PEOPLE POTENTIAL POSSIBILITIES
Bespoke Hoarding Service
What is hoarding?
According to Hoarding Support, hoarding affects two per cent to five per cent of the UK population (1.3 to 3.3 million people).
Hoarding is a disorder where a person has such difficulty discarding their belongings, they accumulate an excessive number of items. A hoard will often include broken or unwanted goods and can grow so large it prevents people from accessing or using the rooms in their home, safely or comfortably.
Hoarding poses a genuine risk to peoples safety, increasing the risk of house fires and pest infestations. This ongoing behaviour can damage lives causing people to lose their tenancies or become socially isolated.
Many people who experience this disorder feel unable to let visitors into their homes –even tradespeople, for essential work. The deterioration in their home environment can trigger anxiety and depression which in turn can lead to the acquiring of more items or an increased unwillingness to remove items.
People who struggle to manage their homes in this way need support, not only with the environment in their home, but to understand and enable them to move away from the reasons that led them to hoard in the first place.
Here at P3 we have experience in delivering personalised long-term and non-judgemental support.
We know hoarding is a complex and not well understood behaviour which, if left unsupported, can affect someone’s mental health and wellbeing. We know from first-hand experience how to meet people’s needs, recognising differences in behaviour and circumstances, and tailoring support as necessary.
Our approach is to assist people to access wider services while offering the practical support needed to reorganise their homes and improve their daily living skills and their mental and physical wellbeing.
We have a proven track record with supporting people who are struggling to manage their homes and with our dedicated P3 service we can support and empower people take control and improve their lives.
Our dedicated Home Coaches personalise support, dependent on the person’s needs, are respectful of their wishes and work at their pace while considering long-term behaviour change.
*All names have been changed throughout this booklet for anonymity.
About P3 …
P3 have provided housing-related support services since 1972, and currently deliver a range of support services from over 40 sites across the UK for County, Borough, and City Councils, NHS Clinical Commissioning Groups, and The Department of Health. We deliver support to 9,000 individuals at any one time and over 32,000 people annually.
Our current provision across the UK includes:
• 25 community-based housing related support contracts working in people’s homes and across the community to prevent homelessness and sustain independent living, including bespoke hoarding support services
• 17 accommodation-based housingrelated support services, including supported accommodation for people with Mental Health and complex needs, care leavers, and homeless families.
• 6 homeless street outreach services/ Housing First projects supporting people into accommodation and off the streets and helping people with the most complex needs to access accommodation.
• 4 mental health services supporting people to manage their mental health.
Bespoke Hoarding Service
P3’s Hoarding Support services work intensively with people to ensure they receive the right emotional support, advice and assistance to tackle the practical and emotional issues around their hoarding behaviour.
We take a hands-on approach to declutter and make people’s homes safer while taking the time to get to know the person and help build their confidence and independent living skills. We work hard to link people into aligned services such as social care, mental health support, bereavement counselling and other appropriate community groups to tackle the underlying issues that may be contributing to the hoarding behaviour.
Communication and listening skills are a vital part of the service. We work collaboratively with all agencies ensuring the person is getting the right help to meet their longer-term needs. This person-centred approach means people have autonomy and are involved and invested in their support. We will work with people at their own pace, using motivational interviewing techniques and coaching skills to promote independence and support longer-term behaviour change.
Our trained ‘Home Coaches’ use the ‘Clutter Scale’ assessment measurement tool. This tool helps to standardise definitions of clutter by showing a series of images depicting rooms at various hoarding stages. This allows the person, the ‘Home Coach’, or another observer to select the image on the scale that best corresponds with the state of the main rooms in the home and develop an action plan to reduce the clutter.
P3 currently delivers hoarding support to a range of stakeholders including housing associations, local authorities and adult social care departments across the UK.
We can provide a range of interventions to meet people’s needs through bespoke packages of support or by purchasing a block of support for a number of people.
For more information on packages that are available and associated costs please contact:
hoardingsupport@p3charity.org
Example packages:
• Block support
A full-time ‘Home Coach’ providing intensive interventions for 7-9 people per year, inclusive of training, management support and outcomes reporting. Approximate cost £45k p.a.
