Case study: A better future ahead for Gemma

Case study summary

Gemma was supported to move into a suitable home after leaving hospital. Gemma’s landlord was going to begin legal action to end the tenancy unless they felt assured that Gemma would be moved to alternative accommodation. In her new home Gemma is much happier and interacting with the community in a more positive way. Staff, family and friends say that Gemma is more positive and moving forwards with strong indications of a better future ahead now.

Gemma* has a moderate learning disability, autism and bipolar schizophrenia and has spent many years of her life in hospital.

After moving out of hospital in 2018 Gemma lived in a house where her landlord was at the point of beginning legal action to end the tenancy unless they felt assured that Gemma would be moved to alternative accommodation.

Neighbours living next door to the property had been forced to move their bedrooms to the other side of their house to enable them to sleep due to Gemma’s very loud verbal behaviour, using abusive and racist language and being excessively noisy inside and outside the house both day and night, playing constant loud music with little regard for people around her.

It was decided that Gemma needed to be moved to a single occupancy home in the Manchester City or South Manchester area. The property would need a place for staff to retreat to for personal safety reasons as Gemma does not tolerate staff being in her living space constantly.

A four bedroom detached house was felt to be the most appropriate type of property for Gemma as it would allow for individual living areas for both Gemma and for her staff team.

The team looking at Gemma’s needs felt that a home in a community setting which was not isolated but not so close to other properties that she and her neighbours would be disturbed by each other would enable them to manage her behaviours better. The house would need to have extensive soundproofing to support carers and help them to manage Gemma’s behaviours better.

What happened next?

Bringing together NHS England housing staff, Care Housing Association and New Focus community support staff it was agreed that Gemma would be moved to a purpose bought property in a suitable location using an NHS England capital grant.

It was agreed that a house, with a minimum of four bedrooms, would be purchased and adapted in the Northenden area. The house would have space around it to enable privacy and enable behaviours to be managed within this community setting. The team anticipated that there would be some amount of internal soundproofing needed to the internal walls to enable staff space to be protected from noise, whilst they are on breaks or sleeping in the property.

It was also agreed that it was important that the house included:

  • a new communal kitchen/dining and lounge space aimed at tempting tenant downstairs to mix with staff
  • frosted windows as requested
  • a spacious landing to make sure there was ample safe room to manoeuvre – a staircase to loft area was removed to achieve this.
  • a bedroom which only included a bed and a chest of drawers in it, as requested by Gemma.

How is Gemma doing now?

Gemma has lived in the property for a few months now and feedback has shown that

she is already much happier and interacting with the community in a more positive way.

There has been a substantial reduction in the number and intensity of incidents. This also means less multi-disciplinary professional and police involvement, so less of a drain on public resources. Staff have said they no longer feel in danger of burnout and feel they are able to support Gemma better.

In general staff and family and friends say that Gemma is more positive and

is moving forwards much more happily with her life with strong indications of a better future ahead.

What advice would you give to other teams looking at similar housing situations?

  • Recognise from the start how long it takes to complete the capital grant process and get the project initiation document (PID) together as early as possible
  • It is essential that all disciplines involved are committed to working together from the beginning so that the PID can be completed quickly. A delay from one discipline can hold the whole process up.
  • Involve people who know your client best in every aspect of the move.
  • Involve your client in decisions around structure and layout of the house.
  • Make sure you work with a housing association who are experienced in providing housing for people who have complex needs.
  • Work closely with the NHS England housing team to get the support you need to complete the PID. Always consult with them as soon as you know of any potential extra spending – don’t wait until the end of the build.

For more information contact jane.bellwood@nhs.net