Sustainable Funding for Housing First: Part 1 – Self Directed Support
Our Renfrewshire Housing First service supported an individual who had issues with alcohol and a diagnosis of alcohol related dementia. We recognised that his needs would increase over time and that he would require longer term support. Due to his condition being severe and enduring it was identified that he would require lifelong support and at a level that the Housing First service may not be able to maintain long tem. At this point, the service was funded though the Big Lottery Fund for a five years and there was uncertainty surrounding future funding
This individual had an allocated care manager; staff highlighted his need for long term support with his social worker and they stated that they would look into a Self-Directed Support (SDS) package. SDS is a way of funding adult social care that ensures the people receiving support are at the centre of decisions around what the support should look like. It allows for greater flexibility, empowering people to purchase the right support for them from their chosen support provider
We passed this onto Homeless Services and it was agreed that this individual be transferred to the Housing Support service as part of a planned exit strategy. This support would continue until an SDS package was in place. We were not able to fully discuss this with the service user due to his level of understanding
Discussions took place with social work regarding this support and it was felt by all parties that he would benefit from being supported by staff that he had already built a relationship with, rather than moving to a new service and having to build new relationships. This would ensure that the transfer to SDS support would be as seamless as possible and not result in any confusion or upset to him; his staff team stayed the same, the support he received stayed the same, all that changed was the way in which that support was paid for. Social work assessed that this individual would require 10hrs support a week however after a period of time this was increased to 14hrs, due to his growing needs.
Providing Housing First support through SDS can give a person more control over their support as well as much needed security. People we support in Housing First are very much aware that the service is funded by the Local Authority and many feel great anxiety over their support being reduced or ended. This ongoing anxiety does not tie in with the aims of the Housing First principles re: a fundamental sense of safety, and can create a barrier to individuals achieving positive outcomes. How can a person accept support and work hard to make positive changes in their life whilst continuously worrying that their support will end?
One of the non-negotiable of the Housing First model is that the duration of support must not be time limited, however the reality is somewhat different. Homelessness Services are under intense pressure to move people on from support in order to make room for others to be referred. Their frustration at being the only source of funding is understandable. The name ‘Housing First’ can be misleading as it implies that ‘Housing’ is the only factor to consider however, it is so much more than that
I feel that Housing First can be funded by all statutory services. This will allow us to open the referral route further and alleviate pressure from Homelessness Services. Referrals can then come from mental health, addiction, criminal justice and adult social services as well as giving people the chance to self-refer. We have had a high number of calls over the years from addictions services and social work asking to refer someone however we have had to explain that all referrals must come through Homelessness Services. Not only has this been a missed opportunity for the organisation but more importantly, there may be many, many people who did not receive the support they needed
There may be some fears surrounding recruiting permanent staff to deliver Housing First through SDS due to risk of the funding ending however this risk will always be there, no matter what the service is and where the funding comes from
There have also been individuals who have transferred from the Housing First service to a Housing Support service after a period of time. Both individuals had resettled and no longer require such intense support. Having a planned exit strategy like this can be a smoother transition before successfully moving on from the Housing First service
Elizabeth Pugh – Service Coordinator – Turning Point Scotland