Item 8 Appendix 1 - St Andrews Way
West Dunbartonshire Council · 5 June 2024
Back to Tendering Committee — 5 June 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
Page 1
AssessmentNo 993 Owner rickeera.kaur Resource HSCP Service/Establishment Joint First Name Surname Job title Head Officer Rickeera Kaur Contracts &Commissioning Officer (include job titles/organisation) Members Neil Mckechnie : Contracts, Commissioning &Quality Manager : West dunbartonshire HSCP Sylvia Chatfield : Head of Mental Health, Learning Disability &Addictions Services : West dunbartonshire HSCP Anne Kane : Integrated Operations Manager - Mental Health Services : West Dunbartonshire HSCP (Please note: the word 'policy' is used as shorthand for stategy policy function or financial decision) Policy Title Supported Living Provision - Mental Health Support Services The aim, objective,purpose and intended out come of policy A new service is being commissioned and procured to support people in WD with severe and enduring and complex mental health issues, providing accommodation and support for up to 24 months, whilst planning for future tenancy needs and sustainment. The overarching aim is to support people with vulnerable health and wellbeing to live as independently as able in the community, and to reduce the adversity and trauma of mental ill health. Outcomes are identified as: - Promotion of wellbeing as being paramount. - Adults increase their ability to self-care. - A holistic approach (including mental, physical, social, emotional needs) is taken in relation to the individuals outcomes based care plan. - Mental health is monitored in conjunction with the Community Mental Health Team (CMHT). - Adults have increased levels of confidence and independent living skills. - Adults are supported to move towards to their own tenancy with or without ongoing support. - Adults are supported to engage with local supports and community activities to help build resilience and secure sustainable support networks. - Adults will be supported with interactions with the benefits agency, adult education and employability. - Crisis support will be provided as required to avoid hospital admission (or re-admission) where appropriate - A culture of strengths based approaches and recovery focus is embedded. Service/Partners/Stakeholders/service users involved in the development and/or implementation of policy. WD HSCP Mental Health Services, including multi-disciplinary professional team Provider - to be contracted through procurement processes People with lived experience will be consulted on service design and planning. Does the proposals involve the procurement of any goods or services? Yes If yes please confirm that you have contacted our procurement services to discuss your requirements. Yes SCREENING You must indicate if there is any relevance to the four areas Duty to eliminate discrimination (E), advance equal opportunities (A) or foster good relations (F) Yes
Page 2
Relevance to Human Rights (HR) Yes Relevance to Health Impacts (H) Yes Relevance to Social Economic Impacts (SE) Yes Who will be affected by this policy? Individuals who will be living within the service, or who may wish to access the service Their families, carers, social networks The Provider's workforce Health and social care professionals working with those individuals The community local to the proposed service. Who will be/has been involved in the consultation process? People who have lived experience of ill mental health/ people who may use the service The Provider - yet to be identified through procurement processes Mental health and LD services - West Dunbartonshire HSCP Commissioning services - West Dunbartonshire HSCP. Please outline any particular need/barriers which equality groups may have in relation to this policy list evidence you are using to support this and whether there is any negative impact on particular groups. Needs Evidence Impact Age The service will support people aged 18 -65. This is in line with national guidance, as best practice for supporting people within the services that best meet their needs - services to support children and older adults should be specialist and separate. Scot Gov 2023 - Mental health and wellbeing strategy Scot Gov 2017 - Mental Health Strategy 2017-2027 Scot Gov - The Promise Positive - allows for specialist services to function to best meet individual needs Cross Cutting There are several cross cutting issues, given ill mental health can affect any person. Therefore the above issues should not be considered in isolation, but rather an ongoing, dynamic assessment of each tenant's needs will be required from the Provider, alongside a wider assessment of the service development and needs. NA NA Disability The service will support people will severe and enduring mental health issues, Scot Gov 2019 - Scotland's Wellbeing: national outcomes for Positive - if the service is functioning as required, it will
Page 3
with a focus on recovery within the community, and learning to live healthy lives as independently as possible. The building that houses the service will have accessible bedrooms/ bathrooms/ communal spaces available and staff trained to understand the needs of any resident with disability, including risk assessments such as fire safety and evacuation needs. The service will aim to recognise and support the rights of residents, through expert knowledge of the rights based issues, particular to mental health and wellbeing, tackling stigma . disabled people WD HSCP Strategic Plan 2023 - 2026 Public Health Scotland’s strategic plan – A Scotland Where Everybody Thrives promote the rights and needs of people with disabilities. Social & Economic Impact Some "societal conditions" put some groups at greater risk of poor mental health than others. These conditions are commonly known as 'social determinants' and include traumatic and adverse experiences such as poverty, discrimination, loneliness, unemployment, lack of adequate housing, and lack of social and cultural opportunities. There The Poverty Alliance 2022 - Tackling poverty for good mental health Scot Gov 2023 - Mental health and wellbeing strategy Positive - the service focuses on tenancy sustainment and maintaining independence in the community - therefore will have a focus on empowering people to maximise their income, manage finances and understand financial decision making as best possible. The service will also assess and highlight barriers to people accessing financial support or income
