1.      Report Summary

Bristol Churches Housing Association (BCHA) provides and accommodation based floating service to people with mental ill health from B&OME communities at 7 Marlborough Lane, Bath.  A review of this service was carried out by Lesley Hutchinson on behalf of Bath and North East Somerset (B&NES) Supporting People Team in May 2005.

The review found that BCHA provide a good service and makes several recommendations for service improvements. The service is strategically relevant to the B&NES 5 Year Supporting People Programme though needs to ensure that a short term service is delivered and that service user move into independent living within a two year period. The service achieved a level B in 5 of the 6 core objectives of the QAF and was found to be value for money with regard to unit cost but not for cost per support hour. Service user reported they were pleased with the quality of the accommodation and service. BCHA are commended for the amount of preparation they put into organising the review and are particularly commended on their resource manual. 

2. Introduction to Agency

BCHA was established in 1976 and became part of the Places for People Group in 1999. The overarching vision for the Group and the HA is, ‘creating neighbourhoods of choice for all’ demonstrating the commitment to look at and support the needs of diverse communities.

BCHA is a large organisation that employs 90 staff. It directly manages 129 units of supported housing including homeless hostels; 305 units of sheltered housing and 124 units of floating support. It has 369 units managed by other agencies; 700 leasehold units and 1950 general need’s units. BCHAs services support approximately 558 service users at anyone time. They have Supporting People contracts with 5 Local Authorities including all of our cross authority partners and Wiltshire.

BCHA has maintained its autonomy though has benefited from sharing skills, information and learning from the specialist expertise from some of the other member of the Places for People Group, for example through close working with New Leaf they have developed service outcomes.

2.1 Brief History

Marlborough Lane is a large semi detached Victorian house. It is five minutes walk from Bath city centre and is a two minute walk from Victoria Park, its garden backs onto Charlotte Street car park and there are three car parking spaces at the back of the building.

The scheme has been in operation since 1994 and its primary purpose is to provide low level housing related support to people with mental ill health to support them to achieve and maintain independence. The scheme is specifically from black and minority ethnic communities and is the only service specifically for people from B&OME communities in Bath.

When the scheme first opened tenants were given assured tenancies, thus giving them long term security of tenure. However, since 2002 and the introduction of Supporting People the service aims and objectives have changed and the service now promotes recovery and independent living. Tenants are now offered assured shorthold tenancy agreements and are expected to move through the service and develop independence within two years. At the point of review 5 of the 6 service users had lived at the scheme for over 3 years and 1 person for over 11 years. The person that has lived at the scheme for over 11 years has an assured tenancy and considers this their home for life.

2.2 Monitoring Information

KPI 2: Percentage of service users who moved on in a planned way

The service has been operating at full availability and almost full utilisation from the onset of Supporting People programme to the commencement of the review. Staffing levels have been consistently high except for 2003 quarter 3 which was caused by a long-term staff illness and BCHA had to find appropriate cover for this period. Key performance indicator for service users who moved through the service for Quarter 1 and 2 of 2004 has not been provided, these are a requirement of the ODPM and need to be submitted.

2.3 Service Capacity and Funding

Bristol Churches Housing Association work 35 hours per week and all staff are based at the Head Office in Bristol and come to Bath to visit the service users of the scheme.

There is no reporting of any additional monies being paid to this service.

4. Legal / ODPM Guidance on group and type of service

In spring 2003, The Prime Minister and Deputy Prime Minister asked the Social Exclusion Unit to consider what more could be done to reduce exclusion among adults with mental health problems. The project focused on people of working age, and asked two questions:

• What more can be done to help adults with mental health problems to enter and retain work?
• How can adults with mental health problems secure the same opportunities for social participation and access to services as the general population?

