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Housing Needs Assessment for Drug/Alcohol Users in the LBL August 2006 Summary Findings.

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Presentation on theme: "Housing Needs Assessment for Drug/Alcohol Users in the LBL August 2006 Summary Findings."— Presentation transcript:

1 Housing Needs Assessment for Drug/Alcohol Users in the LBL August 2006 Summary Findings

2 Background  Commissioned by Lewisham Community Safety and Drug Action Partnership (CSDAP)  Objectives: 1. To determine the nature, extent and pattern of homelessness among problematic substance users in Lewisham 2. To examine the pattern of tenancy and supported housing for problematic substance users in Lewisham 3. To examine age, gender and ethnicity variation in homelessness in the target group 4. To determine the gap in housing provision for problematic substance users.

3 Methods The project adopted various methods including (i) systematic literature analysis; (i) systematic literature analysis; (ii) use of inferential indicators and multipliers (ii) use of inferential indicators and multipliers (iii) secondary analyses of data from substance misuse services, probation, Drug Intervention Programmes and housing providers; (iii) secondary analyses of data from substance misuse services, probation, Drug Intervention Programmes and housing providers; (iv) a semi-structured interview survey of people in supported housing and those currently homeless; a semi-structured interview of supported housing providers; and (iv) a semi-structured interview survey of people in supported housing and those currently homeless; a semi-structured interview of supported housing providers; and (v) gap and risk analysis (v) gap and risk analysis

4 Operational Definition of Homelessness Adopting the Charity Shelter’s definition homelessness, the following parameters were applied to cases “You should be considered homeless if:  you have no home in the UK or anywhere else in the world  you have no home where you can live together with your immediate family  you can only stay where you are on a very temporary basis  you don’t have permission to live where you are  you have been locked out of home and you aren’t allowed back  you can’t live at home because of violence or threats of violence which are likely to be carried out against you or someone else in your household  it isn’t reasonable for you to stay in your home for any reason (for example, if your home is in very poor condition)  you can’t afford to stay where you are  you live in a vehicle or boat and you have nowhere to put it.”

5 Current Capacity  Supporting People Programme (temporary) Provides funding for 4,500 units of accommodation managed by 70 different providers, of which 166 units are designated specifically to support people with drug (52) and alcohol (114) problems.  General Housing (permanent tenancy) Council housing stock is 27,545 In 2005 the number of people on the Housing Register was 17,000 and the number of lettings that became available was 1,800

6 Challenges  No readily available, comprehensive and robust source of information on the numbers of single homeless people in UK  Varying definitions of homelessness  ‘hidden’ and ‘mobile’ nature of many people’s homelessness

7 Extent of Statutory Homelessness in the UK  2005 LAs in England accepted that 100,170 households as ‘unintentionally homeless’ and in priority need  48,990 were considered ‘homeless’ but not in priority need  13,830 were considered ‘intentionally homeless’ and in priority need (ODPM, 2006)  Crisis (2003) estimates that there are 380,000 single homeless people in Great Britain

8 Extent of homelessness in London  London has the highest number of households in temporary accommodation (63,800) on 31 Dec 05, accounting for 65% of the England total (98,730).  Figures from the ODPM (2005) report 459 people sleeping outdoors (rough sleepers) on any one night in England, 221 in Greater London.

9 Extent of Homelessness in Lewisham  End of April 2006, LBL reported to ODPM that they had 2284 homeless households from the Borough in temporary accommodation  Between March 05 and April lettings became available  The number of rough sleepers varies from 1 to 6 according to official point-in-time counts. Up to 17 in ‘unofficial’ count.

10 Evidence linking substance misuse and homelessness  Share common risk factors  No evidence of a causal relationship – together homelessness and substance misuse may result in, or make more intractable, other problems or disadvantages  Chronically homeless individuals tend to attribute their continued homelessness to a substance abuse problem

11 Pathways to Housing in Lewisham  Main Sources of support Housing Options Centre (HOC) – main gateway Housing Options Centre (HOC) – main gateway Lewisham Supporting People Programme - (offering hostels, shared houses, floating supporting etc) Probation/DIP – employ specific ‘housing support staff’ who offer direct and indirect support to clients and colleagues

12 Procedures for Re-Housing and Banding System  LBL Homesearch Team (choice based lettings scheme active cases run at 10,000 at any one time)  To access Homesearch a person has to be accepted onto the register and needs to maintain their place on the register  Housing assessment results in being ‘banded’ i.e. priority level of need  Four bands AA, A, B, C, and NB

13  Lettings that become available are weighted against the priority bands, for example 70% are assigned to Band A, 20% are assigned to Band B, 9% are assigned to Band C 1% is assigned to the No Band

