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FINAL EVALUATION OF THE ROUGH SLEEPERS
INITIATIVE
CHAPTER 6: CONCLUSIONS
Introduction
6.1 This final Chapter of the evaluation draws together
the key findings from all aspects of the evaluation of the
Scottish RSI, and presents a series of policy and
methodological recommendations arising from the research.
The first part of this Chapter considers the research
evidence in respect of the three main objectives of this
programme level evaluation and reports the main conclusions
in respect of:
- the extent to which RSI funding has been used
effectively to help eliminate the need for rough
sleeping in Scotland;
- the extent and effectiveness of the mainstreaming
of RSI services, and;
- the effectiveness of current monitoring
systems.
6.2 The following section considers the extent to which
RSI has followed the recommendations reported by Yanetta
et al (1999) for the interim evaluation of the
programme. The Chapter then moves on to consider the
opinions of those who participated in the fieldwork on the
future of the programme.
6.3 The remainder of the Chapter covers the
recommendations on future practice for the delivery and
monitoring of services to meet the needs of rough sleepers,
in order to sustain a national position where no-one need
sleep rough.
RSI effectiveness and the need to sleep rough
in Scotland
The effectiveness of RSI
6.4 RSI was viewed as a highly successful initiative by
all of the main types of stakeholders interviewed in the
course of the study. National-level bodies, local authority
representatives, service providers and service users were
all largely positive about its impact and
effectiveness.
6.5 Local authority representatives reported that RSI
had enabled the development of new services and enabled the
expansion of existing services. Cities reported that their
services had become more comprehensive and were able to
specialise, some smaller authorities reported that they
were able to develop services for people sleeping rough for
the first time. A majority took the view that RSI had
placed the needs of people sleeping rough within the
political mainstream at national level and, in most
instances at local level. RSI was seen as a catalyst for
increased joint working and joint planning, initially in
respect of people sleeping rough, but later as the
beginning of the processes that led to the development of
strategic planning in respect of all forms of homelessness.
All local authority respondents reported tangible
reductions in levels of rough sleeping since the
introduction of the programme in their area, although the
extent to which this was the case varied to some degree
between authorities.
6.6 Service providers shared the views of local
authority providers to a considerable extent. RSI was seen
as politically important at a local and national level in
changing policy makers' and service providers' attitudes to
people sleeping rough, so that they began to be seen as
vulnerable individuals who were legitimately within the
remit of publicly funded services. Like local authority
respondents, the service providers felt that RSI had
facilitated an expansion of services where they already
existed and had allowed the development of services in
smaller local authority areas that had previously lacked
services. Again, service providers generally shared the
view that improved coordination and strategic integration
of rough sleeper services had resulted from RSI, and also
tended to report that RSI had acted as an early catalyst
for the development of integrated homelessness strategies.
There was a feeling among service providers that RSI had
produced visible reductions in people sleeping rough in
their areas since the programme was introduced.
6.7 Both local authority respondents and service
providers viewed the flexibility within RSI funding as
making an important contribution to developing specific
services for people sleeping rough and also thought there
were benefits associated with having an identified funding
stream for rough sleepers, which helped keep them and their
needs on the agenda. The evaluation team found that some
RSI funded services, such as street outreach teams and
daycentres, would find it difficult to qualify for the
accommodation-linked funding of the Supporting People
programme or for other funding streams. The evaluation team
also found instances where RSI money had been used to fill
awkward gaps in services for people sleeping rough which
were a by-product of the rules governing larger funding
programmes.
6.8 Service users had varied perspectives on the impacts
of RSI. While these respondents were not able to comment on
the specifics of the programme, they could in many
instances remember what services were like before RSI
arrived and what the impact of RSI had been. In some cases,
service users viewed this change as having been a positive
one, remembering how previously more limited services had
been expanded and extended. However, in one instance, where
the undemanding nature of services that were focused simply
on the provision of food, shelter or other basics for
sustainment had been replaced with an expectation that
service users enter resettlement, the change brought about
by RSI was less positively viewed. Overall, current, former
and potential rough sleepers, while they also identified
some limits and problems, praised the RSI funded services
that they used.
Statistical evidence
6.9 The GSR monitoring data illustrated a reduction in
the need to sleep rough associated with the RSI programme
(see below). Statistical information specifically
illustrating service effectiveness was restricted at the
time of writing, meaning that statistical longitudinal
analysis of the extent to which specific services, or
services as a whole, were able to successfully resettle
former, potential and current rough sleepers was not
possible at the time of writing.
