SB151206-07

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ITEM SP7

SUPPORTING PEOPLE COMMISSIONING BODY - 15 DECEMBER 2006

OXFORD MOVE ON REVIEW: FINAL REPORT Recommendations

Commissioning Recommendations

The Core Strategy Group recommends that the Commissioning Body:

Re-commissions the existing direct access hostels and Simon House.

Re-commissions the existing 96 units of second stage accommodation.

Incorporates the proposed outcomes in the service specifications for the above services.

Commissions a prototype project with a floating support provider to assess the potential for family-based support to be included in the portfolio of move on options.

Includes a standard time scale for transfer and joint working with floating support providers that reflects best practice. We suggest a minimum of 3 months and maximum of 6 months would meet most people’s needs.

Instructs the Oxfordshire Supporting People Team to implement the commissioning and procurement outcomes of the decisions in partnership with the commissioning partners and in conjunction with the County Council’s Legal and Procurement Services

Operational Recommendations

The Core Strategy Group instructs the Supporting People team to work with Districts to:

Encourage front-line providers (e.g. direct access hostels, Foyers) to review their current practice that relates to the first few weeks of their relationship with a new service user and to assess how effective their current arrangements are in achieving the early results for the maximum number of people.

We recommend that providers be encouraged to test out small scale changes in this area of their work as part of the introduction of a more systematic service specification based on the customer journey.

Encourage providers to develop a shared short ‘risk to results’ assessment process and that it is subsequently tested out in both a Foyer and Direct Access setting.

Encourage providers to develop, or use an existing, a shared assessment process and apply it across the whole service system. We suggest that providers start by building on the work already being done in West Oxfordshire.

Encourage providers to develop or adopt a customer journey recording system. It should be developed so that both service users and providers can share information quickly and in an agreed format. This will help service users to see their own progress, ensure that providers build on each others work rather than repeating it and it will help to identify gaps in service delivery and capacity as they emerge in the future.

One of the major providers in Oxford is moving to an outcome based process using the St Mungo’s Star system, this would make an excellent platform for whole service development.

Agree a standard personal client identifier with providers. We suggest agreeing a standard identifier across all providers and implementing that for all new service users from the 1^st of January 2007 and back tracking through current customers by the 31^st March 2007.

Encourage providers to complete follow up tracking with clients they have directly helped into sustainable accommodation (e.g. into their own tenancy), as a minimum that a 20% sample of those moving on each year is followed up at 12 and 24 months after the end of their floating support package or similar support package.

Encourage all housing and support providers to consider if such an approach would be helpful to some of their service users.

Encourage providers to assess both their current training for support workers and their procedures for managing lapse and relapse. Following that self assessment any specific elements added to both training and policy that help to distinguish between serious relapse and other more transient lapse.

Discuss the potential for current schemes to be expanded where possible and that work is done with landlords in the districts to ascertain what the most effective approaches to rent deposit schemes are.

Discuss with teams working in the districts the potential for increasing the use of the private sector. That this should be linked with some of those providing floating support and possibly 2^nd stage accommodation to investigate how capacity for vulnerable people could be increased whilst minimising the risks to sustainable outcomes.

Start discussions with suitable housing and support partners so that examples of best practice can be generated locally.

Start work with local support and housing providers to investigate the wider use of shared ownership options for a broad range of people with support needs across Oxfordshire.

Consider working with floating support providers to keep track of the allocation of move on accommodation and keep a watching brief on the impact in communities where the most vulnerable are being supported in sustained tenancies.

Consider an approach to central government about the impact of Housing Benefit local reference rents on vulnerable groups. Also to investigate how discretionary housing payments can be used to maximise sustainable move on.

Discuss where relevant, this planned use and development of Choice-Based Lettings.

Start to review the current use of section 106 agreements to establish if districts are maximising the housing opportunities for homeless and potentially homeless people.

Executive Summary

MWB Consultancy was commissioned to carry out a review of the barriers to successful move on for single homeless people across Oxfordshire.

In carrying out the work we (MWB Consultancy Ltd) spoke to and received data from a wide range of people across all the districts in the area. This included discussions with service users in a number of providers and districts. The data we looked at included Supporting People review material, data from providers and policies and procedures from district’s housing authorities.

Your start point for the review was that move on accommodation was not working as well as it could for single homeless people. You assumed that people who were ready to move on to sustainable and secure tenancies etc were being held up in second stage accommodation or other resources and unable to move.

You then went on to surmise that this had two implications; firstly some vulnerable people are not able to access ‘specialist’ second stage accommodation at the right point in their journey and that people ready to move might be discouraged and miss the opportunity for successful move on.

Some of the initial assumptions were that there would be issues about affordability and availability of accommodation as well as the processes that helped people to move from homelessness to sustainable living arrangements. We might also expect to see some variation across the county between different districts and across customer groups.

