Housing-led Feasibility Study for Oxfordshire - Full Report Authors: Imogen Blood, Mark Goldup, Anita Birchall, Shelly Dulson and Chloë Hands
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Summary Report Housing-led Feasibility Study for Oxfordshire Full Report Authors: Imogen Blood, Mark Goldup, Anita Birchall, Shelly Dulson and Chloë Hands November 2020
ii Housing-led Feasibility Study for Oxfordshire iii
Housing-led
Feasibility
Study for
The study investigated the feasibility of Oxfordshire moving to and implementing a housing-
led response to homelessness in its county. It was commissioned and funded by Crisis
Oxfordshire
and the Oxfordshire district councils of Cherwell, West Oxfordshire, Oxford City, South
Oxfordshire and the Vale of White Horse. It was overseen by a steering group made up of Full Report
representatives from those councils and was conducted by Imogen Blood & Associates.
Written by Imogen Blood, Mark Goldup, Anita Birchall, Shelly
Dulson and Chloë Hands
Commissioned by Crisis, with funding from Crisis and the
Oxfordshire councils
November 2020iv Housing-led Feasibility Study for Oxfordshire v
Contents
1. Introduction to the study 1
1.1. This commission 1
1.2. W
hat is a ‘housing-led approach’? 1
1.3 Single people and families facing homelessness 4
1.4 Our approach 4
1.5 Structure of this report 6
2. Summary of Recommendations 7
Long-term fundamental priorities 7
Shorter-term practical actions 8
3. T
he current provision of housing-related support to those
experiencing or at risk of homelessness in Oxfordshire 10
3.1. Transitional supported housing 12
3.2. Housing First 14
What is Housing First? 15
3.3. Estimated current spending 16
4. The case for change 17
4.1. The traumatised system 17
4.2. H
ow is the homelessness system across
Oxfordshire performing? 18
4.3. Lived experiences of the homelessness system 20
4.4. The cost benefits of preventing and ending homelessness 22
5.1. Where do people want to live? 25
5. Access to housing 25
5.2. W
hat barriers and challenges do people currently
face in accessing housing? 26
5.3. Access to social housing allocations 27
Recommendations 31
5.4. An assessment of housing supply for single homeless people 33
Crisis head office
66 Commercial Street
London E1 6LT
Tel: 0300 636 1967
Fax: 0300 636 2012
www.crisis.org.uk
© Crisis 2020
Crisis UK (trading as Crisis).
Registered Charity Numbers:
E&W1082947, SC040094.
Company Number: 4024938vi Housing-led Feasibility Study for Oxfordshire vii
Contents
6. What is ‘good support’? 37 Appendix 1: Provision of existing Housing Support Services 74
6.1. The lived experience 37
6.2. The need for a gendered approach 40 Appendix 2: Glossary 81
How women’s needs differ from men’s 40
Why the systems should be better for women 41 Appendix 3: Financial narrative: assumptions and methodology 84
What a gendered approach looks like 42 1. Summary 84
6.3. Access to healthcare 42 2. Recommendations that impact on financial narrative 85
6.4. Professionals’ views about support 43 3. Financial modelling approach 86
4. Changes in where people first present 88
7. What might a ‘housing-led’ approach look like 5. Financial Impact 89
in Oxfordshire? 46 6. Reducing the rough lleeper population 94
7.1. Prevention 47 7. Comparison to existing financial footprint 96
7.2. The response to those experiencing homelessness 51
7.2.1 The ‘hidden’ homeless 51
7.2.2. Overview of the housing-led response to homelessness 51
7.2.3. Multi-agency casework: ‘the By Name List approach’ 52
7.2.4. Assessment Hub: ‘the way in’ 54
7.3. A menu of housing and support options 56
7.3.1 Housing First 56
7.3.2. Rapid rehousing, with support as needed 57
7.3.3. Provision of additional support 58
Medium-long term supported housing 58
Emergency and temporary accommodation 59
8. I s a housing-led approach potentially affordable within the
current financial footprint? 61
Conclusions 63
9. How might we get from here to there? 64
9.1. Strategic alignment across pathways 64
9.2. Re-thinking commissioning 65
Dialogue rather than competition 65
9.3. Bringing the voices of people with lived experience
into service design 66
9.4. Commissioning for change and flexibility 67
9.5. A different way of managing performance 68
9.6. Transforming and developing the workforce 68
9.7. An evidence-informed approach 69
9.8. Effective countywide governance of homelessness 71
9.9. Recommendations based on the Housing First principles 721 Housing-led Feasibility Study for Oxfordshire Summary Report 2
1. Introduction
to the study
1.1. This commission • Collaboration with the steering group
This report presents the findings of to advise on research design, findings The Principles behind a Housing-
a study exploring the feasibility of and implications for operationalising Led (Housing First) approach
moving to a housing-led approach to the conclusions from the study.
tackling single homelessness across • People have a right to a home
Oxfordshire. It was commissioned by The study ran from January to • Flexible support is provided for
Crisis and the Oxfordshire Countywide October 2020 and was delivered by as long as it is needed
Homelessness Steering Group and Imogen Blood, Mark Goldup, Anita • Housing and support are
conducted by a team of independent Birchall, Shelly Dulson and Chloë separated
research consultants at Imogen Blood Hands at IBA, supported by Kate Farrell • Individuals have choice
& Associates (IBA) (www.imogenblood. and Lewis Haines at Crisis. Housing First works best when it and control
co.uk). The study was funded by Crisis, functions as part of an integrated, • The service is based on people’s
Oxford City Council, Cherwell, South 1.2. W
hat is a ‘housing-led multi-agency homelessness strategy, strengths, goals and aspirations
Oxfordshire, Vale of White Horse and approach’? alongside prevention, and low intensity • An active engagement approach
West Oxfordshire District Councils. A Housing-Led or Rapid Rehousing emergency accommodation services:3 is used
approach to ending homelessness • A harm reduction approach
The research was commissioned to aims to move people into their own “An integrated homelessness is used
cover the following main elements: homes as quickly as possible and strategy, characterised by
provide them with the support they extensive interagency working,
Housing First England: The Principles of Housing
• Construction of an operational need to make it work1. The approach uses preventative services and a First 2017
model to consult with local seeks to minimise the amount of time range of homelessness services (of
stakeholders for the delivery of spent in temporary accommodation which Housing First services are Housing-led is a whole system
a housing-led approach across and the number of transitions a person one group) to effectively meet the approach, which seeks to apply the
Oxfordshire; has to make before they move into a diverse needs of single homeless principles of Housing First model to
permanent home. people”. (p.iii)4 all those experiencing or at risk of
• Consultation and peer research homelessness.
