Tag Archives: rough sleeping

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

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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.

Everyone Out?

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by Charlotte Murray, Director of Care, Health & Wellbeing, South Yorkshire Housing Association

The Government’s response to homelessness—particularly rough sleeping—when the first Covid-19 lockdown was announced was pretty amazing.  For the first time, the Government showed leadership in supporting homeless people and there was unity amongst people affected by homelessness, homelessness groups, local authorities, and housing associations.

In one weekend in March, all rough sleepers were offered housing.  No-one stopped to check immigration status, income levels or intentionality: everyone was offered a roof over their head.  Hotels, student halls of residence, and other shared accommodation were made available.  Some of it wasn’t ideal, but it was much better than the prospect of sleeping out, exposed to the pandemic.

Determination and sense of a common goal was maintained

In the months that followed, that determination and sense of a common goal was maintained.  It took many forms.  For example, civil servants began to shape programmes and new funding streams for permanent accommodation for homeless people, councils prioritised homelessness projects for nominations, and housing associations bent over backwards to provide a higher proportion of self-contained accommodation for these groups. 

It was Mahatma Gandhi who said: “A nation’s greatness is measured by how it treats its most vulnerable members.”  The test, though, isn’t what can be achieved in a crisis. It’s whether we can sustain our determination to end homelessness once and for all.

Short-term or one-off initiatives won’t cut it

This was the objective of Crisis’s brilliant report, Everybody In (2018).  The detail of its 250 pages means we need never ask ourselves again how we can end homelessness.  The report pulled together in one place best practice from around the world; we now know how to do it.  The report makes it clear that short-term or one-off initiatives won’t cut it.  There are many different causes of homelessness: poverty, mental illness, the lack of social housing and a dysfunctional housing market.  Initiatives have failed in the past because they adopt the ‘whack-a-mole’ approach, addressing an issue in one area for it to pop out somewhere else. 

Reports and announcements in recent weeks demonstrate that we’re relapsing back to a disjointed approach.  These include:

  • the debate regarding the possible termination of the additional Universal Credit payments of £20 per week
  • research by the New Economics Foundation warning that one third of the population will be living below the minimum socially acceptable standard of living by next Spring
  • the significant weakening of the eviction ban.
Crisis’ ‘Everybody In’ report pulls together best practice on homelessness

It’s not all bad news though.  There’s a clear Government commitment to provide access for rough sleepers to the vaccination programme.  The Joint Committee on Vaccination and Immunisation has asked local authorities to ensure that homeless people can be protected from the virus and that they’re registered with GPs.  Local authorities have been asked to reach out once again to people who have previously refused their support.

One in four lettings by social landlords made to statutorily homeless

Similarly, recent HouseMark data shows over a quarter of social housing landlords are prioritising lettings to homeless people.  As a result, one in four lettings were made to households identified as statutorily homeless—equivalent to 9,000 households across the UK. The Next Steps Accommodation programme is increasing the number of homes and the support available to homeless people (for a maximum of two years, rather than a home for life but progress never the less).

SYHA's Cuthbert Bank supported accommodation houses homeless families in their own homes
SYHA’s Cuthbert Bank supported accommodation houses homeless families in their own homes

At SYHA, we’re keeping our voids work and lettings open to ensure we can house the most in need. We’re strictly following our ‘no evictions into street homelessness’ policy and working closely with local authorities to increase support and accommodation.

It sometimes feels like we’re standing on a street corner with a megaphone shouting, “Is anybody there?”  The leadership has gone.  SYHA and the other associations in the Homes for Cathy Group will continue to work in line with our values and commitments and challenge ourselves to do more, but we do need leadership, urgency—and, importantly, a long-term, joined up strategy.  The new Housing Minister, Eddie Hughes, reportedly brings with him a background in and “passion for” housing.  Great. Right now, we need someone with the vision and steady determination to continue the momentum built up in 2020. We are ready and waiting.

South Yorkshire Housing Association is a founding member of the Homes for Cathy group and offers safe and secure spaces for homeless people and families to live in.

