Pilot Therapeutic Sober Living Treatment Model for Kirklees

1.      Introduction To Freedom House

Over the last 12 months, The Basement Recovery Project has been developing a pilot therapeutic treatment model for a 24/7, peer-led, sober living house in Kirklees, called Freedom House. The house is now fully occupied and has delivered some outstanding outcomes. We have achieved our main objective of offering a comprehensive programme of recovery support for individuals (for whom no housing would be a barrier) to continue their recovery journey in their natural community surroundings. The last 12 months have seen Freedom House offer all of the predicted interventions listed below, plus an assortment of unexpected outcomes:

  • Relapse prevention
  • Planned completion of treatment
  • Reduction in harm associated with drug and/or alcohol use
  • Reduction in re-offending and anti-social behaviour
  • Referrals made to appropriate treatment services or for legal or specialist help and advice
  • Independent living established and maintained
  • Enhancement of community safety
  • Reduction in homelessness and incidences of repeat homelessness
  • Maximised income through welfare benefit, debt and money management advice
  • Increased participation in resident’s local communities
  • Stronger links with other agencies
  • Better use of resources through co-ordinated access to housing and complementary support
  • Opportunities for new life choices explored e.g. return to education, training or employment.
  • Localised sober living alternative to in-patient rehabilitation
  • Cost savings to the local authority and other services

2.     The Story at 12 Months

At the beginning of the pilot project, we had identified a gap in the provision of female-specific recovery housing in Kirklees. Initially, three local women came forward who were at the beginning of their recovery journey and were currently living in unstable housing.

It took weeks to identify the right building which was in keeping with our values. We set about renovating the property to meet our high standards for residential sober living accommodation before developing a typical programme of activities for potential residents. With positions advertised for Residential Support Worker, we were fortunate that one of the successful applicants was a female WY-FI navigator, who had previously come through our recovery programme some years ago and was looking to move back to the area. In addition, regular meetings were convened with Emma Hanley, Contracts Manager for Kirklees Council. With Emma’s support, we quickly managed to acquire enhanced housing benefit rates for residents, making the project sustainable into year two.

Freedom House has now been continuously and fully occupied for the past twelve months.  All residents have been referred into the WI-FI peer mentoring training programmes and have benefited greatly from the support offered by our partner service, for example, a successful application for funding was made to the WY-FI personalisation fund to enable the residents to take themselves and their children to Flamingo Land in Warrington. Due to the success of the pilot, we now have a waiting list for stage one accommodation which we feel further evidences the need for abstinent based therapeutic housing locally.

The new financial year will see TBRP coproduce our therapeutic community living model alongside Fusion Housing. They will help to add some local knowledge and experience of housing related issues, ensuring the model has an opportunity to embed itself within the Kirklees community, allowing for further growth and continued sustainability.

3.     Referral / Assessment Process and Ongoing Support

We have worked closely with the WY-FI team and as a result, we have seen the original assessment process modified and adapted to address some of the initial issues that we first encountered during the early stages of delivery. The end product is a coproduced, client centred, responsive referral and assessment process that responds effectively to the needs of our client group.

All residents of Freedom House attend or have completed, TBRP’s recovery programme which consists of group activities, held in our town centre hub, every day. In addition, all residents have proactively volunteered across both our Huddersfield and Dewsbury recovery hubs adding an element of continuity, structure and warmth to the environment.

