Homelessness Task Group Report - LINk work library...Homelessness Task Group Report April 2010 Julie Harris: Development Officer 3 The Setting up of the Task Group Towards the end

Access to Health and Social Care

Services for the Homeless

Task Group Report

April 2010

Julie Harris: Development Officer

Homelessness Task Group Report

April 2010

Julie Harris: Development Officer 1

Contents Page/s Introduction 2

Setting up of the Task Group 3

Meeting One 4-5

Preparation for Meeting Two/Workshop 6-7

Meeting Two/Workshop 8-11

Meeting Two/Workshop Session Evaluation 12

Meeting Three 13

Recommendations 14

References 15

Appendices

1. V4W Prioritisation Framework 17-19

2. Terms of Reference 20-21

3. Task Group Meeting 1 Minutes 22-24

4. Targeted Invite List (Workshop) 25-27

5. Letter & Questionnaire 28-29

6. Evaluation Sheet 30

7. Task Group Meeting 2 (Workshop) Minutes 31-33

8. Task Group Meeting 3 Minutes 34-35


April 2010


Introduction

Voices 4 Wellbeing is Rochdale Borough’s Local Involvement Network (LINk). Established 1st

April 2008 by the Department of Health, LINks were set up nationally in place of Patient and

Public Forums (PPIF’s) to enable organisations, community groups and individuals (anyone

with and interest in improving health and social care services), to have a say about how

health and social care services could or should be improved at local level. Funded via

Rochdale Metropolitan Borough Council, the Gaddum Centre was procured to host the LINk

to enable independent working.

Further information can be found at www.voices4wellbeing.co.uk

During the first twelve months Voices 4 Wellbeing (Rochdale Borough LINk) began

undertaking community engagement work across the borough of Rochdale. Meeting with a

variety of organisations, groups and individuals not only provided the opportunity to

promote Voices 4 Wellbeing, but also to record issues and concerns about health and social

care services across the borough. Access to health and social care services for people who

are homeless or vulnerably housed was one of the major concerns recorded.

Using our Prioritisation Framework (Appendix 1), Voices 4 Wellbeing’s Interim Governance

Group (IGG) identified access to health and social care services for people who are homeless

as a priority; it was agreed to place this on our annual Workplan. It was also agreed to set up

a task group to further examine the situation across the borough of Rochdale, to examine

what is being done to improve the situation and to plan a piece of work to provide feedback

to relevant health and social care service commissioners in the form of a report. The task

groups Terms of Reference can be found in Appendix 2.

Therefore, the purpose of this report is to provide a record of the work carried out by the

task group and to make formal recommendations to relevant health and social care

commissioners.

I would at this point like to acknowledge and express my gratitude to all those who have

contributed to this piece of work.

Many thanks

Jules

http://www.voices4wellbeing.co.uk/


April 2010


The Setting up of the Task Group

Towards the end of 2008, community work carried out by Voices 4 Wellbeing had

highlighted some of the issues homeless people face with regards to accessing health and

social care services. Having now established its Governance Framework, Voices 4

Wellbeing’s Interim Governance Group (IGG) were now ready to formulate a Workplan for

the coming year.

Though it was clear that accessing health and social care services may be a problem for

some, the IGG agreed that the Host staff should carry out some further research and

investigate further the situation across the Rochdale Borough. Mary Drummond (IGG

member) agreed to provide a report based on research carried out at in a London based

homeless hostel St Mungo’s (Bilton 2008), which highlighted some of the issues homeless

people have regarding health and access to services. Mary also agreed to provide some

statistical information regarding the situation across the Rochdale Borough. The research

material gathered was circulated at the next meeting (9th February 09).

Research references: St Mungo’s (2009), RMBC (2009), Tansley (2007), Murray (2008), Crisis

(2002), RMBC (2006-2011)

The host staff explained that some of the research gathered may be out of date as there had

been some difficulties in obtaining more recent data. However, Mary Drummond provided

some up-to date data including the number of people registered as homeless across the

Rochdale borough in 2008; 3961, 1009 in the final quarter (no ref) and further information

about individuals vulnerable to homelessness, homelessness legislation, information about

young homeless people and street homelessness.

The IGG put the issues of homelessness and access to health and social care services

through Voices 4 Wellbeing’s Priority Framework (Appendix 1), which scored 23 out of a

possible 25 points. It was therefore agreed that this was a high priority and the IGG put

homelessness and access to health and social care services on Voices 4 Wellbeing’s annual

Workplan.

Next Steps:

Host to further map area- to make sure organisations working with the homeless

were all on V4W database

Host to set up a task group inviting all on Voices 4 Wellbeing’s database

Hence, a letter was sent out to all on Voices 4 Wellbeing database informing that a task

group was being set up to examine homelessness and access to health and social care

services and that the first meeting would take place on the 1st June 09 at Partnership House.


April 2010


Task Group: Meeting one

The first task group meeting took place at Partnership house on the 1st June 09. In

attendance was Jules Harris: Voices 4 Wellbeing Development Officer, Steven Journeaux:

Voices 4 Wellbeing Administrator, Eleanor Tierney: Member of the Interim Governance

Group, Dr Marian Corns: Interim Governance Group Chair, Mike Fishwick: Health Trainer

HMR PCT, Dennis Skelton: Petrus, Melanie Doyle: Senior Worker DePaul UK, Libby Walsh:

Great Howarth Homeless Families Unit, Charlotte Watson: Manager Homeless Shelter

RMBC.

