Health and Homelessness Project Annual Report

Transcription

1 St Mungo s Broadway Health and Homelessness Project Annual Report Jessica Clark Health and Homelessness Project Coordinator April

2 Jessica Clark Health and Homelessness Project Coordinator St Mungo s Broadway About St Mungo s Broadway St Mungo s Broadway provides a bed and support to more than 2,500 people a night who are either homeless or at risk, and works to prevent homelessness, helping about 25,000 people a year. We believe no one should be homeless and that people can and do recover from the issues that create homelessness. We support men and women through more than 250 projects including emergency, hostel and supportive housing projects, advice services and specialist physical health, mental health, skills and work services. Formed in April 2014 by the merger of two long established charities, we currently work across London and the south of England but influence and campaign nationally to help people to rebuild their lives. 2

3 Contents Acknowledgements... Page 4 Abbreviations and Acronyms... Page 5 Executive Report... Page 6 HHP in numbers... Page 8 Health and Homelessness Project Model... Page 9 Quarterly Statistics... Page 11 Dental Screening... Page 25 HHP Staff and Service User Conference... Page 26 H&F Health and Wellbeing Fair... Page 29 Health Action Group Meetings... Page 37 Flu Vaccinations Programme... Page 38 Staff Training... Page 39 HHP Volunteering Programme... Page 41 Conclusions and Recommendations... Page 43 3

4 Acknowledgements This past year has seen an improved focus on health and wellbeing for service users across the borough. Due to the success of previous events, the Health and Homelessness Project was in a position to invite more support services to its annual health and wellbeing fair than before. This past year has also seen an increase in engagement with the Health and Homelessness Project across Hammersmith and Fulham. Health professionals and service providers have been working in partnership to improve the health and wellbeing of service users in the borough. The activities and events are testament to the joint working efforts of health and housing services in Hammersmith and Fulham and the achievements of the HHP would not have been possible without the efforts of the following; Julia Copeland, H&F Supported Housing Commissioning Manager for her continued support of the HHP and dedication to the health and wellbeing of service users in Hammersmith and Fulham. Fiona O Dell, The St Mungo s Broadway Centre Health Team and the Horn of Africa Health and Wellbeing Team and volunteers. The health and wellbeing services who have participated in delivering training, health screening, attending the service user conference and the health and wellbeing fair to improve service user health. The health and housing providers who regularly attend and contribute to the Health Action Group meetings. The supported housing managers and staff for promoting and coordinating events within their projects and supporting service users to attend HHP health events. Pret A Manger and Greggs for generously providing refreshments and food at the HHP events. Capita, Harper Collins and The Big Yellow Storage Company for generously contributing bags, books and pens to the health and wellbeing fair event. The Health and Homelessness Project volunteers for generously giving up their time to run health and wellbeing sessions, conduct research and assist at the annual HHP events. Most of all, the service users and their commitment to improve their health and wellbeing. All photographs featured in this report were taken with consent. 4

5 Abbreviations and Acronyms BBV CAB CALM CASS CCG CDAS CHAT CLCH CNWL CRI DVIP EASL ETE H&F HAG HGCA HHP LBHF MARAC NPL NWL CSU SBHG SMOC SOVA WLMHT YPI Blood-borne Viruses Citizens Advice Bureau Campaign Against Living Miserably Community Alcohol Support Service Clinical Commissioning Group Community Drug and Alcohol Service Community Health Assessment Tool Central London Community Health Central and North West London Crime Reduction Initiative Domestic Violence Intervention Programme Enabling Assessment Service London Education, Training and Employment Hammersmith and Fulham Health Action Group Hammersmith Community Gardens Association Health and Homelessness Project London Borough of Hammersmith and Fulham Multi-Agency Risk Assessment Conference Naz Project London North West London Commissioning Support Unit Shepherds Bush Housing Group Substance Misuse Offender Care Safeguarding of Vulnerable Adults West London Mental Health Trust Youth Project International 5

6 Executive Report Homeless and vulnerably/temporarily housed people experience some of the poorest health outcomes. Often, service users experience multiple complex health needs (physical, mental and substance misuse). The ever changing landscape of the health care system, housing service providers and staffing teams means it is important to maintain a high standard of joint working to ensure service users receive the best health outcomes. It is important for the Health and Homelessness Project to continue to work in partnership with health services and housing service providers to ensure that service users continue to address their health issues and improve their health and wellbeing. The Health and Homelessness Project (HHP) works with supported housing projects across Hammersmith and Fulham (H&F) to improve health access and decrease health inequalities of those who are vulnerably/temporarily housed. The Community Health Assessment Tool (CHAT) and wellbeing plan is used to assess the needs of service users and staff in supported accommodation projects and address these needs. Based on the most recent statistics the HHP determined that key areas of focus are; strengthening relationships with external health services, developing new relationships with external health services, delivering health and wellbeing training to staff, delivering health screenings, improving the participation at the annual HHP events and Health Action Group Meetings, implementing wellbeing plans and promoting the Health and Homelessness Project. I have also had the opportunity to develop the Health and Homelessness Volunteer Programme. At present the programme has twelve dedicated volunteers with roles that vary from running in-reach health and wellbeing sessions in St Mungo s Broadway hostels, facilitating weekly art workshops to participating in a two year research and resource development project, discussed later in this report. The HHP has further plans for the future these are discussed in the conclusion. Positive outcomes and highlights of the past year: 24 clients attended dental screenings with CLCH Community Dental Service and Groundswell Peer Advocate Support on 12 th November supported accommodation projects took part in alcohol awareness week, running events to raise awareness about the harmful effects of alcohol. 12 clients and 9 front line workers received the flu vaccination as part of the flu vaccination event hosted by the HHP. 70 staff and service users from supported accommodation projects attended the annual service user conference. 182 staff, volunteers, service users and health and wellbeing professionals attended the H&F health and wellbeing fair on 27 th February A total of 122 attendees at the Health Action Group meetings in the last year. Housing providers have received presentations from; Simple Living, H&F Mind, Only Connect, Turning Point, BMX, Living well CIC, Better Gyms, CDAS, OPS, Desta Diabetes, CLCH Community Dental Services, Kick-It Smoking Cessation, Standing Together against Domestic Violence, Hammersmith Community Gardens Association, St Mungo s Broadway drugs 6

