Case study 6
Description
This case study highlights the approach taken by Simon Community Scotland to combat the causes and effects of homelessness. It is based on a discussion with Lorraine McGrath, Chief Executive. Simon Community Scotland provides support services which include prevention of rough sleeping, advice and information, intensive outreach, emergency access, supported accommodation, life skills and development groups. It currently provides residential accommodation in seven areas in and around Glasgow. A passionate advocate of personalisation, in 2014, Simon Community Scotland led Scottish Government funded research into Self-directed Support for people experiencing homelessness in Scotland.
Contact
Simon Community Scotland, 472 Ballater Street, Glasgow, G5 0QW
T: 0141 418 6980
Engagement and inclusion
Simon Community Scotland (SCS) aims to engage with the most vulnerable people with complex needs who ‘struggle to maintain any contact with services’. They believe that it is not the responsibility of the person experiencing homelessness to adapt to services, but that the service should adapt to the individual’s needs and circumstances.
‘I don’t like the term ‘difficult to engage’. They struggle to maintain contact with us because we don’t get it right for them basically. That’s the way I like to think about it. That’s the kind of stuff that we really focus on…’
SCS also work with people with ongoing substance misuse problems, particularly alcohol. However, this is not seen as a reason for exclusion:
‘We were passionate advocates of the non-exclusion agenda… We work with people who have lifelong addiction challenges and I constantly use the analogy, that we also work with people with mental health issues, if they suffer a relapse in their mental health, do we say now you have to leave because you’re not well?’
SCS has moved away from the deficit model suggested by the term ‘non-exclusion’ towards a more positive message which has happened in other sectors:
‘If you do an Human Resources analogy, it’s the difference between absence management and attendance management that we went for. That shift had happened in Human Resources so we did the same in the Community that we’ve stopped talking about non-exclusion. We now talk about active inclusion.’
Lived experience
SCS understands the value and power of lived experience of homelessness which many of its employees have, but also importantly, is brought into the organisation by volunteers. The work of the volunteers is vital to the approach and effectiveness of SCS.
‘You come in looking for some help and advice and it should be a peer volunteer that is the first person that you talk to. They do the meet and greet and be a listening ear and if, for any reason you have to wait because the place is busy, they’ll sit with you and talk with you.’
The volunteer programme exists because of calls from people with experience of homelessness:
‘The reason that we did it in the first place is when we were developing the Rough Sleepers Vulnerable People (RSVP) model was when we talked to as many groups… I think we ended up talking to about fifty-six service users from all different settings and different age groups and gender balances and different routes into services. We talked about peer volunteers and everybody said, yeah talk to somebody who’s been there. Talk to somebody who’s not paid to be there… They’re just doing because they’ve been there and they want to help us. That was a really important message that came out…’
The volunteer role is highly valued and treated with the same respect as a paid job at SCS.
‘The recruitment process is virtually the same as it is for any member of staff. It’s just as robust and just as demanding. People do value that. They talk a lot about having got the job as a peer volunteer… It’s a serious role and the training package covers a lot of the core elements that we would give to staff as well.’
One of challenges of the volunteer programme is its turnover which is testament to its success:
‘At the moment everybody has got jobs and moved on and left us! People either got houses or jobs or moved onto other education programmes all in a few weeks which is fantastic.’
Choice
SCS recognises the importance of choice for people experiencing homelessness, especially in light of the personalisation and Self-Directed Support agendas in Scotland, the principles of which should be accessible to those experiencing homelessness.
‘Probably the one care group… the one defining group within social care that have absolutely zero choice at the moment.’
Having choice can be a positive first step for some people to get control back in their life. SCS received funding from Scottish Government to carry out research on Self-Directed Support and homelessness in 2014. When discussing choice and Self-Directed Support with people experiencing homelessness, some ‘insightful questions, insightful ideas and thoughts about what they may use the budget for’ were uncovered:
‘It still gives me tingles, stuff like people saying could I use that for rehab? Could I use that to choose the time, the place and the provider for rehab because when I’ve had to do that before I’ve said I want it and the place has not been there and then when the place has become available I’ve not been ready’. That’s hugely powerful.”