Edinburgh and Glasgow
6.10 The majority of funding under the RSI programme was
directed to Glasgow and Edinburgh, and so it is important
to give these cities specific consideration. The two cities
differ from one another in a number of respects. Edinburgh
is characterised by a combination of a highly pressured
housing market and by inward migration from other parts of
the country and from other countries in the UK. Some parts
of the city's social rented stock are characterised by
residualisation
9, which through a combination of higher than normal
rates of crime and anti-social behaviour makes the stock
difficult to let, creating a further pressure on affordable
and adequate housing supply. There is also evidence that
Edinburgh has a higher than usual number of people sleeping
rough who arrive in the capital from elsewhere in the
country and from England (see
Chapter Two).
10
6.11 Glasgow, in contrast with Edinburgh, while it has
areas that have highly pressured housing markets, is a city
that has experienced outward migration and lost population
in recent years. Within the city, pressures on affordable
and adequate housing are more closely linked to the
residualisation of the social rented stock than they are in
Edinburgh. Although both cities face drug problems (Neale
and Kennedy, 2002), this social problem seems particularly
pronounced in Glasgow among people sleeping rough
(Morrison, 2003, reports 48 per cent of people sleeping
rough are drug users, p. 39). Evidence from the fieldwork
conducted in Glasgow also suggests that there is a higher
concentration of people sleeping rough who are
characterised by multiple needs and challenging behaviour
than is found in other local authorities in Scotland. The
development of long stay supported housing targeted
particularly on this group by the city council reflects
this pattern of need. There also appear to be fewer rough
sleepers arriving from outside the city than is the case
for Edinburgh.
6.12 Respondents in Edinburgh, both from within and
outside the city council and amongst service providers,
took the view that the RSI had been highly effective in the
capital, with rough sleeper and other homelessness services
that were well co-ordinated. Edinburgh services also seemed
particularly well-regarded by service users and not just by
those currently using services in the capital. Integration
between RSI funded services, Supporting People planning and
the local authority homelessness strategy was seen as well
advanced and the city had developed an outcome led version
of the GHN database monitoring all homelessness services
across the city (see
Chapters Three and Four).
6.13 The picture in Glasgow was more mixed. RSI was seen
as having made a visible difference to rough sleeping
within the city. Glasgow was also felt, by respondents
within the city, to have responded particularly quickly to
the opportunities presented by the RSI, facilitated by the
co-ordinating role that the GHN undertook in putting
together the bid.
6.14 However, while it was generally emphasised that
much had been achieved by the RSI programme in Glasgow, a
few respondents felt that the quality of service had not in
all respects matched the level of investment. Glasgow was
in a position, according to respondents in the city, where
it had to manage major RSI grants, a major programme to
replace its homeless hostel provision and the Supporting
People changes in quick succession. Coordination had not,
according to a few respondents in the city, always been all
that it could be, both in terms of joint working between
the city council and the voluntary sector and in the
strategic synchronisation of the hostel closure programme
with wider homelessness strategy in the city. There were
varied views on these issues within the city.
6.15 At the same time, Glasgow respondents acknowledged
that the RSI in Glasgow was 'starting from a different
place' than elsewhere in Scotland, because of the presence
of the large-scale hostels (now being replaced) and their
associated legacy of drugs and violence, making
implementation more challenging than in other cities.
6.16 Recent developments in the city were seen as
positive, with work towards addressing some of these issues
being described as well underway. There was a general view
that earlier difficulties were being overcome and that
progress was being made in coordination and strategic
planning across the city (see
Chapters Three and Four).
The limitations of RSI
6.17 For the local authority respondents, the
effectiveness of RSI was limited in two main ways. The
first was the wider social and economic context in which
services were working. In most localities, difficulties in
accessing affordable housing were seen as an important
limitation on service effectiveness, as former, potential
and current rough sleepers could not always be resettled
into permanent housing very easily. In some rural areas,
with economies dependent at least in part on tourism, where
there were both planning restrictions to preserve areas of
outstanding natural beauty and thriving second home and
holiday home markets, affordable housing was viewed as
extremely scarce in relation to need. In some urban areas,
notably Glasgow and Dundee, the issue was less the
availability of affordable stock than the situation of that
stock, which was located in areas of severe economic
deprivation, with high crime and high levels of anti-social
behaviour. Some of this housing stock was felt to be
unsuitable for the resettlement of people sleeping rough
and other homeless households. Edinburgh seemed to be
caught in a situation of having very high levels of housing
demand existing alongside a partly residualised social
rented sector.
6.18 The second limitation of RSI, for local authority
respondents, was that some elements within the population
of people who sleep rough were difficult to reach. As noted
in
Chapters Three and Four, these
elements included three main groups. The first of these
groups were people sleeping rough characterised by multiple
needs and challenging behaviour, who were difficult to
engage with because of their characteristics and the
tendency of some individuals to be highly mobile. Outside
Glasgow, this group were felt to be very small in number.
