One fee, four hours: why we built 1-2-1 support into the price

In specialist mental health care, one-to-one hours are usually the thing everyone argues about. The assessment says a person needs them. The funding panel asks for evidence. The provider submits a request, the panel meets, a time-limited award is made, and a few months later the whole process starts again. While that goes on, the person at the centre of it waits for the support most likely to help them.

At Bancroft Care Centre we decided to stop treating 1-2-1 time as an extra. Every person who lives here receives four hours of dedicated one-to-one support each day, as standard, included in a single weekly fee.

What happens when 1-2-1 is an add-on

When one-to-one time has to be applied for, it gets rationed. It tends to go to whoever is in crisis this week, because crisis is what generates the evidence a panel needs. And it tends to disappear when things improve, which is often exactly when it is needed to keep things improved. People learn that the way to get time with someone is to be unwell.

It is hard on staff too. A support worker who does not know from one month to the next whether the hours will be funded cannot plan, cannot promise, and cannot build the kind of steady relationship that recovery depends on.

What happens when it is standard

When the time is guaranteed, everything about it changes. Staff can plan the week with the person. People know when their time is and who it is with. Relationships form, and with them trust. Small changes in mood or routine are noticed early, by someone who knows what is usual for that person, before they become incidents. And staff stay, because they have time to do the job they came into care to do.

Why four hours

Four hours is enough to do something real. It is a trip into town and lunch made together afterwards. It is an accompanied appointment and time to talk about it on the way home. It can be taken in one block or spread across the day, and it is shaped around what the person wants to work on. It is one-to-one, with a named member of staff, and it is not shared between residents.

Some people will need more than four hours, particularly at first. We assess carefully before admission and say so plainly. Anything above the standard is agreed separately, evidenced, and reviewed so that it reduces when it can. What changes is the starting point: a meaningful level of individual support is already there on day one.

A simple idea

We have never met a person with complex mental health needs who did not benefit from protected time with someone on their side. So we built it in. One fee, four hours, every person, every day. We think it should be ordinary.

Bancroft Care Centre is part of ASHA Healthcare.

To talk about a referral, arrange a visit or ask about our fee, contact Megan.tranter@ashahealthcare.co.uk or visit www.ashahealthcare.co.uk