Referral

Outline of section

Introduction | Aims of the referral stage | Tasks | General Information | Informed consent | Co-ordination | Advocacy | Standards | Good practice checklist

Introduction

Depending on the type and location of the resettlement service, clients may be referred to it while staying in temporary accommodation, and it may be that the resettlement service forms part of the service offered by a hostel. In this case, the first stage of the referral will involve a handover meeting with the client's keyworker and the first meeting with the resettlement worker could take place with the keyworker also present, if the client thinks that would be appropriate or useful.

In other services, the client may refer herself or himself to a resettlement service, or the service may receive a referral from an external agency. The importance of successful interagency work in the referral process is covered in the section on The Environment.

Aims of the referral stage

• To talk through with the client what the resettlement service provides, what it can and cannot help with, the general ethos of the service, and that the client understands these elements.
• Considering with the client how motivated they are to begin the process and how much engagement is expected of them, how they can conact you, and that the client understands and is happy with the level of input you will have in the process, and the level they will have.

Tasks

• The resettlement service will most likely have some criteria that potential clients may be required to meet. If you have sufficient information from the referral agency that the person is suitable to your project you can just run through this at the time, if the person has referred themselves you may have to ask a number of questions of them.

If a certain level of motivation to change is seen as a criterion of admission to the project, you can address this in a number of ways. In some cases it may be evident that they are motivated, but don't assume that a person is not just because they are not very forthcoming. Nevertheless, if a level of engagement is required this must be explained in detail and you should have a discussion about this.

General information that may be required at the referral stage

• Name, date of birth, National Insurance number.
• Details of any known support needs e.g, suspected medical or mental health problems or drug, alcohol or other addictions.
• Basic assessment of how much support the client needs in these areas
• Details of and relationship with other agencies working with the client - these may be primary health, mental health, or substance misuse teams.

Informed consent

The first referral meeting is an opportunity to discuss the concept of confidentiality and informed consent with the client. The worker will be involved in linking the client in with other services and will need to share information about the client with those agencies in order to identify housing and any support needs - i.e. in order to do their job. It should be explained what information will be shared, in what circumstances and why, and it should be ascertained that the client understands and agrees to this - gives their informed consent. An important aspect of the notion of informed consent is the opportunity to withdraw it at any time. The client should be made aware of this, and also made aware of their right to complain, and the procedures for this.

The Clunis Report (February 1994) which followed the killing of a member of the public by a mentally ill man, Christopher Clunis, noted the mistaken way in which professionals in the housing and mental health field chose not to pass on relevant information about a client. In circumstances where a person may be put at risk by the behaviour of a client, information must be passed on, and the client should be told this clearly.

For further information on confidentiality and record keeping see Records and confidentiality

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Co-ordination

• Liaise with colleagues and external agencies to ensure that every client that would be eligible to access your service, is aware of it and how to access it.
• Ensure that every client is offered the chance to either refer herself or himself, or be referred for an initial assessment.
• Ensure that the appropriate worker makes an initial assessment of each client who wants to be referred.

Advocacy

• Ensure that there is an appeals system in place for clients who may have been denied referral, or who are not referred appropriately.

Standards

• It is extremely important that resettlement workers have manageable caseloads. This will impact on the quality and effectiveness of the service offered.
• Clients may be placed on a waiting list to be taken on by the resettlement worker if their caseload is too high. Care should be taken that the waiting is kept to the absolute minimum.
• Case management should be part of the regular supervision of the worker by their manager. The numbers on the caseload will be determined by the support levels needed by the clients, and as such needs to be flexible and regularly reviewed.
• Agency Example: Although in Britain caseloads generally vary from 10 to 40 clients, at a project in Rotterdam the workers have a caseload of four, but with a very limited time-frame of five weeks in which they must complete the resettlement process.

Good practice checklist

• The potential client group is aware of the resettlement service, what it offers and how to access it. Do the referrals to resettlement services reflect fairly the client group of the project? Is there any in-built prejudice against sections of the client group?

• Referrals and applications are replied to and followed up within a reasonable timeframe, even if it is to inform that there may be a wait to access the service.

• On referral, the client is invited to discuss their situation and their aspirations and needs from the service from their own point of view from the word go.

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