The second group were those individuals who might be
described as very precariously accommodated. These included
those people who were moving repeatedly from one relative
or friend to another, who might sleep rough if any of these
arrangements broke down, but who, for the most part were
keeping a roof over their head through informal
arrangements. The third group were those individuals and
households who suddenly became homeless and had no idea
where to go for assistance, meaning that they spent a short
amount of time sleeping rough prior to finding a service or
presenting as homeless to a local authority. Members of
this third group were not viewed as being likely to sleep
rough for a sustained period or to experience recurrent
rough sleeping.
6.19 To a large extent, the service providers shared
these views of the limitations of RSI. Several described
the presence of a 'difficult to engage' group of people
sleeping rough who absorbed disproportionate levels of
staff time and with whom it was more difficult to proceed
to effective resettlement. This group were described by a
few respondents as being in a situation of continual
crisis. Similarly, successes were sometimes reported as
being easiest to achieve with those in the second and third
groups of people sleeping rough, as these individuals were
mainly in housing need, something that was easier to
address than meeting a range of different housing, health,
personal care and low intensity support needs. Service
providers shared the views of local authority respondents
in respect of issues of access to affordable housing and
they also added an additional external limitation, which
was the accessibility of some other services, particularly
supported housing (in some areas) and drug and alcohol
rehabilitation.
6.20 Service users raised issues about the availability
of services and appropriate accommodation. For drug users,
the major issue in their lives was what they saw as the
lack of support and detoxification services to help them
end their dependency, particularly for those using opiates.
Problems in accessing mental health services were also
reported by a few service users. Service users also
reported issues in a lack of suitable, affordable housing
and, in a few instances, a wish to access supported housing
services.
Statistical evidence
6.21 The available statistical data, largely drawn from
the GHN dataset (see
Chapter Two) suggested an
ongoing need for rough sleeper services nationally, as
there was evidence of presentation of 'new' rough sleepers
to RSI funded services, albeit in fairly low numbers. As
noted in
Chapter Two, the available
statistical evidence on service effectiveness is limited in
a number of respects at the time of writing, so accurate
statistical measurement of the extent to which services
successfully engage with current, former and potential
rough sleepers was not really possible (see below and
Chapter Two for more discussion
of these issues).
Edinburgh and Glasgow
6.22 Edinburgh was seen as a city with well coordinated
services working within an effectively integrated strategic
planning framework, by local authority respondents and
service providers, both within and outside the capital.
Limitations on RSI effectiveness could only really be
discussed in terms of the factors affecting wider
homelessness strategy within the city, which centred on
supply issues in affordable and appropriate permanent
accommodation and some issues in respect of access to other
services (see
Chapters Three and Four).
6.23 Within Glasgow, coordination between services was
felt by respondents, both within and outside the city, to
be somewhat less developed. RSI was generally associated
with an ongoing process of ever increasing levels of joint
working between agencies within the city, but coordination
was sometimes felt not to be all that it might be. The main
example of this was the hostel closure programme within the
city, which a few respondents felt was not as well matched
with the homelessness strategy and objectives in relation
to rough sleeping as it could be. Some service providers in
the city reported a shortfall in hostel bed-spaces, as
existing hostel provision was closed more quickly than it
was replaced, seen by some as leading to short term
increases in rough sleeping, although all respondents
within the city reported that it was right to close and
replace the existing hostel provision.
6.24 The city was also reported by respondents as having
a higher proportion of difficult to reach people sleeping
rough who were characterised by multiple needs and
sometimes challenging behaviour that made them difficult
for services to engage with effectively. This concentration
of need had been reacted to by the city council, which had
sought to develop long stay supported housing for people in
this group (see
Chapters Three and Four).
6.25 Glasgow respondents also reported there were
difficulties in relation to access to appropriate
affordable accommodation, because of the residualisation of
some of the city's housing stock. There were also issues in
relation to access to other services, particularly for drug
users (see
Chapters Three and Four).
Ending the need to sleep rough
6.26 Local authority respondents varied in their views
as to how far the national target that no one need sleep
rough had been met in their area. Tangible, visible
reductions in rough sleeping were universally reported in
comparison with the situation that existed prior to the
introduction of the RSI programme. However, these
reductions were in many instances seen as the result of a
process of service development and strategic planning that
RSI had begun, rather than as a product simply of RSI
itself. It was the development of integrated homelessness
strategies, health and homelessness action plans and
Supporting People plans within each area, for which, as
noted above, RSI was seen as a catalyst that had produced
these tangible effects in the view of most local authority
respondents. In some instances, RSI remained at the core of
these processes, in others, where the amount of grant had
never been large, RSI had become peripheral within wider
homelessness and Supporting People strategies.
6.27 Some local authority respondents identified what
they saw as ongoing structural issues linked to housing
availability and other issues, as discussed above,
preventing achievement of the target. In some rural and
smaller urban areas it was felt that the need to sleep
rough had not ended because of continuing shortages in
suitable temporary and permanent accommodation. In a number
of cases these difficulties were said to have worsened
recently as a result of the increased demand for temporary
accommodation following the 2001 legislative changes.