The purpose of this meeting was to provided information about why the task group had

been set up and to explore what work could be done and how. Dr Marion Corns V4W

Interim Governance Group Chair, chaired the meeting. After welcoming everyone and

introductions made, Marian explained why the group had been set up. The group then

began to discuss the multiple and complex health and social needs people who are

homeless may have.

It was agreed by all that homeless people suffer a multiple of complex health and social

problems. Some examples were given: Problems accessing benefits, problems with hospital

discharge, dentistry, mental health issues, drug use and other addictions, poor nutrition,

abuse, access to services, sexual health issues, and sexual violence. A lack of joined up

working between health and social care services was highlighted as a concern and it was

suggested that this can further exacerbate the problems homeless people have.

Due to the multiplicity and complexity of health and social needs of people who are

homeless, the group suggested that people from other services, such as mental health and

drug teams should be invited to join the task group before progressing further. The

suggestions were as follows:

Triple H

Mental Health Service Representative

Drug & Alcohol Representative

Police Officer (PC O’Brian)

Steve Buick

PCSO’s who work around Broadfield Park

Salvation Army

Overview & Scrutiny Representative


April 2010


The group also discussed ways of gathering information and agreed to share any

information, statistics, reports etc relevant to the task. It was suggested that the St Mungo’s

Report (2009) be used and also that hospital discharge polices be obtained from A&E.

The group agreed that the next meeting should include some workshops based around the

questions set out in the Terms of Reference.

Workshop questions based on:

What is the situation in Rochdale?

What is being done to improve the situation?

What do we need to find out?

How will we do this?

Next meeting date was set, 4th August 09, 12noon-4pm

It was agreed that a lunch would be provided and the Host would organise this along with

the venue and invites. The group also agreed to send out a small questionnaire with the

invites in the hope that some feedback might be obtained from those who could not make

the meeting. This would be based on the questions to be asked during the Workshop

(above).

(Minutes: Appendix 3)


April 2010


Preparation for Task Group Meeting Two/Workshop

Following the suggestions and advice of the attendees of the first task group meeting,

Voices 4 Wellbeing’s host staff carried out further mapping work and updated their

database to enable the targeting of specific groups i.e. Housing Associations, mental health

organisations, drug and alcohol organisations. Triple H, The Salvation Army and the Health

Overview and Scrutiny Committee were also added as contacts specific to the task group

work.

The host organisation then organised a venue (Rochdale Town Hall) and buffet and

produced a letter/invite, inviting the targeted groups to attend the next task group meeting.

(The list can be found in Appendix 4) As agreed during the first task group meeting, a short

questionnaire was produced to accompany the letter so that those who could not attend

the next meeting but wanted to contribute to the workshop could, as the same questions

were to be used at the meeting. (The letter and questionnaire can be found in Appendix 5).

A flyer and information about LINks were also sent out. (NHS Centre for Involvement, Feb

2008)

Posters and flyers were also distributed via V4W members, other task groups and during

other community engagement activity. The original task group members were sent large

posters to display in the hope that this would encourage homeless people/specific service

users to attend.

Apologies:

Eleanor Tierney: Voices 4 Wellbeing Interim Governance Group Member

Mike Fishwick: Health Trainer

Francis Hallworth: Johnie Johnson

Gaye Horton: POPPS (annual leave)

Wendy Hopwood: Tripple H (due to staff shortages)

Oaklands (due to staff shortages)

Spotland and Falinge Housing (due to staff shortages)

Stuart Perry: Rochdale CSS (Together)

Stuart Hall: Rochdale CSS (Together) Client

Councillor Dorren Brophey-Lee (on annual leave)


April 2010


Preparation for Task Group Meeting Two/Workshop

Confirmed Attendees:

Julie Darbyshire: Voices 4 Wellbeing Manager

Jules Harris: Voices 4 Wellbeing Development Officer

Dr Marian Corns: Voices 4 Wellbeing Interim Governance Group Chair

Jennifer Fletcher: Voices 4 Wellbeing Interim Governance Group Member

Mary Drummond: Voices 4 Wellbeing Interim Governance Group Member

Denis Skelton: Petrus

Melanie Doyle: DePaul

Libby Walsh: Great Howarth Homeless Families Hostel

Charlotte Watson: Homeless Shelter

Kelly Shaw: Community Drug Outreach Team

Elaine Clues: Scheme Manager English Churches

George Watson: Court Manager Housing 21

Lisa Gilbert: Borough Wide User Forum

Homelessness Advice centre (Two people attending)

Emma Salloway: Community Drug Outreach Team

Donna Arden: Homestart

Councillor Dale Mulgrew

Kathie Schuller: RMBC/Pennine Care Mental Health Development Manager

Glenys Ogden: RMBC/Pennine Care Head of Care & Social Inclusion

Food was ordered for 30 in anticipation of unconfirmed attendees. It was agreed that any

food left over would be taken to a homeless shelter.


