Challenges: Where do we want to be in 2025? · The outcomes from each engagement session using the...

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Challenges: Where do we want to be in 2025? A series of engagement sessions were held prior to and over the main three month consultation phase using the framework identified through previous consultation: i.e. Excellence in Homelessness Services; Preventing Homelessness; Homeless Interventions; and Recovering from Homelessness. These engagement sessions were with a range of stakeholders including service users, frontline staff and senior officers. The outcomes from each engagement session using the framework are described below. It became clear when analysing the outcomes that three main ‘principles’ or ‘themes’ ran throughout the sessions as follows – and each are colour coded in the tables below and will be used to influence Cornwall’s new Strategy.

Putting the Person at the centre

Transformation and Continual Improvement

Working Together Any comments relating to where we want to be by 2025 in terms of homelessness and rough sleeping have been colour coded to ‘Vision’.

Approach 1: Operational Delivery

Engagement Event Challenge Response Influence

MHCLG Feedback on implementation of Homelessness Reduction Act 4th April

Process driven to date but now need to concentrate on user perspective, more up front discussions of support client needs to open up more preventative work, need more learning from cases, staff as problem solvers to meet individual needs

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as meeting specific needs

Person centred approach (P) System transformation

Learning from experiences/cases – for system transformation and staff training

Communities of Practice – organised by HomelessLink 10th April 2019 - (bold are the main points picked out in workshops – highlight from round up)

United in strategies – more joined up working - less homelessness – clear communication

Fill in the gaps – some people do not fit any criteria

More complex needs/dual diagnosis services

Client should always come first – regardless/human element

Duty to prevent abuse in services – client -> client

No conditions attached to services

Universal database for all services e.g. Inform/Jigsaw

Reduce barriers to referral services – no wrong door approach and choice

A developed support/supervision service for the homelessness workers (commissioners recognise value of staff wellbeing) – an agreed value base to design homelessness services from

Trauma informed services

Understanding of ACEs

All clients are eligible for a service

Single partnership care plan with one lead agency

Co-production

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as being able to work with clients with complex needs and better information sharing

Reflects current professional thinking in relation to ACEs, trauma informed services and multi-agency working

Person centred approach

Work with all homeless (including those without recourse to public funds and/or no local connections) (P)

Working together

Improved partnership working – all to commit to playing role (P)

Agencies to work with those with multiple needs (I/R)

Improved data sharing (P)

Improved communication between agencies (P) System transformation

Learning from experiences/cases – for system transformation and staff training (P)

Rough Sleeping System Transformation Workshop – 12th April Other - Map –

High Risk Behaviours Panel

Prevention Nos Da project

Complex needs meetings in some towns

Homelessness charter MOU

Cornwall Rough Sleeper Operational Group

No-one has to sleep rough within next 2 years Other - Gap –

Strategic Homelessness Forum

Integrated service – upstream and downstream

Limited awareness of services

Lived experience – input in to system change

Ability to track peoples journey

Journey of clients in one database

Self-help and self-service

User led projects and provisions

Variable provision across Cornwall

Voices from the front line

Voluntary Community Sector and community role in provision unclear and uncoordinated Other - Challenges –

Access to online services

Short term funding

Political buy-in

Lack of tolerance

Commissioning approaches – prevents open dialogue?

Market capacity

Universal credit

Separate strategies – homeless and mental health

Staffing resource

Changing needs and complexity

MPs/community opposition sometimes stunts growth/opportunity for services

Vision – challenge is to make this happen within the lifetime of the new strategy. Absolute zero generally not possible as the desire to rough sleep can be personal choice but measures will be put in place to ensure that no-one HAS to sleep rough

Identified need for strategic overview – link to outcomes from recent Government consultation on ‘Tackling Homelessness Together’ and the proposals around homelessness reduction boards

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as more person centred working, better sharing of information and working with those with complex needs

Reflects current professional thinking in relation to multi-agency working and the short term nature of funding inhibiting long term planning

Vision Working together

Strategic accountability

Improved partnership working – all to commit to playing role

Improved working with voluntary and community sector

Public perceptions

Commit to multi-agency working as way of overcoming issues of short term nature of funding

Role of commissioning System transformation

Improved communication for those who may be affected by homelessness


Improved data sharing

Serious case reviews – learn lessons

https://www.cornwall.gov.uk/housing/housing-strategy/homelessness-strategy-review/homelessness-strategy-consultation-may-to-august-2019/

https://www.cornwall.gov.uk/media/38298555/guiding-principle-1.pdf






Cornwall Housing Ltd – Housing Options Directorate Meeting 16th April

Co-location – sharing office space, partnership agreements across Cornwall (Direct Access has multi agency support space)

Reviewing Homelessness Charter - No one has to sleep rough – emergency provision – safe place – assess and move on schemes

Everyone has a right to a home – council has the right to accommodate regardless of priority need – temporary accommodation (might not be) provided to all single homeless approaches – TA strategy, support until move on to other

Prevention & Engagement Teams accessible 24/7

Vision – challenge is to make this happen within the lifetime of the new strategy. Absolute zero generally not possible as the desire to rough sleep can be personal choice but measures will be put in place to ensure that no-one HAS to sleep rough