Again, the presence of three 'hard to reach groups' -
highly dependent people with multiple needs, a
'sofa-surfing' population of precariously accommodated
people and those who slept rough for a little while because
they did not know where to seek assistance, was reported by
local authority respondents.
6.28 The existence of these three groups meant that, in
the view of some local authority respondents, a permanent
elimination of rough sleeping was not likely to occur.
However, this was viewed in the context of the bulk of the
problem that existed prior to RSI having largely been
addressed. The continuing existence of these forms of rough
sleeping need not necessarily be viewed as reflecting
poorly on the effectiveness of the RSI: the numbers
involved in the first group were thought to be extremely
small; the rough sleeping experience of the second group
was thought not to constitute a public policy priority if
their problems are adequately dealt with once they make
contact with a local authority or other services; and the
'invisibility' of the third group meant that they are
extremely difficult for services to reach. It is also worth
noting that the extension in the rights of 'non-priority'
groups under the 2001 and 2003 Acts may mean that the
second and third groups have better access to permanent
housing.
6.29 For service providers, the picture was essentially
the same as that seen by local authority respondents. RSI
was universally seen as producing falls in the levels of
rough sleeping, although, again, these falls were also seen
by some respondents as being a product of ever greater
joint working and strategic planning across homelessness
services as a whole. Supporting People and homelessness
strategies, along with the health and homelessness action
plans, were all important in understanding how the
reductions in rough sleeping had occurred. The effects of
RSI in helping bring agencies together were often seen as
almost as important as the money it had provided. Problems
remained, from their point of view, in relation to
affordable housing supply and access to some services, such
as drug and alcohol and mental health services, as
discussed above.
6.30 Among service users, views on the need to sleep
rough in different areas were more mixed. Some pointed to
an improvement in services over time, but others identified
both shortages in suitable housing and in access to drug
detoxification and rehabilitation services as significant
obstacles. In a few cases, current, former and potential
rough sleepers reported what they perceived as a shortfalls
in service provision for people sleeping rough in their
area.
Statistical evidence
6.31 The GSR monitoring of the need to sleep rough
nationally suggested a fall in the number of people
sleeping rough that were being seen by the projects
participating in the GSR monitoring (see
Chapter Two). The figure
reported in October 2003 was more than one third lower than
the figure reported in May 2001. It should also be noted
the data collection was somewhat less complete in May 2001
than it was by the end of 2003, suggesting that the
reduction may have been somewhat greater than that reported
(Laird
et al, 2004). The findings of this monitoring were
felt to tally with local experience of levels of rough
sleeping by many respondents.
6.32 As is noted in
Chapter Two, the GSR monitoring
was intended as an assessment of the need to sleep rough,
not as a census of people sleeping rough across the
country. In essence, the monitoring tracked an improving
balance between increasing numbers of available services
and falling numbers of current, former and potential rough
sleepers seeking those services. These findings and the
weight of qualitative evidence from this report, indicated
tangible and sustained reductions in the need to sleep
rough across the country; these were a direct result of RSI
and other policy and strategic innovations around
homelessness at national and local level.
6.33 The distinction between a target to end the
need to sleep rough and a target to end sleeping
rough must always be borne in mind, in that the views of
most respondents (and the available statistical and
research evidence) suggest that new rough sleepers will
continue to appear and continue to need services. While
this issue might be addressed to some extent through an
increased emphasis on preventative work, both qualitative
evidence from this research and the data from the GHN
monitoring, do suggest that various socioeconomic factors,
interacting with personal needs, characteristics and
experiences, will continue to generate rough sleeping, just
as they continue to generate homelessness.
Geographical mobility and the need to sleep
rough
6.34 There is a need to bear in mind that while in most
areas people sleeping rough are local to those areas, the
situation appears to be different in Edinburgh and some
rural areas. According to the GHN monitoring (see
Chapter Two) and the fieldwork
conducted for this evaluation, some areas have more people
sleeping rough who have come from other parts of the
country than some other areas.
6.35 Both local authority respondents and service
providers sometimes reported that their area was
characterised by people sleeping rough who 'passed through'
the area or by people sleeping rough being quite often
found to be from outside the area. This is a difficult
issue, as it is a common misconception that people sleeping
rough are a mobile population who come from 'outside' areas
to access services that are intended for local people. In
practice, even where respondents from Edinburgh and some of
tourism centres in the Highlands reported this as being an
issue, they nevertheless reported that people sleeping
rough in their area were generally locals. Across much of
the country, service providers and local authority
respondents viewed their homeless and rough sleeping
populations as overwhelmingly local.
