1. Community Links Personality Disorder Accommodation Service. Providing a Stable Base in a Chaotic World.

2. Why a Housing Team? People with a PD diagnosis are much more likely to experience homelessness, live in deprived areas and be placed in inappropriate accommodation. (DOH 2009) It has been recognised that without a stable base, further treatment options are likely to fail. A lack of appropriate move on accommodation is a major contributor to a blocked pathway. Whether coming from secure hospital or prison, housing is often overlooked as part of care/sentence planning. Appropriate accommodation can greatly improve an individuals life and help to manage their risk.

3. Who are we? Employed by Community Links 3 rd Sector Provision. Half PD time services manager, 1 Team lead, 1 FT staff 1 PT. Original partner of the Leeds MCN Focus specifically on Housing and Resettlement. Work in an integrated way with Leeds MCN outside agencies.

4. What we do. Support clients under care coordination to access and maintain appropriate accommodation. Support clients who access MCN therapy services with short term housing issues, eg: Housing Benefit, Utility Management. Provide advice and consultation on PD to other housing provision in the city. We do not hold our own housing stock.

5. How do we do this? We have worked hard to develop a Housing and Resettlement model which ensures good outcomes for our clients. Made good links with a variety of local providers Historically housing providers felt unsupported to manage this complex client group and were “left holding the baby”. We are the constant. Wanted to offer something different that would enable housing providers to take a chance with our clients.

6. The First Phase.... Assessment. Completion of holistic assessment to identify need and explore where things gone wrong in the past. Psychologically informed via Clinical review & supervision. Community focus and pathways out of approved premises/ward environments. Within the MAPPA/CPA process.

7. ……Brokering Housing Team broker appropriate package based on recommendations and formulation. To work in collaboration with all relevant agencies around move on and with Care Coordinators in full holistic assessment. Housing Team to resettle clients into appropriate housing environments. To include single tenancy, hostel, supported housing. Housing worker will remain constant throughout the resettlement journey.

8. …….Consultation. Where supported accommodation has been agreed; over a 3 month period through active engagement with housing provider and referrer. Delivery via telephone contact, direct service visits with support staff. Work with service around “settling in” and application of housing recommendations. Also liaison between Care Coordinator and provider to share wider understanding of PD and how this impacts on housing.

9. However..... Where a client has been deemed best placed in a tenancy of their own, PDAS staff will stay involved and provide ongoing housing support, until the client is discharged from the MCN

10. The Challenges... Lack of housing stock Local cuts to SP funded services Access to appropriate funding for more intensive/specialist placements Services feeling unable to manage the risk Services feeling ill equipped to work with the complexities of PD Lack of ongoing communication/involvement between services

11. Case Study Lee is a man in his 40’s currently due for release for arson. Has been accepted for Care Coordination. Will be moving into Approved Premises accommodation upon release. This is second arson conviction so will be difficult to place.

12. At Assessment. Visit in HMP to conduct ax and begin to formulate working relationship. Identify need and work alongside MCN team to formulate a psychological understanding of his difficulties. (Issues related to abandonment led to fire). Complete report and feedback to Lee and wider care team including MAPPA. Agree a pathway based on identified support needs and support Lee to manage his expectations. (Move towards independent living vrs Supported).

13. At Brokering Meet regularly with Lee, Care Co and Approved Premises to facilitate move on. Liaise with Council and MAPPA about suitability for Council Tenancy – deemed inappropriate. Make referrals to appropriate agencies and support Lee to attend. Work alongside Housing Association to agree move to adapted property with sprinkler system. Identify long term floating support from CL. Support move on from Approved into own tenancy.

14. At Consultation Continue to support Lee during transitional period. If taken on by long term floating support, remain involved for 3 months prior to hand over. During this time arrange x3 support sessions for Lee and new support worker. If no other support identified, continue in role as accommodation support worker.

15. References. Department of Health, Recognising Complexity. Commissioning guidance for personality disorder services. 2009. Department of Health, Healthcare for Single Homeless People. 2010.