Equality of Access to Services and Actions for the Vulnerable Rehoused Homeless

Introduction

This paper is one of a suite of documents used as part of our Community Integrated Risk Management planning. A number of groups have been identified as potentially being at greater risk of fire or are potentially not accessing services such as Safe and Well visits.

There is a range of equal access cases presented which require focus and additional resources to evaluate further whether this is the case. In our CRMP public consultations, we will outline that we want to work with people in our communities to understand further any issues from their perspectives that mean we need to re-design services or access pathways. We would want to do this in partnership with communities.

As a public service focused on excellent service to our customers, we need to ensure equality of access to our services for every person in permanent, temporary residence or transit through our counties and metropolitan areas.

We know through our incident data that certain groups are more likely to have a fire, and they include people who are living with Dementia, mobility issues, and mental health issues.

There are however other groups who aren’t necessarily showing as being at higher risk of a fire, but they may not be accessing our services such as Safe and Well visits or reporting fires because of other barriers, which may be language, perceived prejudice and other societal factors.

Equality of access means actively seeking to engage these groups who may be unaware or choosing not to access services from us and other public sector providers.

We need to work to reduce fire risk and other life risks across all the people, and that needs different approaches. Within our equality of access approach, we also need to:

  • Identify all the communities and customers that comprise the Fire Rescue Service (FRS) area.
  • Consider how we improve the provision of FRS services as well as access to employment opportunities with FRS to include all our communities across a range of variables including ethnicity, disability, gender, sexual orientation, religion or belief and age.
  • Learn from and enhance good practice identified through equality monitoring.
  • Use the results of equality monitoring to mitigate any adverse impact of our services and employment processes on groups within our diverse communities.
  • Eliminate any unlawful discrimination identified through equality monitoring.
  • Promote good community relations.
  • Use appropriate engagement techniques including social marketing to inform and focus on behaviours to help customers adopt safer ways of living.

Data, academic evidence and case studies inform our people’s impact assessments. These now need refining by contributions and insights from community-based groups such as specialist charities, faith groups and associations. Fire Services equally need to consider how we look at our service provision. This paper is intended to start the conversation.

Why we need to focus on equality of access to services for homeless people returning to regular community living

From the outset, it is important to stress this paper has some urgency and our understanding is limited; the issues described have been exacerbated by Covid-19. The recent extremely high number of homeless returning to housed accommodation is unprecedented.

Historically, the numbers of homeless people rehomed year-on-year has been small, meaning there is little meaningful data on which to statistically draw from. Equality of access means actively seeking to engage these groups who may be unaware or choosing not to access services from us and other public sector providers.

Early research into the approach of rehousing by King’s College London indicates a significant proportion of previously homeless people remained vulnerable during the first few years and required long-term support to maintain a tenancy and prevent a return to homelessness.

Living independently is not easy for people and adaption takes time, indeed many find it hard to cope after several years. The research found a quarter of rehoused homeless researched were after five years struggling to look after their accommodation and manage everyday tasks and were living in dirty or squalid conditions. Many of these had mental health or substance misuse problems and had little or no experience of living alone. A few were hoarding, and parts of their accommodation had become inaccessible. For just over a third (35%) of the participants in the study, their accommodation was in serious disrepair: they were experiencing problems with damp and mould, faulty heating or wiring or damage caused by floods and leaks. People in both social housing and the private-rented sector were affected by poor living conditions.

The recent swell in numbers is not only a cause for concern in terms of support and resources but in terms of fire, reported incidents of suicide, dwelling fire and near misses, enabled us to investigate what appears to be a pattern of risk. A correlated suicide and dwelling fires in Dover are perhaps the starkest reminders of the extreme vulnerability of this group of people at this point in time.

Professional judgement and intelligence from all supporting sectors and partners passionately reinforce the need for comprehensive intervention and support as part of the delivery of this governmental objective. Those involved need to recognise the complexity of this group; little or no thought to fire safety, social, health and economic challenges and high prevalence of poor mental health, having been disassociated from regular society in some cases for extensive periods of time. There is a unanimous view by partner agencies that if measures are not taken swiftly, there soon will be so much data on lost lives, both through more fires and suicides, that would be accountable to no action being taken, or possibly taken too slowly.