Our current assessment is that in any 12 month period that in the region of 250 people are able to move on successfully but that 100 single homeless people are unable to move into sustainable accommodation e.g. their own tenancy as a result of limitations in the current configuration of services and lack of move on accommodation.

The core providers and processes currently provide a strong platform for development and there is substantial commitment and enthusiasm for improvement.

Using the customer journey model, which is attached to the report as appendix 1, our analysis suggests that improvements could be made at the start of the person’s journey through services by implementing a more coherent and shared approach to initial placements and assessment. This needs to include a stronger focus on the initial decision making process with potential clients and a consistent assessment of the routes to sustainable housing, for example by making access to primary prevention and secondary prevention options available at an early stage of the process.

There are variations in the rates that people drop out of services across providers and the rate of early drop out of services could be reduced.

We believe that in the middle stages of the journey that most providers are doing a sound job but that there can be improvements in some elements of coordination and that drop out from services could be reduced further by a more systematic approach to assessing the risk of drop out and planning with service users to manage those risks.

We also suggest that there is some scope for some providers to review the way in which they deal with lapse and relapse and the knock on effect on a person’s potential eviction from services.

There is evidence from a national perspective that in this middle part of a journey there is a place for accommodation based services (you refer to them as move on services e.g. Julian Housing) for the most vulnerable and that they can provide a very useful bridge into sustainable accommodation.

There is some evidence locally that people are being held up from accessing second stage accommodation along their journey by lack of move on accommodation for those further down the journey.

At the end of the journey the current arrangement of floating support and relationships with housing providers are sound and the key element that restricts move on is housing availability rather than support based.

Current procedures and policies e.g. allocations policies do not appear to be a major barrier. However the application of Housing Benefit rent assessments maybe contributing to reducing available options for people on low incomes.

The range of housing options at this end point could be extended by further work in the private sector, by the use of shared accommodation and by opening up access to a wider range of accommodation type where that is available.

A significant number of people make planned moves out of services by returning to family and friends, the success of such planned moves is not adequately tracked or supported in a consistent way, there is an opportunity to support this route of homelessness more effectively.

More Detailed Comments and Feedback

What We Think is Happening Now

There is evidence that people are having their journey to sustainable housing and lifestyles compromised by the current arrangements for and capacity of move on accommodation.

Our analysis suggests that across the county as a whole in the region of 350 people could make the journey from homelessness to sustained accommodation every year if the current systems and process worked at their optimum level.

Last year (2005-06) we estimate that between 200 and 250 people completed the journey to their own accommodation or to a sustainable place to live (which includes a return to family for some people).

What we can not tell is how long people are able to sustain those moves once they have the front door key. It appears as if there are only very small numbers of people who do not succeed BUT the current systems for recording outcomes means that it is very hard to be certain about this.

Based on the figures we have on actual moves and on estimates of the potential numbers who might be able to make successful moves to secure tenancies (or similar alternative) it is likely that up to 350 people could move through services each year and into sustained accommodation.

For the 5 districts this splits roughly like this:

District	Potential numbers of successful moves at end of journey in any 12 month period
Oxford City	224 (64%)
Cherwell	42 (12%)
South Oxfordshire	28 (8%)
West Oxfordshire	28 (8%)
Vale of White Horse	28 (8%)

Actual figures for move on in West Oxfordshire (2005/06) were 22 people recommended for RSL move on and 16 accepted, one person moved to the private sector.

The gap between that actual figure and the projected one above reflects a number of factors; prediction of need has to include assumptions about future trends, numbers not coming forward to access services now etc. We suggest that figures in the table above are used as a guide to potential scale rather than a specific target.

Where People are Currently Moving To

Based on the figures we have been able to access it looks as if over 250 people across the county have been helped to make a planned move, the majority into some kind of ‘sustainable’ accommodation. There is some variation across the districts, for example West Oxfordshire has a very high percentage of move on into RSL accommodation, but these figures appear to be roughly in line with national trends.

Moved to	Percentage of total
Private rented sector	34%

Local authority or RSL	36%

Family or friends	30%

What is currently difficult to track is how successful these planned moves are, and whether some types of move on accommodation are more sustainable than others.

What does look likely is that once a person has moved to a secure tenancy that most are able to sustain that for at least 12 months.

What We Can’t Tell You

If any particular customer groups do better than others, e.g. are young women getting better results than young men.

How successful moves are in the medium to long term.

How successful moves back to family home or to friends are being.

Which providers get the best medium to long term results?

Key Message

There is some good joint working going on and a real willingness between partners to see this as a shared problem which they can contribute to. Based on that willingness we believe that the problem can be addressed in Oxfordshire.

