53 Ardglass Road

1. 53 Ardglass Road 24 hour supported living accommodation in Downpatrick

2. The strategic drivers for change in the care of the mentally ill were:- - Bamford Review of Mental Health and Learning Disability Services 2005. - Supporting People Strategy 2005 -2010 - SET Mental Health Strategy 2008 Along with these drivers for change came additional funding so that hospitals were able to consider moving formerly long-stay patients out of the wards and into appropriate community settings.

3. Project Team identified / established. Model identified and designed to care for the client group. Partnerships identified to move forward: • Health and Social Care Board • Regulation and Quality Improvement Authority • Supporting People • Oaklee Housing Association

4. Preparation and submission of Business Case • Eighteen patients could be accommodated in the building. • Workforce planning. • Ethos was to provide enough staff to fully support the Recovery Model approach in mental illness.

5. In practice the Recovery Model looks as follows:- • All patients identified had a severe and enduring mental illness with complex needs. • The aim was to provide a homely and spacious environment with appropriate décor which included their own en-suite bedroom. The patients were fully involved in choosing the colours for their bedrooms and buying furnishings for their room. • The building was designed so that all residents could have their own front door and a key to access their home. • In setting up this facility it was clear that in order for all the above to be met, we needed staff who were trained in the recovery model and who had a clear vision of enabling the residents to live in the community and to provide a safe environment in which the residents could reach their full potential. The ratio of staff to patient was a crucial factor in making this a success. • Through an expression of interest we recruited seven senior support workers, eight support workers chose to transfer from a hospital setting to the community and the remaining staff were recruited through job recruitment.

6. The importance of good communication between staff, relatives and residents led by the project team was vital to offer reassurance about what would be a life-changing move. Communication was maintained in the following ways:- • One to one meetings with potential residents • Group meetings with relatives • Group meetings with staff • Regular communication and meetings with external agencies • Preparatory work to move into the community was carried out in the wards before discharge • Regular communication with Staff Side/Human Resources Although the Project Team communicated freely and regularly with all those who would be affected by the move, there were high levels of stress for patients, staff and relatives. For example choosing a colour for a bedroom presented the patients with great difficulty as many had lost the ability to make decisions. Handling and budgeting their own money after so long in hospital created high stress levels.

7. Planning for patient discharge from hospital: • Discussion of the order in which the patient would move keeping in mind friendships and patient choice about who they would be willing to share accommodation. • Decision to move the more stable and settled patients first. • Single sex units as this was the patient choice • The transfer of the patients took place over a five to six week period • There are currently 17 tenants in the properties with one remaining place to be filled.

8. Residents have been at 53 Ardglass Road for three months. The feedback from residents, staff and families has been very positive. There were initial settling in periods for the residents but our high level of staff helped to contain this in the unit, with no one having to come back to hospital or relapse in their illness. Positive resident feedback refers to: • Own room • Own bathroom • Privacy • Double bed • Increased quality of life Reintegration into the community has been determined by developing daily living skills which had been lost because of their long stay in hospital. These include: • Cooking • Money management • Use of public transport • Social visits to cinema and restaurants • Leisure centre and golf

9. Future plans for 53 Ardglass Road: • Creation of a green gym through partnership working with Belfast Conservation Society. This will enable those residents interested in gardening to grow their own vegetables. There is evidence to support that gardening has a therapeutic effect on people mental state. • To encourage a move towards more independent living for the residents in the units. This this will be determined by the residents and it is important that recovery is carried out at the resident’s pace. • Further proposed retraction of Downshire Hospital will enable planning for reinvestment of hospital money into the community thereby building a secure infrastructure in the community. This will offer a continuum of care for patients in the community.

10. Extract from a letter to a member of staff from Rosie: “You fought to get me out and it was worth your while. This is appreciated. You made the right decision and it’s the best thing that ever happened. I have had absolutely no run in with the staff, in fact they are all pleasant. I’m enjoying the responsibility and the freedom that comes with it, in the sense I can eat when I want, sleep when I want and cook my own meals and choose what to cook and take part in the weekly grocery shop. I haven’t been this happy since I was a little girl. I look on here as home and if I had to change anything about it, there would be nothing to change. I get support and praise and encouragement from both peers and staff. They bend over backwards for me and everyone else. If it wasn’t for here, I’d be stuck in ward 27 and classed as homeless. It’s nice for the first time in about 13 years to say I’m no longer homeless. Home is where the heart is and I’m there. There’s days I miss ward 27 but I just get on with it coz this is my new life and I deserve it, coz I’m good and a nice person.” Love Rosie