with people with lived experience of Housing First is one type of housing- Only a relatively small number of single
homelessness in the area; led model, and this is specifically people experiencing homelessness The following table suggests what
designed for those with the highest need Housing First; however, a it might mean to apply each of the
• Analysis of the policy and practice and most complex needs. As the housing-led approach recognises that Housing First principles to the whole
implications of the model to following graphic – developed by the principles underlying the Housing homelessness system.
understand how it would work Homeless Network Scotland2 – shows, First model can and should benefit all
across Oxfordshire; Housing First is one type of housing- those who are experiencing or at risk
led solution, aimed at those with the of homelessness.
• Analysis on the costs of most complex needs.
implementing a new housing-led
model and transitional arrangements
needed;
3 Blood, I., Copeman, I., Goldup, M., Pleace, N., Bretherton, J. and Dulson, S. (2017). Housing First
Feasibility Study for the Liverpool City Region. London: Crisis UK. [Online]. Available at: https://www.
1 Downie, M. (2017). Plan to end homelessness. London: Crisis UK. [Online]. Available at: https://www. crisis.org.uk/media/237545/housing_first_feasibility_study_for_the_liverpool_city_region_2017.pdf
crisis.org.uk/ending-homelessness/the-plan-to-end-homelessness-full-version/executive-summary/ 4 Pleace, N. (2018). Using Housing First in Integrated Homelessness Strategies: A Review of the Evidence.
2 Scotland Rapid Rehousing Guidance https://homelessnetwork.scot/wp-content/uploads/2019/11/rapid- York: University of York. [Online]. Available at: https://www.mungos.org/app/uploads/2018/02/ST_
rehousing-guidance.pdf Mungos_HousingFirst_Report_2018.pdf.3 Housing-led Feasibility Study for Oxfordshire Summary Report 4
A whole system approach 1.3 Single people and families facing family homelessness. A fully housing-
homelessness led approach can benefit all those
Housing First Our brief was to focus on single facing homelessness, regardless of
principle households. Single people made up their household composition.
People have a right Bolstering the supply of affordable housing options and keeping any
51% of all homelessness presentations
to a home evictions to an absolute minimum. across Oxfordshire in 2018/19 (rising 1.4 Our approach
Removing the conditionality from the system, e.g. so people do not have to 60% in Oxford city). Although family Key data collection activities have
to first prove they are tenancy ready, thereby earning the right to a home. homelessness is also a key challenge included:
The system views housing as a human right. in Oxfordshire, the responses to the
Flexible support Our need for support naturally fluctuates; it is almost impossible to predict homelessness experienced by single • Development and population of
is provided for as exactly how much support an individual will need, around which issues households and those with dependent a model showing flows of single
long as it is needed and for how long. Yet support for those experiencing homelessness tends
children are somewhat different, homeless households through
to be commissioned in time-limited blocks; some people experience
‘cliff-edges’ where support suddenly ends, some may be over-supported not least because of the stronger the homelessness system across
at times. Instead, a housing-led system allows for support to flex around a duties which local authorities have Oxfordshire.
person in their own home when they need it. to accommodate households with
Housing and This separation means that the housing offer is not dependent on the dependent children. This means that • Peer research co-produced
support are support offer; so if the support comes to an end, the person does families with dependent children with the LEAF (Lived Experience
separated not have to move. Conversely, a person does not have to move into a and pregnant women who are Advisory Forum); 30 interviews with
buildings-based project in order to access support; and the support homeless tend to be placed in self- people (6 of whom were women
relationship can stay with a person where they want or need to move.
Separating the support from the landlord function can also help to clarify contained temporary or permanent and 2 of whom were from BAME
the role of different workers, thereby building better relationships (in our accommodation (rather than in backgrounds, with ages ranging
research with people using the system, some felt staff are more interested settings with shared facilities) as from 20s to 70s) in Oxford city
in the building than the people). quickly as possible, and should not be experiencing homelessness were
Individuals have Choice is often designed out of the service response to single homeless at risk of rough sleeping. The response conducted, transcribed and analysed
choice and control people: people are ‘placed’, ‘sent’, ‘signposted’ and, if very lucky, ‘housed’. to homeless families is, at least in during July and August 2020.
Research suggests that increasing a person’s sense of choice and control terms of the recognition of housing as
improves their outcomes5 and that services are less effective when they
are “done to people”.
a human right, more ‘housing led’ than • Analysis of quantitative and
Instead, a housing-led system treats people experiencing homelessness the response to single households, qualitative data contained in the
as adults and citizens. since there is a consensus that getting 86 Strengths-based Needs
The service is Seeing the person as a survivor, as an individual, as a person, rather than a a family into their own stable home Assessments collected and shared
based on people’s problem to be managed, and recognising that everyone has strengths. as quickly as possible should be with us by Oxfordshire councils
strengths, goals In a housing-led approach, we move from assessments which focus on the priority. However, the response with those placed in emergency
and aspirations risks, needs and eligibility to more creative assessments which recognise to homeless families is often not accommodation during ‘Everyone
the strengths, resources and relationships the person brings to the
consistent with the remaining Housing In7 ’.
situation and works with them to consider how they can build on these.
