“Crash Pad provides a calming environment. Hospital can be noisy and overcrowded, and for me, who has autistic spectrum disorder, this isn’t helpful, but I find Crash Pad calming.”
This is how someone described the help they recently received at the Crash Pad, a short-term housing and support service in the Black Country.
The purpose of the Crash Pad is to enable people to avoid inappropriate hospital admission, preventing adults with learning disabilities and autistic people from becoming institutionalised in long-stay secure units.
If someone’s care has broken down, whether in their own home or in residential care, a temporary stay at the Crash Pad can help them return home more quickly.
The Crash Pad is part of the local health and social care offer (the official range of support in the area) and it supports the aims of NHS England’s national Learning Disability and Autism Programme as it helps prevent inappropriate hospital admissions. The aim is to identify and address behavioural and mental health issues and enable individuals to retain their independence.
The scheme is funded by the Black Country Healthcare NHS Foundation Trust and was established by care provider Empowering U and the trust. Support is either one to one or two to one, depending on a person’s needs.
The service, an ordinary house on an ordinary street, can accommodate up to two people plus support staff at any one time and this is always risk assessed.
For example, if someone has complex behaviour, the service may decide not to offer a space to a second person.
Latest figures show that between its launch in June 2023 and July 2024, 27 people had used the service, helping avoid a total of 39 stays in hospital (some people have used the service more than once).
As for the time people spend at the house, 22 admissions were for one week or less, 11 were for 1-3 weeks and six admissions lasted for more than three weeks.
The Crash Pad was set up by Nicola Protheroe-Jones, head of services at Empowering U, and Jo-Anne Ricketts, senior commissioner at the NHS trust’s learning disability and autism commissioning team.
Ricketts describes working on the collaborative scheme as being “tasked with being brave to transform care services”.
People may need peace and quiet, their meals cooked, a listening ear or one-to-one support
She adds: “We are preventing trauma because people are avoiding inpatient settings which are, by their nature, intense environments unsuited to autistic people. It is cost effective because it promotes long-term savings by preventing someone from going into hospital.
“It works because the staff are skilled, competent and trained to support autistic people. They understand how to respond to behaviours of concern and treat people with respect, have good communication and are resilient. When things get tough, they are quick to adapt to any new situation.”
Empowering U’s Michael Stevenson, who manages the Crash Pad alongside Andrea Welsh, says it works because “it is a safe and quieter environment which enables individuals to regulate [their behaviour] quicker”.
Because both the service and staff team are small, it has been possible to develop strong and effective professional relationships between the commissioning teams and the provider, as well as between the provider and the local hospital.
A small team also means the service works smoothly from triage to referral point and until the person goes home.
Problems
Of course, issues arise. Ricketts says people can end up staying for too long because they need somewhere to move onto but no suitable accommodation or social care support is available. This means others cannot use the service.
Sometimes, the Crash Pad has not been used as intended because family relationships have broken down and there is no alternative place for the person to live.
Why it works
Staff believe the Crash Pad works because they help calm a difficult situation down. Someone could be stuck in a behavioural cycle and the team brings in a fresh pair of eyes at a crisis point, helping to find solutions with the person and their family.
Of those who have stayed at the Crash Pad so far, some have moved on to supported living and others have returned to their family homes.
As Stevenson adds: “Quite a few young people go into full-time work or college to see a brighter future.”
Amanda Topps is a health and social care consultant