6.36 Assessments of the need to sleep rough do need to
reflect these variations in the mobility of rough sleeping
populations where they exist. As noted, it is important not
to exaggerate the extent to which this is an issue, but
some localities faced different patterns of need linked to
the mobility of current, former and potential rough
sleepers in their area.
Edinburgh and Glasgow
6.37 Both cities faced ongoing issues in tackling the
need to sleep rough. Edinburgh had difficulties in relation
to housing supply and the city tending to have higher
proportions of people sleeping rough who had origins
outside the area. However, its services were generally
praised by respondents.
6.38 In Glasgow, two sets of issues were identified by
respondents within the city. Again, the presence of an
unusually large group of 'hard to reach' people sleeping
rough with multiple needs and challenging behaviour was
reported by respondents. This 'hard to reach' group, had,
as noted led to a city council service initiative aimed at
providing long stay high support housing. The second set of
issues related to issues of accommodation supply, both in
respect of suitable affordable permanent housing, because
of residualisation and in respect of a lack of temporary
accommodation, which was seen by some respondents as being
caused by shortfalls in hostel beds as a result of the
city's hostel replacement programme.
The mainstreaming of RSI services
6.39 The results of the fieldwork for this evaluation
suggested that the process of mainstreaming RSI services
within strategic planning was well underway across the
country. From being a sector that was, at best, only
partially involved in wider strategic thinking at local and
national level, rough sleeper services were increasingly
well integrated within mainstream service planning. RSI was
widely seen by interview respondents as representing the
first steps towards both the integration of rough sleeper
services with other homelessness services, NHS Scotland and
local authorities. This process had been accelerated by the
advent of homelessness strategies, the recent and planned
changes to the homelessness legislation, health and
homelessness action plans and Supporting People
planning.
6.40 Mainstreaming had also occurred in the sense that
RSI budgets were increasingly integrated within spending
across homelessness services. This process was still
underway in some areas, but in others, such as Edinburgh,
RSI funds were effectively treated as part of a
strategically organised 'homelessness' budget, made up of
RSI, Supporting People and a range of other grants.
6.41 The mainstreaming of services can also have another
meaning, which refers directly to the point of service
delivery. Within the NHS, for some years, there has been a
debate about the extent to which primary care should be
offered directly via specialist services to people sleeping
rough as opposed to gearing generalist services so that
they can cope more effectively with the needs of rough
sleepers. The arguments for 'mainstreaming', in this very
particular sense, are that the difficulties exist with
providing specialist services (they are only viable in
areas where given populations exist in relatively
concentrated numbers and create additional costs). There is
also the feeling among some commentators that specialist
services may reinforce the separateness and alienation of
groups like people sleeping rough, making it more difficult
for them to use mainstream NHS services. The contrary
arguments are that trying to engage with groups like people
sleeping rough via generalist NHS services creates
management problems for medical and administrative staff,
potential difficulties for both staff and other patients
linked to issues such as drug dependency and challenging
behaviour and that services insensitive to the particular
needs of groups like people sleeping rough will be
inaccessible. What research evidence there is suggests that
people sleeping rough have difficulty engaging with the
mainstream NHS and, in the absence of specialist services,
or unusually sympathetic individual GPs, they fail to
access necessary healthcare (Pleace
et al, 2000).
6.42 Issues around mainstreaming at the point of service
delivery do not exist in quite the same way with respect to
the interrelationship between rough sleeper services and
other homelessness services. In some respects, all forms of
homelessness service, including the statutory discharge of
duties by local authorities are 'specialist', because they
deal with forms of housing need which most people never
experience. Social landlords and Supporting People funded
services provide a wealth of support and other services
beyond accommodation to homeless people, sometimes
coordinated with other specialist services targeted on
homelessness from the NHS or social work departments.
6.43 Alongside integration at strategic level, rough
sleeper services have increasingly been brought into closer
and closer relationships with other homelessness services.
An examination of RSI funding shows that, in most
instances, the distinction between an 'RSI funded service'
and other homelessness services has broken down. While
isolated examples of solely RSI funded services exist at
the time of writing, essentially just the street outreach
teams, almost all services in receipt of RSI funds are also
in receipt of Supporting People funds, often at a higher
level than their RSI grants. Service level integration
between RSI funded services and homelessness services
funded by Supporting People is almost uniform.
6.44 This process of the mainstream integration of RSI
funded services at both service delivery and strategic
level seems likely to be reinforced by the changes in the
homelessness legislation.
Monitoring information on rough sleeping and
RSI services
The GSR monitoring of the need to sleep
rough
6.45 The GSR monitoring was based on a bi-annual survey
of projects and services working with people sleeping rough
across the country undertaken during the years 2001 to
2003. The GSR monitoring had a very specific objective - to
assess the need to sleep rough nationally by comparing the
number of rough sleepers with the supply of emergency
accommodation available to them.
