Former Orchard Hill residents flourishing out in the community

Former Orchard Hill worker Janette Silla has seen clients’ lives transformed since they moved into their own flats (pic: Tom Parkes)

Three years after institutional abuse was found at Orchard Hill, England’s last long-stay hospital, former residents and staff are flourishing out in the community. Natalie Valios reports

The name Orchard Hill evokes the worst image of learning disability care. In 2007, the Healthcare Commission slammed Sutton and Merton Primary Care Trust for institutional abuse uncovered at England’s last long-stay hospital and 11 NHS campus homes another form of long-stay service. Among the failures, the commission listed a lack of activities, rigid regimes and inappropriate use of restraint.

Now Sutton Council is aiming to make its part of south London a byword for high-quality support for people with learning disabilities.

Orchard Hill formally closed in April 2009, although some residents moved into bungalows on the same site. However, by the end of June 2011, new supported living schemes will provide secure homes and tenancies for 85 adults with learning disabilities who had lived in Orchard Hill and its associated campus homes for many years. Only 10 former residents were deemed to need more specialist registered care.

Sutton is responsible for all but a handful, and is securing provision for the rest with funding from other councils and PCTs.

There will be 12 supported living schemes of between three and 10 flats. “This is so that people can live as neighbours and maintain friendships without having to live with each other,” says Jan Underhill, Sutton Council’s manager for the Orchard Hill and campus reprovision programme.

Eight schemes are new build, the others high-quality refurbishments of existing properties. The whole capital build programme cost about £19m – drawn from the Department of Health, Sutton and Merton PCT and the two housing associations involved in the scheme, Progress Care and Raven Housing Trust. “We wanted people back in the heart of the community with a flat of their own and a secure tenancy; a home for life for however long they wanted to live there,” Underhill says. “Each flat has been customised to meet individual needs. In one cluster the flats are larger than average to accommodate the custom-built wheelchairs that some service users have.”

Nothing is communal and, by making flats individual, fitting them with assistive technology, and placing them in prime locations in the middle of communities with good transport links, they are future-proofed for the next generation, adds Underhill.

Sutton Council has commissioned three third sector organisations – MCCH, Choice Support and Avenues – to provide flexible support services. Waking night staff ensure safety in the hours of darkness and react to any telecare alarms or sensors that are triggered.

The council has also been transforming day services by closing the traditional building-based service used by 200 adults with learning disabilities living in the community and the day centre used by Orchard Hill residents. Just as the latter now have personalised support allowing them to access mainstream social and leisure options, the council has contracted five learning disability organisations to provide personal assistants to support those who were already living in the community to do the same.

There has also been a financial spin-off for the former Orchard Hill residents, which has further increased their independence, says Underhill. “Because they are no longer in NHS services or registered care they are entitled to benefits so they have a disposable income to make choices about what they want to do. Staff have helped them choose furniture, they can go on holiday and some are using their mobility allowance to buy a car that staff can drive them around in, instead of using taxis.

“They now have a personalised service that makes them more independent; they have choices that they didn’t have before.’

Case study: ‘I just wish this could have happened years ago’

Janette Silla worked at Orchard Hill for 10 years and says: “I always felt the way it was run wasn’t right but when you are only a support worker you can’t voice things.”

Now working as a support co-ordinator for MCCH at the Homeland Drive cluster of eight flats in Sutton, south London, she is excited to be part of a programme that is transforming the lives of former Orchard Hill residents.

“There was a lot of hostility from Orchard Hill staff about one lady who moved here,” Silla says. “They said it would never work for her; they said she had dementia and self-harmed. She would hit and scratch herself and bang her head on the floor. She hasn’t done that here and we are having her reassessed because we don’t feel she has dementia.

“She is visually impaired, so we minimised the furniture in her flat and what is there is dark so she can make it out. She has white plates that stand out on the table so she can see where the food is. There is a picture with different textures on the wall outside her front door so she knows when she has reached her flat.

“She is so much happier and the doctor is looking at taking her off one of the drugs she had at Orchard Hill to control her behaviour.

“One man came to visit his sister and as he left he hugged me and said ‘whatever you are doing carry on, because that is the best conversation I’ve had with my sister in 20 years’.”

A woman who came to visit her sister summed up the lack of choice and control that she was accustomed to at Orchard Hill, says Silla. “When I said we could support her sister to come to her home, she said ‘is she allowed out?’, because she wasn’t used to that happening.

“It is unbelievable to see the difference now – I just wish it could have happened years ago.”

Case study: ‘There has been much improvement in my daughter’

Julie never used to talk much at all, now she is talking lots more and I think it’s because she is happier,” says Joyce Smith of her 43-year-old daughter’s move to her own flat from one of Orchard Hill’s campus homes.

Julie, who has severe learning disabilities and is blind, moved to her flat in Cheam Village – one in a cluster of seven – in April after being in residential care since she was 10.

After more than 20 years living in the campus home, Joyce was worried about the move, but says: “Julie loves the flat and being on her own. Support is there when she needs it; she is far happier, has more friends and gets out more.”

Music is important to Julie, but at the campus home she could only have music on at certain times so that other residents could watch TV. Staff bought her headphones but, says Joyce, she didn’t like them because they made her feel deaf and blind.

“Now she can choose what music to put on and when she wants to listen to it. She can be noisy, but if she wants to be quiet she can – at the campus home there was always noise from other residents.”

Although she cannot see, Julie has her own TV for the first time because she has started to enjoy listening to children’s programmes. Her benefits have bought all the furniture for her flat and staff discuss options with Joyce before they buy anything on Julie’s behalf. A personalised touch in Julie’s flat is the dado rail running round it to help her find her way.

“There has been so much improvement in her. I thought she couldn’t be in a better place than the campus home, but I was wrong,” says Joyce.

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