Culture
Choice is the bedrock of personalisation. SCS has a culture which has ‘a core of personalisation’ and ‘a mantra of everything that we decide as an organisation and an individual within an organisation, you should be able to draw either a direct line or a dotted line to an impact for service users. If we can’t do that we have to ask why we’re doing it…’ What helped develop this culture in its early days was ‘talking about it… triggered by the fact that we were excluding a lot of people.’
‘Talking about expectations, being really clear, seeing the person, that very individualised, very personalised context. It came from that minute you meet somebody. We wrote up an approach.’
Shifting the culture of the organisation had its challenges where ‘some of it had to be imposed and that didn’t go incredibly well in some cases.’ A culture with personalisation at the core meant that staff had to use ‘much more judgement… much more discussion and much more thinking about the person’ which at times was challenging:
‘People wanted rules. People wanted black and white. Staff wanted black and white. Gradually, as people started to see the difference it made with particular service users, some services more than others really got that and started to see the difference, particularly in people who we would have found challenging before. Just having that slightly different way of thinking about them and talking to them.’
What this personalised approach looks like in practice was highlighted using ‘two small examples of a culture shift that some staff embraced really easily and others struggled with’:
Example 1
‘A lady turned up having descended into extreme homelessness.. She’d landed on Mars from her point of view… a set of circumstances that dropped her in this position… she didn’t have an alcohol issue but what was important to her was her daily routine. Part of that routine was to have a glass of red wine with her dinner every night. The rules of the environment said she couldn’t have that so she’d been stripped of just about everything that you could possibly think of and they were going to take that final thing away from her as well… Under active inclusion when you take a step back and think how do you make this work for this person… We sat down and talked to her about that, we talked about the whys and wherefores of it. It was a quality of life issue, her identity. Staff very creatively worked out and said we think we can make this work for you but it means you can’t eat in the kitchen, you would have to eat in your room. We got a small table and chair sorted out for her in her room and she was quite happy with that.’
Example 2
‘…because the building was alcohol free, the rules were very clear and if they [the residents] were found with alcohol in the building they would have been excluded previously. What would happen is that they were coming back about nine or ten o’clock at night and just downing whatever they had… because they weren’t allowed to bring it in or stashing it somewhere in the local community and then getting up really early and having disturbed sleep as well because of the anxiety of not knowing whether or not it was going to be there in the morning for them. That was the addiction that they had. We came to an arrangement with one or two of them from a harm reduction point of view that they would come back to the building and if they had alcohol, they would hand it over and the staff would hold it. We didn’t do this for a lot of people, it was all risk assessed and very much on the balance of harm and in partnership with the addiction workers etc, so that for one woman in particular that meant that she slept a lot better because she knew it was there. She had the comfort of knowing that it was safe. The outcome of that was the level of trust she then built up with the staff and she’s much more likely to engage with us and talk to us. She was coming back less inebriated at night because she wasn’t trying to cram in as much as she could before she had to come back to the building. In the morning she was engaging with us rather than just getting out of the building to get to her supplies or get new supplies.’
Reflection
Reflection plays an important role in prompting the conversations which help support the culture. SCS staff are supported to reflect on their practice through pulling out examples, using incident reports and in supervision.
‘It is unpicking. It is always going back to the person and thinking about taking a story that didn’t go well, let’s unpick that and see. One of the things that we do is supervision models based around their values. We talk about where values are supported and personalised and creative.’
Another aspect of the conversations at SCS are around expectations:
‘We’ve started a process of expectations exchange between different levels, between myself and the immediate level below and what I expect of them, what they expect of me. We’re working on cascading that down.’
Importantly, SCS also reflects with other organisations to help pool resources, share ideas and make connections:
‘There’s a group of us together… that are the twelve specialist care and support providers for homelessness in Scotland. We come together to look at how we bring our collective resources into one place with a focus on prevention. It’s called the HP3 group… There’s no formality about it, we’ve just come together… Everybody’s out there just getting on with it and the really nice thing about homelessness is that… round the table people just give…The potential for joint working across the country is phenomenal.’
Innovation
The discussion suggested a natural evolution to the development of the SCS approach to working with people experiencing homelessness rather than a conscious innovation.
‘I don’t know if I’d use the word innovate…. it was like ‘that is just the right thing to do so we’ll do it’.