ADD2061 Female Entrenched Rough Sleeper Project

Type of decision: 
Assistant Director's decision
Code: 
ADD2061
Date signed: 
15 December 2016
Decision by: 
Jamie Ratcliff, Assistant Director of Policy, Programme and Services

Executive summary

Approval is sought to contribute grant funding towards a third phase of the Central and North West London NHS Foundation Trust’s Female Entrenched Rough Sleeper Project (FERSP). This funding will contribute to the provision of a dedicated mental health specialist outreach worker who, with commissioned outreach teams, will co-ordinate access to appropriate support. The aim is to provide a route off the streets for some of the most entrenched, complex needs women who are sleeping rough - to help tackle rough sleeping and address the scourge of homelessness in the capital. 

 

Decision

That the Assistant Director approves expenditure of £21,000 of grant funding to the Central and North West London NHS Foundation Trust towards the cost of the Female Entrenched Rough Sleeper Project, which will run from 1 February 2017 to 31 March 2018.

 

Part 1: Non-confidential facts and advice

Introduction and background

1.1    The Mayor has committed to tackling the “scourge of homelessness” and in particular has noted that the rise in rough sleeping over recent years is a growing source of shame that we have a “moral imperative” to stop. In his manifesto he pledged to look at preventing rough sleeping and to develop a ‘No Nights Sleeping Rough’ initiative, a London-wide taskforce to oversee the implementation of the Mayor’s rough sleeping work and funding priorities.The Female Entrenched Rough Sleeper Project (FERSP) will assist in targeting entrenched older female rough sleepers with mental health needs who typically avoid services by moving between London boroughs, and are often ‘hidden’ , for example, on buses, sheltering in A&E departments, in winter shelters or in woods.

1.2    The Mayor has responsibility for funding and commissioning a range of pan-London rough sleeping services. These are services for rough sleepers, or initiatives to tackle rough sleeping, that cannot or would not be provided at a London borough level, as they are pan-London or multi-borough in their remit. A budget of £33.8 million for these services was approved for the period 1 April 2016 to 31 March 2020 through MD1532.

1.3    The shape and nature of these services is underpinned by the pan-London Rough Sleeping Commissioning Framework, which includes a priority ‘to work with boroughs and partners to meet the physical and mental health needs of rough sleepers’. In order to help meet this priority, it is proposed that the GLA contributes grant funding to the Central and North West London NHS Foundation Trust (CNWL) (one of the largest trusts in the UK, caring for people with a wide range of physical and mental health needs) for a third phase of the FERSP. 

1.4    The FERSP has run for two years. It has had two phases, the most recent of which ended almost a year ago. The most recent phase was funded by the North London Housing Partnership and Westminster City Council (WCC), and administered by the Partnership, Westminster City Council, WCC and CNWL. It worked with a cohort of 25 female entrenched rough sleepers displaying certain characteristics, with the ultimate aim of securing housing outcomes for participants. As a result of the project, only one of the cohort is still sleeping rough. The next phase will involve a new pan-London cohort of 25 people, and will work flexibly to better co-ordinate a range of services to help them off the streets. The total cost for the period 1 February 2017 to 31 March 2018 will be £27,800.

1.5    The North London Housing Partnership is unable contribute funding to the next phase. However, WCC have committed £6,800. It is therefore proposed that the GLA grant funds the shortfall of £21,000.

1.6    There has been a significant increase in the number of rough sleepers in recent years. Over 8,000 people were seen rough sleeping by outreach workers during 2015/16 and whilst women account for only 15 per cent of those sleeping rough, this proportion has increased by one per cent over the past three years. However, this group are often ‘hidden’, and are significantly less likely to access the help and support they need; a study by Crisis showed that only 12 per cent of homeless women have engaged with street outreach teams (Crisis, 2004).

1.7    The targets for the project have been negotiated with WCC and CNWL and will be incorporated into the grant funding agreement (see Appendix 1 for more information).  
 