6.46 This evaluation concluded that the GSR monitoring
achieved this aim, though there was inevitably some
under-counting, as the monitoring was confined to those
people sleeping rough who presented themselves to services
during the survey periods. It is not appropriate to treat
the results as representing a census of people sleeping
rough, as it was designed to assess the balance between
people sleeping rough and service provision, the 'need' to
sleep rough rather than absolute numbers. As with all such
snapshot counts, its key broader value may be in the trend
data it supplies rather than in the 'absolute' numbers it
generates, and the indications from the GSR monitoring were
that the need to sleep rough had declined during the period
covered by the surveys.
6.47 Theoretically, a more accurate enumeration of the
current number of rough sleepers, which could then be
contrasted with available service levels, was possible.
However, the expense and logistical difficulties of such an
exercise, which would involve attempting to find and count
people sleeping rough wherever they might be, meant that it
was not viable. The same basic methodology as was used by
GSR was also employed for a national survey of homelessness
in the US for similar logistical reasons (Burt, 2001).
6.48 On balance, it seems the decision only to record
movement between local authority areas during the survey
weeks led the George Street team to a partially incorrect
conclusion about the geographical mobility of people
sleeping rough. As the team detected few such movements
during the survey weeks, they concluded that geographical
movement by people sleeping rough was generally restricted.
However, as noted elsewhere in this report, there is strong
evidence indicating this is not the case in at least some
areas (see
Chapter Two and above).
Understanding the degree of mobility among people sleeping
rough was important in terms of the main objective of the
George Street work, which was to assess the numbers and
distribution of people sleeping rough against available
services and bed-spaces.
GHN National Rough Sleeping Initiative Core
Data
6.49 When the original RSI was extended into a second
phase, it was decided to introduce a common monitoring
system across the projects that were being supported by the
programme, operated by GHN. At the time of writing, this
system recorded the numbers of people sleeping rough with
whom 57 RSI funded projects reported contact; their
characteristics and support needs; and project
activity.
6.50 The evaluation concluded that GHN have implemented
a monitoring system with a minimal use of resources. The
scale of the achievement in securing so much robust data
from services that can find themselves relatively short of
staffing and under a great deal of pressure should not be
underestimated. There are issues with respect to data entry
that do affect the quality of the GHN database, but most of
these could be solved through relatively minor adjustments
to the database.
6.51 The demographic and geographical data collected by
the GHN monitoring are very rich, providing a wealth of
information on the characteristics of people sleeping
rough, their mobility and their geographical distribution.
However, the GHN monitoring is markedly less well developed
in respect of its role as a tool by which the activities of
RSI funded services are monitored and as a tool by which
the service outcomes of RSI projects can be recorded and
assessed. At the time of writing, the limitations are
twofold. First, although around one third of services
complete the 'outcomes' sections of the database and
second, the range of data collected are quite restricted.
The decision of Edinburgh City Council to develop its own
monitoring system in parallel with the GHN monitoring,
which was an explicit attempt to develop an 'outcome led'
database rather than a 'demographic' database, does serve
as something of an illustration of these limitations.
6.52 At the same time it should be noted that, despite
the relatively much greater scale of expenditure under RSI
and from the Homelessness and Housing Support Directorate
in England, there is no equivalent national dataset in that
country, meaning information on rough sleeping is much more
restricted than is the case for Scotland. Understanding of
rough sleeping for policy and strategic planning is
considerably enhanced by the GHN dataset.
Progress since the interim evaluation
6.53 An interim evaluation of the RSI conducted by
Yanetta
et al was published in 1999. This evaluation
reported on the initial round of RSI grants (RSI-1) which
were received by thirteen of the local authorities that
submitted bids. The authors found that RSI was proving
successful, but that a number of issues remained to be
resolved, these included:
- a stronger emphasis on incorporating services for
people sleeping rough into strategic planning,
including incorporation into homelessness
strategies;
- greater NHS Scotland and social work department
involvement in service provision for rough
sleepers;
- an appropriate package of resettlement, tenancy
sustainment and preventative services for people
sleeping rough in each local authority area;
- recognition of ongoing issues in affordable housing
supply in some areas, affecting the ability of services
to move former rough sleepers on;
- recognition of barriers to entry and shortages of
some forms of service for people sleeping rough,
particularly drug and alcohol services.
6.54 Some of the recommendations of the interim
evaluation have been successfully met in the intervening
years between its publication in 1999 and the time of
writing in early 2005. In the case of the recommendations
for greater integration, the adoption of the ideas within
the Homelessness Task Force report, including the
requirement for local authorities to have homelessness
strategies and the requirement for health boards to have
health and homelessness action plans, coupled with the
strategic requirements attached to Supporting People
funding, have generated integration at strategic level. In
terms of integration at service delivery level, there was
evidence of progress in access to NHS Scotland primary care
services for people sleeping rough, but less evidence of
success in relation to the drug rehabilitation services and
mental health services accessed through either the NHS or
social work departments.
