Agenda item

This report presents the findings and recommendations of the Rough Sleeping Commission.

RESOLVED

That the order of business be varied, to take Agenda Item 7 as the first substantive Item.

Fawad Bhatti presented the report, together with Councillor Sue Fennimore, which set out the work of the Rough Sleepers Commission, commissioned and sponsored by the Council, in January 2017.  Its remit was determined by what needed to happen to reduce rough sleeping in LBHF, with the key element being Prevention.  This was an expert led commission and Chaired by Jon Sparkes, Chief Executive of Crises (who unfortunately had been unable to attend due to work commitments). 

The Commission conducted wide ranging review, supported by the policy team at Crisis, gathering both written and verbal evidence from service providers, stakeholders. Peer led research was commissioned, with researchers speaking to 108 rough sleepers.  Of those interviewed, 62% were currently rough sleeping, 23% were living on the streets in the Borough; and the remainder had slept rough in the past year.  Local outreach organisations gathered the views of volunteers who worked with rough sleepers daily.  The period of April 2016 to March 2017 had seen 246 rough sleepers. 61% were new to the streets, 28% were previously seen last year, during 2015/16.  11% were recognised as returnees, and known to the outreach teams. 

Groundswell reported rough sleepers would not be on the streets, had they access to affordable housing or received help with work and to move on.  For many, homelessness was extensive.  Council and third sector staff were viewed as helpful but lacked the specialised expertise required to support rough sleepers with alcohol / drugs advice. 50% experienced difficulties with benefits and national numbers had increased over the past year.  A peer led methodology for research was selected, i.e., those who conducted interviews had themselves experienced homelessness. 46% of those interviewed self-identified as having mental health problems, with 23% experiencing domestic violence, 17% having been in local authority care, 14% formerly in the armed forces and 12% with learning disabilities.

Key findings of the report were that rough sleeping could be significantly reduced in the borough, particularly in terms of outcomes.  Welfare reform was making it hard to resolve the issue but with empowered outreach staff, specialist support could be more readily available.  There were 30 recommendations aimed at the Council and the CCG, local and central government, detailed in the report and grouped into four sections:

1.    Council implements stronger prevention framework across a range of partners and stakeholders

2.    Emergency response

3.    Housing First and housing led approaches

4.    Ensuring access and adequate supply of secure and affordable housing for rough sleepers or people at immediate risk of rough sleeping

In addition to greater collaborative working between the Council and health partners, a long-term approach was needed to ensure secure, affordable and sustainable accommodation. In Manchester for example, they were exploring options for housing first provision in new developments. There were 20 recommendations for the Council, which could not work in isolation.

Cllr Fennimore observed that it was appropriate this issue was being discussed on such a cold night, when there were significant numbers of rough sleepers on the streets of the Borough. The Commission had approached Jon Sparkes as a leading expert in this area, whom she thanked for chairing the Commission and to stakeholders and commissioners. The voice of rough sleepers, who were vulnerable and living in an appalling sense of isolation, was reflected in the report thanks to the peer led research, helping to produce a comprehensive and structured report.

Patrick McVeigh commended the report and enquired about what the public support and how the Housing First approach worked in in practice and implementation.  Following the recommendations, they were now looking at costings and how to implement them.  A fundamental part of the report was to help members of the public not just to walk past rough sleepers without acknowledgement.  To illustrate, they could volunteer at Glass Door, who were overwhelmed with what needs to be done.  There was a collective responsibility to offer support.

Julia Copeland explained that Housing First aimed to address a person’s complex issues or traumas that culminated in causing homelessness. By putting you in home first, then help support your needs.  Research commissioned by the Joseph Rowntree had indicated very positive outcomes. 

Jim Grealy commented that the report was both thorough and remarkably bleak, observing that many more rough sleepers had been seen in the last few years than previously. He suggested that an outreach team be based at the CCG to ensure that rough sleepers have access to medical services. It was recognised that there were large numbers not on the GP practice lists; that there was a need for greater collaboration with between health partners and the Council; to avoid rough sleepers having to access A&E and to look at discharge issues; and work with WLMH NHS Trust to address mental health issues experienced by rough sleepers.  Councillor Fennimore concurred, the national picture was that rough sleeping was increasing both within the Borough and across London.  Addressing mental health concerns was a key element and required joined up work with A&E and the CCGs.

