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Annex B |
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Executive
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27 August 2020 |
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Report of the Corporate Director of Health, Housing & Adult Social Care |
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Mental Health Housing and Support |
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Summary
1. This report is the culmination of over two and a half years of detailed needs analysis, partnership engagement and strategic design. It outlines a vision for the development of an improved mental health housing and support pathway in York and includes specific proposals that will address a long-standing gap in provision within the city - for the development of specialist mental health housing and support for people with multiple and complex needs.
2. These proposals have been developed in response to priorities identified in a number of key strategies including York’s Joint Health and Wellbeing Strategy 2017-2022, the All Age Mental Health Strategy for York 2018-2023, and the York Homelessness Strategy 2018-2023. All three strategies identify the development of improved mental health housing and support options as a priority for the city.
3. The proposals are also in line with the city’s stated commitment to a ‘whole person, whole life, whole system’ approach which will see us applying the lessons from Trieste (in Italy) in York by taking a more community based approach to mental health and wellbeing. Safe, secure and appropriate housing, with the right support, is an integral part of this approach, ensuring that people can access the support and stability that they need in the community, rather than in institutions.
4. Background papers tracing the journey to this report are available from the author - see list at the end of the report.
5. These proposals focus on the development of 53 specialist mental health housing and support places through:
· Two new specialist mental health supported housing schemes - to be developed on two sites currently owned by the Council at Woolnough House, off Hull Road, and Crombie House on Danebury Drive in Acomb. Each scheme will have 24/7 on-site staffing and will contain 10 places, as well as providing support to another 6 satellite flats within a 1-2 mile radius of the scheme. There will be 32 specialist mental health supported housing places in total.
· The development of 21 Housing First places. Housing First is an internationally recognised and evidence-based model of housing and support for those with chronic housing, health and social care needs. With Housing First the idea is that people are provided with permanent housing with no requirement to prove that they are ‘housing ready’ and then personalised, intensive ‘wrap around’ support is provided to help them develop and retain their independence, and maintain a tenancy.
6. There are challenges within the current system which can only be addressed by a ‘whole system’ response involving health, housing, social care, the voluntary and community sector, landlords, the people who receive services and support, carers, and communities.
7. The report is co-signed by commissioning colleagues from City of York Council, Tees, Esk and Wear Valleys NHS Foundation Trust, and the NHS Vale of York Clinical Commissioning Group. Our collective vision is to develop a range of housing and support options that will ensure people with mental ill health can access the right type of housing, with the right level of support, at the right time to meet their needs, regardless of diagnosis.
8. Voluntary and community sector partners were involved in all stages of the development of the proposals – at the original stakeholder workshop; in the working groups; in the mock referral/allocation exercise; and in the stakeholder feedback sessions.
Recommendations
9. The Executive is asked to:
a) Approve City of York Council and NHS Vale of York CCG entering into an agreement and jointly commissioning new specialist mental health housing and support provision in the shape of:
· Two specialist mental health supported housing schemes that will support 32 places between them (10 places + 6 satellite flats supported from each site)
· 21 Housing First places – people in their own properties supported by 3 Housing First workers (7 cases each)
and to delegate to the Director of Health, Housing & Adult Social Care and the Portfolio Holders for Health & Adult Social Care and Housing and Safer Neighbourhoods (in consultation with the Director of Governance or her delegated officers and the S151 Officer) the authority to take such steps as are necessary to enter into the resulting agreement.
b) Note that a formal soft-market testing exercise will be undertaken to identify the level of interest from both Registered Social Landlords (to develop the sites) and external partners (to deliver the support) to define the most appropriate structure for the resulting procurement process(es) to select the partners we will work with.
c) Approve the procurement of a Registered Social Landlord (RSL) to develop the sites and an external partner to provide the specialist mental health support services and to delegate to the Director of Health, Housing & Adult Social Care and the Portfolio Holders for Health & Adult Social Care and Housing and Safer Neighbourhoods (in consultation with the Director of Governance or her delegated officers and the S151 Officer) the authority to take such steps as are necessary to procure, award and enter into the resulting contracts.
