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Redefining Complex Care: Bespoke Solutions for a Better Future

Rob Fountain from LivesthroughFriends discusses their approach to finding imaginative solutions to supporting individuals in the community, and redefining complex care.

LivesthroughFriends is a Community Interest Company (CIC) and not-for-profit social enterprise that helps people with complex reputations live better lives. We do this by developing bespoke support arrangements that are tailored to the individual’s needs and goals.

In every local area there are individuals who expose the limitations of the placement model. These people have acquired complex reputations, and have often experienced multiple placement breakdowns with providers feeling they cannot meet the needs presented. These people often get stuck in institutional settings, without hope and with an ever-increasing ratio of staff put around them to control distressed behaviours. The outcome is a high-cost situation delivering a deeply unsatisfying life for the person.

However, there is another way. We have learned from hard won experience how to transform these scenarios to provide good lives for institutionalised and traumatised people, often at lower cost to the public purse.

Image shows a man and a young boy wearing helmets and headtorches, giving a thumbs up.
Rob Fountain with a young person he has worked with.

Our experience-informed approach  

  1. Start with Good Life Planning (rather than needs assessments)

  2. Build support around the person (don’t try and fit complexity into a placement)

  3. Anticipate turbulence and plan for it (don’t just cross your fingers and hope)


We have learnt that it is essential to start with the person and the life they want to live, rather than focusing on their needs. This means that we look beyond containment to create a life of purpose, relationships, and contribution.


Once a Good Life Plan has been created, we help to make it happen by finding suitable housing and identifying the best support provider. We also devise detailed transition plans and project manage the set up and preparations for the new arrangement.

Does bespoke mean more expensive?

Not at all.  Building a home and support team around the person, informed by a clinical picture of how to reduce the triggers of challenging behaviour, and proactively building a wider community network around someone, makes it possible to aim for reductions in the paid-for input over time. Not only does our approach improve lives, it can also offer a far more cost-effective way of doing so.  

How can we help?

The LivesthroughFriends team are located throughout the UK and work ‘hands-on’ wherever we are engaged.  We have current work in England, Wales and Scotland. We welcome conversations with those in health and local authority roles who are feeling stuck with one or more people and would like to explore whether our approach might reveal another way. We are always happy to talk to families about pushing for a better life for their loved ones, and we are happy to be introduced to statutory bodies to explain what is possible when you apply some different thinking.

To speak to a member of the LivesthroughFriends team about how they could help you or a person you care for, visit

Written by Rob Fountain

COO at LivesthroughFriends


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