What is going on in this house?

People really need to educate themselves on how funding works with NHS, LA etc and how it works with providers before commenting on threads like this and offering disgusting and ignorant views.

Yes agree with this. In my ICB which serves a huge area of probably 1 million plus. We have no more than 10 high cost cases and most of them are 3:1 max and thats only waking hours.

@ForeverNowWithin

So say a 15yr old fell off their bike. Wasn’t wearing their helmet. Got a brain injury. Parents tried to care for them for a few years but their other dc were at risk due to the change in them since their injury. Now requires 2:1 care, regularly inappropriate and difficult to look after. Prior to the accident was just a normal kid. If this was your child you honestly think they should just be locked up? You would be ok with that? Providers and carers work hard to ensure they still have a fulfilling life as much as possible but you would be ok with your child not getting that?

Fuck me, some of the responses on this thread are disgusting.

OP I don’t blame you for being curious, lots of us would be.

You’ve hit the nail on the head. No one wants to take responsibility. The attitude on here seems to be that care in the community doesn’t work, so let’s step back sixty years and start locking people away again, simply for being mentally unwell.

"Any measures, at absolutely any cost" - that is just not what happens. If you think LAs and ICBs are jumping up to give out expensive packages so that all people can live their best lives, you are seriously mistaken.

No one knows yet what went wrong with that crocodile case (just a matter of time before it was brought up). It may well have been unbelievably stupid planning, staffing and negligence that led to it, therefore it won't be a case of "let's give him 6 carers so he can visit crocodiles again" (how ridiculous). It may well reveal absolutely nothing about the care needs of the general population of people with high needs LD. It certainly won't be proof that we need to go back to mass institutionalisation. When a woman with rapid onset postpartum psychosis kills her baby, do we say all postpartum women need locking up for a year just in case?

For all we know the OP's neighbour needs 2:1 care because he is a danger to himself and absolutely no one else, and has extensive personal care needs. I know several children like that.

So whose spending half a million for 1 person?

It’s neither realistic, nor pragmatic, it’s cruel and it’s a backward step. You’re basically advocating for putting people in prison simply because they have difficult mental health conditions, and you’re making the massive assumption that they’re not cognisant enough to realise what’s happening to them, so that makes it OK.

So after decades of being the absolute last in line for resources, you’re now suggesting that those with mental health/cognitive difficulties should be even less of a priority, simply because of the cost of addressing their needs ? Lock them away from the rest of society - hell, they’re so far gone they won’t even notice ? That appears to be what you’re saying. I’m wondering what kind of experience is informing your opinion, because you clearly haven’t the first clue about mental health.

Im a social worker, and I worked for a charity for the vulnerably housed for a time. We set something up like this. So we bought a few run down properties, did them up, then started off with 1 man who was homeless and we moved him in (there were strict criteria for this), once we could ensure there were no drugs, no alcohol, no anti-social behaviour, bills being paid etc then it became more permanent and we would put more people in. We had to ensure the residents wouldn't clash and negatively influence each other. It could be something like that - people just needing a leg up and support before they stabilise.

Theres a house a bit like that in our community. The authority paid 1.8M for it, its a 4/5 bed. (We are in the south and thats the going rate!) Spent nearly 1m renovating, and now it sits empty for the past 18mths because it doesn’t meet some of the fire/safety regulations. It was going to be a type of children’s/teenagers home. Not sure what/if it can be made compliant but this is tax payers money they are throwing about!
I’d imagine they could have bought a similar property for buttons in different parts of the country, but then harder for family to visit I suppose. I expect similar with your house OP - its a cheaper place for the council to buy a suitable property for people that their responsible for?

Yes, exactly that, but in some form of solitary confinement where he has access to carers but not actual physical access to other residents. Or very limited access to other residents in strictly controlled circumstances and small doses. So like when you see someone doing a prison visit via a protective screen, they could socialise to a degree, if capable or willing to do so, but not have the opportunity to physically attack other residents.

It's not very nice, I know, but it's just the most realistic and pragmatic option. People are saying 'where are these facilities? They don't exist.' Well neither do these very expensive, bespoke assisted living places until some committee decided to buy a house and convert it to one. These people are essentially being kept in solitary confinement (apart from access to their carers) anyway aren't they? That would appear to be the entire point of these houses, to accommodate certain very high needs, high risk individuals away from other residents in a shared facility. So we may as well drop the hand wringing and outrage at the idea of solitary confinement for unwell or mentally disabled people. Because that is basically what these outrageously expensive tailor-made solutions are designed to do.

That's what they said./s

I was actually about to post similarly. The assumption here is that the tax payer is footing the bill for these facilities, and that’s not always the case. As an outreach worker l supported a fair number of people who were awaiting compensation/insurance payments and who went on to use them to set up their care.

We have a mental health crisis, largely due to years of underfunding and lack of foresight. Now that it’s here, what some people seem to be advocating for is locking people up and forgetting them - one poster upthread actually intimated that their lives weren’t worth living anyway so essentially they wouldn’t care !! It’s shocking.

24/7 5:1 care is absolutely exceptional. 4:1 is the most I've heard of in previous work and that is incredibly rare. The vast majority of community packages for even very high needs autistic people or people with LD or brain injury or mental illness will come nowhere near that level of resourcing.

