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.

That's really interesting. Thanks for elucidating.

Joint commissioning sounds possible/probable?

This patient must have someone advocating for them strongly (good for them). I've just looked up what DoLS is (Deprivation of Liberty Safeguarding), it seems like someone somewhere is taking good care of this young man. For other posters and maybe the OP, I found this:

The Deprivation of Liberty Safeguards (DoLS) procedure is designed to protect your rights if you are deprived of your liberty in a hospital or care home in England or Wales and you lack mental capacity to consent to being there. If it is assessed that you do not have mental capacity to consent to care or treatment, it may be necessary, in your best interests, for other people to decide to place you somewhere to receive it.

So, able bodied but seemingly severely enough lacking in mental capacity and with enough back up/support for this option to be funded. I find that very reassuring, if it's the best option for him.

@likelysuspect when you said "People wanted care in the community. This is the outcome", are you speaking as someone with knowledge/experience of all this, who has an opinion on whether this is a good thing or a bad thing?

My friend's husband was diagnosed with early onset frontal lobe dementia in his 40s and now, early 50s, lives in supported housing where he receives 3:1 care due to his behavioural needs. I don't think you have a right to know why this man is living there and I doubt very much if the carers would tell you anything anyway, patient confidentiality would forbid it.

I can't understand all the unpleasant replies you have had OP as if I were you I would be fascinated and desperate to know.

I worked in this sector for years. It was not unusual for a care package to be put in place, including care workers to cover 24 hours a day, and extensive adaptations to accommodation to meet one individual's needs.
One care package could cost hundreds of thousands of pounds a year.
Sometimes staffed by NHS and sometimes contracted out to care companies and sometimes a mixture of both.

OP isn’t asking for the diagnosis which is rather by the by. She’s just wondering what kind of set up it is.

Yes because it won't put anyone in a horrible position or compromise their privacy. I'm the same way that there are hundreds of anonymous threads on here discussing real life things that can't be discussed for whatever reason in the person's real world. Mumsnet would close down wouldn't it if every thread was shut down with "go and talk in real life"

Exactly . I don't have the right to ask

I think the people saying it's most likely the man has some level of LDs, potentially autism with very high support needs are right. And yes of course the NHS and social care services would rather go for a cheaper option such as living with relatives or in a residential home or shared living type of situation is preferable, but that really doesn't work for all. A lot of people with LDs really don't cope well with that kind of setting, can be distressed by the busy environment, and become violent (or even sexually disinhibited) towards themselves or other residents and staff. They can do a lot better in their own space which can be the completely set up to suit them and with dedicated, consistent carers. And yes this is cheaper too, not that I personally think cost should be the only determinant, stopping people getting assaulted for instance more important but if the person can manage say with 2 carers in their own placement vs needing 4-6 in a group home (which is what it takes to safely restrain a young healthy man having a meltdown) then that's win win.

The people wondering about why the carers appear to have lanyards from the further away trust, presumably because that trust is funding care so employs them, but they may well be local to your area, if they're with this client 12 hours at a time this is likely their full time job, there's nothing stopping NHS Devon to recruit carers in Newcastle or vice versa. They might have to travel to Devon occasionally for training but likely not every day. And yes the cost of buying and renovating the house might seem like an extra cost but is also as an asset for the trust so it all does add up from a taxpayer value for money point of view (unless you think people with very severe mental health or LD issues should just be locked away in padded cells or similar)...

Adult being cared for in a placement at great expense to the taxpayer?

Maybe he's a Russian defector and the carers are MI6 involved in a very long detailed debrief. the NHS bit is all deep cover, they obviously don't want to go public and aren't going to put a sign up outside that says "Safe House". Have you seen Alec Guinness, or his look-alike wandering around?

God I hadn't even considered spies!

Have a look on your council website for planning decisions. There might be one for a change of use for the house.

We recently had one for a house on our street. They wanted to change a house from residential to a home for 3 children with behavioural problems. It was turned down because we’ve got so many covenants on our houses and, also, it wasn’t in a suitable location according to the council. None of us were made aware apart from the direct neighbour who shares a drive with that house.

No I dont think its a good thing. I started working in MH just as Care in the Community was taking off, hospitals closing. 'Day centres' 'support groups' were the replacement.

People were too ill to live independently but of course they're not 'ill enough' to remain in hospitals. So they live chaotic and disconnected lives sometimes causing harm to themselves through accident or self neglect, sometimes causing harm to others by dysregulation and lashing out. Usually small scale. Usually criminalised.
Im including people with conditions which also are not strictly speaking MH issues but which are usually comorbid associations so ASD, LD etc

Care in the community was politically convenient as its cheaper on the surface and done under the guise of empowerment and indivdualism, service users having choice and agency and moving away from instutionalising people.

I dont minimise those concerns but believe me, it is not better now. And its costing the country a fortune. For every penny saved on a care home setting, you can times that by 10 in terms of housing pressures, police, social care, affect on the wider community, affect on relatives who often have violent and high need adult children living with them at home meaning their parents or relatives are unable to work/have MH conditions themselves caused the stress of managing this.

I could go on but theres too much to say about it.

If its assisted living, why have nhs staff from a trust hundreds of miles away?

Is the NHS Trust in an expensive area and this is a cheaper area? Might have been more cost effective by hundreds of thousands to buy and adapt a property in a less expensive postcode.

The fact the NHS carers live in the property mean they can be hired locally by the NHS Trust. Similar to me if I worked in the UK for a US company based thousands of miles away.

You can’t tell someone’s health status by looking at them. It’s likely they have complex learning disabilities and need 1:1 support ..which is expensive ..are they in a cheaper property area? They may have been targeted in their home community. So generating gossip about them would be highly unwelcome for the public good and safeguarding this person.

To Kill A Mocking Bird

Oh and he may not have someone advocating for him at all, he might just have been so dangerous to others or so at risk from others that the only way to support him is this. If he could live with others in a facility or home, he would do, which suggests he needs a solo placement for others' protection

I’d be intrigued too. Have you tried checking the CQC website to see if it’s registered there?

I am not in the slightest generating gossip.

It would seem perfectly normal to me to strike up a conversation with the new neighbours or their visitors/staff.

If it's being used as a halfway house or something, wouldn't that need a change of use planning application?. I know there was one here when a house was changed to a children's home, even though it was only to care for three children.

I would say this. They might not be a danger but also might not really be able to function in society. Especially if their crime was caused by psychosis etc. They will be medicated. Then one carer wouldn't be permitted to do the job alone so there's 2 of them.

I'm thinking it's bespoke secure assisted living accommodation for someone who's not safe to be in the community but there's nowhere else to house him. He could be physically ok but may have severe learning difficulties and be dangerous to himself and others. Probably hasn't committed a crime but there's a risk he could.

The accommodation is probably built with future residents in mind as well.

Mos likely he either has mental health issues or a learning disability.

Wouldn’t you want that for your loved one if it was the best and safest option for them?

1 - He has very high, very specific care needs that mean seeing the outside and being able to get out easily isn't a good idea..

2 - ditto, but he's in witness protection.

So the NHS involvement but out of area could be as a result of witness protection or, because its a much cheaper area to house him in. I favour the witness protection theory myself because I doubt you'd have to go THAT far to get cheaper properties, assuming the real location of the NHS trust involved is a comparably long way from the house location as your fictional examples are.

Would the NHS in "Liverpool" send their own staff/uniforms? Wouldn't they commission the local NHS to provide the care?

That's how it works in Children's Services anyway. Local authorities pay each other for children placed in the area.