Alcohol and Housing: Policy Overview Yvonne Maxwell. Housing Learning and Improvement Network. Is the national network for promoting new ideas and supporting change in the delivery of housing , care and support services for older and vulnerable people. Part of a wider DH Care Networks .
Alcohol and Housing:Policy OverviewYvonne Maxwell
Is the national network for promoting new ideas and supporting change in the delivery of housing , care and support services for older and vulnerable people.
Part of a wider DH Care Networks .
Part of the Putting People First Team.
A focus on 18-24 binge drinkers and harmful drinkers.
Working together to promote sensible drinking.
Long term goal : “To minimise the health harms, violence and antisocial behaviour associated with alcohol , while ensuring that people are able to enjoy alcohol safely and responsibly”
More help for people who want to drink less.
Public Information campaigns to promote a new sensible drinking culture.
Local alcohol strategies.
Why do alcohol services and supported housing need to work together?
People who live in supported housing or receive floating support may also have an alcohol problem.
This includes people with mental health problems, older people, physical disabilities and learning disabilities.
Strategies, access to services and information campaigns will need to address how to reach and engage them.
Housing and support can help with this. They need to be involved and informed and ways to reach people developed.
Some groups may get missed such as older people or those with a learning disability. Different approaches will need to be developed.
Cross Government Strategy lead by CLG.
A focus on preventing rough sleeping , moving away from reactive to proactive and preventive services
Partnerships at both national and local level, between Government Departments and locally with community groups , health and local authorities and homelessness agencies.
Sustainable outcomes and a focus on building people’s skills to maintain tenancies, address underlying issues that have contributed to their homelessness such as mental health, substance and alcohol misuse and routes into training and employment .
Improving the health of rough sleepers and their access to services
User involvement and empowerment, including using individual budgets
There are 15 actions points under 4 chapter headings :
Right help, right place, right time
Making it happen
The Strategy identifies that many rough sleepers have problems with alcohol. For example a survey in London found :
“Roughly 87% of people contacted by outreach teams are male and many have problems relating to drugs (41%), alcohol(49%) and mental health (35%) with around a quarter having a combination of these problems. People who have been in prison or the care system are overrepresented”
There is a commitment in the Strategy to work with the Alcohol Network.
Action 3 “We will extend positive activities that motivate and empower people to take greater control in their lives.”Action 4 “We will promote and enable opportunities for homeless people to break out of worklessness.”
“For many people getting off the streets into a hostel, or even getting their own flat, will not necessarily deal with underlying problems. Anxiety, depression, low self-esteem, self-harm or challenging behaviour, often exacerbated by misuse of alcohol and drugs, means that people can feel stuck in a life that is damaging to themselves and others.”
ACTION 5 “We will further improve access to health and social care services for people with multiple needs who are sleeping rough or in hostels.”
Among people who sleep rough or who have moved into hostels is a group of individuals with severe, complex and multiple health and social care needs. The nature of these needs and the competing priorities of survival on the streets can mean that, without specialist or targeted help, they often do not access health and social care services at all .
Some homelessness agencies report that it can be difficult for people with multiple needs to access services including registration with local primary care services or treatment for alcohol dependency or mental health problems. Better co-ordination of statutory and non-statutory services is needed as well as this group being part of the assessment of need and commissioning process.
In some areas promising approaches have been developed such as joint outreach between outreach workers and drugs/nurses/mental health workers and the piloting of ‘wet’ drop in sessions. These are staffed by several agencies who engage with clients who may be excluded from other drop-ins and services due to consistent alcohol use.
“Ensuring the engagement of particularly vulnerable and hard to reach to reach groups , those with complex medical and social care needs and those experiencing exclusion will be one of the significant challenges of Joint Strategic Needs Assessment (JSNA). Their involvement is important , since they are more likely to suffer from poor health and wellbeing and from inequalities, and their engagement with JSNA will best shape services to meet their needs . Third sector and local user-led organisations often have considerable experience in identifying need within these groups.”
Guidance on JSNA
There will be ongoing work around the development of the JSNA process and CLG.
‘Putting People First’: A shared vision and commitment to the transformation of adult social care…through personalisation, prevention and early intervention
signed by 6 Government Departments, the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS)
Supporting people to live in their own home for longer
Concentration on safeguarding adults
Universal information, advice and advocacy service
Common assessment processes – more self-assessment
Telecare as integral not marginal
Self directed support as the mainstream – personal budgets for all, direct payments for more people
Greater role for voluntary sector and user led organisations
Not a prescriptive policy document – there is no detailed roadmap
There are many things to decide locally to ensure that personalisation works for us
Doesn’t say we’re doing a bad job – this is about building on what we do well already and extending choices to those using our services
Under Self-Directed Support...
The process by which state provided services can be adapted to suit users
Support that is determined and controlled by users, based on an assessment of need by the state. (Includes receiving cash, spending on services that meet user needs, to choosing which hospital you wish to attend)
Self directed support
Like an IB but solely made up of social care funding
An indicative amount of money that can combine several funding sources that users can use to purchase services, from the public, private or voluntary sector
A cash payment paid directly to users so they can acquire their own services, rather than having them delivered by the council
A block contract service which is flexible, person-centred and tailored to meet each person’s needs → →
through to →
→ → direct payment of an Individual Budget for person to purchase what they choose (could be either an IB held by the Council or a direct payment to client or an IB held by a provider-but the service user has a key say over how it is to be spent)
Personalisation affects many other public services – housing, education, health.
Darzi review confirmed personal budgets in Health.
Grew out of small movement in Learning Disabilities, scope is continually growing…
Impacts on the wider customer experience
Early Intervention & Prevention
Support available to assist people who may need a little more help, their carers and supporters at an early stage to stay independent for as long as possible, such as to:
Choice and Control
Self directed support, e.g.
How society works to make sure everyone has the
opportunity to be part of a community, such as:
Authorities are spending more on services for people with alcohol problems (£18.5m in 06/07 to £19.5m in 07/08)
Services support around 3,500 people with alcohol problems and deliver positive outcomes. In 2007/08:
1,500 able to better manage physical health
1,100 able to better manage mental health
1,650 maintained accommodation and avoided eviction
670 accessed desired training and education
Removal of the ringfence on Supporting People funding from April 2009 provides opportunities to develop innovative ways to support vulnerable groups
CLG is developing a local toolkit which will provide evidence at a local level on the financial benefits of investing in housing-related support (to be available in Summer of 2009)
Characteristics of people with alcohol problems in support services
Previous accommodation Move-on accommodation
27% general needs- 40% general needs
16% rough sleeping- 13% private sector/ownership
12% family/friends- 11% supported housing
12% supported housing- 9% family/friends
Service type accessedHighest needs
44% floating support- managing substance misuse
36% supported housing- maintaining accommodation
15% direct access hostel- greater choice/control/involvement
Highest achievement of needs
- maximising income
- access to services
- greater choice/control/involvement
- minimising harm from others
Housing Info - www.networks.csip.org.uk/housing
Yvonne Maxwell , Social Inclusion and Equalities Project Manager [email protected]