7 and alcohol adviser, Youth Project International, LBHF Assistive Technology, H&F Citizens Advice Bureau and H&F Advice Centre. Positive increase of service users registered with a GP. New partnerships and development of the GP Link Project. Development and implementation of the HHP in-reach health promotion volunteers and the Research and Resource Development (RRD) team. Safe sex promotion, condom budget allocated to each organisation in Hammersmith and Fulham. Jess Clark, HHP Coordinator 7

8 HHP in numbers 70 Health and Wellbeing Service User Conference attendees. 21 staff and service users received the flu vaccination condoms distributed. 200 Attendees to the Health and Wellbeing Fair in total. 24 service users attended a workshop on oral health and 16 received dental screenings. 8

9 Health and Homelessness Project Model HHP Model 9

10 Health and Homelessness Project Model The Health and Homelessness Project (HHP) model was developed to demonstrate how the HHP works to coordinate the work of health and housing providers across H&F to improve the health for service users. The HHP works in partnership with 16 different housing providers and numerous primary, secondary and community health and wellbeing services. Through health action group meetings, annual events, training, promotion, quarterly statistics and attending team meetings the HHP works to ensure that; Housing staff are: Knowledgeable of what health and wellbeing services are available in their area. Knowledgeable of where to refer and sign post service users. Monitoring and identifying service user health needs and supporting service users to address these needs. Raising awareness about important health issues in the form of monthly health and wellbeing sessions. Networking with health and wellbeing services. Sharing examples of best practice with other services. Service users are: Thoroughly assessed for health needs and given the appropriate support and advice. Made aware of available health services and treatments they provide. Feel empowered to acknowledge health needs, access local support services and make decisions regarding their health. Encouraged to attend HHP annual events and supported to make positive changes to their health and wellbeing. Experiencing improved health outcomes. The annual Staff and Service User Conference provides a structured and valuable networking opportunity for both staff and service users. Staff and service users are given the opportunity to network with health and wellbeing services as well as other housing providers. The annual Health and Wellbeing Fair also provides a valuable opportunity for staff, service users and health services to meet and learn from one another. Joint working further informs knowledge on health and treatment services in the borough, specifically addressing our service user health needs. Events such as these have resulted in housing and health providers developing joint working agreements and arranging in-reach training and screening sessions at hostels. Health service providers are given the opportunity to meet with staff and service users on the day and promote their projects and services. Feedback from these events has always been positive and has been very useful in regards to planning consecutive events and influencing the delivery of the HHP. The commitment and dedication of borough-wide health and wellbeing services in attending these events and providing training to staff and service users has been instrumental in service development, implementation and feedback. The continued engagement and feedback from housing service providers has also been instrumental in service implementation and delivery. 10

11 H&F Health and Wellbeing Annual Statistical Review 1 April March 2015 The following graphs display the health and wellbeing outcomes over the last financial year. This data is taken from the supported accommodation and floating support quarterly submissions and used to track the health and wellbeing trends in the borough. The data is also used to identify areas of improvement and note areas of change. The HHP Co-ordinator will analyse this data and formulate an action plan based on the identified need. This plan includes; establishing new partnerships, attending staffing meetings to identify areas of concern, investigating areas of negative increase and improving existing relationships. 350 Total number of service users per quarter Total no. Of service users One Two Three Four Action: Plan: IMPROVE DATA SUBMISSION TOTALS HHP Coordinator to introduce the new health and wellbeing plans and offer all accommodation providers and floating support providers training in regards to completing the databases. HHP to send out notification at end of May to remind services they should be completing the new plans and data for Q1 will be required in July. individual managers and send out reminders. 11

12 Total no. of service users registered with GP per quarter One Two Three Four No. Of service users registered with GP Analysis: The graph shows the total number of service users registered with a GP per quarter. There was a positive increase between quarters one and two and then a gradual decrease between quarters two and three and a dramatic decline between quarters three and four. - Quarter One: 272/304 (32 not registered with a GP) - Quarter Two: 310/317 (7 not registered with a GP) - Quarter Three: 294/314 (20 not registered with a GP) - Quarter Four: 262/263 (1 not registered with a GP) The total number of service users effects this data and as we can see the results in quarter four are more positive than the graph demonstrates. Action: Plan: INCREASE AND MAINTAIN THE NUMBER OF SERVICE USERS REGISTERED WITH A GP HHP coordinator to address the stats at the HAG meeting in June. HHP coordinator to discuss with individual projects those clients that were recorded as not being registered and where possible identify ways to address this. Coordinator to raise GP referrals at the next GP Federation network meeting and at CCG meetings where applicable. Continue to link in with GP federation and share knowledge of homeless and vulnerable sector. 12