Objectives and expected outcomes

Milestones

To work with a cohort of 25 female rough sleepers (who will be nominated by the local authority and outreach teams), with the following characteristics:

  • over 40
  • known to more than two London boroughs
  • do not use drugs/alcohol
  • may indicate a mental health concerns 

To implement full CHAIN recording for every woman in the cohort (detailing all known bedded down and non-bedded down contacts)

95 per cent of the cohort to have a health, social care and housing support plan including  a short term accommodation offer identified on CHAIN (for all teams to see and implement when opportunity arises)

100 per cent of the cohort to have a short/medium and long term accommodation offer identified on the action plan field on CHAIN (for all teams to see and implement when opportunity arises).

At least 60 per cent of the cohort to be off the street by the end of the project

To improve CHAIN reporting for this group (achieved through the implementation of: a FERSP tag on CHAIN, the FERSP worker inputting on CHAIN, awareness raising with outreach teams and a new search mechanism for unknown women to better match records)

To improve multi-agency working and joint training  - linking in relevant services who lack knowledge/skills to toolkits and training particularly in relation to the Mental Capacity Act and the Care Act 2014

To have agreement between local authorities for flexible women’s beds provision – a tailor made  offer for every woman will be developed in advance and negotiated via the Women’s Outreach Network and the GLA local authority rough sleeping leads meeting

To produce brief quarterly reports along with an end of year project report with recommendations for the future to best meet the needs of this group.

Feedback from service users and service providers.

 

Equality comments

3.1   Of those seen rough sleeping in 2015/16:
•    15 per cent were women
•    59 per cent were non-UK nationals
•    46 per cent had a mental health need
•    most of those seen rough sleeping (58 per cent) were in the 26-45 age group
•    10 per cent were under 26 years old
•    11 per cent were over 55
•    four people were under 18.

3.2    As rough sleepers are over-represented among those with the protected characteristics of sex and disability, the proposals in this paper are likely to have positive impacts on these.
 

Other considerations

a)        Key risks and issues

Risk description

 

Rating

Mitigating action

 

The cohort may refuse to engage with the mental health outreach worker

Green

The first two phases of the project have developed practice to ensure a higher level of engagement from this challenging group.    

Too many, or not enough, women in this cohort

Green

The cohort will be nominated by local authorities and outreach teams. If too many women meet the criteria, the most complex, challenging clients will be prioritised (in agreement with boroughs). If there are not enough women meeting the criteria, the criteria will be reviewed.

 

Lack of capacity of other services to work flexibly with this group

 

This cohort is likely to contain a large of number women who are not suffering from a diagnosed mental health issue of a nature or degree that warrants an assessment under the Mental Health Act.

 

Increasingly across London, secondary mental health services are accessed via telephone triage systems. This can pose significant barriers to homeless people, whose cases will be closed in they fail to attend an appointment. Often, members of this cohort will make a single approach, and then not follow it up if the process seems difficult.

 

The mental health outreach worker will play an essential role in ensuring that mental health services fulfil their responsibilities to assess cohort members. In some cases, the outreach worker can ensure that the first approach is successful, and avoid the women experiencing rejection and being lost to services.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b)        Links to Mayoral strategies and priorities

The objectives of the proposals are in line with

  • the pan-London Rough Sleeping Commissioning Framework 2016 priorities 3,7 and 8
  • the Mayor’s manifesto commitment to ‘tackle the scourge of homelessness’

 

c)         Impact assessments and consultations.

The Rough Sleeping Commissioning Framework 2016+ was made available for consultation with key stakeholders and partners and was subject to a full equalities impact assessment.

 

Financial comments

5.1    This decision seeks approval to expend £21,000 to grant fund Central and North West London NHS Foundation Trust (CNWL) to run the Female Entrenched Rough Sleeper Project (FERSP). Funds are available from Mayor’s Rough Sleeping services, which have been allocated with total funding of £8.49m for the 2016/17 financial year. Expenditure will incur in 2016/17 financial year.

5.2    The Programme, Policy and Services Unit of the Housing and Land Directorate, will be responsible for monitoring and managing the grant and ensuring that all activities and associated expenditure comply with the Authority’s Financial Regulations, Contracts and Funding Code and Expenses and Benefits Framework. Any changes to this proposal, including the requirement of additional funds, will be subject to further approval via the Authority’s decision making process.
 

Planned delivery approach and next steps

6.1    The GLA will monitor the service on a quarterly basis to assess performance against targets. As with the other pan-London rough sleeping services funded by the Mayor, the performance of this service will be reported to the Deputy Mayor for Housing and Residential Development each quarter.