Homelessness JSNA | Boltons Health Matters
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Homelessness JSNA

Abstract

This is the JSNA chapter on homelessness. Theme chapters summarises implications for commissioning, who is at risk and why, the level of need in the population, service provision and use, unmet needs, what works in terms of evidence, community views and priorities, any related equality impact assessments, unmet service needs/gaps and recommendations for further needs assessment work. 

Introduction

Homelessness to many people may be synonymous with people sleeping rough.  The definition of homelessness might simply be viewed as someone who is without permanent or settled accommodation.

Bolton Council has a range of duties (some statutory) to people who are homeless, and this always includes advice and assistance and often the provision of accommodation.  There is also an ongoing duty to some homeless people.
  The main housing duty is to accommodate those who are vulnerable, unintentionally homeless and in priority need.
At one level, the definition of homelessness can be divided into two main groups: statutory and non-statutory, or single homelessness.  As a result of this divide, many agencies in the voluntary sector tend to support those who are non-statutory or single homeless.

The legal provisions for statutory homelessness are contained in the 1996 Housing Act, the Homelessness Act 2002 and The Homelessness (Priority Need for Accommodation) (England) Order 2002.

The Homelessness JSNA chapter has direct links to other parts of the JSNA such as alcohol, drugs, mental health, learning disability, and housing.

Implications for Commissioning

Support the delivery of Bolton’s Homelessness Strategy 2012-13 Action Plan.

Consider the development of health services specific for this client group.  Health sessions and surgeries to be held in the new Gilead House.  Town Centre GP who will accept appointments from those without permanent accommodation.

Support services which assist those on the fringe of homelessness.

Support Floating Support services which assist those in transition to secure accommodation.  Consider additional physical support measures during this period such as a starter pack, assistance with utilities, support to establish a home such as curtains, bedding, cooker etc.

Assist the development of services in Gilead house to become a vibrant, multi-agency focal point where homeless people can access a range of services.

Who's at Risk and Why?

Homelessness can be classified as:
• Legally homeless: Have no accommodation that they are entitled to occupy or their accommodation is not reasonable and prevents them from continuing their occupation of it;
• Statutory Homeless: The Homeless Person’s Act 1977, the 1985 and 1996 Housing Acts and Homelessness Act 2002 define who is entitled to receive permanent housing by or on behalf of a local authority.  The main homelessness duty is owed to people who have a ‘priority need’ and are not ‘intentionally homeless’.  Priority need groups are those households:
– with dependent children (including pregnant women);
– with people who are vulnerable due to old age, mental illness, handicap, physical disability or other special reason;
– rendered homeless or threatened with homeless because of a disaster such as a fire or flood;
– children between 16 and 17;
– care leavers under 21;
– people vulnerable as a result of being a member of the armed forces;
– people vulnerable as a result of having been in prison or on remand;
– people vulnerable as a result of threats of violence;
• The ‘hidden homeless’:
– rough sleepers – people without shelter of any kind.  This includes people sleeping in the open air for example on the street, in doorways and in parks.   It also includes people in buildings that are not designed for habitation, for example in sheds, car parks, barns, and make shift shelters;
– the ‘houseless’ – those who are living in emergency or temporary accommodation such as shelters, hostels, and refuges;
– those who live in accommodation because they have nowhere else to stay, such and B&Bs, that is unsuitable as for a long stay;
– those in insecure accommodation:
– those who have no legal right or permission to stay in their accommodation, for example squatters;
– those who only have permission to stay in their accommodation for a short period, for example those who are moving around the houses of friends and family;
– those who are threatened with homelessness:
– those who need to leave their accommodation due to relationship breakdown;
– those faced with possession proceedings;
– those who are currently in hospital, prison or supported housing schemes, due to leave and have to move-on accommodation.
Those who suffer from physical and mental ill health, poverty and debt issues, domestic violence, relationship breakdown, live within an intolerant relationship with parents, and substance misuse are more likely to become homeless.

The Level of Need in The Population

The following data provides a summary of known homelessness in Bolton over the last three years:

Current Services in Relation to Need

Homeless Welfare – investigates the circumstances of those presenting as homeless in accordance with legislation.
Housing Advice Service – advice and assistance on a range of housing and homeownership issue and to help find accommodation.

Coordinated prevention activity that has seen a lower number of homelessness applications and acceptances maintained and any potential increases managed as a result of wider economic pressures.

Family Intervention Tenancy model.
The Salvation Army, Gilead House provides 52 temporary accommodation (up to 6 months) units for single homeless males.

Irwell valley at Fleet House provides 20 temporary accommodation units for single homeless women.

