Community based services

Mental health day opportunities are a combination of private and voluntary not-for-profit provision, mainly offering an outreach service and supporting those in their homes and in the community.

There are a number of services delivered by residential care home providers where someone comes into the service and has a meal, a shower, and support with managing bills and budgeting, for example.

Current shape of the mental health day opportunities market

In the main, mental health day opportunity services remained accessible to those with mental ill-health during the pandemic. At the time of this report, there were 681 people accessing support from 44 different providers.

The 2022-2023 spend and the snapshot at the end of March 2023 of the number of people accessing day services for those with mental health, excluding transport costs:

• Our spend on day services for adults with mental health conditions in 2022-2023: £3.8m
• The number of people accessing day services for people with mental health conditions, funded by us in 2022-2023: 681
• The number of Norfolk County Council (NCC) accredited locations registered by March 2023: 44

Challenges

Challenges with day opportunities for people with mental ill-health include:

• Having sufficient commissioning resources to be able to review and understand in more detail the range of interventions and their effectiveness for people with mental health problems currently offered under the day opportunities heading

Supply and demand

The services provided are predominantly community outreach services. Day opportunities services provide a range of support options, such as:

• Personalised one-to-one support
• Connecting people to peer support (individual and group)
• Centre-based provision

Services support individuals to improve and maintain their mental health and well-being. People are supported to identify goals that are important to them and that help them to continue to live as independently as possible.

In January 2023, the percentage of people accessing day opportunities support in each locality was:

• Norwich: 51%
• South Norfolk: 20%
• North Norfolk: 14%
• West Norfolk: 8%
• East Norfolk: 7%

Commissioning intentions

Our intentions for commissioning day opportunities for people with mental ill-health:

• Explore a separate procurement approach that may be a better fit for current mental health day opportunity services
• A single framework for all day services is in development, along with a plan for the new service model(s) to be implemented
• To better understand what is being delivered, what is working well and what needs to change
• Developing innovative outreach and preventative service models, supporting people to access community, voluntary sectors, employment and hobbies
• Introduce psychological and trauma informed practices
• Explore alternative models of support and whether these are of benefit

Key messages to providers

We want to work alongside stakeholders to better understand:

• Current delivery and what will be needed in the future
• What is working well
• What people want and how they want to be supported
• What 'good' looks like and how we can evidence that this is being achieved
• We want to work with providers to develop new approaches to determine how best we can work together
• We want to continue working collaboratively to support providers and understand their challenges
• We want to ensure the delivery of a consistent day opportunities model across the county, embedding recovery, rehabilitation and psychological and trauma informed approaches

Feedback

We want people to say:

• "I am supported to manage and continue my mental and physical health recovery, addressing inequalities experienced by those with mental ill health"
• "I am supported to have less avoidable harm, which includes better psychological and mental wellbeing and improved confidence, self-esteem, and self-perception"
• "I am supported to have a positive experience of support through flexible, emotionally resilient, competent, reflective, and self-aware colleagues who demonstrate tolerance and hope, forming honest and respectful relationships"
• "I am supported to regain and develop skills and encouraged to participate in the community, meaningful activities, hobbies, leisure, employment, managing my home, keeping safe, and daily living tasks"