Moving from traditional residential care to independent living can be daunting for someone with mental health issues who has known nothing else. But with the right planning, involvement and support it can be life-changing.
Ipswich Walk, a residential home for people with severe, long-term mental health issues, had operated for 25 years but no longer offered people modern accommodation. Some had lived there for 10 years or more. Most had never had their own place, a few had tried independent living but struggled to cope.
The building was getting run down and although the 16 clients had their own bedrooms, they had to share bathrooms, dining and sitting rooms.
The service provider Home Group, the UK’s largest care and support provider, worked with care commissioners to identify a suitable site for a purpose-built replacement providing 28 single-tenancy flats. They found one a few miles away in Smith’s Wood, at the heart of a newly regenerated area.
Everyone was involved in the project from the start. An award-winning architect talked to clients and their families, staff and managers about exactly what they wanted from the new building, named Aviary House. A 3D model meant they could see the design and layout for themselves at an early stage. Two flats were made fully wheelchair accessible although most tenants have only minor mobility issues.
Throughout the year-long build, clients and staff visited the site regularly to watch their new home take shape and get to know the area with visits to local shops and cafés.
Each client chose their own colour scheme, kitchen units and furniture. “They needed to feel it was very much their flat right from the start,” says registered and senior manager Vicky. “It was a massive change for people and that level of involvement eased the transition.”
At the same time the team worked closely with social services on finding new clients for Aviary House.
“They were keen to bring local people back from expensive, residential out-of-area placements, especially those who were getting high levels of support they did not necessarily need, as well as offering a real alternative to clients already living independently in the community but not coping,” explains Vicky. “Aviary House offers a middle ground that wasn’t available before for individuals who don’t need to be supervised all the time but might struggle to live entirely on their own.”
There is a 25-strong team of support workers and senior support coordinators, many of whom had worked together at Ipswich Walk. They can offer 24/7 on-site support so individual clients can be independent but know there’s always someone on hand if they get anxious at night, for instance, have a self-harming injury, or any problems with their flat.
All the existing clients moved together – which is what they and the staff wanted to make the change less unsettling.
With the new arrivals there is now much wider mix than at Ipswich Walk, with ages ranging from early 20s to late 70s. Everyone has adapted to the new model. “They were concerned about things like shopping and cooking for themselves, even with our support, but they have taken to it fantastically well and really take pride in their own environment and welcoming visitors,” says Vicky.
“Most never thought they would have this opportunity. It has boosted their confidence. People are developing not just independent living but IT and other skills. They’ve identified personal goals, like getting into work and college, volunteering and becoming more active.”
The clients themselves say: “We all now feel that we are living, not just existing. The staff team have worked really hard, helping us to regain the skills that we need for our new, more independent lives and to develop the skills and confidence needed to achieve our goals. We have hope for a better future and many of us now feel that we are active members of the local community.”
It helps that they have easy access to neighbourhood facilities like a library and gym. As well as organising activities within Aviary House, staff are helping to build relationships throughout the area, such as recruiting locally and involving teachers, parents and pupils from the primary school next door. In fact, it was a group of schoolchildren who came up with the name Aviary House. And the school and local businesses were among those invited to an open day to further cement good links.
“We want to be a resource for the community, to help people understand what Aviary House is about, and for clients to feel safe,” says Vicky.
The move has also meant changes for staff in their approach. “It’s now much less about doing things for clients and more about supporting them to do things themselves. We need to respect each person’s choices and rights – after all, it’s their home,” says Vicky. “The challenge is getting the right balance between those choices and our duty of care.”
The increased size and different nature both of the service and the team can throw up complex issues and generally makes the working environment faster paced and more unpredictable.
As with any big move, especially into a new building, there have been teething troubles. But now things are settling down the team can look ahead to making the most of the Aviary House model.
“It’s very flexible. Individual care packages can be adapted to give someone extra hours to cope with a crisis or fewer hours as they gain independence,” says Vicky.
Four of the flats have been allocated on a two-weekly basis to ‘step up, step down’ respite care in a pilot scheme to support people with mental health issues either on discharge from hospital if they’re not ready to go home or to avoid a hospital stay in the first place.
“These flats are nearly always full. We work closely with the home treatment team, which offers intensive short-term support to prevent hospital admissions and can refer individuals to us. Sometimes people just need a break from their responsibilities or would benefit from more company,” explains Vicky.
Secrets of our success
- Involve everyone right from the start
- Build on the familiar but work at new relationships
- Be prepared to respond to changing needs
- Respect individual choices
- Encourage personal goals