Individual care packages for people with severe mental illness: a description of their implementation in an English County

Abstract

BackgroundThis paper includes a brief review of the historical and policy background to a new form of supported accommodation, the Individual Care Package (ICP). This is a co-ordinated, individualised and flexible method to support people with complex mental health problems in the community.MethodThe study aimed to describe the implementation of this new form of care in Gloucestershire, England, over a 5-year period. We aimed to audit the quality of care in the packages against six care standards, derived by a project steering group. Staff working in community mental health services and staff providing ICPs were asked to report their levels of satisfaction with care provision.ResultsA total of 35 ICPs were developed, mostly relating to service users with severe mental illness. Only 60% of the community mental health team key workers were aware of the expected level of care. In many cases, service users were accessing support from day services or family alongside the ICP. Four service users were admitted, and four moved accommodation after going into ICPs. Overall, levels of care provided within ICPs tended to remain static. Trust key workers were mostly satisfied with the support provided in ICPs, but a range of concerns were expressed. ICP staff reported mostly positive views about the support that they received from statutory services, but also reported some concerns.ConclusionsICPs appeared to be successful in enabling a number of service users with complex difficulties to obtain and maintain tenancies in the community. There were some concerns about the quality of monitoring of the ICPs and some uncertainty about whether ICP staff would have the skills, support and training to promote recovery and increasing independence of service users. There was little evidence of service users moving on or reduction in care over time. There is a need for good inter-agency working for the successful deployment of this new form of service. There is also a need for more research, comparing ICPs with other forms of supported accommodation and considering the service user experience through qualitative research.