supported living.

Partners told us about a mixed picture of supported living. Some spoke about supported living operating in a failed system, which prevented person-centred support.

A lack of funding was described as a major concern which had a negative impact on the ability of supported living services to operate consistently and effectively. This can mean budgets are prioritised above truly person-centred approaches to support.

I think it’s not even about this provider’s bad and that provider’s good. The providers I’m thinking of will have very, very good services and really poor ones and I think that will be very difficult for a provider to admit to.
Family member

One coalition partner said that if a local authority didn’t pay for one-to-one support, a placement could fail because of a “local authority refusing to give the hours and we just can’t support them properly.”

Even in our own services […] some people’s needs are perhaps so high or so intense that the local authority aren’t willing to pay for that one-to-one support.

With the voices and stories of people with lived experience at its heart, the Coalition has always looked to find out what helps people in supported living to have a good quality of life — and do more of it together.

It makes sense then, to tell you about a second key factor affecting supported living, which is all about the need for collaboration.

Sharing, learning, and working together

One key area of improvement identified by Coalition partners was the need for collaboration. They wanted to see everyone involved in a person’s support — including the person themselves — collaborating and working in a joined-up way. Everyone should use the concept of person-centred support as a basis for collaboration to make sure their priorities match the things people in supported living care most about.

Coalition partners outlined the important role policies and guidelines can play in improving services and people’s lives. They can often include the principles of enabling choice, independence and equality. Providers need to make sure that staff understand what these guidelines mean in a practical sense.

The importance and positive impact of sharing best practice among service providers was stressed by some.

I think ultimately, if you’re going to create a web of support or a net to support somebody, you can’t only be joined-up by that one person […] that’s not joined-up; you need lines going between all of the different groups, to really create a really consolidated understanding of the support that somebody needs.
Social care membership organisation

The problems come in actually getting those policies and procedures in a large organisation into reality. People in the organisation still don’t understand how they should work, even after policies and procedures have changed, so it’s the training and making sure the staff understand it”
Family member

In my next blog, I’ll focus one the final 2 factors which will be all about choice and relationships.

We are sharing this learning with the hope that anyone involved in supported living services can use the findings to learn, collaborate and improve the experiences of people in supported living.

Please do share your reflections on anything in this blog on our online participation platform. This could include your ideas and examples of how we can make improvements happen together.

Blog author Stefan Kallee, Senior Specialist for People with a learning disability and autistic people
Blog author Stefan Kallee



Care Quality Commission

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.