Creating change in service delivery

If agencies have these building blocks in place, they are in a great position to look at new and innovative ways of working. As well as organisational change, we need to change the way we deliver services to homeless people. Some of the best and most innovative practice in the sector can only be delivered by different agencies working in partnership.

The DCLG along with homelessness agencies have developed a framework to consider the housing and non-housing needs of homeless people in eight key action areas:

1. Accommodation

2. Education, skills and employment

3. Mental and physical health

4. Drugs and alcohol

5. Finance, benefits and debt

6. Children, families and relationships

7. Attitudes, thinking and behaviour

8. Safer and stronger communities

This approach recognises that homeless people are not a single homogenous group, and that each individual is different, with different needs – and talents. At one end of the spectrum, some people need a limited intervention, perhaps only the space and the opportunity to find their own solutions to their homelessness. At the other end, people can have a range of complex and inter-related needs which can best be addressed through government departments, local authorities and local service providers working together more effectively. Agencies could use this framework to think the services they and others provide , identifying blocks and gaps. Here are some examples from our members that are very effective:

Accommodation

• Look at the design of the space in which staff and clients interact – this has an enormous impact on relationships – a great example is the open reception in Snow Hill hostel in Birmingham run by Focus Futures

• Think about the quality of the accommodation itself. What does this say about how residents are valued?
• Does the accommodation provide for couples – or exclude them/split them up?
• Do communal areas facilitate meaningful occupation (see below) – or foster boredom and despair?
• Delivering services in partnership with others under one roof can make services more accessible to clients – as can delivering outreach services to places clients go
• If the building is not in use 24 hours a day, could it be rented out to other local groups for both income and partnership building?

Education, skills and employment

• Literacy and numeracy taught through meaningful occupation rather than as a basic skills course has proven more successful with certain client groups with high needs
• Retraining and refresher courses - a lot of homeless people have acquired skills and learning before becoming homeless
• Oral communication skills courses
• Basic car repair, construction and building skills workshops such as those run by Shekinah Mission
• Carpentry courses and plumbing courses like the Kipper Project
• Self-build schemes such as that run by Tyneside Cyrenians
• Training on peer research
• Access to volunteering opportunities
• Developing financially sound social enterprises such as:
• White goods renovation and resale such as that run by Noah Enterprise in Luton
• Furniture recycling such as Emmaus Bristol
• Cafes and catering services such as the Arlington Café chain run by Novas
• Manufacture of specialist products, such as presentation boxes and fireplaces
• Maintenance contracts with local authorities and schools for upkeep of green space as at the Booth Centre
• Shoe shining (see Streetshine)
• Crewing services for large events such as The Connection Crew run by Connection@St Martins
• Market gardening/organic farming

Mental and physical health

• Having mechanisms in place to enable service users to register with a GP. Shekinah Mission in Plymouth have some health services delivered on-site
• Gardening projects on site can prove a useful way of getting and keeping fit, such as the allotments at Bevin Court in Sheffield, run by St Anne’s
• Create good links with local statutory health and homelessness authorities to prevent homelessness as a result of hospital discharge
• Better services for homeless people when attending A&E – see Thames Reach Bondway
• Therapeutic communities have proven successful for some service users. The Richmond Fellowship have a good track record of developing these kinds of services. Some organisations provide mental health community houses, such as London Cyrenians
• Homeless people can be engaged in monitoring local health services - see the report on the pilot of Health Link/Groundswell monitoring the Hommerton and Whittington Hospital’s A&E Departments
• Services specifically set up to work with people with multiple needs – such as the Multiple Needs Unit run by Focus Futures in Birmingham
• Some organisations have a range of accommodation with differing levels of support which enable people to move at their own pace towards independence, such as Together: Working for Wellbeing
• Sheltered housing provision can play an enormous role in promoting continued independence and well-being for residents, bringing in a range of health practitioners in local statutory agencies to deliver services on site
• Promoting better health through gardening and other physical activity – St Mungo's Putting Down Roots gardening project is a great example

Drugs and alcohol

No one size fits all. Homeless people need a variety of services at all stages of addiction – still using regularly, mostly off, completely off with very occasional lapse, totally abstinent. As with all accommodation, hostels especially need to be able to work with some of the most challenging clients.

