Ed Addison and Nathan Rosier
This blog is the third in a series of three by The People’s Recovery Project (TPRP), a charity building sustained recovery for people experiencing homelessness and addiction. As a follow up to their involvement in the HSCWRU Strengthening adult safeguarding responses to homelessness and self-neglect study, HSCWRU invited TPRP to facilitate an event at King’s.
This blog by TPRP co-founders Ed Addison and Nathan Rosier shares final messages from this event on re-thinking approaches to supporting people to move on from multiple exclusion homelessness (MEH), with a focus on building new communities.
Blog 3: A peer-led community – improving routes into residential treatment
As we continue to develop The People’s Recovery Project (TPRP) we emphasise the importance of a peer-led community in guiding and supporting our approach. In the previous blog in this series we heard from Danny, an active TPRP community member, about his experience of street homelessness, residential treatment and recovery from addiction. Danny’s story is an example of how getting the opportunity to access residential rehabilitation can contribute to individuals making huge and positive life changes. Despite the many obstacles faced by our community members experiencing MEH, Danny is not the only one who has managed to embark on a journey of recovery. Through building a peer-led community in recovery from homelessness and addiction, we are striving to create the conditions that will allow members to use their own experiences to demonstrate to those living on the streets that a permanent recovery from street homelessness is possible. Continue reading
This month sees the start of a new study at the NIHR Health and Social Care Workforce Research Unit, King’s College London. Over the next two and a half years researchers will work with people with experience of homelessness and professionals who work with them to examine mental capacity assessments and multiple exclusion homelessness in England. Stephen Martineau, Research Fellow at the Unit, introduces the study, which is funded by the NIHR Health and Social Care Delivery Research (HSDR) Programme.
At the Unit this month we are starting a study, ‘Use of the Mental Capacity Act 2005 with people experiencing multiple exclusion homelessness in England’. The co-Principal Investigators are Kritika Samsi (KCL) and Michelle Cornes (Salford & KCL), with the main researchers being Jess Harris (KCL) and Stephen Martineau (KCL). The lived-experience Advisory Group (PPIE) is led by Stan Burridge, who, as a member of the research team, will also be carrying out interviews with people experiencing homelessness.
After an evidence review, interviews with national experts and a national practitioner survey, we will focus on three contrasting sites in England – interviewing people with experience of homelessness and a range of professionals engaged in their support and care. Finally, informed by our findings, we plan to bring together stakeholders and, in consensus, revise a pre-existing capacity assessment Tools and Guidance document for practitioners working with people experiencing homelessness.
About a decade ago in the London Borough of Lambeth, a review into the death of a 63-year-old man who had been sleeping on the streets recommended work on ‘understanding how the Mental Capacity Act (2005) [MCA] can be used to safeguard people in this context.’* One consequence came in the form of a pioneering Tools and Guidance document – now in its third edition (2017) – that places the MCA in context with the Mental Health Act 1983 (MHA), risk assessment, adult safeguarding and hospital admission procedures, all calibrated for those working with people who are street sleeping. Continue reading
Carolin Hess is a PhD student in the NIHR Policy Research Unit in Health and Social Care Workforce who has been awarded Doctoral funding from the NIHR School for Social Care Research. She reports from a recent webinar, the latest in the Unit’s Homelessness series. (920 words)
The webinar, attended by over 200 people, presented emerging findings from an innovative study ‘Addressing Homelessness in Social Work Education’, conducted by Jess Harris and Karl Mason and funded by the National Institute for Health and Care Research (NIHR) School for Social Care Research (SSCR).
