Category Archives: Best practice

The value of cross-sector collaboration to improve health outcomes for homeless people

The link between homelessness and poor health is well documented, with data indicating that the number of A&E visits and hospital admissions per homeless person is four times higher than for the general public.  But what part can housing associations play in breaking that link?

Homes for Cathy recently caught up with Rebecca Whittle, Neighbourhoods Strategic Lead at ForHousing, to find out more about its new housing-led ‘Homeless Discharge Support’ pilot, a collaborative project with Salford Primary Care Together (SPCT), Salford City Council, Greater Manchester Housing and Social Care Partnership and Greater Manchester Mental Health Service that aims to improve health outcomes for rough sleepers leaving hospital.

There’s clear evidence that good quality housing is not only critical for good health but also reduces demand for NHS services, so it’s great to see an example of joined up working between housing and health providers. How did the partnership with SPCT come about?

The initial idea came from discussions with the GP Clinical Lead for the SPCT Inclusion Service, Dr Wan-Ley Yeung, who provides a GP inclusion service for homeless patients within Salford.  We were both concerned that individuals were being discharged from hospital and weren’t engaging with ongoing medical treatment, because they were either returning to the streets or being placed into temporary accommodation which wasn’t wholly suitable given their on-going medical needs.  

We’re quite fortunate in Salford in terms of homelessness provision; Reducing homelessness is a priority for Salford City Council and they are very successful in attracting government funding to end homelessness, with lots of different initiatives in place to prevent people from having no option other than to sleep on the streets.  What’s important is that we make sure that the provision is suitable for all individuals.  In the past, people with no fixed abode and ongoing medical needs would have either been unable to be discharged from hospital, or picked up by the local authority and put in a provision that wasn’t entirely suitable for their ongoing medical treatment and rehabilitation.

In partnership with SPCT and Salford City Council’s associated departments including adult social care, housing options and supported tenancies, we successfully applied for funding through Greater Manchester Health and Social Care Partnership to the Department of Health and Social Care’s (DHSC) shared outcomes fund.  We were awarded approximately £450,000, which covers accommodation costs as well as a support element.

The whole concept is to take a test and learn approach to inform future commissioning and future service delivery, to ensure safe discharge from Salford Royal Hospital for those people that are either;

  • medically optimised  for discharge  but would be returning to the streets or
  •  going to accommodation that wouldn’t be able to meet their needs adequately or
  • For those who are medically fit for discharge but have ongoing health needs requiring further clinical support

How is the scheme working in practice?

ForHousing is the landlord and we are providing eight self-contained properties that are all accessible for individuals with mobility difficulties.  The aim is not only that individuals can be safe within that accommodation but that we can work closely with them for a greater chance of securing settled accommodation. Health, social care and housing services work closely in partnership to provide wrap around intensive support for each person to improve their health outcomes and also their life skills and tenancy skills, so they have more likelihood of being able to move on to more secure, permanent accommodation in the long term.

In terms of the support, there’s a dedicated housing support officer for the eight properties and they work alongside Salford City Council’s Supported Housing Service who provide two dedicated support workers to support the individuals both in this accommodation and in their future move on home.  The reason why we’ve taken that combined approach is we know it’s really important to have the engagement of housing options for move-on to suitable long-term housing.  They have access to a full range of accommodation, particularly if that individual has aspirations to move to a locality where ForHousing doesn’t have properties.

With regards to move-on, there’s a guiding principle of three months but all the partners are extremely committed to the fundamental principle that the service priority is about supporting individuals, so we won’t necessarily be working to timescales – ultimately we need to go at the individual’s own pace.  We’ve also been very clear from the outset that if a tenant moves into a property, develops a really good support network within the local community and is thriving where they are, we won’t uproot them to another area for long-term housing.  We’ll convert the accommodation into a general needs tenancy and identify another property to bring into the scheme.

Are there any particular barriers that you have had to overcome in setting up the scheme?

It’s still very early days but one difficulty has been around the availability of social care support in the community.  There have been situations where people were medically ready to be discharged, and we had a home available for them, but the care support wasn’t in place, so the person was effectively classified as a delayed discharge.  It’s for this reason that the pilot is being evaluated by King’s College London, in order to inform further research into the delays in hospital discharge that are occurring nationally.

The launch of integrated care systems (ICSs) in 2018 was intended to deepen the relationship between NHS, local councils and other strategic partners.  How easy has it been for you to get housing’s voice heard in local health commissioning?