14 Supporting Vulnerable Groups  Housing allocate a number of ‘nominations’ to agencies in the Borough including those working with drug and alcohol. These ‘quotas’ offer agencies the opportunity to access ‘band A’. Quotas for 06/07 e.g.  ARP- 5; DIP -3; TRB – 15; St Mungos 30

15 Supply ???(Drug/Alcohol) HHUs per 100,000 population People with Alcohol Problems People with Drug Problems Lewisham4520 London Average 166 Inner London Average 3311 LSL Average 4821 National Average 77

16 Extent of Illicit Drug Use and Chronic Drinking in LBL  Estimated number of illicit drug users in LBL in the last year is 21,187 (males 14,894, females 6,293)  Estimated rate is 13.2% compared to England and Wales (11.3%) and London (12.2%)  Estimated number of chronic drinkers in LBL 31,342 (males 19,127, females 12,215)  First national alcohol needs assessment estimated that 23.5% of chronic drinkers engage in harmful drinking, who are also considered the group at high risk of homelessness. Hence applying this multiplier, estimated number of chronic drinkers at risk of homelessness is 7,365 (male 4495; female 2870)

17 Prevalence rates and multipliers of homelessness in this study  Drawing on the literature there are various rates of homelessness – some applying to general population, others to clinical populations, this study proposed that the estimate rate of homelessness would be the median value of published rates i.e. 20%

18 Estimated Number of Problem Drug Users and chronic drinkers (harmful use) that are homeless  Using the 20% multiplier Drug= 423 (Male 296; Female 126) Alcohol = 1,473 (Male 899; Female 574)

19 Extent of Homeless among problem drug users and harmful alcohol users in treatment  CDP = (196 clients records – 1 April 04 – March 31 05) – information on housing available on 182 cases homeless rate was 49%  DIP = (576 clients records 1 Dec 04 – Nov 30 05) – information on housing available on 138 cases – homeless rate was 54%  Dual Team = (86 clients records – 1 April 04 – March 31 05) – information on housing available on 69 cases – homeless rate was 73%  ARP = (120 clients records – 1 April 05 to March 31 06) – information on housing available on all cases – homeless rate was 28%

20 Demand for Housing among probation clients  Total of 135 probation clients with a range of housing needs were referred over an 8 mth period June 05 to Feb 06.  Information on housing available on 133 cases. - 82% of cases were homeless  19% of homeless cases had been involved in drugs (offence), 4% in alcohol and 2 % in both drugs and alcohol

21 Demand for housing to LBL HOC  Secondary analysis of data on clients applications to HOC (n=2,236)  27% cited homelessness  No information on drug/alcohol hence applying multipliers from estimates  Problem drug users = 29  Chronic drinkers = 105

22 Users Perspectives  Summary Issues (In-Treatment and Homeless Group)  Majority male, British Born with ties to Lewisham. Poly drug history, initiation in their teens, extensive forensic history, numerous treatment episodes (none however in residential rehabs). Factors precipitating homelessness include chaotic drug use, mounting debts, involvement in criminal activities and breakdown in family support. Domestic violence is indicated for female clients. Male clients tend to experience homelessness at an earlier age to females, and do not have experience of having their own tenancies. Majority currently ‘sofa surf’ among friends and family, and main obstacles in accessing housing support are linked to negative attitudes of housing staff towards drug users and lack of accurate information.

23 Users Perspectives  Summary Issues (In Supported Housing Group)  Majority male, British born with ties to Lewisham. Similar profiles to the ‘In Treatment group’ with respect to drug use. Respondents described long and serious criminal histories. For the majority of the sample access to housing support was via assistance received as a result of being engaged with the criminal justice system. With the exception of one person all respondents were satisfied with their accommodation, and regarded their key worker as an important source of support. Maintaining their supported housing was facilitated by being drug free and/or remaining engaged in treatment. All respondents were engaged in some form of meaningful daily activity e.g. voluntary work or college. Key concerns regarding long term tenancies was having access to choice in where they were to live and support services being maintained once longer term tenancy was in place.

24 Summary  The estimated rate of homelessness among problem substance users in Lewisham is 20%. The rates of homelessness among users of substance misuse services and associated agencies in Lewisham are diverse as follows: CDP (49%); DIP (54%); Dual Team (73%); ARP (28%). The majority (93%) of Probation clients referred for housing support were homeless.  Given that these rates are higher than the overall rate, it may well mean that the overall rate was a conservative estimate.  However, the rates in services could be elevated because of missing data on housing status in some of the agency data used. In addition, the estimates provided are not exact. There are assumptions that the margin of error is less than ± 5 percent of the estimates.  It must be remembered that clients applying for housing may well conceal drug and alcohol problems fearing that such information would have a negative impact on their application.

