Page 13 - TSAB Adult B FINAL (1)

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short period of stability was not recognised nor were the reasons for this breakdown questioned.

6.15. The reasons why the response to homelessness of Josh was not successfully addressed were multi-
faceted. In this section it has been identified that there was a lack of understanding by professionals as
to how the housing system worked, and, as housing staff were not involved in any multi agency
meetings, they were not able to have a platform for ensuring that the system could provide what Josh
needed and required. Some of the reasons also link to other sections below.

Learning Point 1: Housing staff are better able to meet the needs of homeless people if
they are fully appraised of the circumstances related to the person.
Learning Point 2: There is a benefit to homeless people when non housing professionals
have a basic understanding of homeless processes.
Learning Point 3: Staff that are known and trusted by a person can act as an advocate to
help people navigate difficult to understand systems.

RESPONSE TO REPEAT ATTENDERS and SELF HARM

6.16. Due to the number of admissions that Josh had to the acute hospital, the liaison psychiatry team made
the decision that the criteria were met to convene a Frequent Attender Meeting. This meeting is a
health led process facilitated by liaison psychiatry. Its purpose is to manage the number of attendances
made by those who attend emergency departments on a regular basis with attempts at self-harm and
other reasons.

6.17. Addressing frequent attenders is also part of the Acute Hospital Trust process in response to a
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dedicated CQUIN .

6.18. The planning meeting is open to other agencies. In the case of Josh, the staff who attended and the
emerging plan are discussed above in para 5.31.

6.19. This process had the potential to be a positive multi agency plan to support and manage the issues that
Josh was facing. The meeting focussed on how to deal with Josh on the ward; the psychological
understanding of overdose was discussed. The hospital social worker attended and made the decision
that there was no role for social work. The Local Authority safeguarding social work team were invited
but did not attend as the hospital social work team were attending.

6.20. This meeting happened when Josh had been rehoused at a time when Josh was at his most stable. This
was due to the length of time it takes to organise meetings of this nature. Not all of the invited
attendees were at the meeting. There are no minutes produced from this meeting, but the care plan
was circulated to the acute hospital and substance misuse services.

5 CQUIN stands for commissioning for quality and innovation. The system was introduced in 2009 to make a proportion of healthcare
providers’ income conditional on demonstrating improvements in quality and innovation in specified areas of patient care.

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