Key Findings and Brief Commentary Relating to Current Blockages to Move on: Problems and Issues

Housing stock

Availability of move on accommodation, all the people we spoke to in the various districts and service providers all noted that there was a physical lack of suitable property for people to move into at the end of their journey.

Variation did occur across the districts, for example where they had had recent developments and growth in housing stock there was much less of an issue and a greater flow of people into sustainable accommodation. However these districts were predicting future problems.

The location of properties was also noted as an issue; in particular that the limit stock meant that where offers are being made they may not be in the most sustainable areas or communities.

Affordability of move on accommodation, the cost of accommodation and day to day living in Oxfordshire is expensive. This has implications for rent levels which are high in the private sector, for house prices which limit the flow of people out of the social rented sector and for new developments. High rents are meaning that some people are discouraged from working in case they lose key benefits such as Housing Benefit.

There was also some concern that Housing Benefit local reference rent levels were being set too low in some districts which restricted the access to some accommodation. This had a particular impact on younger homeless people and those wanting to get into work. Individual tenants can challenge rent levels though are rarely successful so a more strategic approach might be required e.g. lobbying central government, investigating the use of discretionary payments etc.

Range of housing options being used or available, the majority of housing (except where people return home or to friends) is single person accommodation, varying from bed sits to single bedroom flats. There were some very limited examples of people being let two bedroom flats.

The use of the private sector is more wide spread than we might have originally thought. We could find no examples of shared ownership or similar schemes being used, there was in the past some examples of this for people with long term mental health distress.

Most providers we spoke to were very wary of using multiple occupancy solutions except on very rare occasions.

Access to housing allocation, one of the concerns raised in the original discussions about move on accommodation was the part played by housing allocation and other policies on those in greatest need. The evidence suggests that allocations policies have the biggest impact on the youngest people. This is related to the ability to give tenancies to those under 18 and some reluctance to give tenancies to those just passed 18.

Housing providers all insist that a vulnerable person moving into their accommodation has suitable support in place if they require it, which could act as a delaying factor but the evidence suggests this is not a major blockage and that joint working in the districts is being used to develop good support packages. So it appears that housing policies are not a major blockage in this respect.

A bigger blockage is the application of rules about rent arrears and we did receive some feedback that this was a block to some people, but no figures are available on this.

There is a growing use of Assured Shorthold Tenancies which may help to tackle some of this but this needs to be monitored to make sure it does not mean the most vulnerable have the least security. Some RSLs are using what they refer to as starter tenancies as an alternative to Assured Shorthold Tenancies.

Geographical concentrations of vulnerable adults was raised as an issue of concern by a number of people, given the structure of both the private rented and social rented stock there is a risk that vulnerable people are allocated the most vulnerable properties in areas of highest turn over. This is unhelpful both for the person and for the communities that can become challenging places to live. If social networks are a key part of sustaining a person then some of the most vulnerable are being allocated property in the areas least able to provide those networks, in fact in some cases areas that may exacerbate problems like substance misuse.

Joint working is going a long way to overcome some of the issues that may have been barriers in the past. The success of the joint approaches is likely to encourage more flexible use of resources.

Your original hypothesis that some of the problem with move on is a lack of suitable accommodation for people at the end of their journey is accurate. There are large pressures on the rented sector across the county and little evidence that this will change in the foreseeable future.

Policies and procedures do not appear to be a major barrier, with the possible exception of rent arrears.

The geography and economic make up of Oxfordshire creates a very challenging market.

The role of families and friendship moves needs to be investigated further.

The Current Journey for Homeless People

Start of the journey, for people who are homeless this has two elements firstly avoiding homelessness through early intervention (primary prevention) and secondly the start of the journey back from homelessness to sustained accommodation (secondary prevention).

Primary prevention; there is a growing perception that the use of Housing Options teams and other shared approaches to tenants at risk in the districts is making a positive impact on the numbers of people, in particular young people, who present as homeless and subsequently have to move into homelessness services.

Although no accurate figures are available for the success of such approaches locally this perception would be in line with work in other areas that suggest that prevention work can be highly effective, again particularly with young people. Some groups of potential service users could benefit from a greater focus on primary prevention of homelessness, in particular groups like care leavers.

The start of the journey for people who are already homeless and have little or no chance of immediate return to family is more problematic.

The data and information we collected suggest that this is the least successful stage of the person’s journey. As might be expected there are high levels of ‘churn’ at this stage for the most vulnerable and challenging of customers. This quick movement includes those that drop out and reappear in an unplanned way and not those that move in a planned way. The latter category should be moving for positive reasons e.g. getting to the right provider as quickly as possible.

We can tell how many are leaving in an unplanned way which may put them at further risk. However we could not accurately track the numbers that drop out in an unplanned way and then re-emerge, in some cases restarting with the same provider.

