The site of a former care home in Sheffield offered Dimensions an opportunity to create flats for five young adults with behaviours of distress, to be supported to live independently. It’s an optimistic and future-focused commitment to supporting young people who might otherwise be in residential or secure settings outside the city.
Highgreave in Sheffield is an old care home built on a big but very steep plot of land. The last resident moved out in 2016 and Dimensions decided not to re-let the space, as the property, with complex ownership arrangements, didn’t meet modern expectations for good housing for people with learning disabilities. The site had great potential though. Working in close partnership with NHS England and NHS Improvement, Sheffield CCG and Sheffield City Council, Dimensions developed a new vision for it.
Working in partnership for successful transitions
Pip Hughes, Housing Senior Manager for NHS England in Yorkshire & Humber: “It’s great to work with Dimensions and local health and social care partners to bring a disused asset back into use for young people with a learning disability and autistic people. We know going through transitions into adulthood can be hard for young people.”
The young adults aged between 18 -25 live in individual flats, learning the skills needed for independent living over 2-5 years, before moving on. Young adults transitioning to adult support for the first time face many challenges. One of the most fundamental is finding the right property for their needs – needs that, like any young person, may change quickly as they grow and gain increasing independence. These young adults would be at risk of residential or secure settings and would need high levels of support. This, commissioners confirmed, would make Highgreave an important resource within the local community.
Clinical Director, Jason Bardell said: “Our person-centred positive behavioural support philosophy is front and centre of this because it’s been built in from the start.”
Setting their own goals
This is a time-limited support for a maximum of five years on a secure tenancy. Individuals who are supported set their own goals and this gives Dimensions time to look to the future with them and their families.
AAD Architects helped Dimensions to create a building designed for the needs of the individuals who would live there. This is a specialist, high level, living environment which is calming, open and flowing. There are no internal doors, rounded walls, and no hanging light fittings or fixtures in the walls. Bathrooms are wet rooms but there is minimal disruption to install a bath or remove it later for the needs of a different individual.
The woodland area is also important and even though the development is alongside a busy road, it takes advantage of a corner of it which cannot be built on and is planted in a natural way. Dimensions spent a lot of time creating the right environment and the local authority was very open to suggestions including adapting a woodland walk to add some plug-in lights.
The assistive technology in the property also means that some of the people at Highgreave can now have privacy, because they don’t need to have a support worker sleeping in their room with them.
Giving people privacy and independence
19 year-old Brian lives in one of the flats. His transition has gone smoothly and he has developed a good rapport with his support team. They carried out a six-week shadowing period in his previous home and supported him there before he moved.
He used to exhibit aggression as part of his behaviours of distress but this hasn’t happened since Dimensions has been supporting him. The assistive technology at Highgreave is particularly helpful in supporting Ben because it keeps him safe while giving him the privacy and independence he requires. There are sensors on the front and back door, cooker and shower, so his support team know he is safe.
Brian’s mother has commented on how much happier he is. He no longer rings her every hour as he used to, and when she visits with his granddad, Brian is more likely to invite them in which he wouldn’t have done in his previous home.
The assessment process
Richard has profound and multiple learning disabilities, and was living with his father and grandparent in a two bedroom flat and sharing a bed with his dad. He is very active and requires a lot of sensory input to overcome any behaviours of distress. In an emergency placement which followed living at home, he was moved to a listed building that couldn’t be adapted to his needs and he was only able to be supported to go out once, because his provider was concerned about the risk to others and was struggling to recruit support staff.
Richard spent most of his time in his bedroom with a member of staff sitting outside his bedroom. Ryan Mitchell, Referrals and Assessment Manager with Dimensions, said: “When I first spoke to Richard’s dad and explained what Highgreave could offer Richard, he broke down and cried on the phone. He said he never thought there would be this option for his son and he was considering taking him out of care completely.”
Richard and his dad visited the flats and Richard loved the environment; he ran his hands around the curved walls in and out of the bedroom area and ran through the woodland walk and enjoyed touching and experiencing the entire environment.
Planning for the future
Alex is a young man who is being given outreach support by the team at Highgreave. He currently lives with a foster family and there have been instances of physical aggression, as part of behaviours of distress, which have resulted in provider breakdown and police involvement.
During the initial assessment phase it became apparent that Alex and his family weren’t ready to move yet but Dimensions is working with him so that he can visit Highgreave to develop daily living skills. There will then be an apartment ready for him after the first person moves on, and he will already know the environment and the team.
Communications is key
Dimensions has weekly meetings with the commissioners who have been advocates of this project. Solutions have been found by everyone working together. There isn’t a `them’ and `us’.
NHS England’s Pip Hughes, Housing Senior Manager, Yorkshire and Humber, Learning Disability and Autism Programme, has also been keen to find solutions to create a purpose-built environment which is designed specifically to avoid young people requiring emergency placements that are unlikely to be suitable for them.
By working with commissioning, Dimensions has explored how to meet Richard’s three-to-one community needs with two personal support colleagues and access to a shared support colleague. Commissioning were on board with the idea and shared the idea that support should be dynamic and ‘not tied to the building’.
There is CQC anxiety that if the person’s landlord is the same as the organisation that supports them, the social landlord potentially has a vested interest which could mean that the support needs of the individual aren’t prioritised. However, a tenant is a tenant and they have a legal contract with Dimensions and if there is an issue with an individual’s support this is taken up with operations as a separate matter. Sheffield City Council has a pragmatic approach to this and commissioners are open to different kinds of support models.