Providing personalised support to rough sleepers

Key points

• Fifteen people who had been sleeping rough for between four and 45 years were offered a personalised budget. By the time of the evaluation, the majority were in accommodation (seven) or making plans to move into accommodation (two).
• Those who had moved off the streets talked positively about their lives in accommodation and had begun to make plans for the future, including taking courses, reconnecting with family, and addressing physical and mental health and substance misuse problems.
• The personalised budget fulfilled several functions. It helped to establish a trusting relationship with the project co-ordinator; gave people an incentive to move into and stay in accommodation; and supported people in maintaining tenancies by responding to crisis and planning for a future.
• Many people experienced high levels of anxiety around moving into accommodation. Long-term personalised support after resettlement, provided by one dedicated worker, was seen as essential to maintaining tenancies.
• Everyone involved – both those with personalised budgets and professionals – believed that this personalised approach could work with other rough sleepers.
• The authors conclude that the personalised support provided to individuals was as important to the success of the project as the provision of personalised budgets. The personalised approach has brought people elements of choice and control not provided by standard offers of support, alongside intensive support from one trusted worker.

The research
By Juliette Hough and Becky Rice, Broadway, a London-based homelessness charity.

Background

The personalised budgets pilot project has tested a new way of working with long-term rough sleepers in the City of London who were very resistant to moving off the streets. The project has been delivered by Broadway, a London-based homelessness charity. It has been funded and supported by the City of London Corporation and Communities and Local Government (CLG) as part of their strategy to end rough sleeping. This study evaluated the project 13 months into its operation.

The personalised budgets project

The main resources for the pilot were a full-time co-ordinator and a budget that allowed £3,000 per person for a personalised budget. Most people spent less than this, while a few spent more. In the model developed in the pilot, rough sleepers were:

• asked what they needed to help them off the streets;
• told there was a personalised budget available for them to help them achieve this;
• supported to develop an action plan which was agreed by the local authority.

Participants had to choose a broker to help them write a plan for their personalised budget; they all chose the project co-ordinator as their broker. Unlike the personalisation model used in social care, there was no specific allocation system for the resources and no formal assessment of participants' needs.

Fifteen long-term rough sleepers were offered a personalised budget plus flexible, personal support from the project co-ordinator; 13 accepted. These 15 were targeted because they were the hardest to reach using standard methods. They had been sleeping rough for between four and 45 years.

Results

The results achieved for these long-term rough sleepers have far exceeded many people's expectations of the project. Seven of the 15 who were offered a personalised budget have moved into and remain in accommodation, which they have maintained for between four and 11 months. A further two were making plans to move into accommodation.

It has made it possible for me to stay [in accommodation]. There's a good chance I could have been back out there by now if not for the budget. (Former rough sleeper)

Despite previously being reluctant to leave the streets, 11 people moved into accommodation; in four cases this resulted in negative outcomes such as abandoning the accommodation and imprisonment. Several people moved into hostels, a form of accommodation they had repeatedly refused to consider in the past. Of the seven resettled people interviewed for the project evaluation, all but one (who subsequently abandoned his accommodation) talked positively about their lives in accommodation, and had begun making plans for a long-term future in accommodation.

This suggests that even long-term rough sleepers who say that they do not want to go into accommodation can choose to do so when they are in control of the conditions for making such a move. Throughout the interviews, many people used the phrases "I chose" or "I made the decision" when discussing their accommodation and the use of their personalised budget, emphasising their sense of choice and control.

It empowers people, it gives choices, I think it can make a difference. (Street Population Manager, City of London Corporation)

Wider results included people registering for courses, reconnecting with family, developing independent living skills (such as cooking and paying bills), and addressing physical and mental health and substance misuse problems. Five people who previously did not claim welfare benefits set up claims, and four have maintained these.

How the personalised budget worked

Participants were not told how much money was available in their budget. Instead, they were asked what they wanted in order to help them. Total spending in the first year averaged £794 per person, compared with the £3,000 allowed.

The budget worked in different ways in different circumstances. At an early stage, it facilitated people's engagement with the project co-ordinator, building trust and demonstrating that the personalised approach was different from previous offers of help. When someone was contemplating moving off the streets, the budget could help them make the decision; for example, they could buy furniture or a television to make the move more comfortable and desirable. At later stages, the budget could be used to help people to sustain accommodation – for example, by paying off small arrears or by buying gas, electricity or food when there were problems receiving benefits. The budget could also help people to plan for a future in accommodation, for example by paying for courses.

