« Previous | Contents | Next »
Listen
FINAL EVALUATION OF THE ROUGH SLEEPERS
INITIATIVE
CHAPTER 4: RSI FROM THE PERSPECTIVE OF SERVICE
PROVIDERS
Introduction
4.1 Alongside the critical review of existing research
and monitoring of the RSI programme presented in
Chapter Two and the series of
interviews with local authority representatives and
national level respondents involved in the RSI programme,
which focused on their evaluation of the impact of RSI (
Chapter Three) the fieldwork for
this research also included interviews with the staff who
worked in a range of RSI funded services. This Chapter
concentrates on the views of the staff in RSI funded
projects. A total of 25 staff working in eight RSI funded
services were interviewed during the course of the research
and the topic guide used is presented in
Appendix Three.
4.2 This Chapter begins with an overview of the RSI
funded services which took part in the fieldwork for this
research, providing a brief description of the range of the
support and, where applicable, the accommodation that was
provided by each service. The fieldwork was not large in
scale, as the budget for this research did not allow for
extensive interviewing across the country, therefore an
attempt was made to select case study services that were
representative of the broad types of service provision
funded by RSI and which also gave an overview of the
different contexts in which RSI funded projects work.
4.3 The remainder of the Chapter is devoted to
discussion of the needs of people sleeping rough from the
perspective of service providers, followed by an overview
of their assessments as to the effectiveness of their own
services in meeting those needs. The Chapter concludes with
a description of the views of service providers on the
effectiveness of the RSI programme in their area, including
the impact of the programme on the need to sleep rough.
This section includes the points that service providers
made about the future of the RSI programme.
The services that participated in the
fieldwork
4.4 The services that agreed to take part in the
research were as follows:
- The Four Square Follow Up team in Edinburgh
- Dunedin Harbour Hostel in Edinburgh
- The Wayside Daycentre in Glasgow
- The Simon Community Street Outreach Team in
Glasgow
- The Dundee Cyrenians Street Outreach Team
- Loretto housing in Falkirk
- The SOLAS direct access hostel in Oban
- Inverness Daycentre
4.5 The Four Square Follow Up Team in Edinburgh provides
resettlement support to former, current and potential rough
sleepers aged 16-25. Young people are initially provided
with a 'first stage' flat for six months, which is sublet
from an RSL or the City Council and furnished, with one of
three workers providing a combination of practical and
emotional low intensity support, including help with
claiming benefits and help in developing self-esteem and
coping skills. A 'second stage' flat can be made available
after someone has stayed in a 'first stage' flat. Service
users can be provided ongoing support where needed in these
flats, but the intention is that the flat will become the
permanent home of the service user in which they live
independently. Most of the referrals to this service are
from hostels, rather than current rough sleepers, although
some service users have a history of rough sleeping and
many have characteristics associated with the risk of
sleeping rough. The bulk of the project's funding was from
the Supporting People programme at the time of writing,
though a large capital grant and other funding from RSI was
used to establish the service and get it running.
4.6 Dunedin Harbour Hostel in Edinburgh provides direct
access emergency accommodation to people sleeping rough, or
those at risk of sleeping rough for a maximum of eight
weeks. The main focus of the project is on the provision of
temporary accommodation and removing the immediate need of
individuals to sleep rough. The project workers provide
advice and support with housing, social skills, budgeting,
education and training. The hostel operates links with
other services to help promote resettlement and provides an
on-site nursing service, needle exchange and visiting
benefits surgery. Capital funding for the hostel came from
RSI and did provide revenue funding until the advent of
Supporting People, which at the time of writing provides
the revenue funding for the support workers.
4.7 The Wayside Daycentre in Glasgow was an established
service before the advent of RSI. At the time of writing,
the daycentre provides a range of facilities, including
food, clothing and other basic services and also has a team
of workers. Much of the role undertaken by the workers in
the daycentre is focused on the provision of advice and on
the provision of advocacy on behalf of service users and
help with referrals to other services. With the advent of
Supporting People, the Wayside has become more focused on
its role as a daycentre and places more emphasis on
referral to external resettlement and tenancy sustainment
services, whereas it had at one point been more involved in
the provision of such services itself. The daycentre
provides support and other services to current, former and
potential rough sleepers and reports that many of its
service users have at least a history of sleeping rough.
The Wayside also supports vulnerable individuals who have
been rehoused following homelessness or who might be at
risk of homelessness. The daycentre received significant
RSI funding in the past and continued to do so at the time
of writing.
4.8 At the time of writing, the Simon community Street
Work Team is focused on Glasgow city centre. The team
employs six full time street-workers (all full time) and an
administrative worker, plus a manager, who are supported by
sessional staff who help with providing a seven day
service. The service describes itself as providing a
mixture of 'advocacy work' and 'crisis work', within a
general framework of promoting resettlement. Advocacy work
involves referral, liaison and representation of service
users' interests to various other services in the city,
including the homelessness service provided by the City
Council. The crisis work involves the arrangement of
emergency accommodation and other services for the people
that the outreach team find within the city who would
otherwise be sleeping outside. Emergency accommodation is
provided via a network of links and working relationships
with other services in the city. All the users of the
project are current rough sleepers at the time they engage
with the service, although in some circumstances the team
will provide ongoing support for a while after someone has
been placed in temporary accommodation or rehoused. Funding
for the service is entirely through RSI.