d) Approve the council owned sites at Woolnough House and Crombie House being sold to the successful Registered Social Landlord (RSL) bidder as part of the procurement process, to be developed out as specialist mental health supported housing schemes.
e) Approve the relocation of the supported housing provision at the Council-managed 22 The Avenue in Clifton to the new provision and the marketing for sale and subsequent disposal of that site following the development of the two specialist mental health supported housing schemes.
f) Approve that, once 22 The Avenue is vacated, it be sold and that authority to proceed and complete the sale be delegated to the Director of Economy and Place in consultation with the Portfolio Holder for Finance and Performance (in consultation with the Director of Governance or her delegated officers and the S151 Officer).
Reason: To enable the city to develop specialist mental health housing and support that will address a significant gap in existing provision for people with multiple and complex needs, and to realise capital receipts for three sites currently owned by City of York Council – at Woolnough House, Crombie House and 22 The Avenue.
Background
Challenges in the current mental health housing and support pathway
10. A report to the Health and Wellbeing Board (24 January 2018) set out in some detail the challenges currently facing the mental health housing and support pathway. At present in York we are not always able to provide the right housing, with the right support, at the right time, as we do not have the full range of housing and support options that we need. The biggest gap in our current provision is for people with multiple and complex needs.
11. At present we struggle to find suitable placements for people who are chronically homeless or vulnerably housed (e.g. at risk of eviction or placement breakdown, sofa surfing) and have mental, psychological or emotional health needs, but who may also have some of the following:
· Drug and/or alcohol dependency
· Contact with the criminal justice system
· Physical health needs
· Experience of domestic violence and abuse
· No (recent) experience of settled independent accommodation
· No (recent) experience of having structure in day to day life
· Lack of positive relationships and a support structure.
12. As a result, people sometimes stay longer in hospital than they need to, or are housed in accommodation that doesn’t properly meet their needs, or are placed in accommodation outside of York (at significant expense), away from family and friends and their support networks.
13. The proposed specialist mental health housing and support provision will work with people with the type of needs described in paragraph 11 above. The emphasis will be on looking for ways to manage risk and accept customers rather than to exclude them.
The work that has been undertaken to inform our final proposals
14. Between September 2017 and June 2018 significant work was undertaken to research and develop these proposals. This work is summarised in a table at Paragraph 17 below, and included two multi-agency working groups – one to research and develop a supported housing model, and one to research and develop a Housing First model.
15. In July 2018 the core project team held two stakeholder sessions at the Quaker Meeting House – to update a wider audience on the work that the core project team and working groups had delivered since January of that year, and for stakeholders to comment on draft proposals that have since been refined and are included in this report.
16. The two sessions were attended by a total of 47 people and their detailed feedback informed a comprehensive 30 page report. In summary the feedback:
a) Endorsed the proposed mental health housing and support pathway
b) Endorsed the accompanying underpinning principles
c) Suggested a number of areas requiring further work and detail which will be incorporated into the implementation plan
d) Asked that the detail behind these proposals be developed in partnership with people who use services, carers, staff, and all partner agencies, through a co-production approach.
