Step Down is a new short term, community-based accommodation service in Central and North West London which supports the move of individuals from inpatient services back to the community.

The service aims to facilitate early discharge from hospital, reduce the length of stay on acute mental health wards and enable people to reintegrate back into the community in a safe and supported way.

Step-Down offers 24-hour live-in care in one of our temporary accommodations with in-reach from a community team made up of occupational therapist, nurse, social worker and support worker. The service takes an innovative approach to supporting patients who could benefit from continuing care in a community based, recovery-focused environment. Residents are supported with activities of daily living and any social or practical needs for up to a maximum of four weeks and where possible much shorter. 

The Step-Down project is part of the CNWL Community Access Service, a team made up of social workers, peer support workers and third sector organisation workers who support inpatient service users with complex needs to be able to reside in the least restrictive setting possible.

The accommodations have a live-in Support Worker on site 24 hours a day, 7 days a week, provided by our partner Lifecome Care. Alongside this, a step-down team made up of a Senior Occupational Therapist, Senior Nurse, Patient Flow Support Worker, Support Worker, and local Community Mental Health and Home Treatment Teams are all actively involved in supporting the discharge process.

Step-Down provides support for patients who are clinically optimised to leave the inpatient ward, but waiting for non-clinical decisions or issues to be resolved.

Patients can receive support with a range of activities of daily living, including shopping and cooking. They also receive practical support to help their social care needs, such as applying for housing, employment, benefits and PIP.

Step-Down offers a holistic approach to care, with a multi-disciplinary team supporting different elements of the patient’s recovery journey, including:

  • Nurse input to monitor mental state and medication
  • Occupational Therapy assessments and intervention
  • Activity coordinator input to practice daily living skills
  • Sessions on mindfulness and relaxation and 1:1s
  • Signposting to community groups, volunteer services and drug and alcohol counselling

Patients can be referred on to Step-Down by acute and urgent care leads. Step-Down only accepts referrals from acute inpatient services.

The service does not accept referrals for patients who are in need of a forensic placement; have complex physical health, mobility or drug and alcohol issues; or who already have a tenancy.

There are currently seven Step-Down accommodations across the North West London boroughs including Brent, Harrow, Hillingdon, Westminster and Battersea.

For more information go to: https://www.youtube.com/watch?v=I-LKP28i4Uc&ab_channel=CNWLStepDownProject or contact cnwl.stepdown@nhs.net

What our service users say

"Staff presence was helpful, able to talk to them when needed. I liked the room… I was ordered a bed and a mattress to help with my move back to my property."(K&C SU)

"Staff were able to support me to complete tasks I needed help with such as dealing with benefits and learning to cook meals. Joseph (support worker on site) has been very helpful in providing assistance to me whilst I have been here in the property." (Hillingdon SU)

"Thanks all of you for taking care of me. Your kindness, care and help are lovely treasures. You guys are wonderful to help me past through this hard time."(Westminster SU)