Could the Housing First model end the ‘national shame’ of rough sleeping?
The Housing First principle to tackling homelessness has seen success in countries such as Finland, Canada and the United States. With three pilots being rolled out in England later this year, could this be the route to solving the country’s rough sleeping crisis? Sebastian Whale spends time with workers on the SIB project in Greater Manchester to see how it works
A crumpled McDonald’s coffee cup is slowly filling up with coins. It is positioned about a foot in front of Steve (whose name has been changed to protect his identity), who is sat cross-legged with his hands clasped in his waist underneath an overpass. He is wearing a beanie and has a blue blanket wrapped around his lower half. The worst of the cold weather has mercifully passed, but a chilling wind still swirls around the centre of Manchester.
An engagement worker at Shelter kneels beside him. She has some good news. A place has been found for Steve to live in the north-east of the city. Initially, he seems slightly unsure. He doesn’t know the area very well. As it sinks in, a broad smile breaks out on his face. “Ah, that’s great,” he says. The timing couldn’t be better. Today, it turns out, is Steve's 38th birthday.
Steve is one of hundreds of people who have signed up to a payment-by-results pilot in Greater Manchester to find homes for entrenched rough sleepers; individuals who have slept rough at least six times in the past two years or are well known to homelessness services.
The three-year project, which has been going for 13 months, was funded by an initial £1.8m Social Impact Bond (SIB), where social investors receive a return from the Government based on a series of outcomes being met. The properties were provided by 15 housing associations and two private-rented sector suppliers, who form part of the Greater Manchester Homes Partnership. Alongside housing, people are offered intensive support from Shelter, Great Places and The Brick.
More than 500 people were referred to the SIB project, far more than the initial estimate of 300 (prompting ministers to put in an extra £829,000). This led many to question official statistics on rough sleeping in Greater Manchester, with 241 recorded as being out on the streets in November 2018, down from 268 a year earlier.
The scheme, which is one of eight in the UK, is based on the Housing First principle; the idea of securing permanent accommodation immediately without preconditions. The traditional approach has been to offer a home after a person has sought help in temporary accommodation. Though the principle originates from New York, it is often associated with Finland, where homelessness has fallen steeply in recent years (rough sleeping in Helsinki is nearly non-existent).
In addition to the SIB projects, the Government has invested £28m in three Housing First pilots in Greater Manchester, Liverpool and the West Midlands. Its advocates are unwavering in their belief that the Housing First method works. But could it provide the solution to the UK’s rough sleeping crisis?
Early on Tuesday morning, I board a train at Euston en route to Manchester Piccadilly. I’m spending the day with Shelter’s SIB team, led by Liz Norris, a deeply passionate activist and longstanding charity worker. Alongside her work at Shelter, Norris founded Street Shakers, a social enterprise which uses sport as a tool to empower young people in the region. She is also a board director of England Boxing.
In the heart of the city centre, Norris manages a team of 23 working on the SIB project, comprised mostly of case workers. The charity expected to receive 200 referrals, with many of those predicted to drop off. Instead, 350 people have been passed on, and with staff contracts coming to an end, the desired ratio of one engagement worker to 12 clients could end up becoming one to 30 later this year.
The team, which oversees five local authority areas, is involved throughout the process from securing housing to providing support. Around 60% of the staff have “lived experience” such as being homeless or experience with alcoholism, drug addiction or abuse. All are given mandatory training in managing aggression, establishing boundaries and carrying out risk assessments.
Rough sleeping in England has increased by 165% since 2010. Officials in the project say a combination of austerity, benefit cuts, the rollout of universal credit, a reduction in mental health services and a lack of affordable homes in the right places are all key reasons behind the rise.
The main difficulties in keeping people off the streets – or “wobble points” as Norris refers to them – come early in the process. The first challenge is to get an ID or bank account for a person; no easy task if they do not have access to a birth certificate or are trepidatious about being on ‘the system’.
Norris refers to the experience of a Windrush generation man in his 60s who served in the British Army. He was evicted and ended up homeless after he couldn’t prove his identity. Securing such documentation is time-consuming, and while temporary accommodation can be sought in the meantime, people often prefer to stay on the streets rather than in crowded bedsits. “It’s a prison in its own way,” Norris says of temporary accommodation.
The next step is to organise benefits. As rough sleepers often rest during the day to be able to protect themselves at night, making morning appointments at the job centre can prove difficult. Universal credit “strips you of any integrity”, Norris says, as applicants go through various checks on their physical and mental capacity for work. This provides more time for people to get cold feet. The system also relies on a reasonable level of computer literacy and access to IT, and most people end up in arrears on rent before receiving their first payment, which often leads to homelessness in the first instance.