4.9 The Dundee Cyrenians Outreach Team have both an
outreach and resettlement function at the time of writing.
The outreach service is focused on identifying people
sleeping rough and directing them to the appropriate
services within the city, including some other services
provided by the Cyrenians. The resettlement function is
based around accommodation provided by external landlords
to which the outreach team provide resettlement support. As
is the case for the Simon Community outreach team in
Glasgow, there is also a role in arranging emergency
accommodation for those people sleeping rough who would
otherwise be on the street. The outreach team also provide
support to vulnerable individuals whose tenancies are at
risk, as part of a wider preventative role in relation to
homelessness in the city. Most of the individuals with whom
the service engages are current or former rough sleepers.
The outreach and resettlement work of the service was RSI
funded in the first instance and continued to be supported
solely by RSI at the time the fieldwork was conducted.
4.10 Loretto provides two supported housing units in
Falkirk at the time of writing. One is a short stay
assessment unit and the second provides transitional or
'move-on' accommodation. The first unit might make a
referral to the second, or it might refer individuals
elsewhere. The second unit provides five flats for up to 15
service users and has a clear emphasis on promoting the
skills and resources needed for successful independent
living. It is specifically designed as a halfway point
between emergency accommodation and service users having
their own tenancy. Although some service users are former
or potential rough sleepers, the proportion of referrals
who are current rough sleepers is very low, with the
emphasis of the service being on lone people with support
needs who would find it difficult to secure and sustain
their own tenancy without support. The support services
within the second unit reflect this emphasis. RSI initially
provided capital funding for the projects in Falkirk and
revenue support, but this was prior to Loretto assuming the
management of these projects, which now receive all their
revenue funding from Supporting People.
4.11 The SOLAS direct access hostel in Oban provides
four beds and is designed primarily as emergency
accommodation for people who would otherwise be sleeping
rough. The hostel has four beds and a living area, with
basic cooking facilities. There is also a drop-in service
for people sleeping rough, which uses the living area in
the afternoons and evenings. The hostel works towards the
resettlement of its residents, with a focus on securing
accommodation within the locality and also provides advice
and information services for its residents. Most of the
service users are people sleeping rough, although other
homeless people are sometimes accommodated as well. At the
time of writing, RSI funding supports the four beds and the
associated staff costs and also provided the initial
capital grant that was used to set up the building. The
local authority provides funding for the drop-in
service.
4.12 Inverness Daycentre is provided by Highland
Council. The service was originally a nightshelter run by a
voluntary sector provider, but was, with the advent of RSI,
changed into a daycentre. The daycentre provides food,
basic facilities such as a laundry area, clothing store and
secure lockers and also has team of workers. The workers
provide a mixture of advice, advocacy, referrals to other
agencies and other forms of low intensity support, such as
emotional support. The daycentre has a range of supported
and unsupported 'satellite' temporary accommodation, some
hostel places and some dispersed flats, in which 25-30
people are accommodated at any one point in time, via
initial contact with the nightshelter. The daycentre sees a
mix of current, former and potential rough sleepers, along
with vulnerable individuals who are at risk of
homelessness. Funding for the daycentre functions comes
entirely from RSI, but the accommodation related functions,
including a team of four outreach workers who provide
resettlement and tenancy sustainment services to
individuals living in the dispersed flats, are funded via
Supporting People.
Service providers' perceptions of the needs of
people sleeping rough
4.13 The service providers worked in localities as
diverse as central Glasgow and the rural highlands and were
providing a variety of services ranging from direct access
accommodation to daycentres and resettlement services.
Despite the variations in context and service type, there
was near total consensus in terms of how the service
providers saw the causation and nature of rough sleeping as
a social problem.
The needs of people sleeping rough
Support needs among people sleeping rough
4.14 All the service providers saw the majority of
people sleeping rough as vulnerable individuals with
support needs who faced barriers to housing and to other
services. The housing needs of people sleeping rough were
seen as secondary to their support needs. An association
between rough sleeping and individuals who are
characterised by negative experiences, support needs and
health care needs has long been established. Local and
national research on people sleeping rough has repeatedly
identified significant support needs alongside housing
needs (Yanetta
et al, 1999; Kershaw
et al, 2000; Third and Yanetta, 2000; Owen and
Hendry, 2001; Grigor, 2002; Laird
et al, 2004). Identical findings have been
reported in studies conducted in England (Anderson
et al, 1993; Pleace, 1998; Pleace
et al, 2000; Randall and Brown, 1993, 1996 and
2002).
4.15 Service providers often described people sleeping
rough as being individuals who had experienced little or no
stability during the course of their lives. Rough sleeping
was seen as often arising, initially, as a result of males
experiencing relationship breakdowns, as a result of drug
dependency, or through support needs that made it difficult
for an individual to find and sustain a tenancy. Often,
rough sleepers had experienced disrupted childhoods or
spent much, or all, of their lives in a series of
precarious and short term housing arrangements. Poor social
skills, limited education and low self esteem formed
barriers to employment and training and also made it
problematic for some individuals to engage successfully
with support, care, health and housing services without
support.
