Case study pro form – Housing models

The Transforming Care programme aims to improve services and support for children, young people and adults with a learning disability and/or autism who display behaviour that challenges, including those with a mental health condition. The programme of work is led by six national delivery partners: NHS England, the Local Government Association, the Department of Health, the Association of Directors of Adult Social Services, the Care Quality Commission and Health Education England.

Building the Right Support sets out our national plan to develop community services and close 35-50% of inpatient facilities for people with a learning disability and/or autism who display behaviour that challenges over the next three years.

We know that a key barrier to moving people out of hospital settings is a difficulty in accessing the right accommodation; we also know that inappropriate housing arrangements that are poorly organised or do not meet the individual needs of the person can increase the likelihood of behaviour that challenges and lead to placement breakdown.

To support the ambition to reduce overall inpatient capacity for people with a learning disability and/or autism by 35-50% over the next 3 years, we therefore need to see a significant expansion in housing options for this group.

NHS England is developing resources to support commissioners in developing housing to achieve the objectives set out in Building the Right Support. We are looking for case studies on any housing models you currently provide for children, young people or adults with a learning disability and/or autism people who might variously:

  • Have a mental health condition (such as severe anxiety, depression, or a psychotic illness) or a personality disorder
  • Display self-injurious or aggressive behaviour that is not related to several mental ill-health
  • Display risky behaviours (such as fire-setting, abusive, aggressive or sexually inappropriate behaviour) which may put themselves or others at risk and which could lead to contact with the criminal justice system
  • Display behaviour that challenges, including behaviours that lead to contact with the criminal justice system, and who have lower-level health and care support needs but often come from disadvantaged backgrounds (e.g. social disadvantage, substance abuse, troubled family history).
  • Have been in hospital for a very long period of time, often having not been discharged when NHS campuses or long-stay hospitals were closed. This group will include people whose needs are similar to the four described in a) to d) above, but who face additional challenges as a result of having been in hospital care for so long.

Name of scheme / Age range
Number of units / Gender
User cohort / New build or redesign
Cost of redesign/adaptations / Annual running costs (not including support or care)
Type of tenure / Average length of Stay
Predominant diagnosis (LD/autism;
Personality disorders, etc.)

Overview of the scheme:

The model in action: (from referral stage and throughout the pathway, whether there is a stepped approach, whether the level of support and care changes over time, other agencies you work with, how you manage risk, service user reviews, etc.)