Reflects current professional thinking in relation to multi-agency working and co-location

Co-location of services


Vision

24/7 help

Crisis Care Concordat 21st May Referrals – don’t fit vulnerable persons criteria especially those with psychosis – can be an operational issue Reflects many of the key messages arising out of the key stakeholder and service user surveys such as more person centred working, better sharing of information and working with those with complex needs


C&IOS Executive Group 23rd May

No rough sleeping within the lifetime of the new strategy (2 years) Vision – challenge is to make this happen within the lifetime of the new strategy. Absolute zero generally not possible as the desire to rough sleep can be personal choice but measures will be put in place to ensure that no-one HAS to sleep rough

Vision

Cosgarne 4th June Access to Housing Options – frustration of communication via phone Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues


Health for Homeless 5th June Issues with key workers contacting named housing case worker – story of one such incidence where social worker was told the applicant would have to start application process again and call centre refused to put social worker through (56 days may have expired..?)

Duty to refer – no feedback received following referral

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues


Improved communication between agencies

Safeguarding Children’s Board 6th June

Need to link into review of support commissioning particularly for 16-17 year olds Improved partnership working – all to commit to playing role

Role of commissioning

Event at Coastline Offices 26th June (looked at in terms of excellence in homelessness services) (bold highlights are the main points picked out in workshops)

All households owed relief duty provided with suitable offer of temporary accommodation

General awareness across Cornwall of what services are available and how to access them

Easy to access services

If a client asks any council employee about housing they can help them get in contact with excellent empathic advice

A leading authority delivering the best service

Nos Da Kernow model to be extended to FWC

Mirror the national Rough Sleeping Reduction Strategy

Linked in – working with service users sharing important information

Funding and staff to deliver

Joint approach within individual organisations

Person centred

Client led support

A fully funded linked in joint approach with all agencies and sharing information

Needs to be a floating support service available

An action plan to stop the ‘hot potato’ effect and constant revolving door

Dedicated multi agency or multi skilled workers and/or mobile hub – address multitude of issues with 1 presentation to the service

Needs to be new not rehash of same – look to innovative ideas – may need to look at commissioning models

Secondment to specialist services

Care coordination done through county level

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues, person centred, multi-agency working etc.

Effective referrals






Vision


Cornwall Rough Sleepers Operational Group 12th July

Housing First – some issues with finding accommodation due to s106 criteria

Housing First for young people in Scotland – project underway – is there any learning we can take from this?

Links into local connection blockages and review of Allocations Policy



Event at St Petroc’s 16th July (staff and service users)

A free phone number that is known to all that could act as a gateway to all services would be really helpful

Somewhere central in each town in Cornwall that everyone could go to – and can then be directed to help from there;

Issues with Homechoice – when need to change address had to make a new application – or if you change your address the system doesn’t recognise you…

Homechoice – if someone needs to get ID this can take some time – which means the application is put on hold and the applicant has to phone in again to restart the process. DWP use historical data on customers to verify ID so no hold up in processing an application – why can’t Homechoice do the same?

Co-location work between CHL and outreach – much better outcomes and working well

If St Petroc’s contact Council to support vulnerable clients – need to recognise vulnerability. It take such a long time and often have to chase for a response – if goes into out of hours this can create difficulties with clients in terms of getting scripts etc. as don’t know where they may be going. System doesn’t really work for this client group – but dedicated CHL officers can get faster responses – should be same through all routes. Would be good to improve working relationship – more work shadowing by CHL staff? More trauma informed training generally.

Local connection – is an issue to get people housed. Many are fleeing abuse/situation at home – some have a crime number but others just go for their own safety and don’t and this can be a real issue – there needs to be more understanding on why people end up in Cornwall without a local connection.

Should expand NDK service

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues, operational issues, etc.




PROCESSES DO NOT WORK FOR MOST COMPLEX ROUGH SLEEPERS


Event at CN4C 18th July (service users/those with experience of homelessness)

Local connection issues

Disrepair – work with PSHT when issues of disrepair but if evicted as a result need to work with another team – needs more joining up/continuation of case

Navigator role could work but they could very easily get overwhelmed

Should be able to share information more widely with service users permission

Help with paying deposits – needs to be much quicker as when person finds their own accommodation need deposit/answer in couple of days otherwise landlord won’t keep – landlords know Council takes forever and this makes them reluctant in the first place ….

Feel men with children are often treated differently

Homechoice – delays to system in getting changes made/passwords changed, really clunky system. Some don’t bother with Homechoice as easier to go directly to letting agencies, find a property and then seek help with deposits/rent in advance. Coastline system seems easier to use.

Better understanding of housing benefit which comes in 13x4 week blocks – landlords do calendar months and although evens out over the year can be difficult for some households to manage this

Links into local connection blockages and review of Allocations Policy

Links to ‘navigator’ roles and consistency of support worker to navigate through the system

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues, data sharing, operational issues, etc.