April 2010


Task Group Meeting Two/Workshop

The second task group took place in the form of a Workshop on the 4th August at Rochdale

Town Hall 12noon-3pm. Lunch was available between 12noon & 1pm, leaving the further

two hours for a short presentation and the Workshop.

In attendance were, Julie Darbyshire: Voices 4 Wellbeing Manger, Jules Harris: Voices 4

Wellbeing Development Officer, Dr Marian Corns: Voices 4 Wellbeing Interim Governance

Group Chair, Jennifer Fletcher: Interim Governance Group Member, Mary Drummond:

Voices 4 Wellbeing Interim Governance Group Member, Donna Arden: Homestart, Sue

Scott: Making Space, Kathie Sculler: RMBC/Pennine Care, Glenys Ogden: RMBC/Pennine

Care, George Watson: Housing 21, Elaine Clews: ECHG, Emma Salloway: RMBC Community

Outreach Team, Kelly Shaw: RMBC Community Drugs Outreach Team, Ian Jolley: RMBC,

Fozia Ali: Women’s Housing Action Group, Sofia Vesterinen: Women’s Housing Action Group

and Lisa Gilbert: Borough Wide User Forum (BWUF).

Dr Marian Corns chaired the meeting and opened by welcoming everyone. Everyone then introduced themselves. Marian asked whether anyone objected to photographs being taken throughout the afternoon, no one objected. Some background information was then given about LINks and why the homelessness task group had been set up. Marian explained a little about what had been discussed at the first meeting and why Voices 4 Wellbeing had set up the second meeting in the form of a Workshop. Marian then explained that the purpose of the Workshop was to gather information regarding access to health and social care services for the homeless i.e. barriers and how the situation might be improved and that the Workshop would take place after a short presentation by Mary Drummond, with the permission of her line manager. Mary was introduced and invited to give her presentation. Health & Homelessness Presentation Mary Drummond explained the problem of defining what is meant by Homeless i.e. no accepted definition in the UK. Mary talked a little about the 1977 Housing (Homeless Persons) Act which clarified and reinforced Local Authority obligations to tackle homelessness. In the main, Mary talked about the impact of homelessness on individuals in relation to health and social problems i.e. physical health problems such as skin problems, respiratory diseases, poor dental health, physical injury and premature death. Mental health problems and substance abuse were also highlighted as major health problems for homeless people. Mary stressed the complexity of the needs of homeless and the difficulties in accessing health and social care services. Barriers include shame and embarrassment, the need to find shelter prioritised over health needs, administrative and financial barriers such as appointment procedures, opening times and location; the systems in place operates on the assumption of a permanent address. Mary also stressed that stereotypical attitude towards the homeless can act as a barrier.


April 2010


Prior to the Workshop session beginning George Watson raised the question what is meant by homeless? A short discussion took place as Ian Jolley offered an explanation. However, for the purpose of the Workshop, Marian explained that homeless was to be classed as having no fixed abode. The Workshop Session The attendees split into two workable groups and were asked to look at the question sheet provided. Each group was given 20 minutes to discuss each of the three questions and asked to record their answers on the flipchart paper provided. The questions were as follows:

1) What do you think are the main barriers for people who are homeless or

vulnerably housed when accessing health and social care services?

2) What are the main priorities to be addressed to improve access to health and social care services for people who are homeless or vulnerably housed?

3) The LINk will feed back to health and social care commissioners. Can you think of any other ways this can be fed to bring about change?

Feeding Back It was decided that each group should feedback one answer given for each of the three questions. All answers recorded on the flipchart paper would be typed up in the report; see below. Question One: What do you think are the main barriers for people who are homeless or vulnerably housed when accessing health and social care services? Answers given:

Gate keeping of statutory service...(you can’t come) i.e. no G.P’s

Target driven-not need (arrangement across L.A.-Pennine, voluntary)

Rights-What are they? Do they understand?

Red tape

Use of traditional services-What alternative do we have? Previous bad experiences

Poor links with services i.e. probation/PCT/etc

Communication- People not knowing what is available


April 2010


Lack of identification leading to being unable to access services (i.e. not having access to transport)

Unable to get ‘follow-up’ appointments for health care due to having no fixed abode-Non contactable

Lack of responsibility from other services-Not following through care

Criteria within services-Individuals being labelled as ‘too high needs’ or ‘too chaotic’-Meeting criteria within mental health and social care services

Language and cultural barriers

Technology-Computer bidding for empty properties

Closure of local Housing Offices

Question Two: What are the main priorities to be addressed to improve access to health and social care services for people who are homeless or vulnerably housed? Answers given:

Work together with individual homeless people-Awareness

Perception-Route cause-Frontline staff a source of information

Proactive support-Understood from every discipline

Protocols across services-N. Indicators

Pathways-Access

Training

Informing people earlier regarding rent arrears

‘Help’ instead of ‘punishment’- early intervention

More effective interagency working

Services being target led

Workers being more productive

Opening times of services-Out of hours support-Night and weekend workers

Services taking responsibility-Case management

A more holistic approach

Identification-ID Cards

Language barrier

Advertise service and how to access

One-stop-shop


April 2010


Question Three: The LINk will feed back to health and social care commissioners. Can you think of any other ways this can be fed to bring about change? Answers given:

Feed into structures that can direct change to inform commissioners

Feed into-Imbed into ‘real’ work plans

Integrate

Health and Social Care Commissioners; which one’s? PCT-Area Base Grant and LA-Voluntary Women’s?

