A place to go for people in crisis: Durham

Case study summary

Durham have set up an emergency crisis bed to give people with a learning disability, autism or both somewhere to go when they need extra support. This means that they don’t have to go into hospital.


The ‘crash pad’ is a self-contained flat with a lounge, kitchen and bathroom which is an annex to a residential care home. This means that staff are on-site and can easily help the person living there if needed.

The bed is designed for when a person’s existing placement breaks down and can take referrals at very short notice. It’s on the ground floor and accessible so that anyone can use it.

They are given intensive support from the Community Behavioural Team at Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), learning disability nurses and the provider, Swanton Care. Early priorities are to stabilise the person and plan their discharge.

Matthew was living in a residential care home. One Friday afternoon he reached a point of crisis and assaulted a member of staff. It was possible that criminal charges would be pressed, and he needed a place of safety over the weekend.

Matthew spent a month in the crash pad, where he was given intensive support from the multi-disciplinary team. After a month he was ready to move on. He was fully involved in the decision about where he would live and his now living in a much more suitable placement in his own flat. He is doing well, and is no longer considered ‘at risk’ on the local dynamic risk register.

Fred Grand, Commissioning Policy and Planning Officer at Durham Council says: “It provides a bridge between living in the community and going to hospital.  Typically a person might have had a dip in their mental health which leads to challenging behaviour.”

“Everyone has either gone back to their previous placement or moved on to somewhere different that was more suitable than what they had before. Care based in the community is very likely to be cheaper than a hospital ward.”

“People shouldn’t be in hospital if they don’t need to be, and the crisis bed helps us to achieve that.”

The unit was set up in February 2017 as a six month pilot. In that time, three people spent time in the unit that would otherwise have been admitted to hospital.


Fred Grand