First principles, e.g. promoting choice
An active Recognising that services are often ‘hard-to-reach’, and that closing
and control and offering flexible, • Stakeholder engagement to
engagement the case of a person who is experiencing homelessness, substance
approach is used use or mental health challenges because they behave in a way we find strengths-based support for as long as consider the provision of support,
challenging is often counter-productive. is needed. involving a total of 60 professionals
Instead, professionals are responsible for proactively engaging their and citizens:
clients; making the service fit the individual instead of trying to make the Although our study did not consider
individual fit the service.6 the data, lived experience, policies • a workshop including all
A harm reduction Recognising that abstinence from substance use and other potentially or practice in relation to family commissioned providers;
approach is used harmful behaviours is not desirable and/or realistic for many at this homelessness in Oxfordshire, we are • a series of 3 x 2-hour online
point in time, and that these individuals may disengage if pressured into
abstinence by professionals. aware of a recent service redesign group discussions;
Instead, workers support individuals to set their own goals and develop in Children’s Services, which aims • an online survey (collecting
their own strategies to manage risk. to improve housing solutions to qualitative views) to which a
A housing-led approach recognises the harm that comes from all forms vulnerable families. We believe that further 33 responded,
of homelessness (especially rough sleeping) and seeks to reduce this by some of the key messages from this • supplementary 'phone interviews
avoiding homelessness or by supporting a person to exit homelessness as
report can inform the Oxfordshire
quickly as possible.
authorities’ ongoing improvement
of how they prevent and respond to
5 Manning, R.M. and Greenwood, R.M. (2019). Recovery in Homelessness: The Influence of Choice and
Mastery on Physical Health, Psychiatric Symptoms, Alcohol and Drug Use, and Community Integration.
Psychiatric Rehabilitation Journal, 42(2), pp. 1-11. DOI: 10.1037/prj0000350 7 ‘Everyone In’ is the term given to the government-funded initiative to ensure all rough sleepers and those
6 Homeless Link. (2017). Housing First in England: The Principles. London: Homeless Link. [Online]. with shared air space in homelessness accommodation were given ‘safe harbour’ during the Covid-19
Available at: https://hfe.homeless.org.uk/sites/default/files/attachments/The%20Principles%20for%20 outbreak in spring 2020.
Housing%20First.pdf5 Housing-led Feasibility Study for Oxfordshire Summary Report 6
• An exercise to map and bring • A financial narrative based on 1.5 Structure of this report
together basic data about units, type running on a hypothetical scenario to A summary version of this report is also
of provision, cost, provider, referrals compare flows of homeless people available at https://www.crisis.org.uk/
and outcomes for all homelessness through the system during 2018/19 media/243746/crisis_oxfordshire_
support services commissioned with what might have happened if a report_summary.pdf
across the county (including mental different set of service configurations
health and young people’s pathways). had been in place. This full report includes the following
chapters:
• A review of Oxfordshire councils’ • Sharing and gathering feedback on
social housing allocation the emerging headlines and initial Chapter 2: in which we summarise the
policies and move-on protocols, recommendations during October. key recommendations for Oxfordshire
benchmarked nationally using CORE This included:
data, national research findings and Chapter 3: in which we give an overview
review of a selection of policies from • Producing a high level summary of the current provision of housing-
other authorities. document and circulating this for related support to single households
comments from the Countywide facing homelessness across the county;
• Review of relevant documents and a Homelessness Steering Group;
series of interviews and meetings to Chapter 4: in which we present the case
understand issues and opportunities • Presentations and discussions for changing the system, based on the
in relation to housing supply. at: Providers’ Forum; Lived lived experience research findings, overall
Experience Advisory Forum; system performance, and wider evidence
• A review of housing data (including a session on Workforce about the costs of homelessness to
social rented/affordable lettings, Transformation held by the public services.
Local Housing Allowance (LHA) rates, County Council; Oxford’s
analysis of house sale prices). Housing & Homelessness group Chapter 5: in which we consider people’s
meeting; a webinar hosted by experiences and aspirations in relation
• Review of prevention activities Oxfordshire Homelessness to accessing housing, and present the
undertaken by each district/city Forum; a short radio interview findings of our review of Oxfordshire’s
council, analysis of H-CLIC and other for JACKfm Oxfordshire; Mental social housing allocations and a summary
outcome, research and audit data Health Housing, Care and of the key opportunities and risks to
relevant to prevention; desk-based Support project commissioning bolstering housing options.
benchmarking with other authorities workstream; and an additional
nationally to identify best practice. session with commissioned Chapter 6: in which consider what ‘good
providers following the Providers’ support’ looks like, from the perspectives
• Alignment with health, social care Forum. of people receiving it, professionals and
and safeguarding: interviews/ research evidence.
meetings with public health, We recognise a few limitations in our
Oxfordshire Clinical Commissioning engagement. Regrettably, we were Chapter 7: in which we present our vision
Group, Oxford Health, Vale Adult not able within the time and resources for a housing-led approach, looking both
Social care, and substance use of the study and given the impact of at the prevention of and the response to
services and a review of relevant Covid-19, to engage: homelessness.
local research and strategies. Chapter 8: in which we discuss in
• Elected members; more detail how Oxfordshire might
• Action learning from Everyone transition to a housing-led approach and
In and rapid rehousing: attending • Colleagues from the criminal justice the recommended next steps for the
meetings, working closely with local system; and authorities and their partners.
authorities, interviews or group
sessions with each council to capture • People with lived experience of Appendix 1: Provision of existing housing
action learning, structured sessions homelessness outside of Oxford support services
to record action learning from city (though the analysis of forms
Crisis’ work to support Strengths- completed during Everyone In Appendix 2: Glossary
based Needs Assessment and triage mitigated this to a degree).