Consultation
17. The table below summarises the stakeholder consultation and engagement:
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Date |
Consultation/Engagement |
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29 Sep 2017 |
Initial stakeholder workshop at Priory Street Centre attended by 70+ delegates. Executive summary of full workshop report available at Annex 2 to Health & Wellbeing Board report (24 Jan 2018) |
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28 Nov 2017 |
VCS Forum for Mental Health |
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Jan-Apr 2018 |
Supported Housing working group |
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Housing First working group |
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29 Mar 2018 |
Tees, Esk & Wears Valley NHS Foundation Trust (TEWV) Service User Network |
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11 Apr 2018 |
York Mental Health Carers Group |
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Apr/May 2018 |
Mock allocation panels (x3) – specialist mental health housing and support |
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5 Jul 2018 |
TEWV Local Transformation Board |
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12/19 Jul 2018 |
Two stakeholder sessions held at Quaker Meeting House to share, and invite feedback on, draft proposals |
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7 Nov 2018 |
York Place Based Improvement Partnership. The YPBIP is made up of the Chief Executives from across the whole health and social care system (i.e. CCG, CYC, Hospital Trust, Police, TEWV, York CVS). System leaders at the YPBIP confirmed their support for the project and their commitment to delivering it. |
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Jan-Nov 2019 |
Ongoing discussions between the three key partners (CYC, TEWV, VoY CCG) around how the revenue element of the proposals (the support) would be funded. |
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Sep 2019- Mar 2020
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A sub-group of CYC (Adult Social Care, Housing, Property) and NHS Property colleagues undertook a comprehensive analysis of potential sites for the two supported housing schemes against the key location criteria identified by stakeholders in the working group phase of the project. A short-list of options was discussed at the CYC Housing Delivery Board on 7 Jan and, on 12 Mar, the same group approved the use of the Woolnough House and Crombie House sites for the proposed supported housing schemes, and agreed to release the site at 22 The Avenue for a capital receipt.
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Options / Analysis
18. This section outlines the specific proposals for the development of 53 specialist mental health housing and support places for people with multiple and complex needs (32 specialist supported housing places and 21 Housing First places). See Annex 1 for a breakdown of the current and proposed places across the whole mental health housing and support pathway. Overall, once proposals across the whole pathway are fully implemented, the number of mental health housing placements in the city will have increased from 47 places to 98 places.
Specialist supported housing
19. It is proposed that two supported housing schemes (with 24/7 on-site staffing) be developed within the city, each containing 10 places, and each providing support to another 6 satellite flats within a 1-2 mile radius of the project. This represents a total of 32 specialist mental health supported housing places.
20. The project team undertook a comprehensive analysis of potential sites for the two supported housing schemes with NHS Property and CYC Housing/Property colleagues and, after discussion at the Council’s Housing Delivery Board, it was agreed that the two sites should be at Woolnough House and Crombie House.
21. Woolnough House is the site of an ex-council residential care home which has been demolished, off Hull Road. Crombie House, on Danebury Drive in Acomb, currently provides emergency temporary accommodation for homeless families which is being re-located to the new provision at James House. The recommendation is to sell the two sites to a Registered Social Landlord (RSL) to develop the sites and build the two specialist mental health supported housing schemes.
22. These locations ensure there will be specialist mental health supported housing provision in both the East and West of the city and, crucially, both sites are integrated within communities, close to local amenities and good transport links. These were the key site location criteria previously identified by stakeholders.
23. The proposal is that the assessment, short-break, and short-term supported housing places currently provided by City of York Council at 22 The Avenue in Clifton would be re-provided within the new supported housing provision at the two new sites.
24. The Project Board recommends that we seek an external partner to provide the proposed specialist mental health support, in preference to it being provided by City of York Council or the NHS. It believes the current Council-run service would struggle to adopt the level of flexibility required in order to be able to accommodate and support the needs of clients as described in paragraph 11 above.
25. Our research confirmed that there are organisations with far greater experience of delivering this type of housing and support to people with multiple and complex needs than the Council or NHS. When members of the project team visited one such provider in Leeds they were very impressed with what they saw and heard. Bringing in a new external partner will also help establish this as a new and different way of working.
26. We have carried out informal soft market-testing which has indicated that there are both housing providers and support providers in the marketplace who would welcome the opportunity to deliver this specialist mental health housing and support provision in York.
27. Our plan would be to carry out a formal soft market-testing exercise before deciding on a procurement or partnership route.
Housing First
28. Housing First is an internationally recognised and evidence-based model of housing and support for those with chronic housing, health and social care needs.
29. With Housing First people are provided with permanent housing with no requirement to prove that they are ‘housing ready’ and then personalised, intensive ‘wrap around’ support is provided to help them develop and retain their independence, and maintain a tenancy.
30. Our proposal is that the external partner would employ three Housing First support workers each of whom would eventually build up to a caseload of seven cases – resulting in a total of 21 Housing First places. The caseloads will be kept small to reflect the intensity and flexibility of the support needed by the individuals who will receive this service, and who typically will have lived a very chaotic lifestyle and not routinely have engaged with statutory services.