For a number of years it’s been quite difficult for us to get engagement with health partners; it’s taken a lot of tenacity, banging on doors and literally turning up to every event possible saying ‘Hi, we’re here’.  Ultimately, this project has come about through our shared passion for supporting people.  SPCT recognises that, as an organisation, ForHousing is really committed to ending homelessness; consequently, they see us as an equal partner.  We’re open to exploring opportunities and taking risks, and because SPCT can see our passion, they’ve been happy to bring us along on the journey.

What advice would you give to other Homes for Cathy members seeking to forge stronger partnerships with their local health agencies?

As an organisation, ForHousing is quite bold in the way we articulate our ambition around wellbeing; social housing is not just about bricks and mortar, it’s about improving people’s lives.  We’re not a housing association that gives people a set of keys and only contacts them when they need to pay their rent.  Because we articulate our vision and are prepared to take risks, other agencies such as health are willing to partner with us.  We’re also open to the fact that sometimes things won’t always work; the key is to learn and adapt from that.

Find out more about how the Discharge to Assess scheme has helped Tom here.


ForHousing is a progressive landlord that owns and manages more than 24,000 homes and delivers housing management services for other landlords across the North West.

Tackling migrant homelessness: A call for innovation and collaboration

Ahead of 2021 International Migrants Day on 18 December, Katie Fawcett and Paul Catterill, Network Development Coordinators at NACCOM, explain how the network supports housing associations to collaborate on innovative projects to prevent destitution among people seeking asylum in the UK

The potential for housing associations to play an important role in helping to end homelessness experienced by people under immigration control has always been an area of interest and exploration for NACCOM and our members.  In February 2020, before the world was gripped by the Covid-19 pandemic, we jointly hosted the Ending Migrant Homelessness conference in York with Crisis and Homes for Cathy.

Addressing Homes for Cathy’s eighth commitment

This provided a springboard for the development of a number of new relationships between housing associations and NACCOM members, working together through a joint desire to address homelessness in the asylum and immigration system and in many cases specifically to address the Homes for Cathy Commitment 8 “to contribute to ending migrant homelessness in areas where housing associations operate”.

Over the past year, data gathered through NACCOM’s annual members’ survey has revealed that 2,771 people were accommodated across the NACCOM network between April 2020 and June 2021. 1,503 (54%) of people were housed (NACCOM projects include housing, hosting and night shelters) across 363 properties, 37 (10%) of which were provided by 21 housing associations across England, Wales, Scotland and Northern Ireland, including seven from Homes for Cathy members.

Accommodation models vary

Accommodation models vary and include difficult to let properties (because of size and bedroom tax) being converted to HMOs and made available rent-free specifically for the housing of people with No Recourse to Public Funds (NRPF).  In addition, there are new supported housing initiatives where newly granted refugees at risk of homelessness are housed, with the income generated enabling beds to be made available to people seeking asylum with NRPF whilst they are supported to regularise their immigration status.

Covid-19 has obviously created challenges to the momentum of this work, however in 2021, several further opportunities presented themselves to continue our collective efforts of raising awareness around destitution and homelessness in the asylum system and exploring ways that housing associations can make a positive impact.

Firstly, Homes for Cathy joined Bradford-based NACCOM member Hope Housing in delivering a Homelessness Summit to discuss ‘what next after Everyone In ends’. This was followed by an Ending Destitution event in Calderdale, working with another NACCOM member St Augustine’s to promote and explore partnership approaches for developing NRPF accommodation in the borough.

NACCOM’s Network Development team also presented at the Homes for Cathy ‘Ending Migrant Homelessness’ forum in September, which brought together over 61 housing associations, charities and other agencies to hear about innovative ideas and responses to accommodation solutions for people with NRPF.

Our collective work will continue in 2022 and will be an important consideration when NACCOM launches its new strategy in spring next year. Further challenges presented by the Nationality and Borders Bill and ongoing Covid-19 crisis will undoubtedly require innovative and collaborative responses from the sector to end homelessness for people in the asylum and immigration system, and we look forward to being part of the response.


NACCOM – the No Accommodation Network – is a charity committed to bringing an end to destitution amongst people seeking asylum, refugees and migrants with no recourse to public funds living in the UK, through promoting best practice and supporting the establishment of accommodation projects.  For more information, email office@naccom.org.uk.

We’re often told by housing associations that they deliver what we do already. Here’s why they don’t and how we bring value to their offer

Rebecca White, CEO and founder of Your Own Place, explains how partnering with an external tenancy training provider can amplify a housing association’s existing support offer to prevent homelessness

Your Own Place turned eight in October.  Both a huge milestone and a source of great pride.  What is often unseen beneath the veneer of glossy social media, is the knock backs, the failures, the disappointments and frustrations – especially when I’m told ‘we do that already’. 

