Market Position Statement 2025 to 2040 for Services for Working Age Adults with Long-Term Needs - Future Models Of Supported Living Services In Walsall

The Council is aiming to get providers thinking about developing larger-scale supported living arrangements/environments on a core-and-cluster model. Taking its inspiration from large scale extra-care sheltered housing schemes, Upward Developments (West Midlands) Ltd have been encouraged to develop, at their own cost, a younger adults supported living development into which is incorporated a short stay/respite care ‘hotel’. On the ground floor there are four apartments for people with learning and/or physical disabilities or complex needs and five business lets e.g. for a shop, charity, beautician, pharmacy or café which will bring in the local community and support local business. Additionally, the council has invested £350,000 in developing a community hub on the ground floor including a hydrotherapy pool, potential for a local children’s centre to re-locate and a centre for those living onsite and the wider community offering activities including art, music, meeting/ community rooms. 

Upward Care Limited (the separate care arm of Upward Developments) is looking at offering crisis/ emergency beds using a ‘tenancy at will’ approach. On the first floor are 21 one or two bed apartments plus two communal areas and a housing management suite with a ‘hotel’ reception for the care hotel. Ten of these apartments will be the ‘care hotel’ for short breaks or respite breaks and the two-bedroom apartments provide scope for family members to also stay over. These can be used by anyone, not just Birmingham residents, although the council does have a priority nominations agreement linked to their £350,000 investment. On the second floor are 21 one or two bed apartments plus two communal areas and a housing management suite. There is also a short break element on this floor – these apartments are for temporary and long-term occupation. 

Also in Birmingham, Bromford Housing has developed a ‘MyPlace’ model, which is supported living based around 14 self-contained apartments. Birmingham is the first MyPlace scheme for people with long-term conditions as an alternative to residential care. Bromford wishes to replicate this model in Walsall. 

Lifeways are one of several providers in the City starting to develop ‘core and cluster’ models of care on a larger scale which are linked to more than one care delivery model. In March 2017 Lifeways (in conjunction with Inclusion Housing) opened its largest scheme in the country – two blocks of 16 supported living apartments; on the same site there is also a nine bed ‘high and complex care’/autistic specialist residential suite. Birmingham City Council recognises that in future there will be reduced demand for residential care and more for extra-care housing for older age adults.

Aviary House in North Solihull accommodates adults with a history of severe and enduring mental health needs through combined housing and onsite support. It aims to create a friendly, safe and supportive environment in which people can develop and improve their skills to live more independently. Aviary House, run by Home Group is home to 24 long-term residents. There are also four Step Up, Step Down beds funded by the NHS, which offer short term accommodation and support to people with severe mental health needs. 

This combined service model increases Aviary House’s cost effectiveness by sharing staff across the Step Up, Step Down facility and supported living. By reducing the need for hospital admissions and out of area placements, Aviary House delivered a net saving of £71,000 in 2017/18.

Individuals reported a 52% improvement in their wellbeing after their stay in Aviary House.

“The Step Up and Step Down service offers people the time and space to recover from crisis delivering a therapeutic, effective, safe alternative to hospital for some people who would previously have been admitted. It has proven to be a very valuable resource to the NHS”.

This is a partnership between Northampton Partnership Homes, the County Council and NHS Partnership. There are 8 individual bungalow units plus one management and staff building. Each unit has its own front door, private garden, communal courtyard and garden. The scheme has been designed with service users to meet the needs of people with learning disabilities and autistic spectrum conditions

NHS Devon Clinical Commissioning Group (CCG – now ICB) working with three local authorities as Devon Learning Disability and Autism Partnership (LDAP) formerly Transforming Care Partnership, has successfully supported 50 adults to return to live at home since 2015. The Partnership continues to work with NHS and community providers to source suitable packages of care for people with learning disabilities and autism.

The Partnership has facilitated seven property purchases since 2018, using NHS England capital, and jointly worked with a national housing association to provide homes for people within the programme. Properties are sourced based on the person’s wishes and needs, support is commissioned on an individual basis and staff provide support 24/7. 

NHS Devon CCG led a ‘Test of Change’ pilot that sought to encourage more quality supported living providers to the market by developing an enhanced community support specification. Following extensive engagement with the supported living market, the enhanced specification contains a contingency fund to cover emergencies without the need to navigate around complex funding panels, a fixed funding model and the use of the 24/7 grid toolkit to monitor progression from hands on care to enabling care based on the progression model.

The CCG worked with providers and community partners to design services to meet the complex needs of each person, using Individual Service Designs (ISD) to capture the essence of the person and specific likes/dislikes to ensure that the care provided is both person centred and flexible. The CCG just offered a clear indication of future need to providers and has encouraged providers to work together to share training costs and workforce plans.

Supported living schemes are part of the Council’s ‘Homes for Wandsworth’ (1,000 homes programme) which is led by the Housing Development Team. This programme identifies council owned sites across the Borough as potential spaces for new council rent homes. Most are allocated for general needs, but sites are also earmarked for supported housing where appropriate. The Council’s design standard is for all new homes to be built as inclusive, adaptable and accessible, with M4(2) homes future-proofed for adaptation and over 10% M4(3) wheelchair user homes built out as fully accessible. All homes are fitted with contemporary, inclusive and flexible products. 

Stag House -a £7million development in Putney Vale -was the first of the Development Team’s supported housing projects. In 2016, planning permission was granted for 21 new homes on a former disused council community centre site, following input from the local community who were supportive throughout. In 2021, 10 years after the original vision, the development was completed. 

