A’s story
A spent five years in a secure hospital after a brain injury left him with severe neurological and behavioural challenges. Over time, he received neuro‑rehabilitation to prepare for independent living.
Through the Delayed Transfer of Care project, which helps people move on from clinical settings when they no longer need that level of support, A was given truly person‑centred support. SD, his support worker, helped him find a home close to family, choose furniture and essentials, and set up benefits – things A simply couldn’t have managed alone. SD also made sure the flat was safe, suitable and welcoming.
SD kept in regular contact, sorted any issues quickly, and built a warm, trusting relationship with A. He always knew he could message her if he needed help. For us as a family, she has genuinely been a lifeline.
This pilot has transformed A’s life. Instead of being placed somewhere unsuitable and left to cope, he’s had support that put his wellbeing first. He now loves his flat and feels safe, confident and happy living independently.
S’s story
S became seriously unwell with her mental health at 28, not long after the birth of her son, and was later diagnosed with paranoid schizophrenia. She managed at home for years with family support, but things became difficult again when her teenage son began using cannabis and becoming aggressive. S turned to alcohol to cope, and by 2021 she’d disengaged from services.
In late 2022, S was found unconscious and admitted to hospital with serious physical health issues. With poor insight and declining self‑care, she was placed on a Section 3 and admitted to Meadowbrook Mental Health Unit. She was then referred to the Delayed Transfer of Care project.
Through this project, S was supported to find a home that suited her needs. After honest conversations about what would help her thrive, she moved into Kemball House – a supported scheme for over‑55s – where she felt safe and settled. The Housing Support Officer made the whole move‑in process warm and reassuring, helping S choose carpets and blinds, which really boosted her confidence and excitement about her new home.
They also noticed S struggled with mobility and arranged an OT referral for a walking aid, which has made a huge difference. Alongside this, they helped her attend GP and job centre appointments, challenged benefits decisions, set up her online UC account, and supported her with bills, repairs and getting digitally connected.
Five months on, S is thriving. She loves her new home, keeps it spotless, and says she wouldn’t have managed any of this without the support she received. She now has ongoing community support and feels hopeful about her future.
