Westminster Homeless Health Action Group Meeting Minutes Venue: Westminster City Hall 24 Attendees 8th December, 11.30am 1pm 1. Online CHAT: The online CHAT needs to be completed with all new clients within 2 months of entering supported housing, and for all existing clients by the end of March 2016 The online CHAT is located at: https://docs.google.com/forms/d/1zer2cyit6d9pzctc_rp3trq0xvtiluasbfxdkbbjtdy/viewfo rm We really do appreciate the work that is being put in by staff to complete the online CHAT thank you! A total of 81 chats completed so far. Breakdown in chart on page 3. It s been feedback that some people are confused about how to save the CHAT form as a PDF (essential as the PDF needs to be sent with the BBS referral form/ or for a sideways move). There is guidance on how to do this on the CHAT form, and Anna is happy to visit and show staff how to save it if needed. We will be able to share the anonymised data from 64 (80%) of the 81 completed CHAT forms with commissioners, as they have indicated that the information can be shared. Although this is good number and we can t force anyone to share their health information with us, it is important to stress that it is completely anonymous. The information is vital if commissioners are to have the intelligence and evidence it needs to improve health services for homeless people in Westminster in the future. Please encourage as many clients as possible to share the information.
CHAT completed for existing client CHAT completed for new client (within 2 months of entering project) Percentage completed Harrow Road 8 3 27% Hopkinson House 1 3% Passage House 1 1 5% Edward Alsop Court 5 5 13% Montford House 0% Bruce House 6 1 25% Shroton Street 3 14% King George's 28 5 49% Wytham Hall Westbourne Park No new clients 3-5 Bravington 2 2 33% 225 Bravington Chippenham Road 113 Sutherland Road 2 20% 105 Shirland Road 5 63% 17-19 Shirland Rd 1 8% Westminster Training 1 1 20% Flats TOTAL 57 24 81 2. Time Credits: Caroline Murray carolinemurray@justaddspice.org and Laura Jenner Caroline Murray and Laura Jenner spoke about their organisation Spice, which is funded by Westminster CC for 3 years. Spices have set up a time based community currency in Westminster that services can sign up to offer to their clients. Time credits could be used as a motivational tool for clients to complete the CHAT, and are used to increase volunteering opportunities and community participation. There is an asset based approach to time credits. 1 hour of giving time will equate to receiving 1 hour back, and this can be exchanged for many things: tickets for the cinema or Tower Bridge for instance. Resources can be shared between projects e.g. Cardinal Hume have signed up and one of the offers they have is the use of room to use. Page 2 of 6
Caroline and Laura will be able to support teams to do asset mapping exercises in their projects. Each organisation needs to sign up individually to Time Credits and offer a spend opportunity for volunteers. To find out further information email carolinemurray@justaddspice.org 3. EASL: Angus Stevenson and Nicola Bygrave angus@easl.org.uk Angus Stevenson and Nicola Bygrave spoke about EASL (Enabling Access Services LTD). This is a social enterprise that originally started in Islington. EASL provides outreach psychological support in hostels, and also a capacity building function. They are a multi-disciplinary team consisting of an occupational therapist, a mental health social worker, a mental health nurse with and have access to a clinical psychologist and psychiatrist. They work a lot in the 3 NSNO hubs so if you are working with a client who comes to your service via one of the hubs, it is worth checking with EASL as they may have assessed the client already (this information will not be on CHAIN). EASL also provide training sessions on the Mental Health Act and Mental Capacity with a particular reference to working with homeless clients. EASL is operating a 1 year pilot programme in Westminster working within 5 hostels. They are able to support services with reflective practice sessions which can equip staff teams to manage challenging behaviours effectively. They can also conduct face to face mental health assessments and look at referrals being made to statutory services. 4. Single Point of Access One-stop entry point into adult secondary community mental health services for patients in Westminster started on the 3 rd November 2015. This replaces the out of hours crisis line that was in place before this time. Referrals of an emergency or urgent nature (requiring a 4 hour or 24 hour response) should be made by telephone. Have clear timeframes for response to all calls, working to the agreed referral deadlines of emergency (4 hours), urgent (24 hours), routine + (7 days) and routine (28 days). Please see attached SPA operational policy or visit http://www.cnwl.nhs.uk/wpcontent/uploads/spa_operational_policy.pdf (from page 11) for the presentations required to make the specified timeframes for call response. This also provides information on what Page 3 of 6
