1. Merton Step-Down Accommodation Review

2. Step Down Accommodation The short term treatment and recovery of patients who have passed through the acute phase of their inpatient treatment, but still require 24/7 health treatment/rehabilitation before moving to more independent accommodation.

3. MH Prevalence in Merton 24,996 - Common MH Disorders 621 – Psychotic Disorders 208 – Working age adult admissions 2014.15 37 – admissions to Norfolk Lodge 2014.15

4. Bed Occupancy

5. Norfolk Lodge 11 beds Commissioned by MCCG Provided by SWLSTG Building rented from private landlord Male only as does not meet NHS gender segregation criteria e.g shared bathrooms. Dated environment in need of major refurbishment Leased from 2010-2020 with 1 break clause in 2015.

6. Recent Reviews ‘The spectrum of accommodation in Merton, from high to low dependent and independent accommodation for people with mental health needs should be reviewed, in order to establish current needs, to enable forward planning for the future provision of housing and support options for people with mental health needs’. Adult Mental Health Needs Assessment 2013-14, Public Health Merton ‘Partners in Merton need to prepare and examine business cases…for a replacement service for Norfolk Lodge. It would need to provide short-term step down support from Hospital as described in Annex 4. It needs to cater for male and female residents and it needs to have capacity for 5 or 6 people’. Merton Mental Health Housing Support and Accommodation Review (draft) 2015, London Borough of Merton

7. Where are we now? There is an ongoing need for step-down accommodation – funding protected. MCCG and SWLSTG have concluded that there is a likelihood of better accommodation than Norfolk Lodge – lease will not be extended beyond September’15. MCCG and SWLSTG want to develop innovative partnerships with Housing providers to extend/improve model. Need for interim arrangements beyond Sept’15.

8. Future Specification? 24/7 step/down provision in high quality accommodation. An increased emphasis of outreaching into community (employment, shopping, structured activities, accommodation) to support service users to make the next step in their recovery. An increased emphasis on peer support and drop-in functions. A clinical in reach service provided by SWLSTG. Overall pathway management operated by SWLSTG.

9. Interim Arrangements Opportunity top test market – single or multiple providers Negotiations taking place with existing providers in Merton and local environs to provide interim service. Block contract and/or spot purchase

10. Service User & Carer Involvement Opportunity to import innovation and best practice into Merton Apr-June – workshop/presentations June – Working Group set up – specification of new service, evaluation criteria July – Market warming event for potential providers Healthwatch event – wider involvement of stakeholders Oct – interviews of potential providers.