31. These Housing First support workers would call on, and help co-ordinate, specialist input and support from a range of other services.
Specialist input and support from other services
32. The working groups which developed the proposed models for supported housing and Housing First were very clear that being able to access specialist input and support from other services would be vital and integral to the success of any specialist mental health housing and support for people with multiple and complex needs. Feedback from the two stakeholder sessions in July 2018 strongly supported this position.
33. There was widespread agreement that formal agreements need to be put in place between all core and key services and the specialist mental health housing and support provision, and the rest of the mental health housing and support pathway. This will help ensure that dedicated/protected resource is in place and that all partner agencies’ inputand support is timely and appropriate.
34. All partners need to have a shared understanding of each other’s roles and responsibilities in supporting this provision and the individuals receiving housing and support within it.
35. The diagram below shows the core and key services that will need to be involved in providing additional and specialist support to both the individuals within, and the staff providing, the specialist mental health housing and support provision.
36. To recognise the importance of adopting a ‘whole system’ approach and the desire to achieve a cultural shift that will help ensure more effective joint working and collaboration between agencies, a series of principles have been agreed within the project and will underpin the development and implementation of the improved mental health housing and support pathway. These principles are referenced in the background papers.
37. It is important to recognise that good progress has already been made in terms of better joint working with Mental Health (Health and Adult Social Care) and Housing colleagues meeting monthly, since late 2018, to discuss their most challenging cases around mental health housing and support. These meetings have helped foster improved working relationships and a much better understanding of each other’s processes and pressures.
High level implementation plan and timeline
38. An approximate timeline for implementation is set out below:
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Timeline |
Headline Tasks |
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Sep 2020–Apr 2021 |
Finding and selecting partners · Soft-market testing · Procurement exercise · Select housing and support partners
Gradual expansion of existing Housing First offer · Very gradual implementation of extra Housing First places supported by additional funding to existing Making Every Adult Matter (MEAM) programme
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May 2021– Spring 2022 |
2 x supported housing schemes · Finalise designs · Planning applications · Construction begins on both sites
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Spring 2022– Apr 2023 |
· Site development ongoing
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May 2023 |
· New support provider starts its contract · Supported housing schemes open at Woolnough House and Crombie House · Service at 22 The Avenue closes
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The rest of the mental health housing and support pathway
39. As outlined in the opening section of this report, the overall vision for this project is the development of an improved mental health housing and support pathway that can meet the needs of people with low level mental health support needs right through to the needs of people with multiple and complex needs.
40. This report has focused on how we can close the biggest gap that exists within the city which is the provision of specialist mental health housing and support for people with multiple and complex needs. We recognise, however, that work is also needed to strengthen and improve other elements of the mental health housing and support pathway. The Project Board will also seek to progress this work in partnership with colleagues from across a whole range of partner agencies via, for example, the work of the York Mental Health Partnership, the Multiple Complex Needs Network, the Northern Quarter Project: Mental Health and Wellbeing, and existing contracts/arrangements.
41. This work will include consideration of:
· Short-term supported housing (visiting support)
· Floating support
· Intensive Housing Management support
· Direct Payments/Personal Health Budgets
· Developing a ‘Shared Lives’ model for mental health where people can receive short-term breaks and/or short-term support in a family setting
· Exploring the possibility of self-contained tenancies for U/60s in independent living schemes
· Improved building design within social housing schemes
· Support for people once they have moved on into general needs housing
· Mental health support to homeless hostels
· Private sector provision
Council Plan
42. Of the eight core outcomes outlined in the Council Plan 2019-2023, three are particularly relevant in relation to the development of an improved mental health housing and support pathway. Relevant extracts from the Council Plan are shown below:
a) Good health and wellbeing
We know that 80% of a person’s health is determined by wider factors rather than by health or care services (e.g. housing). However, there are communities within our city whose health and wellbeing outcomes fall short of those enjoyed by the majority and we work hard to reduce those inequalities.
b) Safe communities and culture for all
It is vital that we continue to work with others to nurture inclusive communities, particularly for those that can feel isolated and vulnerable, in order to better connect them to others and the activities York has to offer. This will also have a positive effect in reducing crime and provide a safety net to protect those at risk of harm.
c) Creating homes and world-class infrastructure
Prioritise support for rough sleepers and work in partnership with the police and other agencies to develop new initiatives such as the ‘Housing Navigators’ and improved services for people with complex needs, such as substance abuse and mental health issues, including extended use of the Housing First approach.
