Catering for mental health

Cheshire Council’s award-winning Link Resource Centre provides a
variety of services for its mental health clients. One which has
particularly helped to boost service users’ self esteem and
motivation is its catering service. Natalie Valios reports.

At the age of 50, with 200 driving lessons and six tests behind
him, Geoff Poynter passed his test recently and ripped up his L
plates. He started taking lessons after his 80-year-old mother had
a fall. Although he has always hated cars, his mother’s fall gave
him a motive to learn to drive, so that he could take her out for
day trips.

Poynter is diagnosed with anxiety, depression, and obsessive
compulsive disorder. His mental health problems have lowered his
confidence. On bad days he is reluctant to leave the house and he
finds it difficult to socialise. Taking driving lessons was a big
challenge and passing his test a major achievement. He has bought a
Ford Fiesta and is enjoying driving his mother around. Poynter
believes that this would not have been possible without the support
he receives from Cheshire Council’s Link Resource Centre. He has
used the centre’s drop-in group three times a week for more than
three years.

“It’s a marvellous place. You get support not just from the
staff but the people here as well. If I didn’t come here I don’t
know where I would be now. I became very low before,” he says.

About 250 adults with mental health problems use the centre
every week, which won the mental health category of the
Community Care Awards 2000. There are several strands to
the centre: outreach, respite service, day care, supported
employment, and assertive outreach. The aim of combining all
elements within one resource centre is to help clients achieve or
work towards independent living, provide a holistic and flexible
service to meet individual needs, and allow cross-working
throughout all teams.

Assertive outreach and an employment programme are the latest
additions to the service, the first introduced in March, while the
latter started up in September 2000.

Day care at the resource centre is the core element of the
service. Operating seven days a week, it comprises drop-in sessions
and structured groups. Drop-in takes place on Monday, Wednesday,
and Friday, while the structured groups are run on the remaining

These have been set up because clients feel more comfortable
working in their own groups, says team leader Linda Couchman.
Clients have to be referred to these groups, which include a men’s
group, women’s group, agoraphobic group, luncheon group, young
people’s group for clients aged between 18 and 25, and Sunday
luncheon group – where staff wait on them during a two-course

Day care aims to develop individual potential through social
skills, raising self-esteem and motivation through an
activity-based environment. To this end, clients have started a
catering venue with the ethos of a work environment. The scheme has
been running for a year and users provide a professional catering
service for the Link groups and for private and voluntary
organisations that use the conference facilities at the resource

The catering scheme follows two other successful user ventures –
a millennium garden and a small landscaped sensory garden at a
local fishery. A subsequent user consultation revealed that these
two projects had generated feelings of worth and achievement. Users
wanted to continue this by creating other projects that had the
potential to lead to real work and would simultaneously develop
their skills in other areas.

The award money has been ploughed into the catering venture. The
centre has bought a computer, uniforms and the kitchen is now fully
equipped. Users are producing their own professional menu cards and
publicity material.

The Link respite scheme provides a short-term service either in
an individual’s home or in social services supported accommodation
– this is a terraced house which can be supported 24 hours a day by
telephone or visiting as necessary for people in crisis. Respite is
offered to both the client or the carer or both and operates either
as a planned period of respite care or during a period of

By providing a multi-faceted service, the client can remain
within the community while accessing all relevant agencies during
their period of crisis. The respite service has been running for 10
years, during this time about 240 clients have used the service,
none have been admitted to hospital.

Complementing the short-term respite care, long-term provision
for clients is supplied by Link Housing. This offers a 24-hour
service to about 100 people a week, and because many have serious
personality disorders and dual diagnosis needs the majority need
this high level of support, says Couchman.

They are cared for in a variety of accommodation appropriate to
their needs, either their own homes, or a purpose-built bungalow
housing three people, or the eight flats attached to it.

“These are people who are very damaged and have had years of
hospitalisation. Their needs demand close supervision and constant
monitoring to maintain a stable lifestyle that enables them to live
in the community,” she says.

They are provided with a structured and generally complex core
package, which deals with everything from helping clients with
their benefits, outpatient appointments and medication, to shopping
for food and clothes.

Individuals contribute to their own development by specifying
their own needs through their care plan reviews. Partners in the
form of consultants, community psychiatric nurses, families, carers
and voluntary agencies are encouraged informally to contact the
service to discuss issues and improvements.

Outcomes reveal that the service has largely wiped out the
revolving door syndrome so commonly associated with the treatment
of people with mental health problems. Of the 300 clients who have
used the service since 1984, only 51 have had to re-enter hospital
and this has been mostly for short spells, while 10 clients have
moved on to live independently.

Outreach provides long-term support for people in their own
homes promoting independence and development through individual
care plans with the addition of a 24-hour on-call system 365 days a
year, dependent on needs.

Clients come from all walks of life and include professionals,
such as accountants, teachers, and nurses. Of the 250 people the
centre supports, few will return to full-time open employment.
Those who can are helped by Link employment services. The work
placement officer assesses them to establish what they want to
achieve. Once a suitable position is found, the officer approaches
the employer to explain what they can expect from this prospective
employee and the back-up that they will be offered by the

Couchman doesn’t pretend it’s easy: “It’s very difficult to get
people to accept employing somebody with mental health problems.
There’s still stigma around.”

If they are offered the job, on-site training is offered by
either the employer or the work placement officer. This continues
until it is agreed that the employee is ready to take on the job on
their own.

In the week that I talk to Couchman, the employment service has
placed a client as a care worker in an older people’s home.

One of the centre’s principles is to stop people’s skills going
to waste because of mental health problems. Although clients may
not be able to take on open employment, they may want to make use
of skills from their career, or new skills learned at the centre.
The employment service also helps clients move into voluntary work
or further education. “Some people might never go back to work but
might get some self-esteem from doing voluntary work,” she

The mental health category of the Community Care Awards
2000 was sponsored by Personnel & Care Bank Recruitment

Project Profile

Project: Link Resource Centre.

History: In 1984, Cheshire Council had a supported housing
network called Link Housing for adults with mental health problems.
In 1993, the council used money from the mental illness specific
grant to set up respite short-term care. In 1995, this service took
over the running of day service provision and it was decided to
encompass all three areas under a collective name.

Funding: Total budget is £738,000. £439,000 comes from
Cheshire social services department, £219,000 is health
contribution, and £80,000 from the mental health grant.

Staff: 60 members of staff, comprising Linda Couchman as team
leader, six group leaders, five residential care workers, three-day
service officers, a work placement officer, 41 care staff and the
remainder are administration staff.

Clients: Adults aged between 18 and 65 with severe and enduring
mental health problems. They must have an assessed need from a
professional such as a psychiatric nurse, social worker or GP. The
centre also deals with adults with dual diagnosis of a mental
health problem with drug or alcohol misuse.

Contact: Linda Couchman, Link Resource Centre, Macon House,
Macon Way, Crewe, Cheshire CW1 6DR. Tel: 01270 252927.

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