• Spot purchase, per person
Initial assessment, followed by a bespoke costed action plan with an indication of weekly support hours, review dates and time frames. Approximate cost £34 p/hr.
• One-off bespoke interventions
To complement support packages, priced on request, for example skip hire, clean and clear, CBT and counselling.
Amy* was experiencing a mental health crisis and did not wish to fully engage … However, with the Home Coach’s approach of a gradual introduction, providing Amy with opportunities for change and control, P3 were able to encourage Amy to make positive changes.
Social Worker feedback to P3
The support worker’s approach of a gradual introduction, providing Ray* with opportunities for change and control, enabled and encouraged Ray to make positive change. This has not only provided Ray with a safe and hygienic living environment, but has also helped to improve Ray’s mental health and emotional wellbeing.
Social Worker feedback to P3
I began to believe that was my lot. You provided me with the means to believe in myself and make my own decisions. I have started to get my home back.
Person P3 supported
Meet Emily*
Emily is 65 years old and lives with her son who has a chronic skin condition. Their home is a two-bedroom Paradigm property located in Chesham, Buckinghamshire.
Emily was referred to P3 as she was struggling with her mobility. She had sustained injuries to both her shoulder and arm and had asked for help to clear her house of unwanted belongings.
When we met with Emily our team quickly recognised behaviours consistent with a hoarding disorder. On entering her home, we found all the rooms were very cluttered and unclean. The problem was further exacerbated by dead skin being present on the surfaces and flooring throughout the house from her son’s condition.
The two of them were sleeping in the lounge as both beds upstairs had become unusable. Added to this, Emily’s son also lives with sight loss and was at a high risk of trips and falls, so it was important for our team to act quickly to minimise this risk and create a safer living space.
With P3 support
Emily has made slow but consistent progress in decluttering her home. (She is working at a pace expected of someone experiencing hoarding disorder behaviours.) She has built a strong relationship with our team and understands and engages well in her ongoing support. The trust developed with her P3 support workers has been key to enabling her to access much needed wider support. Emily now knows she can discuss her challenges and we have supported her to have the confidence to undertake a mental health assessment in her home.
All these steps show significant progress compared to before P3’s support.
“P3 are great, you really understand the problem we have, you are all so great, you have so much patience I don’t know how you did, I can’t sing your praises enough. You haven’t just helped with hoarding; you have done so much more.”
Allowing people into her home was a huge milestone in Emily’s progress. She now feels able to allow contractors and surveyors into her house to complete much needed maintenance work and investigate areas needing repair, something Emily had previously turned down.
P3 Impact
With P3 support, Emily’s home was decluttered:
• 89 bags of refuse have been removed and disposed of.
• Eight bags of clothing have been recycled or donated to charity.
• 11 bags of books, magazines, toys, DVDs and CDs have been donated to charity.
• 17 bags of general household items, kitchenware and electrical equipment have been recycled or disposed of.
• Eight large pieces of furniture have been removed from the property.
All the waste and clutter was removed from Emily’s son’s room (taking the room from 8 to 1 on the clutter rating scale), and today:
• The room is redecorated, and a new carpet has been fitted.
• Two unusable mattresses were removed and replaced with a single bed and new mattress.
• Storage was provided with a new wardrobe.
Overall, P3’s support has dramatically changed the family’s lives for the better. Their home is decluttered and clean reducing the risk of any infestations, and their improved living conditions have improved their day-to-day wellbeing.
Today
The P3 team have helped Emily to apply for PIP and Universal Credit for her son, and we supported Emily to undertake a financial capacity assessment. Our aim is to ensure they are better equipped to support themselves financially.
We’ve also worked to ensure Emily has access to support for her mental ill-health, liaising with her GP to gain a referral for mental health support and enabling her to keep on top of her long-term wellbeing.
These were all crucial changes; Emily now feels better able to manage her home and her mental health and appreciates everything the team at P3 have done to support her and her son to just live life.
