Guidance for Children and Families Homeless or Resident in Temporary or Supported Accommodation Reference No: G_CS_63 Version 2 Ratified by: 13 th June 2017 Date ratified: LCHS Trust Board Name of originator / author: Claire Saggiorato /Sylvia Wilkinson Name of responsible committee / Individual Quality Scrutiny Group Date issued: June 2017 Review date: May 2019 Target audience: Health visitors and school nurses Distributed via Website 1
Version Control Sheet Version Section / Para / Appendi Version / Description of Amendments Date 1 V0 March 2015 Author / Amended by C.Saggiorato / S.Wilkinson 2 Updating of references Section 2 V1 March 2017 C.Saggiorato/S Wilkinson 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Copyright 2017 Lincolnshire Community Health Services NHS Trust, All Rights Reserved. Not to be reproduced in whole or in part without the permission of the copyright owner. 2
Guidance for children and families homeless or resident in temporary or supported accommodation Contents Version control sheet 2 Policy statement Section Page 1 Rational 4 2 Purpose 5 3 Duties 6 4 Statement 6 5 Responsibilities 6 6 Training 7 7 Dissemination 7 8 Resource Implication 7 9 Process whilst child/ family resident within temporary/ supported accommodation 10 Process on transfer out of supported/ temporary accommodation 7 9 11 References 10 12 Appendi 1 11 3
1. Rational Individuals are considered homeless if they have no home in the United Kingdom or anywhere else available for them to live. Even if an individual has somewhere to stay, they may still be considered homeless. Eamples of situations where an individual may be considered to be homeless even though they have accommodation include: they have no home where they can live together with their immediate family they can only stay on a very temporary basis they do not have permission to live where you are they have been locked out of home and aren't allowed back they cannot live at home because of violence or abuse or threats of violence or abuse, which are likely to be carried out against them it is not reasonable for them to stay in their home for any reason (for eample, if your home is in very poor condition) Individuals may also be considered homeless if their accommodation is very temporary for eample a hostel or refuge. (Shelter.org.uk 2015) Families and children who are homeless or living in poor quality temporary accommodation can face great inequalities in accessing health services. It can impact upon their health, physical safety, enjoyment, personal achievement, schooling and life chances. Children and families living in temporary accommodation, often at a distance from previous support networks or those who move home frequently, can lead to individuals and families falling through the net and becoming disengaged from health, education, social care and welfare support systems. They may not be registered with a local GP or be known to local health services. 4
Homeless people may often leave health problems untreated until they reach a crisis point and then present inappropriately at A&E. This combines to make health problems more epensive to treat, hospital waiting lists longer and leads to people being less able to support themselves. It is important that effective systems are in place and essential that local authorities and health services work together to provide accessible and appropriate services if we are to tackle health inequalities and homelessness (OPDM 2004, Shelter 2010, DH 2010). In order to improve the lives of homeless children and families providing early help is more effective than reacting later. Early help means providing support as soon as a problem emerges. Effective early help relies on agencies working together to identify children and families who require additional support, to undertake an assessment and provide targeted intervention and referral to appropriate voluntary and statutory agencies to improve outcomes for children and families (HM Government 2013) 2. Purpose: To ensure that a robust service is provided to homeless families resident within supported or temporary accommodations within the LCHS catchment area. To provide consistent support and advice to resident families at a time when they are at their most vulnerable and have high levels of emotional and social need. To ensure that the Healthy Child Programme (DH 2009) is delivered and to enable assessment of vulnerability to facilitate early help support as necessary. To share information with relevant professionals and other agencies, on a need to know basis, using information sharing guidance (2015), to support and empower 5
vulnerable families in their care. 3. Duties: Chief eecutive has ultimate accountability and responsibility for the physical health of service users and the implementation of this policy. Operational leads and locality managers have accountabilities and responsibilities for ensuring staff are aware of policies and have the knowledge and skills to practice effectively. Resources must also be available to achieve practice safely and effectively. Community practitioners are responsible for ensuring clinical staff can competently achieve the standards referred to in the guidance 4. Statement: Lincolnshire Community Health Services NHS Trust will develop policies to fulfil all statutory and organisational requirements. These will be comprehensive formally approved and ratified, disseminated through approved channels and implemented 5. Responsibilities: Compliance with the guidance will be the responsibility of all Lincolnshire Community Health Services staff. Authors of the policy are responsible for undertaking appropriate consultation in the development of the guidance. Guidance will be ratified by clinical effectiveness and risk committee. 6
6. Training: Training will be disseminated by health visiting practice educators and staff email. 7. Dissemination: Relevant staff will be made aware via health visitor practice educators and email. All staff have access to Lincolnshire health services website, policies and guidance 8. Resource Implication: This guidance will act as a useful clear resource for health visitors and school nurse. 9. Process whilst child/ family resident within temporary/ supported accommodation: A liaison HV will attend the setting on a weekly basis, at a minimum, to offer support to resident families and staff. Should the liaison HV be unavailable a deputy should be assigned to complete the liaison during his/her absence. Liaison with accommodation staff and other relevant professionals on a need to know basis, (using information sharing guidance HM Government 2015) 7
