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CHAPTER THREE: SUPPORT NEEDS AND ASSESSMENTS

INTRODUCTION

3.1 Chapter 2 considered local authorities' role and practice in the assessment of intentional homelessness and it highlighted the significant role of discretion in gate-keeping access to accommodation. This Chapter now focuses on support issues. It will consider, what is known about the support needs of homeless households generally, how local authorities assess the support needs of intentionally homeless applicants and discuss our findings on the support needs of intentionally homeless households. The Chapter draws on all strands of the research methodology. This discussion will lead on to a review of the accommodation and support provided for applicants who are assessed as intentionally homeless in Chapter 4.

WHAT IS KNOWN ABOUT THE SUPPORT NEEDS OF HOMELESS PEOPLE

3.2 Homeless people's needs are diverse and sometimes complex. This has been recognised through research (Kennett and Marsh 1999, Fisher and Collins 1993) and in government policy and guidance, including that issued by the Homelessness Task Force (Scottish Executive, 2001), Scottish Executive (2005b) and the ODPM (2003 and 2005). The ODPM guidance stresses that homeless (or potentially homeless) households' support needs must be addressed to prevent persistent problems and future homelessness (Pleace and Quilgars ODPM 2003). The need to identify and address homeless people's support needs is similarly emphasised across Europe and the United States, as is the value of providing a continuum or spectrum of accommodation and support services (U.S. Department of Housing and Urban Development 2005).

3.3 Three points about homeless people's support needs were illustrated by the pro-forma findings and the literature review: support needs are wide-ranging; they vary in intensity both between households and over time and some people have multiple and complex needs. These 3 features of support needs influence the types of support responses required.

The range of support needs

3.4 As highlighted above, homelessness affects a wide range of households. These include: young and older people, single people and families, women and men, lone parents, people with health problems (physical and mental), people with disabilities (learning and physical), people from minority ethnic groups and people who have suffered traumas and institutionalisation. Beyond particular and often historically unmet needs, the most common problems experienced by homeless people relate to poverty, ill health and poor diet, literacy problems, histories of abuse, disconnection from prior communities, facilities and established supports, social isolation, mental health problems, substance abuse and exclusion from education and employment. Homeless people's particular needs vary in intensity and longevity, while some households present 2 or more needs, in varying combinations. (Fitzpatrick et al, 2000, Homeless Alliance 2002, Rosengard et al, 2002 and Randall and Brown, 2003).

Level or intensity of support needs

3.5 Randall and Brown (2003) have usefully identified 3 levels of support needs and related required service responses, as follows:

Adapted from Randall and Brown (2003)

3.6 Mainly in accordance with the intensity of support needs (though not always so), homeless households are likely to need support for different lengths of time, including:

• short term support - for up to 6 months
• medium term support - for up to one year
• longer term continuing support needs - for at least a year and possibly indefinitely. (Randall and Brown, 2003).

Multiple or complex needs

3.7 'Multiple or complex needs' relates to situations where homeless people are disadvantaged by 2 or more types of needs, where there is a misfit of services with needs, and/or there are exclusive policies and practices (Anderson, 1999; Bevan, 2000).

3.8 From a community care perspective, the term 'complex needs' has usefully been defined as:

"a framework for understanding multiple, interlocking needs that span health and social issues. People with complex needs may have to negotiate a number of different issues in their life, for example learning disability, mental health problems, substance abuse. They may also be living in deprived circumstances and lack access to suitable housing or meaningful daily activity. As this framework suggests, there is no generic complex needs case. Each individual with complex needs has a unique interaction between their health and social care needs and requires a personalised response from services." (Rankin and Regan, 2004).

3.9 Rankin and Regan point out that complex needs may have breadth (range of needs) and/or depth (severity of need). Additionally they stress that complex needs should not be seen as "a service label to determine eligibility", but as an active description to trigger a targeted response.

3.10 One example of "complex need" would be someone who has mental health problems with additional needs such as learning disabilities, substance misuse problems or offending behaviour ( ODPM 2005). The Guidance on Accommodation and Support Options for people with mental health problems highlights that commissioners and providers should take such needs into account in designing appropriate services ( ODPM, 2005).

