About Highams Lodge
Highams Lodge operates as a residential recovery community for 15 service users who are experiencing complex mental health difficulties. This includes those who have been diagnosed with a personality disorder, psychosis, forensic history or a history of complex trauma and those for whom placements have broken down elsewhere.
The service is in a quiet residential area with good access to public transport links. All residents have their own bedroom with en-suite bathroom. There is a shared lounge, kitchen, as well as a large garden area. Highams Lodge is staffed 24 hours a day, with waking night staff.
Our basic requirement is that those referred will benefit from a structured, yet individualised programme which is both practical and therapeutic.
The length of stay for each resident varies each individual’s treatment plan. The aim is to encourage residents to share responsibilities, make decisions for themselves and to regain their independence as far as possible. Residents are encouraged to set realistic goals with staff and establish a range of activities in the project and the local community.
Referrals to Highams Lodge usually come via NHS or Local Authorities. Initially we request the completion of an application form with background information (recent risk assessment, care plan, social circumstances report etc); this is reviewed by the clinical team prior to the offer of an assessment. An assessment interview is then arranged where a staff member visits the person being referred and completes an assessment. Following this, recommendations on the CHT service that would meet the individuals’ needs is made. A visit to the most appropriate service is then arranged and a transition plan discussed with the person being referred and with their care team.
CHT uses a model derived from Therapeutic Communities and Psychologically Informed Environments (PIEs), incorporating the latest perspectives from developmental psychology and relational neurobiology to create a participative and democratic recovery approach to enable people to achieve more of their potential and to fulfil more of their aspirations in life. Each resident is allocated an individual key-worker and also has access to individual psychotherapy with the services registered psychologist / psychotherapist.
CHT’s programmes focus on encouraging engagement in three distinct, but overlapping areas:-
Community Housing Therapy
• Insights from developmental psychology and relational neurobiology are used to create formulations that underpin the therapeutic work within CHT’s residential and supported living services, and to help create an emotionally safe space in which developmental processes can flourish.
• Residents are supported to gradually increase participation and decision-making within the community and through this, CHT offers residents the opportunities to take increasing control of their own lives
• Central to recovery are positive relationships, and relationships are the main tool that residents, staff and psychotherapists have to enable development and recovery.
• The treatment plan of each resident is implemented through an individual recovery plan which is reviewed at least every three to six months. Reviews are multi-disciplinary and the resident is supported to set goals and review their progress along with CHT Psychotherapists and Recovery Practitioners, as well as their care teams. These goals focus on key areas in the life of each service user, for example, accommodation needs, relationships, and meaningful occupation.
Many residents have experienced significant trauma in their lives before coming to CHT, so formal psychotherapy provides a safe space with a fully-qualified professional to work through some of the issues and relationships that trouble them. We aim to create a space in which people feel safe emotionally and physically, a space which facilitates positive social interactions and ‘groupishness’, and also allows individuality and privacy; CHT’s services aim to provide a range of therapeutic relationships within a therapeutic space.
Each resident has an individual recovery plan and therapy plan that sets out their recovery pathway
Co-production is at the centre of CHT’s approach. Central to the CHT model is the concept of learning through the experience of living together. We run a programme of Community Groups which residents are expected to increasingly participate in. The act of working with other people in a group to achieve a particular purpose, and the social and emotional regulation skills required to do so, are deeply therapeutic and developmental; they also support reparative processes in attachment behaviours, and the development of clear care-seeking and care-giving capacities. Community Groups include daily semi-formal Community Catch-ups in the morning, weekly formal Community Meetings where the business and dynamics of the community are thought about, Activities Meetings where proposed group activities are agreed, and Housekeeping Meetings where the week’s menu is decided, who will cook what, who will do the cleaning or shopping and so on. The daily living tasks of the community are shared among the staff and residents, to be done by all, and there is at least one communal meal each day.
As in all CHT’s projects in Highams Lodge residents are involved in four keys areas.
• Residents are at the centre of drawing up and reviewing their recovery and therapy plans. They are involved in discussions about their placement, they help to organise and chair their own reviews at which progress is discussed and recovery and therapy plans revised.
• Residents are responsible for the administrative running of the household. Together with staff, residents are responsible for decisions concerning the total running of the household including catering, maintenance and cleaning the house, social activities, health and safety, budgeting and any community rules that may need to be revised or established.
• Residents are involved in monitoring and reviewing the service. The therapeutic programme is co-produced with residents. Residents attend regular resident forums with CHT’s senior team, where there is an opportunity to provide feedback. Regular feedback is collected and reviewed as part of CHT’s quality assurance process. Residents also produce a resident led newsletter and have the opportunity to be part of CHT’s resident activity fund and resident fundraising committees.
• Residents are involved in an ongoing dialogue with staff. Staff listen to the experiences of service users in groups, in individual sessions, and informally. Particular attention is paid to the residents subjective perspective. Emphasis is placed on forming authentic relationships with residents. Time is spent informally with residents within the household and this helps to flatten the hierarchy between residents and staff and provides a culture where real contact can be made between people.
CHT employs staff committed to recovery, and encourages applications from those with lived experience. Each service’s staff team is made up of Recovery Practitioners, Senior Recovery Practitioners, a Service Manager and has an integrated fully qualified Psychologist or Psychotherapist, supported by a Psychiatrist in Psychotherapy in the Senior Team. Highams Lodge offers 24 hour waking support.
Our dedicated staff are crucial to the successful delivery of recovery and therapeutic services, so CHT is committed to providing high quality staff training, including Skills for Care training for staff and managers, and a 20-module tailored programme of training in psychosocial theory and practice.
Staff also have regular supervision, weekly reflective practice facilitated by the service psychologist, and access to an employee assistance programme.
Highams Lodge, 49-51 The Avenue, Highams Park, London E4 9LB
Telephone: 020 8523 4651 E-mail: email@example.com
Marina Salles Tavares Paes