Improved funding allocation-Services should be encouraged to work together

Less target-led services

Need for pet friendly accommodation

More accommodation for women

How can it be fed back? Case studies, stats, management on the ground, lobby parliament

(Minutes Appendix 7)


April 2010


Task Group Meeting Two/Workshop

Session Evaluation

To enable evaluation of the second task group meeting/workshop an

evaluation sheet was produced. (See Appendix 6)

Those who commented were all happy with the venue, the food, the length of the session,

the content, the paperwork provided.

Other comments:

What was good...

It was refreshing to find so much consistency between people

Very interesting to meet other people from services across the Borough and hear

different points of view

Brief pace which allowed me to get information

Good to meet other agencies

The information given and gained about other services out there

Good event, very interesting

Good sharing information & ideas

Concerns...

Might have been better if the session was longer, more presentations from heads of

services

What will be done?

When will things change?

Funding may reduce possible action

Poorly attended


April 2010


Task Group: Meeting Three

The third task group meeting took place at Partnership House on the 19th October 09. In

attendance was Jules Harris: Voices 4 Wellbeing Development Officer, Julie Darbyshire:

Voices 4 Wellbeing Manager, Dr Marian Corns: Interim Governance Group Chair, Nicola

Crosby: NHS Heywood Middleton & Rochdale Patient and Public Involvement Lead, Lisa

Gilbert: Borough Wide User Forum member, Sean Landsborough: RBH Homelessness

Prevention Officer, Kellie Shaw RMBC Community Drugs Outreach Team, Dennis Skelton:

Petrus, Collette Banton: Supporting People and Mike Fishwick NHS Heywood Middleton &

Rochdale Health Trainer.

The purpose of this meeting was to formulate some formal recommendations from the

information gathered during the workshop held in August. As there where many answers

given to the questions set at the workshop, and many of the answers could be linked up, it

was decided to cover as many of the points made in a small number of recommendations.

The host staff agreed to put the recommendations together in a word document so that

they could be circulated for agreement, not only to those in attendance, but also to those

who were not. The recommendations can be found on page 14.

Initially it was felt that another meeting might be needed before completing the report; this

was not the case. However, it is hoped that further meetings will take place with health

and social care commissioners to discuss in more depth the recommendations made in

this report.


April 2010


Recommendations

1. Better access for people to health and social care services, particularly access to

primary care services and defined referral routes, which includes specified roles for

workers.

2. Better packages of care across health and social care for people with clear lines of

responsibility with interactive and joined - up working. Possibility of a one-stop

shop where people can access information regarding services available.

Enhancement of services to be available ‘out of hours’.

3. Clear protocols across services – health, social care, housing, effective inter-agency

work, including early intervention for people with problems with paying their rent.

Recommend that a multi-agency working group or forum is set up to assess how to

develop a better service for those who are homeless.

4. Recommended that Health Care Professionals (often first point of access for many

vulnerable people) to be aware of the main Welfare Benefits available and to

signpost people to the relevant advice and support.

4a. Protocols for Mental Health Clients who are discharged from the Psychiatric Unit

have been developed through the Mental Health/Housing Working group and

process is currently being under taken and soon to be implemented.

4b Further recommendation for Health Care Professionals to initiate a similar robust

Protocol highlighting direct pathways for mental health clients into secondary

services.

5. Recommend that health and social care commissioners meet with those involved

with this Voices4Wellbeing task group to discuss these recommendations in more

detail.


April 2010


References

Bilton, H. MA MSc (2008). St Mungo’s Health Report: Homelessness It makes you sick. St

Mungo’s: London

Crisis. (2002). Critical Condition: Homeless Peoples Access to GP’s. Available at

www.crisis.org.uk Accessed Jan 2009. Crisis: London

Murray, G. (2008). Supporting People Update. Dec 2008. RMBC: Rochdale

RMBC. (2006-2011). Rochdale Homelessness Strategy. Available at

www.rochdale.gov.uk/pdf/2006-11-01_homelessness_strategy [Accessed Jan 2009]. RMBC:

Rochdale

St Mungo’s. (2009). St Mungo’s Call 4 Evidence: Mental Health and Street Homeless.

Available at www.mungos.org.call4evidence. *Accessed May 2009+. St Mungo’s: London

Tansley, K. (2007). Health and Homelessness. The Queens Nursing Institute. 8 [Pg n.k.]. QNI:

London

http://www.crisis.org.uk/

http://www.rochdale.gov.uk/pdf/2006-11-01_homelessness_strategy

http://www.mungos.org.call4evidence/


April 2010


Appendices Page/s

Appendix 1: Voices 4 Wellbeing Prioritisation Framework 17-19

Appendix 2: Homelessness Task Group; Terms of Reference 20-21

Appendix 3: Meeting 1 Minutes 22-24

Appendix 4: Targeted Invite List 25-27

Appendix 5: Letter & Questionnaire 28-29

Appendix 6: Evaluation Sheet 30

Appendix 7: Meeting 2/Workshop Minutes 31-33

Appendix 8: Meeting 3 Minutes 34-35


April 2010


Appendix 1

Voices 4 Wellbeing: Workplan Prioritisation Framework

Stage One (Of Two)

Other than in exceptional circumstances no issue should be addressed by the LINk unless all of the

following questions can be answered positively:

Yes No

Does this issue have an impact now or in the future for one

or more groups of service users / carers?