4.16 According to some service providers, there were
some individuals who had been within the 'world' of
homelessness for so long that it was difficult for them to
wholly disengage with it. The idea of a 'culture' of
homelessness that draws individuals in is a contentious
one, particularly as it might be seen as implying an active
choice to either become or stay homeless; something that
sits uncomfortably with the evidence about disrupted,
chaotic lives and socioeconomic marginalisation that often
precede rough sleeping (Vincent
et al, 1993). However, when some service providers
spoke about difficulties in disengaging with this 'world',
they were not referring to any unwillingness to leave
actual homelessness, but rather a difficulty in
leaving what had become familiar as a source of social and
practical support. A series of research findings from the
late 1980s and early 1990s also indicated that isolation,
boredom and poor social supports could be one of the
greatest difficulties faced by former rough sleepers who
were trying to sustain resettlement (Dant and Deacon, 1989;
Pleace, 1995).
We find that it's unrealistic to expect someone tae
integrate really smoothly intae local communities, many
of them keep coming back here because their social
contacts are here, they've maybe been homeless for a
lengthy period of time, they're on benefits, this is a
cheap source of food for them, they can get a main meal
in the canteen frae a pound, things like
that…(Worker, Daycentre).
4.17 Young people who were sleeping rough were sometimes
described as lacking significant experience of parental
guidance. They were also seen as having had few positive
experiences of contact with adults, with both genders being
described as often having experienced traumatic events,
particularly sexual abuse and working as prostitutes. Poor
self image and low self esteem, sometimes coupled with
depression, was also reported by service providers working
with young people who were current, former or potential
rough sleepers.
4.18 Drug use was often seen as a particular issue among
those aged under 25. In urban areas heroin dependency was
generally associated with all groups of people sleeping
rough by service providers.
Early in my days here it would have been
predominantly somebody of middle age or an older age
group with an alcohol issue…maybe ten, fifteen years
ago, predominantly, if they were rough sleeping,
alcohol issues and middle aged plus. Yes, there would
be drug users there, of that younger age group, but it
was significantly more towards alcohol…as the years
have gone on, it's hard to say now, maybe
fifty-fifty…(Daycentre worker).
4.19 Women rough sleepers were reported as having
increased in number over the past few years, but as still
being very firmly in the minority. The increase in women
being seen by services was disproportionately younger
women, a trend that has also been reported in England
(Pleace, 1998). In most, though not all, cases, service
providers reported that people sleeping rough were on their
own.
People sleeping rough whose main need is
accommodation
4.20 The service providers sometimes differentiated
between what they saw as distinct elements within the rough
sleeping population. Some described a group of people who
had become homeless suddenly, quite often because of a
relationship breakdown, who did not know where to go for
assistance and who initially ended up on the street, or in
direct access or other emergency accommodation. When these
individuals had relatively low support needs, or needed
little assistance at all beyond the provision of
accommodation, their needs could be quite swiftly dealt
with and there was no need to provide ongoing support.
People who work well with other services, we do try
and draw back from, so if people have got things going,
the crisis has been sorted out, and people are working
well and establishing relationships with other
services, then we start to withdraw. (Outreach
Team Manager).
4.21 In such cases the difficult issue was often not
about dealing with the support needs of a given individual,
where these were limited and quite easily met, but about
how to secure long term or permanent suitable accommodation
in the locality for that individual. The perceptions of
service providers about the structural role of local
housing markets and housing supply in all forms of
homelessness, including rough sleeping, are discussed in
detail in the following section on service
effectiveness.
People sleeping rough characterised by very high
support needs
4.22 The service providers often reported the presence
of small numbers of people sleeping rough who were
characterised by
very high support needs and chaotic behaviour.
Individuals in this group were reported as always having
multiple needs, often centred on drug or alcohol
addiction combined with various forms of mental health
problem and physical health problems. Some of the service
providers described this minority of their client group as
absorbing much of their time and effort:
…out of that there's like a, what you call it, a
hard core of long term rough sleepers who have like
addictions, who have mental health problems, who are
involved in sex work etcetera, who we may spend a
considerable amount of time with, because of multiple
needs or complex needs, depending on what phrase you
prefer…(Worker, outreach service).
I think there's a group, a small core, who are in
like revolving door homelessness, they're in
institutions, like they come out of prison, they go
into bed and breakfast, maybe have contact with mental
health services…those are people that tend to use the
daycentre, almost all day, almost everyday…people who
come in and use the shower facilities, they'll
certainly have a breakfast, they'll use the laundry
facilities…I guess they are the people that get that
'chaotic, complex needs' type label and at any given
time we're trying to identify when we can next sensibly
work with them, put them into accommodation and use
that time to address their addiction or whatever it is
that's driving their rough sleeping
homelessness…(Daycentre Manager).