For some, Covid-19 as dual diagnosis because of their mental health will not currently be supported by practitioners, due to the pandemic. Therefore, no interventions will be taking place as rough sleepers move to temporary accommodation and then on to permanent. Councils alone are struggling to provide personalised support due to encountering bureaucratic barriers to help. This includes overly onerous requests for proof of homelessness and identity, having to make an application online, and referrals from other public authorities not being accepted until crisis point. Through early intervention, it has been identified that working directly with the NHS, and third sector organisations such as Porchlight and Outreach, we can more directly identify people requiring access to our services. Furthermore, through community safety visits (safe and well) as a sector we can potentially be a conduit to signposting for mental health issues to other services.

Background

The Rough Sleeping Strategy set out a plan to halve the number of rough sleepers by 2022 and end it by 2027. However, Covid-19 has exposed the extreme vulnerability of this community and highlighted the need to expedite the government’s response. This means in many cases, planned housing delivery has not yet been met and demand has outstripped the homes available, although if presented a “validated” homeless person would be found accommodation.

It is important to stress that whilst some people’s homelessness is associated with addiction in combination with severe mental illness and other support needs, this isn’t the bulk of homelessness. For example, there are around 3,000 people living rough in England at the moment (Gov.UK, 2020) but around 93,000 households who the local authorities have found ‘homeless’ (under the terms of the homelessness laws) and provided with temporary accommodation (e.g. hotels, bed and breakfast, other forms of temporary housing) and within those 93,000 households there are around 120,000 children (Gov.UK, 2020).

Most people who are homeless aren’t really any more likely to start a fire than the general population. That said, risk stems from standards in some of the lower end of the private rented sector (which is often used to rehouse homeless people) and within some temporary accommodation. Here the issue is that the accommodation isn’t up to specification; it might contain bad wiring, lack a working smoke alarm or have other issues that make fire more likely. Furthermore, there’s less inspection of properties and accommodation than there was because of competing demands and finite resources for Environmental Health services in local authorities.

The Housing Rights Service reports that chronic entrenched homelessness, serial homelessness and at risk/circumstantial homelessness all share the vulnerabilities ranging from poor life skills and a disconnect from family and community to serious physical and mental health issues. They report the solution in all cases revolves around multi-agency support.

Likewise, vulnerability and resilience of homeless ex-servicemen shows that mental and physical health difficulties were challenges leading to homelessness in veterans (Armes et al.). So, by default, organisations and services can expect that when visiting newly-housed homeless veterans they will need to be able to sign-post for mental health support.

In both cases, the use of alcohol and drugs are a challenge to ending homelessness, so with a government determination to help keep this community housed, if we take just that one vulnerability and apply it to fire safety in the home, for example, we can again see that the newly housed homeless have unprecedented challenges.

There is a lack of daily living skills in homeless to re-housed persons in that they have often lost basic living skills through living outside of mainstream society; no longer being able to cook safely, for example (Pleake, 2019).

Lastly, the very term homeless is given to people because they are held to be ‘vulnerable’, whether through age, mental illness or ‘at risk’ due to the likelihood of drug or alcohol use, although this also includes victims of abuse or racial harassment.

If the Government is able to meet its objective, the numbers will be unprecedented. The lack of everyday living skills associated with being housed, or safety awareness (whether fire or other), along with an acceptance of such a high level of mental illness alone, necessitates focus and requires interaction between organisations to provide assistance and services to this group of people.

Pre-Covid-19, there was a Ministry of Housing plan with the LGA to eradicate homelessness over a four-year period with a £381 million spend. Covid-19 and the subsequent immediate housing of all discernible homeless people has brought this plan forward in a leap, with an immediate spend intended of £160 million to keep many of the current people housed.