The study delved deeper into an aspect of a previous study on Safeguarding responses to homelessness and self-neglect, which examined why social workers, including those in safeguarding roles, may be inadequately prepared for working with people experiencing homelessness. The study is also connected to a previous webinar on a study on the ‘Homelessness Social Worker Role’ which explored the experiences and support needs of specialist homelessness social workers, as well as the systemic barriers they face. This earlier webinar revealed that many social workers reported limited exposure to homelessness-related topics during their qualifying courses and uncertainty about their role in this area. Continue reading
This blog is the second in a series of three by The People’s Recovery Project (TPRP), a charity that aims to build sustained recovery for people experiencing homelessness and addiction. As a follow up to their involvement in the NIHR SSCR funded Strengthening adult safeguarding responses to homelessness and self-neglect study, HSCWRU invited TPRP to host an event at King’s. This blog by TPRP co-founders Ed Addison and Nathan Rosier shares further messages from this event and focuses on ‘lived experience’.
The People’s Recovery Project event at HSCWRU brought together individuals from across the homelessness and substance misuse sectors, and within the group were many people with both expertise and lived experience. From the foundation of TPRP, at the core of development has been the involvement of people with lived experience of both homelessness and substance use. At the event we heard from community member Danny who has been supporting the development of the charity over the past year, and who spoke of his personal lived experience of addiction and of being on the streets:
I was homeless in Westminster for about 20 years. In this time, I was in and out of homelessness services, police custody and incarcerated in prison on a number of occasions. I never wanted to go to rehab and did not see this as an option. The first time I went was due to a drug rehabilitation requirement issued by the court, and it was a way of getting me out of prison. I was not ready for rehab at this point.
When you are accessing different homelessness services, such as hostels and day centres, it is really difficult to access rehab: you have to jump through so many hoops. It felt like there was always a constant block and if it was not the limitations of one service it was due to the requirement of another organisation, or legislation that says you have to have a local connection, live in the right catchment area, or meet a certain criteria. Continue reading
Carolin Hess is a PhD student in the NIHR Policy Research Unit in Health and Social Care Workforce who has been awarded Doctoral funding from the NIHR School for Social Care Research. (701 words)
Over 280 participants joined Ben Scher, a PhD candidate in Social Intervention and Policy Evaluation at the University of Oxford and outreach worker at St. Mungo’s, for the latest webinar of the HSCWRU Homelessness series on how low-barrier drug interventions can reach people experiencing homelessness and drug-related harms. Presenting findings of his doctoral project, which compares the lived experience of street-based drug dependency based on people’s access to low-barrier overdose prevention centres (OPC) across sites in Vancouver (Canada), Birmingham (UK), and Athens (Greece), he provided ethnographic evidence on the effectiveness and feasibility of implementing OPCs.
OPCs are “safer consumption spaces” where drug consumption is monitored by medically-trained professionals. Substantial observational evidence across the 15 countries currently operating OPCs has demonstrated how these centres can be successful in preventing fatal overdoses, reducing risk of blood borne diseases, and increasing safer injecting practices and engagement with substance treatment services. Continue reading
This blog is the first in a series of three by The People’s Recovery Project (TPRP), a charity that aims to build sustained recovery for people experiencing homelessness and addiction. As a follow up to their involvement in the NIHR SSCR funded Strengthening adult safeguarding responses to homelessness and self-neglect study, HSCWRU invited TPRP to host an event at King’s with invited stakeholders. This was an opportunity to share ideas with a wide spectrum of perspectives from across the homelessness and substance misuse sectors, including safeguarding, commissioners, health, mental health, grassroots organisations, experts by experience and researchers. This blog by co-founders Ed Addison (left) and Nathan Rosier highlights messages from the 2023 event and introduces TPRP’s work. Continue reading
Carolin Hess is a PhD student in the NIHR Policy Research Unit in Health and Social Care Workforce who has been awarded Doctoral funding from the NIHR School for Social Care Research, commencing February 2023. (896 words)
In the latest webinar in the HSCWRU Homelessness series, 225 participants joined Ellie Atkins, a senior social worker and Safeguarding lead, for a presentation which asked, What does research and expert practice tell us about the importance of executive functioning assessments? The topic builds on themes from last month’s webinar, exploring mechanisms of agency and choice, and how self-neglect among homeless populations can be addressed by strengthening safeguarding responses.