processes. Appendix 3: Financial narrative7 Housing-led Feasibility Study for Oxfordshire Summary Report 8
2. Summary of Housing supply
Develop a countywide strategy to
increase the supply of a range of
affordable housing options for single
• Introducing effective systems to
monitor exclusions from the register,
and any nominations refused by
Registered Providers;
recommendations
homeless households across the
county. We have highlighted some of • Using this data to review allocations
the opportunities and risks in section policies and nominations
5.4. As part of this strategy: agreements;
• Promote more consistent access • Working with social landlords to
to and sustainment of tenancies find alternatives to blanket bans to
in the Private Rented Sector for manage risk;
In a successful housing-led system: Long-term fundamental priorities this group, working in partnership
with the Social Enterprise sector • Establishing a reasonable preference
• All opportunities are maximised Prevention and the Oxfordshire Homelessness group for those with a history of/at
to prevent people from becoming Increasing investment in evidence- Movement. risk of rough sleeping; and
homeless in the first place. based prevention, underpinned by
a countywide and multi-agency • Review the designation of 1-bed • Adopting targets in the Annual
• Those who do become homeless homelessness prevention strategy. properties for older people; consider Lettings Plan for the number of
are supported into stable, ordinary within or alongside this the feasibility allocations made to those with
housing as quickly as possible, Our recommendations are detailed in of creating a scheme of long-term additional support needs.
recognising that the longer a person section 7.1 and include: but ‘own front door’ supported
is without a home, the more negative housing for those whose needs Shorter-term practical actions
the impacts for both the individual • Encouraging a consistent tenancy are currently not well-met by either
and society. sustainment offer from social homelessness or adult social care Governance
landlords, and looking at whether services. Effective countywide and multi-
• Those with more complex needs and how tenancy sustainment might agency governance to oversee
who have experienced or are at be extended to private rented sector • Work with housing and support the transition and to ensure a
risk of long term homelessness and their landlords. providers to roll out and develop a whole system approach, linking
and housing instability are actively consistent and high fidelity model for example to the Primary Care
engaged through multi-agency • Better use of data, underpinned of Housing First across the county Networks, work to promote financial
casework, including, for some, a by effective data-sharing protocols, (see section 3.2). inclusion, neighbourhood community
Housing First approach. Agencies to proactively target individuals, development and the Development
work together to minimise the maintain higher levels of contact, • Bring together and explore ways to Plan.
numbers of people who drop out of and evaluate outcomes. scale up and/or replicate the wide
the system. range of options and activities to In section 9.8, we recommend:
• Sustained or ideally increased promote housing supply within the
• Support is provided to those who investment by councils to keep community, faith and voluntary • A senior and multi-agency
need it in a flexible, person-centred people in their homes where safe sectors. Homelessness Reduction Board – or
and strengths-based way, regardless and possible to do so, e.g. through similar model - operating at county-
of where they are currently living. mediation with landlords, financial • Ensure that the housing-led level to drive this forward.
assistance, housing advice and approach informs the countywide
• All those working in the relevant community navigators: this is likely programme of housing and spatial • Strong project management to
services recognise the impact of to become even more important as a development. ensure that actions are followed
trauma on individuals and recognise result of the pandemic. through.
that maximising choice and control is Housing allocations
key to recovery. • Linking the current countywide Reducing the additional barriers to Re-thinking commissioning
floating support contract more accessing social housing faced by In order to transition to a housing-led
• Data and feedback from people with clearly to Housing Options those in acute housing need especially system, it will be necessary to replace
lived experience is used to monitor prevention activity and outcomes. those who have additional support a significant proportion of congregate
and improve the performance of the needs. Our recommendations are with dispersed supported housing.
whole system. • Using the existing Homelessness detailed in Section 5.3 and include: As discussed in section 9, to achieve
Champions Network as an asset this in a positive way which builds
from which to build a countywide on existing assets and relationships
prevention strategy. between commissioners and providers9 Housing-led Feasibility Study for Oxfordshire Summary Report 10
locally, it will be important to:
• Engage in dialogue with providers
and involve with providers and
• Develop a new countywide
Assessment Hub model to
coordinate the By Name List
approach and provide an accessible
3. The current
the involvement of people with
lived experience and community
providers;
and inclusive gateway into services
for those who are homeless. We
describe this in more detail in section
provision of
housing-related
7.2.4.
• Move away from a competitive,
traditional contracts model, to an • Review data collection in relation
alliance-style model, where a range to single homelessness, setting
support to those
of providers are incentivised to up countywide systems which
work together and are collectively can support the By Name list, and
accountable for results; strategic information to inform
continuous improvement, through
experiencing
• Build into the contract the required a set of whole-system performance
transition to a housing-led model indicators. Gather feedback regularly
and the flexibility to review and adapt from people with lived experience as
regularly, and ensuring the contract well as quantitative data. We describe
or at risk of
is long enough to enable this; this in more detail in section 9.7.
• Develop performance management Workforce
which focuses on the quality of Workforce development will be key
service users’ experience; case
management via the By Name
List; and ‘whole system indicators’
(such as successful referrals to
to creating and sustaining a culture of
positive risk, giving back choice and
control to individuals, and supporting
them to exit homelessness. This
homelessness in
support, managed moves rather
than evictions, moves to settled
accommodation)
needs to include strengths-based,
trauma- and psychologically-informed
approaches and should be informed
by lived experience.
