King's College London

Unit researchers Jess Harris and Stephen Martineau visited the Framework Housing Association today to take part in a national roundtable exploring executive dysfunction in homelessness services. In particular, attendees were considering the findings and recommendations presented by Imogen Blood in advance of the publication of her report on the topic, commissioned by Framework.

Executive dysfunction refers broadly to problems in goal-directed behaviour. It can arise from damage to the frontal lobe of the brain and common presentations include impulsivity and difficulties in task initiation. Such challenges can render executive dysfunction a concern under the Mental Capacity Act 2005 – as decision-making ability can be affected. Jess Harris gave a short presentation from the Unit's MCA study, which is itself entering its reporting phase.

Attendees were welcomed by Framework CEO Claire McGonigle. They were also presented with a case study involving executive dysfunction and heard about the contribution of Nottingham's Practice Development Unit.

The report from Imogen Blood & Associates will be published shortly (we will update this page with a link).

Among the attendees at this event were: Lesley Hutchinson and Michael Preston-Shoot (co-chairs of the National Network of Safeguarding Adults Board Chairs); Sarah Finnegan (Head of Policy, National Housing Federation); civil servants with oversight of multiple disadvantage, and substance use, from DHSC; Ellie Atkins (Safeguarding Lead & Manager: The Entrenched Rough Sleeper Social Work Team, Manchester); and Mark Holloway, the authority on brain injury. Mark highlighted the following resources:

• New paper on the Frontal Lobe Paradox
• Frontal Lobe Paradox field guide
• Forthcoming in The Journal of Adult Protection: "Repetition Without Learning: Nine Years of Safeguarding Adults Review Involving Acquired Brain Injury."
• NICE guideline: NG252
• A resource for ascertaining whether someone may have a cognitive communication disorder
• Article about cognitive communication disorder

Also noted in the meeting:

• Changing Futures final report
• Beryl's story (from Ellie Atkins, Manchester)
• A national Peer Network for social workers specialising in homelessness and rough sleeping (supported by this Unit)

Framework operates in Nottinghamshire, Lincolnshire, Derbyshire and Sheffield, providing support services across housing, health and employment for people facing homelessness, mental health and substance use challenges.