25  The profile of homeless problem drug users in treatment was consistent across agencies. The age group most at risk were those aged years accounting for between 32% and 48% of homeless persons in treatment.  In most agencies studied, the predominant ethnic group among the homeless was White. However, in the probation and housing department samples, as well as the TRB cohort, the largest ethnic group was Black. The proportion of homeless Asian clients was relatively small.

26  Altogether, 1,896 problem substance users (493 problem drug users and 1,473 problem drinkers) are in need of housing. The current HHUs provision is 12% of that required to meet the need of problem drug users and 7.7% of that for problem drinkers.  However, the gap between demand and current provision is optimal for problem drinkers where 78% of demand is being met. Conversely, only 18% of demand for housing is being met in the case of problem drug users.

27  Risk analysis revealed that current housing provision is most suited to male and female problem drinkers, and female problem drug users, but less so for male problem drug users. Furthermore, problem drug users aged and years are at risk of poor access to supported housing. So also are problem drinkers aged years. It would seem that current provision is somewhat favourable towards the earlier identified year-old problem drug users at the expense of other age groups.

28 Recommendations  The JCM should explore the introduction of ‘common assessment frameworks’ which would include sufficient detail on clients past and current housing status. In the first instance the DST may wish to consider undertaking a review of current datasets. Such practice should assist in effective monitoring of the Treatment Plan and identify areas for improvement.  Furthermore consideration should be given to encouraging housing providers and the HOC in recording ‘drug and alcohol use’ as part of their routine datasets. Clearly, training particularly on attitudes will need to be addressed to ensure data collected does not result in a barrier to engagement.  The DST may wish to further examine the heightened risk of homelessness in those aged years given that this is also the age group most at risk of drug-related deaths. This activity could be incorporated into the DST’s proposed harm reduction audit and strategy.

29 Recommendations  It may prove useful to examine the pathway to homelessness in the different ethnic groups and communities in Lewisham, identifying any potential protective factors in specific ethnic groups and communities that can be disseminated widely.  Given the gap between need, demand and housing provision, there is a need to increase the number of HHUs stipulated in the Lewisham Supported People’s Strategy for  The DST, Supporting People and YOT jointly may wish to examine the barrier to access for those problem drug users aged and years; and problem drinkers aged years.

30 Recommendations   In view of the client’s negative perception of the HOC, the CSDAP may wish to consider undertaking a training needs analysis (TNA) of HOC and associated agencies. The outcome of the TNA should be employed to develop a continuing professional development (CPD) module, which should be included both in new staff induction programmes, and as part of CPD training within the organisation. To ensure that this training and workforce support is given the necessary priority, CSDAP should ensure that this recommendation is taken forward within the LBL Substance Misuse Training and Workforce Strategy.   The CSDAP may wish to invite the HOC to develop a collaborative working partnership to address the ‘gap in information’ identified by clients as part of an information dissemination strategy.

31 Recommendations   Given clients anxiety about losing support once they are settled into housing Supporting People may need to re examine the current policy regarding ongoing support and consider introducing additional steps as part of a longer term disengagement programme.   In keeping with this review and in view of the priority groups identified in the Housing Needs Assessment, Supporting People may wish to introduce a ‘screening panel’ to manage the block quotas for marginalised groups. The panel should consider establishing criteria which would ensure that nominations which may have alternative routes into housing are screened out.

32 Recommendations   Supporting People may wish to undertake a review with their Housing Providers on admission criteria and exclusion policies, with the recommendation that Housing Providers should not exclude clients purely based on the fact that they are in treatment for substance misuse.   Furthermore the DAAT Substance Misuse Training and Workforce Strategy, in collaboration with DIP and Supporting People target Supporting People Housing Providers around working with drug and alcohol clients. In particular the training programme should incorporate a module on Risk Assessment associated with offending.

33 Recommendations   To ensure that the issues and gaps identified by this report are addressed the CSDAP may wish to repeat this exercise in the future, employing the data from this review as its baseline measurement by which to bench mark progress.