Oxfordshire
• Strategically align the adults’, young
people’s and mental health pathways, We propose an initial skills matrix
so all are operating consistently for further development in section Understanding the existing resources There are separately commissioned
within housing-led principles 9.6, and recommend that each is a necessary first step to system ‘pathways’ for mental health, young
commissioned provider be required to re-design. Our countywide mapping people, and adult homelessness. Each
System-wide case management train staff to this level, and participate identified a considerable amount of pathway and authority is collecting
This is core recommendation if people in communities of practice to share activity – both commissioned by the slightly different data under different
are to be supported into, and within, a and further develop good practice. councils and delivered independently categories, so there is no consistent
stable housing solution, and in order by charities, social enterprises and faith approach to understanding the
to reduce the current high level of groups - to both prevent and respond scale of the problem. Provision
‘dropout’ from the system. It will be to homelessness across Oxfordshire. is ever-changing, with additional
important to: We sought to gather data on as much capacity being added/services being
of this provision as possible. This decommissioned or re-designed
• Develop effective multi-agency exercise was complex because: in some way, generally in response
case management throughout the to either cuts or short-term central
system, with Personal Housing • The two-tier authority structure, government, a point to which we
Plans at the prevention stage, and combined with additional layers of return in the next chapter. Even within
the By Name List approach to case services commissioned a) jointly this, 2020 has been highly atypical,
management for those experiencing by the districts and b) with Rough with the pandemic forcing changes
homelessness. We describe this Sleeper Initiative funding, makes it and closures to existing and planned
approach in more detail in section challenging – but also particularly services, and giving rise to new funding
7.2.3. important - to understand the whole, streams from central government.
countywide picture.11 Housing-led Feasibility Study for Oxfordshire Summary Report 12
Overview of service provision in experiencing homelessness;
Oxfordshire The Service Landscape
• Four street outreach services (one of
The mapping activity identified: which is run by the Police);
Preventing Responding to
Resettlement
• Over 1110 units or bed spaces of • Two exemplar tenancy sustainment homelessness homelessness
what might best be described as services, offered by Oxford City
‘transitional’ supported housing8 Council (as landlord) and Soha
across Oxfordshire, targeted at adults housing association • Housing Advice • Street outreach • Access to PRS
and young people experiencing Housing
homelessness and/or mental health • A number of services offering • Resilience building • Emergency housing
challenges. This includes a number additional (or ‘floating’) support, • Housing First
of hostels, including a large hostel including Aspire’s countywide • Tenancy sustainment • Supported housing
in the centre of Oxford with more Community Navigators and • Resettlement
than 50 beds, and many shared Connection Support who offer • Day services support
house projects (especially in the mental health support services as
mental health pathway). Just 8% of part of the Oxfordshire Mental Health
‘units’ involve floating support i.e. Partnership as well as more general There is clearly a lot of positive work This is not unusual and can be a
support which could be provided housing support. across the county, and there are natural reaction to high levels of
independently of housing. many assets to build on. However, homelessness; however, a key
• Health also fund a number of this is hampered by a high level of message of this report is that a move
• Several ‘Housing First’ pilots and relevant initiatives, including the silo-based working – geographically, to a housing-led approach will require
projects, offering up to 30 tenancies Luther Street Medical Practice, between agencies, and even within a more coherent focus on both
in total at the time of writing, with offering primary health services to larger organisations – and by a lack preventing and supporting single
more planned. We discuss these in those experiencing homelessness of consistent data collection against people out of homelessness and into
more detail in section 3.2. in the centre of Oxford; two short- which outcomes and progress can be stable housing.
term step-down houses (for those monitored across the whole system.
• A number of schemes to support who are homeless on discharge from There has been a lot of incremental The adult homeless pathway is a
access to the private rented sector, general or psychiatric hospitals) and development of provision across partnership between the county
run both by councils and by charities; embedded housing workers. the county to in response to central council, city council, district councils
government funding programmes. and the Clinical Commissioning Group
• A range of daytime services offering • Oxfordshire Homelessness But until now, there does not appear to jointly fund 140 units of supported
food and both practical and Movement is a countywide to have been a meaningful attempt to housing, for those with a connection
emotional support; partnership of public, private and look at the entire system. to an Oxfordshire council. Around half
charitable organisations with the of these units are in hostels, with the
• Prior to Covid-19, a number of vision that nobody should have to 3.1. Transitional supported housing remainder in smaller shared settings or
initiatives to provide emergency sleep rough on our streets. The There is considerable activity in with floating support.
accommodation, mostly during movement aims to coordinate efforts Oxfordshire to prevent people
winter months; across sector and to supplement becoming homeless. However, far Although the pooling of budgets
statutory provision in a strategic way, greater focus and investment goes into across the county in this way is a
• Housing Advice services, for example responding to those with responding to homelessness, usually positive step, there appears to be an
commissioned by all the district No Recourse to Public Funds. through the default of transitional emerging consensus that change is
councils and provided by Shelter, supported housing (a hostel or other needed within this pathway. Issues
CAB and the Wantage Advice Centre; The different types of service provision congregate setting) In 2018/19, there highlighted through our engagement
are summarised in the following were 1420 placements in supported included: the concentration of
• At least 18 services which provide diagram; key terms are defined in the housing of people who would pathway provision in a large hostel in
assistance around income glossary (Appendix 2), and further otherwise be homeless9 across the Oxford city and the impact of this on
maximisation, debt management, detail about the current provision county (830 of whom were already the movement of people experiencing
education, employment, skills of each of these types of service is living in supported housing at the start homelessness away from their local
development, mental health; supplied in Appendix 1. It should be of the year). areas; and challenges for providers
substance use, family mediation, or noted that not all of these services and commissioners operating a
countering social isolation, with a are available across the county, for
particular focus on those at risk of or example street outreach. 9 For the purposes of the research, we have included 75% of the placements and people in the mental
health pathway; there is clearly significant (though not complete) overlap between the mental health and
homelessness pathway. This is based on data from Oxfordshire mental health services estimating that 75% of
8 Johns, M. and Longlands, S. (2020). At a Crossroads: The Future of Transitional Supported Housing. those coming through their pathway are at risk of homelessness/ would otherwise be homeless.