Approach 2: Communication


MHCLG Feedback on implementation of Homelessness reduction Act 4th April

Face to face is key as cannot pick up on issues such as domestic abuse over phone – rurality is an issue but needs ways round this. Regular communication – even if nothing to update on, better sign offs/handovers between sections, consistent messages, not having to repeat story unless want to

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues and better sharing of information




Offering face to face meetings

All agencies attending consultations

Honesty with clients and other agencies

Shadow different agencies

Accurate notes and acting on actions

Better communication routes between services, clearer guidelines around sharing information

Reduce work duplications

One profile for clients – sharing databases

Co-location – 1 system, shared agreement, method of bypassing GDPR, methodology of shared info and agreed support

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as multi-agency working, co-location and better sharing of information






Rough Sleeping System Transformation Workshop – 12th April

Other - Gap -

Limited awareness of services




Self-help and self-service



Voluntary Community Sector and community role in provision unclear and uncoordinated Other - Challenges –

Public perception – mix of ASB and rough sleeping

Access to online services

Media

MPs/community opposition sometimes stunts growth/opportunity for services

Lack of awareness in whose responsibility and strategies by elected members





Public perceptions



Upstream prevention – corporate buy in, awareness raising

Schools – need to do more around housing issues, money management, peer support (Media School at University may have done something in the past, e.g. game of life for housing

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues




Safeguarding Children’s Board 6th June

Questionnaires should be simpler and available in several languages

Need to link into review of support commissioning particularly for 16-17 year olds



Improved partnership working






Person centred

Client led support


Dedicated ‘single’ consent form

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues, partnership working, person centred





Homelessness Round table 27th June

Good news stories – need to promote what we do but need Comms to work with us – focus on the positive not the negative

Trust – tell your story once

Those who have been supported – could we pay them to undertake work/speak to current RS?

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues, learning from experience

Public perceptions


Improved communication




Understanding of customer’s point of view – they are continually being let down by the system which leads to frustration, anger, withdrawal – this is exacerbated when you are homeless

Public should be aware that homelessness can happen to anyone and that many people are only one pay check away… and that it not only of concern at Christmas but is an issues all year round – need ongoing publicity campaign, use of case studies, media e.g. following outreach workers around – would help to reduce public fear of homeless people.


Public perceptions




Better understanding that when a person is homeless they feel very exposed

Face to face communication definitely


Public perceptions



Approach 3: Developing an Evidence Base



Shared computer system (think it would be difficult for all providers to agree)

Encourage regular case studies to review services/pathways – increase in all services providing regular case studies (success and failure)

Keeping information within recent dates

SROI (social return on investment)

Encourage ‘evidence generating practice (EGP)

Proactive feedback to service users when refused service or upon successful completion of support

Cornwall as a rural setting needs case studies that reflect this




Rough Sleeping System Transformation Workshop – 12th April

Other - Gap -




Voices from the front line Other - Challenges –






Monitoring – real monitoring – sometimes small interventions can make a massive difference – how do we measure this? Links to person centred approach Learning from experiences/cases – for system transformation and staff training

Homeless Network 6th June CWP, church breakfasts/suppers – numbers have decreased but showing an increase at the moment – and lots of new faces – what are the reasons?

Should we be counting how many people we have helped rather than how many rough sleepers there are?

Local connection criteria is an issue

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as better sharing of information





Whole system change – get genuine buy in from all Partners

Each organisation must detail what their offer is to help case the problem



Person centred

Client led support


Accountability by agencies



Reflects many of the key messages arising out of the key stakeholder and service user surveys such as better sharing of information





Homelessness Round Table 27th June

Intelligence for those on register with a homelessness duty – was it a perceived risk or an active risk? Need to change behaviours towards this



Approach 4: Building Resilience



Key is flow – more prevention and faster move on from temporary accommodation

PRS – need one offer not multiple as currently

Reflects current professional thinking in relation to moving people away from homelessness as soon as possible to prevent them becoming used to the lifestyle

Agree can be confusing




Move on towards independent living should be a priority for those that become homeless


All providers deliver programmes (accredited) on tenancy sustainment

Anyone in the community can access support/education that helps them to live in the world – money management, life skills, housing related

Better support for frontline staff reflecting practice, exit interventions and minimal supervision

Where accommodation and housing related support are required they should be provided by the same organisation

Co-location

Housing providers in Cornwall are working on a ‘Cornwall’ version of an accredited scheme that will be recognised by all providers locally

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as better




Building resilience of those that might struggle with maintaining a tenancy


Ending short term prison sentences sharing of information, multi-agency working, co-location and learning from experience

Improve outcomes for those discharged from prison who are likely to become homeless on discharge



Co-location – sharing office space, partnership agreements across Cornwall

‘Spend to save’ – how much would we save if we offered incentives to landlords rather than spend on temporary accom? HACT tool… how do we monitor this…

Who can make referrals – GPs

Simple interventions can make significant impact – e.g. helping someone access UC

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as better sharing of information, multi-agency working, co-location and learning from experience







The need for business to consider what role they can play, for example in recruiting homeless people.

Universal Credit funding for skills is available to build pilots based on special needs – NK to provide details.

There are good examples we could learn from in other parts of the country - Section 106 agreements to put hours into community activity rather than funding; Only a Pavement Away – NK to share details.

JO to provide details of opportunities to work through Work Skills Academy to provide construction skills

The homeless should be included in inclusivity agenda work being led by St Petroc’s, the LEP and Sarah Newton MP. KC to explore and open dialogue with employers who are struggling to recruit.