13 No. of service users with completed CHAT No of service users with completed CHAT 50 0 One Two Three Four Q1: 199 Q2: 255 Q3: 218 Q4: 176 Analysis: The graph shows the number of service users with completed Community Health Assessment Tool forms per quarter. The graph demonstrates a positive increase between quarter one and quarter two and a gradual decline from quarters two to four. - Quarter One: 199/304 (105 service users without completed CHAT) - Quarter Two: 255/317 (62 service users without completed CHAT) - Quarter Three: 218/314 (96 Service users without completed CHAT) - Quarter Four: 176/263 (87 Service users without completed CHAT) Taking into account the above data we can see a decline in service users without a completed CHAT form between quarters one and two, an increase between quarter two and three and a decline between quarter three and four. Action: Plan: REDUCE THE NUMBER OF SERVICE USERS WITHOUT COMPLETED CHAT FORMS HHP coordinator to address this area at one of the HAG meetings and go through the CHAT form. HHP Coordinator to host CHAT consultation to discuss changes to the form and reducing it s size. HHP Coordinator to identify services with low levels of completion and arrange meeting to discuss this indviduallly. 13

14 Total number of ambulance call outs per quarter Total number of ambulance call outs One Two Three Four Q1: 27 Q2: 21 Q3: 18 Q4: 31 Analysis: The graph shows the total number of ambulance call outs per quarter. The graph demonstrates a decline in the total number of callouts between quarters one and three and a dramatic increase between quarters three and four. The number of service users in quarter four were far less than previous quarters therefore you would expect this number to be smaller. Action: Plan: REDUCE THE NUMBER OF AMBULANCE CALL OUTS HHP Coordinator to address these stats at the HAG and invite ambulance services to come along and give presentation in regards to appropriate use of emergency services. HHP Coordinator to contact hostel managers of hostels identified and arrange meeting to discuss reasons for call outs and how these can be reduced. Things to consider; - First Aid refresher training. - Advising managers to invite ambulance services to staff meetings to talk to all staff about emergency services and educate staff in regards to ambulance call outs. 14

15 30 Total numer of unplanned hospital admissions per quarter Total number of hospital admissions 5 0 One Two Three Four Q1: 25 Q2: 16 Q3: 17 Q4: 26 Analysis: The graph shows the total number of unplanned hospital admissions per quarter. The graph demonstrates a decline in unplanned hospital admissions between quarters one and two and an increase between quarters two and four. Quarter four shows the highest number of unplanned hospital admissions in the financial year. Analysing the core data from quarter four, there were a total of 28 ambulance call outs between January and March 2015 that didn t require a hospital admission. Action: Plan: REDUCE THE NUMBER OF UNPLANNED HOSPITAL ADMISSIONS HHP Coordinator to discuss these stats at the next HAG meeting with the accommodation providers. Share these stats with Hospital to Home to identify how we can work in partnership to reduce these. Send stats to hostel managers with high call outs and admissions and ask to meet to discuss this data. Obtain record of reasons for admissions and work with hostel managers to reduce these where possible. When reasons for unplanned admissions have been identified, where applicable, identify health service that educate and assist as method of prevention for future call outs and admissions. 15

16 Total number of admissions due to lack of engagement with primary care services per quarter One Two Three Four Total number of admissions due to lack of engagement with primary care services Q1: 2 Q3: 3 Q4: 3 Q4: 9 Analysis: The graph shows the total number of hospital admissions due to lack of engagement with primary care services per quarter. The graph demonstrates an increase in this area between quarters one and two, no change between quarters two and three and a rapid increase between quarters three and four. Quarter four shows the highest number of hospital admissions due to a lack of engagement with primary care services in the last financial year. Action: Plan: REDUCE THE NUMBER OF ADMISSIONS DUE TO LACK OF ENGAGEMENT WITH PRIMARY CARE SERVICES HHP Coordinator to discuss these stats at the next HAG meeting and discuss with attendees how we can engage hard to reach clients with primary care services. Focus on projects with highest totals in quarter four and obtain reasons why clients are not engaging with primary care services. Address these reasons by; - Educating/informing staff in relevant health area. - Arrange in-reach sessions from health and wellbeing providers. - Arrange peer support where necessary. - Work with Hospital to Home and other health services to reduce this number. 16

17 35 Total number of A&E presentations per quarter Total no. Of A&E presentation One Two Three Four Q1: 28 Q2: 23 Q3: 27 Q4: 32 Analysis: The graph shows the total number of A&E presentations per quarter. The graph demonstrates a decline in A&E presentations between quarter one and two and an increase between quarters two and four. Quarter four shows the highest number of A&E presentations in the last financial year. Analysing the core data from quarter four; there were a total of 44 A&E presentations between January and March Action: Plan: REDUCE THE NUMBER OF A&E PRESENTATIONS PER QUARTER HHP Coordinator to address these stats at the HAG meeting and invite emergency service and A&E professionals to talk to attendees about emergency services. Arrange meetings with hostel managers of hostels identified above, obtain reasons for A&E presentations and address these reasons where appropriate; - Link in with Hospital to Home to work in partnership to reduce these figures. - Link hostels in with relevant health services to address health reasons for A&E presentations. - Encourage hostel managers to invite emergency services to talk at team and resident meetings to educate staff/clients about appropriate use of emergency services. 17

18 60 Total no. of missed GP/physical/mental health appointments per quarter Total no. Of missed GP/physical/mental health appointments One Two Three Four Q1: 32 Q2: 41 Q3: 37 Q4: 57 Analysis: The graph shows the total number of missed health appointments per quarter. The graph demonstrates an increase of missed appointments from quarter one to quarter two, a decrease between quarter two and quarter three and a dramatic increase between quarter three and quarter four. Quarter four shows the highest number of missed appointments in the last finanical year. Analysing the core data from quarter four, there were a total of 132 missed health appointments between January and March Action: Plan: REDUCE THE NUMBER MISSED HEALTH APPOINTMENTS HHP Coordinator to address these stats at the HAG meeting and obtain feedback from attendees how these could be reduced? Should the GP appointment card be amended. Is it being used? Arrange meetings with hostel managers of hostels identified above, obtain reasons for missed appointments and address these where possible. - Discuss these stats at the GP Network meetings. - Discuss this topic at the GP Link quarterly meetings. - Review these stats with Groundswell and work in partnership to reduce the number of missed appointments. - Discuss the peer mentor scheme, can we link into outside in to develop this? 18