4.23 Successful engagement with this small group of
people was reported as highly problematic by service
providers. Often, this small group were described as highly
alienated, difficult to work with and as presenting service
providers with difficult or challenging behaviour. In some
areas, particularly Glasgow, a city in which homelessness
services were highly centralised, these individuals were
generally talked about as being a population who had often
been 'banned' across several services.
Service effectiveness: the views of service
providers
The factors influencing success
Variations in service effectiveness linked to rough
sleepers' characteristics
4.24 As noted, service providers tended to differentiate
between groups of service users chiefly on the basis of the
extent of their support needs. Service providers did report
that successful engagement with former, potential or
current rough sleepers tended to be most frequently
effective when the person being supported had lower support
needs or only had a need for assistance with getting access
to accommodation. By contrast, successful engagement with
the minority of people sleeping rough with very high needs,
who also tended to be more chaotic and more mobile, was
often viewed as more problematic. This was not to say that
the service providers did not report successes with people
from this group, it was more the case that high need
service users both absorbed more time and effort and that
outcomes might be mixed.
4.25 Service providers who were working with people
sleeping rough with a mixed range of needs reported that
they faced a dilemma about engaging with this minority
'high need' population of people sleeping rough. These
difficulties centred on ensuring that the service they
provided remained safe, stable and productive, whilst at
the same time not wishing to turn away individuals who,
while they had high needs, might also be characterised by
highly challenging and in a few cases potentially violent
behaviour. One day centre manager described this dilemma in
the following terms:
…there are individuals who've not been able to
be accommodated because of some of the stuff they
bring to a situation…very vulnerable people on the
one hand, and on the other hand they can be very,
very challenging and sometimes getting the balance
right in terms of where those individuals go, is
difficult. Having said that, I don't think we have
all the people who sleep rough in X at any given
time, because we have to effectively manage our
door here in terms of the risk that people can
present with, then sometimes for a given period of
time, sometimes someone isn't able to access the
daycentre. Unfortunately, sometimes, you know,
that's part of the dilemma you face on a daily
basis, because sometimes they are the most
vulnerable people, but also the most challenging,
because they are using illicit substances or the
degree to which they are predatory with other
vulnerable people…
4.26 Another dilemma faced by services was a perception
that engagement with this most vulnerable group of people
sleeping rough would often be characterised by only limited
or partial success. In a few instances, chaotic behaviour
and high support needs were associated with a tendency to
frequently travel, often over considerable distances and
seemingly at random, which meant that someone could
disappear from a locality at any given point while a
service was working with them. In other cases, services
reported accepting that the degree to which they could
engage with some people within this minority of people with
very high support needs was limited, because individuals
would sometimes refuse assistance or be very suspicious and
untrusting of services. One outreach team worker gave an
example of this kind of issue from their perspective:
There's a guy who's in town now who just hangs
around X Square and doesnae access any service, and
I think that we're the only service that he
accesses and it's difficult, but we can make a
difference. Because he doesnae want to engage with
anyone and he stays away from services, it's making
sure he's got food, because he doesnae claim any
benefits, making sure he has access to food, so
people buy him a meal when they see him, making
sure that he's warm, so it's now winter, so it's
making sure he's got hats and gloves and stuff, you
know, and trying to see if he will go in somewhere,
though he won't, making sure then that if he is
gonnae be out there then making sure he's got a
sleeping bag, you know, so he's got a bit of
protection out there…so we know that this guy is
there now, so he would be on our regular kind of
thing, d'you know, so, we go up and we know where
he hangs out, so every evening someone will see
him, though he's a travelling man and sometimes
goes to London and other places…
4.27 Such cases were seen as exceptional, as in many
instances people with high support needs could be engaged
with to a greater extent than this. Individuals could often
be provided with emergency or temporary accommodation,
support could be provided and advocacy undertaken so that
individuals with high needs were given access to benefits,
social work services, NHS services and resettlement or
tenancy sustainment services funded through Supporting
People.
4.28 However, another problem was noted with respect to
this minority of people with high levels of support need,
which was that service engagement with these individuals
could break down, as support needs and associated issues
could still overwhelm people who had been given a package
of services. There were a few individuals who were
described by service providers as being in a situation of
near perpetual 'crisis', repeatedly contacting rough
sleeper services, homelessness services and accessing
packages of housing and support and yet being unable to
sustain these arrangements. As one project manager put
it:
We work with a group, I would say, of about
20-25 who are hard core rough sleepers, on average,
but then if we kind of extend our definition of
rough sleeping, there's a lot of people who stay in
places that are unsafe, so they're not out on the
street…women staying with punters, staying
somewhere that is unsafe, just to have somewhere to
say. People with complex needs who let's say go
through a continuous cycle of crisis…
The impacts of local housing supply on service
effectiveness
4.29 Local housing supply was seen as a key factor
influencing the success of service interventions by service
providers. The responses on this question varied by area,
with the service providers describing three main problems
from their perspective:
- a shortage of affordable housing in some areas,
providing difficulties in finding temporary
accommodation and securing long-term housing for people
sleeping rough;
- a shortage of suitable affordable housing, i.e.
affordable housing located outside neighbourhoods
characterised by a high degree of crime, anti-social
behaviour and socioeconomic marginalisation, causing
difficulties in securing suitable temporary
accommodation and long-term housing;
- a shortage of suitable supported housing and hostel
provision in some areas.