will provide information to support and empower service delivery to children and families. When the liaison HV has notification of a new family resident in the homeless accommodation, she/he will inform the named HV/SN and an agreement will be established regarding who will take responsibility for the ongoing service delivery to the family. Best practice suggests that this should remain the responsibility of the named HV unless geographical distance deters this. If the decision is for the liaison HV to take responsibility for the case then she/he will become the named HV for the family. The HV/SN that holds the responsibility (named HV) for the care of the family must be clearly stated in the groups and relationships template and documented in the child s SystmOne record. All homeless families (including antenatal mothers) that are encountered by the liaison HV will be registered (if not already) on SystmOne and robust, contemporaneous records will be maintained. The liaison HV will provide all new families with local GP practice details and local services information signposting parents and families to groups and services appropriately All families will receive the Healthy Child Programme. Additional services will be provided as an individual need within LCHS core offer specification. The named HV and the liaison HV/SN will communicate as required to ensure continuity of care; this can be within the task system on SystmOne for universal core programme families (green triangle families) or by telephone or face to face contact if urgent or more in-depth communication is required as per families on individual need offers (all amber and red triangle families or those with safeguarding flags). The assessment framework, signs of safety and the vulnerability/risk matri should be utilised and families may be 8
discussed with the Senoir SCPHN and/or deputy named nurse for safeguarding children as per LCHS supervision policy at the professional discretion of the responsible HV. 10. Process on transfer out of supported/ temporary accommodation Upon notification of the transfer out of children and families from the homeless accommodation the liaison HV will notify the named HV/SN who held responsibility for the family whilst resident in the temporary accommodation. The named HV/SN will review the SystmOne records and complete a summary on the SOAPE template to include current outstanding health needs and immunisations, risks and vulnerabilities and any safeguarding concerns. This should also be completed on the mother s records if the mother is an antenatal patient and open to LCHS care. The named HV/SN will then liaise with the new named HV/SN (local or out of area) to ensure seamless transition of care. The named HV/SN should then transfer records and communicate as appropriate with the new HV/SN within LCHS or out of area. Transfer of all records must be via the child health department to facilitate an audit trail of where records are sent/received. LCHS transfer out policy is to be adhered to and SystmOne transfer out template to be completed. Named HV/SN to liaise with other agencies/professionals as required within Working Together (2015) recommendations to alert them of the families move. 9
Inform deputy named nurse for safeguarding or the vulnerable children and young people team of transfers out of the area if families are considered to be high risk or looked after children (LAC). It is the duty of the Named HV to liaise, in a timely manner, with the receiving area HV regarding Child in Need, Child Protection, LAC or families of concern. 10
References 1. Department of Health (2009) Healthy Child Programme 2. HM Government (2015) Information sharing, Advice for practitioners providing safeguarding services to children, young people, parents and carers,www.gov.uk, March 2015. 3. HM Government (2015) Working together to safeguard Children,www.gov.uk 4. OPDM (2004) Homelessness and Health Information Sheet. Health Visiting Services 5. Shelter (2010) Good practice briefing supporting homeless children. Guidance for health visitors. 6. Shelter.org.uk (2015). 11
Appendi 1 Homeless Accommodation Family/Resident Family moves in from the Lincolnshire Community Health service catchment area Family moves in from outside Lincolnshire Community Health Service catchment area Liaison HV to inform named HV/SN. Named HV/SN and liaison HV to determine who will take responsibility for the ongoing service provision. Liaison HV to complete transfer in visit and commence service provision Liaison HV to provide local information and encourage local GP registration Liaison HV to inform the Named HV/SN when family leaves the homeless accommodation. Ensure summary of child is recorded in systmone records Named HV/SN transfers to receiving area HV/SN as per transfer out policy Inform DNNSC and other professionals as required Liaison HV to inform named HV/SN when family registers with a local GP Decision to be made as to who retains responsibility for the family and clearly documented within the records Liaison HV notifies the Named HV/SN when family leaves the homeless accommodation. Ensure summary of child is completed in systmone record 12
NHSLA Monitoring Minimum requirement to be monitored Process for monitoring e.g. audit Responsible individuals/ group/ committee Frequency of monitoring/audit Responsible individuals/ group/ committee (multidisciplinary) for review of results Responsible individuals/ group/ committee for development of action plan Responsible individuals/ group/ committee for monitoring of action plan As policy per Audit tool in organisational wider policy for development and management of policy and procedural documents Health visitor practice educators Operational Leads 2 yearly Health visitor practice educators Operational Leads All using policy staff the Health visitor practice educators Operational Leads Health visitor practice educators Operational Leads 13
Name of Policy/Procedure/Function* Guidance for children of homeless or resident in temporary or supported accomadation Equality Analysis Carried out by: C.Saggiorato/S Wilkinson Date: March 2017 Equality & Human rights Lead: Rachel Higgins Director\General Manager: Lisa Green *In this template the term policy\service is used as shorthand for what needs to be analysed. Policy\Service needs to be understood broadly to embrace the full range of policies, practices, activities and decisions: essentially everything we do, whether it is formally written down or whether it is informal custom and practice. This includes eisting policies and any new policies under development. 14
Section 1 to be completed for all policies A. Briefly give an outline of the key objectives of the policy; what it s intended outcome is and who the intended beneficiaries are epected to be To ensure that a robust service is provided to homeless families resident within supported or temporary accommodations within the LCHS catchment area. To provide consistent support and advice to resident families at a time when they are at their most vulnerable and have high levels of emotional and social need. B. C. D. Does the policy have an impact on patients, carers or staff, or the wider community that we have links with? Please give details Is there is any evidence that the policy\service relates to an area with known inequalities? Please give details Will/Does the implementation of the policy\service result in different impacts for protected characteristics? Yes relevant to children and families Yes - Homeless Disability Seual Orientation Se Gender Reassignment Race Marriage/Civil Partnership Maternity/Pregnancy Age Religion or Belief Carers Yes If you have answered Yes to any of the questions then you are required to carry out a full Equality Analysis which should be approved by the Equality and Human Rights Lead please go to section 2 No The above named policy has been considered and does not require a full equality analysis Equality Analysis Carried out by: C.Saggiorato/S Wilkinson Date: March 2017 15