19 Total no. of clients with underlying health needs and not engaging with primary care services Total no. Of clients with underlying health needs and engaging with primary care services Q1: 26 Q2: 20 Q3: 29 Q4: 46 Analysis: The graph shows the total number of clients with underlying health needs and not engaging with primary care services per quarter. The graph demonstrates a decrease in this area between quarters one and two and an increase between quarters two and four.the core data from quarter four shows there were a total of 45 clients with underlying health needs and not engaging with primary care services between January to March Action: Plan: REDUCE THE NUMBER OF CLIENTS WITH UNDERLYING HEALTH NEEDS AND NOT ENGAGING WITH PRIMARY HEALTH SERVICES HHP Coordinator to raise these results at the HAG and ask group why they think this area is increasing, and collate ideas to reduce this number. Contact the managers of hostels identified to discuss these results and ascertain the reasons for the increase. Once reasons have been obtained, raise these with the GP s at network meetings and other relevant health providers. 19

20 160 Total no. of service users that attended hostel in reach/training sesssions Total no. Of service users that attended hostel in reach/training sesssions Q1: 142 Q2: 135 Q3: 112 Q4: 104 Analysis: The graph shows the total number of service users that attended health and wellbeing and training sessions per quarter. The graph demonstrates a gradual decrease in the number of clients attending health and wellbeing and training sessions from quarter one to quarter four. New health and wellbeing plans have been introduced in the last quarter and it is compulsory that accommodation providers and floating support services faciliate health and wellbeing events either monthly or quarterly. Therefore I would expect to see this figure increase in quarter one of 2015/2016. Action: Plan: INCREASE THE NUMBER OF SERVICE USERS ATTENDING HEALTH AND WELLBEING SESSIONS AND/OR TRAINING HHP Coordinator to highlight these stats at the HAG and ask managers and staff how they are encouraging clients to take part in their events. SL from Hestia to give presentation as an example of good practice in this area. HHP Coordinator to continue to visit hostels and services and train managers and staff how to complete the new plans. - Contact Outside In events planner and ask them to attend the HAG in August to discuss how they encourage people to attend their events. 20

21 120 Total no. of successful GP referrals per quarter Total no. Of successful GP referrals One Two Three Four Q1: 46 Q2: 100 Q3: 35 Q4:31 Analysis: The graph shows the total number of successful referrals to GP s per quarter. The graph demonstrates an increase in the total number of successful referrals to GP s between quarter one and two and a decrease between quarter two and four. - Quarter One: 46/304 service users successfully referred to the GP - Quarter Two:100/317 service users successfully referred to the GP - Quarter Three: 35/314 service users succesfully referred to the GP - Quarter Four: 31/263 service users successfully referred to the GP. This data is not a reflection on the number of unsuccessful referrals as not all clients are referred to the GP. The decrease in successful referrals could be linked to unsuccessful referrals, however, this could all be due to the number of clients needing referrals to a GP decreasing. Action: Plan: NO ACTION NO PLAN. 21

22 12 Total number of unsuccessful GP referrals per quarter Total Number Of Unsuccessful GP Referrals Per Quarter One Two Three Four Q1: 2 Q2: 9 Q3: 1 Q4:10 Analysis: The graph shows the total number of unsuccessful referrals to GP s per quarter. The graph demonstrates an increase in the number of unsuccessful referrals between quarters one and two, a decrease between quarter two and three, and a dramatic increase between quarter three and four. Data from the last financial year shows; - Quarter One: 2/304 unsuccessful referrals to the GP - Quarter Two: 9/317 unsuccessful referrals to the GP - Quarter Three: 1/314 unsuccessful referrals to the GP - Quarter Four: 10/263 unusccessful referrals to the GP This data shows a concerning rise in the number of unsuccessful referrals to GP s. Quarter four shows the highest number of unsuccessful GP referrals per quarter. Reasons given for unsuccessful referrals; client feels they do need a GP, client unwilling to engage, chaotic client, other (not specified). Action: Plan: DECREASE THE NUMBER OF UNSUCCESSFUL GP REFERRALS HHP Coordinator to raise these stats at the HAG and discuss ways of improving this in a group working session. Arrange meetings with hostels identified to ascertain exact reasons why clients not willing to engage and how they can be encouraged to engage with GP s. Once above data has been collated, raise these stats and problem areas at the GP Federation Network meetings and CCG meetings. Speak to Seb and Conan about these figures. 22

23 12 Total no. of unsuccessful mental health referrals per quarter Total No. Of Unsuccessful Mental Health Referrals Per Quarter 2 0 One Two Three Four Q1: 11 Q2: 4 Q3: 4 Q4: 7 Analysis: The graph shows the total number of unsuccessful referrals to mental health services per quarter. The graph demonstrates a positive decrease in unusccessful referrals between quarters one and two, no change between quarters two and three and a negative increase in quarters three and four. Data from the last financial year shows; - Quarter One: 11/304 unsuccessful referrals to mental health services. - Quarter Two: 4/317 unsuccessful referrals to mental health services. - Quarter Three: 4/314 unsuccessful referrals to mental health services. - Quarter Four: 7/263 unsuccessful referrals to mental health services. The data shows a slight rise in unsuccessful referrals to mental health services between quarter three and four, however this figure is still less than quarter one. Data pulled from quarter four shows that reasons for unsuccessful referrals to mental health services are as follows; Service user unwilling to engage, Service user not happy with service. Difficulty booking appointment and Other (not specified). Action: Plan: DECREASE THE NUMBER OF UNSUCCESSFUL MENTAL HEALTH REFERRALS HHP Coordinator to raise these stats at the HAG and discuss ways of improving this in a group working session. Identify hostels that have given the above reasons for their unsuccessful referrals and explore this further by arranging meetings with staff and managers. Coordinator to speak to mental health services and identify ways of improving partnership working. Review these stats with claybrook and EASL. 23