Chorley Old Road provides 16 short to medium term units for men.

Action for Children provides 8 supported lodgings for 16-21 year olds.

Bolton Council temporary accommodation Benjamin Court, 34 units – where the local authority has accepted main duty to rehouse people who are homeless, under the homeless legislation.

Bolton at Home Family Floating Support – residential services and intensive outreach support for 24 families with children who are threatened with homelessness or eviction due to anti-social behaviour

Bolton Bond Board – a rental deposit scheme, assisting homeless people into private rented accommodation by issuing non-cash bonds to landlords, with a floating support scheme.

Urban Outreach – voluntary sector service providing advice, accommodation, floating support and emergency provision.
Floating Support Services providing intensive support for people in crisis and longer term support to assist people to sustain existing secure tenancies.

Specialist services for women under threat of domestic violence.  This includes dispersed properties, outreach support and a specialist hostel accommodation.  Supporting a total of 40 units.
Dispersed properties throughout Bolton and hostel accommodation including outreach support for young people aged 16-24 supporting a total of 74 people.

Homes of multiple occupation for people with mental health issues – 18 units.

Accommodation for teenage parents – 24 units.

Move-On flats from temporary hostel accommodation – 20 units.

Development of offender management housing pathway including prison release arrangements.

Increasing numbers of Lease Managed properties (currently 90 units) provide well managed private sector homes, often for people on the fringes of homelessness.

Continued maintenance of minimal ‘bed blocking’ with Mental Health ward liaison and planned discharges from hospital.

Provision of timely family mediation to prevent homelessness of young people.

More efficient use of temporary accommodation resources through the development of the ‘Gateway Approach’ and MOP (Move-On Protocol).  This includes advice, options and active turn-over case management, improved temporary accommodation vacancy management, increased turnover, and improved positive housing outcomes (both in volume of known positive outputs and sustainable outcomes).

Improving use of social housing stock, including development of ‘downsizing’ and mutual exchange processes, and tackling ‘housing fraud’, returning significant numbers of units of social housing to legitimate use.

Development of housing repossession interventions including county court casework offer, mortgage rescue, Prevention of Repossession Fund, landlord liaison and high rate of prevention outcomes.

Development of financial inclusion support including money advice, budgeting and accredited financial capability workshops.

Overall the trend in commissioning homelessness services is a reduction in long-term accommodation based support to shorter-term, more targeted floating support interventions.

Projected Service Use and Outcomes

Nationally, uncertainty in the economy, following the recession and concerns over the levels of public spending resulting in significant cuts, has led to:

• Instability in the housing market;
• More stringent lending criteria for mortgages;
• Low levels of new housing building;
• Higher levels of unemployment;
• Increase in number of repossessions.
The Government has implemented a number of policy changes in relation to housing and homelessness to address these issues.  All of the measures will have an impact on an individuals’ ability to secure and sustain accommodation. These include:
• Vision to end rough sleeping (with the ‘No Second Night Out’ approach);
• Greater emphasis on utilisation of the private rented sector;
• Assistance to former members of the Armed Forces (via the Military Covenant) including access to housing;
• Preventative approaches to tackling homelessness;
• Tenure reforms which provide for fixed term tenancies and affordable rents;
• Clearer responsibilities to co-operate and assist in respect of Safeguarding children and vulnerable adults as well as duties in relation to the management of high risk offenders;
• Changes to Welfare and Housing Benefits, affecting both private and social housing sectors.

Locally, Bolton Council is responding to Government policy through the implementation of a number of austerity measures.  This has meant the targeting of resources to ensure services continue to be delivered to the most vulnerable people in the borough.  However, the impact of these changes cannot be entirely mitigated and there is often an increase in demand for homelessness and housing services as personal circumstances worsen.

Evidence of What Works
In August 2012, the Government released a report ‘Making Every Contact Count: A Joint Approach to Preventing Homelessness’.  This report sets out ten local challenges which it expects local Homelessness Services to achieve through partnership working.  These challenges are:
• Adopt a corporate commitment to prevent homelessness which has buy in across all local authority services;
• Actively work in partnership with voluntary sector and other local partners to address support, education, employment and training needs;
• Offer a Housing Options prevention service, including written advice, to all clients;
• Adopt a No Second Night Out model or an effective local alternative;
• Housing pathways agreed or in development with each key partner and client group that includes appropriate accommodation and support;
• Develop a suitable private rented sector offer for all client groups, including advice and support to both clients and landlords;
• Actively engage in preventing mortgage repossessions including through the Mortgage Rescue Scheme;
• A homelessness strategy which sets out a proactive approach to preventing homelessness and is reviewed annually so that it is responsive to emerging needs;
• Not place any young person aged 16 or 17 in Bed and Breakfast accommodation;
• Not place any families in Bed and Breakfast accommodation unless in an emergency and then for no longer than 6 weeks.
Further key sources for information on effective interventions and evidence-based policy are highlighted on Bolton’s Health Matters
 
Community Views and Priorities

Housing Strategy Consultation

The 2008 Housing Strategy included service user consultation.  Issues identified by customers relevant to homelessness were:
• Provide affordable housing for young people and couples;
• Provide more ‘move on’ accommodation for people in supported housing, including young people;
• Address problems of access to services for homeless people and substance misusers.