CYC Recovery and Renewal Strategy – Covid-19 Response
43. It is widely acknowledged that the Covid-19 pandemic, and the economic challenges it has triggered, is likely to have a long-term negative impact on the mental health and wellbeing of many across the city. People with multiple and complex needs who were struggling before Covid-19 will be facing even greater challenges now and in the coming years. The early but gradual introduction of extra Housing First places will help ensure there is greater support available for some of the most vulnerable people in the near future, albeit in very small numbers, and the full development of the specialist provision by May 2023 will mean the city will have significantly greater capacity to support people with multiple and complex needs, the numbers of which can be expected to grow in the coming years.
Health and Wellbeing Board
44. At its meeting on 4th March 2020 the Health and Wellbeing Board re-focused its priorities at the half-way point in the life of its 2017-2022 strategy. Relevant extracts from the report are shown below and help illustrate the clear link between the proposals contained within this report and the city’s vision for providing improved mental health housing and support options that are embedded in communities that will welcome and support them, including provision for people with multiple and complex needs.
Mental Health
“The board will promote awareness and understanding of the protective factors that support good mental wellbeing and ensure that compassionate, strength-based approaches in communities are developed.”
The Mental Health Partnership is well established now and is in a good place to take on this re-focused health priority. They have identified four key priorities:
· A community approach to mental health and wellbeing
· Mental health housing and support
· Multiple and complex needs
· Self-harm
Implications
Financial
45. The table below shows the ongoing financial position once the specialist mental health housing and support provision is fully implemented. There will be a gradual introduction of Housing First placements starting in 2020/21 but the full costings shown below will not apply until Spring 2023 when the two new supported housing schemes are due to open.
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Fully implemented model costs and funding |
£000 |
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Estimated total cost of service |
1,321 |
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Total funding |
1,321 |
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Council base budget (22 The Avenue’s budget) |
423 |
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Reduction in residential and community spend |
186 |
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Increased Intensive Housing Mgmt income |
212 |
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NHS Vale of York CCG commitment |
500 |
46. The CCG contract with TEWV is due to expire in 2024. Neither the CCG nor TEWV can pre-empt the legal procurement process for the contract to be awarded for the subsequent period but it is the settled intention of the CCG that this model of care will - having demonstrated its efficiency and effectiveness by that date - be intrinsic to our care pathways. It therefore will continue to be a feature of the services and outcomes specified in the new contract to be let from 2024.
47. Overall the projected costs of the programme and delivering the services will be met from:
· £423K - is the current revenue funding available from the existing service at 22 The Avenue and is the budget released by re-providing the existing 22 The Avenue service.
· £186K – this will be from savings realised within Adult Social Care Mental Health budgets due to CYC social workers reducing the numbers of individuals placed in long term care settings (residential) and the numbers accessing intensive community support options.
· £212K – increased income that will go to the support provider to offset the overall costs. This income will come through accessing increased housing benefit entitlements through the use of Intensive Housing Management (IHM). Intensive Housing Management is a term used to describe the services provided by a supported housing landlord, differentiating it from a general needs landlord. The services are provided to ensure the ongoing viability of the tenancy with respect to the needs of the tenant.
· £500K – this is the contribution from the Vale of York CCG via TEWV that will be achieved by health partners through a reduction in the number of out-of-area placements made. The funding will be ring-fenced for the programme and delivery of the new model and pathway and secured formally with health partners.
48. The revenue modelling has been based on an assumption of staff being transferred to one of the schemes under current terms and conditions and uses the current market rate for mental health supported housing to forecast the cost of the second scheme.