24 25 Total no. of unsuccessful substance misuse referrals per quarter Total No. Of Unsuccessful Substance Misuse Referrals Per Quarter 5 0 One Two Three Four Q1: 11 Q2: 4 Q3: 2 Q4: 20 Analysis: The graph shows the total number of unsuccessful referrals to substance misuse services. The graph demonstrates a positive decrease of unsuccessful referrals to substance misuse referrals between quarters one and three and a negative increase between quarters three and four. Data from the last finanical year shows; - Quarter One: 11/304 unsuccessful referrals to substance misuse services. - Quarter Two: 4/317 unsuccessful referrals to substance misuse services. - Quarter Three: 2/314 unusccessful substance misuse services. - Quarter Four: 20/263 unsuccessful substance misuse services. The data shows a concerning increase in referrals between quarters three and four. Quarter four shows the highest number of unsuccessful referrals, data pulled from quarter four informs us that the following reasons were given in regards to why referrals were unsuccessful; Client feels does not need service, Client unwilling to engage, Difficulty booking appointment, Chaotic client. Action: Plan: DECREASE THE NUMBER OF UNSUCCESSFUL SUBSTANCE MISUSE REFERRALS HHP Coordinator to raise these stats at the HAG and discuss ways of improving this in a group working session. Identify hostels that have given the above reasons for their unsuccessful referrals and explore this further by arranging meetings with staff and managers, focusing on difficulty booking appointment in particular. HHP Coordinator to speak to substance misuse services and hostels and identify ways of improving partnership working and successful referrals. 24

25 Dental Screening 12 November 2014 Broadway Day Centre Services Attended: CLCH Community Dental Services Screening Report: On 12 November 2014, the Health and Homelessness Project in partnership with the CLCH Community Dental Services hosted an Oral health awareness event. 24 clients attended this event and 16 clients received an oral health screening. Data taken from the event register shows; 16 clients were sleeping rough, three were living in supported accommodation, one was sofa surfing and three declined to disclose their housing circumstances. All clients screened were male. Service users received: Oral cancer screening Soft tissue examination Gum and tooth assessment Oral hygiene and oral disease assessment Free toothpaste sample Summary by Katrina Matthews, Manager for Dental Therapy and Oral Health Promotion, Specialist and Community Dental Services, CLCH NHS Trust: It has been good to visit Broadway and offer screenings and have the opportunity to discuss with clients their oral health questions and any concerns. When we offer screenings we always advise and direct clients to a full dental check-up in a dental surgery which could be at a local GDP or our CLCH Dental surgery at Great Chapel Street. Pathway for NHS care was explained. This is because to diagnose dental disease effectively, x-rays would be beneficial and to enable appropriate treatment planning. During the screening I asked all clients about their smoking status and alcohol intake as this is higher risk for Oral Cancer. A combination with recreational drugs also increase tooth loss. The client oral hygiene was worst in those with smoking patterns and broken teeth as cleaning is less effective. I didn't see any signs of suspicious oral cancer lesions on that day. A majority of clients cleaned once a day not twice and some were not cleaning every day. Access to toothbrushes and toothpaste helps this situation and improves oral health status. Some clients had broken down teeth but no emergency dental pain. Oral Health Screening 25

26 HHP Staff and Service User Conference Looking after and improving my health during the winter season 15 December 2015 Small Hall, H&F Town Hall Agenda: 12 12:15pm Networking and Lunch 12:15 12:30pm Introductions/welcome 12:30 12:45pm Cardboard Citizens 12:45 1pm Guest Speaker - Dr Al Story, Clinical Lead & Manager for find and treat, university college hospitals, NHS Foundation Trust. 1 1:15pm Foundation 66 Alcohol Awareness 1:15-1:45pm Guest Speakers Tim Cox & Angus Angus, RBKC, First Aid practical demonstration - CPR 1:45 2pm BREAK TB Screening 2:00 2:30pm Guest Speaker Howard Tingle, Tri-borough, Desta Diabetes 2:30 2:45pm Qi Jong Adam Bulewski 2:45 3:45pm 3:35 4pm 4pm Knowledge Café CLCH Dental Services, Victim Support, Kick-It, Desta Diabetes, British Heart Foundation, Community Respiratory Services. The Knowledge basket group activity, Thank you, raffle and Evaluation. END Attendees: 70 The Health and Homelessness Project facilitated the annual Staff and Service User conference on 15 December 2014 at the Small Hall in Hammersmith and Fulham Town Hall. The theme of the conference was Looking after and improving my health during the winter period. Individual invitations were sent out to staff and service users with details about the event. A total of 118 service users registered to attend. On the 15 December a total of 70 guests attended including health services and staff from the St Mungo s Broadway communications team. The conference began with a presentation from the Health and Homelessness Coordinator welcoming guests and sharing the project achievements to date. The service user health action group was also advertised and service users were encouraged to apply for the role of representative. 26

