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This Toolkit is the property of Orbit Group Limited No portion of this Toolkit is to be reproduced or copied without permission of Orbit Group Limited Copyright ŠOrbit Group Limited 2013 All requests for permission to copy or reproduce any portion of this Toolkit needs to be made in writing to: Orbit Group Limited Garden Court Harry Weston Road Binley Business Park Binley Coventry CV3 2SU United Kingdom Clarke Print Clarkeprint Limited 45-47 Stour Street Birmingham B18 7AJ First published in 2013 The Initial Assessment and the Hoarding House Assessment have been included within this Toolkit with the permission of ŠCoventry University 2013 First published in Coventry 2013
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‘Welcome to the Orbit Independent Living toolkit on working with, and supporting, people who compulsively hoard. This is the outcome of an innovative two year research and development project delivered in partnership between the Care and Repair team in Orbit Independent Living and Coventry University. The Knowledge Transfer Partnership initiative of the Technology Strategy Board provided funding or the project. A few years back, the Coventry Care and Repair team identified that they were being asked to intervene more and more in situations where, it transpired that, the poor or deteriorating condition of the property was the result of compulsive hoarding people were not maintaining or enabling access to their home for maintenance, repairs, safety checks and general upkeep. It became increasingly apparent that working with, and trying to manage the properties of those who compulsively hoard has a significant impact on the time and resources of the housing provider or landlord. The condition often puts the health, safety and well being of the person living in the home at risk, as well as in some cases also impacting on neighbours and the wider community. This was an experience shared by other Care and Repair/ Home Improvement Agency teams as a study in 2009 of 40 such agencies, found that 87% had recently or were currently working with customers who compulsively hoard.
Compulsive Hoarding Frontline Worker’s Toolkit
Foreword
This is what the toolkit therefore aims to provide – a practise based range of interventions, that have been developed in partnership with health professionals, the Coventry Care and Repair Team and those who hoard. The interventions have proven effective, in practise, in supporting people to address their hoarding behaviour, as well as providing cost benefits to the organisation and Landlord. Thank you to everyone who has committed their time, expertise and energy in getting this project to this stage – we hope that you will find the toolkit useful and it can enable us all to work more effectively with people who compulsively hoard’. Vicky Harwood Director of Orbit Independent Living
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Acknowledgements This Toolkit would not have been possible without the insight by Orbit Care and Repair Coventry who identified the need to address compulsive hoarding and whose team have provided valuable support during its development. Coventry University has provided academic support throughout the project with valuable input from Darren Awang, Mike Morgan and Ruth Heames. Thank you to the Knowledge Transfer Partnership team which has provided guidance during this project. Throughout the project we have had the support of an Advisory Group which has helped to steer the project with their valuable experience and knowledge. Advisory Group members:
• • • • • • •
Steve Chantler – Coventry City Council Enforcement Team Etain McDermott – Coventry City Council Baiju Panchmatia – West Midlands Fire Services Martin Morley – MIND Coventry Robert Bindley – Age UK Pete Kendall – Community Occupational Therapy Service Ian Rix – Rainbow International Ltd
A special thank you to all our clients who have supported the project through trialling aspects of our Toolkit and providing valuable insight into compulsive hoarding through interviews, attending focus groups and attending our support group. Without the input from these people we would not have been able to develop a Toolkit and training programme which is based on first-hand experience. During the course of the two year project we have been extremely lucky to have had two third year Occupational Therapy students from Coventry University who have provided valuable support. Roland Simmons KTP Associate and Project Lead
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Compulsive Hoarding Frontline Worker’s Toolkit
Table of Contents 1. Background
Why develop a Toolkit and training programme? Who has developed the Toolkit and training programme? How the Toolkit and training programme have been developed Who is the Toolkit and training programme aimed at? How to use it? Terminology Structure of the Toolkit Expectations
2. Introduction
What is compulsive hoarding? What are the triggers? Your role, ground rules and ice-breakers Multi-organisation working The importance of reflecting Challenges - Making a decision, problem solving and cognition Building a therapeutic relationship
3. Assessments
What is an assessment? What assessments have we used? The initial assessment The Hoarding House assessment
4. Intervention
What is an intervention? Effective intervention planning How to use the intervention plan Carrying out interventions Organising Categorising Discarding
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Table of Contents 5. Measuring improvement
Why measure improvement? What can I do to prevent relapse? Follow up and monitoring Groups which the client can attend
6. Case Scenarios 7. Sign posting
Where can I get additional support? Useful web addresses Moving forward
8. Setting up your own self help/ support group What do I need to consider?
9. Legal 10. The impact of compulsive hoarding on a service Costing template
11. APPENDIX
Case Scenario Answers References
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