The presentation opened with the question of why the Everyone In Initiative, a £3.2 million emergency fund set up during the COVID-19 pandemic to house people in the UK who were rough sleeping, did not end rough sleeping for all individuals. The scheme was widely hailed as a success, with organisations praising the unprecedented effort and rapid response to homelessness through increased partnership working and communication, which supported over 30,000 people into accessing accommodation. Continue reading
Carolin Hess is a PhD student at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. (583 words)
As part of the NIHR Policy Research Unit in Health and Social Care Workforce Homelessness Series, Research Fellow at the Unit, Jess Harris, and Stan Burridge (public contributor) recently presented ‘lived experience’ perspectives from the emerging findings of an NIHR School for Social Care Research funded national study of homelessness, self-neglect, and safeguarding. The event, held on 25 April, was attended by over 180 people.
In light of a recent report that revealed that 1313 people died while homeless (including people sleeping rough, in emergency or other insecure settings) in the UK during 2022, an 85% increase on the number recorded in 2019, the research could not be more timely.
Bringing together the voices of multi-disciplinary practitioners and people with lived experience, the study findings highlight the complexities of safeguarding but also offer suggestions on how to strengthen safeguarding responses and more effectively support people who face multiple exclusion homelessness (MEH). Continue reading
The NIHR Policy Research Unit in Health and Social Care Workforce has published an evaluation of an access to employment programme in the NHS targeted at those with lived experience of homelessness. The pilot programme involved the homelessness charities Pathway and Groundswell and five NHS Trusts in England. Report author, Ian Kessler, here outlines the programme and the main findings of his evaluation.
Ian Kessler is Deputy Director of the NIHR Policy Research Unit in Health and Social Care Workforce. He is also Professor of Public Policy and Management at King’s Business School. (1,016 words)
Widening participation in the healthcare workforce has long been an important policy objective in the NHS. This has been reflected in an equalities, diversity, and inclusion agenda traditionally centring on gender and race, and more recently on young people with disabilities with the introduction of supported employment programmes by NHS Trusts, such as Project Search and Choice. However, the pursuit of widening participation is a rich policy space, connecting to an increasing range of workforce and broader service priorities.
Framed as ‘anchor institutions’, playing a key role as local employers, NHS Trusts have been encouraged to develop workforces which reflect, in socio-economic and demographic terms, the communities they serve. This role overlaps with moves to bring into the NHS workforce people with lived experience of various health conditions as a means of delivering patient-centred services and more effectively addressing health inequalities. Such moves have been especially evident in the introduction of the peer support worker role in mental health (which our Unit evaluated many years ago). More prosaically, but perhaps most pressing, the search for workforce diversity and inclusion addresses the recruitment and retention challenges faced by healthcare employers, with those at the margins of employment representing a new and reliable source of labour. Continue reading
Helena Kitto is a third-year PhD student at Keele University. (1,097 words)
Homelessness and law
Homelessness is complicated to talk about from a legislative perspective. The Housing (Homeless Persons) Act 1977 is the first piece of English legislation that specifically pertains to homeless people, but other laws have been applied to people who are homeless, most infamously the Vagrancy Act 1824. Following the Housing (Homeless Persons) Act, there is now the Homelessness Act 2002, and later the Homelessness Reduction Act 2017. Another piece of legislation that does not specifically apply to homeless people, but nevertheless has significantly impacted them, is the Care Act 2014, primarily due to the changes the Act made to adult safeguarding in England.
These laws span a number of legal domains, from criminal concerns to property to social care. This is where the complications of discussing homelessness from a legislative perspective arise, because they require a degree of contextual understanding of several different areas of legal concern. Concepts like responsibility, entitlement and safeguarding can be hard to define.
One way to view homelessness legislation could be as in a state of evolution. A chronological analysis of laws that pertain to homeless people (including those that are not specifically about them) shows a gradual move away from viewing homelessness in a punitive fashion, or one that is exclusively a concern of housing and entitlement to housing support, to one that acknowledges homelessness as bringing in adult safeguarding and public health. Continue reading