49. The capital implications have also been considered. The recommendation is to sell the council land to a Registered Social Landlord (RSL) to develop the sites and build two specialist mental health supported housing schemes. Soft market testing has shown there would be keen interest in developing such sites whilst generating the expected capital receipts for Woolnough House and Crombie House.
50. When selling the sites to a RSL (as part of a procurement process), the council’s contract with the RSL will stipulate that the sites can only be used for the purpose of providing specialist mental health supported housing (for as long as CYC requires it). The support element of the specialist mental health housing and support provision will be re-tenderedat timely intervals (e.g. every 5+2 years) to help ensure continued quality provision.
51. The recommendation would also mean that a capital receipt could be realised from the sale of 22 The Avenue. Provision has been made in the revenue model for upkeep of 22 The Avenue until the new schemes are operational and holding costs (e.g. security) of the building until its sale.
Human Resources (HR)
52. Any council staff that may be impacted by this proposal and their Trade Union representatives have been informed about the content of this report and will continue to be kept informed and consulted as appropriate as the proposals are developed.
53. Any change to provision of services will be managed in accordance with the Council’s Supporting Transformation (Managing Change) policies and appropriate employment legislation.
One Planet Council / Equalities
54. Ensuring that people experiencing mental ill-health are able to access appropriate housing and support is a significant equalities issue. The project team recognise that further work is required to ensure that people experiencing mental ill-health have the right support and pathways in place to enable them to access, and meet, this basic human need. A full analysis of the project’s impact upon the One Planet Principles and Equalities & Human Rights has been undertaken using the Better Decision Making Tool - see Annex 2.
55. Completing the Better Decision Making Tool has served to highlight/reinforce a few key areas where we will need to do focussed work within the project implementation phase, including the need to:
a) Ensure that the voice of people with lived experience is influential within the specification of the specialist housing and support that is required, and within the process for selecting the housing and support providers who will deliver the provision.
b) Invest time and energy, alongside the housing and support providers and other partner agencies, in supporting the development of positive links between the two supported housing schemes and the communities within which they will be located. Our aim will be to encourage mutual understanding and support that will help foster positive community relations.
c) Work closely with Housing and Procurement colleagues during project implentation to ensure that the two new supported housing schemes are designed and built in a way that is as positive as possible in terms of environmental and sustainability considerations.
d) Link up with other key related projects/developments - e.g. the Multiple Complex Needs Network, and the Northern Quarter Project: Mental Health and Wellbeing - to ensure that we maximise all opportunities to connect individuals, organisations and communities as part of a strengths-based approach that builds on 'what's strong rather than what's wrong.'
e) Link in with the Pathway team to ensure that, if it is appropriate and possible, young people aged 16-18 who have mental health and other needs which cannot always be met in existing young people’s supported accommodation, can be considered for this specialist housing and support provision, with appropriate packages of support.
Legal
56. Section 117 of the Mental Health Act describes the duty to provide aftercare services in some circumstances following hospital admission. Section 75(5) of the Care Act 2014 defines “after care services” as services which (i) meet a need arising from or related to the person’s mental disorder; and (ii) reduce the risk of a deterioration of the person’s mental condition (and, accordingly, reducing the risk of the person requiring admission to a hospital again for treatment for the disorder). Establishing a supported housing pathway would help to meet the Section 117 duty, prevent re-admission and support long term recovery. The Children Act 1989 and associated legislation places ‘pathway’ duties on local authorities to support young care leavers into independence, which includes support with accommodation needs.
57. The Housing Act 1996 provides instances where the local authority has a duty to provide accommodation to homeless persons, including some instances where an individual is considered to be in “priority need”. Priority need includes several categories of individual, including persons who are vulnerable as a result of mental illness. Without appropriate accommodation for people with complex needs there is a risk that this duty may not be met.
58. There are a number of ways in which the Council and the CCG could work together to procure the required services, from a formal partnership through to an agreement in accordance with section 75 of the National Health Services Act 2006. Each route has different risks and advantages and work will need to be undertaken with the support of Legal Services to ascertain the most appropriate route.
