Around 60,000 people with mental health problems live in supported accommodation in England, typically receiving one of three types of support:
- Residential Care
- Supported Housing
- Floating Outreach
However, little is known about the quality, cost and effectiveness of these services.
The QuEST Project aims to deliver the first standardised quality assessment tool for supported accommodation, a detailed description of supported accommodation services in England and those who use them, evidence on clinical and cost-effectiveness of these services and to explore the feasibility of a trial to test the clinical and cost effectiveness of two models of supported housing.
This NIHR-funded project will run for five years (2012-2017) and is comprised of four separate workpackages:
- Workpackage 1
In workpackage one we will be carrying out focus groups with service users and staff of supported accommodation services in order to adapt existing quality assessment tools for supported accommodation. Staff participants will be asked to consider the Quality Indicator for Rehabilitative Care (QuIRC) and service user participants will review the Client's Assessment of Treatment Scale (CAT).
Six focus groups will be carried out in total, one each with staff and service users in each of the three types of supported accommodation.
Amendments to the two measures will be considered by our Service User Reference Group and Expert Panel with the final decision on the new format taken by our Programme Management Group.
In the second part of workpackage one we will test the inter-rater reliability of the adapted QuIRC with 60 services (20 of each of the three types).
Timeframe: Focus groups April - June 2013; Inter-rater reliability July - September 2013
- Workpackage 2
In workpackage two, we will survey 90 supported accommodation services (30 of each of the three types) across England. In each of these services managers will be asked to complete the amended QuIRC and to provide some general information about their service.
Five service users will be recruited in each service to take part in an interview about their abilities, needs and any specific difficulties they may have. We will ask service users for their permission to collect information from their case notes and speak with a member of staff involved in their care. Service users will also be asked to give their consent for staff to be contacted again in 30 months' time in order to find out how the service user is getting on and whether they have moved on to more independent accommodation.
Timeframe: Baseline data collection October 2013 - September 2014; Follow-up April 2016 - March 2017
- Workpackage 3
In workpackage three we will conduct interviews with staff and service users to identify the aspects of care they find most useful and the challenges involved in providing that care.
We will use the findings from this workpackage and those from workpackage two to identify key aspects of care and incorporate these into the supported housing models that we will compare in workpackage four.
Timeframe: October 2013 - March 2014
- Workpackage 4
In workpackage four we will undertake a small trial involving 50 service users living in three regions of England to investigate the feasibility of undertaking a large scale trial to compare the effectiveness of two different models of supported accommodation - supported housing and floating outreach.
Service users will be randomly assigned to either supported housing or floating outreach and will be interviewed twice, once before they are assigned to one of the two types of housing and again 12 months later. We will ask service users about their activities, their satisfaction with different aspects of their life and their views on the support they receive. We will also ask service users for their permission to speak with a member of staff involved in their care in order to collect data from their case notes.
We will interview 10 of the 50 participants in more depth to understand more about their experiences in taking part in the trial.
Timeframe: Baseline data collection April 2015 - March 2016; Qualitative interviews April 2015 - January 2016; Follow-up April 2016 - March 2017