What is going on in this house?

[Neighbourmystery]

Right, this is going to sound nosy but here goes...
A house in a street I know was owned by an old lady with no family. When she died, her house stood empty for nearly a year then it started having work done. It's been bought by a health service far away from he town we live in (think I live in Liverpool and NHS Devon and Cornwall bought it) BTW these are not the real locations. So, they do lots of renovations, including putting a much higher fence up which has a key code entry they also put frosted film on every window. There's a new build extension on the side with coded keypads too. This is where 2 carers are. There are 4 carers altogether, 2 at a time and then a swap. There is one man who lives there . He is in his 30s , able bodied can move well etc I've seen him once or twice in the garden in a whole year. Another twice I saw a darkened van come to get him. He was only gone for an hour or so then back.
I cannot imagine the scenario this might be. I'm not curtain twitching and permanently watching but I am fascinated.

Yes I am aware that ASD is not a MH condition. I don't think that just because it falls between the cracks in terms of not being a MH illness as such and also not being a health condition that can be cured or improved, and also not always intersecting with intellectual impairment or LDs either, that there should not be a more efficient and cost effective way of dealing with those autistic people who are not safe to live independently, and a constant danger to others.

Just because technically, hospital isn't the appropriate setting, doesn't mean this sort of setting is appropriate. It's not. And it's not remotely affordable.

This is why relatives can't be involved in these kinds of decisions. Of course we all want the best that's possibly available for our relatives, whether that's care or some ultra expensive drug or treatment.

But, "we" can't pay for it all, so difficult decisions have to be made. My neighbour went to the US, after being told her cancer was terminal, for treatment that wasn't available on the NHS. 20 years on she's just run a marathon. The NHS would have let her die because of cost, those kinds of decisions happen daily.

Well, of course you're interested, OP! And I bet those who've been snide and pious to you on this thread would be just the same. Try to ignore the people who are trying to rile you - they are literally on every thread.

The PP who said that talking about this on an anonymous chat site with an anonymous username, giving precisely zero identifying information "crosses some boundaries" - LMAO! 😂😂😂 Well, by that logic, none of the hundreds of thousands of threads on here discussing situations with family, friends, and partners should be allowed, as they all contain much more identifying information than this! Perhaps MN should be shut down if anonymous people can't discuss anonymous neighbours on an anonymous website! 😂😂😂 Crosses some boundaries - oh, my sides!

Im just explaining to you why these arrangements are made and the limitations of the formal settings for different conditions

There is a lot and I mean a LOT of argument between health and Local Authorities about who picks up the tab for this or that person. No one wants to put these packages together, health will say its not a health problem, social care will say it is a health problem. Both will say its the family's problem. Criminal justice will say its a health or social care problem. Society will say its a criminal justice problem. Police have opted out a long time ago and will say 'right time, right service, dont call us'

Who's problem is it?

If it makes you feel any better, I don't think the situation of OP's neighbour is very common. His problems must be unusually severe.

And I'm not sure what you want society to do with a person who has such needs. Take him out the back and shoot him?

We don't put people in institutions for life anymore. I'm proud to live in such a humane country.

Yes that made me laugh as well, the OP is crossing boundaries!!!!

Very good.

Didn't they shut pretty much all the secure hospitals though, remember "care in the community" from the dear departed Mrs Thatcher? They used the excuse that it was better for people to be cared for in their own communities and homes to shut down residential psychiatric units etc.

There are loads of houses like this for autistic / disabled / troubled children too. Sometimes with up to 6 carers per child. Privately run / outsourced and costing local authorities millions and millions per child every year. Private businesses making crazy profit off it.

The problem with the families who want their mentally unwell or mentally disabled relative to live the most free life they can, is that they don't want to be the ones caring for them 24/7 while they do it.

Because they already know how exhausting and demoralising and risky and dangerous and basically impossible it is to enable them to have that. But they want the rest of us to pay for round the clock care for other people to provide the care that they themselves don't want to do provide because it's too much like hard work and they are tired of being head butted or having their house smashed up daily.

So I'm sorry but unless you are prepared to do it yourself then you can't always demand and dictate the level of 'care' and 'freedom' and independence' or 'autonomy' or 'inclusion' or whatever you want to call it, that you'd like that relative to have.

Look at the situation recently of the little boy thrown into the crocodile enclosure. That mentally disabled man had two full time carers with him and this still happened. And we've been told that his limited capacity to understand what he did means he won't face any charges for it. His right to 'enjoyment' and 'inclusion' meant other people were put needlessly at risk and it almost cost that poor child his life.

Perhaps, after the inevitable enquiry about what went wrong (apart from the bleeding obvious) some genius will argue that 'lessons have been learnt' and from now on, the answer to this is that people like him should have six carers, not two, when they are taken out for the day among the general public. Any measures, at absolutely any cost, just so long as they aren't 'locked up in an institution like Victorian times'.

So what do you suggest they do with this man? put him in a residential care home where he may attack and seriously hurt other residents? If your family member was in residential care and other resident killed them, how would you feel about that?

wow.

just wow.

Putting a person, an actual human being who is unwell in solitary confinement. Ah well, might as well put them on death row eh? Not like they have feelings and are deserving of a life.

Your supposition that a person who requires this level of care is someone unable to have a meaningful life or be able to have any understanding of a meaningful life is both wildly inaccurate and offensive.

What a spiteful post. I worked in disability outreach and saw things from the other end of he scale. Families who lived with adult disabled children with severe autism or mental health conditions which made them prone to violent meltdowns.

I’ve seen parents - often with younger children at home - having to set up safe rooms in their own homes, essentially barricading themselves in to protect themselves from the violence involved. Often the adult child is much bigger and stronger than their parents and I’ve seen families living in what sometimes resembles a war zone because of repeated damage, and parents/family members repeatedly assaulted.

These families are often essentially left to get on with things because there is little or no support available in their area - services are patchy across the country and non existent in some areas.

Placements are few and far between for these people because they cannot be housed safely in residential settings and there aren’t nearly enough secure settings for care, so they end up in these circumstances - many also end up in inappropriate care settings where they are a danger to themselves and others, often with serious consequences.

I’m not suggesting that this is the case here, but you clearly have no idea of how some people have to live, or of the nature of these conditions and what they mean for individual care settings. Where would you prefer the resources go, when the current infrastructure is creaking ?

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.

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.

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)

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

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.

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.

Absolutely this.

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.

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

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.

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.

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 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.