SUPPORT RESPONSES

A brief context

3.11 Since the 1980s support services primarily responded to the needs of single homeless people, although more recently the support needs of households with children have been better recognised (Scottish Executive, 2001), so prompting the development of new types of services to meet their needs (for example Families Projects which will be discussed in more detail in Chapter 4).

3.12 The stakeholders in support provision that bear relevance to this research include:

• Social Work Authorities which led the response to homelessness prior to the 1977 Act and which have subsequently played a role in relation to their statutory responsibilities in regard to young people leaving care and homeless people with community care needs. Some Social Work departments in large urban areas worked to resettle single homeless people from hostels ( e.g. Glasgow, Edinburgh, Manchester, London). Such teams often operated on an outreach basis and engaged in individual and group work methods. Additionally, links were developed between specialist Social Work teams and housing providers (such as Criminal Justice and Addictions).
• Housing Authorities have led the homelessness response for almost 30 years, working in partnership. Some larger authorities developed specialist sections to assess needs and co-ordinate the support response to hostel resettlement and to assist the resettlement of families in bed and breakfast. Many promoted and co-ordinated the work of voluntary agencies in responding to the particular support needs of single homeless households. A key driver to increasing the support response was the Government's Rough Sleepers Initiative in the 1990s, which focused on the needs of people who were currently or at risk of sleeping rough, and which started in 1997 in Scotland (7 years later than in England).
• Voluntary agencies (including some housing associations), funded by Housing and Social Work Authorities, as well as charitable sources, have increasingly provided a diverse range of advice and residential services (crisis/ transitional or longer-stay services) for homeless people with mental health problems, people leaving institutions with nowhere to go, or young people.
• Health Authorities and providers had been involved mainly in a reactive way in responding to homeless people's health crises, and to their primary and specialist health care needs. However in the 1990s they became more strategically engaged, reflecting the increased profile of homeless people's support needs (such as in relation to addictions and mental health) and the catalyst of the Scottish Executive's requirement on Health Authorities to produce Health and Homelessness Action Plans (2001).
• Strategic and operational inter-agency partnerships increased in volume from the millennium, and these were stimulated by the obligation on local authorities to develop Homelessness Strategies that took account of accommodation and support needs and reprovisioning agendas.

3.13 The net effect was a persistent rise in specialist services (often provided through funding and operational partnerships) to meet the particular needs of homeless households. Against this background it is notable that Homelessness Assessments invariably identified gaps in support services, ranging from low level to higher level support services.

Housing support and Supporting People

3.14 One key emergent gap was that of lower level, personalised and flexible housing support that gathered significance as a model for resettlement services in the 1980s ( ODPM, 2003). The consensus on this gap at policy and practice level was a driver towards the key policy response of Supporting People.

3.15 The Supporting People ( SP) policy and funding framework was established in April 2003. This replaced existing funding for housing support such as transitional housing benefit/ housing benefit. Together with the new legal obligations under the 2001 and 2003 Acts, the new framework has supported innovation, development and expansion of housing-related support services in Scotland and across the UK. One priority targeted through SP funding was to address homelessness, and SP grant has been used significantly to fund resettlement and floating support services as well as support in transitional supported accommodation services for homeless people.

3.16 Housing support complements care and health services by helping people:

• to secure suitable accommodation
• to develop daily living skills (if these are underdeveloped or lacking) required to live independently
• to develop personal and social skills that will allow reintegration into social and economic life and maximise inclusion ( ODPM, 2003)
• to ensure sustainability through support planning and by responding appropriately to problems and crises, for example to prevent homelessness and institutionalisation. ( DETR 1998).

3.17 The types of housing related support that homeless households may need and that are consistent with the Regulations as defined under the Housing (Scotland) Act 2001 ¹⁰ include:

• general (non specialist) counselling and support (excluding personal care/ support) that may include befriending and help people in regard to, for example, relationships and neighbour disputes
• support to set up and maintain a suitable home and to prevent homelessness
• support with daily living skills - help, advice and training in budgeting, food preparation/ cooking
• help with the security, maintenance and safety of the dwelling and arranging adaptations in the case of disabled service users
• assistance with budgeting, benefit claims and debt counselling
• helping people to engage with those involved in their welfare
• help with resettlement and moving on to more independent accommodation
• encouraging the person to develop and sustain social networks and social support
• help to engage with activities within the local community.

