Agenda item

This report seeks approval for a change in delivery methodology to enable people with complex mental health needs, including those with associated substance use disorder and behavioural difficulties, to access the right type of housing, with the right level of support, at the right time to meet their needs.

Resolved:

                      i.         To adopt a phased approach of delivery for the wider

programme which significantly includes a 7-unit pilot at 92 Holgate Road for 12-months;

                    ii.         To enter a service contract with mental health support services provider (the “Provider”) for a Term of 12-months for provision by the Provider from 92 Holgate Road of a 7-unit mental health support service (the “Service Contract”);

                   iii.         To grant a lease of 92 Holgate Road to the Provider for a Term of 12-months (the “Lease”)

                  iv.         To amend the existing Section 75 Agreement with the ICB to address changes to the long-term intentions of the Mental Health Housing and Support project and the funding requirements for the 12-month pilot at 92 Holgate Road;

                    v.         To delegate authority to the Corporate Director of Adult; Services and Integration (“DASS”) (and their delegated officers), in consultation with the Director of Governance (and their delegated officers), to:

1. negotiate the provisions, and conclude the entry into, of the Service Contract and the Lease;

2. negotiate and approve any  required amendments to the existing Section 75 Agreement and arrangements with the ICB on the Council’s behalf; and

3. negotiate and agree any arrangements and agreements with TEWV, ICB or other stakeholders as may be required including (but not limited to) any alternatives or replacements to the existing ICB Section 75 Agreement if necessary.

Reasons:   The reasons for this are as follows:

a) The Pilot should allow for in-year financial savings against high-cost residential placements.

b) The delivery of suitable accommodation at the 2-sites previously identified at Woolnough House and Crombie House will take several years. A 7-unit pilot at 92 Holgate Road will enable immediate delivery of the project’s aspirations within a currently vacant resource.

c) The level and acuity of demand has only increased since the development of the original delivery plan. The Pilot will enable us to go a small way towards meeting this increased level of need.

d) Although the shared house setting is not suitable for people with the highest level of associated risks who require self-contained accommodation, it will increase our ability in the interim to meet the needs of people we have been previously unable to successfully support due to levels of complexity. The pilot cohort will contain a mixture of people who have been in expensive out-of-area residential placements, in long-term NHS rehabilitation placements, people within the resettlement pathway with significant mental health and substance use disorder support needs and people stepping down from Foss Park.

e) This new service will not succeed without the support of other specialist services such as the mental health teams with TEWV, Drug and Alcohol services, police and community safety, primary care and the third sector offer for people with multiple and complex needs. The pilot will provide an opportunity to develop a methodology of how York successfully supports people with multiple and complex needs in a community setting. Work is ongoing with TEWV and other partners to develop what this support will look like. The pilot is an opportunity to develop partner working arrangements whilst managing the risk by working with a smaller cohort of people. These arrangements will be tested and refined over the pilot period ready for the expansion into the final phase of the project.

The Executive Member for Health, Wellbeing and Adult Social Care welcomed the report and noted her support to amend the existing Section 75 Agreement with the Integrated Care Board to seek to support individuals with mental ill-health in placements in York rather than more expensive out of area placements. She welcomed the proposed 12- month pilot of 7-units at 92 Holgate Road.

Resolved:

                   i.        To adopt a phased approach of delivery for the wider

programme which significantly includes a 7-unit pilot at 92 Holgate Road for 12-months;

                  ii.        To enter a service contract with mental health support services provider (the “Provider”) for a Term of 12-months for provision by the Provider from 92 Holgate Road of a 7-unit mental health support service (the “Service Contract”);

                 iii.        To grant a lease of 92 Holgate Road to the Provider for a Term of 12-months (the “Lease”)

                iv.        To amend the existing Section 75 Agreement with the ICB to address changes to the long-term intentions of the Mental Health Housing and Support project and the funding requirements for the 12-month pilot at 92 Holgate Road;

                  v.        To delegate authority to the Corporate Director of Adult; Services and Integration (“DASS”) (and their delegated officers), in consultation with the Director of Governance (and their delegated officers), to:

1. negotiate the provisions, and conclude the entry into, of the Service Contract and the Lease;

2. negotiate and approve any  required amendments to the existing Section 75 Agreement and arrangements with the ICB on the Council’s behalf; and

3. negotiate and agree any arrangements and agreements with TEWV, ICB or other stakeholders as may be required including (but not limited to) any alternatives or replacements to the existing ICB Section 75 Agreement if necessary.

Reasons:   The reasons for this are as follows:

a) The Pilot should allow for in-year financial savings against high-cost residential placements.

b) The delivery of suitable accommodation at the 2-sites previously identified at Woolnough House and Crombie House will take several years. A 7-unit pilot at 92 Holgate Road will enable immediate delivery of the project’s aspirations within a currently vacant resource.

c) The level and acuity of demand has only increased since the development of the original delivery plan. The Pilot will enable us to go a small way towards meeting this increased level of need.

d) Although the shared house setting is not suitable for people with the highest level of associated risks who require self-contained accommodation, it will increase our ability in the interim to meet the needs of people we have been previously unable to successfully support due to levels of complexity. The pilot cohort will contain a mixture of people who have been in expensive out-of-area residential placements, in long-term NHS rehabilitation placements, people within the resettlement pathway with significant mental health and substance use disorder support needs and people stepping down from Foss Park.

e) This new service will not succeed without the support of other specialist services such as the mental health teams with TEWV, Drug and Alcohol services, police and community safety, primary care and the third sector offer for people with multiple and complex needs. The pilot will provide an opportunity to develop a methodology of how York successfully supports people with multiple and complex needs in a community setting. Work is ongoing with TEWV and other partners to develop what this support will look like. The pilot is an opportunity to develop partner working arrangements whilst managing the risk by working with a smaller cohort of people. These arrangements will be tested and refined over the pilot period ready for the expansion into the final phase of the project.