Rough sleepers who drink are often caught in a cycle they can’t escape: they are not accepted into hostels because of their alcohol misuse – or if they are, their behaviour soon has them evicted – but by being left on the streets they have no support to help them manage their drinking.
The English Churches Housing Group’s Centenary House Project in Derby was a 31-bed homeless hostel that, like most, didn’t accept clients who drank. But this changed when it opened the six-bed Wet Unit as an additional facility to the main hostel at the beginning of 2005.
The challenge was to provide accommodation that would also allow rough sleepers to drink so that they could feel settled and gradually take up support services, reduce the amount of alcohol they drank, regain their health and develop life skills such as planning meals and tidying their rooms with a view to living more independently.
Research with Derby Council and Derby University on what services this client group would want led ECHG to put forward a bid to the Office of the Deputy Prime Minister to provide the service – which it won, and the service has become a pilot for the city. Funding was used to redesign the accommodation to provide a separate unit with a communal lounge to deter drinking in private, a garden for day use and a kitchen area to encourage healthy eating.
Reg Smith, ECHG supported housing manager for Derbyshire, says: “We had to retrain staff to work with these clients. Most of our client group were heroin users. Some staff were concerned about violence from drinkers, but they have caused fewer problems than other clients in the hostel.”
Two dedicated staff work closely with the Wet Unit residents to help them reduce their drinking to a manageable level. The staff had to learn ways of working with clients who were vulnerable but often drunk. And they had to accept clients’ active addiction but be able to work with them to improve their situation. The emphasis at the unit is very much on reduction rather than abstinence: “We are talking about entrenched drinkers who aren’t going to change their drinking habits,” says Smith.
Some of the younger residents may aim to give up and go on to detox and rehabilitation, but most will not reach that stage. Instead, the aim is to get them into a routine. “Just to get them to come in, have two meals a day, and sleep in the same bed every night is an achievement,” he says.
They are also able to use education and training facilities at the unit if they want.
A combination of years of rough sleeping and heavy drinking with no access to health services have taken their toll and staff at the Wet Unit have found that many residents are seriously ill. Once living at the unit they are all registered with a GP – none were previously – and common diagnoses are cirrhosis of the liver, kidney problems, and long-term mental health problems.
One benefit of the unit’s work, says Smith, is that staff have been able to put residents in touch with the families they haven’t spoken to in years.
The unit has housed 17 residents since opening, and of these, four have moved on to more independent living. Of the first six residents, three still live at the unit.
“Some will stay a long time, others may never reach the stage of independence, because of their age and may have to go to residential or nursing homes,” says Smith.
But for those who do progress onto the next stage of living more independently, ECHG has secured more funding to build move-on flats. And by allowing residents to carry on drinking, the unit has reduced rough sleeping in the city by half, as well as reducing associated antisocial behaviour. Many of the residents had previously been in court on antisocial behaviour orders, but since they have been living in the unit none have been arrested by the police.
The prize money from winning the Community Care drugs and alcohol award will be used for research into the scope for a street outreach worker.
Smith says: “The Wet Unit shows that these drinkers don’t want to live on the streets and that you can work with them.”