59. The proposals to obtain a Registered Social Landlord (to develop the sites) and an external partner (to deliver the support) are both governed by the Contract Procedure Rules and the Public Contracts Regulations 2015 and will require compliant procurement processes to be carried out. The proposal to carry out formal market testing in order to ascertain the view of the market in relation to the proposals will assist in further defining the structure of the resulting procurement processes.
60. As one of the three sites is part of the Housing Revenue Account (HRA) portfolio, consent from the Secretary of State for Housing, Communities and Local Government for their disposal may need to be obtained under Section 32 of the Housing Act 1985. Pursuant to the General Housing Consents Order 2013, the Secretary of State has given consent to disposals by local authorities of housing/HRA land in the circumstances specified in the Order, which includes disposal of land for its market value. However, if the disposal price/capital receipt being obtained is less than best consideration reasonably obtainable for the site in question, this would fall outside the Order and specific express written consent from the Secretary of State would need to be applied for and obtained before any contract for sale or sale/transfer deed is entered into.
Crime and Disorder
61. The provision of appropriate housing and support, able to meet the needs of people with multiple and complex needs, would help provide the stability required for them to develop their recovery and independent living skills. This is likely to reduce the impact on the crime and disorder of a small number of individuals whose anti-social behaviour can sometimes have a significant impact on neighbours and communities.
Information Technology (IT)
62. There are no identified implications at this stage.
Property
63. Mental health housing and support is currently provided in a range of settings including 22 The Avenue, which is a Council managed service.
64. The two buildings at 22 The Avenue are old and no longer fit for purpose. The house at 22 The Avenue was closed in late 2019 and the housing provided there is now provided at a recently refurbished 5 bed property in Clifton (a 15 minute walk away), with outreach support being provided to residents by staff from 22 the Avenue.
65. Our vision is that, when the new specialist mental health supported housing schemes open, the 5 bed property in Clifton will still remain in the mental health housing and support pathway, most likely as short-term supported housing with visiting support provided by a VCS or Housing Association partner.
66. Whilst the house at 22 The Avenue has been closed, the Annex building at 22 The Avenue remains operational. CYC Property Services has undertaken a full condition survey of the building and developed a three year programme of works to keep the building fit for operational use until such time as the two new supported housing schemes are ready. This building maintenance work is being funded from the £131k budget agreed by Full Council in July 2019 to help pump-prime this project.
67. The eventual closure of the service at 22 The Avenue will mean that the site can be released for a capital receipt.
68. Two existing council sites have been identified as the proposed locations for the two specialist mental health supported housing schemes. Woolnough House is the site of an ex-council residential care home which has been demolished, off Hull Road. Crombie House, on Danebury Drive in Acomb, currently provides temporary accommodation for homeless families which is being re-located to new provision at James House.
69. The Executive approved the scope of the Council’s Housing Delivery Programme on 12 July 2018. Seven sites were named and one of these was Woolnough House. Approving this proposal, to develop a specialist mental health supported housing scheme at Woolnough House, will mean removing it from the scope of the Housing Delivery Programme. This proposal has been discussed at the Housing Delivery Board and is supported by that Board. It is not felt that its removal will negatively impact on the ability of the Housing Delivery Programme to meet its objectives.
70. As noted above in the Financial Implications section, the recommendation is to sell the above two council sites to a Registered Social Landlord (RSL) to develop the sites and build two specialist mental health supported housing schemes. Soft market testing has shown there would be keen interest in developing such sites whilst generating the expected capital receipts for Woolnough House and Crombie House.
71. The council’s contract with the RSL will stipulate that the sites can only be used for the purpose of providing specialist mental health supported housing.
Other – TEWV’s strategic approach
72. TEWV NHS Trust is moving from a traditional reliance on bed based services to enhance recovery focussed community provision that reflects the ‘whole person, whole life, whole system’ principles. This paradigm shift has led to:
· Dedicated capacity to proactively manage complex mental health placements which may be managed out of the York locality
· Enhancement of community teams to enable more proactive care in the area
· Piloting of new ways of working to maximise the delivery of evidence based rehabilitation care models
· Working closely with service users and carers to better understand their experiences and to inform the delivery of recovery focussed care.