3.18 The 2 key models for the delivery of housing support are firstly, 'floating' support, whereby staff leave their premises to deliver support to people in their own accommodation regardless of where they live; or secondly, that the provision of support depends on people's residence in particular accommodation. Models of support provision are considered in more detail in Chapter 4.

Guidance on support assessments

3.19 Before turning to the research findings on how local authorities currently assess needs and plan support to meet the needs of intentionally homeless applicants, we shall consider what the relevant guidance says on this.

3.20 Building on good practice in community care, the Supporting People ( SP) framework requires that housing support needs are properly assessed and systematically addressed through a structured, strategic planning process involving the service user and relevant agencies. This methodology is consistent with the Homelessness Guidance. On the planning of resettlement support for example, the Code of Guidance (Scottish Executive, 2005b) advises that in considering resettlement, local authorities and partner agencies should bear in mind the key principles set out by the Homelessness Task Force (Scottish Executive 2001) that:

• Solutions to homelessness should be based on a thorough assessment of the household's needs, including support needs, and the particular needs of families with children should be addressed.
• The objective should always be to find sustainable solutions which enable homeless people to be reintegrated back into the community and which are likely to last in the longer term.
• Joint working is crucial in addressing complex or multiple needs.
• The provision of social work advice and assistance/community care and other support issues should be addressed as required.

3.21 The multi-agency context of homelessness and addressing complex needs, means that people often face multiple assessments and that, at times, people have fallen through the "care net". Again consistent with community care guidance, the Scottish Executive has encouraged single shared assessments (including for housing support services). The Scottish Executive's Guidance (2001) on single shared assessments highlights that they should achieve:

"better results for people who use services and their carers by improving the efficiency of the assessment process, and linking the service to the most appropriate professional to take the lead in co-ordinating assessment and care planning".

3.22 The key principles outlined in the guidance are that:

• service users and carers should be actively involved and enabled to participate
• the assessment should be appropriate to the person's indicated need
• it should be carried out by the most appropriate lead professional who is adequately skilled and qualified to deal with the type and level of assessment
• appropriate information should be shared by informed consent of the person or their representative
• single shared assessments must facilitate access to all community care services
• other professionals and agencies must accept the results.

3.23 Having been introduced in April 2002 initially for older people, in April 2004 the framework of single shared assessments was extended to all community care groups, including homeless people who may have community care and/or housing support needs. Homelessness services' officers are expected to know the arrangements in their area, including referral arrangements and what is expected of them (Scottish Executive 2005). Implementation of, or movement towards single shared assessments, was ongoing at the time of this study. It should be noted that before the movement to single shared assessments, some local authorities had instituted varying forms of joint assessment systems, such as community care or vulnerability panels, to which homeless applicants may be referred.

3.24 Also of note is that the good practice guidance in relation to assessment and support planning stresses the need for service providers to conduct regular and participatory reviews of support needs in which service users are consulted throughout the process.

SUPPORT ASSESSMENTS IN PRACTICE

Assessment systems in the case study areas

3.25 Interviews with professionals highlighted variations in whether local authorities conduct support assessments as a matter of course and in the systems of assessment operated. This variation is illustrated below for the case study areas.

Case study area (A) has a policy to assess the support needs of all homeless households, including those assessed as intentionally homeless. Interviews with service users who had been so assessed, verified that this policy was being carried out. Overall, these service users perceived the assessment as being reasonable; they felt that they had been dealt with fairly and quickly, and they valued the quality of service received from support staff.

In the urban case study area (B) none of 5 single people interviewed appeared to have had their support needs assessed, despite reporting mental health problems, problematic substance use and fleeing domestic violence. Only one of the 3 households with children interviewed appeared to have had any assessment of support needs. Professionals reported that the local authority had piloted a housing support needs assessment form, but that this had not proved successful for 2 main reasons - applicants' unwillingness to rate their level of capacity and differing perceptions of support needs by housing staff and applicants themselves.