Is the issue strategic or significant to Health & Social Care

provision within the borough?

Is there a clear objective for undertaking this project?

Is there evidence to support the need for the LINk to address

the item?

Is the LINk clear about what it hopes to achieve?

Could it amount to definite benefits for service users /

carers?

Is the LINk likely to achieve a desired outcome?

Does the LINk have adequate resources available to do the

activity well?

Is the LINk task group activity timely?


April 2010


Stage One (Of Two) continued

Even where all of these questions can be answered positively, it may still be appropriate to reject

a prospective issue, and it is proposed that V4W would not normally carry out work on an issue if

one of the following conditions applied:

Stage Two

It is anticipated that even by applying these criteria there will be a significant prospective caseload,

and it will therefore be necessary to score the items in some way to establish a priority rank for each

issue on the work programme.

It is been agreed to apply the following to items which merit the attention of the LINk, and that points be awarded for each criterion which is met, according to the predetermined weighting system for the various criteria. The total points score will be used to prioritise the issue.

Public Interest

True False

The issue is being examined elsewhere. (Although the LINk

may map onto the work already being carried out).

The issue has been examined less than 2 years ago, or is due

to be examined in the near future.

New legislation or guidance is expected within the next

year. (Except where V4W has the opportunity to inform the

legislation or guidance)

There is no scope for V4W to add value/ make a difference.

The objective cannot be achieved within the specified

timescale.

Issue Score

Issue identified by 2 or more independent sources through contact with

Individuals / organisations and /or market surveys

0 1 2 3 4 5

Issue identified through the outreach work of the LINk 0 1 2 3 4 5

User dissatisfaction with service (e.g. pattern of user dissatisfaction

with a service)

0 1 2 3 4 5


April 2010


Stage Two continued...

External Drivers

It is anticipated that as new issues arise some items may never achieve a score high enough for them to be added to the LINk work plan. It is therefore proposed that the work plan be reviewed quarterly and items not short listed will be should be re-scored or deleted from the work plan by the LINk Governance Group.

Issue Score

New government guidance or legislation that significantly impact on

Rochdale service users / carers

0 1 2 3 4 5

Key reports or new evidence provided by external organisations on a key issue

0 1 2 3 4 5

Total Score:


April 2010


Appendix 2

TASK GROUP – HEALTH & SOCIAL CARE ISSUES AFFECTING THE HOMELESS

Initial Meeting – Terms of Reference

Rationale: access to adequate health and social care services for people who are homeless

is problematic for a variety of reasons. This means that homeless people suffer

unnecessarily and their conditions can even worsen due to lack of adequate care.

What is the situation in Rochdale Borough?

According to RMBC’s Homelessness Strategy, total presentations to the local

authority homelessness unit have increased with the trend suggesting that this will

be maintained at a level of over 2000 cases per year. The most significant

proportion of presentations is from non-priority cases which have shown a

substantial increase over the same period with a trend in excess of 800 cases per

year.

Research shows that homeless people suffer some of the most severe and complex

health problems and are thus one of the most vulnerable groups in our society. Yet

they still encounter substantial barriers in accessing health care. (The Queen’s

Nursing Institute, Briefing Paper No. 8)

What is being done to improve the situation?

RMBC have a homelessness strategy, there are many charities and groups in the Borough

making provision for the homeless. However there does not appear to be anything being

done to improve the health and social care needs of the homeless apart from there being

The Triple H Team providing health services for people who are homeless after leaving

hospital or rehab units.


April 2010


How can the LINk improve the situation for Rochdale Borough?

Examples:

By highlighting the impact of lack of adequate access to health and social care

services to improve the health of homeless people in the Borough

By working with other LINks across the country to strengthen the case for the need

for better access to health and social care services for the homeless

What do we need to find out?

The experience of homeless people in the Borough and how lack of access has

affected their health.

The state of the health of the Borough’s homeless

How will we do this?

By using members and participants of our LINk and by asking them to ask groups

and organisations that they are involved with

By utilising patient forums/patients councils/using our website to gather

information, utilising community events to ask the general public

By asking service users themselves

Outcome

To highlight the impact of lack of adequate health and social care services by informing

commissioners that there should be equal access for the Borough. The outcome being that

the issue has been highlighted to the commissioners and that procedures can be put into

place to improve the health of the Borough’s homeless.