KK highlighted that funding model for housing with support may be prohibitive for those seeking to gain employment. A pathway that makes progress on all aspects of improving lifestyle, not just housing, is needed with an appropriate model of funding and investment. There is a need to consider what more could be achieved through joint funding across agencies.

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as multi-agency working and learning from experience



Better partnership working to help those that need support moving toward independent living

Continue to lobby Government for changes that will improve services for those that experience homelessness

Homeless Network 6th June DISC are helping quite a few families struggling with housing costs (preventative work) Example of what can be achieved by an organisation in the Voluntary & Community Sector








Supply and demand model for Cornwall Council have a wider variety of housing options available (including greater???)

Social housing a realistic prospect for more households


Annual meeting with all stakeholders – attached to funding – that is mandatory




If partners don’t engage and work with the Council then the Council should not use them as Partners in other areas of the Council’s operation. If HAs don’t engage stop allowing them to develop in Cornwall




Person centred

Client led support

















Better partnership working – all to commit to playing role



Building resilience – not quick, can take years and needs to start as early as possible

Short term funding

Pre-tenancy training – getting tenancy ready

Bidding for funding – are all partners involved and happy with their level of engagement – would an online forum to quickly gather information be useful?

Those who have been supported – could we pay them to undertake work/speak to current RS? Gateway for opportunities?

Former tenant arrears and behaviours

Unable to sustain tenancy due to seasonal work and accommodation linked to work

Unable to afford social rent

Challenge around Universal Credit




Support required for as long as is needed


Better partnership working – all to commit to playing role





Pre-tenancy training – should be linked to landlord incentive schemes

Boredom and loneliness can be an issue for people when they are housed after a long period of rough sleeping – need easy access to courses, volunteering opportunities – or someone to talk to when they need a bit of support. Finding a home does not solve all issues – need more ongoing support when it is needed (suggested weekly). People who have been rough sleeping for long periods of time need space to learn to trust people/agencies again – and to trust themselves – but do need to be some way along road to recovery before this can happen.

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as building resilience, person centred, operational issues, etc.






Blocks on work when in supported accommodation – can act as a deterrent. Also if do find work there should be at least a 3 month transitional window before having to leave as new job and new home can be traumatic for vulnerable people

Approach 5: Partnership Working



Safeguarding funding for continuation of current projects around partnership working

Long term funds to find tools/resources to be used within the CRSOG, i.e. long term STAR, Housing First

Everyone in the room – cross agency service agreement

Cross agency assessment tool/risk assessment to reduce duplication

Dual diagnosis outreach service made up of qualified mental health worker and drug & alcohol workers

Mental health workers working within other services and supported housing projects

Commissioners recognising value of staff wellbeing

Plymouth Alliance Scheme – sharing commissioning services and loose contracts and 10 years

No wrong door approach

Transparency – one database for all agencies (common portal)

Statutory parties should be at all conversations

3rd sector already partnership working

More transparency from stat agencies – less gatekeeping

Multi agency complex needs strategy


Reflects many of the key messages arising out of the key stakeholder and service user surveys such as better sharing of information, multi-agency working, working with those with complex needs and learning from experience









Co-location – sharing office space, partnership agreements across Cornwall;

Reviewing Homelessness Charter - No one has to sleep rough – emergency provision – safe place – assess and move on schemes

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as multi-agency working, co-location and learning from experience




Vision




Homelessness review should capture the opportunities for partnership working and should identify outcomes that the strategy is on track rather than simply waiting for count of rough sleepers.

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as multi-agency working, co-location and learning from experience

Regular monitoring to ensure strategy is working to resolve current issues


Vision







Annual meeting with all stakeholders – attached to funding – that is mandatory







Person centred

Client led support










Reflects many of the key messages arising out of the key stakeholder and service user surveys such as communication issues, partnership working, person centred approach, etc.







Vision


Need to use voluntary agencies like churches more as offer a good service and are in more places Improved working with voluntary and community sector

Approach 6: Safeguarding



Increase in safeguarding resource (not just meetings) accom, support to rough sleepers, complex needs

Internal services to be delivered – i.e. care/cleaning for clients under safeguarding

Joint commissioning services – to meet complex needs of vulnerable individuals

Training for social workers around complex needs and homelessness

Faster response following referral

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as multi-agency working, working with those with complex needs and learning from experience





Agile, responsive, multi-agency person centred actions – right enabling, strengths based and solution focused

Relationship based and trauma informed services

Front line staff in all agencies safeguarded from work related illness/mental health issues

Investigate rough sleeper deaths/complex needs

Remit for safeguarding expanded

More support for the service user and the provider

Specialist safeguarding team surrounding mental health/dual diagnosis

More stat guidance, support, flexibility and joint working/shared accountability

Stat lead agencies to take other professionals assessments seriously

Reduction in safeguarding /more funding

People to take responsibility for reporting safeguarding

Safeguarding alerts to be accepted at a significantly lower threshold

Social services to respond and act upon referrals within 3 days

Single care plans, multi-agency working, virtual multi-agency teams


Agencies to work with those with multiple needs



Work with all homelessness (including those without recourse to public funds and/or no local connections)