Case study area (C) has produced a support assessment and referral framework based on the single shared assessment, which is now used in all but one of its 8 local offices. In that office, homelessness staff use the Supporting People form to identify support needs. Where the need for a more in depth assessment is identified, applicants are referred on to relevant services, although the nature of these will depend on local arrangements.

In case study area (D), there was no uniform procedure for ensuring that the support needs of all households are assessed. A support needs assessment form had however been developed and was being piloted at the time of the case study. The procedure adopted involved a referral from the local office to which the person had presented as homeless, to a tenancy support worker, who would then carry out the support needs assessment. Initially, the assessment would only be available to people placed by the local authority in temporary accommodation, although it was hoped that in the longer term, people living in temporary c/o of arrangements would be included in this process. Only 2 of the 6 interviewees reported having had their support needs assessed.

SUPPORT ASSESSMENTS FOR INTENTIONALLY HOMELESS HOUSEHOLDS

Support assessments noted in the pro-formas

3.26 The aim of this research to clarify the support needs of intentionally homeless households was seriously inhibited by the lack of information supplied by the pro-forma returns on homeless people's needs and local authorities' assessments of these. A key finding was that in most cases there had been no support needs assessment carried out or recorded, with some 41 pro-formas indicating that no support needs assessment had been carried out for the applicant. A further twenty six pro-formas were returned with the section on the support needs assessment left blank.

3.27 The research did not therefore obtain a comprehensive picture of whether intentionally homeless households require specific forms of support.

3.28 This apparent lack of support assessments by Scottish local authorities however, mirrors both the case study authority findings and the findings of research across the Border, where only a quarter of the 58 local authorities replying to a postal questionnaire said that they had carried out a structured needs assessment (Randall and Brown, 2003).

3.29 Some of the 41 pro-formas indicated that there had been no assessment of support needs, because the applicant had stated that they had none. In other cases it was noted that no support assessment had been carried out, either because the service did not have the capacity to do one, or because there was already, for example, social work or multi agency support in place. In the main however, there was no explanation as to why no support needs assessment had been carried out. Whether applicants had been in receipt of support prior to presenting as homeless will be considered at para 3.50 below.

3.30 Where the pro-formas indicated that a support assessment had been carried out, generally minimal information was provided on the process of the support assessment. However, some information was supplied on matters such as: who conducted the assessment; the setting of the assessment; the level of the assessment and follow up action, such as referrals and known outcomes. From this it emerged that some local authorities do systematically conduct needs assessments; they seek to do so at suitable locations and they are noting assessment processes and follow up action.

"On accessing temporary accommodation, a full needs assessment was carried out (by the assessment team) and a support worker allocated."

"The support needs assessment is to be carried out at the supported accommodation which has been offered and accepted."

3.31 Another example once again highlighted the themes of repeat homelessness and non-engagement with support, which we shall consider later.

"The applicant has had support plans, as they have been involved with tenancy support twice before. However, they have not engaged with the service. An assessment was done while in temporary accommodation."

3.32 However overall it appeared that inter-agency involvement in support assessments has been limited, or that it is ongoing so that assessment outcomes were unknown or not identified. Examples related to mental health issues - "the mental health team are currently assessing the client" - or to persistent ASB. In one case it was reported that:

"The client was referred to (a specialist families support project) for a full assessment due to a history of anti social behaviour. This referral was made while they were in temporary accommodation. The outcome of the assessment is awaited."

3.33 Other cases similarly indicated joint work in assessment. Referring to one family who had an eviction decree against them on the grounds of ASB, but who had not yet been evicted, the pro-forma commented that:

"Assessment is ongoing at present. All named agencies (social work, health, criminal justice and community alcohol and drug services) are involved, each carrying out relevant support needs assessment as their situation has changed again and they are potentially intentionally homeless."

3.34 In the above case it was unclear whether the 4 services mentioned were each carrying out discrete and parallel assessments, and if so how these would be integrated within a support plan, while in the case that follows it appears that the housing authority has been co-ordinating a joint approach to meeting support needs.

"There has been ongoing assessment from initial interview until the decision. The local housing team provided tenancy and arrears reports. The household was assessed as needing housing support and social work support as they were not coping with the children. Social work were contacted and agreed that they would support while they were in temporary accommodation."