For younger people our estimate is that in the first stages of their journey turn over is lower with between 30% and 40% moving on quickly in an unplanned way.

For people using direct access who are older (i.e. over 25) the figures appear to suggest that between 60% and 70% are leaving in an unplanned way and we would suggest that this is most likely to occur at the earliest stages of their journey.

This ‘churn’ or quick movement is not inevitable and there are some local variations between providers for example one provider reporting 66% planned moves and another 28%.

There is a commonly held assumption that some people will take ‘several goes’ at starting on the journey to sustained life styles before they are successful. This is thought to be particularly true for people with the most chaotic life styles and substance misuse issues.

A key question is how much this churn is generated by the way services are structured and provided and how much is an inevitable outcome of personal chaos, substance misuse and poor mental health.

Research and our work in other areas suggests that it will be a mixture of both factors which means that it can be reduced and therefore improvements can be made to the start some people get to their journey.

The evidence suggests that getting to the right service as quickly as possible can be crucial in reducing the number of starts a person has on their journey. This in turn can increase the likelihood of people making successful journeys and making a success of their move on into sustained accommodation.

Our assessment is that there is some good work going on at the start of people’s journeys but that it is not consistent enough or intentional enough. We think that the current front end is more haphazard than it need be. It can be improved and reduce the incidence churn for some people.

Maximising planned journeys; our assessment is that at the start of a person’s journey services do not act as a single entity and that the development of early changes is not focused enough on the key early results. This means there is too much luck and not enough planning involved in getting early results.

One of the structural issues that contribute to unplanned moves is the way in which ‘rules’ and process impact on service users. For example, mounting rent arrears or use of alcohol in a ‘dry’ setting. Our assessment is that these things are likely to have the biggest impact early on in a person’s journey and may encourage greater numbers of unplanned moves than are necessary.

Movement into Oxford from the surrounding districts, and in some cases from outside Oxfordshire is an issue that needs to be considered as a cross authority issue and the local connections policy implementation will have some impacts on this. There is evidence that people from outside Oxford City are using direct access services in the city. This appears to be a mixture of both the presence of services in the city and the lack of services in people’s own areas.

Our discussions with current service users suggests that on the whole people do not want to move out of the areas they know well, where there maybe some vestigial support network etc.

Middle of the journey, it appears that there is some variation in this middle stage of the journey once people have got beyond the ‘starting to make changes’ stage.

The data is a little suspect and needs to be improved through joint tracking (see below) but it appears that some providers are better at supporting people through these vital stages of the journey than others.

We should be seeing a relatively low level of unplanned moves by this stage of the journey. Both the service user and the provider have invested time and energy in engaging and starting to make changes and unplanned moves can be a waste of that joint effort.

The data suggests (this comes with a health warning) that for those moving from direct access to second stage providers that the number of unplanned moves once they have moved on varies from an impressive 15% to a much less impressive 50%.

The current provision of Foyer type services for younger people suggests similar spread of planned and unplanned moves the most concerning being a ratio of 33% planned to 66% unplanned moves and the best being 80% planned to 20% unplanned moves.

Our assumption, partly backed by evidence from interviews and research, suggests that the majority of the unplanned moves/drop out happen at a time when the service user comes under the greatest pressure to change and develop new ways of relating to the world. This suggests that a risk management needs to be focused on people at this time of their journey. That means thinking about managing the risk of them not achieving change rather than the risk they pose to themselves or others.

We need to view this suggestion in the context of the issues facing providers as they judge the pace of someone’s journey. Part of the skill of achieving good results with service users is balancing the tension between the need to keep people’s journeys moving at a pace that creates changes whilst not forcing people to change at a pace they cannot maintain. Managing this tension is an important part of the risk management with each service user.

There is some evidence that a number of people in direct access services could make the journey to their own sustainable accommodation directly from the direct access provider.

One provider we talked to suggested that at any one time 4 to 6 people could be ready to move directly from their resettlement phase into their own accommodation. This one figure would suggest that between 30% and 40% of those who have made it through the first stages of the journey might be able to make fairly quick progress to sustainable accommodation with the help of floating support.

It is worth noting that the same provider noted that it was a struggle to get those people into accommodation because of the lack of end of journey tenancies.

Reducing the range of 2nd stage accommodation and replacing it with floating support may not help people with the most complex needs and risks increasing isolation too early in a person’s journey.

Because of the reluctance some housing and support providers have to the use of shared move on accommodation, even when supported by floating support, the move to more floating support may in fact be counter productive, reducing the availability of structured second stage accommodation and creating bottle necks further down the journey.

Evidence from other areas of the country suggests that the most vulnerable service users get the best results from accommodation based services as they move through the middle stages of their journey.

Floating support as an alternative at this stage of the journey works well for those that are making quick progress and have previous experience of being independent.