4.30 Shortages of affordable housing were reported as
being a particular difficulty by service providers in more
rural areas. The SOLAS direct access hostel in Oban
reported that pressure on accommodation in the area, which
has a large tourist industry, was particularly high and
that even during the winter months, securing temporary or
permanent accommodation was difficult. In Inverness, which
although it is a small city, is in the heart of a very
large rural hinterland, increasing pressure on affordable
accommodation was reported by service providers.
…you get that dilemma that they've worked hard,
they've done well in the hostel environment and then
become very frustrated that they're not able to move
out of that situation. Up until this point we've had
good results in terms of move-on accommodation,
inevitably that's now starting to slow down and silt up
to a degree. The people that we have in the floating
support accommodation, sometimes we've taken the view
that that accommodation can become theirs in the longer
term, so that takes care of itself and again that's
been helpful. (Daycentre Manager, Inverness).
4.31 In Edinburgh, there was straightforward shortage of
affordable housing in relation to demand, as was reported
in the more rural areas, alongside a problem with the
available affordable housing stock tending to be located in
highly deprived areas characterised by anti-social
behaviour and crime. One service provider in Edinburgh, for
example, reported what they saw as very high housing stress
in the city, and that City Council had:
…lots of empties, but it's not that
simple…often someone will be offered somewhere like
X and don't want it because of social
problems.
4.32 In Glasgow, although parts of the city were
inaccessible for either temporary or permanent
accommodation because of high housing costs, the issue of
housing supply was seen much more as one about the quality
of available affordable housing. A lack of suitable move-on
accommodation was felt to be an issue by the service
providers in the city.
…the most frustrating thing for us is that you get
them into crisis accommodation, a crisis placement
[then]…
because of the lack of choice about, then
appropriate accommodation kind of goes out the window,
'cos you just want accommodation, do you know, 'I just
want to do anything to stop you sleeping rough' and the
worst thing occasionally, we do have to go back to the
Hamish Allen [City Council Homelessness Assessment
Centre]
and present for B&B, which is a real shame,
because you lose all that work…(Service Provider,
Glasgow).
Appropriate accommodation is a big problem, because
if you're dealing with chaotic people and put them in a
chaotic environment, things are nae gonnae get any
better…(Service Provider, Glasgow).
4.33 In some localities an absence of dedicated
supported housing and hostel provision was seen as an issue
by service providers. The nature of the problem varied. In
rural and smaller urban areas there was sometimes felt to
be an issue in securing supported accommodation for
specific groups of people sleeping rough. Care leavers, for
example, would find it problematic to access supported
housing in some areas, whereas there would be a variety of
options available within the major cities.
4.34 Glasgow service providers expressed particular
concerns about what they saw as the impact of the hostel
closure programme within the city. They reported their view
that the number of bed-spaces within the city had fallen
significantly, because there had been a development lag
between hostel closure and the provision of replacement
supported housing. This was seen as creating pressures on
their services in terms of locating suitable emergency and
temporary accommodation. It is important to note, however,
that the hostel closure programme within the city and the
proposals for replacement services, including the
development of long stay housing with high level support,
were viewed as a positive development in overall terms.
Good idea to close the hostels. People were lying
there, in hostels with 200 people, in a wee room there,
anonymous, with all their issues not being dealt with,
a smaller unit of say maybe 15 bed-spaces, with a
dedicated staff, looking at dealing with particular
needs, nobody will be anonymous there. (Service
Provider, Glasgow).
4.35 Problems with housing supply were not uniformly
reported. Although none of the service providers reported
that they were working in areas that were unaffected by
shortages of affordable and suitable accommodation, the
issue was less severe in some areas than in others. Service
providers in Dundee were working in a context which they
described as being a situation of a surplus of unsuitable
affordable accommodation, a view shared by respondents from
the local authority, but they nevertheless took the view
that options were available in terms of supported housing,
the private rented sector and RSL housing. Service
providers in Falkirk reported a similar situation in their
area.
The impacts of access to other services on service
effectiveness
4.36 Much of the work of service providers involved the
provision of referral to other services, liaison with other
services and advocacy on service users' behalf. Service
providers were therefore in a good position to comment on
the effectiveness of joint working in their areas.
4.37 Service effectiveness could also be potentially
affected by the access that service providers and people
sleeping rough had to Supporting People funded services,
Social Work services and the NHS. If a support or health
care need went unmet, it could potentially undermine the
capacity of a resettled individual to sustain their
tenancy, whereas a well coordinated package of appropriate
services might increase the chances of successful
resettlement and tenancy sustainment.
4.38 Fieldwork conducted with local authorities and
service users suggested difficulties in relation to
accessing drug and alcohol services, including counselling
and detoxification, in several areas, though the service
providers were less likely to mention this as an issue.