We have grown modestly, safely and sustainably, partly out of choice and partly because what we do is hard, different, bespoke, time-consuming and we’ve an unwavering commitment to doing it right and very well.  Continuing in this modest vein is almost comfortable right up until the point when I ponder the phenomenal difference we make beyond our great outcomes and numbers.  More people deserve to benefit from it!

Like many, Covid19 threw a curveball opportunity that has neither fundamentally changed us nor endangered us.  This is because our mission and vision were always clear – to prevent homelessness. The team is as strong as they have ever been, their ideas are getting away from me (in a good way) and our digital transformation (and I mean every letter of that second word) was all their work.

Amplifying existing housing association support

Our current brilliant housing association customers recognise the strength of their own offer alongside how it can be boosted by partnering with us. When we start a partnership we equip housing teams with the knowledge about our service and how it’s different – and also complementary.  Together we are able to further develop the skills, knowledge and confidence of your tenants alongside your offer.  With our delivery of tenancy sustainment workshops (TILS+ and DigiTILS+) we provide the space for tenants to reflect on what they have heard from their housing support officer or income officer.  Together, trainees in a group find their voice with us as an independent organisation.  They find themselves able to share their knowledge of the support they have received as well as their new skills. In so doing, the support your teams are providing already is amplified. Hearing from peer tenants about what support they have accessed and found useful as well as hearing the same content from a different voice in a different way boosts what you are doing already. This reinforces the messages that housing associations are already investing so much in.

Whether it’s income teams, benefits or money advice or even getting to the point of eviction, the support we see many housing associations offer often faces huge challenges of reaching people in difficult situations and often already in crisis. Ours is a prevention offer that can both prevent a crisis happening (freeing up your team’s time) or build the skills of the tenant to resolve the situation themselves (building resilience for the future and also freeing up staff time). These are not simply life skills, but skills for life.  They equip people to go further than simply resolving their money worries or tenancy responsibilities, but to consider enrolling at college, finding work, or simply leaving their room for the first time.

Partnership approach

We’re often told by housing associations that they deliver what we do already.  What we see are housing associations doing phenomenal work around advice and sustainment work that can be enhanced by a partnership. Here’s the value we can bring to that work:

FREEING UP YOUR STAFF TIME

  • Through facilitation rather than advice or 1-2-1 crisis support, we ensure the trainee residents not only gain the new knowledge, skills and confidence to sustain their tenancy, but develop the longer term skills of realising they have the skills needed to get help and find their own solutions.  All this means there is less pressure on your teams as trainees become more inter-dependent and resilient.

REINFORCING YOUR MESSAGES

  • Like many housing associations, you’re as committed to tenancy support as we are.  We also know that our delivery style will be different to yours.  To take information on board and change behaviour the human brain has to hear things multiple times in multiple ways – by attending our workshops we reinforce your messages.

GROUP WORK & PEER LEARNING

  • We know how hard it can be to get groups of residents together and yet we know how powerful the peer group can be.  As experts in their own lives, our group workshops offer the space to reflect on the support they may have had from you already, support each other and gain the confidence to act on your advice. This is our area of expertise and strengthened by being an independent organisation. It builds connections and inter-dependence and the confidence to engage with other group interventions (college or training courses and volunteering etc).

INDEPENDENCE

  • Our independence as an external organisation is a huge strength and enables us to hear the voice of the resident that is sometimes silent.  We can work with them and with you during our interventions to understand how they receive your service and include this in our impact reports for you.

Your Own Place exists to prevent homelessness by ensuring people have the skills to sustain a tenancy. For more information about the services it provides, contact rebecca@yourownplace.org.uk

Supporting Survivors: How tackling domestic abuse helps us deliver on the Homes for Cathy Commitments

By Iain Turner, Corporate Compliance Manager at Wandle

Wandle is a founding member of Homes for Cathy and, like many other members, was set-up in the 1960’s in response to concerns about rising levels of homelessness. Our founding members wanted to provide homes for families in desperate need of the stability and security a good home brings. Over 50 years on, that aim hasn’t changed, and we are still working to try and end homelessness, by providing safe and affordable homes in South London.

Few people will value a safe and secure home more than a survivor of domestic abuse. Under our long-term strategic plan, we began a project in 2019 to overhaul our approach to domestic abuse. Our aim is to achieve accreditation from the Domestic Abuse Housing Alliance (DAHA) – an organisation which is driving a step change in tackling domestic abuse across the social housing sector.