The report sets out a 27 point action plan to bring together the work of Government departments and other organisations in a concerted effort to challenge attitudes, enable people to fulfil their aspirations, and significantly improve outcomes and opportunities for this excluded group. Action falls into six categories:

• Stigma and Discrimination – A sustained programme to try and challenge negative attitudes and promote awareness of peoples rights
• The role of Health and Social Care in tackling social exclusion – implementing evidence based practice in vocational services and enabling reintegration into the community.
• Employment – Giving people with mental health problems a real chance of sustained paid work reflecting their skills and experiences.
• Supporting Families and Community Participation – enabling people to lead fulfilling lives the way they choose.
• Getting the basics right – access to decent homes, financial advice and affordable transport.
• Making it Happen – Clear arrangements for leading this programme and maintaining momentum.

(Mental Health and Social Exclusion, SEU Report Summary, June 2004)

The review did not identify any further ODPM specific steers for this client group under Supporting People, so recommendations have been drawn from above in reference to the role of Health and Social Care, and Getting the Basics right.

There is no national steer on legacy high support services for people with mental ill health, yet in the main this group alongside learning disabilities represent much of the high cost individual long term expenditure for the Supporting People programme. Contracts can be renewed at the same level only when there is ample evidence they are high quality and represent value for money, though this must be within the overall limits imposed by the strategic direction for Supporting People that decides where housing related support fits as a funding stream and to what extent it will contribute.

6. Consultation

Staff at BCHA were interviewed as part of the review, this included interviews with the Supported Housing Manager, Hostels Manager, and one of the tenancy support officers.  2 of the 6 service users were interviewed (33%).

Key stakeholders interviewed including: Community Mental Health Team, Social Services Adult Duty Team and the Homeseekers Team at B&NES Council.

6.1 Consultation Findings

Service users at Marlborough Buildings

Both service users interviewed had lived at Marlborough Lane for over 3 years.

• One service user felt ready to move out and was waiting for a property to become available through the Housing Register. They had been on the waiting list since 1999 and were hoping for a one bedroom flat to become available through the ‘move on’ scheme. They had recently started to receive bulletins. They had always known that they would move out of Marlborough Lane when they were ready and felt they no longer needed support but would like some help when they move into their own place though thinks they will probably get this from friends rather than BCHA staff. 
• One service user liked their flat and did not want to move from it.
• Both service users see their support worker every 3 weeks, the meetings take place in their flats at Marlborough Lane. At these meetings they discuss maintenance and general housing issues eg, rent, housing benefit, letters from the LA etc and generally how they were feeling.
• One service user had recently carried out a Risk Assessment with their worker and stated they were now signing their Support Plans and notes on the support they receive after each session. They remember reviewing their support plan. Neither service user could produce their support plan though one stated they new exactly where it was.
• Both service users attended the house meetings which took place every 3 or 4 months and one felt these could be more frequent as there was no real socialising or interaction between people in the house unless at the meetings or if there was a complaint about noise.
• One service user wanted to be able to use the communal area and for this to have comfortable chairs and a TV in, though understood that there had been problems and this was why it was no longer used and only had one chair in.
• Both service users were supported by their worker initially when they met other support staff, eg, Psychiatrist and CPN but now this support was not needed and they went to the meetings on their own.
• Overall both service users felt the support service they received was good.
• Both service users said the house was stable and that only one person had moved out and a new person had moved in since they had lived there.

BCHA Staff

• Referrals come to the larger BCHA team meetings and are allocated to team members for follow up. Potential tenants are assessed when a vacancy becomes available.
• BCHA started using Support Plans soon after Supporting People came in however there has not been any training in this. Despite this service provision is much better and service users are getting used to ‘owning’ their own support plans. Reviews now take place and dates are set in advance.
• Work in partnership and attend CPA meetings, identified clear lines of responsibility at these meetings.
• Meetings with service users mainly take place in their own rooms at Marlborough Buildings.

Other Stakeholders

• CMHT refer to the service when there is a vacancy and identified a clear need for the service.

• CMHT worked in partnership with the service support workers when the need arose, often that was at the beginning of the service users tenancy.

• People are rarely housed through the housing register at the scheme as places rarely become available. One LA housing worker had not heard of the scheme before.

Homeseekers Team were aware of one person on the Assisted Move On scheme but  did not recall being contacted about this