A strategic assessment of the accommodation with support needs for people with a learning disability, autism and mental health conditions 2020-2030

It is critical that people have the right accommodation to meet their needs to ensure sustainable housing solutions. This means that we have to have a personalised response to accommodation, which will require us to fully understand a person’s individual needs and then seek to meet those needs in the best possible way.


What went in

  • Priority area addressed: The need to establish an evidence-based assessment of the housing needs over the next 10 to 15 years for those with:
    • learning disabilities
    • autism
    • and those identified as being part of the Transforming Care Programme cohort
  • Budget: £37,700 – including the grant of £31,500 from the LGA, £4,500 from CCG for the lived experience element, plus £1,700 from RMBC for follow on workshop to confirm priorities for development at local and regional level.
  • Other resource needed: To recruit the expertise needed to carry out the strategic needs assessment we needed procurement colleagues to run the tender once we had developed the specification. This allowed us to recruit consultants with experience in both this area of work and in co-production with those with lived experience. Performance and data teams from the local authorities provided data on the current and projected future needs for each local authority area. Local data and intelligence was collated from clinical commissioning groups specifically focusing on individuals who formed part of the Transforming Care Programme.  It was really important this information was included as part of the housing needs assessment to ensure that the housing needs for these individuals were identified as an enabler and also to ensure that we can prevent admissions that lead to long stays in hospital settings in the future. To make sure that the voice of those with lived experience was central to the project Speakup; the self, group and peer advocacy organisation were asked to support the part of the project that was designed to collect the views of those with lived experience. 
  • Time taken to achieve outcomes: We originally planned for the work to be completed in 6 months, but this moved to 8 months as the delivery of the project ran alongside the LA response to the COVID pandemic.  We also needed a longer timeframe to co-produce the questionnaire which replaced the original proposal to hold face to face meetings with those with lived experience.  Throughout the project we had to adjust and adapt to new ways of working and it was essential that we put in the reasonable adjustments to allow our experts by experience to be equal partners, and to ensure they were not digitally excluded from doing so.

What came out

  • A quotation from a relevant stakeholder about their experience:Deliverables: The project produced a strategic needs assessment which sets out the accommodation needs up to 2030 for those with learning disabilities, those with autism and those in the Transforming Care cohort; an action plan to implement the findings at regional and local authority level and an Easy Read version of the report to make sure the findings are accessible to all those who contributed to the project.
  • Difference made/ indication of success: The Transforming Care Housing Group have committed to deliver the findings of the report.  The report gives a clear message that over three quarters of those with lived experience want their own accommodation with support.
  • A statistic that evidences the above: 138 responses were received to the survey from those with lived experience.  77% of respondents said they would rather live in their own accommodation with support.

Campbell Tickell, who were appointed to deliver the report - "The key things that helped were the partnership we formed with the LA Lead and CCG Lead for the project. We worked together to problem solve. For example, a key part of the brief was the engagement of people with lived experience. Our original proposal was to hold a series of consultation meetings in each LA. When this was not possible, we agreed that we could conduct some meetings remotely using Zoom - by joining the existing meetings that were being co-ordinated by the various user groups. We used these meetings to co-produce a web-based questionnaire with people with lived experience and their families."

Speakup - Speakup is commissioned by the South Yorkshire Transforming Care Partnership to ensure all of their work is co-produced with people with learning disabilities and autistic people. Experts by Experience at Speakup then worked together to design a questionnaire for people with learning disabilities and family carers to gather their views. The questionnaire was created in easy read and available in a paper copy and online.


Executive summary

Building the Right Home and the National Service Model state that people should have choice about where they live and who they live with. It is critical that people have the right accommodation to meet their needs to ensure sustainable housing solutions. This means that we have to have a personalised response to accommodation, which will require us to fully understand a person’s individual needs and then seek to meet those needs in the best possible way. The project set out to provide the evidence for accommodation needs in line with the principles that people with learning disabilities and/or autism who display behaviour that challenges, including those with a mental health condition should be supported to live in their own homes in the community with the right support, in a home of their choice, where they feel happy and safe.

