Support models that really work

Rising to the challenge of delivering flexible support in West Hampshire

What was the challenge?

The brief we were given by the commissioner was to make housing related support in the area more creative – a more complete, fluid pathway that people could join at any stage of their recovery, and where staff teams would be available in the community wherever they were needed.

They wanted to stop people getting ‘stuck’ and not progressing because there was no suitable accommodation for them to move on to, or because the system wasn’t helping them to progress.

We already had some supported accommodation and community support in the area so we were well placed to build on our foundations and adapt to meet the brief.

What did we do?

We spoke with the housing departments of various councils to look at opportunities, needs and gaps, building relationships to help understand how to respond together to the lack of housing and to people being ‘stuck’ in services.

One solution we identified was to take on leases for some Eastleigh properties in an arrangement with a local housing association. This means we can be more proactive in helping people to move through the pathway, by offering them housing in shared properties and supporting them until they find somewhere to live independently.

Something else we did was to work with our staff teams so that they operate much more flexibly  between services, in the community, in people’s homes, offering support on the phone and supporting people on an ongoing basis as and when needed, including outside office hours. As part of this, we established community drop-in sessions that anyone with a mental health or housing issue can access. This also provides a preventative measure for those who manage well independently, but might need a bit of input at certain times.  

What are the benefits of the new service?

The new service offers a ‘menu’ of services that people can pick from, to give them the greatest possible choice and control over how they are supported. This includes support with getting into training or employment, and peer support, where people support others by drawing on their own experiences of dealing with mental health difficulties.

We encourage people to use technology as part of their support where this would help, for example by using apps for relevant practical purposes, or to manage their mood, sleep, anxiety and mental health in general.

We are able to work much more flexibly and reach areas that previously had no support. This means working collaboratively with housing departments, social care teams and Community Mental Health Teams to work around rules based on rigid geographical boundaries, so that these don’t stop people finding somewhere suitable to live.

And once someone has moved on to live independently, we provide them with ongoing community support to give them the best possible chance of continuing to do well on their own. Even once they have left the service, they can still access our community clinics, so they’ll never feel they’ve been left without support.

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"Together has to be one of the best organisations I've ever come across. The amount of help and support has been phenomenal! I feel that my mental health is understood very well by staff and their friendly and supportive attitude has helped towards inspiring me to become a Peer Supporter. Peer support is an amazing opportunity for me to help other users within the network, without the clinical approach which many people find uncomfortable." A user of the West Hampshire service

Our advocates helped more than 1,700 people a month to have their views and wishes heard

Making advocacy a seamless experience

Advocacy Together Hubs provide a range of independent advocacy services through a single point of access. All our Hubs are commissioned according to the needs of the local area and we adapt to meet what each community needs from us. This year we won contracts to run Advocacy Hubs in Rochdale and Warrington.

Bringing advocacy services together in one place makes it easier for people to access the right kind of support at the time they need it. We use a community based model so, as well as always having our own local office base, our advocates can provide support in other local venues like libraries or other voluntary organisation offices.

Many of our advocates are trained to provide more than one type of advocacy so service users can often have the same advocate even when more than one type of support is required. This approach makes the experience of using the service smoother for people at some of the most challenging times in their lives.

Case Study: Dave’s story

Marie is allocated as an to support an individual, Dave*, on a psychiatric ward. She begins to build a relationship with Dave and discovers that some of his important personal possessions have not been brought to the ward – his glasses and a particular, special mug that he likes to have all his drinks in. Marie talks to the social worker and care support staff from Dave’s home on his behalf, passing on information (with his consent) about the importance of these items for his wellbeing. The items are brought to him and Dave is reported to be more settled.

Plans are made for Dave’s discharge and he has been assessed as lacking capacity to make the decision about where to live. This means Dave is referred to our service for an . As Marie is trained in this area, she can accept the allocation and works with him to explore the options for accommodation given by the social worker, and makes note of his thoughts, values, wishes and feelings. These are presented in a report where they must be considered when the decision is made by the Decision Maker on Dave’s behalf. Dave’s pleased because he has already developed a positive relationship with Marie and doesn’t have to tell his story again to somebody new.

In order for Dave to get the most appropriate level of support, a Care Review must be completed by the Social Worker. The Social Worker has assessed that Dave has substantial difficulty understanding the process and no family member or friend to support him. The Social Worker refers to our service for a . Once again, Marie can be allocated the case and supports Dave under the Care Act. She spends time with him gathering information about his thoughts, feelings and wishes in relation to his care needs and general wellbeing. She attends the review and supports Dave to put forward his views so that the best care package can be negotiated to support his physical, mental and emotional wellbeing.

*Name has been changed

Independent Mental Health Advocate (IMHA)

Our IMHAs help people to understand the legislation they are subject to and how this affects their lives. This may include the conditions or restrictions placed on them and their rights under the Mental Health Act 2007. IMHAs can also help people to understand what medical treatment is being given or proposed and give information on the authority under which the treatment would be given.

Independent Mental Capacity Advocate (IMCA)

Our IMCAs work with people who lack capacity to make a specific, life changing decision for reasons including, but not limited to, learning disability, dementia, mental health needs and acquired brain injury.

These decisions could concern: serious medical treatment, safeguarding, deprivation of liberty, accommodation changes and care reviews.

Care Act Advocacy (CAA)

Under the Care Act (2014), individuals must be supported to be involved in planning their support and making decisions about their care, no matter how complex their needs. Where someone has substantial difficulty in understanding this process, they have a legal right to the support of an independent advocate who will help them to express their wishes and feelings. We can support people by helping them to understand their rights and to express their views, assisting them with meetings about their support, helping them to be involved in planning their support, and making decisions about their care.