Enter and view: 120 Besley Street Supported Living Scheme

Healthwatch Wandsworth visited 120 Besley Street, a supported living scheme for adults with learning disabilities, to understand tenants' experiences and assess the quality of care and support provided. The scheme is operated by Brandon Trust and is intended as a "stepping stone" to greater independence rather than a permanent home. 

The property accommodates up to six tenants and provides support for adults with relatively low support needs. At the time of the visit, four male tenants lived there. Staff support tenants with daily living skills, personal goals, healthcare appointments and activities designed to promote independence.

Overall, Healthwatch found that the scheme was clean, well maintained and had a positive atmosphere. Tenants and relatives were generally complimentary about staff, and the key worker system appeared to be functioning effectively. Tenants valued the freedom, privacy and independence offered by the service, and healthcare needs were generally being met appropriately. 

However, investigators identified several concerns. There was ongoing tension and occasional aggressive behaviour between some tenants, which was observed during the visit. Although staff handled incidents appropriately, Healthwatch was concerned that the atmosphere created by these conflicts could negatively affect tenants' wellbeing and the scheme's objective of promoting independence. One tenant and a relative specifically reported feeling distressed by the situation. 

The report also highlighted a lack of clarity around the scheme's purpose. While some relatives understood that the accommodation was intended to support tenants in moving towards more independent living, others and some tenants appeared to regard it as a permanent home. Healthwatch warned that this misunderstanding could lead to difficulties in future. 

Food and nutrition were another area of concern. Although tenants were involved in food shopping and meal choices, an oven had been broken for several weeks, resulting in a heavy reliance on microwave meals and processed foods. Healthwatch felt that more should be done to encourage healthy eating, greater use of fresh ingredients, and the development of cooking skills. They also observed that one tenant was not being actively encouraged to participate in preparing his own meal. 

Property maintenance issues were noted, including the broken oven and a leaking shower in one tenant's room. Communication with families was generally good, although relatives described previous occasions when they felt they had not been adequately informed about important matters.

Key Recommendations

Healthwatch recommended that:

1. The provider ensures that all tenants' needs are considered while managing the ongoing behavioural issues between residents.
2. Relatives are kept fully informed and involved during this period.
3. No additional tenants should be admitted until the tensions within the scheme are resolved.
4. The scheme's role as a temporary pathway towards greater independence should be clearly explained to tenants and families and reinforced during reviews.
5. Greater emphasis should be placed on healthy eating, cooking skills and tenant involvement in meal preparation.
6. The broken oven should be repaired or replaced urgently.
7. The leaking shower should be fixed. 

Overall Conclusion

Healthwatch concluded that Besley Street provided generally good support from caring staff and helped tenants maintain independence and access activities and healthcare. However, concerns about resident tensions, healthy living opportunities, and unresolved maintenance problems meant that improvements were needed to ensure the scheme fully met its goal of preparing tenants for more independent living.