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learning disability | autism | mental health Design for People with Behaviours that Challenge Richard Webb Executive Director of Housing & Development

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Who are mcch? Providers of care, support and housing Learning disability, autism and mental health Support 2000 people Registered charity Not a Registered Provider London and the south-east Specialist housing department Tenancy management New build development Private sector Partnership with RSLs

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Why do we (mcch) design and build new schemes?

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Accommodation out of date Poor quality Needs and aspirations Direct link between environment and outcomes But.. Engagement of Registered Providers (development & service delivery) Lack of money Squeeze on local authorities Procurement v Commissioning Short term thinking

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Could the NHS help? Releasing capital Land and assets Long term partnerships It can work but....be prepared for.... Fatigue Hair loss Frustration Broken furniture Legal battles Capital Grant Agreements

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So, what is challenging behaviour?

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Holly Lodge

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Sector Recognition Kent Business Award for Innovation in Partnerships National Learning Disability Award for Supported Housing Good practice example for Winterbourne View studies Had its own Blog! Local Authorities up and down the country trying to replicate

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Concept Environment to influence/reduce behaviours Self contained v shared accommodation Learning from experience Designed by people who really know staff, families, care managers Flexibility Attention to detail no matter how small Long term commitment no ordinary development

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Site layout

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Internal Layout

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Design

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Technology

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Features (1) Toughened kitchen sinks with overflow shut off valves Magnetic release locked cupboards without handles Metal kick plates to back of kitchen floor units Induction hobs with lockable metal covers Narrow, tall windows with sloping sills Integral blinds with detachable, magnetic mechanism Sun pipe (for Seasonal Affective Disorder) with electric blinds Curved wooden walls covered with marmoleum covering LED lighting throughout Built in toughened Formica media unit Large lockable storage cupboards Cupboard with sluice facility Toughened bathroom suite with flexibility for flush floor or bath Hygienic Whiterock wall covering

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Features (2) Zoned underfloor heating External access panels for repairs Fingerprint entry to all external doors Call point to staff from each unit Sensor lighting from bedroom to bathroom Sensors and shut off values to all water supplies Bathroom sensors Ceiling movement sensors throughout Mood lighting ISDN lines to make remote system changes Digital handsets for telecare alerts Separate boiler room (with back up system) Green (seedum) roof Solid doors with appropriate handles

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Challenges Cost Time Design aiming for right first time User testing Clinicians/professionals Voids pragmatic approach required

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Successes Improved outcomes Reduction in crisis intervention People able to return to Kent Repair cost savings (some) Commissioner savings Improved environment for staff less stress Made the sector think influence future design

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Is Holly Lodge the answer? Yes and No Range of providers Multiple solutions Flexible approach different solution for a different time Housing/environment is critical for users and staff Long term financial benefits Invest to save

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Roberts story 38 years old Severe learning disability Autistic Spectrum Disorder Epilepsy Displays challenging behaviour physical injury and damage to environment Limited cognitive ability Sense of humour Physical activities Duel funded by Health and Local Authority

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Roberts story

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Robert moved in September 2013 Building more appropriate Continued to challenge the environment user testing Staff less stressed breaks are now possible More choice he can choose what he does, where and who with Support interventions have decreased Now able to spend time on his own Can now socialise when he wants to Outcomes improving

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Richard Webb Executive Director, Housing and Development 01622 722493 r.webb@mcch.org.uk