you can expect the SPA service to do as a response to the timeframe they place on a referral Call 0800 0234 650 for emergency and urgent calls, or email or by email at cnwtr.spa@nhs.net for less urgent requests. 5. Medication discussion Thank you to everyone that has forwarded me their organisation s medication policies. From the medication policies 2 organisations can centrally store medication/prompt clients to take medication, and 3 aren t able to, 2 don t have a policy. Harrow Road hostel described its medication protocol (mandatory staff training, medication discussion being part of the clients booking in process, insistence on medication in blister packs, use of standard MAR sheets and work with GPs and pharmacies). It seems that there are various organisational interpretations of the current law, but it isn t clear if storing/dispensing/conveying medication would be or should be considered a registered activity. To take forward guidance on medication management in hostels a working group is being formed to ultimately help organisations to take their meds properly and safely (storage and prompting of medication for clients). The working group is being led by Nigel Hewett from the UCH Pathway Team. Homeless Link are going to be involved in this, as is Al Storey from Find and Treat, Steve Davies, taking best practice from Edward Gibbons House who successfully hold and administer medication for clients (mainly cognitively impaired due to alcohol use). Homeless Link s guidance around providing naloxone in hostels was published 3 rd December http://www.homeless.org.uk/our-work/resources/naloxone-in-homelessness-services. Naloxone can now be supplied by drug services without a prescription, and can be supplied to staff at hostels without the expressed permission of the person using opioids to reduce to use it to save life in an emergency (although of course, not all services are allowed to do this due to their meds policy). Naloxone training is being run by Turning Point on the 16 th December 2pm-3.30pm. It was agreed that the nurses could give out naloxone on the training day, but services that aren t allowed to use it should not take any. Exchange supplies DVD was given out to services which provides information on administering naloxone and responding to an overdose. 6. Room checks discussion Page 4 of 6
There have been a couple of serious incidents relating to room check processes which were discussed. There needs to be a balance between client safety and client privacy. Services shared their practices: Checks took place 3 times a day and 2 times a night (high support) Missing persons procedure Checks every 2 days but risk assessment would contain information on what to do if client had not been seen in 24 hours Physically seeing client every day and not relying on client saying they were fine. Incorporating with monitoring clients seen at breakfast and adding to the seen list. Calling the check a welfare check and not a room check Consider the time of the welfare check Checks were dependent on vulnerability of the client Asking clients to inform teams if away overnight 7. Health MOT events The health MOT event pilot generally went very well with a range of health services attending. Anna and 3 members of groundswell peers advocates helped on the day to encourage clients to attend screening. Services that offered screening: 56 Dean Street came to offer sexual health screening, CLCH Dental service offered dental health session, Turning Point s Health Checkers provided Health checks for people aged 40-74. A podiatrist attended Passage House. Turning point also ran spice/naloxone session in HH and KGH. Edward Alsop Hopkinson House Passage House Semiindependent Wytham Hall TB screening 39% 82% 86% 42% 50% Sexual Health screening 8 0 7 N/A N/A Health checkers 6 4 4 4 N/A Foot checks N/A N/A 3, 1 referral N/A N/A Dental health session 15 N/A N/A N/A N/A Referrals to Groundswell 7 3 2 2 N/A Page 5 of 6
Sexual health screening wasn t as popular as hoped. NHS health checkers were booked out during every event, but limited in the amount they could see on the day. As TB screening had been stopped at semi-independent projects, and had never taken place at Wytham Hall, Anna requested that the TB trialled a session at these projects. Feedback was requested and there was a complaint from a client regarding the lack of confidentiality and sensitivity when using the TB mobile unit. Steve Davies explained that confidentiality moving forward on the van should improve due to a new information system. 8. HHCP training update Since September 2015, 204 staff members have attended 17 training sessions coordinated by the HHCP. Training has been lead by the Joint Homelessness Team, EASL, Westminster Drug Project, CLCH Dental Service, London Ambulance Service, Westminster Dementia Service, Andy Solomon-Osbourne, and Rob Frier/Hannah Hunter/Anna Midgley. Topics include: Dual diagnosis, personality disorders, introduction to mindfulness, psychologically informed environments. Resources sent out to attendees and services after the training to support learning. In addition 56 services users have attended training coordinated by the HHCP. This has included diabetes awareness, dental health awareness and sessions ran by HHCP health promotion volunteers. 9. HHCP plans for 2016 HHCP online resource to include a health directory Health promotion medical volunteers Homeless frequent attendee meeting at St Mary s 1 st March Mental Health Pathways day 19 th April HHCP service user and staff conference - Abbey Community Centre Health improvement team health sessions Bi-annual dental screening supporting clients to register with dental services HHCP annual report including data completed from the online CHAT July 2016 And last but not least - training for staff and clients Date of next meeting: 16th February, 10am-12pm, Westminster City Hall, 17 th Floor, Room 1b and 1c. Page 6 of 6