There are 10 self-contained homes for young people with physical and learning disabilities, and a ground floor community flat which also serves as staff office and sleepover. Alongside these homes are 11 new general needs flats which were prioritised for local residents seeking to downsize, including 2 fully accessible wheelchair user flats. The area is green and leafy and the scheme is located directly adjacent to Wimbledon Common. The supported flats at Stag House are all wheelchair accessible because double lift access is available (Wandsworth Council has insisted on double lifts for all new wheelchair homes above ground floor for the last 10+ years). The flats all have modern wet rooms and accessible kitchens with electric rise-fall worktops. They are spacious and light, with balconies jutting out amongst mature trees and overlooking the Common. Biodiverse roofs and photovoltaic panels were fitted to help the development exceed environmental planning requirements. The Council also completed significant improvements to landscaping, access paths, lighting and parking and provided a completely renewed multi-use games area opposite the new development. As a result of feedback from residents at Stag House, and in consultation with internal and external colleagues, the Housing Occupational Therapist produced a Supported Housing specification which is now used for all council schemes across both Wandsworth and Richmond Boroughs

This project developed the site of a former care home and over the course of just 12 months unlocked its potential by creating a facility with so much more to offer. Extensive grounds have been cleared, upgraded and given a new lease of life, whilst the secure internal courtyard provides a much-loved focal point. 

Private garden areas provide a sense of freedom, whilst off street parking and secure access enables visitors to easily see loved ones. Kirkdale House has been carefully designed to accommodate individuals with differing care needs such as Mental Health, Autism and Learning Difficulties.

The Government HOLD scheme provides a grant to support people to become homeowners. It does require a deposit of £16,000, however, which excludes some people. Council involvement in the planning of such arrangements might allow for the development of multi-unit schemes which would make care more economic. The provision of mixed tenure schemes can allow families who want the security of owning the property to access a model where shared care can be an option.

Under this model, when it has been used with people with a learning disability and/or autism, a housing association buys the chosen property with the individual and their family. To buy its share of the property, the housing association uses grant funding from the Homes and Communities Agency (HCA) which helps to keep the rent low. 

On the day the property is purchased, the Housing Association sells a share of the home to the individual with a learning disability or autism. The individual gets a mortgage to pay for his or her share of the property, with mortgage repayments covered by a repayable loan called Support for Mortgage Interest (SMI). The shared owner with a disability pays rent on the share of the property owned by the Housing Association. The Housing Association may retain responsibility for many of the repairs and maintenance that shared owners may need help and support with. The cost of this is then included in a service charge. The rent and service charges are eligible to be covered by the person’s housing benefit. 

Benefits of the HOLD model 

• Security of tenure - Ownership offers the most secure tenure available to people and promotes the separation of accommodation and support. This separation means that the individual can choose to change his/her care and support provider, without the risk of losing their home or facing eviction/notice on the property
• Personalised - It allows for an individualised environment that meets the specific needs of the person; bespoke accommodation, environment and location can be key to managing behaviours that challenge
• Choice and control - It allows for choice about where the individual wants to live and with whom. Some people may want to live with other people. However, some people don’t want to. Shared living arrangements are not right for some people and can have an impact on behaviour which can lead to placement breakdown
• Promotes natural relationships - This model follows the principles of an ‘ordinary house, in an ordinary street’ – the same as anyone else and allows people to be a part of their community, with the right support
• Long-term settled accommodation - Many people with a learning disability and/or autism who have bought a house through HOLD have chosen to remain in the same place. Where people move on, this is usually because family moved, their needs changed due to ageing or they passed away.

Sam lived a life of isolation and mistrust, spending most of his time alone, wary of strangers and new staff members. He rarely engaged with others, focusing instead on computer games. The hospital staff, unsure of how to connect with him, would clean his room and do his laundry while he slept, actions that only deepened his mistrust and led to aggressive outbursts. When the Beyond Limits Support Team began working with Sam, they were advised to leave him alone. However, they chose to actively engage with him instead. Despite initial resistance they persisted in trying to build a relationship. Over time, Sam began to wait for the staff he trusted before engaging in his daily routines, gradually developing a level of trust with the team, though he still struggled with new staff members. 

Sam had a clear vision for his future: his own house, two cats, some fish, a garden, a chimney for Father Christmas, and his own set of keys. After a long search, a house was found opposite his mother’s home, allowing for a gradual transition where Sam first moved in with his mother. This structured environment eased him into independent living. With the continued support of Beyond Limits, Sam started to socialize more. As Sam settled into his new home, he began to accept support more readily. Initially, he was supported 24/7 due to concerns about his frequent seizures and the risk of SUDEP (Sudden Unexpected Death in Epilepsy). However, Sam expressed a desire to reduce the level of support, which the team gradually implemented. This change positively impacted his mood and independence. Sam started doing his own shopping, engaging more socially, and taking control of his staffing by conducting interviews and managing staff schedules. Over time, Sam transformed from an isolated and distrustful individual into a sociable and independent person. He began hosting gatherings, including a 50th birthday party where he invited over fifteen people—a significant achievement for someone who previously reacted with extreme anxiety to unexpected visitors. Sam has been seizure-free for nearly four years, a stark contrast to the frequent hospital visits of his past. His new lifestyle, coupled with support tailored to his needs, has led to a happier and more fulfilled life. Sam continues to grow in independence, with plans to further reduce his support, including potentially eliminating night -time assistance. He now communicates confidently, makes decisions about his life, and actively participates in his community. The creative, person-centred approach of his support team has been instrumental in helping Sam achieve the life he once only dreamed of, with his own home, pets, and a sense of autonomy that has transformed his life.

A transformation of more specialist service provision for working age adults with long-term needs is needed in Walsall. We need new providers to come forward as well as existing providers to re-imagine these services of the future and to build an action plan on the back of this Market Position Statement. Below summarises key requirements for each specialist service moving forward.