1. The problem: home as the site of lawful care

“Care Home Without Walls” is not a statutory category. It is a proposed description of an outcome: a coordinated package that makes ordinary home life safe and sustainable. Its legal value lies in translating lived experience into outcomes and risks that the Care Act 2014 recognises. Its limits matter equally. A local authority is not bound to adopt the phrase or fund a preferred model merely because it has been requested.

The comparison is functional. It asks which supports an institution would ordinarily provide—observation, rapid response, night assistance, personal care, communication support, safeguarding and backup—and how those functions can be delivered in an ordinary home. It does not assume that every function requires a worker continuously present; it requires an intelligible account of who responds, within what time, under what protocol and with what contingency when the first plan fails.

1.1 The justiciable question

The central issue is whether the authority has lawfully identified all needs, determined eligibility, specified which needs it must meet, prepared a plan capable of meeting them, calculated a rational personal budget, considered less restrictive and effective options, and given intelligible reasons. “Ten hours versus twenty-four hours” is therefore the conclusion of an assessment dispute, not its legal starting point.

Judicial review normally tests legality rather than choosing a preferred package. The book therefore converts experience into reviewable questions: Was the correct statutory test applied? Were relevant risks investigated? Was unavailable family care treated as available? Were reasons adequate? Were communication adjustments made? Was a less intrusive effective alternative considered?

Working thesis If risk exists across the whole day and night, intermittent visits may be incapable of meeting the need. But continuous one-to-one staffing is only one possible response. The evidence must address why technology, planned visits, on-call arrangements, shared support, clinical services or informal help are insufficient, unavailable, unsafe or unacceptable.

1.2 Proposed outcomes

  • Remain safely at home with dignity and control.
  • Receive assistance during predictable and unpredictable episodes, including at night.
  • Communicate by speech, text or other augmentative method when fatigue limits speech.
  • Obtain intimate and personal care without sexualisation, coercion or dependence on unwilling relatives.
  • Have trauma-informed support and clinically assessed physical and mental-health symptoms.
  • Maintain companionship with the dog, subject to welfare and practical care planning.