Medical Assessment Team

1. Medical Assessment Team 15/07/14

2. Medical Assessment Team • The medical Assessment Team use various models interchangeably. namely the Canadian Model of Occupational Performance, Model of Human Occupational as well as the Social Model. • The team adopts frames of reference as well as the model simultaneously with local, national and professional policy and codes of guidance when working with anyone who comes in contact with the service. • Some of these are educational frame of reference as well as biomedical frame of reference, to name a few. • Hackney-Housing Policy 2014 (John) • NICE/COT/WHO/HPCP • Occupational Therapist are trained and experienced to understand the effects of a condition and how this condition impacts ones quality of life.

3. What do the Medical Assessment Team do? Not an extensive list • Assess applicants/tenants who require re-housing on medical ground, • apply priority and make recommendations on suitable future housing • This includes bed blockers/Hospital non-discharge who are in Acute Mental health wards and other specialist ward (rehab) • Conduct vulnerability assessments and medical recommendations for Homelessness Team and Housing Advice team. • Homelessness Reviews • Tenancy disputes/successions • Direct offers & viewings • Recommendations on new builds • Major adaptations using shell units for bespoke homes for severely disabled applicants to promote independence and improved quality of life

4. How cont.. Housing a record of the 811 housing applicants who have a need for accessible housing because of a physical disability. • 72 families waiting for wheelchair standard • 278 families waiting for properties with no steps to the front door • 97 families need a property with a level access shower • 364 families need a property with maximum of 4 steps. Adapted Housing Transfer Scheme • Aimed at those living in adapted or accessible housing but don’t need it. Similar to the under occupation scheme. It is dealt with jointly by Medical Assessment and Lettings Initiatives Teams.

5. Medical assessments • The medical advisor’s assessment states the priority given and the type of housing needed. The format is designed to make it clear what kind of property the applicant is assessed as needing so they know what to bid for. Bidding • Case work: • Bidding advice to cases where there are high needs, to either main applicant or support person identified. • Check bidding history and work with family. • Those who (have no support) have been assessed as experiencing difficulty with bidding receive adverts via post. • They can use adverts to bid by telephone. Autobid can be selected for applicants who are not able to bid by telephone. We try to avoid this as much possible as it does not allow flexibility.

6. Property adverts • We advertise an accessible housing property in the same way as general needs properties to maximise choice for applicants. Viewings • OT or OTA from this team will sometimes attend viewings.   Outreach • We facilitate housing workshop to professionals who are often the first service to establish housing need for those with significant mobility problems or functional difficulties.

7. Medical Priorities Emergency Non Discharge Cases Highly complex cases • When someone needs to be discharged from hospital however, due to their medical condition they cannot return to their property (e.g. in a wheelchair living in an un-lifted block). • Where temporary accommodation is not suitable or not in the interest of the Council; for example, where major adaptations are not possible or costly aids and adaptations are required). • Agreement-The hospital should give housing 7 days notice to the Housing Needs team prior to discharge

8. Extra Bedroom/Own Bedroom Those households containing persons who require their own bedroom on medical grounds who would otherwise be expected to share with another household member. This includes children and adults with complex needs and care requirements

9. Medical Priorities It is important to note that although medical priority is awarded it is not this only that determines the band, for instance someone is awarded a “B” General band but the household is severely overcrowded which would place them in urgent band. Therefore, applicant and tenants are advised to contact their neighbourhood office or housing register team for any queries related to Banding and band dates. “A” Medical Priority: is only given to the most urgent cases “B” Medical Priority: Will be awarded to other urgent cases where circumstances do not merit an “A” grade.

10. Medical Priorities “A” Special Needs priority: This priority is awardedis only available to a person for whom a Community Care Assessment has been carried out and it is confirmed by those professionals together with Medical Assessment Team Leader that the provision of support services is not possible. • “B” Special Needs priority: There are two circumstances where this award is applicable • For any person where a Community Care Assessment has been carried out or an Occupational Therapist has made a written assessment of the need. • E.g. The provision of care or support services would be significantly • limited in the present home. • 2)For older people

11. Medical Priorities • “A” Carers priority may be awarded in the following circumstances: • Level of personal daily care • High level of dependence on carer – if care not given • social/health services would have to be provided • Priority can be given to the carer or the person needing care • An extra bedroom may be recommended if care is needed during the • night on a regular basis • “B”Carers priority may be awarded in the following circumstances: • Regular, (probably daily) care is needed for a person who is • housebound but able to care for themselves within the home • Provision of social contact/ support/shopping etc. • Priority can be given to the carer or the person needing care • There will not be consideration of any request for additional bedroom • for cases where “B” Carer priority is agreed.

12. Identifying Medical Priority Cases (some guidance*