Two women a week are killed by a current or former partner in England and Wales. It’s an issue that can impact anyone, from any walk of life – regardless of gender, sexuality, class or race. Ian Wright’s recent documentary about growing up with an abusive father shone a light on the long-term impact it can have on children and grown men too.  According to research by homelessness charity St Mungo’s, 32 per cent of homeless women said domestic abuse contributed to their homelessness.

My experience leading our project

Our domestic abuse project is sponsored by our Chief Executive, Tracey Lees, who has been passionately talking about the subject for as long as I’ve been at Wandle. When Tracey asked me to be the project lead I was surprised. I was Wandle’s Policy Officer at the time, working in the Governance Team. I have no hands-on housing management experience, no lived experience of domestic abuse, and had very little knowledge or expertise on the subject.

Fast forward almost three years I’m a trained domestic abuse champion, I’ve attended countless webinars and learned more than I could have imagined about the impact of abuse and how housing providers can support survivors. It’s been emotionally draining at times, but I’ve learned to openly talk about the subject, regardless of whether it might make some people feel uncomfortable (while being mindful of the impact this can have on those who have witnessed or lived through abuse). It’s an uncomfortable topic but that doesn’t mean we shouldn’t talk about it.

Supporting our staff

One of the key changes we have made at Wandle is to acknowledge that anyone can be a victim or perpetrator of abuse. It’s not something that affects just our residents – it’s something many of our colleagues will live with too. Many providers may think just about their residents when addressing domestic abuse – and that’s the approach we initially were taking – but this changed when we made contact with Hestia and went through their ‘Everyone’s Business’ programme. Hestia worked with us to develop an employee focus policy, raise awareness and train managers and a group of champions in how to support colleagues who may be enduring abuse or supporting someone who is. This work has obviously helped inform our approach for residents too but having a separate policy has really helped us make clear to staff that support is there if they need it.

Meeting our commitments

So, how does our focus on supporting survivors of domestic abuse link to our work as Homes for Cathy members? We have signed up to the nine commitments, one of which is meeting the needs of vulnerable tenant groups. Given that potentially one in three of our female tenants will endure domestic abuse in their lifetime, we know that tackling domestic abuse certainly helps us towards meeting that commitment. There are numerous ways we can do this, whether it’s transferring someone to a property away from their abuser or putting extra security in place to keep someone safe in their home. Even just signposting to other support services can be a vital first step.

There is still work to do, but we’ve definitely started seeing the benefits of our new approach. We have unfortunately seen a rise in cases since the pandemic hit, but we’ve also provided more support to survivors than ever. We have numerous examples of our Housing Team going out of their way to support survivors, even arranging removals in the dead of night so that a young parent could move without her abuser knowing. We are offering smart doorbells to survivors so they can see who’s at their door and we have a new online web app, developed by Hestia and the Post Office. This signposts to local and national resources, while leaving no internet history, which might otherwise be found by abusers.

Most importantly our automatic response is to believe anyone who tells us they are enduring abuse and will investigate any reports of potential concerns. There’s no doubt that tackling domestic abuse can help Homes for Cathy members meet their commitments, sustain tenancies, and most importantly save lives.

Iain Turner, Corporate Compliance Manager, Wandle


Wandle is a founding member of the Homes for Cathy group. Founded in 1967 as the Merton Family Housing Trust, it has since grown into an organisation with over 7,000 homes across nine south London boroughs.

A psychologically informed approach to supporting young people out of homelessness

Trauma informed care and a psychologically informed environment can support young people at risk of homelessness on their journey towards independence, writes Spiros Georgiou, Supported Housing Operations Manager at Homes for Cathy member Hightown Housing Association.

During the past year the homelessness crisis has seen new challenges. Covid-19 has exacerbated some of the disadvantages faced by people, with family tensions, loss of jobs and income and mental ill health being key drivers for homelessness.  Evidence shows that experience of trauma can lead to homelessness and losing your home and becoming homeless can be very traumatic. 

There is also evidence of the strong link between homelessness and adverse childhood experiences, such as abuse, neglect and domestic violence.  People who have experienced trauma can be left feeling helpless and terrified.  They often feel a lack of control and a sense of unpredictability, a loss of safety and, in the worst case scenarios, a fear of serious harm or death.  Trauma is defined by the experience of the individual and not the event, so not everyone who experiences trauma will develop chronic symptoms – it depends on their resilience.  What we do know is that early childhood has more of an effect than experiencing trauma as an adult.

Preparing young people for an independent, self-sufficient life

At Hightown, we identified the need for us to take a more trauma informed approach in our young people’s care and supported housing service. The service provides semi-independent living for young people aged 16-24 who may have left care or become estranged from family and are at a high risk of homelessness.  Our goal with the service is to prepare our young people for an independent, self-sufficient life.  We believed that by implementing a psychologically informed environment (PIE) – that was sensitive to their emotional needs – we could overcome some of the barriers that were impeding their journey to independence. 