Service users' views on the assessment process

3.35 Service user interviewees were consulted on their experience of assessment and advice on options, while staff were consulted on the framework and processes of assessment. This highlighted a diversity of approaches, experiences and views.

3.36 Service users had positive and negative experiences. Positive views related to the speed of response, the help received and to the quality and ease of the contact with staff. Comment included: "The council's been real good for us. We had a support worker within a week." (urban-rural area) and "the officer was nice and approachable" (rural area).

3.37 Critical comment related to the absence or partiality of assessment and discussion of options. Two interviewees said they had not been asked about support needs, with one commenting, "You are the first person to have asked in any depth exactly how the arrears built up". The other stated simply, "I was never asked if I had any support needs." A third person indicated that they had not appreciated the range of support needs being enquired about, or if there was other help on offer that might have prevented their homelessness.

"We were asked if we had any health or support needs but said that we had none. The council did not mention money/debt advice. In hindsight, that would have been very useful." (a family who had sold their house due to mortgage difficulties).

3.38 The overall picture generated therefore was that the assessment of support needs is variable and that processes and outcomes are variably recorded.

SUPPORT NEEDS IDENTIFIED FOR INTENTIONALLY HOMELESS HOUSEHOLDS

The pro-forma analysis

3.39 Assessment plays a key role in support planning, as identifying needs is the first stage in planning and negotiating homeless people's routes of access to services. The pro-forma exercise sought to explore this by asking local authorities to outline services that they had identified as being needed.

3.40 Given the significant number of pro-forma cases which involved no support needs assessment, frequently this pro-forma section was not completed or the response stated 'unknown'. Where support needs had been identified these included: housing support; social work support; specialist support in regard to substance misuse/ addictions and health services in general.

• The housing support identified as being required in 26 cases mainly related to the need to secure alternative accommodation, or to assist with tasks such as form filling and benefit claims.
• Social work support was the next most prevalent support need identified (22 cases). However as additional social work support provision was noted in only 5 cases (see Chapter 4) it would appear that a number of households were receiving social work support prior to the application. One pro-forma stated for example that:

"The children are registered on the Child Protection Register. Social work is monitoring the situation. A referral to an agency, which supports parents; children's groups, activities etc…is ongoing at present."

• Assistance with addiction problems was noted as being required for some 15 cases. Again, most applicants who were said to be receiving support with addictions, had been getting this prior to their most recent homeless application.
• Health services were identified as needed in 13 cases, and again it appeared that health needs were already being addressed, for example by the applicants' GP.
• Support in relation to mental health problems was identified as needed for 6 pro-forma applicants, while in one case it was noted that the applicant had failed to engage with services.
• Support in relation to ASB was identified as needed in 5 cases.

Assessed support needs in one case study authority

One case study authority (area D) which reported that it had not assessed support needs systematically at the point of homelessness presentations, has recently recorded the support needs of homeless households placed in its temporary accommodation unit, as assessed by the tenancy support workers. This approach resulted from the Homelessness Assessment (2002) that informed the Homelessness Strategy. While no support needs had been recorded for 56% of the 223 households in homeless units and B&B, for the remainder support needs were noted as relating to:
- domestic violence - 9% of households
- health needs - 7% of all households: mental health issues - 6% of all households
- families with chaotic lifestyles - 6% of all cases
- drug misuse - 6% of all households:- alcohol misuse - 4% of all households.

3.41 As the above assessment exercise only identified one support need per household, it offered no indications of multiple or complex needs.

Service user interviewees' comments on support needs

3.42 While this study interviewed only a small sample of 29 service users who were agency-nominated and participated voluntarily, a wide range of support needs emerged in the interviews. Overall interviewees identified mainly lower level forms of support, including practical resettlement assistance and advice, guidance and advocacy on benefits matters - although some higher level support needs were also mentioned. Needs identified by service users (both met and unmet) are summarised thematically below.

• Information, advice and assistance needs: These included a widespread need for advice on benefits and money/ debt matters, given that eviction for rent arrears was a strong factor in intentionality decisions that in turn raises issues for homelessness prevention. One interviewee said:

"If I had known that the notice didn't mean that we would definitely lose the house, I would probably still have been there."