27 The first part of the conference consisted of presentations from Cardboard Citizens, Find and Treat TB Van, Foundation 66, RBKC Parks Police who gave a practical CPR demonstration and advice on how to recognise the signs of a heart attack, Desta Diabetes and a meditative Qi Jong session. During the break, guests were also offered the opportunity to have a free TB screening in the find and treat van. Find and Treat The second part of the conference consisted of a knowledge café where guests spent 10 minutes at each knowledge table gathering information. There were a total of six services taking part in the knowledge café and these were; CLCH Dental Services, Victim Support, Kick-it smoking cessation, Desta Diabetes, British Heart Foundation and Community Respiratory Services. The conference concluded with a short group working activity where guests were asked to fill their knowledge basket reflecting on five key lessons they had learnt during the day and make a health pledge. The coordinator asked guests to feedback to the group what health pledge they had made. Here are some examples of the health pledges made by conference guests; Drink Less Walk More Smoke Less Eat more healthily Think more positively Eat five portions of fruit and veg per day Do more physical exercise Get tested for TB Look after my health, this leads to a better quality of life. Feedback from the day was positive and data from the evaluation forms shows that guests from the conference found the conference very useful. BHF Conference 27

28 120 gingerbread biscuits were donated by Pret A Manger, 100 doughnuts were donated by Greggs and refreshments, sandwiches and fruit was provided by the Health and Homelessness Project and Centre Health Team. The day concluded with a raffle where guests won prizes that had been donated by L Oreal, Shepherds Bush market stall holders, Hammersmith and Fulham outreach team, The Centre Health Team and Rolls Royce. St Mungo s Broadway wrote an article about the event and this was shared on their website on the 16 December and released to local media. The press release can be found here; Press Release Health providers taking part in the conference fed back; I felt it was an excellent event with a good attendance. Alison Fraser, Oral Health Promoter, CLCH Dental services 28

29 It was a really good event and we enjoyed it and learnt a lot of useful stuff. Also made some good contacts. Matt Lucas, Cardboard Citizens Team We really appreciate your invite to The Homeless Conference, it was a worthwhile event. Tim Cox, RBKC Parks Police H&F Health and Wellbeing Fair 27 February 2015 Assembly Hall, H&F Town Hall On the 27 February 2015 the Health and Homelessness Project hosted its annual Health and Wellbeing fair. The fair was organised and facilitated by the Health and Homelessness Project to inform and educate residents living in supported accommodation or receiving support, about the health and wellbeing services in the local area. The fair also provided the opportunity for local services in the area to network with one another and ascertain important contacts. The event ran from 1pm to 4pm and all HHP contacts and all supported accommodation residents and providers in the borough were invited. The health and wellbeing fair was publicised in the St Mungo s Broadway bulletin as well as on the People First website. 29

30 Thirty three health and wellbeing services registered to attend and thirty two services attended on the day. These services were; Adult Social Care Services People First Assistive Technology Blenheim Campaign Against Living Miserably Cardboard Citizens Carers Network Central London Community Healthcare Dental Services Community Alcohol Support Services Desta Diabetes Elgin Close Resource Centre Groundswell Hammersmith and Fulham Citizens Advice Bureau Hammersmith and Fulham MIND Hammersmith and Community Gardens Association Kick-It Living well CIC Look Ahead Older Persons Service Nubian Life Resource Centre/Expert Patient Services CASS Older Persons Service Open Access Substance Intervention Service Reiki Treatment St Mungo s Broadway Art Workshops St Mungo s Broadway Centre Health Team St Mungo s Broadway Homeless Health Matters Campaign Team St Mungo s Broadway Horn of Africa Health and Wellbeing Team St Mungo s Broadway Work and Learning Stroke Association TuiNa Massage Turning Point Turning Point Victim Support Voice Ability West London Centre for Sexual Health The HHP Coordinator asked services to facilitate and run fun and engaging activities to capture the attention of guests. The Centre Health Team and Horn of Africa Health and Wellbeing Team brought along fruit and made some healthy smoothies, which they handed out to guests on the refreshment stand. The Citizens Advice Bureau offered three mini training sessions on avoiding financial scams and budgeting money. Guests also had the opportunity to receive a free blood pressure check, a free sexual health screening, sign up to the homeless health matters campaign, make a health pledge, sign up to stop smoking courses, take part in alcohol and drug quizzes and receive a free Reiki treatment and Tui Na massage. Turning Point healthy kickers gave guests the opportunity to take part in a fats and sugars game, St Mungo s Broadway HHP art workshop provided guests with the opportunity to take part in an art competition and get creative, CLCH Dental Services offered free dental screenings and all services gave out useful information in the form of leaflets, brochures and business cards. The HHP put on a how well do you know your body? quiz and guests were given the opportunity to win a prize by correctly labelling the bones of a skeleton or organs in the human body. The event was hosted in the Assembly Hall in Hammersmith and Fulham Town Hall hired by LBHF and the HHP. Services were given name badges and a map to direct them to their stall and guests were given a goody bag. The goody bags consisted of a yellow pen donated by the Southall branch of the Big 30

31 Yellow Storage Company, a leaflet of the event created and produced in partnership by the St Mungo s Broadway communications team, the HHP and LBHF. The leaflet consisted of a short introductory paragraph, a short poem, a list of services attending the event and a map of the hall on the back to direct guests. The goody bag also consisted of an enlarged map of the event and goody bags were donated by Capita and Share a Smile. Programmes, posters and maps were created to share information and publicise the event. St Mungo s Broadway communications team worked with the HHP to create the official programme for the event (displayed below). The event was also advertised on to reach a larger number of people and the St Mungo s Broadway Bulletin. Design and Publication: Health and Wellbeing Fair Programme (front and back) 31