End of the journey, the use of current approach to floating support appears to be sound in most cases. There are some very good examples of joint working and good practice. The available data, which is thin, suggests that once someone has moved they are able to sustain their tenancy for at least the initial period of independence.

The key blockage is lack of suitable accommodation; see below, we were given some anecdotal evidence of people waiting to move because of lack of other services e.g. floating support but moves to better joint working seem to be addressing this.

However if this key blockage of capacity of housing is freed up this will have a knock on affect on the volume of floating support required to support people in the latter stages of their journey which in turn may create new barriers to move on.

If we assume an average (maths tenuous at this point) support need of 6 months at 4 hours per week this would equate to 104 hours per person. If the current rate of move on can be increased by 100 this could create a demand for an extra 10,000 extra hours of floating support per year.

Customers who cannot move because of blockages, based on the data we collected and on the interviews etc we have developed an assumption that in any given 12 month period in the region of 100 people are ready to move on to their own sustained accommodation but can’t because of lack of accommodation. This will be having down stream impacts on those waiting for intermediate options to move through their journey.

As we have noted above the final blockage in the journey is the lack of suitable final phase accommodation.

If we use the current outline journey as a template for looking at the services and customers experience we see that the start of the journey could be improved, that some of the providers in the middle stages could improve their performance but that the end support stages seem to work well enough.

The existing direct access accommodation and Simon House have a key role to play in supporting people through the early stages of their journey and the designated second stage accommodation e.g. Julian Housing will be essential to the middle section of customers journeys.

The evidence of good practice across all sectors in the area suggests that improvements can be made and that there is the skill, will and expertise to make it happen.

Crucially, as you suspected, access to good quality sustainable accommodation needs to be increased.

Related Process and Other Issues

Tracking of customers, the current arrangements for tracking people’s journey through services and to successful outcomes are poor. Providers use different identifiers from each other, and sometimes a single provider uses different formats of identifier. There is very limited tracking of people who are settled once floating support has ended.

Tracking itself will not make people’s journeys better but it is important to help planners, commissioners etc know what is working or not and why. It does customers no favours if they have to retell their story which leads us nicely to the idea of more shared assessment and a more customer focused whole systems approach.

Joint assessment, there is limited joint assessment (see below) and the feedback from service users suggests that more sharing would be welcomed by most people. Joint assessment and information sharing can contribute to better outcomes particularly if the service user is deeply involved in the process.

Not all providers are the same; there are variations in the results, measured by planned moves and other KPI data, that providers deliver. These cannot be wholly explained by the different customer groups served. For example Foyers work with very similar customers but are getting very different results.

Not all customers are the same; with effective tracking we would be able to make judgements about which types of customers are getting the best results at the moment. There is contextual data (anecdotal) that the most chaotic people with substance misuse are the toughest group to get results with, closely followed by those with other complex needs including mental health distress. At present you are unable to make any sound judgements about the equality issues related to successfully tackling homelessness.

Local Processes e.g. housing rules, we have noted above that local rules seem to have less of an impact than one might at first suspect. The evidence from interviews etc suggest that partners are working to overcome some of the restrictions that allocations processes may put in the way of helping people into accommodation.

Further changes to processes will make limited difference except in relation to the types of property that people are let, there is some evidence that allocations of two bedroom properties might be helpful for some groups of people, in particular those who have children that visit.

The biggest risk, and opportunity, is the introduction of Choice Based Lettings. The evidence from early implementers is that the most vulnerable can be severely disadvantaged unless the Choice Based Lettings system is designed with them in mind as a key customer group. Support providers need to be included in developing joint ways of including and maximising the use of Choice Based Lettings.

The processes and practices of providers also have an impact on people’s journeys, the most keenly felt by service users were the policies relating to rent arrears and misuse of substances. See notes in next section and links to risk management noted above.

National processes e.g. benefits; a potentially less tractable problem is the way in which welfare benefits are allocated and constructed. For example the ways in which benefits are calculated for young people is restricting their choices and opportunities.

Links to other services; this features as both a weakness and a positive (next section) there are some strong links between services but we think the links to training and other broader life skills areas could be strengthened further to help service users achieve results across a wide range of outcomes (see the 5 Government outcomes). Although this did not feature as a large part of our data collection it has been raised by some participants along the way and our work in other areas suggests it is crucial to success in helping people to maintain sustainable and enjoyable lives.

Positives and Opportunities

Housing Options and primary prevention, the development of Housing Options and its variants across the county has been positive and could be linked to a more strategic approach at the start of people’s journeys. There is growing evidence that primary prevention can pay dividends but it needs to be linked to secondary prevention so that at the point of presentation potential service users have the options to benefit from the approach most likely to deliver results for them.