To assess the accommodation needs case management data was analysed along with interviews with practitioners while those with lived experience took part in designing and completing a survey. The project identified that some existing placements for all cohorts could move to supported living. The 10-year projections across the ICS, taking re-lets into account show a need for 663 units of accommodation with support for those with learning disabilities and autism, while the need for those with severe mental health needs is 653 accommodation units.

Challenge and context

Building the Right Support (October 2015) and the National Service Model identify the need to provide accommodation that meets the needs of those with learning disabilities, autism and those with a mental health condition who display behaviour that challenges. To develop accommodation that meets the needs of these cohorts is both a national and regional challenge. This project, to identify the needs for the next 10 years gives both a clearly identified need and the starting point for a solution.

Co-production to make sure the voice of those with lived experience was central to the project. We were fortunate to have Speakup as part of the project as they already work with partners to make sure services are accessible for those with autism and learning disabilities. Having an experience advocacy group and consultants helped to keep the project on track when delivering during the pandemic.

COVID meant that from the beginning all partners had to think how we could deliver the project within the constraints of lockdown and the local authority focus on the emergency response. This was new for everyone, but we all had experience of delivering this work face to face so had that to fall back on in developing virtual solutions. Everyone was committed to delivering the project because this work is a priority for health, adult care and housing. With the strength of experience, we were able to make sure that the voice of those with lived experience stayed central to the project.

What we did
  • Developed a specification to recruit an experienced advisor to make the strategic needs assessment
  • Made the inclusion of those with lived experience an essential requirement of the tender
  • When we could not meet with those with lived experience made sure they were central to the development of the replacement questionnaire and survey
  • Held regular project updates to share any issues and resolve any blockers to progress
  • Made sure we shared draft findings with senior leaders and included feedback in subsequent project stages
The difference we made

This report gives the underpinning needs assessment to allow for the development of delivery plans at ICS and local authority level that are based on evidenced need.

What's next?

Following on from completion of the report we held a workshop to confirm the finding and to agree the next steps.  The outcome of the workshop was to develop an action plan with regional (ICS level) and local authority actions.

Currently we are looking to bring in some additional resource to give capacity to lead the delivery of the recommendations.

Lessons learned

We were aware that what we were aiming to do was ambitious within the time and cost envelope. A key element in securing the success of our project was being clear what we wanted to achieve in our specification; focusing on experience of delivering similar pieces of work that included the views of those with lived experience. The Transforming Care Housing Project Group already existed, and the delivery of a strategic needs’ assessment was already an identified priority for the group.  Members of the group were already committed to work together to deliver and this gave the project an already established governance structure.  A high-level strategy was already in place, but this was specifically around the Transforming Care cohorts.  The housing needs assessment project allowed us to widen the scope to incorporate all individuals with LD, Autism and SMI’s who require additional support to be included.

Although the COVID pandemic did threaten to slow the project down at the beginning, the fact that everyone involved had to adjust to a new way of working encouraged us to be flexible to focus on the delivery of our agreed outcomes. Our consultants, Campbell Tickell and our partner for those with lived experience, Speak Up were prepared to be flexible and work with us to find ways to deliver.

Why it worked well
  • Already a strategy in place and the strategic needs assessment was already identified as necessary to deliver the strategy
  • Co-production was already an established way of working.
  • We could use existing governance structures through Transforming Care Partnerships and an existing Transforming Case Housing Project Group to deliver the project and its recommendations.
  • Positive engagement from key stakeholders
  • Senior leadership support and buy in including Assistant Director of Housing picking up the SRO role for the project.

Contacts

Sue Shelley, Business Development Manager Housing, Rotherham Metropolitan Borough Council

Email: sue.shelley@rotherham.gov.uk

Kelly Glover, Transforming Care Strategic Lead - Sheffield, Doncaster and Rotherham TCP Autism Lead – South Yorkshire and Bassetlaw ICS

Email: kelly.glover@nhs.net