World Homeless Day 2020

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World Homeless Day is a chance for our community and members to highlight the needs of homeless people.

We’ve partnered with South Yorkshire HA, Shared Health, One Housing, BCHA and Hightown HA across here and our social media channels today to help educate and celebrate the work being done by some of our members and partners.

South Yorkshire Housing Association

Mazrab came from Afghanistan in 2011 with his family as refugees. SYHA and his support worker Kay have helped the family settle in South Yorkshire.

Vic Stirling, Head of services for homeless services, answers some questions about the misconceptions around homelessness and where she would like extra funding to be spent.

Shared Health

Shared Health Foundation is an initiative of the Oglesby Charitable Trust,
which is seeking to tackle health inequalities across Greater Manchester. They shared the following from their call to action report.

The poorer the area, the greater the need and the lack quality healthcare available. Our families sometimes get placed in emergency accommodation that is out of borough and miles away from their families, communities, schools and GPs. They then can’t access the same resources as everyone else easily. 

The children in these families also don’t get the same rights as Looked After Children so don’t get any official extra help or support from schools. The help they do get is professionals going above and beyond.

Their situation from fleeing domestic violence affects their health and can set them back years as the ‘temporary accommodation’ can last up to 2 years.

Read more :
A Call to Action:
To safeguard homeless families during the Covid-19 pandemic
and in its aftermath

One Housing

Ahmed a customer at One Housing, tells us where he would like more government funding spent.

BCHA

BCHA want to say a big THANK YOU to all their staff and volunteers that have gone above and beyond this year to help those that are homeless, particularly when lockdown happened. Below is some of the help they offered to take on.

A senior practitioner from BCHA Bournemouth and Christchurch domestic abuse service has also shared how their residents battle isolation everyday but this year has been particularly testing.

Read more here.

Hightown Housing Association

It’s nearly been a year since Hightown began its Housing First project, Malcolm and Liana tell us how they have been helped by the service.

Read more about Hightown’s Housing First journey here.

COVID-19: Homelessness, Rough Sleeping, the PRS

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Submission from ‘Homes for Cathy Group’ to HCLG Select Committee inquiry

How effective has the support provided by MHCLG and other Government departments in addressing the impact of COVID-19 on those in the private rented sector, rough sleepers, and the homeless?

The Homes for Cathy group is made up of over 100 housing associations and housing charities/organisations who are committed to providing housing and support to homeless people and households and have developed nine Homes for Cathy commitments with the homeless charity, Crisis, which underpin our work.

This submission only relates to rough sleepers and homeless people.

The ‘Everyone In’ initiative has been a huge success in getting rough sleepers off the streets and in to temporary housing and the Government and the MHCLG must be congratulated.

Of course, it has required a massive effort from our members, from local government and from many other housing and support organisations to find accommodation and immediate support for the approximately 5,400 rough sleepers that were housed.

We now need to plan for how those 5,400 people will be permanently housed and supported and the key to this is capital funding to provide affordable housing and revenue funding to provide support.

What problems remain a current and immediate concern for these groups?

Clearly, the primary concern is for the long term future for those rough sleepers recently housed in temporary accommodation. We do not know when they will be asked to leave their current accommodation. There is no fixed ‘end date’ for lockdown. But individual hotels where many of the rough sleepers are housed will eventually want the rooms back.

Another concern, however, is the breakdown of many of the placements that were made. The Guardian has reported that 20% of those rehoused in Manchester are homeless once again, and our members are reporting similar figures in other parts of the country. South Yorkshire Housing Association in Sheffield found that many people rehoused have been targeted and “cuckooed” – typically by drug dealers and criminal groups. Providing the accommodation on its own is not sufficient. Many people need very intensive housing support, such as that provided by Housing First and similar schemes, and the consistent support of other public services such as mental health and drug and alcohol services.