Joint working, there are some good examples of providers working together across boundaries and wanting to help each other to get good results. This can be built on to develop a more coherent set of options and interrelationships between providers. This in turn helping to introduce ‘intentionality’ at key points in the person’s journey. The approach being used in West Oxfordshire to joint assessment is a good example of providers and authorities trying to work as a whole system.

The use of panels and other joint arrangements where the needs of the most vulnerable can be discussed and resolved is excellent.

Joint assessment, as we note above the development of a shared approach to assessment in one district is a positive step and needs to be used more widely.

Second stage and move on, there are some good examples of well planned services helping people through the middle stage of their journey and linking well with both direct access and floating support.

‘Move on (OC)’, the move on arrangements in Oxford City, whilst not being big enough in terms of capacity, do provide a coherent approach to using scarce resources. This could be extended and should be once Choice Based Lettings is in place.

Use of the Private Rented Sector, there are some good examples of how the private sector is being used to help people move on. The ways in which rent deposit and other schemes are being rethought suggests that there is scope for more work here. The way in which some of the districts have sought out the private sector and come up with ways of making it easier for private landlords to get involved and feel secure about their role is good.

At least one provider is making a conscious assessment of which service users would get the best results in the private sector and those that might be too vulnerable to use it.

Local connections policy; at the time of carrying out the review these policies were still in formation or very early stages of implementation, the early evidence from Oxford City is that sensitive use of the policy can be a positive factor in both helping people to link to their old networks and in providing a early assessment of need.

Links to other services, there are some really good examples of how the non-accommodation based services are linking well with direct access etc. The work of the Street Teams in Oxford was praised by service users and providers. The links to medical services in the city area are strong and this is really positive.

Although there are a number of barriers to increasing move on there is both the desire and imagination available in both the authorities and providers to make the most of what is a very challenging process.

What did the service users say?

We spoke to over 50 service users across a range of ages and venues, including some out of the Oxford City area.

The majority of people who talked to us were from Oxfordshire

We met a couple of people who told us they travelled from county to county.

People seem aware of some of the hostel/shelter/temporary accommodation services on offer, suggesting that lack of knowledge of what is available to support them is not a barrier to moving on from the street or other temporary housing.

People report reaching these services by a variety of routes and referral agencies, word of mouth is also a crucial factor. Nobody complained about not being able to access supported housing services.

This indicates that a variety of agencies around the city and districts are clued in to all these services and are pro-active in referring people to them and that people are usually able to access them, if they meet service criteria.

People we met at The Gatehouse not currently using supported housing services were nevertheless aware of a range of service provision. A number of the people we met at each meeting mentioned Street Services team as doing outreach work which reached and informed homeless people sleeping rough of what support might be available to them.

There is some directly self reported evidence of "revolving door" syndrome, from what the people we met said "revolving door" is not a major issue for most of them, however the majority of people we talked to were current customers (i.e. inside the door at the moment).

Some people’s journeys, whether written down by themselves or described to us, indicated "revolving door" syndrome. Those reporting this were in the minority. Escalating use of alcohol and other drugs, "falling off the wagon" was the main reason the majority of people we talked to saw as the underlying cause of revolving door syndrome.

Use of alcohol and other drugs was something people came back to over and over again

Uncontrolled and/or escalating use of alcohol and drugs was referred to by the majority of people we met, and in the following ways:

Uncontrolled use of drugs and alcohol and any resulting anti-social or aggressive behaviours could mean you couldn’t access hostel or other supported housing services – this was not seen as a very bad thing by the majority of those we spoke to, most people preferred not to be where others were always "kicking off" and those that were trying to get "clean" especially didn’t want users who were not trying to do the same around them. However the attitude towards occasional lapses was different (see below).

"Stupid" rules by service providers i.e. kicking you out of hostels or shelters because you’d "made a mistake", like lost your temper or had a drink or used a drug, were seen as unfair, and contributing to revolving door syndrome i.e. you had to start from the beginning all over again.

The majority of people we met felt that a lot of staff were unskilled in dealing with the anger/aggression of service users and unskilled in working with alcohol and drug users (for example not recognising when people actually were using).

They thought the three results of this were that people got evicted from provision unnecessarily; that if you were a drug or alcohol user trying to stop or control your use staff didn’t understand/support you (although other agencies would, and do); that you could feel unsafe because you knew other people, or even you yourself, were using and staff didn’t realise.

Zoning, seen as a way of moving gradually towards independence whilst living in hostels, causes some frustration and is seen as "clogging up" move on

Some people at Simon House and The Night Shelter thought the zoning systems in operation there were frustrating because whether or not you moved zones was less dependent on your readiness for more independence than on whether there was a space in a particular zone. Others were very positive about the zoning and felt a real sense of progress through their own journey.

