Lack of duty acts as barrier to social care support for homeless people

The lack of social services involvement in drawing up local homelessness plans was described as “surprising” in a report from MPs last week (news, 24 November).

Alan Williams, a member of the House of Commons public accounts committee, which published the report, even went as far as to say it seemed illogical that social services were not “at the forefront” of work on the strategies.

But the lack of health and social care involvement is no surprise to providers, despite the Homelessness Act 2002 placing a duty on social services departments to co-operate with their housing colleagues in drawing up strategies.

John O’Sullivan, chief executive of Suffolk charity St John’s Housing Trust, was involved in drawing up his area’s strategy but says it was difficult to get social services to the table.

“They said they haven’t got the resources and can’t spare people to lead on this,” he says. He adds that it was even more difficult to secure the involvement of health representatives. He believes many statutory agencies, including health and social services, draw up eligibility criteria that create barriers for homeless people. “Whenever we get them to accept their responsibility it’s a big battle,” he says.

Charity Thames Reach Bondway, which provides services for homeless people in London, has benefited from health and social services support for one of its mental health projects. But business development manager Michelle Binfield says it is difficult to get them to see beyond the client groups they perceive as their responsibility.

Crucially, there is no duty on social services to co-operate with housing departments in assessing the needs of individual homeless people. Dominic Williamson, who is director of policy, practice and campaigns at the umbrella organisation Homeless Link, believes this must be introduced if the dislocation of housing and support is to end.

Binfield says a new client group, described by her project as the “young old”, is finding it very difficult to obtain social services support.

Members of the group are typically in their forties and fifties and have chronically abused alcohol for such a long time that their physical and mental condition is more like somebody in their late sixties or older.

Binfield says they suffer from dementia, incontinence and mobility problems and need the kind of physical care provided to much older people.

Thames Reach Bondway’s projects, funded by Supporting People, are not supposed to provide physical care, so an intervention by social services is crucial. But she says social services are reluctant to provide for the group because they are not actually elderly.

Even when a package of care is agreed, social services send a low-paid agency support worker, who is expecting to care for a “cheerful, nicely mannered older person”, not the challenging behaviour of a street drinker, says Binfield.

She believes the problem is because of a lack of resources in social services, a lack of understanding of homeless people, and an unwillingness to address a multiplicity of needs.

British Association of Social Workers president Ian Johnston recognises these problems but says increasing specialisation within social services may also be an issue.

If homeless people have mental health, physical health and substance misuse problems it is difficult for services to provide a holistic response and difficult to fit them neatly into the boxes social services structures have created.

Tony Hunter, Liverpool Council’s executive director of social care and housing, says that social work roles have become more targeted but that much of social services’ influence, particularly in funding other organisations, is simply less visible.

But Williamson says it is still “notoriously difficult” to get statutory agencies, such as community mental health teams, to engage with homelessness organisations.

Social services either believe homeless people do not have additional needs beyond housing or assume that those needs are being met by homelessness projects, he claims, adding: “We are still left with a legacy of a statutory framework that does not recognise support needs.” cc