Dorothy's Journey to Independence

Dorothy's Transition

After 12 years in secure hospital settings, Dorothy’s transition to her own home in Liverpool marked a milestone in person-centred support. Accomplish, in partnership with Liverpool City Council and Mersey Care NHS Trust, led the project to source, adapt, and secure a bespoke home where she could live safely and independently.

Dorothy had been detained since 2009 due to risk behaviours, vulnerabilities, and environmental sensitivities that made community living unsafe. Diagnosed with a learning disability and autism, she also had a history of self-harm, requiring specialist support. While hospital provided structure and safety, it was never intended as a permanent solution.

Creating the Right Home

Dorothy needed a detached, adaptable home that was safe, non-institutional, and spacious enough to support her needs while maintaining a sense of independence. It also had to be close to support networks for additional resources. Finding such a property proved challenging but collaborating with Liverpool City Council, NHS Trust representatives, landlords and developers, a suitable home was secured, though it required significant structural modifications.

The home was adapted specifically to meet Dorothy’s individual needs and included: open spaces, multiple entry and exit points, durable materials, ligature-free fixtures and underfloor heating all of which were incorporated to ensure safety without unnecessary restrictions. Regular multidisciplinary team (MDT) meetings ensured that every adaptation met and exceeded Dorothy’s needs.

Building the Right Support Team

The success of Dorothy’s transition relied heavily on her support team. Accomplish recruited and trained staff months in advance, providing in-depth training on autism and positive behaviour support (PBS). To build trust, they engaged with Dorothy in hospital over an extended period, ensuring she became familiar with those who would support her in her new home. This structured yet flexible approach prioritised her preferences and comfort, making the transition as smooth as possible.

A Carefully Planned Transition

Dorothy’s transition was gradual and carefully managed. Staff engaged with her early on, initially observing and then interacting in ways that respected her space. Instead of visiting her new home before the move, she was shown photos and videos and given the opportunity to choose paint colours, helping her feel a sense of ownership. Over time, staff increased their presence, providing consistent support for up to 12 hours a day in hospital to ensure familiarity. On the day of the move, she settled in quickly, putting up a Christmas tree, exploring her garden, and welcoming family.

The Impact – A Life Transformed

Dorothy now lives independently for the first time in 15 years. Since moving, restrictive practices have significantly reduced, with no seclusion, no hands-on interventions, and a decrease in staff support from six-to-one to four-to-one within 12 weeks. A calmer environment and personalised routine have contributed to her stability and happiness, allowing her to reconnect with family and host her own Christmas meal for the first time in years.

Wider Benefits

Dorothy’s discharge has relieved pressure on NHS services by freeing a specialist mental health hospital bed. Supporting her in the community is also more cost-effective than long-term hospital care. This project to support Dorothy’s discharge from hospital and attend to her own needs services as a model for future planning.  It demonstrates the effectiveness of collaboration, persistence and creative problem-solving.

Conclusion – A Testament to Teamwork

Dorothy’s journey exemplifies what can be achieved when health, social care, and housing sectors work together. Through joint effort and commitment, Accomplish and its partners proved that people’s goals and ambitions can be realised.

*name has been changed to protect identity