Support staff will, therefore, request an Alternative Payment Arrangement to pay rent directly to landlords. Outreach workers will also apply for grants to furnish the accommodation for clients. Often, the priority beyond core amenities such as a fridge will be for a television and games console. An empty home can exacerbate feelings of isolation, so online gaming can provide the sense of community that is lost from leaving the streets.
This has been the case for David who we visit at his new home. Last month, after six years of sleeping rough, he moved into a new property. The flat has just been carpeted, and he has spent some time playing Golden Axe on his PlayStation 3. He has already been involved with organising utility bills and getting in new furniture. Cardboard covers the windows while the housing association sorts out new blinds. With David amenable to a stint in rehab, his engagement worker is hopeful he will stick out his new life.
The SIB has so far housed 250 people, with few people returning to the streets. Around five per cent of Shelter’s clients are women, Norris tells me, who are often “more resilient and smarter”. The vast majority are British. Her team also run a peer mentor scheme, where people with similar experiences are introduced to help foster friendships and attend events such as Zumba classes and pool halls.
Those involved with the project say there is much more to overcoming rough sleeping than simply handing over the keys to a new flat. Many have developed addictions, illnesses and mental health problems from their time on the street. Norris is concerned about the three-year project coming to an end in December of next year. “I know there will be people we haven’t been able to change. But we will keep trying,” she insists.
Under the payment-by-results method, Shelter receives money for each individual when outcomes are achieved (there are 18 in total). Norris doesn’t keep her team abreast of whether targets are being met. “If you are doing everything you can, that’s good enough for me,” she explains.
Naturally, her staff have witnessed some very difficult scenes, and lost clients along the way. She is determined that her workers are uncontactable outside of office hours. They also have access to in-house counselling. But she does not want them to become “desensitised” to the situation. This way, they can maintain their motivation. “If I can get people to give a shit, we can get things done,” she says.
Norris argues the social return on investment for the project is massive. With fewer people on the streets, there is less pressure on emergency services. There are fewer hospitalisations for people dealing with diseases such as pneumonia, hepatitis B and HIV. There are also fewer callouts for people taking Spice; the synthetic cannabinoids that have spread across the streets of the UK and often leave people presenting as dead.
But the system – which activists feel is responsible for the rise in homelessness in the first place – often provides obstacles to keeping people off the streets. And for all the great work done by those providing the support, there must be the necessary accommodation in which to house them. “You can have all the wrap-around support in the world, but without enough affordable homes it’s impossible to complete the jigsaw,” a Shelter official declares.
Andy Burnham, the mayor of Greater Manchester, has been vocal about tackling homelessness and rough sleeping. He has also put his money where his mouth is, donating 15% of his salary towards his manifesto pledge of ending rough sleeping in the area by May 2020.
Greater Manchester is set to receive £7.6m to create 400 homes for homeless people or those at risk of becoming so as part of a Housing First pilot, which will run alongside the SIB scheme. Burnham has become a vocal champion of the model. “Housing First will ensure hundreds of people who currently live precarious lives will be helped to begin their recoveries and move away from homelessness,” he said.
Burnham has also launched his flagship ‘A Bed Every Night’ scheme, where people sleeping rough are offered accommodation during winter. Officials say more than 1,400 people have been helped indoors since the start of November. The scheme has not been without its difficulties – one homeless shelter in the city centre has closed permanently due to electricity problems. During my time in Manchester, the scheme is also referred to as a “sticking plaster”. Few if any doubt the intention behind it, however.
Could the Housing First model work on a national scale? To do so would require a large amount of investment to build more social housing. As the experience of the SIB project in Manchester illustrates, years of sustained support would also have to be provided. The Finnish government has spent more than £260m over the past decade on 3,5000 new homes and more than 300 new support workers.
“Housing First is part of the solution. I don’t think it’s all of the solution,” Melanie Onn, the shadow Housing minister, tells The House. “When it works and it’s done well… then it’s fantastic. But it’s supposed to be a long-term support and it’s very, very intensive.”
“It’s not just something that you can do for a year and then walk away from,” she adds. “So, in terms of policy implications for the future, everybody needs to be really aware that it’s not a short-term fix.”
Heather Wheeler, the minister for homelessness, says: “Evidence from elsewhere shows that Housing First has an incredible rate of success in helping people rebuild their lives and these pilots will help us assess the case for a national roll-out.
“The pilots are working alongside the Government’s £100m Rough Sleeping Strategy, which has led to the first fall in Rough Sleeping numbers for eight years, and £1.2bn budget overall to tackle homelessness and make sure the most vulnerable in our society have a place to call home.”
Polly Neate, chief executive of Shelter, concludes: “The point of piloting new approaches is to find out whether they work. The evidence, both nationally and internationally, now shows that Housing First works. Politicians of every stripe should now look long and hard at how they can contribute to ending the national shame of the chronic rough sleeping we all witness across the country.”