Rough Sleeping System Transformation Workshop – 12th April Map –

Integrated Community Services Design Group

Health for Homeless – in the West

Dual diagnosis training

Health MOU

Hospital discharge

Needle exchange in tolerant accommodation and new hostel

Hepatitis C treatment

Naloxone in tolerant supported accommodation

CCG – GP/Nurse clinic at Cosgarne once a month

Community psychiatric nurse support for health for homeless

Hospital outreach team

Mental health support in health for homeless

Health for homeless co located un 3 venues, with support, West

Other plus Equality/Diversity/Inclusion plus Health - Gaps –


Ability to track peoples journey, Journey of clients in one database


Serious case review for deaths of rough sleeping

End of life care

Access to interpreters

Meeting the needs of LGBTIQ

Veterans accessing services

Young people and county lines

Refugee provision

Accommodation for offenders

Physical care needs of people in supported accommodation – still actively using alcohol and drugs, Palliative care for aging population who continue to drink alcohol within accommodation

Gender informed services – only one female unit known of specific for homelessness

No recourse to public funding

Dual diagnosis services and taking responsibility

GP access for rough sleepers, Health for homeless in all areas, Access (continuous) to health for those in temporary accommodation if move, Access to primary care services in the east

Hospital discharge pathway

Mental health, Access to mental health diagnosis and treatment especially crisis and in the community, Quick access to mental health where drugs and alcohol are present, Lack of mental health outreach and flexibility

Psychological skills linked to outreach services

Needle exchange in the community

Settled accommodation required before care package

Care packages on hospital discharge and transparency of individuals needs e.g. violence and substance misuse

Re-imagine/re-understand accommodation as a health intervention Other plus Equality/Diversity/Inclusion - Challenges –

Lack of tolerance

Commissioning approaches – prevents open dialogue?

Separate strategies – homeless and mental health


Modern day slavery

No recourse to public funding

Migrants needs

Local connection criteria

All agencies to accept they have a role to play

Policy/safety equation (e.g. high risk/complex needs/offenders)

The label complex needs is misunderstood

Different source of funding for health

Mental health strategy separate to homelessness

Mainstreaming – getting in to services

Funding/capacity of mental health

Dental access

Only countywide mental service is criminal justice and mental health – all other community mental health teams locality based

Separate commissioning process/timetable

Attitude of some health professionals towards rough sleepers

Geographical spread of health for homeless – only mid and west at present

DAAT: o Budget cuts o Outreach o Treatment

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as multi-agency working, better sharing of data, working with those with complex needs and learning from experience












Improved health care – mental and physical


Role of commissioning in provision of supported accommodation to meet needs



o Places


Balance between households having the capacity to make unwise decisions v Care Act duty of care

Services not currently available to homelessness if in Cornwall less than 6 months due to local connection requirements

Gap - Rehousing service people not meeting help for heroes criteria but who still need help

Transitional support key – should be available to those that need it when they need it

Homechoice policy

Affordability and suitability

Safeguarding referrals – not sure what happens to these as don’t get feedback

Mental health input

Need to ensure that signposting is available to those that have concerns about safeguarding issues





Ongoing support for those that might need help long term or at key times of stress

Feed into review of Allocations Policy

Feedback from referrals

TB Service Group Meeting – 17th April

Incidences of TB are increasing in Cornwall and is likely to continue to increase

Would be good to have a specific pathway (wider public health issues)

Reconnection does work but need support and treatment packages in place

Links to review of housing allocations due to wider public health issues needing to be taken into account



Wider public health pathway required


The pathway for homeless health programme which cuts across health specialisms has been a successful model - NK to provide details.

FH to share information relating to changes to probation services’ impacts upon support services. There are concerns about those leaving prison, particularly women offender. It is important that any new arrangements work for Cornwall where there is a potential gap around offender services.

RW highlighted the consortium of VCS agencies who could help to support offender management work.



















Person centred

Client led support























Vision


Former tenant arrears and behaviours – could link to domestic abuse and benefit arrears

End of life care – Cosgarne currently looking at storage of medicines on site (long piece of work). Skills and support required, shared work with health colleagues

RS who are taken to hospital and then die in hospital – not recorded as a RS death

Physical health and wellbeing

Mental health – need support in place for providers










Registering with a GP can be an issue without ID

Referrals to other support agencies – can take a long time but if someone is vulnerable they need help quickly as likely to revert to ‘bad behaviours’ if wait too long

Better and faster access to mental health










Feel men with children often treated differently

Advice going forward – physical disability is sometimes easy to see but mental health issues not – if someone has mental health issues and tells you this then you should be believed.