34 Action Plan The JCM should explore the introduction of ‘common assessment frameworks’ which would include sufficient detail on clients past and current housing status. In the first instance the DST/commissioning team may wish to consider undertaking a review of current datasets. Such practice should assist in effective monitoring of the Treatment Plan and identify areas for improvement. The JCM should explore the introduction of ‘common assessment frameworks’ which would include sufficient detail on clients past and current housing status. In the first instance the DST/commissioning team may wish to consider undertaking a review of current datasets. Such practice should assist in effective monitoring of the Treatment Plan and identify areas for improvement.  This works fits in with the ‘models of care’ work that has been started in the borough covering standard assessment tools.  Liaison with DIP housing lead re nature of data needed.  Include housing data in new commissioning team database design.  Una Carnochan – Joint commissioning manager. Lorna Thomas - DST data officer

35 Action Plan Furthermore, consideration should be given to encouraging housing providers and the HOC in recording ‘drug and alcohol use’ as part of their routine datasets. Clearly training particularly on attitudes, will need to be addressed to ensure data collected does not result in a barrier to engagement. Furthermore, consideration should be given to encouraging housing providers and the HOC in recording ‘drug and alcohol use’ as part of their routine datasets. Clearly training particularly on attitudes, will need to be addressed to ensure data collected does not result in a barrier to engagement.  Supporting people could carry this recommendation out fairly easily with supported housing providers.  Housing options centre may be more difficult. It may be more realistic in the first instance to carry out a sample survey for a fixed period of time, provide training, then roll out further.  Supporting people team, DST data officer & HOC management to work jointly on this. DST training & workforce development manager

36 Action Plan The DST may wish to further examine the heightened risk of homelessness in those aged years given that this is also the age group mostly at risk of drug- related deaths. This activity could be incorporated into the DAAT’s proposed harm reduction audit and strategy. The DST may wish to further examine the heightened risk of homelessness in those aged years given that this is also the age group mostly at risk of drug- related deaths. This activity could be incorporated into the DAAT’s proposed harm reduction audit and strategy.  This area of risk has been highlighted in the current harm reduction audit/strategy work.  Use of rent deposit schemes – widen the remit of HOC scheme.  Explore funding options for extending rent deposits schemes  Una Carnochan – Joint commissioning manager Supporting people, HOC & DIP housing lead

37 Action Plan It may prove useful to examine the pathway to homelessness in the different ethnic groups and communities in Lewisham, identifying any potential protective factors in specific ethnic groups and communities that can be disseminated widely. It may prove useful to examine the pathway to homelessness in the different ethnic groups and communities in Lewisham, identifying any potential protective factors in specific ethnic groups and communities that can be disseminated widely.  Research – future priority.  Ensure DIP & DST have input into HOC research re BME access to housing.  Need to ensure the Supporting people diversity plan links in with this work.  DST and DIP housing lead, Supporting people team

38 Action Plan In view of this finding, there is a need to increase the number of HHUs stipulated in the Lewisham Supporting People’s Strategy for In view of this finding, there is a need to increase the number of HHUs stipulated in the Lewisham Supporting People’s Strategy for  Supporting people to explore options for increased or more targeted use of existing units. Balance commissioning decisions based on evidence of gaps.  Supporting people

39 Action Plan SP may wish to examine the barrier to access for those problem drug users aged and years; and problem drinkers aged years. The following are two suggestions that could be pursued immediately: SP may wish to examine the barrier to access for those problem drug users aged and years; and problem drinkers aged years. The following are two suggestions that could be pursued immediately: a. as there already exists two Supporting People workers within HOC targeting years old, the supporting people team may wish to consider expanding the remit of the SP workers, with an emphasis on facilitating ‘sign posting’ to services that offer appropriate support. a. as there already exists two Supporting People workers within HOC targeting years old, the supporting people team may wish to consider expanding the remit of the SP workers, with an emphasis on facilitating ‘sign posting’ to services that offer appropriate support. b. CSDAP may wish to explore undertaking, with the Substance Misuse Worker attached to YOT and ACAPS and the Supporting People’s Young People’s Worker, a survey of young people’s views on the specific barriers they encounter in accessing housing services. b. CSDAP may wish to explore undertaking, with the Substance Misuse Worker attached to YOT and ACAPS and the Supporting People’s Young People’s Worker, a survey of young people’s views on the specific barriers they encounter in accessing housing services.

40 Action Plan  SP investigate the coverage of the current posts and ensure adequate training around drug & alcohol issues.  Make use of substance misuse link worker at HOC to provide info and advice to other HOC workers and signposting.  Survey to be carried out by partners – co-ordinated by DST  Supporting people team, HOC, DST YP co-ordinator

41 Action Plan In view of the client’s negative perception of the HOC, the DST/HOC may wish to consider undertaking a training needs analysis (TNA) of HOC and associated agencies. The outcome of the TNA should be employed to develop a continuing professional development (CPD) module, which should be included both in new staff induction programmes, and as part of CPD training within the organisation. To ensure that this training and workforce support is given the necessary priority, DST/HOC should ensure that this recommendation is taken forward within the LBL Substance Misuse Training and Workforce Strategy. In view of the client’s negative perception of the HOC, the DST/HOC may wish to consider undertaking a training needs analysis (TNA) of HOC and associated agencies. The outcome of the TNA should be employed to develop a continuing professional development (CPD) module, which should be included both in new staff induction programmes, and as part of CPD training within the organisation. To ensure that this training and workforce support is given the necessary priority, DST/HOC should ensure that this recommendation is taken forward within the LBL Substance Misuse Training and Workforce Strategy.

