ANNEX 1: HOUSING SUPPORT - PRACTICE EXAMPLES AND CASE STUDIES
1. There are many examples of housing support being provided across Scotland. The practice examples and case studies below, provided at the time of publication of this Guidance in June 2013, seek to cover some of the experiences of local authorities, third sector organisations and service users.They are not intended to cover all forms of practice and experience and it is recognised there will be other approaches being implemented across Scotland with innovative and flexible responses being developed in response to local circumstances.
2. The examples below highlight practice and case studies in relation to housing support assessment and housing support provision. A link is provided in each study for those wishing to know more about the local authority area. For further information on any of the practice examples in this Guidance please contact the local authority area concerned or contact firstname.lastname@example.org.
A PRACTICE EXAMPLE - HOUSING SUPPORT ASSESSMENT - SOUTH LANARKSHIRE COUNCIL
The local authority adopts a triage system where every homeless applicant has a discussion with the homelessness officer regarding their support needs. This is based on a checklist approach and helps decide whether or not a household needs a referral for housing support. If at the point of application it is decided that housing support is not required, yet at a later date it is identified that housing support is in fact required, there can be a referral for housing support at that stage. The Housing Support Standards set out how a housing support service should be delivered. However, an effective housing support service would be expected to provide:
- A full assessment of their housing support needs - there should be a format for this assessment which is consistently applied across all households and a record should be kept.
- A support plan is developed on the basis of the housing support assessment covering all the areas that have been identified and the support plan should be reviewed on a regular basis.
Some form of case note recording the evidence of on-going work with the household or individual and that the work set out in the housing support plan is in fact being progressed.
There are opportunities to develop models which include outcome measures. They are very useful in assessing (quantifying) the level of support required by a household and identifying progress made.
The Better Futures assessment model, developed through the Housing Support Enabling Unit, has a full IT package which covers assessment planning and case notes, along with an outcomes measure. Specific systems used by each Council need to be compliant with Care Inspectorate requirements. More detail can be found at: http://www.ccpscotland.org/hseu/information/better-futures
More detail on South Lanarkshire Council: http://www.southlanarkshire.gov.uk/
A PRACTICE EXAMPLE AND CASE STUDY - HOUSING SUPPORT PROVISION - CORPORATE RESPONSIBILITY AND JOINT WORKING - NORTH LANARKSHIRE COUNCIL
North Lanarkshire Council has a locality planning structure in place. Each locality has five Locality Planning Groups ( LPGs) covering each of the main care group areas:
- Children & Families
- Mental Health
- Older People
All LPGs have representation from the Council including Social Work and Housing as well as from specialist health services and voluntary/private organisations. Each LPG provides a quarterly report to each of their Locality Health and Care Partnerships who have overall responsibility for maintaining an overview of performance in each area and across all care groups. The purpose of the LPGs is to co-ordinate services and supports for people who have complex needs and require a joint response to allow them to achieve their desired outcomes. This includes support to maintain their ability to live as independently as possible in their own homes.Each of the LPGs meet on a fortnightly basis to plan and discuss progress on specific cases and enables a partnership response to be targeted and outcome focused.
Mr A is 49 years old and has a history of repeat homelessness. Mr A represented as homeless and was accommodated in temporary homeless accommodation with 24 hour support in place. The accommodation type meant that Mr A shared a lounge, kitchen and bathroom with other residents. Over a period of a year Mr A's health deteriorated and the ability of staff within the accommodation to manage his behaviour became extremely difficult. Mr A's behaviour began to have a negative impact on other residents and he would regularly display periods where he would injure himself but not be aware of it. During this time, Mr A required a significant level of support to maintain his everyday living and was in excess of 5 hours per day. After a case conference, it was agreed to refer the case to the LPGs for joint planning to source suitable assessment of Mr A's mental health.
The LPG reviewed the case and after several attempted assessments, Mr A was diagnosed with Alcohol Related Brain Damage ( ARBD) and it was noted that he would require intensive support for the rest of his life. This diagnosis was followed up by intensive efforts to source alternative suitable longer term accommodation and support. It took several more months, but eventually a suitable place became available within a 24 hour care facility and Mr A was prepared and then re-located to his new supported accommodation placement.
More detail on North Lanarkshire Council: http://www.northlanarkshire.gov.uk/index.aspx?articleid=1
A CASE STUDY - HOUSING SUPPORT PROVISION - NORTH LANARKSHIRE COUNCIL
Mr B became homeless due to a serious alcohol addiction. The addiction had taken over his life and resulted in him splitting up with his partner and losing contact with his child as well as losing his own plumbing and tiling business.