Some service providers also referred to close working
relationships between themselves and drug and alcohol
services, particularly in one of the rural areas. A few
service providers commented that drug and alcohol services
wanted people sleeping rough to seem stable and committed
before they were prepared to engage, something which was
difficult for some more chaotic rough sleepers to
demonstrate.
4.39 The picture on access to Social Work and mental
health services was more mixed. Some service providers
reported that it was difficult to access Social Work
support outside a crisis situation and it was also their
perspective that Social Work departments were working with
restricted resources, which made them difficult to access.
Others reported that there were fewer difficulties and that
coordination with Social Work was working well.
4.40 A similar picture emerged in relation to mental
health services, in some localities there appeared to be
problems, which both from the fieldwork with local
authorities and service providers appeared to be linked to
a perceived overall scarcity of mental health services in
some areas. In some areas, negotiations to improve access
to mental health services were underway, for example a
discussion about a homelessness-focused Community
Psychiatric Nurse (CPN) service, whereas in others such
services were already in place, although sometimes viewed
as being under strain.
4.41 Access to the mainstream NHS, in terms of GP
registration and primary health care was not viewed as
problematic by the majority of service providers. The
introduction of the requirements for health boards to adopt
health and homelessness strategies was seen by some service
providers as having made a positive difference to access to
the NHS. A few reported some difficulties in access to GP
services.
4.42 In both Edinburgh and Glasgow, a situation in which
coordination between homelessness services and NHS Scotland
was increasingly effective was described by service
providers. This was qualified in some instances by service
providers, who took the view that access to specialist
services was now quite good, while access to mainstream
services was not yet all it could be.
I mean initially, five years ago, it was murder
trying to get a GP, still is difficult trying to get
GPs, but there's a special homeless GP service, which
is much easier to access, there's homeless people's
mental health service, chiropody and dentistry, so as
regards getting access to those services, it's ok. As
regards moving things on…like a guy at the moment who
doesnae want to use the homeless GP service, then
there's difficulties, the area GPs won't take him
on. (Service Provider, Glasgow).
4.43 Supporting People funding was viewed positively by
some service providers. Supporting People was seen as
introducing an increased range of support for former,
current and potential rough sleepers, to which RSI funded
services could refer people. The programme was also seen as
allowing their services to expand and extend their range of
activities. The daycentre in Inverness had, for example,
added a team of resettlement workers funded through
Supporting People to give it the capacity to resettle
people in dispersed flats. By contrast, the daycentre in
Glasgow had taken the decision that, since a wide range of
resettlement and tenancy sustainment services were now
being funded via Supporting People, it could reduce its own
outreach worker service, concentrate on core daycentre
activities and use referral to Supporting People funded
services to facilitate resettlement. As described above,
with the exception of the two outreach teams, all the
service providers interviewed were working in projects
receiving at least some Supporting People funding, while a
couple of the projects that were previously RSI-funded were
now funded through Supporting People.
The overall success of services
Issues in the measurement and assessment of service
effectiveness
4.44 As noted above, service providers quite often
described a situation in which the bulk of their effort was
devoted towards a minority of people sleeping rough who had
very high support needs. From the point of view of service
providers, this was a group who were disproportionately
characterised by being less likely to achieve successful
resettlement and tenancy sustainment than those people with
lower support needs, or those whose main need was
accommodation. Engagement with this 'high need' minority
absorbed much of effort of some service providers, but was
at the same time less likely to yield easily enumerated
'successes' that would demonstrate their project's
effectiveness.
4.45 Some service providers also took the view that this
kind of difficulty was exacerbated by some of the
monitoring that they were supposed to complete. As was
noted in
Chapter Two, the GHN monitoring
contained a relatively limited range of data on service
outputs at the time of writing. Some service providers felt
that there were not sufficient indicators, within this or
other monitoring data, that accurately reflected a lot of
their less easily measured activities. The role of workers
in undertaking referrals, promoting the rights and
interests of people sleeping rough through advocacy to
other service providers and in coordinating packages of
support and care, was not always felt to be accurately
represented in existing monitoring. This perceived
difficulty was exacerbated by the extent to which the
'soft' or 'difficult to measure' service outcomes, like
advocacy, were disproportionately concentrated on those
service users with higher support needs.
4.46 The GHN monitoring was also criticised in some
instances by service providers because it was felt to be
quite long and unwieldy for the projects to complete. One
service provider commented:
It's a small thing that was cobbled together in
Glasgow and other things have been hung onto it and
hung onto it. The structure of it, the way it
works, is a bit creaking…
4.47 Such views were not universal, some service
providers reported that the GHN monitoring was easy to use.
It was also the case that some service providers reported
that the data collected by the GHN monitoring were useful
to them as an organisation.
4.48 Interactions between services and people sleeping
rough could also be quite difficult for the service
providers to categorise. Many service providers prided
themselves on what they saw their capacity to react
quickly, flexibly and positively to a wide variety of
support needs among their service users. However, this
diversity was sometimes seen as difficult to categorise
clearly, because there was too much variation in what was
done on a client-by-client basis for a standardised
statistical return to work. As one service provider put
it:
We do everything from arranging dog
vaccinations to arranging appointments with full on
consultant psychiatrists, so it depends, I mean we
really are very client focused, so whatever the
issue is, whatever the problem is, we'll try and
help…
Views on the overall success of services
4.49 Assessment of the overall success of their services
by service providers was always contextualised, both in
terms of the external factors that influenced the
effectiveness of their services (as the service providers
saw it) and, to a lesser extent, by their feelings on how
accurately existing monitoring systems reflected what their
services did.