Approach 7: Clear and Meaningful Pathways



No one should be street homeless

Suitable and appropriate accommodation should be available

More aware/enabled/informed interactive services

People fleeing domestic abuse with complex needs (or fleeing drug debts/arrears)

More choice for homeless people – many pathways

Clear incentives for people to move through pathways

Social housing access for supported housing clients (pathway)

More support for those with PN

Care leaver pathways

Dual diagnosis outreach team – mental health and DA working in partnership. Incorporate street triage

Young people’s pathways

More affordable accommodation

Remember the individual

Joint mental health and housing/homeless pathway

Completely different commissioning process – to keep people open/sharing and cross working

Housing providers build the service to be commissioned /not conversely

More support for non-priority homeless clients

Under 35 years old HB rate scrapped

More suitable housing

Referencing should include support workers for housing association

Non-priority clients need more pathways not just sign posting

Stop segregating pathways e.g. do we really need one for every need – could be a young person, mental health and rough sleeper - Simple form that works rather than 18 different ways

Increase in integrated working. One data recording system used by all agencies

Housing associations should work with support workers for housing references

Working people should have support from HB when living in supported accommodation - 3 month overlap rather than just one month

Remove some barriers to private rent – end ‘no HB’

Effective triage/consultation

Pet friendly accommodation



Vision

Pathway for those fleeing domestic abuse including those with complex needs


Move on towards independent living

Pathway for care leavers and young people



Pathway for mental health

Pathways for non-priority clients

Pathways or one pathway for all?


Pet friendly supported and other accommodation



Generic pathway for all households but with different strands for specific groups e.g. discharge from prisons. Needs multi-agency approach

More to be done at preventative (pre 56 days) stage





Support early prevention work (e.g. NDK)


It would be beneficial to see people with lived experience providing input into the commissioning process to identify what good looks like. SB provided offer of assistance.

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as learning from experience

Role of commissioning in provision of supported

accommodation to meet needs


Event at Coastline Offices 26th June (bold highlights are the main points picked out at the workshop)

One pathway into housing for all – remove barriers

Prevention services need to be embedded for all rough sleepers

Review exclusions for/to housing and coordinated approach to housing pathway

Digital inclusion – national rough sleeper database and include health, housing

Be able to give service users details of clear pathways for move on

‘Linked in’ working. Constant flow of information between agencies

Accountability

Funding - Resources

Asking service users what they want (what could they manage?)

Evidence and awareness of location, need, engagement of rough sleepers to influence and resource service provision

Person centred success to be shared

More multi-occupancy move on properties

Person centred support plans

Significantly increase the number of preventions

Upstreaming to ‘at risk’ group > inclusion

Always refer – plan ahead (even if not on stat list) e.g. when someone goes into prison for a short time

Realistic prevention options

Housing options need to be available

Accessible to all > easy to navigate

Re-visit pathways

All agencies take responsibility

Specific accommodation for the support groups (pathway) > accessible to needs e.g. LGBT, mental health, women, men, disabilities

Dual diagnosis service

Council owned/commissioned supported accommodation (somewhere that will take those of highest need)

Refuge service able to accommodate complex needs


Reflects messages from engagement sessions relating to ‘revolving doors’, past histories etc.


Support early prevention work (e.g. NDK, when people go into prison for short period)

Spend ‘past history’ at some point/proof that have moved on





Pathways for those with complex needs – no refusing to accept someone with multiple issues

Pathway for those fleeing domestic abuse including those with complex needs


Vision


Effective communication between different agencies working with clients

Approach 8: Outreach and Flexible Support

Engagement Event Challenge Response


‘One for All’ support plan – one database

Multi-Agency linking up – one phone number for signposting

Reduce homelessness for those most hard to place

Dual diagnosis training/providers/placements – mental health workers on outreach, addiction and domestic abuse services

Direct link to mental health team – qualified roles in MH SH

Floating support with no end date

Trauma informed services – ACE aware

Multi agency hubs in each of the 10 Safer Cornwall towns and a mobile multi-agency hub to cover all areas

Media/marketing campaigns to raise awareness and highlight services available

Everyone that needs support gets it

EASL (Enabling Assessment Service London) – mental health

Street doctor

Former homeless/those with experience of homelessness employed in all service areas with specialist support, training and supervision

Enable people not disable people

Ending rough sleeping

Social worker on outreach

No-one falls through the gaps

Gender informed services

Accessible support services

Phone assessment – only initial – after face to face/video

Outreach support and services

Lobbying central government

Culture and religion – beliefs

Visible personality disorder service accessible to all

Can get fuel vouchers through foodbanks if in fuel poverty

Council tax – still have to pay even if on very low income

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as early prevention, the need for ongoing support, multi-agency working and learning from experience










Commit to multi-agency working

Pathway for mental health

Pathways for non-priority clients






Vision

Rough Sleeping System Transformation Workshop – 12th April Map

Person centred and led by client

At least 2 re-settlement centres established

Training for staff available

Volunteer programmes

Social prescribing role

Nos Da Kernow

Assertive outreach

Private rented access landlord incentive scheme

Support - Gap

More preventative early intervention needed

Floating support as a prevention tool

Dual diagnosis

Outreach services in Winter when CWP open

Daytime provision and services in certain towns

Street outreach – funding and size

Limited number of resource centres

Short and long term tenancy support in all tenures Challenges –

Short term funding

Workforce development and supply

Blocks from police in some areas e.g. Newquay

Re-traumatising

Skilled staff

Managing risk to staff and clients

No funding for the training pot

Ensuring staff wellbeing – retention

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as early prevention, the need for ongoing support, multi-agency working and learning from experience






Commit to multi-agency working as way of overcoming issues of short term nature of funding (especially in relation to staff training)


Support early prevention work (e.g. NDK, loss of seasonal work)