It was the start of a significant learning curve for the team, requiring us to consider the thinking, emotions, personalities and past experiences of service users and adapt the design and delivery of the service to meet their needs.  Importantly, it also helped us gain a deeper insight into our own personal attitudes and beliefs and reaffirmed our faith in our service users’ ability to change.

In practice, adopting a PIE approach meant support workers building a therapeutic relationship with service users, which involved being non-judgmental, validating individuals’ emotions and feelings and helping them create a safe environment.  It also meant taking the time to understand the past traumas our service users may have experienced and understanding how this may affect their boundaries, their relationships with others and their sense of safety.

Direct impact on evictions and abandonments

Being trauma informed has had a direct impact on the warnings we give out and ultimately on evictions and abandonments, as we are able to find alternative ways to promote a change in behaviour that might otherwise put a tenancy at risk.  In our young people’s housing, we meet weekly as a team to discuss creative and flexible ways to find what works for the individual when it comes to escalating needs and risks.  For example, when an incident occurs, staff deal with the immediate event, before allowing time for individuals to reflect on the incident and come up with personalised and co-produced response.  This may mean that instead of issuing a generic warning – which can be overused or even misused – we provide a support intervention to address the issues at play. 

Most recently, we had a service user who repeatedly refused us access to their property for maintenance works.  They would either become extremely distressed and angry when the staff visited or would prepare for the visit, then self-harm and refuse access.  Instead of issuing a warning, we worked with them as a team to understand and validate the way they were feeling, so that we could build trust and help them feel safe.  We began to look at why they had become homeless in the first place and learned that they had witnessed domestic violence in the home as a child, for which they had never received appropriate support.  We quickly understood that they were becoming overwhelmed with emotion and fear during each visit, triggering a fight or flight response, and their coping strategy was either to become angry or self-harm.  Instead of asserting our authority, we personalised our response, empowering them to access therapy and coaching for their anger, as well as facilitating regular visits from the community mental health team.  We also introduced them to one of our maintenance workers and supported them to build a trusting and professional relationship with that person, so the works could take place.

We have also recently launched a new way of dealing with substance misuse, in response to an ongoing issue around the use of cannabis amongst young people in the scheme.  In the past, this was dealt with by the traditional warnings system.  However, we found that the young people were soon exhausting the warning system and were therefore at risk of eviction and sometimes even evicted as a result, which is something we wanted to avoid.

Traffic light warnings for substance misuse

We know that using illegal substances can be a coping mechanism to deal with stress or emotionally distressing thoughts and/or childhood adversity and unresolved complex trauma. However, we also know that the use of illegal drugs in our services can be problematic, as we have a duty of care to all service users and staff.  Instead, we created a traffic light system for substance misuse, the idea being that before we issue a formal warning that indicates the tenancy is at risk (and could ultimately lead to an eviction), we put in place a tiered support intervention first.

The traffic light system has various support actions and interventions to explore at each stage, for example understanding the young person’s substance misuse habits and patterns through workbooks and surveys, organising support meetings with any professionals involved, referring the young person to drug and alcohol agencies in the community, engaging the young person in meaningful activity, goal setting and support to reach aspirations, facilitating contact with community mental health team, counselling and much more.  Since launching the traffic light system, we have only had one young person reach the amber card stage and no young people reach the red card stage, and there has been a dramatic decrease in substance misuse related incidents.  In addition to this, our young people have engaged really well with the support interventions and benefited from the change in approach.

A PIE approach is not only about being sensitive to the emotional needs of service users; working in homelessness services can sometimes result in staff experiencing secondary trauma, where they are themselves affected by what they see and hear from service users.  Ultimately this can lead to burnout and staff feeling hopeless, depressed, stressed, uncreative and frustrated in their roles.  We therefore actively invite staff members to ask for help if they need it and build in time to reflect as a team, as well as encouraging everyone to do things they enjoy, so that their own basic needs are met too.

Implementing a trauma informed approach and a psychologically informed environment takes time – it’s not something that can be introduced overnight.  However, it’s only a framework – there are no policies or prescriptive set of rules to adhere to.  Essentially, it’s about being person-centred.  At Hightown, we have found that improving our own reflection as a staff team and building our relationship with service users have been positive steps in the right direction.

Spiros Georgiou, Supported Housing Operations Manager, Hightown Housing Association

Interested in finding out how other Homes for Cathy members are implementing a psychologically informed approach in homelessness services and housing? Register for our free online workshop on 26 May.