Service Objectives

1
Service Objectives

• To provide a community based and cost effective
  alternative to hospital admission
• To achieve the benefits typically associated with
  supported living (choice, empowerment, community
  participation)
• Reduce the risk of re-offending and rates of
  hospital admission
• Services that are people centred and tailored to
  the needs of the individual but which are
  delivered in a manner that still enables some
  economies of scale to be achieved
• Move away from the traditional staff user
  relationship to a more positive and collaborative
  model where thee workers recognise users as
  individuals and in return are respected as
  mentors and facilitators
• To combine expertise of voluntary sector
  providers, with that of the NHS, to provide a
  seamless and appropriate service

2
The Housing Web
Mixed economy of housing Supported Living
Outreach Team Mixed economy of care Flats -
houses Health - private
3
Case Study

• 20 year old male, borderline learning disability.
• Has difficulty controlling temper and can be
  impulsive. He also has difficulty building
  relationships and has low self esteem
• Prior history of self harm and suicide attempts
  before being admitted to the medium secure unit
• Age 9 Attempted to cut wrists
• Age 11 Took 5 sleeping tablets leading to a
  severe asthma attack
• Age 15 Seen by child and family psychiatry
  after going berserk with a knife on his arms,
  but refused any therapy
• Age 17 Attempted to hang himself in the loft of
  his mothers house which lead to admission to
  hospital
• Forensic History prior to the Supported Living
  Outreach Team involvement
• 1 charge of Grievous bodily harm
• 2 counts of battery
• 7 common assaults
• 1 arrest for carrying a knife
• 1 charge of disorderly behaviour
• 2 criminal damages charges

4
Case Study (cont.)

• Initially Admitted under Section 2 of Mental
  Health Act 1983, followed by Section 3
• He received 11 supervision in a medium secure
  unit at a cost of 120,000
• Referred to the Supported Living and Outreach
  Team during this time in order for an
  individually designed package to be set up
• In put from The Supported Living and Outreach
  Team commenced Jan 2002. Two staff were
  recruited to support him for 5 hours a day at a
  cost of 40,000
• Forensic incidences in the first year of SLOTs
  involvement
• 2 charges of disorderly behaviour
• 2 charges of breach of the peace
• 1 arrest for actual bodily harm, the charges were
  dropped
• 1 criminal damage charge
• Self harm and suicide attempts in the first year
  of SLOTs involvement
• 1 superficial cut
• 1 attempt to hang self
• Forensic incidence in 2nd year of SLOTs
  involvement
• 1 charge of grievous bodily harm
• 1 arrest for criminal damage, charges were
  dropped
• No self harm or suicide attempts in the 2nd year
  of SLOTs involvement

5
Case Study (cont.)

• Input from the Supported Living and Outreach Team
  reduced to one support worker for five hours
  support a day at a cost of 20,000
• He now lives with his girlfriend in his own fat
  and they are expecting their first child
• He is engaged and to be married in August
• He attends a literacy class and a chess club

6
Clinical Issues

• Lack of understanding of the philosophy of
  supported living and person centred planning from
  other agencies
• Perceived high staff turnover and staff working
  in isolation, along with the effects of burnout
• Difference of opinion as to the levels of support
  a person requires

7
Partnership working

• The philosophy of supported living is new to
  residential organisations in Birmingham
• Concerns relating to people holding tenancy
  agreements
• Issues around recruitment
• Blurring of roles and responsibilities concerning
  staffing and client issues

8
Conclusion

• Develop innovative, person-centred care solutions
  that bridge the health and social care divide.
• Promotes new ways of working that it would, we
  believe, be more difficult to promote within
  mainstream Health services
• Provides a culturally appropriate workforce to a
  far greater extent that NHS recruitment alone