Integrated newsletter pdf

The Quarterly Newsletter

Issue 3 | January – March 2016

Aimed at GPs and Voluntary Organisations

Supporting people to become more involved, connected and active in their communities

Sarah’s journey in finding suitable accommodation After injuring her leg in a traffic accident in her home country of Nigeria, Sarah visited the UK to receive specialist medical treatment. Following treatment, issues became apparent in regards to where funding was going to come from to pay for Sarah’s accommodation.

Adult Social Services was expected by the UK Border Agency to fund accommodation for Sarah due to her substantial level of need. However, Sarah was not eligible for local authority housing after her asylum claim failed. Sarah was at risk of being homeless.

At this point, pending the result of a new Home Office application, Adult Social Care provided accommodation for Sarah in a hotel. Due to difficulties in finding appropriate accommodation, Sarah had no choice but to stay in the hotel for a long period of time which caused Sarah much distress.

Having no recourse to public funds, Sarah survived on food bank packages provided by Halesowen Churches Together Welcome Group and the goodwill of her friends from a local church.

It was at this point that Sarah was referred to a Locality Link Officer by the Primary Mental Health Care Services to see what additional support could be offered to help improve Sarah’s quality of life. The Link Officer and a Mental Health Nurse conducted a joint visit. Due to suffering from depression and anxiety, Sarah was referred for counselling support through the Enhanced Primary Care Mental Health Trust. The Link Officer contacted Sarah’s social worker to see if Integrated Plus could offer any additional support with finding alternative and suitable accommodation for Sarah. The social worker had been searching for alternative accommodation for some time without success. Adult Social Care has no legal obligation to support Sarah while her renewed Home Office application is unresolved, but continued to do so in good will.

Inside this issue: Page 1: Patient Story Page 2 & 3: Spotlight on VCOs Page 4: About Integrated Plus

Sarah’s temporary housing where she receives 3 meals a day.

The Link Officer involved the local MP to apply pressure on the Home Office to have her application seen to as a matter of urgency, as well as to enquire with Adult Social Care about what else could be done to house her appropriately. The Link Officer supported Sarah with visiting proposed housing options, however, many were unsuitable due to Sarah’s disability. Some difficulties with the current accommodation meant that Sarah had to be re-housed quickly which put stress and pressure on both Sarah and the social worker. Fully accessible temporary accommodation was found where Sarah was provided with three meals each day. Following this, the Link Officer continued to liaise with Adult Social Care and advocate on Sarah’s behalf in the search for more suitable and independent accommodation.

After two weeks Sarah was temporarily moved into an adapted local authority flat. The Link Officer supported Sarah with moving some of her belongings and liaised with Sarah’s GP and her pharmacy to ensure her prescribed drugs continued to be prescribed and delivered to her new address.

Sarah’s solicitor has persuaded the Home Office to accept her application via the post, thus negating the need for a long and painful journey to Liverpool. The Link Officer continues to liaise with Ian Austin MP to continue to apply pressure on the Home Office in relation to her application for residency.

For more information on this case study please contact Terry Gee on 07866 020340.

Published By Integrated Plus Main Office: Dudley CVS, 7 Albion Street, Brierley Hill DY5 3EE Tel: 01384 573381 Website: www.dudleycvs.org.uk | Twitter: @intplusDudley | Blog: integratedplusblog.com Integrated Plus is delivered by Dudley CVS and funded by Dudley Clinical Commissioning Group Dudley CVS is a registered charity (number 517766) and a registered company limited by guarantee (number 1998105)

Groups supporting integration AgeUK Dudley Social Prescribing Service Reducing loneliness and isolation Social isolation and loneliness can impact significantly on an individual's emotional and physical wellbeing and their ability to live an independent life. This is often reflected in frequent and inappropriate visits to their GP or Accident and Emergency department. The aim of the social prescribing service is to reduce the number of visits and tackle the underlying social, emotional and practical causes.

Social Prescribing is made up of two members of staff and a team of volunteers, who support patients over the age of 60 to access a range of local, non-clinical services from voluntary and community sector organisations.

Integrated Plus is working in partnership with AgeUK Dudley’s Social Prescribing service to ensure a joined up and holistic service is provided for older people living in Dudley borough.

AgeUK Dudley – a success story Mrs X was frail and feeling depressed when she and Maureen first met. She was afraid to leave the house alone and spent much of her time indoors in the company of her daughter. Mrs X’s confidence levels were at an all time low following a fall almost a year before. Whilst attending church Mrs X had another fall. At the time of Maureen’s visit Mrs X was still having nightmares about the incident along with the occasional flashback.

Her confidence levels were greatly improved and she was less dependent on her daughter and other family members. She thought that these improvements in her health and wellbeing were in great part due to the support she had received from the Falls Service. She felt that these improvements may not have happened or have taken longer to achieve without the intervention of the Social Prescribing service.

For more information on this case study or the Social Prescribing service contact Maureen Lothian or David Hollick on 01384 267008.

Integrated Plus new video The role of Locality Link Officers in Dudley borough Integrated Plus has developed a new video on the role of the five Locality Link Officers in Dudley borough. The video explains the role undertaken by the Link Officers and features a success story of one individual, Jayne, who received support through the service.

Following Maureen’s assessment it was clear that lack of confidence and a fear of falling again were hindering Mrs X’s progress. Maureen suggested the 12 week exercise programme run by the falls service might be beneficial. Mrs X was familiar with the programme having attended it some years ago following a fall, and was unsure whether she would be allowed to attend again. A referral was made to the falls service with an explanation regarding Mrs X’s circumstances and her previous contact with them. She was called for a balance assessment and accepted onto the falls programme.