In response to questions from Bryan Naylor, Councillor Fennimore explained that while she did not have exact numbers, there was anecdotal evidence to indicate that rough sleepers came from various backgrounds and were not a homogenous group. Rough sleeping was transient and could not be viewed on a ward by ward basis but as people moving across the Borough. Groundswell indicated that there were North and South differences with more rough sleepers to be found centrally and south of the borough with cross over into RBKC and the St Charles Square boundary.  Looking at the statistics, there was a rising number of pregnant woman rough sleeping.

Councillor Joe Carlebach commented that this was a troubling report and asked if the Commission had considered the Council’s own processes, particularly evictions (not caused by anti-social behaviour).  It was explained that care leavers, given the corporate parenting approach, meant that support would continue. Councillor Carlebach was concerned about older care leavers, recounting the experience of man in his 40’s.  Councillor Fennimore stated that we were all corporate parents and that a fundamental shift and sea change in our responsibility was required.  When appropriate, councils should be helping young people.

Councillor Fennimore continued that the Administration was increasing the amount of accommodation available to young people, but this took time. It was understood that with regards to the eviction policy, this was actively and regularly reviewed.  Measures such as ethical debt collection were also being implemented, to help genuinely vulnerable groups avoid eviction. S.8 eviction notices were used by many providers, which this Council did not.  There were also early interventions, to prevent evictions happening.  The introduction of Universal Credit policy may have led to 100% increase in the numbers of people using local food banks.  Groundswell had undertaken great work being within Central London. 20% of the people approached had a history of leaving care, which sufficiently raised the risk of being a rough sleeper.  Having a longer of duty of care may be a solution.

Councillor Ben Coleman commented that there were lots of positive things that the Council could do, referencing page 29 of the report. Councillor Coleman invited Groundswell to explain the positive impact the Housing First approach on the health costs.  Homelessness had a significant impact on a person’s health through chronic long-term health conditions.  Groundswell worked in hostels to raise issues, acknowledging the difficulties in getting rough sleepers to engage with the need to address health issues or alcohol and drug problems, and accessing health care programmes. There was an advocacy programme in the borough, with collaboration between health partners and LBHF.  Providing details of a recent case study, they had helped a woman at risk of rough sleeping, accompanying her to medical appointments and ensuring that she was supported throughout. By not addressing this, it became a potential, hidden cost to the NHS.

Julia Copeland explained that the Council was working hard to demonstrate those benefits, and quantify the cost of not intervening.  They were working with the CCG, who understood the benefits of intervention better and the CCG had funded a nurse to go into the hostels.  With reference to housing first, Janet Cree indicated that the CCG was willing to engage in dialogue, as set out in the recommendations, and would continue to work collaboratively on other initiatives.

Councillor Brown commented this complex issue required a multi-faceted approach from all parts of the government, partner agencies, stakeholders, and faith organisations. Recounting his own experience, Councillor Brown observed that there had been an increasing prevalence of rough sleepers in recent years and asked what was being done within the to test and treat serious communicable diseases such as Tuberculosis (TB).  Groundswell confirmed that this was a chronic issue, with 85% of rough sleepers being smokers compounded the issue. There were pan-London organisations that went out and identified people to treat for TB.  They raised awareness of TB and ensured interventions were in place to combat it.  It was recognised that TB significantly shortened life and rough sleepers with TB were offered accommodation and monitored to ensure that they are taking their medication.

Councillor Vaughan closed the discussion by summarising the key points of the discussion:

The Committee commended the report; and endorsed its findings and recommendations:

·         This was an ambitious, evidence led report with impressive, localised research, providing a voice to rough sleepers which added great weight to this report;

·         The Committee expressed interest in the sequence of implementation, hoping that quick wins could be identified and actioned;

·         There was a need for a collaborative, cross-cutting approach including health, housing, and the CCGs, and the Committee a commitment to achieve the ambition of zero rough sleepers;

·         The Committee concurred that collaboration will see the benefit of cost savings to public purse; and

·         This work was difficult and the committee wished those implementing it well and thanked those that had worked on it.