• Varied practical help - e.g. with form-filling; letter writing; storage; advice and financial help to access housing (including in the private sector); with installations, or with removals. For some, lack of storage resulted in loss - one interviewee said they had lost one third of their possessions:

"The house was emptied without me knowing about it. I lost everything. Some things cannot be replaced like my daughter's bracelet from the hospital where she was born".

• Help with acquiring furniture and to get a house fit for occupation including decoration.
• Access to advocacy, which served to overturn the intentionality decision for 2 households and was currently enabling an appeal for another.
• Access to practical advice related to health and well-being, such as guidance in relation to diet and leisure.
• Housing/ tenancy support needs - one person said they had such support but didn't need it, and others said that all they needed was help to access housing.
• Support for children - some had social workers involved - "they seem to be able to get better information than we can"; others had a Families project worker, where such a service was available in the area.
• Some welcomed help to access play facilities and financial help for this - such as to access activities for children, e.g. swimming/ skating.
• Education - including recognition and help where there are literacy problems and information about college courses.
• Addressing mental health issues, including those related to loneliness and depression, more serious psychiatric conditions and the emotional impact of prior domestic abuse. While some needed staff or others to listen and be supportive; others were in contact with GPs, psychiatrist and/or counsellors. Comments from service users included:

"Folk get really down when they're homeless or have been homeless, they should be able to get some help or support with this."

"I was getting depressed in England, so I moved back up - I've a history of depression."

"It's been a nightmare. I had finally got rid of my violent ex-partner (when he was imprisoned) then myself and my kids were made homeless."

"I was under a lot of stress … dealing with everything for the whole family … it all got on top of me. If I had kept up the fortnightly payments or when I couldn't, informed the Council…but I got behind. I got suicidal. I felt I was never getting away from it".

3.43 Overall the housing, support and health professionals interviewed did not consider that intentionally homeless households support needs differ from those of unintentionally homeless households. Nor did they identify any differences between the support needs of those applicants who will be entitled to short SSTs, as compared to those entitled to section 7 accommodation only.

3.44 However some differences did emerge between professionals' perceptions of homeless people's support needs (in terms of the general homeless population) compared with those identified by intentionally homeless service users. The key difference was that, unlike service users, staff frequently stressed homeless people's unmet support needs. Additionally staff stressed the need for specialist support to address behaviours and other matters that may impact on actual or threatened homelessness, and these included:

• drink and drug misuse
• behavioural issues, including "chaotic behaviour"
• institutional histories ( e.g. local authority care or criminal justice establishments)
• health conditions, including mental health
• problematic behaviour of others in the household (or external to it).

3.45 Professionals recognised that many needs cannot be met by general housing support services and saw a need for specialist, more intensive support services. In some cases it was felt that such support could best be provided in dedicated accommodation resources. Service users on the other hand did not generally identify a need for such options.

3.46 Some professional interviewees highlighted the extent to which drug misuse was an issue for their service with staff in a shared accommodation project stating:

"We have 12 intravenous heroin users registered with GPs and the chemist."

3.47 Similarly, Health and Homelessness Action Plans and Homelessness Strategies for the 4 case study areas stressed the need for improved services to meet the needs of those with substance misuse problems and of those with needs in relation to mental health. Gaps in support services identified through the local authority survey will be further discussed in Chapter 4.

3.48 In keeping with our service user interviewees, professionals also stressed the need for lower and medium level support services to be provided for homeless households in general. These included information, advice and assistance to access suitable accommodation; help with budgeting and debt management and with living skills; help to obtain furniture; befriending services; help with emotional and mental health issues and assistance with parenting issues. Professionals also highlighted the range of support options on offer or under development in their areas, some of which were accessible to homeless households generally, while others target particular needs such as mental health, and may be accessed by all homeless applicants and others. The range of accommodation and support on offer in the case study areas will be considered further in Chapter 4.

3.49 The overall message to be taken from this overview is that intentionally homeless households should be provided with the support services relevant to their assessed support needs, rather than that specific services are required for intentionally homeless households. In some cases, these needs will be for specialist services although the homelessness assessments should always act as a trigger to appropriate services being accessed.

