Page 9 - TSAB Adult B FINAL (1)

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5.27. There is no record that Josh attended the homeless service on the day of discharge. Josh failed to
attend his appointment with the affective disorders team the next day.

5.28. Later, on the day after discharge, Josh again took an overdose of insulin outside a local pharmacy and
was taken to hospital. On this admission he stated that he would continue to take overdoses. The
consultant stated that all insulin administration should be supervised. Mental health assessment did not
find Josh to be depressed. Josh also took overdoses of insulin whilst he was an inpatient when he was
off the ward.

5.29. On discharge the medical consultant stated that he would pay the £50 required to secure
accommodation (ID had been gained with the support of the social worker in the mental health team
whilst Josh was an inpatient on the mental health ward).

5.30. On this occasion, with the £50 paid by the consultant, Josh was housed as a self-funding tenant in Area
B.

5.31. As a response to Josh’s continued admissions to hospital from overdoses of insulin, liaison psychiatry
arranged a ‘Frequent Attender’ meeting. This was attended by a social worker, liaison psychiatry, and
staff from the acute hospital. The plans agreed by all at the meeting were:

 Staff to remain boundaried, as an intervening approach was thought to be unhelpful to
Josh.
 Ward staff to ask for his insulin pen whilst Josh was an in-patient, to stop him taking an
overdose whilst an in-patient to extend length of admission.
 Staff to provide a consistent message that Josh needs to engage with substance misuse
services.
 The affective disorders team will try and engage Josh in the assessment process, speak to
housing providers to identify address and cold call on Josh later that day.
 Any admission of Josh to the acute hospital should be for the shortest possible time.
 The affective disorders team will discuss Josh’s children with him and ensure that there are
no safeguarding issues.

5.32. The meeting also spent some time considering the issue of staff in the acute hospital ward having to
discharge Josh with his insulin, knowing that he would be likely to use this to self-harm. No resolution
to this could be found for this situation as Josh’s insulin was needed to preserve his life.

5.33. Over the next couple of days, staff from the affective disorders team and the diabetic team visited Josh
at his new tenancy. Both reported that he was happy with his accommodation and he was feeling
positive. Josh did raise concerns with the diabetic nurse regarding activity taking place within the house
as he suspected drug dealing. The diabetes nurse had a conversation with the homeless service to find
out information regarding the person living above. The nurse was told that information could not be
shared, and intervention was not possible as there was no direct conflict with the two tenants.

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