J Darbyshire, May 09


April 2010


Appendix 3

Homelessness Task Group/Workshop

Minutes: 1st June 2009

Present

Dr Marian Corns Member & Interim Governance Group Chair

Jules Harris Development Officer – Voices 4 Wellbeing

Steven Journeaux Administrator Voices 4 Wellbeing

Eleanor Tierney Member-Voices 4 Wellbeing

Dennis Skelton Coordinator Petrus

Melanie Doyle Senior Worker- Depaul UK

Libby Walsh Great Howarth Homeless Families Unit

Charlotte Watson Manager Homeless Shelter RMBC

Mike Fishwick Health Trainer HMR-PCT

1) Welcome and Introductions Everyone introduced themselves and were welcomed to the meeting. 2) Introduction to V4W Marian Corns gave a brief background of V4W and explained its role and responsibilities. 3) Task Groups Explained It was explained how the task group had been arranged and that from the meeting we wished to discuss the issues involved and how to tackle those issues. 4) Benefits It was brought up that many young people have to wait a long time for benefits and have to take crisis loan after crisis loan, which then has to be paid back. All of this then has knock on effects such as on diet and mental health. It was agreed that this could be looked at and included in any recommendations made in the final report.


April 2010


5) Who to Get Involved? It was agreed that more people needed to be involved in the task group. It was suggested that we contact:

Overview & Scrutiny Representative

Triple H

Mental Health Service representative

Drug and Alcohol representative

Police Officer (PC O’Brian)

Steve Buick

PCSO’s who work around Broadfield Park

Salvation Army

Supporting people 6) Information Gathering Ways of gathering information were discussed:

It was asked that everyone send through any statistics/reports/information that may assist the group

It was agreed to use the results of the St Mungo’s ‘Call 4 evidence’ survey

Ask for statistics on discharge policies from A&E, and a copy of the Discharge Policy

7) Key Issues for the Homeless: The following issues were highlighted as problem areas for the homeless:

Dentistry

Mental Health

Nutrition

Benefits

Levels of Addiction

Abuse/Attacks, especially in Broadfield Park

Sexual Health

Sexual Violence

Lack of joined up working between services


April 2010


8) Next move It was agreed to:

Get more people involved by sending invites. Agreed to send agenda and these minutes with the invitation

It was agreed to send a questionnaire with the invite, so even those who cannot make the next meeting can have their say. Also agreed that people would pass this onto their service users/clients (copies of the questionnaire available from the support team).

9) Next meeting The next meeting will be held on Tuesday 4th August, 12pm-4pm with lunch provided. Venue to be announced.


April 2010


Appendix 4

Targeted Invites: Voices 4 Wellbeing Database

Advocacy Service (Bury and Rochdale)

Anchor Trust

Ashiana Housing Association: Ulfat Hussain

Asylum Seekers Support team

Brentwood Day Centre: John Crosby

Buckley Hall Prison

Compleat Project

Connexions

Councillor Doreen Brophy-Lee

Drugs and Alcohol Action Team: Suzanne Gillman

Early Break

English Churches Housing Group: Elaine Clues

Glenys Ogden: Pennine Care

Good Mental Health

Health Trainer Service

Health Trainer (Rochdale): Mike Fishwick

Health Trainer: Elizabeth Wilson

High Level (Northern Trust)

Holistic Pathways

Home Choice: Rochdale Boroughwide Housing

Homeless Advice Centre: Caireen Daveron

Homeless Advice Centre: Caron Simmonds

Homeless Advice Centre: Debbie Watson

Homeless Advice Centre: Glynn Hodkinson

Homeless Advice Centre: Ian Jolley

Homeless Advice Centre: Lynsey Powers

Homeless Advice Centre: Mahmood Tahir

Homeless Advice Centre: Sean Landsborough


April 2010


Homeless Advice Centre: Teresa Bond

Homeless Advice Centre: Usma Rehman

Homelessness Advice Centre: Lisa Bennet

Homestart (Family Group): Cassie Dixon

Housing 21: George Watson

Howards Place

Improvement Team

Johnnie Johnson: Frances Hallworth

Kathie Schuller: Pennine care & RMBC

Leopold Court Emergency Direct Access: Liz James

MACA

Making Space : Diane Flitcroft

Making Space: Sue Scott

Making Space: Liz Butler

Mental After Care Association (MACA)

MIND Rochdale: Hilary Myers

Northern Counties Housing Association: Lisa Duffy

Oaklands

Petrus Day Centre: Jonathan Wilmot

POPPS: Gaye Horton

Rehab (98) Ltd

Rochdale Borough Council Private Sector Housing- Strategic Housing Service: Beetie

Osborne

Rochdale Borough Wide Housing

Rochdale Community Mental Health Team

Rochdale Community Support Trust

Rochdale Development Agency: John Hudson

Rochdale Development Agency: Saleha Sheikh

Rochdale Housing Initiative

Rochdale Interagency Domestic Forum: Kerry Reddy

Rochdale Interagency Domestic Violence


April 2010


Rochdale Metropolitan Borough Council: Pat Statham

Rochdale YOT (Youth Offending Team): Mike Cross

Rochdle Boroughwide Housing: Gareth Swarbrick

Rochdle Boroughwide Housing: Ian Mcfadyen

ROFTRA (Rochdale Federation of Tenants Na Residents Association): Joanne

Johnston

Salvation Army: Colin Mottershead

Sanctuary Trust Head Office: David Lackner Smith

Senior Citizens Luncheon Club

Shelter Inclusion Project: Cath Ormerod

Shelter Inclusion Project: Sinead O'Connor

Spotland & Falinge Housing Association

St Vincents Housing Association (Three depots)

St Vincents Housing Association: Gillian Ainsworth

Stepping Stone Project: Tony Murphy

Supporting People Team (Rochdale): Louise Shaw

Tenants Participation Unit: Cath Palin

The Guinness Trust (Three depots)

The Hope Group

Thirlmere & District Residents Association

Together: Julie Radcliffe

Triple H Team (GP Practice): Wendy Hopwood

Turning Point (Rochdale)

Women’s Housing Action Group (WHAG): Amanda Garner

Women's Housing Action Group (WHAG): Wendy Stringer

Young People's support Team: Louise Dunstan


April 2010


Appendix 5

Invite Letter & Questionnaire

Hi,

Voices 4 wellbeing is the Local Involvement Network (LINk) for the Rochdale Borough.