42 Action Plan  Training needs assessment to be carried out by DST TWDM. HOC will need to commit to meeting the assessed need.  Training programme to be discussed & negotiated between HOC, DIP housing lead and training and workforce development manager.  DST training & workforce development manager, DIP housing lead and HOC

43 Action Plan The Safer Lewisham partnership & DST/SP team may wish to invite the HOC to develop a collaborative working partnership to address the ‘gap in information’ identified by clients as part of an information dissemination strategy. The Safer Lewisham partnership & DST/SP team may wish to invite the HOC to develop a collaborative working partnership to address the ‘gap in information’ identified by clients as part of an information dissemination strategy.  This could link in with the training programme. Information re drug & alcohol treatment, housing advice and local support is available in DST directory.  DST training & workforce development manager, DIP housing lead and HOC

44 Action Plan Supporting people may need to re examine the current policy regarding ongoing support and consider introducing additional steps as part of a longer term disengagement programme. Supporting people may need to re examine the current policy regarding ongoing support and consider introducing additional steps as part of a longer term disengagement programme.  S.P. team to explore policies and links to support agencies and referral routes to floating support. Waiting times into floating support services to be examined as part of this.  The SP floating support contracts are currently being re- commissioned. Therefore design of the spec will include targeting substance misusers and include waiting times targets.  Supporting people team

45 Action Plan In keeping with this review and in view of the priority groups identified in the Housing Needs Assessment, the supporting people team may wish to introduce a ‘screening panel’ to manage the block quotas for marginalised groups. The panel should consider establishing criteria which would ensure that nominations, which may have alternative routes into housing, are screened out. In keeping with this review and in view of the priority groups identified in the Housing Needs Assessment, the supporting people team may wish to introduce a ‘screening panel’ to manage the block quotas for marginalised groups. The panel should consider establishing criteria which would ensure that nominations, which may have alternative routes into housing, are screened out.  To ensure ‘non-priority’ clients have other routes into housing. Use of a panel to allocate ‘supporting people’ spaces. Design of panel and criteria led by S.P.  Supporting people to lead.

46 Action Plan Supporting People may wish to undertake a review with their Housing Providers on admission criteria and exclusion policies, with the recommendation that Housing Providers should not exclude clients purely based on the fact that they are in treatment for substance misuse. Furthermore the DST Substance Misuse Training and Workforce Strategy, in collaboration with DIP and Supporting People target Supporting People Housing Providers around working with drug and alcohol clients. In particular the training programme should incorporate a module on Risk Assessment associated with offending. Supporting People may wish to undertake a review with their Housing Providers on admission criteria and exclusion policies, with the recommendation that Housing Providers should not exclude clients purely based on the fact that they are in treatment for substance misuse. Furthermore the DST Substance Misuse Training and Workforce Strategy, in collaboration with DIP and Supporting People target Supporting People Housing Providers around working with drug and alcohol clients. In particular the training programme should incorporate a module on Risk Assessment associated with offending.  S.P team to conduct review of policies.  Training to include risk assessment associated with offending. This work should make use of the DIP housing lead given the offending issues  Supporting people, Training & workforce development manager in conjunction with DIP.

47 Action Plan Currently refuge policies can exclude substance using clients. It may be useful for the DV co- ordinator to investigate which policies are in existence, and ensure that refuge staff have access substance use training and support from substance use services. Currently refuge policies can exclude substance using clients. It may be useful for the DV co- ordinator to investigate which policies are in existence, and ensure that refuge staff have access substance use training and support from substance use services.  Joint work between SP/DV co-ordinator  DV co-ordinator to lead & Supporting people team, Training and workforce development manager

48 Action Plan To ensure that the issues and gaps identified by this report are addressed the CSDAP may wish to repeat this exercise in the future, employing the data from this review as its baseline measurement by which to bench mark progress. To ensure that the issues and gaps identified by this report are addressed the CSDAP may wish to repeat this exercise in the future, employing the data from this review as its baseline measurement by which to bench mark progress.  DST to organise any further research after review of initial action plan March 2008  DST manager


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