4.50 The extent of Supporting People funding being
received by the services for whom the majority of service
providers worked also made it difficult for them to speak
in terms of the effectiveness of the 'RSI-funded' part of
their services. It was quite often the case that RSI
funding was being used in conjunction with Supporting
People funds, sometimes combined with other funding.
Differentiating between the 'RSI-funded' aspect of service
provision when these funds were combined with other grants
not always possible for the service providers.
4.51 Generally, service providers were quite upbeat
about what their specific project was able to achieve.
Sometimes the criteria they gave for success were limited
by what they saw as the external constraints affecting the
effectiveness of their service, ranging from housing supply
in their area through to the resources of agencies to which
they might refer people and comments on the size of their
own budgets. However, none reported feeling that their work
and the work of their projects was not making a positive
difference to current, former or potential rough sleepers
in their area. As two service providers put it:
We're a good safety net, if you like, because
inevitably there will be people who, even when the
support systems are set up initially, they fall down or
break down, or even they don't start in some cases and
people fall through the net. The daycentre would be
part of that process which provides another safety net,
for instance for those who might fall through the first
net. Quite often we get people presenting who, maybe
they've missed all the help available through lack of
information, they might come in, retrospectively, say
'I've just moved into a tenancy two months ago, I've no
furniture, can you help me?'. Quite a lot of the time
there's money management, there's debt problems,
there's people presenting more and more who find it
difficult to access basic utilities, gas and
electricity, I mean you can spend about half an hour on
a phone call to these agencies now because of all the
streamlining they've done with call centres and that,
and that's a very, very difficult barrier to get
through for a lot of the people who use our
service. (Worker in Daycentre).
I think we have very good success stories. Number
one, let's say, when it comes to crisis, crisis
intervention, I think 100 per cent of the time we can
get people accommodation if they stick with us. It may
take two days to do that, people hanging on in there,
people being sober and not hitting people and things
like that, but if people stick with us, I don't think,
I've ever heard of one case where we've given up and
said we cannae get accommodation…if somebody is in a
crisis and needs medical services immediately, needs
mental health services immediately, needs kinda benefit
stuff…we can do that, pretty much all the time.
(Worker in outreach team).
4.52 For the service providers, success was often about
individual cases. Workers in a hostel, for example, would
describe how some former residents had been successfully
resettled into general needs housing and had been able to
sustain their tenancies. Sometimes the outcome would be
less definite than that, though 'hard to measure'
successes, for example, getting a highly alienated
individual to talk and respond to a worker after some weeks
of trying to engage with them, were viewed in positive
terms.
The effectiveness of RSI: the views of service
providers
4.53 Knowledge of RSI among the service providers
interviewed was varied. In some cases, respondents had been
working with people sleeping rough since the beginning of
the programme and were able to talk in detail about the
first round bids made by their service and all the
subsequent bids. At the other extreme, there were
individuals who were working for a service that, while it
had initially drawn on RSI funds, was now wholly funded by
Supporting People and whose knowledge of the RSI was
limited.
4.54 As was the case with local authority respondents
(see
Chapter Three) the service
providers who were able to comment on the RSI programme
were generally very positive about the impact of RSI in
their area and on their service. The positive impacts of
the RSI programme were, from the perspective of service
providers, centred on three areas:
- providing a financial base from which new services
could either be developed, or with which existing
services could expand offer a wider range of
services;
- changing local attitudes to rough sleeping by
placing the social problem within the mainstream policy
agenda in their area and by acting the catalyst for
subsequent strategic reforms;
- producing a reduction in overall levels of rough
sleeping in their area.
Providing a financial base for service
development
4.55 In some rural and small urban areas, RSI capital
funding, revenue funding, or a combination of the two, had
allowed the development of new services. Moving from a
situation in which services were non-existent, or in which
existing service provision was highly limited, was always
seen as having been a positive step by service
providers.
4.56 RSI funding was also seen as allowing the
development of innovative new forms of service. The street
outreach teams were designed to meet sets of needs that had
not been the subject of specific service provision before,
as they were sometimes engaging with individuals who might
not even approach a daycentre for assistance.
4.57 RSI funding was also described by some service
providers as making existing services, which previously had
lower levels of funding, more extensive. In many respects,
from the perspective of service providers, this change
might have been characterised as allowing some services to
move from an 'emergency accommodation' model to a
'resettlement' model, or as the means by which generic
homelessness services were able to develop discrete,
targeted support for people sleeping rough for the first
time.
Through the RSI coming on stream from the Scottish
Executive, it doubled our team. We were a relatively
small team. When the funding came on board, it doubled
our team and we were then able to offer an exclusive
service to rough sleepers. That service might have been
there in the past, but in a very limited way, because
of the numbers of our team, yes, we dealt with rough
sleepers who presented, but we dealt with everyone who
presented and a lot of our energies, team wise, were
taken up with operating the building, keeping it
running…(Service Provider, Glasgow).
