Anna’s Blog – Planning Community Placements
In her blog this week our CEO, Anna Lunts, looks at the careful planning needed to help community placements succeed.
Tony Hickmott has been locked away in Cedar House – a 40-bed secure unit near Canterbury in Kent, for ten years. After his case was highlighted by journalist and campaigner, Ian Birrell, Tony was given just 20 days to find an alternative place to live.
In the early 1990s I was a mental health nurse and had first-hand experience of how long-term placements in closed institutions blighted people’s lives. They were prevented from developing the relationships with family and friends that we all take for granted, excluded from communities and denied a home of their own.
I was employed by Manchester Housing Consortium, after they applied for and were awarded a £50,000 grant from Manchester City Council to help re-settle people from long-term mental health institutions. We recognised that living in a supported environment in the community gave people the very best chance of achieving positive outcomes. In 1993 the Consortium changed its name to Creative Support to reflect our commitment to developing creative responses to individual needs and I became the CEO. Twenty-eight years later, we are still developing innovative services that meet the specific needs of individuals.
Tony is one of thousands of people with a learning disability or mental health issue seen by many as a problem. If those responsible for Tony’s care had given him the unconditional positive regard that he deserves, this situation might never have arisen. It seems to me, there is a real danger we are returning to those bygone days, when institutions were all that were on offer to Tony and many like him.
We can talk about costs, I more than most understand the financial pressures on social care budgets, but this is more about attitude than money. Tony’s lifetime care so far has cost an estimated £10million. Not only would supported care in the community be more effective, it would also be considerably cheaper.
After the Winterbourne View scandal, the Government set up Transforming Care and began the process of moving people to more appropriate placements in the community. The process is painfully slow, though, and recent statistics show that initial targets to discharge between 35-50% of in patients by March this year have not been met.
Tony and his family are caught in an impossible position. The publicity that has highlighted his case has also led to a wildly unreasonable timescale from Huntercombe, the company that owns Cedar House, for him to be moved to more ‘appropriate care.’
Community placements are usually very successful but they need painstaking preparation, particularly for those like Tony who are on the autistic spectrum and have been in secure units for many years.
We are in the process of establishing a service for ten people with a learning disability, in the south of the country. All the tenants were long-term hospital patients and have been assessed by the people who support them as part of the carefully planned process to move them into their own homes in the community.
Commissioners and clinicians have been planning the process for years and our senior staff have been working closely with the group and their families for many months, to prepare them for the move. We began a recruitment campaign with the full involvement of the service users, empowering them to ask questions and to help choose key workers. Four people are already in their new homes and the remaining six are due to move in between July and the middle of September.
Moving people from long-term placements in institutions does not happen overnight. The process can take many months and without the proper planning we’re just setting people up to fail.
As the barrister representing Tony and his family, Oliver Lewis says, “Giving 20 days’ notice is irresponsible and unreasonable. Huntercombe’s decision cannot possibly be in Tony’s best interests.”