London: IPPR North. [Online]. Available at: https://www.ippr.org/files/2020-10/supported-housing-oct20.pdf13 Housing-led Feasibility Study for Oxfordshire Summary Report 14
number of different contracts for the In the mental health pathway in One of the limitations of the 3.2. Housing First
same project. Moreover, the pathway particular, there appears to be a lack congregate model is that trying to Housing First is emerging across
operates on a very traditional ‘staircase’ of diversity, with all provision being in support multiple individuals within Oxfordshire – at the time of writing,
model10: people are required to remain shared houses. the same building requires rules and there were 5 schemes offering
in the pathway for at least 6 months to eligibility criteria in order to manage somewhere between 25 and 30
prove tenancy readiness before they The following chart shows the type risk. As one professional in a focus tenancies in total, but with more in
can apply for assistance to move-on11. of housing-related support being group explained: development. As with many early
As one professional attending a focus commissioned in each pathway. or new Housing First services,
group commented: ‘Supported housing other’ includes “Lots of supported housing projects these deliver promising indications;
supported housing commissioned will only take people who meet however, when viewed strategically
“Why are we designing services by city and districts outside of the certain criteria ‘we can’t find the they are piecemeal. Moreover,
which we know people will fail in, adult homelessness pathway, and right kind of person for the house’” because of the way in which they are
because of the inevitably chaotic the supported housing projects we commissioned, many offer insecure
and messy nature of change and identified which are run by charities, A housing-led model hinges on being or short term funding, time limited
recovery?” faith groups or social enterprises and able to provide flexible support for as support (connected to funding) or are
do not receive any council funding long as is needed, separate to housing, available only to those already within
As the following chart shows, much for support. The numbers behind this and at scale. By ‘separate to housing’, the supported housing pathway: all
of the commissioned support is chart are included in the table below. we mean that the tenancy should of which jeopardise fidelity with the
effectively ‘tied’ to either congregate See Appendix 1 for further definitions not come to an end just because the model and risk its dilution.
(e.g. hostel or shared house) settings. and explanations. support is no longer needed, offered
or wanted, because in this instance, As these early pilots mature, it would
there is a need for further move-on, be helpful to have an overarching
with all the disruption, delay and need strategy for Housing First, informed
Types of units/bedspaces identified by service type
for further support which this incurs. by a community of practice and
people with experience of receiving a
Supported housing other “A lot of our supported housing Housing First service. Harnessing the
projects are time-limited (e.g. 6-9 experiences and learning from these
months) – this is strict and process- disparate services will build capacity,
Mental Health Pathway (MHP) laden – it’s often not long enough” and ensure that this expensive and
specialist intervention is focused in the
(Professional, in focus group) right places, and consistently delivers
Adult Homeless Pathway (AHP) the outcomes we have come to expect
Whilst there is undoubtedly a role to from this model.
be played in the system for supported
0 50 100 150 200 250 300 350 400 450 500 550
Hostel/Cluster housing as a package this should be
Units/bedspaces
Shared flat/house a much smaller and specialist part
of the system, including for example
Floating support to individuals refuges, therapeutic communities, or
tenancy-based models for those with
long term care and support needs.
To move to a housing-led system,
Service category Hostel/ Shared Floating Type not
it will be important to re-configure
Cluster flat/ support to noted
commissioned support, so that
house individuals
more of it can be offered flexibly and
Adult homeless pathway (AHP) 70 20 50 0
separately to housing, in a range of
Mental health pathway (MHP) 0 486 0 0 tenures and settings.
Supported housing other 138 125 15 0
TOTAL 208 631 65 0 “We need to develop a process
which really takes into account
strengths, needs and preferences
rather than lumping everyone
10 Johnsen, S. and Teixeira, L. (2010). Staircases, Elevators and Cycles of Change: ‘Housing First’ and other
together – understanding what
Housing Models for Homeless People with Complex Support Needs. London: Crisis UK/ University of York. people are good at, what they are
[Online]. Available at: https://www.crisis.org.uk/media/20498/staircases_elevators_and_cycles_of_change_ interested in, where they want to be
es2010.pdf.
and with whom”.
11 Oxfordshire Adult Homeless Pathway Common Operational Document15 Housing-led Feasibility Study for Oxfordshire Summary Report 16
3.3. Estimated current spending
What is Housing First?
overlap with single homelessness of
For the purposes of our modelling, approximately £2.5M.
we have tried to estimate total spend
Housing First is a well-established model, must have a private, safe, secure place to on single homelessness services Apart from the investment by mental
which aims to support people facing multiple live before they can engage with support across the county. This raises huge health in housing support, this does
and complex issues out of homelessness, for services to address other needs they may challenges in relation to what should not include health and substance use
good. The model is supported by a substantial have. The model therefore seeks to remove be included and what should not. services commissioned specifically for
international evidence base; for example, 85% the conditionality or the barriers to accessing We have not, for example, included this cohort.
of those housed in the Pathways to Housing a tenancy as a first step to making recovery local authority staff costs to manage
project in the US sustained their tenancies possible. At present, the allocation policies in and oversee the statutory system This would bring total spend to
over a 5 year period; evaluation of the French Oxfordshire act as a barrier to this happening and the commissioning of services. somewhere in the region of £12M per
Un Chez Soi d'abord also found 85% tenancy – as we discuss in more detail in Chapter 5. Furthermore, the budgets come annum across the county. This does
sustainment after 2 years12. There are two from different sources, including not include additional government
fundamental aspects of the model, both of The support local authorities, central government, funding prompted by Covid-19.
which differ significantly from our typical Supporting a person to find an ordinary housing associations and charities.
service response to this cohort of people: the property where they want to and can live The different funding streams are
housing and the support. might be a necessary first step, but clearly this linked to different contracts, statutory
alone will not be sufficient where a person frameworks and priorities, and driven
The housing has long-standing multiple challenges with by different timescales and decision-
In the current ’staircase model’ operating substances, mental health, etc. Without the making processes.