At the same time they felt that staff assessment of their ability to move on and/or their own readiness to move on from hostel living was dependent on them first moving to, and succeeding, on the "top floor".

In terms of what was limiting places in each zone only 3 of the people we spoke to felt they were ready, waiting and frustrated at not being able to move out of hostels into temporary supported accommodation (Julian Housing) or independent living in rented council or RSL flat.

Ambition for own place, most people we spoke to had been using the same service consecutively for much less than a year and felt they were not ready to move on yet, but for those we spoke to who had been using services for more than a year there was a high degree of frustration at not being able to move out from services to their own accommodation.

The majority of people want their own place to live, council or RSL accommodation is seen as "safer" i.e. more permanent and in better condition than private rented accommodation.

The majority of those we spoke to did not yet feel ready to move on from where they were currently living. The majority of people living in supported accommodation had been where they were living for less than a year, it was those 3 or 4 that had been where they were for over a year that were frustrated about not being able to get a place in either temporary or permanent accommodation.

Low reported involvement in planning for own move on in partnership with staff; there was relatively high level of anxiety about how to access the information required to make decisions about and to take action to enable move on – particularly move on to rented sector.

The people we spoke to said that there was inconsistency between staff in the same provider.

Some people had regular meetings with their key workers.

Some people said workers were never around or didn’t turn up for meetings.

Most people were uncertain/untrusting of information they got from staff about move on options – they thought information was either not forth-coming or kept changing. They either thought staff didn’t know what they were on about or they thought staff were lying to them.

Many of the people we met expressed a high level of anxiety about their futures and much of this was expressed in terms of wanting practical information e.g. we were asked how housing benefit and working tax credits worked, how long people were allowed to stay in supported housing before they had to leave, how deposit lending systems could be accessed etc.

A key point here is that staff maybe passing on information but not always in a way that means the person can assimilate it or can recall what was said.

Cost of private rented accommodation biggest barrier to moving on

The people we spoke to saw the lack of decent and affordable rented accommodation as the biggest barrier to moving on, including the struggle getting a deposit.

The benefits trap seen to mitigate against move on and sustaining tenancies

There was some anxiety about people’s ability to maintain tenancies if they were working on a low wage. This was balanced against an anxiety about the impact on self-esteem and social standing if not working.

Anxiety and fear for the future in the "mainstream" is one barrier to moving on

Once back "in the mainstream", if you got your own flat, if you were clean, some people had experienced and/or were frightened of returning to alcohol and drug use that they couldn’t control and/or of loneliness and lack of purpose.

Some people imagined themselves, or had experienced themselves, living in a flat, no friends or sense of community, not being able to afford to work (benefits trap) and ending up "going back on the juice". This was understandably affecting their level of motivation to move on and, if and when this sort of scenario actually happens, will contribute to revolving door syndrome.

Background to Recommendations

Family and friends: although there are some local variations across the county roughly 30% of planned moves are to family or friends, there needs to be a review of the support offered to people making this as a planned move. We came across some examples of support following the person but this was patchy. For some people this move will be a positive step on their journey but one fraught with potential pitfalls. Providing support may help to maximise the positives of such a move.

Transfer responsibilities: service users will move between providers as they move through their journey and the point of transfer can be a crucial and risky element in the journey. Best practice suggests that there is a planned handover and period between providers.

Increase coordination and planning at the start of the journey: across each district and with specific reference to the work in Oxford the services which deal with people at the start of their journey could be better coordinated and organised. So that access to the most appropriate option is a managed process as often as possible. Active decision making on prevention, needs to be included in this front end approach.

The most effective approach would be to coordinate the initial access and assessment so that service users get a very early assessment of need and are helped either directly or very quickly to the provider (primary prevention or accommodation based) that will make the biggest positive difference for them. This is already being developed in one area, West Oxfordshire.

There is a role for a shared approach which links the street team with Housing Options team (or equivalent in the districts) and the key direct access providers in delivery of an initial ‘triage’ type assessment which could lead the service user to the most effective provider as quickly as possible.

This needs to be supported by focused work and practice in the first 2 to 3 weeks of a persons involvement with a provider so that they are successfully engaged with services as quickly as possible and can then go on to start work on making key changes along their journey.

Risk management: our assessment suggests that there needs to be more coherent and consistent approaches taken to evaluating and planning for the ‘risks to results’ that individuals will experience. For example the research and best practice suggest that some service users are at risk of dropping out of services when the pressure for change begins to mount, if we know this can we assess that risk and plan to reduce it? This type of assessment should run along side the existing assessment of risk to others and to self. The potential risk to results that service users will experience at times of key change needs to be included in assessment and support planning.

Shared assessments: to help support both a more coordinated approach at the front end of the journey and to ensure that there is the maximum coherence across providers.