Before After
Meet Harry*
Harry is a 53-year-old single parent living with his 23-year-old daughter who has Down’s Syndrome in Fairhive, Buckinghamshire. Their home is a spacious three-bedroom rental property and it should have been a haven for their family life.
Inside, two rooms cannot be used due to the excessive clutter and belongings in them. His daughter’s bedroom also has clutter and black mould is present on the ceiling and windows, posing an increased risk for respiratory problems, allergies and asthma. Further dangerous levels of orange and black mould are present in their bathroom where neglect has enabled it to take hold.
However, Harry’s own health is a factor too; he is living with multiple chronic health conditions while attempting to fulfill his role as the primary carer for his adult daughter.
Harry struggles daily with his mobility and has to wear orthopaedic braces around his lower legs, as well as living with a significant brain injury which affects both his memory and mood. Due to his mobility issues, Harry takes high doses of prescribed pain medication including morphine and is prone to trips and falls.
In addition, Harry has missed important medical appointments because of his fear about the results, meaning he has further undiagnosed health conditions which could have been treated and seen to.
Harry is overwhelmed. His mobility and poor physical health mean he is unable to declutter the house and clean the mould. He has been living on his sofa surrounded by clothes and medication for several years now. The clutter is present here too and it, along with the mould is beginning to take over the whole house.
“I can’t thank P3 enough for what they are doing for me, they have done so much already and every time they are here, I thank them because they are fantastic.”
With P3 support
We met and spoke with Harry and our support workers quickly established his mobility was the biggest factor for him to overcome. Working together, a plan was put in place to declutter and deep clean the house and assist Harry with reorganising his home to make it accessible for him.
Next, we reviewed Harry’s medication and personal wellbeing. After reorganising and disposing of all the out-of-date prescription items, P3 funded and delivered two lockable cabinets to store his medication safely. This enabled Harry to easily see and manage his pills, keeping everything together so he didn’t lose them in his home or over-order from his pharmacy.
We then chaired professionals’ meetings with the agencies involved in the family’s care to discuss plans for their ongoing wellbeing. We assisted Harry to re-book and attend two crucial hospital appointments and contacted occupational therapy. We worked to ensure Harry had all the mobility adaptations he needed installed in his home to give him greater access from room-to-room. Plus, Harry now has a mobility rollator to promote exercise and weight loss.
Next we worked with adult social care to arrange for a personal carer to assist Harry with his medication and getting around. Slowly, Harry’s life came back on track and, crucially, his trust with P3 grew. He was able to think about and discuss his future. He opened up about feeling overwhelmed and initiated the conversation about having a smaller home to manage. He was now able to see the importance of downsizing to a more manageable, accessible home.
Now Harry has been referred to our P3 Housing Support Service for his long-term wellbeing. Here, he can bid on properties and we can provide a weekly check-in service to support with any housing related issues.
P3 Impact
With P3 support, Harry’s home was decluttered:
• 13 bags of refuse were disposed of and 13 more large bags, all full of unwanted belongings, recycled.
• Nine pieces of furniture were removed, including three mattresses, one headboard, two dining chairs, two large cabinets, one dresser and a running machine. Removing these possessions has made it easier for him to move freely around the house, reducing the risk of trips and falls.
• The black and orange mould was cleaned and removed from all visible areas throughout the house.
• A further four large hippo bags were brought into the house, which have now been filled and collected.
• The area under the stairs was cleared to allow for a successful gas safety check.
• The property’s electrical plug sockets have been checked and surge protected as they were being overloaded.
Today
Harry is very happy with the support he has received from P3. He appreciates how his medication has been organised and being able to move freely around his home. He recently admitted being able to eat at his dining table with his daughter is something he hasn’t been able to do for years. He is currently adjusting to the support being delivered by his new carer and is looking forward to moving into a new home with P3’s support. Harry has made excellent progress, he feels empowered and these changes have greatly improved his quality of life. For the future, Harry wants to focus on getting involved in volunteering activities and losing weight to help with his pain management.
HEAD OFFICE
Eagle House, Cotmanhay Road, Ilkeston Derbyshire DE7 8HU
P: 0115 850 8190
E: hoardingsupport@p3charity.org
W: www.p3charity.org
