What is going on in this house?

Have a look on your council website for planning decisions. There might be one for a change of use for the house.

We recently had one for a house on our street. They wanted to change a house from residential to a home for 3 children with behavioural problems. It was turned down because we’ve got so many covenants on our houses and, also, it wasn’t in a suitable location according to the council. None of us were made aware apart from the direct neighbour who shares a drive with that house.

Maybe he's a Russian defector and the carers are MI6 involved in a very long detailed debrief. the NHS bit is all deep cover, they obviously don't want to go public and aren't going to put a sign up outside that says "Safe House". Have you seen Alec Guinness, or his look-alike wandering around?

Adult being cared for in a placement at great expense to the taxpayer?

I think the people saying it's most likely the man has some level of LDs, potentially autism with very high support needs are right. And yes of course the NHS and social care services would rather go for a cheaper option such as living with relatives or in a residential home or shared living type of situation is preferable, but that really doesn't work for all. A lot of people with LDs really don't cope well with that kind of setting, can be distressed by the busy environment, and become violent (or even sexually disinhibited) towards themselves or other residents and staff. They can do a lot better in their own space which can be the completely set up to suit them and with dedicated, consistent carers. And yes this is cheaper too, not that I personally think cost should be the only determinant, stopping people getting assaulted for instance more important but if the person can manage say with 2 carers in their own placement vs needing 4-6 in a group home (which is what it takes to safely restrain a young healthy man having a meltdown) then that's win win.

The people wondering about why the carers appear to have lanyards from the further away trust, presumably because that trust is funding care so employs them, but they may well be local to your area, if they're with this client 12 hours at a time this is likely their full time job, there's nothing stopping NHS Devon to recruit carers in Newcastle or vice versa. They might have to travel to Devon occasionally for training but likely not every day. And yes the cost of buying and renovating the house might seem like an extra cost but is also as an asset for the trust so it all does add up from a taxpayer value for money point of view (unless you think people with very severe mental health or LD issues should just be locked away in padded cells or similar)...

OP isn’t asking for the diagnosis which is rather by the by. She’s just wondering what kind of set up it is.

I worked in this sector for years. It was not unusual for a care package to be put in place, including care workers to cover 24 hours a day, and extensive adaptations to accommodation to meet one individual's needs.
One care package could cost hundreds of thousands of pounds a year.
Sometimes staffed by NHS and sometimes contracted out to care companies and sometimes a mixture of both.

I can't understand all the unpleasant replies you have had OP as if I were you I would be fascinated and desperate to know.

My friend's husband was diagnosed with early onset frontal lobe dementia in his 40s and now, early 50s, lives in supported housing where he receives 3:1 care due to his behavioural needs. I don't think you have a right to know why this man is living there and I doubt very much if the carers would tell you anything anyway, patient confidentiality would forbid it.

That's really interesting. Thanks for elucidating.

Joint commissioning sounds possible/probable?

This patient must have someone advocating for them strongly (good for them). I've just looked up what DoLS is (Deprivation of Liberty Safeguarding), it seems like someone somewhere is taking good care of this young man. For other posters and maybe the OP, I found this:

The Deprivation of Liberty Safeguards (DoLS) procedure is designed to protect your rights if you are deprived of your liberty in a hospital or care home in England or Wales and you lack mental capacity to consent to being there. If it is assessed that you do not have mental capacity to consent to care or treatment, it may be necessary, in your best interests, for other people to decide to place you somewhere to receive it.

So, able bodied but seemingly severely enough lacking in mental capacity and with enough back up/support for this option to be funded. I find that very reassuring, if it's the best option for him.

@likelysuspect when you said "People wanted care in the community. This is the outcome", are you speaking as someone with knowledge/experience of all this, who has an opinion on whether this is a good thing or a bad thing?

You’ll just discuss it on here 🤓

have you checked planning permission applications?

I have placed people in similar set ups. Most likely CHC funded supported living. Why this person receives this support or their diagnosis is honestly nothing to do with you. Clearly they are not causing you any issues. Get a hobby and move on

I don’t. Nor do I wish I had so little curiosity.

I would’ve already gone to talk to the carers to get the low down.

*2 carers per shift that should say

Oh I would find this interesting too.

You have seen an able bodied person, but is it possible there is someone else living there too?

Its fairly common, its usually adult social care, unusual for it to be NHS but there may be some joint commissioning going on

Its very common in childrens social care.

Usually these service users are subject to a DOLs

Care homes of old closed down. People wanted care in the community. This is the outcome.

Much better also for this to be directly arranged by the NHS rather than tendered out to a provider, it would cost even more then.

But it doesn’t mean they commute. They could be from your area but employed by that Trust for this one person

I confess, I'm surprised. This seems like A LOT of money to spend on one person. (No skin off my nose, I'm not a British tax/NI-payer, just used to be one).

I guess I thought that the NHS would want to benefit from economies of scale, so non-individualised options. Residential care homes, facilities, wings of hospitals, even larger houses with more staff but more patients.

4+ staff for 1 patients seems extremely expensive to me. It can surely only be justified because there's no cheaper option?