Some expensive medicines are used only to prolong life, not to cure. I'd cautiously theoretically agree with you that just because one treatment is expensive doesn't mean expensive packages should automatically be used for everything, but I think it is often telling that part of this argument used by some people often betrays a core belief underneath it all that LD, autism, brain injury and mental illness are not worthy of the money that physical conditions are. It's fairly unusual to hear people argue that cancer patients shouldn't get expensive drugs if they're unlikely to live another 10 years, or that premature babies shouldn't be treated due to cost, or that elderly people should not get expensive treatment / operations, or cystic fibrosis patients shouldn't receive expensive drugs, or burns patients shouldn't be treated with multiple highly specialist treatments and expensive surgeries. Sure, some people argue this, but not many. As soon as LD, autism and the like are brought up, immediately people pipe up about the cost not being justified etc etc.

I do agree with you about the benefit of some "community" packages though, as I said in another post. If it is "community" in nothing but name it is harmful, disingenuous and expensive. The harm caused is more important than the wasted money though and there are no guarantees hospital placements would always be cheaper.

I don’t judge you for being nosy OP I have a peculiar situation with my own neighbours that I can’t work out. There’s a woman who lives there sometimes for long stretches and then disappears for a month or two, sometimes there is a second woman, sometimes there is a dog and sometimes there are two and sometimes there are none. Her parents are there often but not necessarily when she is there and her dad seems to be coordinating some building work but then also disappears for long periods of time. I can’t work out what they are using the house for, if they are doing it up to sell on, doing it up to live in or what.

Anyway in your situation I think it’s pretty obvious. It has been purchased and refurbished as supported living.

The reality is that wherever you place these facilities there will be objections. These men may very well have spent years in inappropriate care settings, or their families left to cope with aberrant behaviours with little or no support before these facilities were set up. As you so rightly say, they have to live somewhere, and since we moved away from institutionalisation as the norm a long time ago, it’s hard to see what the alternatives would look like, given that in many cases traditional residential care isn’t appropriate.

Funding does not work in that way. NHS money is not one huge pot every service dips into. On a basic level money is allocated and different services have their own budgets. Budgets are also shared with Local Authorities/Integrated Care Boards etc, so spending on LD has no impact on cancer services.
Some of these care packages are funded by compensation payments, insurance companies or the NHS, birth or medical complications.
Mental Health and Learning Disability have always been historically underfunded hence the crisis points we are seeing now.
but locking people away because they are disabled, infirm or not worth the money as people have said on this post shocks me… after all there for the grace of god go I, it could be any of us one day

And people keep focusing on NHS resources, its unusual for this to be NHS, these settings are usually LA provided from social care

The money is still from the public purse of course.

Absolutely this.

Agree. The life lead by some of the individuals on 4:1 + care in our ICB is harrowing. Not one of those people would have asked for the experiences they have had. Its hard to believe they have survived. Many have already been let down but the authorities many times by the time they reach adulthood. The cost of their care may be expensive but there are far better NHS cost savings to be had than removing specialist care from the most vulnerable in society.

And l would add to that, that many people with mental health/cognitive difficulties are unable to access the help they need before they cross into criminality and end up in the justice system, much of the time with inappropriate outcomes such as prison sentences, simply because there is either nowhere else for them to go, or as l’ve suspected for a long time, and you’ve evidenced here, it’s often the cheaper option. So we end up with people who desperately need appropriate mental health care, instead trapped in a revolving door cycle of prison and reoffending.

A timely post, OP, as far as my personal circumstances go. In the past week we’ve had two new neighbours move in over the fence. Two men, arriving several days apart. Appears that the property is being repurposed as a shared supported living facility. So far, so reasonable. Carers come and go for a block of 4-6 hours a day, but there’s no overnight care/supervision. The problem is, however, that these men are both loudly and aggressively swearing, shrieking, wailing regularly, harassing neighbours at all hours of the day and night including banging on bedroom windows, and generally putting the street on edge. I share a wall with another family who has escaped violence and homelessness, and those are indeed the factors that have led to me and my daughters finally being placed at this address. Everyone needs to live somewhere, but my little family and the one I share a wall with have been through too much to not put our guards up when men are screaming vulgarities that would wake the dead.

I’d be very intrigued if I were you too, OP. Doesn’t make you nosy, just makes you observant X

The bog standard childrens home for a residential placement is usually around 5-7k a week, we think we're doing ok if you can source it for that

Some are up in the 15-20k a week where there is a DOLs, some are more than that.

Providers know there is no where else to put these children and so name their price.

A secure setting for a child comes off surprisingly cheap believe it or not. I think they're around 7k a week.

There are far far fewer children in care of course than there are adults who need placements but that doesnt include costings for all the anciliary costs of childrens needs, foster care for example, school transport (which is an education budget not childrens but it comes out of the same LA pot)

Not just that, but the assumption that there are enough such facilities available is laughable. See my post upthread - the reality is very different. I agree that for some, care in the community simply doesn’t work, but to suggest that we just gather them up and lock them away for life is unconscionable, and reminiscent of a system we’ve moved on from since the mid twentieth century. IME it’s usually people who have no experience of disability or caring who think like this - the mentally ill and disabled are just an inconvenience to be swept out of sight and out of mind.

Some figures of other institutional accommodation, for those indignant at the expense of this sort of care.

It costs approximately £273,000 to £300,000 per year to keep a single patient in a high-security psychiatric hospital in the UK. This equates to roughly £750 to £820 per day for each bed occupied.

Youth (Under 18) in a Young Offender Institution: Approximately £306,492 annually due to required high staffing levels.

To keep an adult woman in prison in the UK costs around £83,987 annually.

High-Security Prisons: Facilities like HMP Woodhill peak at roughly £131,125 per inmate.