Bolton’s Homeless Hostel Clients Consultation

In 2009 and 2012 residents in three of Bolton’s temporary hostels were consulted about existing services and demands for the future.  The main issues were:

• Agencies need to come into the hostel to inform, engage and create a vibrant atmosphere;
• Residents need to engage with local community;
• Need assistance with confidence/support with life events;
• Vast majority would undertake voluntary work;
• More activities in the hostels during the day: fitness, cooking, buddy scheme, health, IT access, education, DIY;
• Need assistance during transition period into more secure accommodation: utilities, fixtures and fittings, starter pack, paperwork;
• Can’t work whilst in hostel – too expensive;
• More structured support sessions;
• Overall support should be focused on assisting independent living.

Equality Impact Assessment

No recent local equality impact assessments have been carried out that we are aware of.  If you are aware of any such work locally please let us know at Bolton Health Matters 

Unmet Needs and Service Gaps
Homelessness is often a result of other factors affecting people’s lives.  Some are within an individual’s control (e.g. use of alcohol), other factors are often out of their control (e.g. loss of employment).

The current economic climate is adding to existing pressures on individuals and families.  Lack of employment, risk of becoming unemployed, youth unemployment, loss of benefits, potential loss of home, limited housing options, reduction in support services etc. is increasing the risk factors which often result in homelessness:
• Homeless presentations in Bolton caused by domestic violence have doubled in three years;
• Youth unemployment is resulting in increased demand for housing support services aimed at young people;
• Increases in substance and alcohol misuse;
• Increasing thresholds to access complementary services including adult social care, mental health and children services is leading to pressures on the preventative services which assist people to maintain their accommodation;
•  The changes to Housing Benefit/Local Housing Allowance will have a significant impact within Bolton.  These changes are estimated to result in the removal of some £3.3million pa of subsidy to rental costs of low income households within Bolton over the implementation period.  Inevitably this will increase the pressure on social rented accommodation as well as upward pressures on homelessness;
• There are difficulties for first time buyers, being able to access home ownership due to the increased difficulty of securing personal finance and in particular mortgages on favourable terms without sizeable percentage deposits.  This has led to an increasing demand for the social and private rented sectors. 

Bolton’s Homelessness Strategy: interim Statement 2012–15 identifies four priority areas:
1. Homelessness prevention and sustainability;
2. Advice and access;
3. Accessing interim accommodation;
4. Move-On and sustainable outcomes.
Service gaps include:
• Need to develop a hub service in Bolton for homelessness.  Multi-agency working providing a vibrant focal point to tackle the main issues faced by homeless people – health, dentist, financial assistance, housing options, employment, training, substance misuse, cooking etc.  The redevelopment of Gilead House (opens summer 2014) will provide the physical structure required.  Statutory and voluntary services must develop provision to engage clients in the hostel and assist them to break the cycle of homelessness;
• Access to GPs is often problematic for people who do not have secure accommodation;
• Floating Support services have been reconfigured, but the lack of suitable housing for ‘move on remains’ a significant problem for this group;
• Increased resources/joint working in preventative services to assist people to live independently in their own home, maintaining sustainable accommodation;
• Housing deprivation is highest in the private rented sector. Increased support and or regulation is required for this tenure;
• Develop a Bolton mortgage scheme to assist first time buyers get on the property ladder.

Recommendations for Further Needs Assessment Work


Local data on homelessness is focused on homeless presentations to Bolton Council.

Housing needs, the housing market, and condition of private sector housing stock in Bolton is assessed every five years through a programme of research which produces the Housing Needs Survey, Strategic Housing Market Assessment, and Private Sector Stock Condition Study.

Further assessment is required to understand the full extent on homelessness in Bolton:
• What services are required to prevent people becoming homeless?
• How can the voluntary sector develop to assist this client group?
• How can people without secure accommodation receive access to health services prior to reaching crisis?

 

Key Contacts

John Slater – Strategic Housing Services
Jon Powell - Housing Options and Advice Services Group Manager                       

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