The Panel considered the report of the
Assistant Chief Executive, introducing the speakers that addressed
the inquiry in relation to access to tackling complex health and
other needs associated with homelessness.
The Panel received presentations from the
Council’s Children Looked after Social Working Team and a
representative of the Southampton Safeguarding Adults Board in
relation to Children Looked After and Adult Safeguarding processes
and procedures and noted:
Children Looked After
- that the Council had a statutory
responsibility to provide support to all care leavers until they
reached the age of 21, or if they are assisted with education and
training , to the end of the agreed programme which could take them
beyond their 25th birthday;
- the
importance of staying in touch with care leavers with regards to
accommodation, education and training issues. There had been
significant improvement in these figures and the local authority
were in touch with 90% of young people. The DfE required
that the Council provided a report on the number of 19 year-old
children they were in touch with and whether they were in suitable
accommodation as well as the number of NEET children;
- that “staying put”
arrangements were being prioritised to ensure that young people
were being enabled to stay in foster care;
- Ofsted
were now specifically monitoring how care leavers were looked after
in terms of resources and how authorities, as Corporate Parents,
were continuing to fulfil their
obligations and responsibilities towards children looked after and
leaving care;
- Phase 2 of the Transformation
Structure provided more of a multi- agency response to children in
care and looked after children and care leavers were being split
into 2 groups ie up to the age of 14
years and 14 plus;
- the number of care leavers had
increased and to date numbered 333, with 211 children looked after
and 122 care leavers;
- the Pathways Team’s focus was
on providing suitable accommodation and increasing the number of
children “staying put” with foster carers; and
- a
strategic review of housing and care leavers was being undertaken
with focus on increasing the number of supported lodgings in the
city, dedicated support time from the 3rd Sector and
work in terms of preparing young people to live independently,
working with foster carers in this
respect. NEET young people
remained a concern and work was being undertaken in terms of
apprenticeships, work experience and working with 3rd
Sector providers;
Adult
Safeguarding
- adults vulnerable to abuse is
defined as “A person who is 18 years of age or over and who
is or may be in need of community care services by reason of mental
or other disability age or illness; and
who is or may be unable to take care of him or herself, or unable
to protect him or herself against significant harm or
exploitation”;
- with adult safeguarding there was a
difference as vulnerable adults had the right to consent to abuse
and people’s rights had to be respected;
- homeless people did not fall easily
into care categories and only a minority of homeless people would
have a care assessment as they would be signposted to relevant
services, with accommodation services being part of the system of
keeping people safe;
- revolving door clients ie young people not known on the system were an
issue for the city; and
- the
importance of holding the Mental Health Trust to account to ensure
they met the expected standards when dealing with people with
mental health problems.
The Panel received presentations from
representatives of the Probation Services and the Police and
noted:
Probation Services
- 15% of people entering probation
services were homeless and 32% of people who were homeless were
re-convicted;
- when offenders were released from
prisons outside of Southampton and returned to the city, beds and
accommodation could not be found for them as they could not be held
indefinitely;
- offenders were at a high risk of
being harmed;
- No Limits were doing great work in
assisting 18 – 24 year olds in getting
accommodation; and
- the
importance of multi-agency working and probation health trainers
working alongside other health professionals.
Police
- that the
statistics on offending homeless people were not accurate and there
was no formal recording process; if a
homeless person was injured they would be directed to a walk-in
centre and if it was a mental health issue they would be directed
to Antelope House. If
a homeless person was not at risk the police would not get
involved. The police would be
willing to assist other agencies and signpost homeless people to
the relevant agencies if they were provided with more
information;
The Panel received presentations from the
Councils Improvement and Housing Needs Managers and a
representative from the EU Welcome Project in relation to the
impact of wealth reforms, migration and situations where there is
no recourse to public funds and the Panel noted:
Improvement and Housing Needs
- the welfare reforms were the biggest
change to the system in 60 years with an overall financial loss of
£53 million and 34,157 households in the city affected;
- welfare and housing benefit reforms,
with the increased conditionality and increase of sanctions, would
be the biggest challenge to preventing and tackling
homelessness;
- there was strong evidence that the
above reforms (for example the single room rate for under 35 year
olds, reforms to disability allowance and movement to a daily
sign-on for jobseekers allowance) and subsequent sanctions were not
motivating people back in to work, but putting them in severe
hardship, which resulted in further disengagement. Compliance with
conditionality, especially for those with complex needs was a huge
challenge as many required additional support to understand the
conditions and find work and homeless people often did not have a
support network of family or friends;
- clients with no previous history of
homelessness had, through rent arrears, lost accommodation and more
young people who were no longer eligible for full housing benefit
were accessing the service since the criteria was raised to above
35. There was an increase in debt
related support and DWP benefit claim support;
- a Working Together Event involving
the Homeless Link/Jobcentre Plus and other local providers had been
held on 28th April 2014 which had been successful;
and
- a 44 page
booklet had been published, providing information on how to claim
benefits and what sanctions were incurred if conditions were not
adhered to.
EU Welcome
Project
- this project supported and
signposted migrants from the EU countries to various agencies;
- many homeless migrants had mental
health and addiction issues ; and
- most
migrants did not want to return to their home country and found it difficult
to find accommodation and Day Centres were monitored by the UK
Border Agency.
The Panel received presentations from
representatives of University Hospitals Southampton, Local General
Practitioners and Healthwatch Southampton and the Panel noted:
Vulnerable Adult Support Team (VAST) and Discharge
Bureau
- the Emergency Department managed the
care of about 280-320 patients a day;
- VAST had been funded from May 2012,
but from September 2014 future funding was at risk;
- since the introduction of VAST, 219
patients had disclosed that they were homeless or at risk of street
homelessness;
- VAST worked in close liaison with
the Cranbury Avenue Day Centre, Street Homeless Prevention Team,
the Healthcare Team and No Limits to provide a robust referral
pathway for homeless patients; and
- VAST provided and promoted expertise
with complex adult vulnerability, a consistent approach, risk
management/safeguarding, access to community services, multi-agency
collaboration and compassionate care.
Psychological
Approach to Homelessness
- formal research at the University of
Southampton had shown that there were psychological factors
implicated with homelessness as well as mental health issues such
as anxiety, depression, psychosis, with associated drug and alcohol
use and self-harm;
- significant factors identified were
childhood neglect and abuse and associated difficulties in managing
emotions and attachment problems, which again were a significant
barrier to healthy societal living and these factors were important
when living in structured social environments such as hostels or
shared housing;
- a number of psychological
interventions were designed to address a number of these factors
which may enable people to operate better in structured
environments; and
- wider use
could be made of psychological knowledge generated through training
delivered in hostels.
General Practice
- Homeless people made greater use of
hospital services, particularly Accident and Emergency departments
as many of them had no ID and the amount of information available
to GP’s was minimal and no medical information was available
on ex offenders;
- If a patient had a number of long
term conditions and this was complicated by mental health problems
or misuse of drugs or alcohol, it would not be possible to help
them in a 10-15 minute consultation
without access to medical records;
- homeless people had a high incidence
of mental health problems which sometimes required drugs and many
GP’s did not have experience in manage drug problems and
access to substance misuse services was very slow; and
- the
Homeless Healthcare Team was better geared to care for the homeless and had greater expertise
to meet their needs than ordinary practices.
RESOLVED
that the presentations made at the meeting be noted and the
information provided be entered into the Inquiry’s file of
evidence.