Summary
Glasgow’s Homelessness Strategy covers a range of projects aimed to help those with enduring experiences of homelessness into housing, target support towards vulnerable groups, and provide services to address issues of mental and physical health.
Making A Difference
Across the breadth of the Homelessness services there are numerous examples of the difference being made, such as an 83% tenancy sustainment rate for Housing First supported tenancies. There really is too much good work to do justice in this small box – read on for many more statistics below.
People facing issues of homelessness are some of the most vulnerable in our communities. Many will have complex health and psycho-social issues with significant challenges accessing help and support to deal with these.
The onset of the Covid-19 pandemic and subsequent lockdown in March 2020 presented unprecedented circumstances with significant additional risk to our homelessness communities and the services who provide essential care and support to these communities.
Since that initial lockdown a number of hotels in Glasgow city centre and surrounding areas have been used to provide shelter for homeless individuals. The multi-agency response to the challenges in Glasgow city centre has been exceptional and demonstrates the commitment of all involved, including the hotel staff, in striving to deliver safe, effective and dynamic responses to complex situations and vulnerable individuals.
The City Centre Strategic Oversight Group was formed in July 2020 with all agencies meeting regularly to understand the current challenges and risks and agree the ongoing collective responses to effectively manage these. It is great to be able to share some examples of the work that our teams have been undertaking.
Homelessness Services
Homelessness Services ensure that people seeking assistance under homelessness legislation secure the advice, support and accommodation that they require. The onset of the Covid-19 Pandemic and the Scottish Government social distancing measures in March last year saw a radical redesign of the HSCP’s Homelessness Services.
Staff across a range of teams including; Community Homelessness Services, Prison Casework Service, Asylum & Refugee Support Team, Out of Hour Service, Emergency Temporary Accommodation Development Section and Allocations Team have worked together, and with wider partners, to ensure that they continue to meet the support and accommodation needs of people seeking assistance under homelessness legislation.
During the pandemic period the service continued to see significant levels of demand. The repurposing of a number of City Centre Hotels and the supply of 500 additional properties for use as temporary furnished flats allowed the service to successfully meet this increased demand for emergency accommodation. As the social distancing measures eased and housing associations became able to provide offers of accommodation, casework teams were able to start to rehouse homeless households into settled housing, remaining committed to ensuring that positive destinations were identified for all households accommodated within the repurposed city centre hotels.
Housing First
The Housing First Service adopted an assertive outreach approach in the hotels. In collaboration with the Housing First Consortium, and with assistance of support partners such as Aspire and Wheatley Care, they were able to engage with those referred to the service and adopt a fast track assessment. Working with Community Homelessness Teams and the Homeless Health Service they were able to identify 57 people with enduring and complex experiences of homelessness who were staying in city centre hotels that may want to consider Housing First as an option.
The service provides assessment, one to one bespoke, flexible support of approximately eight hours per week for those moving to a tenancy, and provides a starter package of basics required to set up a home and help get them moved as quickly and safely as possible. Overall tenancies for the service have an 83% tenancy sustainment rate and no evictions in two years (as of Dec 2020).
Homeless Health Services
Homeless Health Services encompass a range of services including the Homeless Addiction Team (HAT) and the Mental and Physical Health Teams, and close work with partners such as Housing First.
In response to the Covid-19 pandemic and subsequent lockdown restrictions, a Red, Amber, Green (RAG) model was implemented in partnership with the Community Homelessness Teams who undertook a risk assessment of every homeless household and individual. HAT, in conjunction with the Mental Health Team, quickly moved from an appointment based model within Hunter Street to the provision of an outreach service to their clients including those in city centre emergency accommodation.
HAT work closely with the Sexual Health and Blood Borne Virus teams who are also based at Hunter Street and they work collaboratively to deliver this outreach model. The overall impact has been significant with an additional 180 patients placed on Opioid Replacement Therapy (ORT) March and December 2020.
The Women’s Service
The Women’s Service which commenced prior to Covid-19 has continued, with its clinic base moved to an all-female site within the city centre. This location also includes the Sexual Health Service. This is provided in partnership with the Routes Out project.
Service Users can now access a dedicated facility to meet their needs with dignity and sensitivity. Feedback from service users is highly positive.
The Young Person’s Team
The Young Person’s Team was established during the pandemic and, working with closely with Homeless Casework Team, aims to engage those under 25yrs with a key focus on those under 21yrs. This has also been implemented using an outreach model.
The team was initially primarily focused on the city centre hotels, but has now developed to include other homeless and Young Person’s supported accommodations. Engagement is increasing and the team hold an exceptionally complex caseload highlighting the additional vulnerabilities of this group.
The Homeless Addiction and Mental Health Teams
The Homeless Addiction and Mental Health Teams continue to demonstrate the value in their outreach approach. Invaluable support was provided to the committed hotel and security staff who had to adapt to a complex and vulnerable client group, and provided an outstanding response and level of service in circumstances they could not have envisaged.