• Rapid access to methadone scripting has proved very successful in some projects – particularly Endell Street hostel, run by St. Mungos Substance Use Team
• Risk and harm minimisation is standard good working practice in many accommodation-based services – for example sharps bins in every room
• In-house needle exchanges
• Some day centres and hostels offer ‘wet’ accommodation for people continuing to drink – see the briefing on our website for more details
• Hostels can offer in-house detoxification facilities, such as ECHG’s Vaughn House in Guildford
• ECHG also run a house in Oxford which acts as a therapeutic community for people wanting to stay off drugs – it is a very strict regime but with high success rates as people are aware of what needed to stay clean and they want to do so
• Move on to appropriate accommodation in areas where people can keep clear of old haunts and stay off substances can be difficult – working with the local authority homelessness forum may provide innovative solutions for cross-border nominations
• Some organisations have specialist projects (e.g. St Mungos, Palace Rd) or dedicated bedspaces in larger units (e.g. Look Ahead, Dock Street) for street based sex workers – most of whom are using drugs
• New Horizon Youth Centre does outreach with sex workers in Islington and meets them on release from Holloway to try and direct them away from returning to old ways and habits
• Better access to alcohol and drug detoxification – agencies need to map locally what is available and where the gaps are; usually alcohol attracts least funding. To find services in London click here
• Local lobbying for more money to deliver better services to people who are homeless
• Ensuring that hostels and day-centres work with the National Treatment Agency’s four tier structures for the treatment of drug and alcohol misuse:“Models of care for the treatment of adult drug and alcohol misusers” Framework for developing local systems of effective drug and alcohol misuse treatment in England

Finance, benefits and debt

• Toynbee Hall offers the SAFE (Services Against Financial Exclusion) programme, which provides practical support to help people on low incomes to manage their money more efficiently and to access specific financial services, such as bank accounts and savings schemes, as well as to provide debt advice and pensions education
• Capitalise - London’s debt advice partnership - is a London-wide partnership led by Toynbee Hall, Blackfriars Advice Centre, and the Mary Ward Legal Centre, that aims to reduce debt and financial exclusion by improving people’s capacity to manage their debts, enabling them to take more control over their finances and make informed choices in the future

Children, families and relationships

• Counselling services for men, including anger management
• Perpetrator programmes for people who have inflicted domestic violence
• Bringing in family mediation to accommodation-based services via Relate and independent organisations e.g. Alone in London, De Paul Trust
• East Kent Cyrenians work closely with clients on issues such as relationships and children and are happy to talk through their approach with other agencies
• St Basils in Birmingham offer meditation for young people and their families to prevent homelessness

Attitudes, thinking and behaviour

• Holding a ballot to see how clients would like to be referred to (i.e. client, service user, or customer) Carr Gomm undertook a ballot and now work with clients (click here for more details)
• Not holding separate staff and client meetings – confidential information can be dealt with as a ‘closed’ item at the start of the meeting, but everyone can be involved in the discussion about the service
• Involving clients on the Board (Foundation Housing have four customers on theirs)
• Have clients involved in the recruitment of new staff, either by sitting on the panel or holding a separate interview
• Service user-led forums can be involved with an organisation on a strategic level and undertake service reviews
• A success wall which lists the things which have changed/been achieved as a direct result of service user participation
• Using clients from other local agencies to ‘mystery shop’ services
• Working with service users to develop a charter of rights
• Holding ‘Speakout’ events – Groundswell hold annual speakout weeks
• Improving opportunities to engage in meaningful occupation, such as
• Photography and video classes
• Painting and art
• Poetry and prose classes
• Instrument/songwriting workshops
• Opera workshops
• Football teams/five a side competitions
• Fishing trips
• Oral history sessions
• Drama workshops
• Dance workshops

Safer and stronger communities

• Shelter’s Rochdale Inclusion Project works with people otherwise evicted for ASB and has a 84% success rate

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