Last week the spotlight fell on halfway houses, set up to provide accommodation for patients between the time they leave hospital and return to live on their own or with their families, when Jenny Morrison, a social worker for 20 years, was stabbed to death in one in south London. Anthony Joseph, 26 has been charged her murder.
According to the National Schizophrenia Fellowship (NSF), one of the main problems with the "Care in the Community" policy is that nobody keeps a check on the hostels. The charity has called for national standards to ensure safety of staff and residents. It is concerned that health and social services are tempted to provide facilities "on the cheap" by putting those with greater difficulties in medium-level rather than high- level care.
No one knows exactly how many hostels for people with mental health problems exist. Local authorities, housing associations, charities, and private businesses all run them, as do health authorities. They all have different regulations.
The mental health charity Mind estimates that there are 33,200 residents in institutions for people with mental health problems, of which about two-thirds suffer from schizophrenia. But that does not include "halfway house" hostels.
While the Housing Corporation provides funds to housing associations for the actual provision of bricks and mortar, the regulations concerning care are left to the individual health and social services.
"We are talking to the Department of Health about how the regulation of social care and housing can work more closely together," said a spokeswoman for the Housing Corporation.
"We've been very concerned about standards," said Kathleen Boyle, policy officer for the National Housing Federation, which represents housing associations whose members run 2,950 hostels, looking after 15,400 people. "Monitoring varies so much. It is crucial these kind of projects are properly inspected."
Jenny Morrison's case was not the first. In 1992 Katie Sullivan was killed in a hostel in Kingston, Surrey, when a patient attacked her with a carving knife. The following year John Rous, a schizophrenic, killed an untrained volunteer hostel worker Jonathan Newby, 22, in Oxford.
The NSF, which provides space for about for 400 people, has drawn up guidelines on care and conducts assessments of whether people are suitable for their schemes.
Andrew Foster, chief executive of the Audit Commission has also called for a framework of performance indicators to be adopted for all supported housing. He also said that a comprehensive database should be compiled including all registered social landlords involved in supported housing. "The public need to know this service is being delivered economically and to a high standard."
"We need national minimum standards," said Terry Hammond of the NSF, who has set up nearly 60 schemes for housing the mentally ill in the community. "We need rules so that funders - the health and social services - don't think they can do care on the cheap. Care like this cannot be done on the cheap."