Page last updated at 06:10 GMT, Monday, 23 February 2009

Fostering a new life for Sue

By Caroline Parkinson
Health reporter, BBC News

Sue likes living in her family home, but feels it's time to move on and get her own place.

Sue and Nan
Sue is enjoying being part of a family

But she isn't a teenager on the verge of moving away from mum and dad.

Sue Hewish, who is 40, has a learning disability and depression which has made it hard for her to live on her own.

For the last three years, Sue has been "fostered" by carers Nan and Chris Watson, who she is not related to, and lived with them in their home in Folkestone, Kent.

When she had her own place, she became very ill and started self-harming. Winter nights were particularly hard.

I wanted to be loved and cared for because I wasn't loved when I was a child
Sue Hewish

Living in a hostel, where fellow residents had some very serious problems also failed to give her the support she needed.

Adult fostering, or "shared lives" schemes operate across the UK to give people in similar positions to Sue more support than they would have if they lived alone, and more freedom than they would have in supervised accommodation.

For Sue, living in a family home has offered her the chance to start again.

"I got a job when I left home at 17, but I had to give that up because of my depression.

"I lived in a hostel, which I didn't like. There were always people fighting, and the staff weren't there after 8pm.

"Then I lived on my own in a flat for three years. But I had lots of problems. I self-harmed, I'd rub my face on the carpet."

"Living here has changed my life. I work as a volunteer four days a week and go away with friends."

Belgian beginnings

Nan and Chris give her practical assistance, such as cooking her meals and helping her manage her money, but Sue says it is the emotional support she gets that has made the difference.

"I wanted to be loved and cared for, because I wasn't loved when I was a child.

"I can talk to Nan and Chris. I couldn't talk to my mum and dad when I was with them.

Sue
Sue now does a lot of volunteer work

"In the winter, I get a bit down. But now when I get a bit low, I can go and talk to Nan and Chris.

"It's not like counselling, where I might have to talk about my past. I can just talk about how I feel now."

But she's now almost ready to go: "I hope that I can move on to a place on my own."

Nan, who used to work in a residential home, said: "I had about 10 elderly people to care for. I had to get them up, give them breakfast and make their beds.

"I felt I shouldn't be rushing them, and should be giving them more time - as I have been able to do with Sue."

Expansion?

The concept of adult placements dates back to the Middle Ages, when the Belgian town of Gheel became known for families taking people with mental health problems into their homes.

Dr Peter Schofield, of the Institute of Psychiatry, said: "This is often cited as the first example of care in the community, predating other forms of mental health residential care.

"The very visible success of the Gheel scheme lead to this being a much discussed alternative to institutional care in the 19th Century at the same time as most of the large asylums we are now familiar with were being established.

"While adult placements currently play a very minor role in UK mental health service provision, they have been used extensively in the past - for example playing a major role in mental health care in Scotland and Germany up to WWII."

He added: "Now that the era of large psychiatric institutions is over, perhaps it is time for a return to this kind of small scale local support for people with mental health problems."

At the moment, there are an estimated 8,500 carers across the UK who have people living with them under the auspices of 160 Shared Living schemes.

One limiting factor is commissioners' lack of imagination about what's possible
Sian Lockwood, National Association of Adult Placement Schemes

Sian Lockwood, chief executive of the National Association of Adult Placement Schemes (NAAPS), says that number could grow by four or five times over the next five years.

"As well as long-term accommodation and support, there is the possibility of flexible arrangements, like day-care or - where an elderly person's actual family lives hundreds of miles away - having a local family who can offer support and do things like make sure they've got shopping in.

"But one limiting factor is commissioners' lack of imagination about what's possible."

It is social services teams who oversee adult placement schemes.

Richard Webb of the Association of Directors of Social Services admitted the model "could be expanded".

But he said it could be difficult to recruit people to provide placements, and that each area had to develop services which were appropriate to local needs.

However Sian Lockwood feels more is possible.

"These placements aren't appropriate for everyone, but there is a huge amount of potential."

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