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Integrating all partners

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Tile House, a collaboration between Camden & Islington NHS Foundation Trust (C&I) and One Housing Group (OHG), provides supported accommodation for people who have complex long term mental health issues.

It is an alternative to being hospitalised or being put in a care home. We’re proud to have been involved in such an innovative scheme - the first of its kind in the UK - which has helped save the NHS nearly £900,000, according to a report released at the beginning of the year.

Tile House opened in September 2012 and provides 15 high quality, self-contained supported housing units in King’s Cross, London for customers with a range of complex mental health issues. Each customer has their own flat that is designed to the same specification as One Housing Group’s private sale units.

One Housing has collaborated with Camden & Islington NHS Foundation Trust to provide a safe, positive and supportive environment to help customers with their recovery. All customers at Tile House are referred by Camden LBC.

The nature of need among those at Tile House is complex and of a level that would not usually enable other forms of supported housing to offer the nature of
support needed. Many of those referred to Tile House have issues around treatment or medication, they may have a forensic component to their mental health history or a history of placement breakdown. They are often high-risk, especially in terms of self-harm, and require clinical input to manage their
mental health. Due to a combination of these factors and the complexities of their conditions they require a unique support system to aid their recovery and encourage independent living.

Click here to read the rest of Allied Healthcare’s integration report

There are a number of clinical staff who manage the needs of our service users at Tile House. All residents have access to support staff who are on site 24 hours a day and everyone will be allocated a key worker who will develop an individualised support plan. On-site visits are carried out by a care coordinator,
while an occupation therapist facilitates life skill training and a psychologist provides individual assessments and therapeutic interventions. The multi-disciplinary team works closely to avoid crises in people’s care which very often results in hospital admissions.

Prior to moving to Tile House many of the service users had little engagement in social and community activities, but in this environment they are encouraged to maintain positive relationships and build these skills. This underpins part of the philosophy behind the project; you’re not just living with a mental health diagnosis but living well. Good mental health and resilience are fundamental to our physical health but each cannot be thought of as separate entities. All residents at Tile House are registered with a local GP and encouraged to raise any health concerns they have.

This has resulted in a few who have engaged in the stop smoking programme, a target which has been included in their support plan and they all receive an annual health check. The staff run cycling sessions, nutrition workshops and cooking groups too to encourage them to think about health and wellbeing.

Preventing admissions

Mark has a history of several suicide attempts, one of which had resulted in serious permanent physical harm. This stems from severe auditory hallucinations and paranoid beliefs during most of his life. Mark had found talking about this difficult in his previous placements, and had often isolated himself.

When Mark moved to Tile House, the OHG clinical lead worked closely with him to develop a positive relationship and encouraged him to attend the in-house hearing voices group with which he began to engage well. This helped him to feel able to speak to the clinical lead and psychologist when his voices increased and he began to experience suicidal feelings, and reaffirm his crisis plan and coping strategies. The psychologist and care coordinator worked with all staff around containing a suicide crisis and how to approach the voice-hearing experience in a non-challenging way.

Mark’s suicidal feelings continued for approximately two weeks before they subsided. The crisis was contained in-house through therapeutic intervention by the on-site clinical team with no change of medication or hospital admission being required.

Critical to the success of the model is a shared approach to risk management and governance. As well as daily discussions with their key worker and weekly joint team meetings, Tile House is overseen by a strategic implementation board made up of senior managers from OHG and C&I. The senior oversight ensures the momentum for the partnership is maintained and patient outcomes remain a clear focus.

Following their time at Tile House service users who would have been in very highcost placements funded by social care or hospital, move onto more independent and often cheaper accommodation. We are proud to have pioneered an approach that so effectively delivers our values of a positive and dignified recovery journey for our patients. The success of Tile House means we are committed to making the most of further opportunities and deliver the
very best outcomes for our patients across London.

Wendy Wallace, chief executive, Camden & Islington NHS Foundation Trust

This case study forms part of an LGC & HSJ integration report, sponsored by Allied Healthcare

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