6.55 In practice, rough sleeping only exists at
sufficient concentrations in some areas of the country to
allow the development of specialist services aimed
particularly at people sleeping rough. Outside Glasgow,
Edinburgh and some other cities such as Dundee, the numbers
reported, both from the fieldwork conducted for this
evaluation and from the GHN statistical monitoring and GSR
monitoring, are often very low. The development of a suite
of specific rough sleeper services in these areas of the
country is, realistically, not practical. However, the
needs of people sleeping rough can be effectively met
through ensuring that other homelessness services can,
where possible and practical, adapt to their needs. As the
distinction between 'types' of homeless household across
the country begins to come to an end, this kind of generic
homelessness service should become more commonplace. There
is a need to ensure that such services can address the
needs of people sleeping rough in areas where they are less
common.
6.56 As noted by Yanetta
et al (1999), problems with suitable and
affordable housing supply remain a national issue at the
time of writing.
The future of RSI
6.57 Most local authority respondents and service
providers were of the view that a flexible funding source
suitable for funding services for people sleeping rough
would continue to be important. Many respondents reported
that if RSI ceased it was not clear what the future of some
services working with rough sleepers might be. In several
areas it was said that the RSI posts and services would
definitely go if the RSI funding ceased as the local
authority was seeking to make cuts.
6.58 A few local authority respondents felt strongly
that the end of a specific, designated stream of money
would mean a loss of focus on people sleeping rough
11. A concern was expressed that, without a special focus
on people sleeping rough, and funding to match, the
achievements of the programme might be undermined.
6.59 Other respondents, including some in Glasgow and
Edinburgh, took the view that rough sleeper services should
be fully integrated within wider homelessness strategies,
and that RSI funding should be absorbed as part of a single
homelessness grant; a process that was seen as largely
complete in the capital. At the same time, these
respondents emphasised the view that there should continue
to be a specific focus on rough sleepers within local
outcome agreements linked to local homelessness strategies.
This position was echoed by national level respondents.
6.60 Respondents from some smaller urban and rural
authorities felt that, while RSI was a good starting point,
it was now best to merge it with general homelessness
funding. For these authorities, rough sleeping was a small
social problem within the wider problem of homelessness in
their area; in their view, there were not sufficient rough
sleepers in their locality to warrant the development of
specific services, a specific funding stream or a separate
policy focus.
6.61 The main concern of the service providers who were
receiving significant funding from the RSI was that this
income stream be maintained. 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.
6.62 Many respondents felt that there was a need for a
continuing national level target on rough sleeping, though
some took the view that if the 2003 legislation was fully
implemented there would no longer be any requirement for a
specific target on the 'need' to sleep rough.
Overall conclusions
6.63 The evaluation of the RSI as a discrete programme
has become problematic because the planning of services and
the delivery of services is now so integral to responses to
homelessness more generally. Specific monitoring of RSI
services through Local Outcome Agreements has been merged
with the monitoring of homelessness strategies. The
majority of RSI funded services receive at least as much of
their funding, and often a good deal more, through
Supporting People, as via RSI grants. This 'mainstreaming'
at both strategic and service delivery level is a desirable
outcome and an achievement for the RSI programme, but it
does create a situation in which the boundaries of the RSI
programme and the services it funds have become less clear
than they were at the time of the Interim Evaluation
(Yanetta
et al, 1999).
6.64 The RSI has been a successful programme that has
largely fulfilled its objective to end the need to sleep
rough in Scotland. The introduction of a flexible funding
programme allowed the development of new services in areas
that had previously lacked any specific provision and also
enabled the further development of the sector in those
areas that had some service provision. RSI was widely seen
as having culminated in the adoption of local authority
homelessness strategies which are coordinated with both
health and homelessness action plans and Supporting People
plans. Consequently, services for people sleeping rough are
increasingly integral to strategic responses to
homelessness. Positive changes in cultural and political
attitudes, which raised awareness of the multiple needs
among people sleeping rough and placed their needs on local
and national agendas were strongly associated with the
introduction of RSI. There is statistical and qualitative
evidence that significant, tangible reductions in the
levels of rough sleeping have occurred since the programme
began.
6.65 There are limits to the effectiveness of RSI. Some
groups of former, current and potential rough sleepers are
difficult for services to engage with, as much because of
their situation and characteristics as because of the
finite resources available to those services. In terms of
service delivery, beyond the existing provision of services
that specifically target the most marginalised and
challenging people sleeping rough, it is difficult to see
what else might be done. After a certain point,
ever-increasing levels of expenditure on what is quite a
small group of people with high needs, would start to
become hard to justify.