Once Mrs X had completed the programme an appointment was made for Maureen to conduct a review of her situation. Mrs X reported that she had been attending a local day centre and was now regularly attending church.

To watch the video visit: integratedplsublog.com or use this direct link http://wp.me/p5iMmm-2j

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Groups supporting integration For Men Monday Club

Helping to tackle loneliness and isolation The For Men Monday Club started in July 2015, following a discussion led by Nick Tromans, Locality Link Officer (Integrated Plus), and involving Reverend Simon Falshaw, vicar at Christ Church, Lye, and Iram Maan, Community Development Worker at Dudley and Walsall Mental Health Trust. The context for this discussion was a concern for the wellbeing of local men with mental health conditions and the fact that nationally:  

Suicide remains the most common cause of death in men under the age of 35.

British men are three times more likely to commit suicide than women (and it is thought that men are less likely to seek help such as talking to someone or visiting their GP for advice).

Nick had noticed that many of the men with mental health problems referred to him, particularly single men, were isolated and found it difficult to engage socially. Many had been recently divorced, had experienced bereavement or were unemployed. It was not uncommon for these men to feel low self-esteem and that they had limited economic and social usefulness.

The Club would make good use of existing connections with voluntary organisations, Christian faith groups and local mosques, and health professionals. It would create a place where men could meet socially, have a hot drink and a light breakfast, read newspapers or play games such as chess, pool, etc. It was agreed to hold the Club at the Community Hall, located at Christ Church, Lye, which already had good facilities, including a kitchen. The Church was very supportive: one of its members came forward to provide volunteer support.

A grant of £2,100 was obtained from the Black Country Near Neighbours programme to help set the club up – with the proviso that the Club should be open to men of any faith or none. The For Men Monday Club has, so far, met 26 times. The sessions are proving popular and the numbers attending have steadily grown. Thirty-five men have attended so far; the usual turnout is 12 – 15 men per session.

The Club is a good opportunity to pick up information or find out what support might be available. It is also a place where other voluntary organisations such as Dudley Mind, Health Trainers, support workers, etc. can attend with clients or just be on hand to give advice.

The Club is good at providing peer support: attendees often feel more comfortable talking about their problems here than in another setting. Simon, a recent starter, said: “It’s really worth coming to the group; I enjoy taking part, sharing banter about football and trying out those delicious meals we’re cooking! Everyone gets involved in setting up and there is always someone prepared to listen”.

An activity takes place at most sessions and there is usually something for everyone. This has included, for example, a six week Get Cooking course, indoor sports such as bowls and relaxation sessions on mindfulness. Alternatively, attendees can sit quietly, if they wish. The cooking course has proved particularly popular and has provided an opportunity to learn how to cook nutritious and affordable meals.

The next step is to consider whether members of the club want to set up its own committee, develop an activities programme and attract continuation funding to cover the costs of refreshments and room hire from May 2016 onwards.

Note: Attending the group is easy, there is no need to book, and you can simply turn up! It’s open every Monday between 10.00am and 12noon, except Bank Holidays.

For more information please contact Nick Tromans on 07866 0202436 or Iram Maan on 01384 366517.

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About Integrated Plus Integrated Plus is delivered by Dudley CVS as part of the integrated care model, being implemented by Dudley Clinical Commissioning Group and Adult Social Care. Integrated Plus has been established to: 

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Take client referrals (from GPs, other health clinicians and at MDTs) to support them to become more involved, connected and active in their communities.

The difference we aim to make

Represent the voluntary, community and faith sector in the integration model.

Raise awareness about what voluntary and community organisations can offer in the delivery of locality based services and activities.

Identify local service needs and broker solutions with the voluntary sector, health and social care practitioners, local commissioners and citizens.

Integrated Plus works with people aged 16 and over who frequently present at their GP practice or other medical service and people at high risk of hospital admission.

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Help people become more active and involved in their own communities

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Improve quality of life

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Support people to make a difference to their own communities e.g. through volunteering

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Enable the voluntary and community sector to play an active role in integrated care

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Reduce pressure on health services by supporting people to become less reliant on medical practices

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Ensure social inclusion of clients is taken into consideration at Multi-disciplinary team meetings

Integrated Plus is funded by Dudley Clinical Commissioning Group.

The patients in the case studies included within this publication have given permission to share their stories.

Every attempt has been made to accurately reflect their story.

Meet the team Kate Green Manager for Integrated Plus Dudley CVS, 7 Albion Street, Brierley Hill, DY5 3EE Tel: 01384 573381 buildingblocks@dudleycvs.org.uk

Wendy Bains | Locality Link Officer Kingswinford, Amblecote and Brierley Hill wendy@dudleycvs.org.uk 07866 020509 wendy.bains@nhs.net

Terry Gee | Locality Link Officer Dudley and Netherton terry@dudleycvs.org.uk 07866 020340 terry.gee@nhs.net

Jason Griffiths | Locality Link Officer Sedgley, Coseley and Gornal jason@dudleycvs.org.uk 07866 020431 Jason.griffiths1@nhs.net

Sue Bloomer | Locality Link Officer Halesowen and Quarry Bank sue@dudleycvs.org.uk 07989 478567 sue.bloomer@nhs.net

Nick Tromans | Locality Link Officer Stourbridge, Wollescote and Lye nick@dudleycvs.org.uk 07866 020436 nick.tromans@nhs.net