32 Health and wellbeing fair programme (inside) Map of the hall: 32

33 People First and St Mungo s Broadway advertisement: Publications 33

34 Results from the thirty feedback guest questionnaires were input into a database. Health and Wellbeing Fair in general: 23/30 guests found the event very useful and 7/30 found the event useful. Information provided on the day: 20/30 guests found the information provided very useful. 8/30 found the information provided useful. One did not answer the question and one found the information provided slightly useful. Quality of snacks and refreshments: 16/30 found the quality of food very good, 8/30 found the quality of food good, 5/30 did not answer the question and one found the food quality average. Information provided in the programme and by volunteers: 21/30 guests found the programme and verbal information very useful. 8/30 rated it useful and one did not answer. Was the event easy to access: 30 guests rated the event easy to access. Would you recommend this event to a friend: 29/30 would recommend this event to a friend. The HHP Coordinator asked each guest to tick which service they found most useful, these results were collated into a points system and the results are displayed below; Which stall did you find most useful? CASS 10 DESTA DIABETES 10 VICTIM SUPPORT 9 OASIS 6 TURNING POINT 6 CLCH DENTAL SERVICES 6 CARERS NETWORK 6 CENTRE HEALTH TEAM 6 HORN OF AFRICA 6 STROKE ASSOCIATION 5 GROUNDSWELL 5 SMB HOMELESS HEALTH MATTERS 5 KICK-IT 4 H&F MIND 4 REIKI TREATMENT 4 LIVINGWELL CIC 4 ELGIN CLOSE RESOURCE CENTRE 3 CALM 3 TUI NA MASSAGE 3 H&F CAB 3 SMB WORK AND LEARNING 3 WLSCH 3 CARDBOARD CITIZENS 2 LOOK AHEAD 2 HCGA 1 NUBIAN LIFE RESOURCE CENTRE 1 ASSISTIVE TECHNOLOGY 1 VOICE ABILITY 1 SMB ART GROUP 0 34

35 Feedback from services shows; Service # of people spoken to on the day New Dawn 50 Reiki Treatment 35 Turning Point 13 Desta Consortium 80 Carers Network 7 LBHF Assistive Technology 37 CLCH Dental Services 14 Kick-It 37 Victim Support 31 Voice Ability 16 CASS Groundswell 20 Elgin Close Resource Centre 150 OASIS 25 Turning Point 25 SMB Work and Learning 36 Look Ahead 10 Expert Patient Service 23 H&F CAB 32 CDAS 31 Livingwell CIC 33 Homeless Health Matters Campaign 36 WLCSH HGCA 51 Cardboard Citizens 21 Highlights from the health and wellbeing fair: 14 guests received dental screenings from CLCH Community Dental Services. 17 guests received a sexual health screening and condoms from WLSCH. One guest self referred to the HCGA gardening course. Services were able to share their information with a large number of people. One guest signed up for a stop smoking course. Councillor Lukey signed the St Mungo s Broadway Homeless Health Campaign charter. The event received visits from; Cllr Holder. Cllr Lukey (cabinet member). Cllr Fennimore. Cllr Cowans (leader of the council. Services gave away many leaflets and business cards. Meetings have been arranged between service providers to attend team meetings and share information. The event received support from local businesses and other businesses such as; Pret a Manger, The Big Yellow Storage Company, Capita, Harper Collins and Share a Smile. Feedback from guests has been positive. Feedback from services has been positive. 35

36 Very well organised. Nice mix of attendees from various organisations and service user groups. (Amie Witherspoon, LBHF Assistive Technology) I just wanted to say thank you for today s event, it was so nice to see so many great services, happy residents and staff together. It was a truly great event and an amazing achievement so thank you. All of our residents that came really, really enjoyed coming. One resident signed up for support around stopping smoking, one has self referred to a gardening course, and lots of other really positive outcomes!! Thank you so much. (Sebastian Jackson, Assistant Project Manager, St Mungo s Broadway, Hope Gardens) I couldn't believe how much is on offer if we just look for it. (Anonymous, event guest) I enjoyed talking to different people who are all passionate about supporting vulnerable people to improve their health and wellbeing. (Anonymous, event guest) All the residents from TOT have been commenting just how wonderful the Health and Wellbeing Fair was. Am quite sure that everyone who attended benefited from all the diverse stalls present. (Joanne Smith, Project Worker, St Mungo s Broadway, The Old Theatre) 36

37 Health Action Group Meetings The HHP Coordinator chairs bi-monthly Health Action Group (HAG) meetings held in Hammersmith and Fulham Town Hall on Wednesday s from 2:30-4:30pm. Past Meetings : 8 May, 2 July, 29 October, 17 December, 11 February, 15 April Future Meeting Dates : 11 June, 12 August, 14 October, 9 December Health and housing service providers attend the Health Action Group meetings to discuss health events, activities, training and pertinent client health issues. The HHP Coordinator will also use the HAG meeting to update services on the progress of the HHP, gather feedback from services and run through the quarterly and annual statistics to highlight areas of concern. Guest speakers from health services are invited to present about their projects/organisation. The meetings are a valuable networking opportunity for housing service providers to make links with health service providers in Hammersmith and Fulham. During 2014 to 2015 there were a total of 122 HAG attendees. Below is a list of attendees and presenters represented from May 2014 to July 2015; Attendees Assistive Technology Better Gyms CASS Centrepoint CLCH Community Dental Desta Diabetes Family Mosaic Groundswell H&F CAB H&F MIND H&F Reach Hammersmith Community Gardens Association Hestia LBHF PATHS London Cyrenians Look Ahead NHHG Only Connect Sage Care Floating Support Simple Living Presenters Assistive Technology Better Gyms British Heart Foundation CDAS Community Dental (CLCH) Desta Diabetes Foundation 66, Older Persons Team H&F Advice Station H&FCAB H&F MIND Hammersmith Community Gardens Associati Hestia Physical and Learning Disabilities Horn of Africa Health & Wellbeing Project Hospital to Home Project Kick-It Stop Smoking Livingwell CIC London Ambulance Service Only Connect Simple Living St Mungo s Broadway Stop Smoking Advisor 37

