Safeguarding homelessness and rough sleeping 7 MINUTE BRIEFING

Safeguarding, homelessness and rough sleeping 7 MINUTE BRIEFING

Background This 7 minute briefing presents findings from an analysis of 14 Safeguarding Adults Reviews (SARs) in England where homelessness was a factor, and the results of a review of the literature relating to third sector and local authority policy and guidance on adult safeguarding and homelessness. The purpose of practice reviews is not to apportion blame, but to learn lessons to improve practice. In the analysis of the 14 SARs the research isolated five broad themes Please share this seven minute briefing with your multi agency colleagues

Co-operation, co-ordination and leadership Within the local authority. Some practice reviews reported the lack of a lead agency or professional to co-ordinate care of individuals who were homeless. Complex cases were sometimes referred back and forth between agencies and there was a failure to give any feedback to professionals and agencies when they requested multi-agency support. Inter-authority co-operation. Some practice reviews highlighted the lack of (and difficulty surrounding) inter-authority notifications and the necessity for active outreach when the person moved between authorities. In one practice review, there was a dispute between three local authorities as to the person’s ordinary residence, only resolved by a fourth taking up his care

Being assessed Homeless legislation. Two Reviews are critical of assessments under the legal framework for Housing: one because there was no formal assessment of the person’s vulnerability and needs; the other questioned the outcome of the assessment. Care and support needs. Some Reviews report a failure to recognize care and support needs. There was some evidence to suggest a reluctance to see the person’s needs as anything other than a housing matter. Two reviews reported a failure to make a needs assessment in the wake of a safeguarding referral, despite such needs being part of the picture. Mental capacity assessments. Concern about practitioners’ use of the Mental Capacity Act 2005 is a recurring theme, arising in relation to: points of transition (for example, as the person made an application for housing); fluctuating and executive capacity; where the person had capacity and was taking decisions considered unwise by others; and, the failure to recognize that coercion may have been in play.

Suitable accommodation provision Concern was expressed by some reviews about insufficient provision of accommodation suitable for those who had a history of mental illness and those who had an alcohol dependency. This might be a ‘wet’ hostel (alcohol permitted) or extra care housing accommodation (care can be accessed on site). There was recognition in the reviews of the economic context that might be implicated here.

Hospital discharge Two of the reviews were highly critical of the hospital discharge arrangements in their respective cases. Absence of co-ordination and care planning together with failures regarding assessment were associated in both cases with the person going to inappropriate accommodation (a homeless shelter and bed and breakfast accommodation).

Safeguarding Possible missed opportunities. These may have arisen because certain agencies (alcohol advice service; hostel staff) did not see it as part of their role to make referrals. Practitioners also reported lack of feedback on referrals that they had made. Self-neglect. This was reported in eight of the 14 reviews. Reviews described concern among practitioners about the relationship between alcohol dependency and self-neglect. In one review, three referrals for self-neglect did not give rise to a enquiry under Adult Safeguarding. In another, the review author found that practitioners did not understand that self-neglect could trigger such an enquiry.

Safeguarding Lack of ‘professional curiosity’. Some of these reviews express concern about what they call a lack of ‘professional’ or ‘concerned’ curiosity among professionals. This ranged from a lack of interest in the homeless person’s ‘story’, to a failure to see patterns in the person’s record that might have triggered a safeguarding alert. . Difficulties with engagement; normalising of risk; practitioner attitudes. Reported difficulties with engagement was common among these reviews, for a variety of reasons. Some reviews noted the danger that high levels of risk could become normalised, meaning that practitioners found it difficult to make a realistic assessment of risk over time. There was some evidence to suggest that practitioner attitudes about people with substance misuse problems might influence the way they had engaged with people.