Joint working on journeys: we think that developing a common approach to the customer’s journey would mean that service users would not need to repeat assessments or feel that their previous results had been lost when they make either a planned or unplanned move across services.

Tracking: there needs to be a shared approach to tracking and recording where service users are on their journey. This needs to include using an agreed and transferable personal identifier across the county e.g. NI number or similar unique identifier.

There also needs to be more assiduous follow up once someone has moved on and floating support has ended.

Rent arrears: rent arrears can be avoided by both ‘in house practice’ and by debt management. Providers need to be encouraged (some are already doing this) to actively manage the risk of arrears and in some cases to consider reducing or writing off arrears where this maybe beneficial to supporting move on.

Drugs and alcohol: service users noted that drugs and alcohol issues regularly got in the way of them making progress, in particular the apparent mis-assessment of serious relapse and more minor lapses.

Rent deposit: the current rent deposit schemes vary across the county in both their capacity and application. They are important schemes and help to link the private sector into the portfolio of housing options for service users.

Private sector: the private sector will continue to be a major source of accommodation. It will also be the accommodation that comes with the greatest risks and pressures e.g. the scale of rent for those on low incomes. Some of the districts are already working hard with the private sector to bring more of their properties into the available pool of affordable housing and this approach needs to be supported. Increasing the options for renting in the private sector is one of the ways that capacity will be addressed, however this needs to be done in a way that limits risk and keeps the option of work etc open to service users.

Multiple occupancy: although this is not the best option for many people it will work for some groups of service users and needs to be included in any portfolio of sustainable accommodation on offer.

Other move on options: some of the groups of people who access the pool of available rented accommodation may be able to make use of other types of schemes for example those with long term disabilities may be able to take up joint ownership schemes. Although this is not directly relevant to many of the service users we looked at it does have a knock on affect and should be considered by the relevant partners on the Supporting People Commissioning Body.

Tracking concentrations of vulnerable tenants: there is a danger that some communities become less sustainable as the balance of those in the community shifts towards those with high levels of need. Given the ways in which housing stock and availability interrelate there is a potential risk that higher concentrations of vulnerable people will be housed in the areas least able to support them. In areas where this was thought to be an issue it would be good practice if agencies involved coordinated activity and kept a shared watching brief on concentrations of vulnerable people in the area.

Housing Benefit eligible rent levels: at a local level Supporting People commissioning body and partners need to investigate if they can lobby with central government for a more flexible approach to the level at which local reference rents are set. There are examples of discretionary payments being used locally, their use may need to be considered in a more strategic way.

Choice based lettings: where Choice Based Lettings are being introduced in Districts the Supporting People Commissioning Body and other partners need to be working now with districts to promote the development of positive approaches to Choice Based Lettings so that vulnerable services users do not become further marginalised. It maybe in the interest of service users to support any moves towards regional choice based lettings schemes. This could help those wanting to move out of Oxford back to the areas they originate from.

Section 106: where plans are being developed to increase housing stock section 106 agreements can be a very useful way of encouraging a sustainable growth in the available housing stock for those most vulnerable service users.

Conclusions

There are blockages to successful move to sustainable accommodation for people who are homeless or potentially homeless; we feel that this is not just a case of a lack of suitable accommodation but that other parts of the overall system have a part to play. Improving the whole approach will help to improve the service users outcomes and increase the potential for sustainable move on.

The role played by family and friends is worthy of further consideration for some service users, given that 30% appear to be making planned moves back to those settings the question is raised about the support offered to ensure that the move is a positive and sustainable one.

The blockages or barriers occur in the following places:

The start of the journey is not always planned consistently.

Primary and secondary prevention are not closely enough linked for some people.

Too many people are dropping out too quickly at the start of their journeys.

Some of the ways in which services run currently maybe increasing the risk that some of the most vulnerable have multiple starts and re-starts to their journey.

Access to the services which promote and sustain changes in the middle section of the person’s journey (2^nd stage or supported accommodation) is made more difficult by the lack of move on at the end point of the journey.

Changes to the mix of floating support and accommodation based services may exacerbate this.

Access to accommodation at the end of the journey is restricted by a mixture of low capacity in the public and social rented sector and by some of the restrictions on finance set by processes like Housing Benefit.

At least a further 100 people per year could be helped in to sustained accommodation if the issues above are addressed.

There are some excellent examples of joint working across sectors that have opened up new opportunities for people.

Appendices:

Optimum Journey for single homeless people using services in Oxfordshire (download as .xls file)

Outcomes to be included in service specifications (download as .doc file)

Service Configuration Table (download as .doc file)

Scale of services required ("Funnel") (download as .docfile)

List of Stage 2 move-on services to be recommissioned (download as .xls file)

(Appendix 6 - download as .xls file)

Report completed by
Paul Muir
Director
MWB Consultancy Ltd

7/11/06

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