Page 4
are direct correlations between poverty, adversity, trauma and poor mental health. Therefore the service must have a robust understanding of how to alleviate poverty, support income maximisation and access to sustainable income, for each tenant. Financial assessment for each individual will be a key part of planning housing support and tenancy sustainment. and can advocate for the individual as required. Sex As a Provider specialist in mental health support, the service should understand and accommodate the differing needs of people using their service. The provider should demonstrate core values in anti oppressive practice, knowledge of gender based violence issues in WD and in promoting empowered communities. The service will operate from a trauma informed perspective and therefore understand that women are more likely than men to have experienced: enduring poverty GBV sexual violence caring roles and Mental wellbeing is lower in West Dunbartonshire than in both the NHSGGC area and Scotland as a whole, with women reporting poorer mental wellbeing than men (WD HSCP Strategic Plan 23-26) Positive: the service should be attuned to individual's needs, informed about local need and able to be responsive to this.
Page 5
duties that will impact on their mental health and wellbeing. The service should recognise that women using the service may continue to experience such adversities and need support to manage these. Similarly, the service must recognise local need and reflect that WD has higher than the national average numbers of men ending their own lives. The service will require this specialist knowledge and ability to anaylse data in order to build nuanced and specific risk assessments and aims and outcomes. Gender Reassign The service will meet the needs of any person who meets the criteria and is assessed as in need of this level of support, by professionals with the MH service in WD HSCP. People from the LGBTQI+ community are more likely to have ill mental health, however this service will be allocated on the basis of need, particularly to support people to live in the community, and will make full assessment of each individual's needs. LGBT+ health inequalities persist in Scotland: BMJ: 2022, shows inequity in access to services persists. Positive - the service will provide support for mental health and wellbeing, and rights based support, to any tenant.
Page 6
The service should undertake equalities monitoring to ensure that the support offered within is reflective of the wider needs of the community, to assess whether it is accessible. Health The service aims to support people to manage and alleviate health issues. Therefore the service must operate from a foundation of understanding local health issues, health inequalities and individual need. Poor mental health is correlated with poor physical health and wellbeing outcomes and therefore both are a priority for this service, including supporting access and uptake of universal services. Scot Gov 2018 - Mental Health in Scotland: Improving the Physical Health and Well Being of those Experiencing Mental Illness Positive - the service will provide a stepping stone to people managing their own tenancies - allowing them time and support to focus on sustaining their health and wellbeing. Human Rights There are numerous relevant human rights issues, for an adult experiencing ill mental health, or for any adult receiving or in need of intensive support from public services, or accessing public housing services. Therefore the Provider must have extensive knowledge and expertise in rights based practice, be active in the mental health support/ research/ development sector and show clear GOOD PRACTICE GUIDE MAY 2017 Human Rights in Mental Health Services, Mental Welfare Commission. West Dunbartonshire Health and Social Care Partnership Participation and Engagement Strategy 2020 - 2023 Positive - if the systems and processes in place consider and account for participation with community forums/ people who use services/ people with lived experience. Negative: if this is not embedded throughout. Positive: the service brings another organisation to multi agency care plans, whose focus should be on empowerment and upholding rights of
Page 7
evidence of how their organisation will demonstrate commitment rights based work. It is expected that tenant's living in the service will have access to advocacy support, formal or informal, as they wish. their tenants. Marriage & Civil Partnership Accommodation through the service will be provided only on a single occupancy basis. This is due to the needs of group living and the likely needs of people accessing the service, for whom a scoping exercise has been completed to assess need. Service specification: St Andrews Way – Supported Living Services for Adults with Severe, Enduring and Complex Mental Health Needs. Neutral - individual assessments of need can be completed on a person centered basis if required and marital status would not prevent referral to the service. Pregnancy & Maternity The service would undertake individual assessment including risk assessment regarding any tenant's health and wellbeing, including pregnancy. An assessment would involve the tenant and relevant professionals, to ensure that the individual is in the best service to meet their unique needs, and where risk can be managed. The service will not be able to provide for infants or children as this is a specialist support that will fall out with their remit and registration. Therefore Scot Gov 2019 - Perinatal mental health services: needs assessment and recommendations Neutral - whilst this prevents parents from residing in the service with their children, this is not a service that is specialised in meeting that need, therefore is not relevant.