Please find enclosed some further information explaining the role of LINks.

One of the topics that Voices 4 Wellbeing has chosen to explore is the issue of how people

who are homeless or vulnerably housed access health and social care services, and the

issues that arise from this.

Therefore, we are inviting you to a workshop of Voices 4 Wellbeing to be held on Tuesday

4th August 2009, 1pm-3pm. There will be a free lunch available from 12noon. The meeting

hopes to bring together people from different agencies that have contact with those who

are homeless or vulnerable housed to give their perspective and to hopefully assist Voices 4

Wellbeing to reach those who are homeless or vulnerably housed and give them the

opportunity to have their say as well.

We do hope that you will be able to attend our workshop, however, if you are unable to or

you feel it more appropriate for someone else to attend that is fine. Also if you are unable

to attend we would very much appreciate if you could fill in the short questionnaire

attached and return it to us ASAP. If you are attending the Workshop, these are the

questions that you will be discussing on the day.

If you would like more information about the meeting or about Voices 4 Wellbeing please

do not hesitate to contact us. You can also find out more information on our website:

www.voices4wellbeing.co.uk

It would be helpful for us if you could let us know if you will be attending the meeting. You

can either reply by email or by calling us on 01706 510 845. Many thanks for your

cooperation in this matter.

Yours sincerely

Marian Corns

Chair – Voices 4 wellbeing Interim Governance Group

http://www.voices4wellbeing.co.uk/


April 2010


Homelessness task group Questions

When answering these questions, please think about different groups of people within

the homeless population, for example:

Older people who are homeless, young people who are homeless, people who are street

homeless, people who’s homelessness may be regarded as ‘hidden’, people with mental

health problems, people with drug and/or alcohol problems, people whose needs are

regarded as complex and people who are from black and minority ethnic groups (including

travellers)

Question 1

What do you think are the main barriers for people who are homeless or vulnerably housed when accessing health and social care services? Question 2

What are the main priorities to be addressed to improve access to health and social care services for people who are homeless or vulnerably housed? Question3

The LINk will feed back to health and social care commissioners. Can you think of any other ways this can be fed to bring about change?


April 2010


Appendix 6

Evaluation Sheet

Please circle whether or not you were happy with the following:

The venue? Yes No

The food? Yes No

The length of the session? Yes No

The content? Yes No

The paperwork provided? Yes No

Any other comments?

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________


April 2010


Appendix 7


Minutes: 4th August 2009

Present

Dr Marian Corns Member & Interim Governance Group Chair – V4W Wellbeing Julie Darbyshire Manager – V4W Jules Harris Development Officer – V4W

Jennifer Fletcher Interim Governance Group Member – V4W

Mary Drummond Interim Governance Group Member – V4W

Donna Arden Homestart

Sue Scott Making space

Kathie Schuller RMBC/Pennine Care M.H. Development Manager

Glenys Ogden RMBC/Pennine Care Head of Social Care and Inclusion

George Watson Housing 21

Elaine Clews ECHG

Emma Salloway RMBC Community Outreach Team

Kelly Shaw RMBC Community Drugs Outreach Team

Ian Jolley RMBC

Fozia Ali Women’s Housing Action Group

Sofia Vesterinen Women’s Housing Action Group

Lisa Gilbert Borough Wide Uers Forum (BWUF)

1) Welcome and Introductions

Everyone was asked to introduce themselves and the organisation they represented. All were welcomed to the meeting. Housekeeping instructions were given and the attendees were asked if anyone minded photographs being taken. There were no objections. All were asked to sign in on the sheet being circulated.

2) Introduction to the task group and its purpose

Marian Corns gave a brief background of why this topic was on Voices 4Wellbeing’s Workplan. Voices 4 Wellbeing has consulted with the community of Rochdale and the issue of accessing health and social care services for homeless people has been identified as a concern. Marian explained that during the first meeting the host were advised about various organisations and individuals who should be contacted and that invites had been sent out to attend this Workshop. Marian then explained that the purpose of the Workshop was to gather information regarding access to health and social care services for the homeless i.e. barriers and how the situation might be improved. Marian then explained that the Workshop would take place after a short presentation by Mary Drummond. Mary Drummond was introduced and invited to give her presentation.