People's journeys

Many participants described similar features in their journeys off the streets and into accommodation.

Pre-engagement

Long-term rough sleepers in the City of London had a strong sense of pride and resilience. Offers of help and support before the personalised budgets project did not match their needs or preferences. This group often perceived themselves as different from people who went into hostel accommodation. There was strong resistance and even antagonism towards outreach workers, who were viewed as part of the establishment, aiming to force rough sleepers into accommodation they did not want to go into.

The option of going to homeless organisations [for support] didn't enter my mind. I know I’m an entirely different creature from most homeless people. (Personalised budget recipient)

I couldn't stand the sight of [outreach worker]. She belonged to the establishment. I despised her. (Personalised budget recipient)

Key to breaking down these barriers among this group was building up a relationship with the project co-ordinator over time and being asked about what they wanted rather than being presented with a repeated offer of hostel accommodation. Although the personalised budget and the co-ordinator's time were intended to help long-term rough sleepers to move off the streets, it was up to individuals how they went about this: they had control over the process.

Engagement

The context of taking an assertive approach to ending rough sleeping in the City of London impacted on some people's decisions to engage with the project. For example, one person moved into accommodation because there was now far less free food available on the streets.

Project stakeholders considered it very important that people knew that the personalised budget was to help them "get off the streets". A clear action plan specified how money would be spent and the actions required of the co-ordinator, the person with the personalised budget, and others.

The personalised service offered by the project co-ordinator was crucial in facilitating change. It had to be genuinely distinct from the standard outreach service. Areas of difference included:

• the rough sleeper choosing where to meet the co-ordinator rather than being approached at their sleep site;
• the co-ordinator largely working on a one-to-one basis rather than in a pair;
• the co-ordinator spending a lot more time with people than is typically possible on an outreach shift;
• the rough sleeper guiding the conversation rather than the worker focusing on a quick move into accommodation.

I've got to be honest here, it wasn't just the individual budget, it was the fact there was [co-ordinator] there as well … We was meeting [regularly] to discuss it, and I'd actually gone from the stage of wanting nothing to do with these people, to actually looking forward to seeing them. So it's not just the actual money. It's the way it's being handled. In this case it's [co-ordinator] … All the people are dealt with as individuals. (Personalised budget recipient)

People who had been sleeping rough for many years often found it hard to think of what they wanted or needed. They required support to help them envisage a life away from the streets and what material things or services would help with this.

Moving into accommodation and remaining in it

A high level of anxiety was associated with moving into accommodation after between four and 45 years sleeping rough. Professionals involved in the project thought it likely that for many people this huge life change brought up hidden trauma associated with past experiences.

Most people settled in over time and adapted to their new accommodation. Some started courses or began engaging with services. Some maintained their old social networks, but others spoke about developing new networks and moving away from an old lifestyle and identity.

I've been able to break away slowly from the rough sleeper lifestyle. I still keep in contact with some of my friends … I use two [day centres] … but the rest of them I don't bother. It's [hard] 'cos it's where all your friends are … If you're not careful you end up isolated. (Personalised budget recipient)

Four people had negative outcomes from their resettlement, including abandoning their accommodation and imprisonment. Challenges in dealing with money, particularly benefits claims, were a source of anxiety and a risk factor in many tenancies. The co-ordinator helped several people to return to accommodation after they had left it. Having a consistent worker involved in the move from street to accommodation was viewed as key in helping people to maintain their tenancies. A number of instances of accommodation being abandoned occurred at times when the co-ordinator was on leave; hence it was found that careful handover and cover arrangements were important. Long-term personalised support, perhaps for several years, was also seen as essential for people to maintain tenancies.

Conclusion

Agreement was widespread among both those with personalised budgets and professionals involved in the project that this personalised approach could be expanded to other rough sleepers in the City and beyond.

A fantastic opportunity to approach work with individuals differently ... We'll certainly encourage the approach. (CLG official)

A different way of working with personalised budgets may be required for people with drug problems. The one drug user in the pilot sold items purchased with his budget to fund his drug use, suggesting that support for drug use needs to be in place before expensive items are bought.

Key features for replication in other areas are:

• support from the local authority, including quick access to money;
• clarity about who is eligible and what the budget is for;
• an action plan to give responsibility to the co-ordinator and the recipient of the personalised budget;
• an intensive and consistent approach to working with people.

The pilot has received additional funding to continue until March 2011. After that it will become a mainstream part of the work of Broadway's outreach team in the City of London.