Occupational therapist guide to housing disrepair referrals

Occupational therapists regularly visit people in their homes and are well placed to identify housing conditions that are affecting their clients' health, function, and independence. Read on for when a housing disrepair referral is appropriate, what you can do to support a client's case, and how to refer to Support for Tenants.

When OT home visits reveal housing disrepair

OT home assessments frequently uncover housing problems that go beyond the initial referral reason:

• Cold homes affecting a client's ability to perform daily activities, getting out of bed, dressing, mobility in cold rooms
• Damp and mould affecting respiratory health and limiting time spent in affected rooms
• Structural hazards, broken handrails, uneven floors, unsafe stairs, that your risk assessment identifies as presenting a falls risk
• Broken heating or hot water preventing a client from following a hygiene or medical routine
• Inadequate lighting, damp affecting electrical safety, or other environmental hazards relevant to your functional assessment

In many of these cases, the problem is one that the landlord is legally required to repair, and the client may have grounds for a claim if the landlord has not acted.

Your role in a housing disrepair case

You are not expected to act as a housing adviser, legal advocate, or claims assessor. Your role is to observe, document, and, where appropriate, refer.

What you can do:

• Document relevant observations: Your home visit notes are professional evidence. If you record observations about cold temperatures, damp conditions, or hazards, these notes can form part of the evidence in a housing disrepair case.
• Write a supporting letter: A letter from you confirming what you observed and how it connects to your client's functional limitations is a valuable piece of evidence. See the guidance in our related article on writing medical evidence letters.
• Refer to housing advice services: You can refer your client to Support for Tenants for advice on whether a disrepair claim is available.

What an OT letter for a housing disrepair case should cover

If your client asks you to provide a supporting letter for a housing disrepair claim, a useful letter includes:

1. Your professional details: name, HCPC registration number, role, and employer
2. Your client's details: name, date of birth, and the nature and duration of your professional involvement
3. What you observed during home visits: temperature, visible damp or mould, structural hazards relevant to your assessment
4. The functional impact: how the housing conditions connect to the limitations you observed, for example, "the client was unable to use the bathroom independently during my assessment, and the cold temperature in the hallway was a contributing factor"
5. Your clinical opinion on the connection: "In my professional opinion, the cold conditions observed in the property contribute to the client's difficulty in carrying out morning care routines independently"

You do not need to express a legal opinion, diagnose causation with certainty, or have visited the property multiple times. A single documented observation, connected to a clinical opinion on the functional impact, is useful.

OT assessments and disabled facilities grants

If your assessment results in a Disabled Facilities Grant (DFG) recommendation, and the reason for the DFG need is connected to the landlord's failure to maintain the property in a habitable state, there may be an overlap between the OT/DFG process and a housing disrepair claim. These are separate routes, the DFG addresses the client's adaptation needs, while the disrepair claim addresses the landlord's repair failures, but both may run in parallel.

The wider picture: housing and occupational performance

The link between housing conditions and occupational performance is well-established in OT literature. Persistent cold, damp and disrepair affect activity performance across all domains, self-care, domestic tasks, work, leisure, and social participation. When the underlying cause is a landlord's failure to maintain the property, a disrepair claim can sometimes produce the repair outcome that the OT referral on its own has not achieved.

How to refer to Support for Tenants

To refer a client (with their consent):

• Call 0800 030 4669 on their behalf (with consent), or
• Give them the number to call themselves
• If a letter to support the referral is helpful, you can address it to "Support for Tenants" and hand it to your client

Consent is required. A consent form is typically provided as part of the instruction process for no-win no-fee cases, you do not need to create your own form, though your own service's consent processes should be followed.

Sources

• Section 11, Landlord and Tenant Act 1985 (legislation.gov.uk)
• Housing Health and Safety Rating System (HHSRS) guidance (GOV.UK)

Related articles for professionals

• Writing a medical evidence letter to support a housing disrepair claim
• How to refer a patient to Support for Tenants
• Signs of disrepair, a quick checklist for professionals
• Social worker guide to housing disrepair referrals
• Consent and confidentiality when referring to us