in Oxfordshire, this acts as a barrier for many right level of support, the individual – and
with complex needs, for whom hostel settings their neighbours – could be set up to fail. The Countywide Homelessness
can be very stressful. Some find it difficult Coordinator undertook an exercise
to conform to the rules, so they either avoid In the current homelessness system in to estimate total spending across
‘the system’ or experience multiple evictions Oxfordshire, floating support services are the county on single homelessness
from projects, getting stuck in what is often available but these are not suitable for a services. This produced a total of
described as a ‘revolving door’. person who has high and complex needs, £6.5M annually across Oxfordshire
since they are time-limited (typically up to in 2018/19, with further annual
Housing First was developed as an 6 months’ support, albeit with a degree of spending on the young person’s
alternative to the ‘staircase model’ in flexibility around the end-point); and workers pathway, of £2.5M.
which people need to demonstrate their support a significant number of individuals at
‘tenancy readiness’ by staying successfully any given time. This does not seem to include some
in hostel or shared accommodation for a of the wider services identified in our
period of time and engaging with support to In contrast, Housing First recognises that a housing support mapping exercise,
change behaviours such as substance use person with long-standing multiple issues is such as the city and districts’ access to
before they are considered for a permanent likely to need support that is highly flexible, private rented sector services, tenancy
tenancy. Housing First was developed out does not come with a time limit, can be more sustainment, housing advice contracts,
of recognition that many of those with long intensive and holistic, and with the continuity or the use of Discretionary Housing
term experiences of homelessness, mental of relationship which is key to building trust. A Payments (DHP) for homelessness
health challenges and substance use have Housing First support offer is not time-limited prevention. We estimate there may be
experienced significant trauma in their lives and the worker typically supports between 5 around an additional £0.5M of funding
– often as both cause and effect of their and 7 active cases at any one time. Perhaps countywide on these further activities,
homelessness. For example, the vast majority the greatest challenge in implementing though this is a very rough estimate,
of women in this cohort have experienced a high fidelity Housing First model, is the since it is hard to work out exactly
domestic and/or sexual violence. For many, shift towards support which promotes self- what was included and what was not,
the use of substances has become a way determination, and places people back in and we do not have costings for some
of dealing with past trauma and with the control of their own lives. of these services.
extremely stressful experience of being
homeless, including rough sleeping. Housing Spending on the mental health
First is based on the premise that a person pathway in 2018/19, was
approximately £3.3M. mental health
commissioners estimated that 75% of
12 For more details, see Downie, M., Gousy, H., Basran, J., Jacob, R., Rowe, S., Hancock, C., Albanese, F., Pritchard, R.,
those in the mental health pathway
Nightingale, K. and Davies, T. (2018). Everybody In: How to end homelessness in Great Britain. London: Crisis UK. [Online].
Available at: https://www.crisis.org.uk/ending-homelessness/the-plan-to-end-homelessness-full-version/solutions/chapter- would otherwise be homeless,
9-the-role-of-housing-first-in-ending-homelessness/ so we will assume that there is an17 Housing-led Feasibility Study for Oxfordshire Summary Report 18
4. The case
4.2. How is the homelessness system impedes this.
across Oxfordshire performing?
In order to explore this question, People already ‘in or known to the
we constructed a model and system’
for change
populated it with data from the official 280 long-term rough sleepers, already
Homelessness Case Level Collection known to the system
(H-CLIC) returns to central government 830 people already staying in
from each of the Oxfordshire councils, supported accommodation at the start
supplemented with data from councils of the year16
and providers. Given the huge
operational challenges for services People who enter the system
resulting from the pandemic, some 1370 who first present at an early
gaps in data remain. It should also be stage17, as being at risk of homeless18
noted that the modelling was also 560 who first present to the council
4.1. The traumatised system of adaptation and even innovation in done using 2018-19 data (since the full and are accepted under the prevention
The national context for this study is the face of this challenging context, we set for 2019-20 was not available at the duty19
ever more inconsistent and uncertain also described a ‘traumatised’ system time). 280 who first present to the council
financing of revenue costs for in which everyone is trying to do ‘more and are accepted under the relief duty20
housing-related support, a decline with less’, with results that can be re- This is a limitation; however, even 260 newly identified rough sleepers
in dedicated budgets, and very deep traumatising for those we are trying to if more recent data had been used, (of whom 26 are known to have come
expenditure cuts from 2008 onwards13. help. 2020-21 will almost certainly generate from out-of-county)
These cuts have taken place against a a very different set of figures, given 660 people referred directly to
backdrop of wider funding reductions; Our study in Oxfordshire recognises the impact of Covid-19. More supported accommodation (with a
other changes to mental health, this context, whilst arguing that what detail regarding the methodology further 125 referred through Housing
addiction, social care, criminal justice, is needed is a bold re-focusing of used for this modelling exercise, a Options or Street Outreach teams); 590
and alongside rising demand for social efforts and resources on ending commentary on its results and a copy actually moved in.
and affordable housing outstripping homelessness, rather than simply of the spreadsheet are found on the
supply and the introduction of welfare managing, containing and fire- report website. Headline findings are Outcomes
reform. The last decade has seen more fighting. There are substantial assets presented here: 1530 people (around 36% of the total
demand for homelessness services, to support this across the county ‘at risk’ group) are known to have
including from increasing numbers of – not least, a highly energised and People coming into contact with the achieved a successful outcome from
people with high and complex needs, confident community sector, as homelessness system their contact with the system. In other
alongside spikes in rough sleeping14. demonstrated during Everyone In. According to the data, just under 4200 words, the data suggests that they have
The government response has been However, transformation will require single households came into contact either avoided or effectively exited
to provide short-term, competitively bold yet dispersed leadership, opening with the homelessness system across homelessness, by either retaining,
accessed and prescriptive funding, up honest dialogue about what is Oxfordshire in 2018-19. This includes securing alternative, or moving on
focused on reducing rough sleeping. working, what is not working and both those already ‘in’ the system from supported accommodation into,
what needs to happen to improve and those who joined it at different stable housing. We have also included
Our research earlier this year with outcomes. This needs to capitalise on stages over the course of the year. the small number who have been
University of York15 for Riverside the human assets across the county We have rounded all the figures to successfully reconnected with another
Housing Group explored the impact of and enable providers to develop reflect the incompleteness of the data, local authority.