April 2010


3) Presentation: ‘Health and Homelessness: The health needs of single homeless

people’ Mary Drummond explained the problem of defining what is meant by Homeless i.e. no accepted definition in the UK. Mary talked a little about the 1977 Housing (Homeless Persons) Act which clarified and reinforced Local Authority obligations to tackle homelessness. In the main, Mary talked about the impact of homelessness on individuals in relation to health and social problems i.e. physical health problems such as skin problems, respiratory diseases, poor dental health, physical injury and premature death. Mental health problems and substance abuse were also highlighted as major health problems for homeless people. Mary stressed the complexity of the needs of homeless and the difficulties in accessing health and social care services. Barriers include shame and embarrassment, the need to find shelter prioritised over health needs, administrative and financial barriers such as appointment procedures, opening times and location; the systems in place operates on the assumption of a permanent address. Mary also stressed that stereotypical attitude towards the homeless can act as a barrier. Unfortunately due to a printing error the final slides of Mary’s presentation were missing. Jules agreed to forward the whole presentation to all in attendance.

4) Workshop session

Prior to the workshop session beginning George Watson raised the question what is meant by homeless? Ian Jolley offered an explanation and informed the group that there are many people who might be classed as homeless or in housing need, including people living in temporary accommodation, individuals sleeping on the sofa of friends and families, plus those that are at a high risk of becoming homeless for a variety of reasons. Marian clarified that for the purpose of the Workshop, being homeless was to be classed as those with no fixed abode. The attendees split into two workable groups and were asked to look at the question sheet provided. Each group was given 20 minutes to discuss each of the three questions and asked to record their answers on the flipchart paper provided. The questions were as follows:

What do you think are the main barriers for people who are homeless or vulnerably housed when accessing health and social care services?

What are the main priorities to be addressed to improve access to health and social care services for people who are homeless or vulnerably housed?

The LINk will feed back to health and social care commissioners. Can you think of any other ways this can be fed to bring about change?

5) Feeding Back

The two groups were each asked to feed back one answer given for each question. It was explained that these along with all other answers would be typed up in a draft report and circulated via email to all attendees. The group would then be invited to a future meeting to discuss the report and to make further recommendations to be added to the report. The report would then be amended and sent to the agreed appropriate commissioners of health and social care services.


April 2010


The answers fed back in the session are as follows: 1) What do you think are the main barriers for people who are homeless or

vulnerably housed when accessing health and social care services?

Gate keeping of main services a barrier

Poor links between services 2) What are the main priorities to be addressed to improve access to health and

social care services for people who are homeless or vulnerably housed?

Perception, proactive support, protocol and pathways

Services taking responsibility for case management

3) The LINk will feed back to health and social care commissioners. Can you think of any other ways this can be fed to bring about change?

Feed into structures which can inform Work plans and commissioners

Management on the ground

6) Mental Health and Homelessness Task Group Information: Glenys Ogden and Kathie Schuller Glenys and Kathie were given the opportunity to tell the group about the task group they had set up to improve access to services for homeless people with mental health needs. It was explained that the group was still in its early stages and that a Workplan had been put together. Kathie agreed to forward the Workplan to Jules so that it could be circulated to the group along with information about their next meeting taking place on Friday 7th August.

7) Evaluation of the Session The group were asked to complete an evaluation form and give their email addresses for future correspondence.

8) Next meeting Date not yet known


April 2010


Appendix 8


Minutes: 19th October 2009

Present

Dr Marian Corns Member & Interim Governance Group Chair – V4W Wellbeing Julie Darbyshire Manager – V4W Jules Harris Development Officer – V4W

Nicola Crosby NHSHMR: PPI Lead

Sean Landsborough Homelessness

Denis Skelton Petrus

Collette Banton Supporting People RMBC

Mike Fishwick NHSHMR Health Trainer

Kelly Shaw RMBC Community Drugs Outreach Team

Lisa Gilbert Borough Wide Uers Forum (BWUF)

1) Welcome and Introductions Everyone was asked to introduce themselves and the organisation they represented. All were welcomed to the meeting and were asked to sign in on the sheet being circulated.

2) Purpose of the Meeting It was explained that the purpose of the meeting was to examine the answers given to the questions set at the workshop held in August and to formulate some recommendations from these for the final report.

3) Discussion As there where many answers given to the questions set at the workshop, and many of the answers could be linked up, it was decided to cover as many of the points made in a small number of recommendations. The host staff agreed to put the recommendations together in a word document so that they could be circulated for agreement, not only to those in attendance, but also to those who were not. The recommendations were as follows:

Recommend better access for people to health and social care services, particularly

access to primary care services and defined referral routes, which includes specified

roles for workers.


April 2010


Better packages of care across health and social care for people with clear lines of

responsibility with interactive and joined - up working. Possibility of a one-stop shop

where people can access information regarding services available. Enhancement of

services to be available ‘out of hours’.

Clear protocols across services – health, social care, housing, effective inter-agency

work, including early intervention for people with problems with paying their rent.

Recommend that a multi-agency working group or forum is set up to assess how to

develop a better service for those who are homeless.

Recommend that health and social care commissioners meet with those involved with

this Voices4Wellbeing task group to discuss these recommendations in more detail.

4) Next Meeting

Monday 11th January 2010, Partnership House, 2pm


April 2010


Mary Drummond: RMBC

Giving a presentation at the August

Workshop

Workshop discussion underway

Documents

Homelessness Task Group Report - LINk work library...Homelessness Task Group Report April 2010 Julie Harris: Development Officer 3 The Setting up of the Task Group Towards the end