Support provided prior to homelessness: intentionally homeless households

3.50 The pro-forma enquired whether applicants had received any support services prior to making their most recent homeless presentation. The majority of returns (56 or 56% of cases) reported that the applicant had not received support prior to their application. However in 29% of cases support services were noted to have been received prior to the homeless presentation. This may under-represent prior provision of support, which may not have always been recorded or identified in the returns: 14% of returns either left this section blank or stated it was unknown whether applicants had been receiving any support. It is worth noting here that similar information on the general homeless population is not recorded at national level.

Types of support received

3.51 Although once again comprehensive quantitative evidence was not obtained, some pro-forma returns illustrated the key types of support received by intentionally homeless applicants prior to their most recent homeless application. Social Work support, for example, was recorded as having been provided for 11 households. This addressed a range of needs, such as for practical advice, money advice and targeted support to address particular needs. It included:

• money matters (rent arrears/ repayment agreement and money advice)
• children's needs and school issues
• throughcare and aftercare needs, including for outreach and specialist support in relation to criminal justice issues
• support in regard to addictions (6 applicants).

3.52 One had also been involved with ASB officers and had been on an Anti Social contract ( ASC) prior to abandoning the tenancy. Another had had a short SST, which was subsequently abandoned and repossessed following the tenant disengaging with support.

3.53 Other types of support needs identified in the pro-formas clearly related to the presence of multiple needs. One applicant for example had had support from a specialist health team, a community health team and social work. Another had been staying in voluntary sector specialist supported accommodation before presenting as homeless.

3.54 Additionally, tenancy support or housing support services had been received by 6 applicants following a previous homelessness application. It is of note that such housing support services did not prevent homelessness in these cases. The circumstances and choices that impacted on homelessness included applicants who had:

• abandoned short SSTs (2 households), one of whom had an ASB contract
• accepted SSTs, which they then terminated to remain in their previous accommodation (2 households)
• were evicted for rent arrears (one household)
• reported external threats as the reason for repeat homelessness (one household).

3.55 This last applicant had initially moved into a local authority tenancy, but was moved on to a second after 2 months, having felt threatened by a neighbour. Some 2 months later they re-presented stating they had been threatened and that eggs had been thrown at the windows, by which stage they had returned to stay with their mother (although the caseworker noted insufficient evidence). The applicant then terminated the tenancy.

3.56 While no specific reasons were identified as to why 6 tenancies with housing support were not sustainable, this alerts us to the simple fact that at times people choose to give up properties and support arrangements for particular reasons, and other research indicates that these may include financial, security/ safety or location issues, as well as personal issues, behaviours and choices (Rosengard et al, 2002). The pro-forma descriptions of the 2 applicants who had previously held short SSTs indicated that one person who had received support prior to their current homeless application, stopped engaging with this, while the other was being referred to the community addiction team at the time of their application.

3.57 Overall therefore while some intentionally homeless applicants had received social work, tenancy support and specialist support before their current application, neither the pro-forma findings nor the service user interviews enabled evaluation of the prior support provided, or of why it had been unable to prevent homelessness.

3.58 Finally we should note that over a third of our interviewees (11) actively sought and received support from their family members and friends, although least so in an area which has an undifferentiated policy of providing accommodation and support to all homeless households. In each case study area some interviewees were staying 'care of' family members when they presented as homeless. Some also chose to stay 'care of' family rather than take up the temporary accommodation initially offered, or until they had obtained a tenancy, because they did not want to move far from where they had lived. One interviewee said he had lived with his mother-in-law for 15 months. Another interviewee said, " After all I had been through I needed support and I got it from my family", while a third said:

"We thought we'd get a house here when we moved back from Ireland but it wasn't like that. We stayed with parents, and applied. There was pressure from our parents and we had no privacy and it was overcrowded so we went to the Council, but they said we had to clear our rent arrears".

The extent to which intentionally homeless households received support

3.59 While this study has alerted us to the fact that information on support needs and provision for homeless households is partial and uneven, it has detected that only a minority of intentionally homeless households receive extra support as a result of their homelessness application. This key finding emerged from both the HL1 data and the pro-forma findings.