Of course, the need to try to maintain ‘social distancing’ while providing support for the people in the temporary accommodation is a major challenge. Some clients are unwilling to fully cooperate putting staff and other clients at risk.

What might be the immediate post-lockdown impacts for these groups, and what action is needed to help with these?

Immediate action is needed to provide Government funding for the long term housing and support for the 5,400 rough sleepers people housed in temporary accommodation. Otherwise we will be back to square one and the Government’s targets on rough sleeping will not be met.

There is unlikely to be time to build new social/affordable homes from scratch so housing associations need capital funds from Government to:

  • Convert unsold shared ownership homes owned by housing associations to social/affordable rent
  • Convert shared ownership homes under construction and about to be handed over to housing associations to social/affordable rent
  • Convert unsold market sale properties owned by housing associations to social/affordable rent
  • Purchase properties on the open market including new, unsold homes from national and local housebuilders

The primary need will be for one bedroom self-contained flats. Ideally the funding will be sufficient for housing associations to charge social rents which will then reduce the housing benefit bill. The Homes for Cathy group is currently working to provide estimated costings for such a programme.

Homes for Cathy members already provide homelessness support services including Housing First.

It is essential that the housing provided to rough sleepers leaving the temporary accommodation comes with appropriate support services. Many of the rough sleepers have high support needs

Crisis estimate the cost of support for the estimated 5400 rough sleepers will be around £63,000,000 for 12 months and the Homes for Cathy group concurs with this estimate. Crisis estimate that 50% of the rough sleepers will require Housing First support, 30% will require Critical Time Intervention support and 20% will require floating support.

An early commitment from the Government to fund the supply of new social homes to house the 5,400 rough sleepers in temporary accommodation will allow housing associations to immediately gear up to convert tenures or purchase homes and be ready when the lock down ends.

Croydon Council and Crystal Palace FC team up to help rough sleepers

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Rough sleepers in Croydon can now get emergency shelter at a Premier League football stadium in extreme weather conditions under a deal between the council and Crystal Palace FC.

The football club and Croydon Council have entered into an agreement where a lounge at Selhurst Park is turned into a temporary overnight shelter for up 10 rough sleepers whenever night time temperatures are forecast to drop below freezing.

Under the deal, people formally identified as rough sleeping are referred by outreach staff to Selhurst Park, where they are welcomed with a camp bed for the night, a hot evening meal, breakfast and washing facilities.

The space is converted back for normal club use each morning, when specialists from the council’s Gateway homelessness prevention service and Thames Reach support workers offer longer-term accommodation, financial advice and help with any medical needs to prevent these rough sleepers from returning to the streets.

The arrangement with Crystal Palace takes effect whenever London temperatures are forecast to hit zero degrees or colder, which triggers the council’s severe weather emergency protocol. This emergency shelter is in addition to rough sleeper referrals who go to the Croydon Churches’ Floating Shelter throughout the winter.

When Selhurst Park is unavailable because of home matches, the council will continue to refer rough sleepers to other emergency shelters in Croydon and central London.

Councillor Alison Butler, deputy leader and cabinet member for homes and Gateway services, said: “Freezing temperatures are a particular safety risk for rough sleepers and this is a wonderful gesture by Crystal Palace for helping us reduce that risk. I do hope that the actions and support of our local Premier League football club will encourage more businesses in Croydon to get in touch and do what they can to help us address homelessness.  Crystal Palace are setting a standard for other clubs to follow.”

Crystal Palace Football Club chief executive Phil Alexander said: “We are delighted to be collaborating with Croydon Council and their partner agencies to ensure that rough sleepers can find an emergency shelter in the event of severe winter weather. The club wants to be a force for good in the community and we are happy to do our bit to help those most in need. A huge thank you to all the volunteers who have given their time freely to make this happen, including club staff, as well as to Sainsbury’s Crystal Palace for donating food.”

Crystal Palace Football Club has a strong relationship with the charity Crisis. First-team stars Mamadou Sakho and Christian Benteke visited the Crisis Skylight Centre for homeless people in Croydon last month.