Complex Personalities Network – 28 February 2017

Present: Victoria Aseervatham(WCC), John Conolly (CLCH), Oliver Hall (Groundswell), Adam Marshall (Groundswell) , Chayne Sanderson (Compass), MirekPolanowski (CLCH), Tom Sutherland (Queen Mary’s), Phillipa Middleton (Marylebone Project), Lola Barbour (Waterview), Jacqui Buckley (Waterview), Karen Mwanki (WLDC), Caroline S (WCC), Gemma Morgan (Dual Diagnosis Team), Erica Karpaiya(Passage House), Thea Fitch (Recovery College), Lorraine Stewart (Probation), GulEryuksel (Inspired)

The meeting started off asking everyone about any particular hot topics for them or things they would like from Network meetings:

A number of people mentioned gaining a better understanding of services that are out there and we agreed to arrange service presentations for each meeting. A directory of Westminster mental health services will also be included in the minutes.

Other ideas were:

-Meeting the needs of very complex women

-Maintaining resilience with declining resources

-Supporting staff

-Conflicts between different client groups – refugees and UK nationals – scapegoating and racism

-

We agreed for the next meeting (18 April 2017 11am) we would have:

-Update on the CNWL Recovery College – Thea

-Family Therapy – Gul

-Gibbs Reflective Cycle – John

Reflecting and learning after serious incidents - presentation from Erica Karpaiya

There has been a rise in the number of deaths across rough sleeping services in the last year. Erica from Passage House discussed two recent deaths in her service.

The following recommendations were taken from these deaths:

 Don’t assume the information you have been given by a referring service is accurate or correct.

 Make sure all members of the team are trained in first aid and this is refreshed during team meeting – discuss and perhaps refresh skills.

 Ensure all staff have face shields should they need to administer CPR – these can be purchased in a key ring form.

 Ensure all staff (including cleaners) have a fully charged radio

 Purchase cordless phone but make sure the phone works in all areas of building, test the range.

 Following a death – arrange a reflective session and encourage staff members to access counselling if needed.

 Remember all staff will have been effected by the death even if not present during the incident.

 Create an incident response flow chart/form – ensure all staff are aware how to respond in an incident.

-Go over everything once in a while – give staff an opportunity to discuss feelings and what has happened.

 Ensure naloxone is being carried around by person doing room checks.

Passage House used EASL to facilitate a reflective/debrief session after the deaths and having an external skilled facilitator was really valued. John agreed to explain the Gibbs reflective cycle at the next meeting which could perhaps be used in house to good effect.

Update on research into the prevalence of autistic spectrum among long term rough sleepers

In terms of background, in the GLA round of reviews of the 205 most entrenched rough sleepers in 2014 , the theme of autism was picked up as a critical factor in helping a number of long term rough sleepers off the street in Westminster and Camden. Quite simply, looking at a persons’ behaviour and needs through the lens of autistic spectrum was the key in helping a number of long termers in doors – push factors into rough sleeping (the death of parents was a particularly common story), sensory intolerance, communication issues, patterns of behaviour etc all suddenly made sense. Keen to share the knowledge, WCC hosted a pan London event to publicise the issue and following this successfully lobbied GLA for funds for pan London awareness training and an advice clinic with the dedicated charity Resources for Autism. The attention to this issue has picked up across London and autistic spectrum is now part of the Homeless Link annual training calendar.

The Westminster rough sleeping teams have excellent join up with the WCC Autism Assessment service who provides regular training for workers across the rough sleeping pathway, a quarterly clinic and have brokered a research project with the University of London with 3 PHD students understanding the quantitative and qualitative aspects of the prevalence of autistic spectrum among long term rough sleepers. This research has just been completed and due to be published later this year. Their findings are that there is a significant prevalence - 12% of long term rough sleepers.

The next steps are for the researchers to get published in the academic press and then they are planning on preparing a good practice briefing and circulating it as widely as possible. So far they have been in touch with the National Autistic Society , Homeless Link and DCLG. The group suggested they also contact Public Health England, and NOMs.

Pre treatment approach – John Conolly

Presentation attached

Next meeting – 18 April 2017 11am Passage day centre