3.60 The national homelessness statistics offered an unclear picture in regard to whether households were receiving support at the stage of the 'final accommodation outcome' (resulting from the homeless application and as recorded on the HL1). Significantly, this was "not known" in 43% of cases Scottish-wide, while notable variation and deficits also applied at local authority level in regard to information on support provision (Scottish Executive statistics). The extent to which this reflects, either or both, a lack in agencies' knowledge of support needs among intentionally homeless applicants, or the fact that contact had been lost with the applicants or poor recording practices, is not clear from the information available. Table A4:4 at Appendix Four provides further information on support provision and links this with final housing outcomes for applicants, at local authority level.

3.61 The pro-forma requested housing staff to comment on whether they considered the applicant's support needs to have been met in full, or in part, or if they are unmet, taking account of indicators such as housing support needs, social work support needs, health care needs etc. In the event, the limited data supplied in response to these questions reflected the deficit in support needs assessments in many local authority areas, as discussed in Chapter 2.

Table 3.1 Responses to pro-forma questions on needs

3.62 Where it was identified that housing support needs were not being met, a duality of reasons were offered by staff - firstly, there was the issue of non-engagement or non-compliance on the part of the household, and secondly, there was the issue of lack of service capacity. Examples quoted of the former were that the client or applicant " did not attend for support assessments", or that they had " absconded from the temporary accommodation". An example of the latter was the comment that " the tenancy support team is currently understaffed and social work felt that a caseworker was not required".

3.63 Where it was commented that particular needs were being met, for example in respect of mental health issues, addiction issues or ASB, in some cases it was apparent that support had been in place prior to the homelessness application. In other cases, support details were unknown.

3.64 In sum therefore, the route of a homelessness application and assessment for applicants assessed as intentionally homeless, does not appear to provide consistent opportunities for people to have their support needs assessed and met. On balance this appears to stem from the deficits in the system that surrounds support needs assessment, which should act as a trigger for appropriate service responses.

SUMMARY

3.65 This Chapter has focused on what is known about the support needs of homeless households in general and it has considered the research findings on whether intentionally homeless households require particular forms of support in accordance with their assessed support needs. Chapter 4 will focus more closely on aspects of support provision.

3.66 The pilot pro-forma that sought to quantify the assessed support needs of intentionally homeless households in general, and those of households potentially entitled to section 7 type accommodation in particular, failed in this objective. Firstly, few support needs assessments had been carried out in respect of intentionally homeless households. Secondly the few pro-forma returns for households who would only be entitled to section 7 accommodation, coupled with a lack of information on their support needs, inhibited assessment of whether their support needs might be distinctive. Thirdly, in instances where an assessment was being carried out, the pilot period was too short for outcomes to be recorded.

3.67 However the pro-forma findings offered strong indicators about support needs, with the main identified need being for housing/tenancy support, and the second most significant being for social work support. The pro-forma findings further indicated that even where support is in place, this may not prevent homelessness. Particular support needs highlighted related to addictions, followed by health issues in general, mental health issues, and anti-social behaviour (in 5% of cases only). There were also indications that some households have multiple and/or complex needs, although their comparative incidence is unclear. However, while the pro-formas offered these insights into the support needs of intentionally homeless households, the lack of comparable information at national level on the support needs of homeless households in general, prevented comparison with the general homeless population.

3.68 The qualitative interview programme with professionals and service users in the case study areas offered further confirmation of needs identified by the pro-formas. Overall it confirmed that homeless households in general have varied and sometimes intense, multiple and/or complex support needs, as reflected in other research. No distinguishable patterns emerged in respect of intentionally homeless households.

3.69 The findings covered in this chapter have important implications for implementing the provisions of the 2003 legislation in regard to households assessed as intentionally homeless. To achieve the best outcomes and to prevent homelessness and repeat homelessness, it is crucial that support needs assessments are conducted systematically. This is in process in some local authority areas. In other areas it will require new procedures as well as additional staff training and capacity for liaison/joint work, which may have budgetary implications, including for Supporting People. These findings also stress the need for future monitoring of assessed support needs in order to meet needs better and to inform strategic planning and operations.

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