Homeless Step Down Pathway Case Study 2

CASE STUDY 2

SOCIAL BACKGROUND:

Patient was a Nigerian National who came to the UK on a student visa in 2012. CN applied for settlement 20 Mar 2013, but his application was rejected. Unknown to the patient, he did not know the reason/s why. He was previously homeless, sleeping on buses in London and the Brent area. He also lived in Croydon working cash in hand as a gardener. He has three siblings living in Nigeria but no contact.

MEDICAL SUMMARY:

CN was admitted to the Mildmay with the following medical issues.

Newly dx retroviral

Right cerebellar subacute infract

Low mood and

Leg pain

IMMIGRATION SUMMARY AND SUPPORT:

He previously made an application to the Home Office, but this was rejected, but unknown to the patient, he did not know the reason/s. He was admitted to the Mildmay on the 29/3/2022 on the homeless pathway. However, during his housing assessment, it was later established he had limited options due to non-status and referred to Hackney Migrant Centre for immigration advice. He was given a few appointments to discuss his immigration issues and health to establish what support could be offered to him. A subject of access request was also made to the Home Office to request, but as advised, could take some time. Hackney Migrant had to wait about 2 months, before his file was received.

Hackney Migrant was also looking at legal reps to support in making an Article 3 application to the Home Office, after receiving information from Islington Law, based on his mental and physical health, that he does have grounds to make an application.

SOCIAL WORK INVOLVEMENT:

CN was initially assessed by Mildmay to establish whether he had a case to be referred to Brent for a Care Act assessment to be done. He was very guarded with his information and extremely isolated. He was referred to Brent social services to request for a Care Act Assessment to be completed, based on his mental and physical health. However, Brent had advised that CN did not have any care and support needs, but no feedback to the patient on the outcome. A complaint was put to Brent social services to request for a letter to be sent to the patient, but no response. Brent social services also established that his main last address was not in Brent, therefore, not an ordinary resident and had no local connection.

The patient was also offered VRS (voluntary return service) back to Nigeria, but the patient declined the offer.

Research was also done to see whether if he returned back to Nigeria, he could be provided with HIV care, which was found to be free, but this would depend on other factors, such as his resettlement after so long, stigmatization, employment and self-management.

HOUSING SUPPORT:

During his time at the Mildmay, the patient was referred to a number of external agencies who work with people with no recourse, refugees and migrants. However, due to the fact that his initially application to the Home Office was rejected, some were unable to offer any support and advised to get immigration advice. Other services only provided support, but no accommodation. There were also others, who were unable to accept, as he was not eligible for the service.

The patient was spoken to on a few occasions, about VRS and his very limited options in finding accommodation. He was also advised to think about friends he may be able to stay with.

Night shelters were also contacted, but they were not yet available due to time of year. The passage in Victoria was also contacted to discuss about his situation and whether they were able to assist, but unfortunately, they could not.

DISCHARGE PLANNING:

• Due to length of time at Mildmay, discharge planning meetings was held with Hackney Migrant centre, SW and Housing, to establish what other practical solutions we could come up with to support the patient, being that he had been referred to a number of services.
• It was established that due to very limited options, that Hackney Migrant would look at sourcing hosting schemes and referral to Hackney Night shelter.
• MDT report was also provided to Hackney Migrant, to provide clarity on the patients’ physical and mental health.
• Housing worker will continue to look at other services, not already researched.
• Continual discussions with patient about his discharge and for him to revisit the options that was given to him
• To encourage to get out and about due to long spells of isolation

CHALLENGES:

ACCOMMODATION OPTIONS AVAILABLE

RESOURCES

CRITERIA’S FOR POSSIBLE SERVICES

FEEDBACK FROM SERVICES (BRENT SOCIAL SERVICES)

LIMITED INFORMATION FROM PATIENT

CLARITY OF CIRCUMSTANCES

FUNDING

DELAYS IN RESPONDING

Case studies written by Sheila James

Housing Officer