In 2020, after two incidents mentioned in one town alone, including a serious house fire and suicide in the space of four weeks with re-housed homeless, organisations including KFRS, NHS, Porchlight, Emmaus and Outreach identified particular vulnerabilities in this sector that were not supported with equal access to services that potentially could have prevented both of these incidents.

The original project discussions centred around all of these organisations working towards a pilot in Dover forming an advisory/work group with the aim of ensuring that newly-housed homeless could access services and advice that could make them immediately less vulnerable, whether safe and well visits for home safety or mental health services. This approach is infinitely scalable.

Additionally, we have newly formed links with the Royal British Legion (RBLI) who are looking to support veterans with resettlement programmes and rehabilitation for Post-Traumatic Stress Disorder (PTSD). Again, we are in early discussions, but this work falls naturally in this overarching project and RBLI can actually provide additional resource to this work-stream.

Now that the high vulnerability of these people has been identified, along with mass re-housing of homeless throughout the country, it can be seen as both a necessity to act upon this intelligence promptly, but also provides an opportunity to plan and resource services together in an efficient and effective manner.

Fire and other incident risks

As mentioned, there have already been known incidents. The picture nationally needs to be understood. A serious house fire and a suicide in the space of four weeks, both involving rehoused homeless customers, is impossible to overlook.

Figures from the Office for National Statistics show that suicide is the second most common cause of death among people who are homeless in England and Wales.

Many homeless people live with mental health problems, which may have been the cause of their homelessness or as a result of it, and are among the most vulnerable individuals in the community.

Homeless veterans are also more likely to have alcohol and drug related problems, and some have been found to have PTSD. Partnership working with organisations such as the RBLI (perhaps nationally) and other charities working with homeless veterans is essential.

Mental illness and homelessness create a cycle of functional impairment that results in an inability to achieve and retain the basic skills necessary for living independently, putting people at even greater risk of fire.

The health and wellbeing of people who experience homelessness is poorer than that of the general population. They often experience the most significant health inequalities. The longer a person experiences homelessness, particularly from young adulthood, the more likely their health and wellbeing will be at risk. Co-morbidity among the longer-term homeless population is not uncommon.

Recent Office for National Statistics reports show that the mean age of death of homeless people is 32 years lower than the general population at 44 years, and even lower for homeless women, at just 42 years.

Whilst Councils have had significant success considering the demands Covid-19 has placed upon them, a shortage of affordable housing is an inevitable blocker, and it cannot be ignored that as a result, assuring the standard of housing provision will be stretched to its limits. The charity Shelter has already raised concerns over the use of private rentals, highlighting conditions in the private rented sector are often poor, with 35% of the sector currently classed as ‘non-decent’. Poor housing conditions, particularly those that may cause a fire, such as poor wiring, are obvious concerns to us a sector.

Using Kent FRS (KFRS) rehoused homeless initiative as an example, it has provided basic fire safety advice and signposting to other services to ensure that as Kent’s homeless are rehoused, they are able to access services and advice that could instantly make them less vulnerable, whether this is a safe and well visit or signposting those who need it to mental health advice.

Employment opportunities

The homeless will very rarely be in employment and at least while living on the streets will not on the whole be looking for employment (the lack of fixed abode being an obvious barrier). There is potential that with re-housed homeless having access to services with a fixed address that further opportunities will arise.

There are groups and charities that support and encourage the gaining of employment, such as Emmaus. There is some opportunity for the sector to consider how we might assist such charities through our resources. Many services have developed a comprehensive coaching and mentoring programme and perhaps volunteer networks may be able to offer a wide range of life skills to share, as well as hard resources, such as being able to print a CV.

Conclusions

Before 2020 and Covid-19, data and statistics for the homeless were literally that; about the homeless, their vulnerabilities living on the streets, drug issues and their lack of public safety.

The serious fire and a suicide highlight that even with relatively low numbers of people re-housed, there is a disproportioned potential for life-risk. Thankfully, even without data, there is a wealth of professional knowledge available from the different services working with the homeless and now the re-housed homeless, who unanimously list off the vulnerabilities of this emerging sector. These include fire safety knowledge, cooking knowledge or safety and the level of mental health within this group.