38 Single Homelessness Project St Christopher s Standing Together against Domestic Violence Thames Reach Turning Point Victim Support Voice Ability West London Mental Health Trust Youth Project International Substance misuse, sexual health and Offender health commissioning team Turning Point Voice Ability Youth Project International Wormwood Scrubs BMX Health Action Group Flu Vaccinations 20 October 2014 Broadway Day Centre Services Attended: CareGrange Pharmacy Event Report: There were a total of 12 clients and 9 front line workers vaccinated against the flu by CareGrange Pharmacy. Caregrange Pharmacy attended the day centre and offered vaccinations to clients and staff that met the following criteria; Anyone aged 65 or over Pregnant women People with heart problems 38

39 People with chest complaints such as COPD People with kidney or liver disease People with low immunity People who have had a stroke or TIA People with diabetes Front line staff CareGrange also offered to go into hostels and vaccinate clients in house. The vaccinations were successful and vulnerable client groups were grateful to receive the vaccination during the winter period when immunity is at its lowest. Flu Vaccinations Staff Training Using the quarterly and annual data submitted by housing service providers and floating support service providers, the HHP Coordinator identifies areas where staff may benefit from additional training and sources the relevant health and wellbeing service to provide this training. Staff members are consulted prior to courses on subject matter they would like to receive further training on where appropriate. Training is provided by local health and community services. Training sessions are offered free of charge to any health and housing staff in H&F and held at various venues across the borough. The HHP Coordinator will organize training when needed and will advertise existing training and events on behalf of health and wellbeing organisations. The benefits to staff of the training offered by the HHP are; staff feel more confident to give clients key health messages, staff have the opportunity to network with health services and other organisations and staff have the opportunity to improve/refresh their existing knowledge. 39

40 Oral Health 12 June Attendees Trainers: Katie Wright, Alison Fraser, Heather Mah. Healthy Eating 22 May Attendees Trainers: CLCH Community Healthcare Dieticians. First Aid March 6 and 7 (4 hour one session) 41 Attendees Trainers: Tim Cox and Angus Angus, RBKC Parks Police Domestic Violence 11 th June Attendees Trainers: Standing Together Against Domestic Violence Domestic Violence 23 March Attendees Trainers: Standing Together Against Domestic Violence Training Feedback Very useful general information which I m able to pass on. Simple, to the point training not too much information, easy to remember. I will be able to identify the signs of DV and have contact numbers to sign post to. Learned about referral pathway makes me more aware of networks available. 40

41 HHP Volunteers Programme To enable the Health and Homelessness Project to progress and develop the HHP Coordinator recruited a team of 12 volunteers. The volunteers are broken down into the following teams; In-Reach Volunteers Sarah Sturrock In-reach Health Promoter Edith Road Bradley Lonergan In-reach Health Promoter Edith Road Laurence Suckling In-reach Health Promoter The Old Theatre Afiqah Adnan In-reach Health Promoter The Old Theatre Inesa Rozenman In-reach Health Promoter Shepherds Bush Road Lei Wang In-reach Health Promoter Shepherds Bush Road Nick Theobald In-reach Health Promoter Hope Gardens Emily Sapsed In-reach Health Promoter Hope Gardens Research and Resource Development Volunteers Mandy Thatcher (Team Leader) Olatunde Akomolafe Justina Chen Art Workshop Volunteer Brita McDonald In-Reach Volunteers: The in-reach volunteers were recruited to assist the hostels to organize and run the monthly health and wellbeing sessions. The volunteers research, plan and run a monthly health and wellbeing session to engage and educate hostel residents on a particular health and wellbeing subject. Research and Resource Development Volunteers (RRD): The RRD were recruited to research and develop an online health and wellbeing directory for H&F supporting people residents and staff to access health and wellbeing services efficiently. The team are in the process of visiting hostels, conducting their research and developing the content of the online resource. The resource will also include workshop plans for staff to enable them to run their compulsory health and wellbeing sessions. Art Workshop Volunteer: The art workshop volunteer was recruited to run weekly art sessions at the Broadway Day Centre. Brita runs a friendly and engaging workshop giving clients the freedom to express themselves in an artistic environment. Brita also accompanies clients to the Royal Academy of Art and attends the HHP health events to promote her workshops and assist with the setup and running of the events. The HHP Volunteers also volunteer at larger events such as the HHP Health and Wellbeing Fair and Service User Conference. 41

42 Art Volunteer Feedback from volunteers: I have really enjoyed my volunteering so far and communication with the HHP and staff at the hostel has been really easy. Staff have also been very supportive and have allowed us a lot of freedom in coming up with the sessions and delivering them. Sarah Sturrock, In-reach Health Promotion Volunteer We visit Edith Road once a month and talk to clients about the health topic of that month, which has ranged from sleep to back health to first aid. We try to make our sessions as interactive as possible and include quizzes, demos and examples. Numbers of attendees are variable, ranging from 1 to 5. I understand the vulnerability of this group better now and will be better equipped in the future to treat homeless patients as I feel like I understand the difficulty of their circumstances better now. Overall, I have enjoyed my experience so far and hope to attract more attendees in the future. (Bradley Lonergan, In-reach Health Promotion Volunteer) 42