Cultural and policy changes and the RSI
4.58 In common with some local authority respondents
(see
Chapter Three), service
providers sometimes referred to the role of the RSI
programme in raising the profile of rough sleeping, and
homelessness in general, within their area. Service
providers in rural and smaller urban areas reported that
the RSI had both drawn attention to sleeping rough as a
social problem and acted as something of a catalyst to
raising the profile of homelessness more generally with
their areas.
4.59 In the cities, RSI was viewed by some service
providers as having raised the profile of rough sleepers
within local policy agendas, both in the sense of drawing
attention to the issue, but also in the sense of
encouraging a greater degree of joint working between
statutory agencies and the voluntary sector. Some service
providers in Glasgow and Edinburgh, for example, viewed the
extensive infrastructure of specialised homelessness and
rough sleeping services of which they were a part as being,
in the first instance, brought about by RSI. The strategic
responses to rough sleeping in these cities, at the time of
writing, were also viewed as product of subsequent
developments, such as health and homelessness action plans,
homelessness strategies, legislative change and Supporting
People. RSI had nevertheless taken the 'first step' in
developing the current range of service provision.
You're seeing less people sleeping rough, I would
say and even those who are sleeping rough are still
getting good support, the street team I'm thinking of
particularly and how agencies like the street team will
liaise with other services like ourselves…there is
partnership working on people's cases, to get them off
the streets, there's a lot more sharing of
information…the RSI brought a lot of the City of
Glasgow's agencies together, if you like, helped them
tae focus, work well as a team and in a partnership
way. I think some of that was already in place, this
helped it, the RSI funding cemented it in place.
(Service Provider, Glasgow).
It has acted like a stepping stone for things to
come after and build on it, like Supporting People.
Without that stepping stone it would have been much
more difficult to develop a Supporting People type
service, RSI allowed a much smoother
transition…(Service Provider, Edinburgh).
4.60 This view of RSI as promoting a positive cultural
change was not universal. In some areas in which RSI
spending was relatively low, a few service providers
reported that local attitudes had not particularly changed
and that attitudes from other service providers towards
people sleeping rough were still sometimes negative.
4.61 In addition, although a few of the service
providers reported feeling that RSI had promoted a cultural
change in the wider sense of having changed public
attitudes towards rough sleepers or homeless people, others
did not share this opinion. Some reported that rough
sleepers were seen by the public as a population who
deliberately choose their specific lifestyle, rather than
as a vulnerable group in need of support services.
Reducing rough sleeping and the need to sleep rough
in their area
4.62 The views of service providers on the impact of RSI
on the level of rough sleeping in their area were almost
universally positive. All reported that rough sleeping was
less of a social problem than it had been before RSI was
introduced. In some cases, service providers' perceptions
were that the RSI had produced a dramatic reduction in
rough sleeping, a view that was reported by service
providers in smaller cities such as Dundee and
Inverness.
4.63 In other cases, service providers took the view
that a marked reduction in rough sleeping had occurred as a
result of RSI. For the most part, this was the view of
service providers working in the two areas where the bulk
of RSI funding had been directed, Glasgow and
Edinburgh.
4.64 However, views on the extent of rough sleeping in
Glasgow at the time of writing were less positive among
service providers in that city. As noted above, some
service providers felt that the hostel closure programme in
the city had not brought sufficient new bed-spaces into
use, meaning that there was a significant shortfall in
temporary accommodation, from their point of view. Although
overall levels of rough sleeping had fallen in Glasgow
since the introduction of RSI, some service providers had
the perception that they were perhaps higher than they
should be, because of logistical issues in the hostel
closure programme.
4.65 In some of those areas where rough sleeping had
been a small scale problem and the amount of RSI funding
had been corresponding small, the impact of RSI on levels
of rough sleeping was again viewed positively by service
providers. However, the perception could be that RSI had
removed something that was not a particular issue in the
area. This view existed particularly among service
providers whose main activities were not focused
specifically on rough sleeping, but on other forms of
homelessness, whose projects had once been supported by
RSI, but were now funded through Supporting People.
The future of RSI
4.66 The main concern of the service providers who were
receiving significant funding from the RSI
7 was that the funding be continued. This was
particularly true of those services which did not have an
obvious alternative source of income, such as the
Supporting People programme, because they were not housing
based. The street outreach teams and the daycentres were
the best examples of services in this category. Those
services receiving a mixture of RSI and Supporting People
funding were also keen to retain their RSI funding, as they
reported that RSI funding could be used in flexible ways
compared to other grants and allowed a specific focus on
people sleeping rough. There was no particular attachment
to the specific programme, merely a wish that funding
specifically allocated to rough sleeper services continued
to be available.
4.67 Those services that were no longer recipients of
RSI funding were less concerned with these issues. In some
instances, these services tended to encounter people
sleeping rough only relatively rarely and so did not see
rough sleeping as a particular issue in their area.
« Previous | Contents | Next »