This week Ruth Hawley @Ruth_Hawley and Beck Skelton @WintRebecca will be hosting here is what they had to say.
Homelessness is a growing issue within the UK and other countries. The issue of homelessness is wider than being roofless and rough sleeping and includes those who don’t have the right to stay where they are, sofa-surfing or in temporary accommodation, and can be those with insecure or inadequate housing for their needs (Shelter, 2019).
The experience of being homeless impacts on occupational performance, participation and identity (Chard et al, 2009; Cunningham & Slade, 2019; Williams & Stickley, 2011) and those who experience homelessness can have complex health and social care needs and be at risk of occupational deprivation and injustice (RCOT, 2019).
Occupational therapy, therefore, has much to offer for working with those who experience homelessness. Indeed, homelessness has been the topic of the recently produced RCOT evidence spotlight which outlines some key reading and evidence available (RCOT, 2019). A networking day in October 2019 at RCOT on Occupational Therapy and Homelessness saw a group of experienced and enthusiastic Occupational Therapists come together to discuss this topic, learn more about it and consider how to advance practice in this area. As was evident on the day, occupational therapists can work with people with homelessness in many different contexts across physical health care, mental health care, in housing adaptations and social care settings as well as third sector or charity settings.
Beck Skelton, an Occupational Therapist in Leeds has been working for a third sector organisation funded by Leeds CCG for 2 years. During 2018-19 over 160 people accessed the Occupational Therapy service. The work is varied as people present with a range of functional difficulties as a result of physical, psychological and social conditions. The role is temporarily funded as with many diverse roles.
As identified on the networking day, to support occupational therapy in this area it would be helpful to have greater development of the OT role in working with people who are homeless, more research evidence and policy guidelines and to establish an effective forum for clinical support and sharing of good practice across the UK.
In order to support these aims, Beck Skelton (Occupational Therapist working at homeless charity in Leeds) and Ruth Hawley (Senior Lecturer in Occupational Therapy at Derby University) would like to host this OTalk considering the following questions:
Q1. Do you have any experiences of working with people who are homeless?
Q2. What do you think are the occupational needs of people who are homeless?
Q3. What do you think the occupational therapy role is when working with people who are homeless?
Q4. What do you think would be good next steps to support the development of this emerging area for occupational therapy? And how could these be implemented?
Boland, L. and Cunningham, M., 2019. Homelessness: Critical reflections and observations from an occupational perspective. Journal of Occupational Science, 26(2), pp.308-315.
Chard, G., Faulkner, T. and Chugg, A., 2009. Exploring occupation and its meaning among homeless men. British Journal of Occupational Therapy, 72(3), pp.116-124.
Cunningham, M.J. and Slade, A., 2019. Exploring the lived experience of homelessness from an occupational perspective. Scandinavian journal of occupational therapy, 26(1), pp.19-32.
Shelter (2019) What is homelessness? Available at: https://england.shelter.org.uk/housing_advice/homelessness/rules/what_is_homelessness [Accessed 31 October 2019]
RCOT (2019), RCOT Evidence Spotlight: Homelessness. London: RCOT
Williams, S. and Stickley, T., 2011. Stories from the streets: people’s experiences of homelessness. Journal of psychiatric and mental health nursing, 18(5), pp.432-439.
Post Chat Updates:
PDF of transcript #OTalk 18th February 2020 Transcript
This week Sherlyn Graham @sherlynmelody will lead the chat this is what she had to say
Direct Payments were set up with the Community Care (Direct Payments) Act (1996) and came into force on 1stApril 1997. Direct payments were initially available only topeople 18 to 65 years with physical and sensory impairments, learning difficulties and mental health problems and who had been assessed as needing community care services. The Act was amended in 2000 to incorporate older disabled people and later in 2001 it was extended to 16- and 17-year-olds, parents of disabled children and carers.
The Act gave local authorities the power to make direct cashpayments to individuals.
A direct payment is a cash payment paid by a social services department to a service user to purchase services that meet their agreed social care needs. Direct payments are the governments preferred mechanism for personalised care and support. They were intended to empower service users giving them independence, choice and control by enabling them to commission their own care and support in order to meet their eligible needs.
For individuals, a direct payment can mean the difference between having to live in an institutional setting and having the assistance they want to be able to live in their own home.(Alzheimer’s society 2007)
To ensure the money is used for the right things, the direct payment is to be managed by the service user; where the service user is unable to do this for themselves they can be supported by a family member, friend or an external advocacy organisation.
As the money given to the service user is given in lieu of the local authority providing the care, the money remains public money. Therefore the use of the money is subject to scrutiny – audit. (TLAP 2019)
Direct Payments can be used to buy all or some of the support the service user needs to meet their needs however, each persons needs are different and will vary from one case to the next. The money can be used to directly employ a personal assistant or hire care workers from a private domiciliary care agency. As an alternative to care services, the service usermay be able to use his or her Direct Payments to fund other local services that enable their independence within their own home and community, such as attending a day centre,accessing taxi cabs and meals on wheels.
According to the Royal College of Occupational Therapy (2019) Occupational therapy provides practical support to empower people to facilitate recovery and overcome barriers preventing them from doing the activities (or occupations) that matter to them. This support increases people’s independence and satisfaction in all aspects of life.
So as an occupational therapist how involved are you in using direct payments as a means of empowering people to engage in meaningful activities?
- What setting are you in and have you given a direct payment to any of your service users/carers?
- In general, what are your services users/carers using the direct payments for?
- Have you used any external organisations to support with the utilisation of direct payments? And what support did they provide?
- What, if any, have you found to be the disadvantages of a direct payment?
- What have you found to be the advantages of a direct payment?
- What have you found to be the main barriers and or facilitators of using direct payments.
- Do you find direct payment are more suited to a certain client group?
Direct payments: answering frequently asked question – social care institute for excellence (2005)
Direct payments – information and guidance booklet, direct payments from Hertfordshire council for adult social care.
Direct Payments – Alzheimer’s society information sheet (2007)
Think Local Act Personal – Money management (2019)
The Royal college of Occupational Therapist – What is occupational therapy? (2019)
Post Chat Updates:
PDF of Transcript: #OTalk 11 Feb 2020
Yesterday was my day off. I’ve had an extremely busy few weeks and for the first day in 2020 I was taking a break . ‘Well earned’, I thought when I sat down with a coffee watching Loraine on ITV, and there she was chatting to Katie Piper about the #FebYouary challenge. I hadn’t heard of this before but I liked the idea of a month to highlight self care. I’m always telling people “you can’t give from an empty cup” but in reality I think my cups overdrawn and I need to set up a repayment plan! I’m a “ spoonie” which basically means I have a chronic health issue and I need to balance my life carefully to ensure I have enough energy to do what needs doing, and prevent running on empty. I am also an occupational therapist who doesn’t always practice what she preaches, although I do try.
listening to Katie and Lorraine chat about finding time for you, and their participants sharing how they plan to engage with this, made me think about occupational therapy and how what we do influences our health and well-being. I hear lots of stories about health professionals neglecting their own health and well-being, stressed, overworked, feeling responsible, feeling like you have to be indestructible and hold it together for everyone else – this made me wonder what everyone else Is doing to manage their self care? I’m going to take the opportunity to engage in the #FebYouary challenge to re focus on some of my own needs and life balance. I shall tweet about this from my twitter account @GillyGorry and I would like to see other occupational therapists join in.
if you would like to join the challenge please use the hashtags #febYouary #Otalk #occupationaltherapy I will gather up the tweets at the end of the month and add to the blog.