#EXboard | Homelessness and Rough Sleeping in Exeter – Update Report

EXETER BOARD
28 April 2015

Homelessness and Rough Sleeping in Exeter – Update Report

Introduction
This report is to provide an update as to the current position of single homelessness and rough sleeping in Exeter. It will highlight the current levels of rough sleeping and demand as well as changes which have been put into place to reduce the number and impact of rough sleeping since the previous Exeter Board meeting in February 2015.

Current Figures
The last official street count was in November 2014 when 34 rough sleepers were identified. This figure was reported to the Department of Communities and Local Government for the annual return. Current figures suggest that there has been a slight reduction in the number of people sleeping rough in Exeter with the Street Homeless Outreach Team (SHOT) reporting an average between 25 and 30 during the first week of April.

More than just a housing issue
Exeter City Council recognises that it cannot work alone in resolving the issue of rough sleeping. The intention is to build a multi agency approach to homelessness with key partners. This has progressed significantly over the last 3 months with the issue being raised strategically in wider arenas:

– Community Safety Partnership
The Community Safety Partnership is currently in the process of revising its strategy and action plan, with a focus on achieving a greater partnership approach. There is a proactive approach emerging with joint work between Exeter City Council, SHOT and the Police. This has included serving Anti Social Behaviour Contracts (ABCs) to prohibit residents with accommodation from sleeping rough, and in serious cases individuals are being considered for criminal behaviour orders and community protection notices. Evidence is also currently being looked at to consider whether there is a need to implement a public spaces protection order. The public spaces protection order can cover issues such as street drinking, defecation and urination, encampments and the taking of new psychoactive substances (NPS). Whilst some of the partnership work will involve dealing with some individuals who are rough sleepers, not all rough sleepers cause Anti Social Behaviour and many can become victims of crime. The aim of the approach is to improve the perception and reality of safety in the city.

Integrated Care Exeter (ICE) – The health needs of the homeless community have been highlighted through the development of the ICE project.
o A review of client health needs at Gabriel House highlighted that 17 residents had significant health needs, 9 of which had multiple health needs. Their needs required a high level of emergency health responses with one hostel having 11 hospital visits in January 2015, with 10 of those being via ambulance.
o Reviews at the St Petrock’s day centre highlighted 37 out of 49 service users 49 services users surveyed had mental health disorders, but only 5 clients were actively engaged in health services. Other health issues included high levels of blood borne viruses and 2 were malnourished.

Potential service redesign has been put forward including integrated health care options with SHOT, health clinics at Gabriel and St Petrock’s to address health inequalities and increase engagement opportunities and a multi agency approach to homeless hospital discharge cases.

Making Every Adult Matter (MEAM) – Exeter was successful alongside East Devon, Mid Devon, Teignbridge and Torbay in gaining Help for Single Homeless Funding from the DCLG.
o Around £80,000 of this has been directed toward implementing a MEAM approach to clients with the most complex needs. Many of these are homeless clients. Torbay Council are pursuing a slightly separate approach which will be used to contrast outcomes.
o The MEAM project has an Executive Steering Board and an Operational Group to promote change at both strategic and case management level. The process will be supported by a co-ordinator who will not only inform the Executive Steering Group of progress and support the work of the front line practitioners they will also lead on maximising the potential future workforce for this area with the inclusion of volunteers and peer mentors. This post is currently out to advert and will be hosted by CVS at the new Engagement Hub at Wat Tyler House.
o An initial cohort of 6 cases has been identified for the first steps with an active caseload of 15 to be achieved within the next 3 months.
o Front line workers are receiving in depth Appreciative Enquiry training to assist in unlocking barriers to engagement. The training is being delivered by Steve Beety (Devon and Cornwall Police) who was heavily involved in changing working approaches within the local Targeted Families programme. The rationale being that the approach needed with complex individuals is similar and that there was a wealth of knowledge gained from this programme.

Current Practice Improvements
Over the last 3 months there have been operational improvements in managing homelessness and rough sleeping in Exeter:
 Aligning of SHOT and Sanctuary Supported Living Support hours – 2 workers from the DCC funded Sanctuary Supported Living contract have been working alongside the Outreach Team to provide support interventions with rough sleepers. This has assisted in increasing capacity within the team and bringing together the work of engagement and support. This new approach has seen 10 rough sleepers received more intensive interventions and improved engagement to move into accommodation.
 Immediate accommodation options for rough sleepers – Whilst limited in number there is emergency accommodation provision in the G8 room of Gabriel House. From April 2015 SHOT have been in control of the access arrangements for this project. The accommodation is funded through Housing Benefit and a small contribution from Exeter City Council. The ability to access the project immediately is also being linked to a move towards the inclusion of evening outreach work. This will enable the team to offer accommodation to some rough sleepers on the spot. This will be especially useful for those new to rough sleeping to provide an intervention before they enter into the rough sleeping community. Unfortunately this resource is not sufficient for all of those sleeping rough and only those with low support needs would be suitable for the communal nature of the project.
 Joint work with the Police to reduce impact of NPS – Whilst not solely a problem for the homeless population, the use of NPS or substances often referred to as ‘legal highs’ has had a significant impact on the sustainability of accommodation and engagement in support across homelessness services. Exeter City Council has worked in partnership with the Police to combat the sale of NPS and has seen 2 shops closed and other businesses voluntarily cease trading in the substances. There are close workings in sharing intelligence and specialist training is being delivered this month for front line workers to raise awareness and understanding of the impacts as well as introducing harm reduction processes.