Mr B was originally accommodated in dispersed accommodation, but after an assessment Mr B decided he wished to be referred to an intensively supported accommodation project where the key aim was to help him recover from his addiction issue. Mr B worked on an outreach basis with a key worker from the project until a space became available.
Once he moved into the project, Mr B attended counselling sessions and was supported to go on a detox programme which he completed successfully. He was also provided with additional support to go food shopping, get his benefit sorted and began joining in social activities within the project. Over a period of time Mr B began to regain his confidence and his health. However, he had a set back when his partner filed for divorce and sought permanent custody of his child. At this time Mr B was admitted to hospital for a few days and then returned to the project. Mr B again began the process of detox and working with project staff to address his addiction.
Over the next few months Mr B began to thrive and managed to come to an agreement over access rights to his child. He also started applying for jobs and although he had several letters informing him that he was not suitable, he never got disheartened and instead kept on trying. At this point a support review confirmed that Mr B was ready to move into his own tenancy and within a few weeks he had the keys to his new home. Mr B poured a great deal of his energy into decorating his new flat and also attended another interview which resulted in him being offered a job as a company rep for a building firm.
Mr B has kept in touch with the project and has gone from strength to strength with a promotion and a new company car as well as reconciling with his partner and young child.
A PRACTICE EXAMPLE - HOUSING SUPPORT PROVISION - POSITIVE STEPS PROJECT AND DUNDEE CITY COUNCIL
Positive Steps is a Scottish based, inter-denominational Christian charity committed to promoting good health and social welfare around the world. In Dundee, they are associated with the delivery of housing support and providing accommodation to vulnerable adults who have in the main come through the homeless system.
Protocols have been agreed with Dundee City Council and several Registered Social Landlords. These housing providers lease out property to the charity. Positive Steps then decorates and furnishes the properties before subletting the accommodation to tenants on short assured tenancies. They believe that this is an important aspect of the service as the new tenant is presented with a clean and comfortable place to live and immediately has an incentive to maintain the tenancy.
Generally the people who move into these flats are homeless or in housing need and have a poor previous housing history, frequently due to their chaotic lifestyles. By offering these tenancies time in temporary accommodation is considerably reduced. The support provided is person centred and holistic in nature. Key workers support service users to address issues which may be causing difficulties as well as helping work toward aspirations. A significant part of this engagement is the development of self esteem, often lacking in service users, and more positive social networks. The building of positive social networks and through those relationships, social capital, is important in enabling the sustaining of a tenancy in the future. Consequently supporting service users to become active in their community is a regularly occurring aspect of support plans.
Once support has been withdrawn, the service user can still re-engage should this be needed. The project believes that continuing to stay in the flat is an important component in the sustainability of the tenancy. Unlike other models where the service user is asked to move to another tenancy after completing their resettlement process, Positive Steps enable the service user to remain in the home they have created, in the community they have developed links with and among people with whom they have established relationships.
Development of the Accommodation Service into the Private Rented Sector
It became apparent that in order to sustain the Accommodation Service, Positive Steps needed to access property in the Private Rented Sector. Positive Steps started the process of developing the business plan to take this concept forward. This has led to a Private Sector Leasing Scheme which is being delivered as a social enterprise. Properties leased under the scheme will be used as accommodation for people who are experiencing homelessness or in housing need. The properties will be sub-let through a tenancy agreement. By preventing or reducing the time spent in temporary accommodation and by providing a furnished and decorated flat with support, there is an increased likelihood of the service user sustaining the tenancy and moving on in their life.
More detail on Dundee City Council: http://www.dundeecity.gov.uk
A CASE STUDY - HOUSING SUPPORT PROVISION - THROUGHCARE AND AFTERCARE - DUNDEE CITY COUNCIL
Supported Lodgings and Respite
The Throughcare and Aftercare Team in the Social Work Department have been working with a young person who has been residing in a supported lodgings placement for over a year and for a period of time was relatively settled. This young person has since been spending a lot of time outwith the placement, failing to adhere to placement rules and generally disengaging from supports in place advising that he would like to move into his own tenancy. There are shared professional concerns about his ability to manage living independently with limited experience and also around his capacity to cope with such a transition. However the young person believed that he could manage a tenancy and did not fully appreciate what that entailed.
A partnership arrangement has been put in place for this young person to move into one of the flats allocated on a 'respite basis' for a 4-week period in order for him to experience living on his own and for a thorough assessment to be carried out about around his abilities/areas of support. This was intended to enable the young person to make an informed choice about his progression and also for the Social Work Department to establish how to best support him. The young person has now understood that he has come across several issues that he cannot manage and also the feeling of isolation that he did not appreciate. The Supported lodgings placement has been held open and it is becoming increasingly likely that he will return to this placement now that he understands the implications of living alone in a tenancy and the subsequent management issues.
