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In response to the urgent need to improve transitions from inpatient mental health settings to the community, we have developed a Clinical and Recovery-focused Accommodation Service (CaRFAS).

Moving from inpatient to community settings is particularly difficult for people with multiple and complex needs who are often working with several teams. If mental health, social care and forensic services fail to work in an integrated and collaborative way, transfers can be delayed, meaning people remain in hospital unnecessarily and lose the coping skills they need on discharge.

CaRFAS is designed for use in a 24-hour CQC registered accommodation setting for adults aged 18 to 65 years who experience severe mental distress. It is aimed at individuals who have multiple and complex needs who may be coming out of hospital after a long stay, moving directly from a secure unit or are looking to avoid the need for inpatient admission in the first place.

The six core elements of CaRFAS are:

  1. A person centred approachCarfas web pic 1

We support people to identify their own needs and goals so that we can tailor support to suit them, and work alongside them to develop robust support plans to help them achieve their goals. This person centred approach is designed to equip people to plan and direct their own support more independently in future. We give people increasing responsibility for directing their own support to prepare them for moving on to more independent living.

  1. A psychologically informed way of workingcarfas 6

All staff are trained and supervised to work with individuals in a
psychologically-informed way. This means using reflective practice, where staff focus on identifying what is and isn’t effective and incorporating this experience into future approaches. Individuals are supported by staff to understand unhelpful behaviours that may have become deeply entrenched as a way of coping with distress, and to manage them before they escalate or are acted out in destructive ways.

Our mental health practitioners support the wider staff team to understand
psychological processes – difficulties and presentations – which informs
their everyday practice.

  1. A blend of clinical and recovery-focused interventionsCarfas 3

We offer people a combination of recovery-focused and clinical interventions. Our clinical and recovery team supports individuals to manage their mental health symptoms, build and practise coping skills and put this knowledge into practice. We help people to develop coping strategies learned in previous placements, and apply them to day-to-day situations in order to promote independent living.

As part of this work, our team supports individuals to reconnect to themselves,
others and their local community. This involves helping them to identify and
grow their strengths and skills, build their resilience and develop personal and
practical resources to self-manage and stay well. Clinicians may engage in more
in-depth, specific pieces of work with clients depending on their individual needs
and experiences.

  1. Sharing recovery experiences through genuine andcarfas 4
    meaningful peer support

All individuals have the option to work with Peer Supporters trained to draw on their own experiences of mental distress to help others towards better mental wellbeing. Genuine and meaningful peer support can help people take huge strides forward in their recovery, and is a key part of our service. We also support and train those using the service to become Peer Supporters themselves if they wish.

  1. Building strong partnerships to ensure a safe transitioncarfas 5

We work in close collaboration with statutory mental health and forensic services to develop and implement risk management strategies in order to ensure a safe transition for those entering the service from more secure settings.

  1. Preparation for moving on to more independent living

At the start of their journey with us, individuals are supported to identify move-on accommodation for more independent living in future, and to set goals and
timelines for achieving this, which are incorporated into their recovery plans.

Read about our CaRFAS service in Wellingborough or enquire about commissioning a CaRFAS service in your area.