Next Steps
The circumstances around this agenda change regularly. The issue of clients with Complex Needs is being picked up nationally with a new government consultation being released. The following projects give an overview of further development in this area expected in the next 6 months.
 Redesign of SHOT – The contract with SHOT has come to an end and a transitional arrangement has been put in place pending a new tender. A new service design is being drawn up with intention to discuss with wider statutory partners before moving to commissioning to align services where possible.
 Eastern Hub – As the data from the first year of Devon County Council’s commissioned homeless prevention services has been completed a review of arrangements at the Eastern Hub meeting is due. This will enable the partnership to look at any gaps in current services to determine a way forward. Whilst there is no additional finance available the contracting circumstances are sufficient to allow delivery arrangements to be flexible to meet local needs. This gives an opportunity to change some of the accommodation options to which support is connected and therefore present a greater choice in the options to meet complex needs.
 Exeter Engagement Hub – Exeter CVS led a successful partnership bid for the department of Health / Public Health England capital funds. They were awarded in excess of £400k to develop a health and wellbeing hub at Wat Tyler House. The project will see the Clock Tower GP Surgery; parts of probation services and a collection of voluntary agencies come together in one building to allow for a more holistic approach to vulnerable individuals to be formed. It is envisaged that SHOT will have a clear presence at the Hub. Exeter City Council is currently looking at how services delivered to the homeless and those in financial need can be aligned to the project.
 Homelessness Strategy – Over the summer of 2015 Exeter City Council will be developing its strategy for tackling homelessness. This will bring together relevant stakeholders to set out a combined vision for the future.

Nicola Forsdyke, Housing Needs Manager
Exeter City Council

Minutes
The County Council’s Senior Commissioning Officer presented the report detailing the work of Devon’s Social Care services in protecting vulnerable people, supporting independent living and providing improved life outcomes for children and young people. He highlighted the work undertaken to ensure children with housing problems are kept safe and work to help adults with housing problems to independence. A joint protocol had been agreed to deliver some shared services for specifically preventing homelessness in 16/17 year olds. His report also detailed the delivery through the commissioned services. The different roles of social workers and Care Direct was explained and he advised that there had been a move away from gender specific accommodation.

The City Council’s Housing Options Manager reported that the health needs of the homeless community had been highlighted through the development of the ICE project and a potential service redesign was being put forward including integrated health care options with SHOT, health clinics at Gabriel and St Petrock’s to address health inequalities and increase engagement opportunities and a multi agency approach to homeless hospital discharge cases.  Help for single Homeless Funding had been obtained from the DCLG for Making Every Adult Matter (MEAM) with around £80,000 of this directed toward implementing a MEAM approach to clients with the most complex needs, many of whom were homeless clients. Further, front line workers were receiving in depth Appreciative Enquiry training to assist in unlocking barriers to engagement.

Rough sleeping had been a problem for many years with no easy solution to this complex and challenging problem. Rough sleepers gravitated to Exeter where there were greater support opportunities for their lifestyle including health and accommodation resources. The majority of rough sleepers accepted as in ‘priority need’ had alcohol and substance misuse issues with some with mental health problems, and it was often difficult to provide the right type of community based treatment options for people that could or would not use the normal referral pathways or client engagement approaches.

Good progress was being made with support workers becoming increasingly skilled at engaging clients who tended to keep themselves to themselves and contract holders had developed their understanding of higher needs homeless people and adapted their services to meet specific needs. The eviction rate from hostels/supported accommodation had substantially reduced and was now only used in exceptional circumstances with more people choosing to complete recovery programmes at hostel/supported accommodation services as services were re-designing their provision around the needs of the residents.

Devon County Council’s Social Care Commissioning Team was one of the partners currently supporting Devon Partnership Trust (DPT) plans for the re-commissioning of a Devon Dual Diagnosis service, the aim being to offer accommodation to people that have problems with both mental health and substance use. It provided a practical forum for Health, Housing and Social Care commissioners to work more closely together on the delivery of better services for people with complex needs who were typically at greatest risk of rough sleeping.

Members thanked the officers for the comprehensive reports which helped explain in detail the work being undertaken in this area. They acknowledged that there had been significant improvement in joint working between the City and County Council and important progress made in the joined up approach between authorities and agencies.

RESOLVED that future reports on this issue be made to the Exeter Health and Wellbeing Board.

Devon County Council contribution to homelessness prevention 

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