Risk Management
73. There are a range of risks attached to doing nothing to address the challenges highlighted in this report. We are currently struggling to provide people with mental ill health, and especially those with multiple and complex needs, the right type of housing, with the right level of support, at the right time. This is due to a number of factors including:
· The lack of a range of options to meet the range of needs
· System pressures
· Increasing demand
· Fragmented services
· Ageing buildings
74. A high-level risk register has been developed and this will be developed in greater detail to ensure that the key risks to the project are identified and managed so as to eliminate or minimise their potential impact.
75. There is a financial risk that would arise if the way customers are currently supported were not changed to reflect these services being in place. The revenue model is dependent on savings being realised in existing budgets to fund this programme.
76. There is also a financial risk that our partners’ financial position might change and the funding earmarked to support this project is diverted elsewhere.
77. To mitigate the risk of the chosen Registered Social Landlord (RSL) deciding at a later date that it no longer wishes to provide the two supported housing schemes, the council’s contract with the RSL will stipulate that the sites can only be used for the purpose of providing specialist mental health supported housing. The procurement process will factor in the ability to re-tender the support element of the contracts at timely intervals (e.g. every 5+2 years) to help ensure continued quality provision.
Authors: Chief Officer Responsible for Report:
Gary Brittain Sharon Houlden
Head of Commissioning Corporate Director of Health, Housing
Adult Social Care, CYC and Adult Social Care
Tel No. 01904 554099
Chris Weeks Report Approved: ü Date: 11/08/20
Commissioning Manager
Adult Social Care, CYC
Tel No. 01904 554066
Kate Grandfield
Housing Management Service Manager, CYC
Tel No. 01904 554067
Sheila Fletcher
Commissioning Specialist, Mental Health & Vulnerable Adults
NHS Vale of York CCG
Tel No. 01904 553298
Teri Sanders
Adult Locality Manager, York and Selby
Tees, Esk and Wear Valleys NHS Foundation Trust
Tel No. 01904 556770
Specialist Implications Officers
Financial
Steve Tait
Principal Accountant, Customer & Corporate Services (ASC Finance)
Tel: 01904 554065
Human Resources
Kay Crabtree
HR Manager (Performance and Change)
Tel: 01904 554218
Legal
Cathryn Moore
Legal Manager (Projects & Governance) and Deputy Monitoring Officer
Tel: 01904 552487
Property
Nick Collins
Head of Commercial & Operational Asset Management
Tel: 01904 552167
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Wards Affected: |
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For further information please contact the authors of the report. |
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Annexes
· Annex 1 – Overview of current places vs. proposed places in the mental health housing and support pathway
· Annex 2 – Better Decision Making Tool (can be viewed with agenda for Executive meeting on 27 August)
Background Papers:
· York’s Joint Health and Wellbeing Strategy 2017-2022
· All Age Mental Health Strategy for York 2018-2023
· York Homelessness Strategy 2018-2023
· Workshop Report: Mental Health Housing and Support Workshop held at Priory Street Centre on 29 Sept 2017
· Mental health housing and support report to Health and Wellbeing Board – 24 January 2018
· Guidance for services on ‘Delivering high fidelity Housing First’ – Homeless Link, 2019
· Principles underpinning the development and implementation of an improved mental health housing and support pathway in York
· Stakeholder Sessions Report: Report on feedback from two stakeholder sessions held on 12th and 19th July 2018 at the Quaker Meeting House
· ‘More Than Shelter’ – Centre for Mental Health report, June 2016
List of Abbreviations Used in this Report
CYC City of York Council
HRA Housing Revenue Account
IHM Intensive Housing Management
MEAM Making Every Adult Matter
NHS National Health Service
RSL Registered Social Landlord
TEWV Tees, Esk and Wear Valleys NHS Foundation Trust
VCS Voluntary and Community Sector
VoY CCG Vale of York Clinical Commissioning Group
York CVS York Centre for Voluntary Service
YPBIP York Place Based Improvement Partnership