Freedom House residents have passionately engaged in their own self-written, person-centred support plans, achieving many planned and unplanned personal goals along the way. An average support plan includes, but is not exclusive to, some of the below:

  • Random alcohol/drug testing
  • Weekly key worker sessions, including support plan updates
  • Attending weekly resident meetings/activities
  • Attending TBRP structured group programme
  • Attending a minimum of three Here and Now / alternative therapy meetings per week
  • Attending six mutual aid meetings per week
  • Encouragement to take on service positions in local mutual aid meetings
  • Volunteering in the Breakfast Club
  • Completing a DBS Check
  • Adhering to a weekly house rota
  • Completing weekly food shopping together
  • Completing housing application forms
  • Referral to other external support services (CVS, college, Fusion Housing etc.)
  • Receiving support in liaising with relatives and significant others involved in their support network (including children)
  • Encouragement to meet own aspirations for employment, education, training, social and leisure activities
  • Provision of relevant information to help access other appropriate services, such as counselling, advocacy or mediation.
  • Receiving advice on issues around home maintenance and self-care
  • Developing confidence in budgeting and domestic skills
  • Assistance with securing Housing Benefit and maximising welfare benefits income
  • Assistance with reducing rent arrears and debt
  • Weekly house meetings to discuss and air any potential issues
  • Assistance with finding and moving into permanent accommodation.
  • Identifying appropriate agencies to provide specialist support or healthcare, and assisting with access to these to prevent admission to hospital or other residential establishments
  • Provision of basic life skills i.e. cooking, cleaning and general budgeting skills

All clients are assigned their own key worker. Each resident is expected to work towards agreed goals and show motivation and commitment to their recovery and tenancy with us. Staff devise individually tailored plans in agreement with clients. These meet their needs as agreed in 1-1 sessions. Staff focus on following this plan as a structure for client support and as a guide to evaluating progress made. It is important that residents participate in planning their support and that they can involve other people in this should they wish to do so, for example, a family member or another worker they are confident with.

Key working sessions are conducted once per week but there is support 24/7 to assist with client’s needs. All key workers are in long-term recovery which clients, past and present, have found to be of great benefit. Key working sessions are an opportunity for the client and their key worker to discuss matters which underlie their drug and/or alcohol problems. Matters relating to welfare, resettlement, health, family, indeed anything at all can also be flagged up for action. Clients are encouraged to develop a rapport with their key worker and vice versa.

Freedom House has a living room, kitchen, bathroom and each individual has their own bedroom. The house is fully furnished and equipped, and residents can bring their own belongings to personalise their room. We prohibit television viewing in an individual’s room to avoid ‘isolating’ behaviour. All residents are encouraged to cook and eat communally in the evenings during their stay.

By working alongside the local navigators, all clients are also part of the system that is supported through the Multi-Agency Review Board (MARB), made up of representatives from Mental Health, Substance Misuse, Housing and Probation services. At the time of producing this report, seven individuals have currently benefited from the support the pilot project provides.

4.     Learning

Many of the early issues surrounding the implementation of processes and pathways were ironed out in the first 6 months of the pilot. Initially, there were a few teething problems with regards to procedures around assessment and case-finding between TBRP’s staff team and the WY-FI team needing to be more robust. In a project of this nature, this is perhaps to be expected as working practices often differ. Through improved communication, this issue was dealt with swiftly and protocols put in place for going forward. Changes made include a joint assessment approach from WY-FI and TBRP, a more thorough case-finding process and confirmed discharge address to be documented at the point of assessment.  In terms of learning, it is our belief that the above teething problems and issues could have been avoided if these protocols had been initiated at an earlier time.

In terms of housing benefits, it became apparent that this is a ‘postcode lottery’ in terms of grace periods (grace periods being an overlap of housing benefit across two properties. i.e. When an individual is in prison or rehab). To give up a property to move into sober living accommodation can be a huge decision in an individual’s journey and a potential barrier to accessing the most appropriate care. At the start of this project it appeared that grace periods were subjective but for this specific scheme, we have now attained a 12-week overlap for individuals meaning they have security and choice. However, this overlap is subject to a separate discretionary payment application and we are informed that the discretionary payments budget is not exhaustive. This has been absolutely priceless for those we work with and has allowed clients to try before committing, meaning there is a safety net for those that don’t feel the service is for them.

TBRP are currently in discussions with the Kirklees housing service Fusion Housing to help create a viable and safe alternative in the event that overlap housing benefit is refused. The hope is that Fusion will offer suitable temporary accommodation close by to our current property, so clients can initiate the therapeutic programmes on offer alongside the current residents of Freedom House, regardless of their entitlement to benefits.

