Stepping out into community living

A case study from Abri, in partnership with Southern Health NHS Foundation Trust and The Society of St James, supported by the Hampshire & Isle of Wight Integrated Care System.

With one in four people in the UK experiencing mental health problems each year and one in six experiencing a problem every week, mental health services are becoming increasingly stretched in an already strained NHS.

Part of the challenge is a lack of move-on accommodation and support for people in recovery or those learning to live with their conditions. This is a growing crisis for the NHS, increasing costs and staff pressure and resulting in substantial added housing need in local communities.

Southern Health NHS Foundation Trust (SHFT) reported that patients who would otherwise be able to return to the community were in fact unable to be discharged as there was not enough appropriately supported move-on accommodation. About 60 people from the area had to be housed in temporary accommodation in cities as far away as Manchester, Bradford and Liverpool, at an average cost of £600 per day.

In partnership with SHFT, Abri helped to address this issue, developing a ‘step-out’ pathway with 15 homes in Southampton. They encourage independence and help people in recovery by being close to community facilities, yet are distanced from known negative influences. These properties are granted through a lease agreement to The Society of St James, a local homelessness charity, who take on full housing management and landlord responsibilities. We have an excellent working relationship, established over many years of working closely together on other local initiatives and community projects.

Step-Out pathway participant Hayden and his support worker Elaine.

Step-Out pathway participant Hayden and his support worker Elaine.

An organisation called The Keep Well Collaborative was also instrumental in the conceptualisation, design and development of this step-out pathway. The group helps to build relationships between housing, health, social care, statutory and voluntary agencies. They tied this pathway into their wider commission by the Hampshire & Isle of Wight Integrated Care System to address health inequalities by focusing on the home.

The process has been very challenging, with people with long-term mental health issues moving from acute inpatient units and needing time and support to get used to their new way of living. There are now eight leases in place and the partnership hope to explore further opportunities to house those in need.

These longer-term, seven-year leases provide much needed time and space for residents. By removing the timeline and expectation to move out quickly, people on the pathway can focus on themselves. There have been no hospital readmissions and residents are establishing themselves within the local community. One person commented: “I have come on leaps and bounds from where I was a year ago and having my own flat has played a part in that. My flat feels secure and it’s nice to have my own home; it gives me a sense of wellbeing and being in control.”  

Avril Ansell, Abri’s Partnership Living Manager, said: “It’s been such a positive piece of partnership working and a clear fulfilment of our strategic aim around community, as we’re building on our relationships with both the NHS and a specialist housing management provider to help people to move on with their lives.

“Having a place to call home, establishing roots and finding opportunities for personal development can make a significant difference to peoples’ lives.”

Jon Pritchard, Associate Director of Housing & Community Inclusion at the SHFT added: “This collaboration provides an excellent discharge solution for people who, traditionally, haven’t had many or any accommodation options at the point of discharge.

“Using a consistent person-centred approach across all of our organisations we can ensure that the property is right for the individual who continue to receive intensive, time-limited support from the Southern Health Community Rehabilitation Team when they move into their new home, which transfers to the Community Mental Health Team over time. This structured support really helps to make the discharge sustainable."

Many housing associations are working in partnership with healthcare providers and we believe that every decision about care should be a decision about housing.

Who to speak to

Ewan Fulford