Navigator role – helping people with support and accommodation found for them

Transitional support key – should be available to those that need it when they need it

Flexibility – may not need support for a while but could do at a later date e.g. when abusive partner released from prison

Need commitment from all to collaborate – formalise commitment

Competitive tendering

Reflects many of the key messages arising out of the key stakeholder and service user surveys such as early prevention and the need for ongoing support

Navigator role





Event at Coastline Offices 26th June (looked at in terms of Intervention so support and accommodation together) (bold highlights are the main points picked out in workshops)

Ongoing support

Person centred – navigation

Accommodation should be matched to individual needs and support

Lots more appropriate accommodation and move on support

Getting it right first time to prevent revolving door

Funding across the board

Long term support


Navigator role




Commit to multi-agency working as way of overcoming issues of short term nature of funding (especially in relation to staff training)



Vision



Targeted key working – e.g. Together for Families – direct contact and working really helped families to address debt, ASB etc.

Time credits – currently only available for those with complex needs but could be rolled out.

Mental health of young people – not enough work around this and unsure of how to move forwards

Physical health and wellbeing

Mental health – need support in place for providers








Ongoing support – as and when needed Ongoing support for those that might need help long term or at key times of stress

Approach 9: Appropriate Accommodation



Haven’t got tools needed to understand what is happening, where people are etc.

Key is flow – more prevention and faster move on from temporary accommodation

PRS – need one offer not multiple as currently


Agree can be confusing






Purpose built, multi-purpose, open access, reception centres/hostels with onsite support from multiple agencies and clear move on plans – EMERGENCY ACCOMMODATION FOR EVERYONE

Better access to private rent and increase in HMOs to help young people on low incomes

Have purpose built stock for emergency and temp only

Permanent accommodation pathways for all homeless people (stat or non-stat). Remove need for temporary accommodation

Prevent further debt

Rent prices, affordable housing costs more than some private rents – rents are very high

No one is homeless long term

No delays in hospital due to lack or poor accom

Sharing information with 3rd sector partners to fix problems

75% reduction in homeless applications due to successful preventative and timely measures

Joint commissioning services – to meet complex needs of vulnerable individuals

Specialist, geographically and need appropriate (i.e. where most need is) accommodation (age appropriate, tolerant, flexible, intensive, semi-independent, independent, supported, aspirational)

More social housing – less emphasis on buying

30,000 more new social homes available as a mix of social and affordable rent

Holistic staging of housing – more fluid

More tolerant of people using substances away from the houses

NOT moving people constantly in emergency accom

Emmaus type accommodation




Need to be building/managing accommodation that meets the needs of those that are likely to become homeless – e.g. single people under 35 only able to claim shared room rate

Fast access to accommodation suitable for household – including tolerant supported accommodation




Navigator role






Vision

Rough Sleeping System Transformation Workshop – 12th April Map –

Move-on accommodation as part of new hostel development

Cold weather provision

Hospital discharge beds

STAR – short term accommodation & re-settlement

Supported accommodation for complex needs

Housing First

STAR development

12 units – domestic abuse and complex needs

Gap –

Levels of tolerance

High tolerance accommodation

Supported accommodation in certain towns

Safe to stay hub

Complex needs – so complex services struggle

Domestic abuse victim accommodation

Pool of supportive private landlords

Lack of self-contained supported accommodation

Long term supported accommodation – those who will never be able to live independently

Alternatives to hostel/shared accommodation – own front door

No Second Night Out accommodation – accommodation to get people off the street today

Varying local provision

Limited move on from hostels/TA and STAR Challenges –

Political buy-in and understanding of complex needs

Local connection criteria

Temporary accommodation supply

Tenancy sustainment

Private landlords leaving/Airbnb



A wide range of suitable accommodation is required to reflect differing needs

Challenge of working within the ‘welfare reform’ framework, including the impact this has had on public funds available for operational purposes and to commission appropriate accommodation








Role of commissioning in provision of supported accommodation to meet needs


Public perceptions



18 beds – direct access night shelter (to new build Summer 2019)

Some Housing First

Social landlords across Cornwall

Funding

Land

Risk of reduction as a result of current tender process

Housing benefits cap and local housing allowance

‘Not in my back yard’ from local residents

Emergency temporary accommodation in right places where needed

Approaches different where you go based on agency e.g. levels of support/tolerance


Reinvent private sector relationships – mitigate concerns around ASB, abandonment, evictions, non-payment of rent – need to keep flow moving – final accommodation offers – tenancy sustainment. Needs properly resourcing as can reach saturation point – also single point of contact. Starts to build on to our Social lettings agency to be resourced (rapid rehousing bid) – navigating type role to support tenancy sustainment – landlord insurance scheme – single point of contact – private schemes need to be aligned – can discharge into private sector - ASTs

Disabled access in both temporary and emergency accom

Large families, heard to house households – need to have flexibility to acquire or adapt to meet specific needs

Multiple complex needs, tolerance – need support attached for some households – need to own some properties that will accommodates these types of households

Past history regarded as ‘spent’ at some stage

STAR more dispersed across Cornwall so don’t need huge moves

A wide range of suitable accommodation is required to reflect differing needs, including a good private sector offer




Fast access to accommodation suitable for household –

including tolerant supported accommodation


Newquay Safe 3rd June Can be some issues at certain properties with mix of tenants – e.g. Mount Wise property – some successes. Will be discussed at ASB meeting as more appropriate venue for discussion.

