Is it possible to discharge someone onto a CTO who is no fixed abode?
To say it is less than ideal is perhaps a gross understatement, but I don’t see why it can’t be legal. There is no requirement to reside inherent in a CTO.
The person will be subject to an underlying s3 (or 37) so s117 aftercare duties will apply. While housing isn’t automatically included in aftercare, I think the patient and their advocate would have some reasonable questions to ask about the work being done to prevent relapse and readmission.
the problem is the patient is wanting to be discharged homeless - how would we go about serving recall papers if needed?
I don’t think any of the step down beds apply here - would they not qualify for Community Care Assessment to address urgent rehousing in the area where the person lives - personalization
There are difficulties finding accommodation due to history - not many providers are prepared to take him. He also doesnt want to live in accomodation but team dont want to discharge without CTO framework in place.
Recall notice can be delivered by hand to the person, in which case the recall comes into force immediately.
yes,they can be Recalled due to non compliance
As previously stated I would assume the CTO needs an address for it to work. Consider referring the person for advocacy IMHA. The local authority might be able to provide urgent supported rehousing but he would need to agree to this.
Im thinking of the occasions when the team cant get hold of the patient and need to serve to last known address.
There are two issues, can the conditions of the order be changed? The conditions of the CTO are the responsibility of the appointed clinician but there should be some input from the patient which takes their views into account so that the order is 'doable - user friendly, proportionate and realistic before they are discharged. Once the order has started, the clinician can still review the conditions, which should (hopefully) prevent recall.
And, if the person can not be contacted I would think the clinician responsible for overseeing the order would contact family, friends in the first instance failing this contact with Police who will attempt to find the person. Once found, the clinician will need to decide next steps.