Practical training and support for the staff’s health and well-being was a key feature of the collaborative approach taken across all the hotel teams. Clients residing in the hotels responded well to treatment, support and advice. Outreach removed some of the barriers clients face when accessing services and they responded positively to services which were provided within the city centre hotels with significantly higher engagement, compliance with treatments and uptake of a range of support and advice. DNAs (Did Not Attend) and restart rates of OTR significantly reduced.
Overall, and in response to the efforts of all teams involved in the provision of services to this client group, there were strong indications that drug related deaths reduced amongst this particular population when compared with previous years.
Alcohol Drugs & Recovery Services (ADRS)
Alcohol Drugs & Recovery Services (ADRS) continue to play a vital role in supporting homeless clients. The city centre outreach team continued to engage fully throughout the COVID response, ensuring there was no reduction in service during this critical period. Staff continued to see people via Abbey Pharmacy as well as out on streets, and importantly in hotels where the majority of clients were then based.
They are continuing to provide a range of interventions including the supply of Naloxone, Blood Borne Virus testing, wound care, physical and mental health assessments and treatments, and ensure onward referral where required.
The Enhanced Drug Treatment Service
The Enhanced Drug Treatment Service provides heroin assisted treatment and intensive support to individuals with opiate dependency and complex needs who are at significant risk of harm.
The service was implemented in December 2019 and is the only one of its kind in Scotland. It was suspended for a short period at the start of the pandemic but retained all patients. As lockdowns eased, the team re-established heroin assisted treatment and initiated new patients into the service.
The service works closely with co-located partners such as the Homeless Addiction Team, Homeless Health GPs and Housing First, and also with Welfare Rights and third sector colleagues ensuring vulnerable clients continue to be identified and receive the range of health and social care support they require. The service is currently undergoing a two year evaluation.
Injecting Equipment Provision (IEP)
Injecting Equipment Provision (IEP) services are a vital element of the city’s harm reduction response. People who prepare and inject their drugs in public places are known to be amongst the most vulnerable and marginalised in society. The chaos that often comes with this injecting culture makes it difficult for individuals to maintain contact with Alcohol and Drug Recovery Services.
The IEP service is both confidential and nonjudgemental. The numbers of visits and equipment provided are testimony to the confidence and trust people have in the programme. As well as providing the person with needles and syringes they provide a full range of paraphernalia, including foil as an alternative to injecting. The service also provides low threshold access to wound care, naloxone, blood born virus testing and access to a range of supporting services.
The introduction of the mobile IEP van added another dimension to the service and has helped engage many harder to reach individuals. During the lockdown period the van recruited volunteers to ensure the service continued throughout this challenging period.
The IEP programme was the main driver for the biggest coordinated harm reduction drive the city has seen. The commitment and partnership working helped produce some phenomenal results over 2020, including:
- 3,518 individuals accessing the city centre IEP outlets
- 24,745 visits made
- 376,200 needles or sheets of foil provided
- 1,563 individuals supplied with life-saving Naloxone
- 711 individuals tested for blood borne viruses including HIV and Hepatitis C
The PHOENIx Team
The PHOENIx Team (Pharmacy Homeless Outreach Engagement Non-medical Independent prescribers) is a collaboration between NHS Pharmacists, the Simon Community and the Marie Trust link workers.
The team of four pharmacists and link workers provide assertive outreach daily covering venues across the city centre. They follow patients wherever it is safe to do so including: Simon Community Hub, Marie Trust, hotels and hostels, the streets, Emergency Departments and Pharmacies.
During the COVID-19 pandemic, the team adapted in order to meet the dynamic needs of the homeless community providing in-person support and services when many other services were unable to do so. The team provided a vital link between HHS, EDs, the hotels and street teams. Using technology provided by the team, clients were supported to contact or attend remote appointments and speak with other healthcare providers. They have administered naloxone to patients in hotels and on the streets, located those with suicidal intent and been able to get them safely into hospital for assessment and continue to work closely with addictions services to start or help maintain patients on prescriptions for ORT.
Patient engagement with the service and outcomes are excellent with new clinical issues identified in 69% of patients and 85% going on to attend either a followup with the Pharmacist or another referred service.
Looking Ahead
The oversight group continues to meet and the exemplar efforts of staff across all agencies continues at pace. Everyone involved recognises that the availability of settled accommodation is critical to reducing risk for our clients and ensuring safe and sustainable futures. The great news is that the number of available lets is significantly increasing.
Alongside the ongoing support to our homeless and asylum seeking communities in Glasgow the key area of focus is to ensure that each individual is offered suitable housing and the invaluable support to make that transition and thrive. Teams will continue to work together to ensure that even over the challenging winter months the number of clients supported into settled accommodation will steadily increase.
More information regarding services and access is available on the NHS website here.