5.     Future sustainability and plans

The right structures are now in place to support the project and we have created a solid foundation on which to build its future. The project will be sustainable by utilising a peer lead in the house, supported by a part-time housing support worker.

The project has been well received by the local council and the housing team are keen to support us in our next stage of development. Within our first six months, the project was gifted a vehicle which is now attached to the sober living scheme. Alongside this, our current landlord is a qualified driving instructor and has promised to offer subsidised driving lessons to the residents of Freedom House to help them obtain a driving licence. This is a real asset to the project and its residents, offering access to more opportunities around mutual aid and social integration more widely as well as improving future employment prospects and confidence.

After discussions with the housing benefit department at Kirklees Council, they agreed to pay a higher rate of housing benefit to TBRP whilst also paying the rent for a client’s current property for a period of up to 12 weeks. This process would allow clients that have current tenancies to access our programmes of support while maintaining their current home. This will open the door to more Kirklees female clients being able to access the support available at Freedom House. Four of the beneficiaries were originally aiming for inpatient rehabilitation but opted to attend our community model when it became available. This represents a £32,000 saving from an already overstretched mental health budget that funds all inpatient rehabilitation episodes. This has been recognised by local commissioners who have expressed an interest in utilising our approach to release monies, previously spent outside of the Kirklees area, by investing it with ourselves, helping towards the sustainability of the project.

As with any project of this nature the most difficult part is to create traction and gain buy-in from local providers. In the middle of the year, one unfortunate piece of news was the incumbent drug and alcohol provider in Kirklees went into sudden liquidation bringing large-scale disruption to the local system. We are happy to report that after a period of remodelling we have worked alongside our colleagues at CGL to find a way forward and they have shown a real interest in our housing model being expanded.

Due to the risks associated with sustainability, we decided against taking on a second property as local landlords’ costs were prohibitive. More sensibly, we have now started to compile a waiting list and plan to use supported properties at Fusion Housing as a feeder into our sober living model. Fusion Housing will also support the long-term sustainability of the model by offering and taking over the management of more affordable multiple occupancy housing in and around the Huddersfield recovery hub. Clients on the therapeutic community living programme will also be able to access the bond bank scheme run by Fusion Housing which has been identified as a barrier to individuals obtaining suitable housing. This will enable our residents to move into independent living, while still receiving low-level support in the Huddersfield area. Hopefully, it will prevent them from feeling isolated and keep them around their newfound recovery community and friends.

With the advances made in developing a peer-led model, strong working relationships with the local authority and the inclusion of Fusion Housing, the next 12 months promise to be as buoyant and productive as our first year. The added social value of Freedom House cannot be underestimated and finding a more effective way to measure this added value presents a challenge. We plan to work alongside the Kirklees WY-FI and wider DISC (now Humankind) service for a solution. Special recognition needs to go to Michelle Monkman (lead navigator WY-FI) for her tireless support in helping to achieve the absolute best outcomes for our residents. Michelle’s warm approach and extensive knowledge of local provision have further enhanced client experience promoting more choices and opportunities for all.

TBRP would like to personally thank all at WY-FI including Mark Crowe, firstly for the opportunity to work alongside such a dynamic and client-focused organisation as DISC and secondly, for helping to launch and design a friendly, caring, safe and responsive model of hosing support that promises to serve the citizens of Kirklees long into the future.

6.     Summary

TBRP’s therapeutic community living programme in conjunction with WY-FI continues to go from strength to strength, supporting women to achieve and maintain abstinence-based recovery in their own community. Alongside WY-FI, the previous twelve months have seen TBRP successfully deliver on and complete a 12-month pilot scheme to support the provision of abstinent based therapeutic community living for females in Kirklees.

Freedom House has been fully occupied for the past twelve months with four female residents currently engaging fully in their respective support plans and achieving individual recovery focused goals. All residents to date have been referred into the WY-FI peer mentoring training programmes and have benefited greatly from the support offered by our partner service.