Social Work were working with a formerly looked after and accommodated young person who was pregnant and living in Action for Children Street Level. She hoped to move into her own tenancy after the baby was born.
Unfortunately, due to the increasing number of concerns about her relationship and the potential risks associated with this, the Social Work Department was carrying out an unborn baby assessment and consideration was being given to a child protection order being taken at birth, which would have meant the baby being removed. In an attempt to prevent this, the Throughcare and Aftercare Team approached the Carolina House Trust requesting that they extend their supported lodgings remit to pilot a 'mother and baby' supported lodgings placement. This was approved by the appropriate panel and the young person moved in with the provider before giving birth to her son. There was an intensive level of work which went into this during the initial few months but the young person and her baby remain in this placement and housing applications are in for her to now move into her own tenancy.
A PRACTICE EXAMPLE AND CASE STUDY - HOUSING SUPPORT PROVISION - LOREBURN HOUSING SUPPORT SERVICE (LHSS) AND DUMFRIES AND GALLOWAY COUNCIL
Loreburn Housing Support Services ( LHSS) has been providing housing support in varying forms for over 25 years. After consulting with Dumfries and Galloway Council's Housing Support Team, LHSS decided to pilot the Outcomes Star for 6 months. The Outcomes Star is an approach to measuring change when working with vulnerable people. These measurable changes are referred to as outcomes. It is used within the key work process and is integrated within assessments and reviews. This approach can be used in key work with service users.
The pilot was conducted across three services and involved 6 staff members and 24 service users. The three services were an outreach service, a family support service and a supported accommodation service. Service users participated in the completion of an initial Star within the first month of the pilot which enabled a minimum of two reviews to be facilitated within the 6 month time period. The resultant scores were recorded on a spread sheet.
The simplicity and adaptability of the Outcomes Star enabled service users with extremely complex needs to engage with the assessment of their support needs and to decide how best to plan intervention. Staff stated that previously service users who presented as unwilling or unable to recognise their own needs were by far the most challenging to engage, requiring significant skill and input on the part of the staff member just to start to address this initial barrier. The findings suggest that this system appears to alleviate elements of this difficulty by reducing some of the mysticism surrounding assessment and intervention for service users. Evidence suggested that the use of straightforward terminology such as being 'stuck' or 'believing' and, more significantly, through the use of visually expressive imagery such as the star itself and the red, amber, green colour coding of the ladder were key. Staff were able to use the Outcomes Star with various techniques such as motivational interviewing and cognitive behaviours approaches and felt it facilitated a level of self-assessment that helped to reveal underlying issues that could act as barriers to effecting positive change:
I have one service user who has literacy difficulties which without a lot of staff input would cause him to withdraw and become uncommunicative when any form of assessment or support planning was broached. However the structure of this system very quickly engaged him and in doing so not only alleviated his anxiety regarding reviews but ultimately actively engaged him in them" - LHSS Keyworker
"The adaptability of the system enables you as the worker to assess which approach best suits the needs of your service user from giving them a copy of the user guide to read over themselves to breaking it down to its very basic components……I love it just for that reason" - LHSS Keyworker
"It was just so easy to get my head round…am I stuck...do I need help…can I do it myself" - Outreach service user.
More detail on Dumfries and Galloway Council: http://www.dumgal.gov.uk/
A PRACTICE EXAMPLE - HOUSING SUPPORT PROVISION - RAVENSWOOD PROJECT AND EAST DUNBARTONSHIRE COUNCIL
Ravenswood is a service which provides accommodation with support to vulnerable homeless households and is run by the Mungo Foundation in partnership with East Dunbartonshire Council. The service offers temporary accommodation and support to homeless households aged 16 years and above who have additional support needs, and can accommodate single people, couples and families. The service provides advice and support to individuals who may have mental health issues, substance misuse issues, learning disabilities or to those who need to develop their independent living skills to maintain a future tenancy.
In order to access the service, customers need to be at least 16 years of age (children under 16 may be accommodated alongside their parent or guardian) and referred to the project by East Dunbartonshire Council's Homelessness Team. The length of stay in the accommodation depends on support needs, although in general terms, some households will be accommodated on a short stay basis. Others will, on a long stay basis, be supported to develop the skills required to enable them to live independently. The staff team from Ravenswood also provide outreach advice and support to homeless households living within some multiple occupancy homes.
More detail on East Dunbartonshire Council: http://www.eastdunbarton.gov.uk/home.aspx