A wide range of suitable accommodation is required to reflect differing needs

Careful mix of clients needed in some types of accommodation


Event at Coastline Offices 26th June (looked at in terms of Intervention so support and accommodation together) (bold highlights are the main points picked out in workshops)

No-one sleeping on the streets

Sustainable accommodation

Temporary night shelters – modular units

Person centred – navigation

Better private rented sector offer

Accommodation should be matched to individual needs and support

Lots more appropriate accommodation and move on support

Getting it right first time to prevent revolving door

Funding across the board

Supply and demand model for Cornwall Council have a wider variety of housing options available (including greater???)

Social housing a realistic prospect for more households

Bigger and more appropriate range of supported accommodation

Widen housing first model




Vision







Focus on social housing




Pathway – not just a case of helping them out of RS and into accommodation but going further and seeing what we can do

Short term funding for projects like NDK, STAR, Housing First etc.

Move on accommodation










Need more accommodation that takes people reliant on benefits – still lots of ‘no DSS’ being advertised

Need to look at houses that would house a group of friends – e.g. 3 bed properties.

If in PRS this would help with local connection blockages – and would be provided with funds to support them/rent in advance/deposit – St Petroc’s do this and can liaise with landlord if there are any issues – knowledge of there being sympathetic landlords out there but often they are let down by the system too – delays in payments etc.

Need for pet friendly accommodation – dog is family to many and act as lifeline – ability to pay bigger deposit to cover any damages should be an option

Would prefer own front door but there is understanding that they may need to share a home initially

Shared room rate can be a real issue for young people with complex needs as often cannot share – investigate housing first for young people (project in Scotland currently underway)

Social landlord is seen as providing more security of tenure than PRS

Need for 1 bed accom – better in towns but is expensive

Why aren’t caravans a sensible option? You can get benefits to cover rent if stationary.

Have to have places for people to go to immediately and when moving on







Feed into review of Allocations Policy – be more flexible in terms of s106 for Housing First, shared accommodation, accommodation for group of friends, etc.

Faster payments for PRS



Move on accommodation – great support at rough sleeping stage but then you get stuck in the system

Wanting to work whilst in supported accommodation – rules stop you as you won’t be able to claim benefits to pay rent (high rents)

Support for single people – need more shared housing

Need accommodation that will take pets – some talk of sharing pets

Loneliness can be an issue after people are accommodated – especially if been sleeping rough for some time

Night shelters – unsafe for many that are rough sleeping – also addictions should be treated the same – are banned for drinking but can under influence of drugs and not banned..?

Some of the landlords on the list will accept money in advance from Council – but are they good landlords?









Approach 10: Complex Needs



Flexible thresholds

Capacity/interpretation of vulnerability

Lifestyle choices to be considered and supported (right to make unwise decisions)

More dual diagnosis services

Risk assessment to reflect flexibility

Less gatekeeping of stat services/more resources/prevention

Training and support for staff and reflective practice embedded in all homelessness services

Reducing stigma around stages – reusing stages – treating service users as individuals

More considered placement of service users – into appropriate accommodation – Housing First

Services to be able to respond to complex needs

Stage 1 housing that houses stage 1 people/more options for stage 1 clients

Dual diagnosis procedure developed e.g. mental health and addiction workers assessing together

Reduce discrimination, develop better risk assessment process shared between services

No-one discharged from hospital/prison/anywhere homeless











Vision



Public perceptions – and staff perceptions


Moorfield – good lessons learnt but was short term solution – need long term solutions (look to work undertaken as part of CWP in 2018 for a more longer term focus)

Some families have generational issues – need to break the cycle




Better data sharing



Individuals need to be in a place where they can work on all their issues not just homelessness – should be working towards getting people back into a (for them) ‘normal’ life…



Event at Coastline Offices 26th June (bold highlights are the main points picked out in workshops)

Nobody needs to live on the streets – there should be somewhere for all to go

‘working together’ – multi agencies – requires strategic agreement (highest level) to remove barriers

Access to services for individuals

Supported accommodation available for highest needs – means in place to prevent exclusion of difficult cases, extension of housing first model, multi skilled, multi-agency working, single consent form for multi-agency working

Commissioned services – deliver to contract

Have ongoing support for complex needs (sheltered, long term) (with on-site support workers)

Less frustrating pathways into external services (i.e. mental health)

More funded detox and rehab (less constraints around funding and time limits)

Managers having a working knowledge of what is happening on the frontline

Excellent communication from frontline -> strategic decision makers – unblocks system barriers, enables shared information and learning, ensures a joined up approach for clients, shares accountability for delivery

STAR – effectively working – extend to other client groups

Funding


Vision







Improved communication between and within agencies



Sometimes the complexity of a person’s needs acts as a barrier to getting and then sustaining accommodation; Ongoing support for those that might need help long term or at key times of stress

Sarah Thorneycroft Housing Strategy & Partnerships Engagement Officer Housing Service August 2019

Challenges: Where do we want to be in 2025? · The outcomes from each engagement session using the...

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