6.66 There are many other changes outside direct service
delivery that can potentially benefit people sleeping
rough. The increased coordination and comprehensiveness of
responses to all forms of homelessness has been of general
benefit to rough sleepers and it can be anticipated that
the ongoing legislative changes will ease their access to
accommodation in some respects. At the same time, however,
a lack of suitable and affordable accommodation is evident
across the country and this will continue to limit the
effectiveness of responses to homelessness at strategic and
service delivery level. There are also issues in respect of
access to certain kinds of health and social work services,
with the adequacy and accessibility of drug detoxification
services for people sleeping rough, being highlighted in
the fieldwork for this evaluation.
Recommendations
6.67 A number of recommendations arise from the analysis
presented in this report. The recommendations presented
below are divided into overall recommendations for the
programme and specific recommendations with respect to
monitoring of services.
The future of the programme
- There are good strategic and logistical arguments
for integrating RSI planning, commissioning and service
delivery within local authority homelessness strategies
and associated Supporting People planning. The process
of mainstreaming RSI services at strategic and service
delivery level is effectively complete in several areas
and should be encouraged where it is not yet
completed.
- Specific targets to ensure services are geared
towards the needs of people sleeping rough should be
integrated into local authority homelessness strategies
and externally monitored, to ensure that the focus
brought to rough sleeping by RSI is not lost.
- If integration of RSI funding with other funding
streams were to occur, it would be of central
importance to retain the flexibility that has
characterised the programme. For example, if RSI
funding became integrated into Supporting People, the
usual rules with respect to tying funding of services
to accommodation would need to be suspended for
services for people sleeping rough. Specific
modifications to the criteria for funding services for
particular client groups are commonplace within the
Supporting People programme.
- There is evidence of a continuing need for rough
sleeper services. Any significant reductions in
expenditure on homelessness and rough sleeper services
are likely to produce corresponding rises in rough
sleeping.
- Further consideration should be given to
investigating the effectiveness of preventative
services, in the light of evidence of ongoing
need.
- The provision of highly supportive long-term
housing settings should be investigated as a possible
option for meeting the needs of people sleeping rough
with multiple needs and challenging behaviour.
- Specific initiatives such as RSI are affected by
the context set by wider housing and social policy
across the country. Issues such as the availability of
suitable and affordable housing across different areas
will have an impact on the effectiveness of
homelessness strategies in relation to rough sleeping.
Wider policy debates should take account of
homelessness and rough sleeping where applicable.
The monitoring of rough sleeping and rough
sleeper services
- There is a strong case for maintaining a specific
national target on rough sleeping to retain appropriate
attention on this easily marginalised group. However,
when the 2003 legislation is fully implemented, it may
be sensible to revise the 'no-one need sleep rough'
target to reflect a changed context whereby there will
be a duty on local authorities to supply accommodation
to all homeless groups. If this revised target relates
to reducing the overall numbers of people sleeping
rough, it may be possible to assess this with the
suggested modified version of the GHN database.
- The need to continue monitoring of rough sleeper
services is clear, in order to assess cost
effectiveness and to provide data for local and
national policy planning and strategy. The existence of
the national dataset on rough sleeping provided by GHN
gives Scotland a much clearer picture of progress in
tackling rough sleeping than is available in
England.
- There is a need to address issues in respect of the
data entry systems within the GHN monitoring database,
as quality control needs some further development.
- The GHN monitoring lacks sufficient outcome
measures, it collects insufficient information from an
insufficient number of organisations. Both the range of
data collection and the response rate need to be
improved.
- Although there are problems with the GHN
monitoring, this dataset provides a wealth of data
within a very small operating budget. There are good
arguments for retaining the role of GHN in managing a
revised database system, despite some operational
problems, because of the degree of success that has
been achieved.
- To maintain a separate 'RSI' database for the
foreseeable future is illogical in the context of the
mainstreaming of RSI funded services within local and
national strategic responses to homelessness. Such a
database would represent a increasingly arbitrary set
of homelessness projects. Consequently, if the GHN
database is to be maintained, it would be logical to
roll it out across homelessness services throughout the
country.
- The database developed by Edinburgh City Council,
which is outcome led and covers all homelessness
services in the city, should be examined in detail and
any valuable lessons transferred to a revised GHN
database. The capital's database system provides both
the outcome measures and the universal coverage of
homelessness services that would make a national
database of great utility for policy planning at local,
regional and national level.
- Monitoring should enable the logging of whether
people sleeping rough are within couples or other forms
of household and whether this has acted as an obstacle
to services and also take account of whether pets have
acted as an obstacle to services.
- Consideration should be given to one extension to
HL1, which would be asking a question about lifetime or
sustained experience of rough sleeping. This would
provide a greater depth of information and allow
analysis of the extent to which local authorities might
be housing people with sustained experience of sleeping
rough. Again, this modification would be of particular
interest following the implementation of the 2003
Act.
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