Learning Disabilities & Autism Opinion

Unlocking better supported living outcomes through integration

David Whittock, Director of Service Development, Eden Futures

As an independent supported living provider, Eden Futures has a significant role to play in progressing NHS England’s ‘homes not hospitals’ agenda. We can be part of the solution in integrating health and social care if we’re brought to the party early too.

Integration has been subject to endless discussion over decades and we’ve observed some excellent practice in local authorities when we’ve co-designed services with CCGs and local authority commissioners. Collaboration is vital, especially their faith in us over a different approach, aided by housing providers, developers and architects.

A prime example of this is our early involvement in the development of specialist bungalows in Shirebrook, near Bolsover with Derbyshire County Council and the Derby & Derbyshire Clinical Commissioning Group. We were to support people living there who had been in long stay hospitals. People who’ve caused property damage before often don’t get referred to independent living. We wanted to input into the housing design and alter it to create a robust environment to counteract these barriers, providing greater choice for people with complex behaviours and support needs.

We worked with our commissioner colleagues, the housing provider, architect, contractor and occupational therapists to adapt the existing housing model and make the new service fit for purpose in line with the Transforming Care programme.

Our adjustments aimed to limit the possibility of harm to the person and property damage. We replaced walled radiators with under floor heating, solid, wipeable walls for studwork, and introduced integrated window blinds with anti-ligature fittings within double glazing, lockable kitchens, a secure private garden and a central service area.

Funding was also provided to recruit staff much earlier in the development process. This meant transition work from hospital to home was carefully planned with the people we’d support, alongside their families and healthcare professionals.

Within a few months of opening Shirebrook was fully occupied and had a waiting list. Today many of the original tenants remain, some of whom had lived in hospital for five years or more before.

By shaping services up-front as a genuine partner, we can generate better outcomes for people we support. Demand for the specialist bungalow model continues to grow as commissioners learn from Derbyshire’s experience. We’re now replicating the model across six more services, bringing 20 new bungalow placements in this financial year.

Every specialist bungalow completed represents a reduction in long stays in hospital, unplanned hospital leaving dates, and an increase in the support available to people with challenging behaviours, as well as improving their independence.

Shirebrook shows the supported living sector at its most active with stakeholders leading the way at the ‘top table’ of decision-making. It highlights the positive outcomes of having a level playing field between the NHS and social care sector to aid greater integration.

Jane Robins, Adult Social Care Commissioning Manager at Derbyshire County Council adds: “Derbyshire County Council’s vision is that by 2024 more adults with complex needs in Derbyshire will have access to lifetime tenancies, supported housing and targeted community support to enable them to sustain their own home and live independent and fulfilling lives.

“We want to design and provide offers of support or services that enable this to happen across Derbyshire. By working with developers and providers of care and support like Eden Futures, we can build on the successful specialist model in Shirebrook.”

Kirsty

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