Page 8
individuals would be supported to move on to more suitable accommodation if required, with this service focusing on the adult's mental health and wellbeing. Race The service specification details that the Provider's recruitment and staffing should as far as reasonably possible reflect the demongraphics of WD communties. Given there are discrepancies in the numbers of adults from minority ethnic groups who require intensive mental health support, for example statutory detention - compared to the number of the same adults who access intensive supports - there should be awareness and monitoring of these within the St Andrew's Way service to ensure it is accessible to people from all ethnicities. However people will be referred to the service on a basis of need and the assessment of need should be holistic, including assessment of social wellbeing outcomes and the service's ability to meet the individual's need. The service should Mental Welfare Commission for Scotland- 'Racial inequality and mental health services in Scotland: A call for action' - details priority areas including racial equality in that workforce, and recording and reporting of ethnicity across mental health services. Scot Gov 2021 : Tackling mental health stigma and discrimination Positive: The service could bring positive benefit if it accurately identifies, supports and empowers people in need.
Page 9
undertake equalities monitoring to ensure that the support offered within is reflective of the wider needs of the community, to assess whether it is accessible. Religion and Belief The service should take into account the religious and cultural needs of any person residing there - this will be part of a wider assessment of holistic needs - and support the individual to manage or uphold these as they wish. As NHSGGC guidance details, there can at times be relevant issues for individuals such as when their lifestyle or wellbeing is in conflict with their religious beliefs and this can cause detriment to their mental wellbeing. The service will be operated by a Provider specialist in supporting mental health recovery and should have skilled and attuned staff who are able to support tenant's emotional wellbeing. Scot Gov 2023 - Core mental health standards Positive: the service should be able to support individual's to understand and overcome stigma and discrimination. The service will support people to meet their own goals in terms of making decisions within their own lives, about their own wellbeing. The service will be able to make provision as required to support their tenant's religious or cultural needs including: - provision of male/female workers if requested for reasonable grounds -provision of safe space for religious practices - support to attend community facilities and resources - support to maintain wellbeing to allow integration in the local community again. Sexual Orientation Research indicates the people from the LGBTQI+ community are more likely to struggle with their mental health and less likely to be able to access or uptake intensive support. LGBT+ health inequalities persist in Scotland: BMJ: 2022, shows inequity in access to services persists. Positive - the service will support people based on assessment of need.
Page 10
However evidence also shows that the same people are not equally in need of intensive services such as inpatient treatment, suggesting that early intervention or community supports may be sufficient to promote resilience and coping. The service should be aware and attuned to how mental health issues impact LGBTQI+ individuals and make person based assessments and care plans to support health and holistic wellbeing. Actions Policy has a negative impact on an equality group,but is still to be implemented, please provide justification for this. Will the impact of the policy be monitored and reported on an ongoing bases? Contract monitoring - monthly initially then, quarterly if appropriate - this should include equalities monitoring to ensure that the service is meeting the needs of the community and addressing inequality/ inequity where possible. Individual care plan and support reviews will also continue for any person living within the service, as required. Q7 What is you recommendation for this policy? Intoduce Please provide a meaningful summary of how you have reached the recommendation A new service is planned that will aim to support people with severe and enduring mental illness. This service will require to be attuned to the needs of individuals and groups of people who struggle with poor mental health and the challenges and inequalities that people might face. The Provider should evidence strong commitment to core values and demonstrable history of promoting human rights and in mental health and wellbeing outcomes. This will be a key factor in awarding the contract to an appropriate provider.