It is widely recognised that effective recovery and prevention of acute mental health problems is supported by good quality housing and especially specialist supported accommodation for people who may otherwise struggle to live independently. Delayed Transfers of Care from acute hospital in MH services are often caused by a lack of access to housing, especially for people with a higher level of needs. Dual diagnosis with autism or drug and alcohol issues makes housing even more challenging. In order to resolve this issue bradford council, working with its partners in the housing dept, housing providers, VCS and NHS partners, has worked to redevelop the way we commission, access and support people to move into appropriate housing
What We Did
It is widely recognised that effective recovery and prevention of acute mental health problems is supported by good quality housing and especially specialist supported accommodation for people who may otherwise struggle to live independently. Delayed Transfers of Care from acute hospital in MH services are often caused by a lack of access to housing, especially for people with a higher level of needs. Dual diagnosis with autism or drug and alcohol issues makes housing even more challenging.
In order to resolve this issue bradford council, working with its partners in the housing dept, housing providers, VCS and NHS partners, has worked to redevelop the way we commission, access and support people to move into appropriate housing. this can be summarised as:
1. A new housing gateway that provides a quick and easy way for service users to access housing and homelessness services. A new commissioning process for homelessness services and social landlords.
2. A new Homelessness service, ‘no second night out’ that provides emergency accommodation for people who are homeless.
3. A new Supported Housing Framework. This identifies a number of providers who we can contract with to provide support in accommodation or in peoples own homes. This framework supported the development of a range of new housing providers to open in Bradford. this is particularly needed as we have a range of people with very high level of needs, previous debt, challenging behaviour etc, who are being delayed in hospital and leading to a reduction in beds for detained people
3. The recruitment of a Specialist Housing Social work, funded by Housing and Social Care and placed within the NHS acute care team. This professional works to support inpatients and others to access housing quickly and easily and will assess housing issues soon after admission. This professional has been key in getting people accommodation and reducing delayed transfers of care.
4. Social Workers within the Community MH teams and the IHT and Crisis services who can support assessment under the Care Act that can be used to access these housing opportunities.
5. A resource allocation process that is accessible for all NHS and Social Care staff so that they can access housing for their clients without having to refer to a social work team waiting list.
6. An agreement with the CCG that we will jointly fund and support people with S117 MHA rights to aftercare. This allows us to facilitate supported discharge from out of area or secure hospitals into much more appropriate, cheaper and more independent supported housing.
7. A ‘Hard to Place’ panel meeting considers the needs of those who have been refused housing due to previous behaviour. This agrees a placement and designs care packages and housing arrangements that meet their needs whilst protecting landlords and support providers.
This has led to a major change in the way we care for and discharge people. Our Delayed Transfers of Care rates have been reduced to nearly zero. We are discharging people in a structured and planned way with housing discharge plans being undertake soon after admission. We are working to ensure easy access to housing for people in mental health crisis, admitted to hospital or in A and E or our safe space projects.
Our supported housing projects are working with people to reduce MH crisis and promote resilience, stability and support
Wider Active Support
A list of our partners:
Bradford Council Housing Department
Bradford Council Dept of Health and Wellbeing
Bradford District Care Trust Community MH Services
Bradford District Care Trust Acute Care Service
Bradford and District CCGs
Housing and support Providers:
– Creative Support
– Accent Housing
– Yorkshire Housing
– Carlton Care
– Our TLC
– Supported Independant Living
– CareTech and Halo Housing
– Home Group housing
– Impact Housing
– Horton Housing
We work with our housing partners through our Housing Gateway, our Supported Living Framework, our Individual & Personalised Support Framework and through other contracts. In addition, we have an agreement with our colleagues in the CCG to jointly commission and fund housing placements that promote people living at home. This is part of the Home First model and the Mental Wellbeing strategy, that has a clear remit to support integrated housing solutions for people with a mental health problem.
One of the key aspects of our mental health and housing strategy is that people have the choice to decide their own accommodation and support package. To achieve this, we use personalised support under the care act, especially direct payments or individual service funds.
In addition, part of the framework is clear that housing providers must engage with co-production and most have tenants groups and other ways of engaging with service users.
Looking Back/Challenges Faced
We would have commissioned step down and emergency housing immediately. this is just being commissioned now but it is vital for the support of people struggling with mental health crisis and accommodation issues.
All of our housing is backed up by our frameworks and the joint commissioning model so is not reliant on individuals. Our Housing Specialist has recently moved on but is being replaced, proving that the project is now sustainable.
Evaluation (Peer or Academic)
Our evaluation is currently in relation to the number of out of area placements, the number of reduced bed length of stay and the number of delayed transfers of care. all of these are reduced. In addition, we are monitoring the use of detention under the MHA for people with long term support and recovery needs and we are monitoring the Adult Social Care Outcomes Framework 1H rating for number of people adults in secondary MH services living independently in which Bradford has a value of 73.3% over an England average of 58% and a local 14/15 score of 64.3.
in addition, we have asked Bradford university to undertake an assessment of our recovery and support services that will include housing.
Adult Social Care Outcomes Framework 1H rating for number of people adults in secondary MH services living independently. Bradford has a value of 73.3% over an England average of 58% and a local 14/15 score of 64.3. this is projected to rise this year. Over 2 years with no out of area or private sector bed usage. Length of stay and DTOC reduced.
male bed occupancy reduced
yes – we train and support housing workers in mental health issues and MH workers in housing and care act issues.
We have written a blog and article on this issue for NHSE and Centre for Mental health
We have written and article for the Mayday Trust
We ran a PPiMH SIG day on may 19th 2017