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Finding great housing for highly complex individuals

Sky News today has a headline story that “At least 40 people have died while admitted to ‘barbaric’ secure hospitals since 2015.”

ATU corridor
Assessment and treatment unit corridor.

The article describes the horror of some of these placements and the awful toll it can take on families.

It concludes with Ray James, NHS England’s National Director for Learning Disabilities, acknowledging the road ahead and highlighting the progress that has been made.

Dimensions is currently working well with the NHS to support one particularly complex individual out of hospital. It is an instructive story, still evolving, which we want to share as it may give other providers and CCGs ideas for working better together to find suitable, affordable housing and thus overcome one of the biggest hurdles to helping people leave ATUs:

When Dimensions received a referral to support an extremely complex young man, who had been in and out of ATUs and with multiple placement breakdowns, we turned to our new Housing Brokerage team to find him a place to live.

“William” was described as having severe challenging behaviour including a history of damaging property and physical abuse of others. He had been in many out-of-area placements. It was clear that living on his own in a modified home near his family was an essential start point for supporting William to begin to live an ordinary life, and move on from the past.

Beyond location, the list of requirements for the home was long. Every room would need two exits. Everything in the property would need to be safe or secured. And the house would need to be in a large, private plot of land due to the potential for William to make noise.

Dimensions housing broker Michael says, “Understandably given the failure of the ‘system’ to date, William’s loving family were anxious about all aspects of support for their son.

Our housing brokerage team spent a few days with William’s family, meeting the local estate agents together and exploring a wide range of property types. That time was invaluable; it gave us a real feel for William’s needs beyond what we could read in black and white. It helped us understand why William’s parents placed such great importance on seemingly small details. And for William’s family, we hope it built a level of trust that Dimensions has William’s best interests at heart – even when what we could offer fell short of what they wanted. Many conversations started with “I can’t do that. But let me tell you what I can do…”

William was funded by the CCG and Local Authority and, working together, we agreed that the NHS would pay for half the property purchase costs and the full adaptation cost of nearly £100k through a capital grant. Without this shared financial commitment, no support for William could possibly have got off the ground. Fortunately, the NHS was prepared to set these costs against the likely cost of continuing to support William in a variety of ATUs and through various crises. That made an important difference.

The next set of tricky negotiations surrounded housing benefit. Clearly William’s rent would be high but through building a strong, personal case for the local housing benefit team, we were able to agree a level of bespoke rent considerably in excess of local norms.

While many experts from Dimensions were involved in different aspects of all these negotiations, the Brokerage team provided the direction, the glue and the constant communication with all stakeholders to ensure that together, we were able to get the job done.

So much so in fact that the same Local Authority and CCG has already approached us again with “Jayne” who has an extremely similar back story and needs. We look forward to finding a similar solution for Jayne and supporting both to live ordinary, fulfilling, safe lives in their local communities – where they both belong.