There seems an obvious risk that without the intervention and services being offered, we will likely be reporting on more house fires and even suicides in the future, as currently there are no firm plans or a facilitator across our organisations. Without such a facilitator, the segmentation of the rehoused homeless will likely remain.

Services can take this role first and foremost to ensure basic fire safety, cooking safety and home safety can be provided, as we would any other vulnerable group.

Due to the mass re-housing and the current situation, the relative luxury of time has been urgently reduced. This does, however, bring in itself a risk, in that the time frame to be effective in this role is immediate. (Covid-19 restrictions permitting). These should include:

  • How we can reliably identify the addresses of the newly-housed homeless for partners to access and offer supporting mechanisms; additionally, how to identify re-housed veterans.
  • How we can resource safe and well visits in a timely manner, as a high-risk referral. There is a strong likelihood of high visit numbers being required in this newly identified vulnerable sector.
  • How Protection Teams working in partnership with Local Authority Housing Teams can ensure that accommodation used to rehouse the homeless meets regulatory compliance both under the Housing Act 2004 and the Regulatory Reform (Fire Safety) Order 2005, when applicable.
  • Consider how the different services can signpost each other effectively, being realistic that most early intervention will likely be from the Fire Sector, with a regular need to signpost for mental health support for these customers.

At the present time, the numbers within this group are relatively low. Intersectionality of identity and an understanding of the consideration of associated issues is limited, although we know many have a veteran or military background.

Starting rehoused homeless engagement initiative

Actions

The addresses of newly-housed homeless can be sketchy at best. It is incumbent on services to work with organisations such as Porchlight, Emmaus, and outreach to identify these addresses and offer services including Safe and Well visits. Fire services can also act as the conduit to share this information with the NHS and relevant Services.

If there is not a formal process in place for visiting this identified vulnerable group, Services should work with NHS, Porchlight, Emmaus, and Outreach to formalise such a process (discussion on whether the service starts the process with a safe and well visit). Additionally, a process should be agreed for sign-posting each other’s service to offer mental health support; the Community Safety App under development by Police being an integral part of sharing information.

We recognise the challenges of the immediate volume of interaction with the number of re-housed homeless. With this in mind, services may wish to pilot engagement, allowing for test on the level of resource. This is a constructive measure to support this activity.

Evaluation will be the establishment of a robust process that ensures our ability to reach newly-housed homeless people in a timely and effective way.

Creating RBLI and Armed Forces Network Champions

Actions

Work with the Armed Forces Network champions for veterans that are re-housed or homeless to:

  • Better understand how to engage with the Armed Forces Community.
  • Understand how we can support their organisation to help this group.
  • Work jointly with Homeless and Veterans, if possible, as a resource.

Develop guidance for services for conducting rehoused homeless safe and well approach

Actions

NFCC to provide services with some introductory advice to embark on rehoused homeless engagement, See the guidance.

Glossary of Terms

Statutory Homelessness – A household is considered statutorily homeless if they do not have a legal right to occupy accommodation that is accessible, physically available and which would be reasonable for the household to continue to live in, as well as households who currently have the right to occupy suitable accommodation, but that are threatened with homelessness within 56 days.

Sources/Bibliography

Gov. UK (2020) Rough Sleeping Snapshot in England Autumn 2020 available at:

https://www.gov.uk/government/statistics/rough-sleeping-snapshot-in-england-autumn2020/rough-sleeping-snapshot-in-england-autumn-2020

Gov.UK (2020) Statutory homelessness release Jul-Sept 2020 available at:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/ 957573/Statutory_homelessness_release_Jul-Sep_2020_REVISED.pdf

King’s College, London (2016) Rebuilding Lives Formerly homeless people’s experiences of independent living and their longer-term outcomes

Office of National Statistics (2020) ONS reveals the number of people dying homeless available at:

Office of National Statistics (2020) People Population and Community Deaths of homeless people in England and Wales 2013-1-2017 available at:

Contributors

This document is completed with great thanks to: Porchlight.