The introduction of a ‘stage two’ house in partnership with Fusion Housing has allowed us to expand our offer to even more individuals whilst creating a safe ‘move through’ process that will support our tenants to acquire and maintain their own tenancies in affordable and appropriate local housing. Our new partners will support our clients to further enhance their budgeting skills whilst engaging them in back to work focused training, education and employment opportunities. The stage two house has been fully decorated and equipped to the same high specification as our stage one and further work will be carried out on the garden and patio area to help make the stage two house a home to be proud of.

6.1.   Problems and issues

In the last 8 weeks, two of our stage one residents graduated to the new stage two house and for the first week, all was well. During the second week, one of the ladies disclosed to our housing worker that alongside some family problems and the change in routine she had used alcohol whilst in the stage two house. A prearranged contingency plan was actioned that saw Fusion Housing provide our resident with safe accommodation until such a time as she was ready to move back into an abstinent environment. In less than 48 hours alongside the support from peers and staff, the lady in question was completely abstinent and back in the stage one house, fully engaging in recovery activities and mutual aid groups.

6.2.   Lessons learnt

Some lessons were learnt during this process including the need for a pre-agreed contingency plan that manages the accumulated risk of relapse and the potential for homelessness for residents living in an abstinent environment. It was noted that the recovery community played a significant role (out of hours contact etc) in the reengagement of our resident and this factor will be implemented into all future risk management plans. This episode has also highlighted the need for a “Safe Bed” to be available at short notice to provide safe accommodation for any future resident that may have relapsed back to substance use. With this in mind, we are now in talks with our partners at Fusion about creating this safe space and making it available 24 hours a day, 7 days a week. Early conversations have highlighted that a void room could be created at a cost of £50 each week and having this available 24/7 would generate an annual cost of £2600.

The past 12 months working alongside WY-FI have proven to be beneficial for all, none more so than the 8 ladies that have spent time at Freedom House. The 12-month pilot scheme achieved all its aims (including some unexpected ones) and now sits ready to become part of the therapeutic pathway for women entering treatment for substance misuse in Kirklees. The first year has helped to save over £32,000 from the Tier4 budget for residential rehabilitation treatment, currently being held with the mental health commissioning team at Kirklees Public Health. We have approached the commissioner for mental health and it’s hoped that a percentage of the savings made in the coming year will be forwarded on to support the Freedom House project to expand further.

About WY-FI

WY-FI supports people who are not engaging effectively with services and are experiencing entrenched needs in at least three of the following HARM area:

  • Homelessness
  • Addiction to drugs and/or alcohol
  • Reoffending
  • Mental ill-health

Our ethos is that these individuals:

  • are supported by Navigators and Specialist Workers who build trusting relationships over time and who are service neutral
  • receive person-centred support to achieve their hopes and aspirations
  • inform future delivery models and innovation

And that by 2020 adults with multiple needs in West Yorkshire should have the opportunity of:

  • a settled home
  • positive health and wellbeing
  • access to education and employment, and
  • trust in a positive future

 

About Fusion Housing

Fusion Housing is a non-profit making charity working to help individuals who are experiencing housing related problems and need support with learning and employment.

Services include:

  • A range of Housing Support services for young people across Kirklees, including Young Parents, Refugees and Asian Women.
  • A Bond Guarantee service to help individuals that do not have children, and on low income and who are in band C/D/E with the council to secure a private rented property in the Kirklees area
  • A Managed Tenancy service that provides tenancies in shared accommodation let directly by Fusion Housing to clients aged 18 to 35 years old.
  • An Advice and Specialist Legal Advice service helping with Housing matters and representation at Housing Possession hearings in the county court.
  • A range of informal and accredited learning opportunities, information, advice and guidance to support young people into education, employment and training.
  • A Food Bank service based in our offices in Dewsbury and serving the North Kirklees area.