these changes in government policy new solutions, with a co-ordinated and made some allowances to avoid
over the last decade on local authority approach to ending homelessness. double-counting, though the inability
commissioning of homelessness of current systems to track individuals
services. Although we found evidence
16 This includes the Young People’s and all Adults’ homelessness services, and we have also included 75%
of the placements in the Mental Health pathway: there is considerable, but not total overlap between the
13 Jarrett, T. (2012). The Supporting People Programme: Research Paper. House of Commons Library. Mental Health and Homelessness systems, so we have worked with colleagues in mental health services to
12/40. London: The Stationery Office. [Online]. Available at: https://commonslibrary.parliament.uk/research- estimate that around 75% of those in mental health services would otherwise be homeless.
briefings/rp12-40/ and Oakley, M. and Bovill Rose, C. (2020). Local authority spending on homelessness 2020 17 Under the Prevention Duty of the Homelessness Reduction Act, housing authorities are required to
update. London: St. Mungo’s / Homeless Link. [Online]. Available at: https://www.mungos.org/publication/ assist those who are threatened with homelessness within the next 56 days. By ‘early stage’, we refer to those
local-authority-spending-on-homelessness-2020-update/ who present ahead of the 56 days.
14 Fitzpatrick, S., Pawson, H., Bramley, G., Wood, J., Watts, B., Stephens, M. and Blenkinsopp, J. (2019). The 18 This will be an under-estimate, as clients of the Tenancy Sustainment and Floating Support services –
homelessness monitor: England 2019. London: Crisis UK. [Online]. Available at: who did not come via Housing Options are not included in this figure.
15 Blood, I., Pleace, N., Alden, S. and Dulson, S. (2020). ‘A Traumatised System’: Research into the 19 It should, however, be noted that the approach to recording prevention cases varies across the
commissioning of homeless services in the last 10 years. Liverpool: The Riverside Group Limited. [Online]. Oxfordshire authorities.
Available at: http://eprints.whiterose.ac.uk/165214/1/A_Traumatised_System_FULL_REPORT_v8_webFINAL. 20 Note that the actual total of relief duty acceptances is 430, since 60 of which were previously accepted
pdf under the Prevention Duty; and 90 of which were rough sleepers19 Housing-led Feasibility Study for Oxfordshire Summary Report 20
Successful outcomes 2018/2019 Total homeless or "at risk"
Stable alternative move-on Reconnected successfully 1,110 3,090
from supported housing with another LA already in system newly present
189 9 R.S. or S.H.
1,050 1,620 1,240
Stable alternative Home sustained at Lose Remain in system Avoid
housing at relief stage pre-prevention stage contact (R.S. or S.H.) homelessness
94 528
Stable alternative housing Home sustained at
at prevention stage prevention stage 290
671 41 Exit homelessness
N.B.
In the system means either in supported housing or a known rough sleeper
EXIT / avoid homelessness refers moving into or retaining stable accommodation
A quarter of the total group (1050) The following chart shows where these
– lose contact with the system. individuals drop out of the system.
Many of these will make their own Note that an unsuccessful referral to 4.3. Lived experiences of the Others struggled to prove their identity:
arrangements, some suitable and supported housing means that the homelessness system
sustainable, but many probably not. person was either not accepted by or The lived experience research was “They don’t want to see me unless
It is likely that a significant number refused supported housing or did not conducted with people who were out I have photo ID. Where am I *******
of this group will go on to ‘sofa-surf’, present at the project to which they on the streets of Oxford (many, but getting photo ID from, so you know
live as a ‘concealed household’, squat were referred. not all of whom were rough sleeping) what I mean?”
or sleep rough ‘off radar’. Although it during July and August. The findings
was not possible to quantify or match The remainder of the total ‘at risk’ from this strand of the study gives Rough sleepers need to be ‘verified’
individuals to their statutory records, population remain within the system, further insight into how some of this in order to receive an adult homeless
many of the individuals we interviewed either staying in, mostly short-term, cohort experience the system and why pathway placement. One person
through the street-based peer supported housing placements, or they either drop out of it, or avoid it described substantial delays within this
research. living on the streets. altogether. process:
Many people described barriers linked “I’ve been there ‘n that and I’ve been
People who lost contact with the system 2018/2019
to eligibility. Not having a local area waiting. It took ‘em 4 months, yeah,
People evicted connection was a common barrier; to verify me, to find where I was
Pre-prevention
from/abandoning and those who had previously been staying, yeah...Now they have, they
cases not resolved
told they did not have a connection still aren’t putting me on the list”.
supported housing 287
tended not to bother with the council.
82
One woman explained that she had Some people told us that they tried
been staying on her boyfriend’s sofa to avoid outreach services, because
Referrals to Prevention duty (with periods of rough sleeping during they did not want to be woken up or
supported housing cases closed arguments) on and off for a decade: otherwise disturbed. Although some
not successful without resolution praised individual workers, some had
327 133 “this was a couple of years ago lost trust in the overall approach:
[when I last went to the council].
Basically, I don’t have a local “The way street services, they go
Relief duty cases closed connection to the area and I along, they find out where you
without resolution don’t have a local connection to live then they tell the owner of the
222 anywhere, even though I’ve been land where you’re living and then
here like 20 odd years, so…” basically get you evicted from there.
That’s what they do though”.You can also read
