This model will deliver a new flexibility in the way we deliver care, so people can access the right level of support, at the right time, in the right setting. The overarching aim is to enable people with mental health to move towards living with greater independence.
You can see an overview diagram of the care pathway below. Select any of the topics which follow to learn in more detail about how we think this model will work.
Care pathway model
To enter this care pathway, there needs to be a referral that identifies that a person's complex mental ill health means that they have specialist care and support needs. This referral will come to the partnership's single point of contact, via a Care Co-ordinator, or in future, a member of the B&NES Council Brokerage Team.
We have already considered feedback from the public and mental health care professionals in our area, as well as council services in other areas. These discussions have identified that simplifying the referral process, and having a single point of contact, reduces the chance of errors, and makes it easier for people to engage with the support on offer.
When there is a referral, there will be a single point of contact to discuss care and support needs, and which services are most suitable. We may provide any of the following forms of support:
- Non-accommodation based Supported Living (including outreach and floating support)
- Accommodation-based Supported Living (any scheme where housing, support, and sometimes care services, are provided as an integrated package)
- Specialist residential care homes
Wherever we can, we will deliver these services through one of our partnership providers:
- Arch Care Services
- Bath Mind
- Milestones Trust
- St. Mungo’s
However, where an off-partnership provider is more appropriate, (for example, for an out-of-region placement, or other specialist services) we will also organise this, and act as the point of contact for service users.
When you enter the pathway, you will experience a flexible, seamless service, focussed on best supporting your needs in the right setting. For example, if you have been cared for in a specialist residential care home which has supported you to develop skills and independence, you will be supported to access accommodation-based Supported Living, through the single point of contact and relationships in the partnership.
You will not be passed 'from pillar to post’, but instead be guided and supported through the process seamlessly. Similarly, the partnership will offer support when you are able to make the step back into living in your own home with support (non-accommodation based Supported Living).
We recognise that moving from one sort of support to another can be stressful. Responsibility for your welfare will remain with your existing care provider, until there has been a comprehensive handover to any new provider or service. This aims to reduce any feelings of anxiety, confusion or isolation that you may feel during important points of transition from one form of support to another.
We recognise that everyone's recovery is different: your pathway may not always travel in one direction, and there may be periods where you need extra help. We will continually assess your progress and needs, and if these change, the partnership will help you to get the right level and sort of help.
The care pathway model is still at an early stage. We continue to work on some important parts of its design, including the following:
Single point of contact for service users, carers and families
- Who this person will be
- How the contact will operate
Continual assessments of service user needs
- Who will make these
- How we will make them
- How we will share them with other partner organisations
- How we will use them to deliver co-ordinated and personal care
While we are still working out some of the details, our approach is very much focusing on the responsibility of the partnership to work collaboratively, to support people in a seamless way. The feedback from this consultation will help to determine how we finalise the care pathway. If you have ideas about the points above, or any aspect of the model, this is an ideal opportunity to influence the final design.
To get a fuller idea of the planned scope and stages of the whole project, please view our Project timeline page.