What is quality supported housing and care for if not to ensure someone can live as happy, meaningful, and independent a life as possible?
Recent government policy to improve life for autistic people and people with complex learning disabilities offers new opportunities for thousands now hoping to move into supported housing.
The Building the Right Support Action Plan and Draft Mental Health Bill both commit to ensuring better lives for all those affected. The former focuses on bringing the 2000 plus individuals living in unsuitable secure facilities, including mental health hospitals, back into their communities where they belong; while the latter makes it harder to put someone with these needs into secure settings. The real challenge however is in the implementation.
Consider a man we supported recently (let us call him Paul). Paul is in his 30s, is autistic and has a learning disability, OCD and associated sensory issues. Before joining Look Ahead, he had lived in secure residential care 150 miles away from his family in London for more than 10 years. Over the 10 years others tried but failed to find a suitable placement for Paul deeming his case “too difficult.”
After months working with Paul, his family, NHS England, and the local council we ensured his successful transition into a new home. We identified Paul a suitable home, then worked with the council to secure an NHS England grant to purchase and adapt it for him. Paul was actively involved in designing his environment, choosing everything from the flooring to the wall colour. Paul now leads a more independent life.
We welcome these new government initiatives, but there are important caveats if Building the Right Support targets are to be met. Here’s my three-point plan:
- Work collaboratively and share the risk equally
It is clear to me and key to our working style at Look Ahead that reaching these goals is not possible without effective collaboration and risk sharing across key services. Look at our recent example of Paul, it was a real team effort. This collaboration should also extend to addressing complex funding arrangements between councils and NHS commissioners, doing so effectively and consistently nationwide could then encourage more providers back into the market and cut out the postcode lottery.
- Fund the ambitions adequately and think long-term
As the recent government-commissioned RedQuadrant study indicates, new funding is needed to support the plans. Commissioners need to be able to pay fair rates for care. Many in hospital have complex needs and placements will be costlier than their current arrangements, but this is no reason to deny citizens the quality of life they deserve. Transitional arrangements can take months and are often the difference between a placement’s success or failure. Yet the private sector is reluctant to enter the high acuity end of the supported living market; the margins are too fine and the perceived risks often too great. So it’s left to the voluntary or non-profit sector to fill the void.
- Invest in our workforce
Care recruitment faces extensive challenges. We must recognise the professionalism and skills that exists within the workforce. Support work must become a profession of choice, but a mere living wage is insufficient for talent retention. Pay must be made higher if the sector is to prevent talented and committed individuals, including graduates, from starting in roles then leaving for better paid jobs elsewhere as they can’t afford their rent.
Delivering on these three points alone, would greatly contribute to the realisation of these noble goals. I am optimistic too that the Health and Care Bill and statutory footing of Integrated Care Systems (ICSs) could drive forward the commissioning of vital services like those we provide for Paul. We are especially encouraged by the number of direct approaches from ICSs for similar services. We welcome the fresh guidance and will be embracing these new opportunities to ensure we support more people like Paul and his family to regain their independence and build a meaningful life in their community.
