What works and what needs more work What works - and what needs more work Please note: this workshop will be run as a participative and consultative event. There will be some new material presented. But the emphasis will be on discussion and dialogue. Presenter: Robin Johnson, Snr Consultant, RJA consultancy

Policy developments Practice developments Research developments Strategy developments What works - and what needs more work Areas to cover What works and what needs more work

What works - and what needs more work NSF for Mental Health Supporting People Personality disorder Social Exclusion Unit report Health and Social Care White Paper Policy developments

What works - and what needs more work The NSF on housing The National Service Framework for Mental Health (1999) had called for “a continuum of accommodation for those with mental health problems”, to include:- Crisis and refuge places, including service-user run “sanctuaries” Long-stay secure accommodation Staffed and supported accommodation Supported living options, including individual tenancies and shared living with flexible support Family placement and respite The NSF

What works - and what needs more work SP and mental health Key Supporting People policy statements on support and mental health include:- “SP Guide to accommodation and support options for people with mental health problems.” The original THBS eligibility criteria The national SP strategy consultation The Robson Rhodes & Matrix consultancy reports SP and MH

Care with support Independence with support Socially excluded Supporting People Groupings Source: national SP strategy consultation document, Nov 2005 SP groupings What works - and what needs more work

The SEU Report “Mental health problems require more than a medical solution; they require a positive response on the part of society to accommodate people’s individual needs and to promote mental well-being.” “…Action will be needed across government to improve the current experiences of people with mental health problems. The problem… cannot be solved by any one department acting in isolation.” Mental Health and Social Exclusion Social Exclusion Unit report, ODPM, June 2004 SEU report

Towards inter-agency inclusion The NHS NIMHE/CSIP NatPact, MHP & SHAs Local authorities LGA & ADSS Other govt interest Cabinet Office Home Office ODPM Neighbourhood Renewal Unit & Housing with Care and Support Audit Commission Housing and Health / Community Care divisions National housing provider reps National Federation of ALMOs & National Housing Federation Housing Quality Assurance Housing Corporation & Chartered Institute for Housing NIMHE Housing Reference Group: Chair: Colin Williams Sec. Zoe Robinson The NIMHE Housing Reference Network Voluntary sector & user reps Affiliates SITRA, hact, MIND, Shelter Crisis, RJA etc HRG SEU report aftermath What works - and what needs more work

Towards locality inclusion Affiliates Providers, advisers & campaigners, R&D Three “tiers” in a Practice Exchange Network Nationally NIMHE Housing Reference Group Local/regionally The Practice Exchange Network The frontline of services, users and carers Three tiers SEU report aftermath

What works - and what needs more work “At Home?” study positive practice in general needs housing Practice developments Social Inclusion practice database Inter-agency bridging practices promoting inclusion Good practice guidance Preventing homelessness, rent arrears etc SEU report aftermath

What works - and what needs more work Joint training, shadowing, or similar liaison exercises Mental Health Liaison Linkworkers in housing services Housing Liaison Linkworkers in CMHTs/Homelessness Liaison or discharge co-ordinator staff on wards Sheltered, “extra-care”, Key-Ring or similarly “clustered” housing to enhance social support Information systems to identify vulnerable tenants and “flag up” the need for early intervention or ensure sensitive communications, avert build-up of arrears etc. Information systems to identify the housing needs of patients/service users, for future service planning and commissioning. AH ww1 The “At Home?” study SEU report aftermath

What works - and what needs more work Mental health training for housing staff Support needs information gathering with tenants CMHT referral mechanisms for housing staff Housing/health information-sharing protocols A directory of local mental health services A policy commitment to joint work and joint needs analysis AH ww2 The “At Home?” study SEU report aftermath

What works - and what needs more work Social Inclusion database Social Inclusion practice database Housing-related support services only Housing support services integrated with social care Extra-care scheme Peer support / befriending Key-ring, core-and-cluster etc allocation systems Warden-aided housing suitable for people with mental health needs Intensive housing management Mental health awareness training for housing staff Shared ownership scheme Mental health linkworkers within the housing service Housing linkworkers within the mental health service Other Practice developments SEU report aftermath

What works - and what needs more work Research developments Qualitative studies: “the data of experience” Census: Factual data on housing and mental health Prevalence studies: mental health problems in supported accommodation ( eg:personality disorder ) Cost effectiveness of housing support vs healthcare Cost effectiveness of housing stock improvement Housing services as “community anchors” Research priorities exercise for future mental health research SEU report aftermath

What works - and what needs more work Strategic developments Health and Social Care White Paper New NSF for Mental Health SP Initial National Strategy Housing Corporation strategy Lyons Inquiry National policy development

The NSF review National policy development The NSF (MH) review “ We now need a plan that recasts the NSF in line with the direction that the NHS as a whole is taking – towards patient choice, care for long-term conditions, and improved access to services. We need to broaden our focus from specialist mental health services, to the mental health needs of the community as a whole....” Louis Appleby, National Director for Mental Health, “The National Service Framework for Mental Health – Five years on”. DoH, Dec What works - and what needs more work

The Health & Social Care White Paper H&SC White paper The whole system to involve social care, primary care and community services such as housing, transport and leisure that contribute to well-being…” ( Chap. 1) PCTs and LAs to “drive” this re-alignment jointly ( Chap. 1) A stress on strengthening local commissioning in achieving health and social care outcomes ( Chap. 2) Planning and budgeting cycles for the NHS and local government to be aligned, starting in ( Chap. 2) Improved needs assessment to inform local decision-making (Chap. 7) Supporting People has a key role in promoting independence and enabling the shift to more preventive work” ( Chapter 1) Specific references to the growing role of extra-care housing (Chap. 6) What works - and what needs more work National policy development

Social housing review The role of social housing Housing and the sustainable communities agenda Housing Corporation strategy consultation Sir John Hills’ review of the role of social housing National Federation of ALMOs response to Hills Housing Associations as robust Volorgs What works - and what needs more work National policy development

The Lyons report National policy development The Lyons Inquiry A statutory duty on other local agencies to co-operate with local authorities should be introduced “National prosperity, local choice and civic engagement: A new partnership between central and local government for the 21 st Century”, May 2006 Local government’s role involves those services it is directly responsible for, and those in which it plays a convening role. National targets and inspection requirements....can “crowd out” local action to meet local needs and priorities... Resolving choices at national level is expensive, as it rules out local trade-offs... The best way of spending limited resources will be different in different places... Where choices and trade-offs are needed, the ability ( of democratically elected councils) to make these choices is essential..... What works - and what needs more work

The wider community Service users & carers Integrated commissioning ? Providers Local commissioning of healthcare, housing, social care, & support Integrated commissioning (1) What works - and what needs more work Local policy development

The wider community Providers Integrated commissioning ? Service users & carers Local commissioning of healthcare, housing, social care, & support Integrated commissioning (2) What works - and what needs more work Local policy development