Housing First is the most important innovation in tackling homelessness of the last few decades. It is proven to end homelessness for around 80 per cent of people with high support needs.
The Housing First model prioritises getting people quickly into stable homes. From this point, any other support needs they might have – such as alcohol and drug dependency, physical and/or mental health problems – are addressed through coordinated and intensive support.
Central to the concept of Housing First is that permanent housing is provided without a test of having to be ‘housing ready’. Furthermore, maintaining the tenancy is not dependent on the tenant using support services.
Housing First is built upon the principle that housing is a human right. It focuses on first giving someone immediate access to a settled and secure home. This is placed above goals such as sobriety or abstinence. The model is specifically tailored for homeless people with complex and multiple needs. It is designed to provide choice and control – it gives rights and responsibilities back to people who may have been repeatedly excluded.
The success of the model depends on wider reforms. These clearly involve people having access to stable and affordable housing. But it also depends on offering them a wide range of services which can offer timely personalised support and in the format they choose.
This chapter sets out the evidence of international and British Housing First successes. It also features results of a new study by Imogen Blood and Associates. This looked at the requirements for implementing Housing First at scale across England, Scotland and Wales.
The study estimates the numbers of people who can and should be offered this solution to their homelessness. There are at least 18,376 homeless people with complex and multiple needs across Great Britain who can and should benefit from Housing First.
Lessons from abroad
Overwhelming evidence highlights the effectiveness of Housing First. This evidence shows how it helps people with complex needs sustain permanent accommodation and also supports them to resolve or improve the other non-housing problems they face. The volume of evidence far exceeds that of any other intervention. It includes a mix of large-scale Randomised Control Trials (RCTs) and smaller studies.
Housing First has particularly high housing retention rates, ranging between 60-90 per cent – typically around 80 per cent. Strong evidence shows how it helps resolve or improves non-housing issues, particularly regarding reductions in offending and improved mental health. Housing First has not been shown to produce the same results regarding physical health, though there is no reason to suggest these outcomes are any worse than in traditional approaches.
Housing First was developed in the US by the organisation Pathways to Housing, and is now being delivered across the world. Perhaps the most striking example of its success is in Finland, where Housing First is part of a wider strategy to end homelessness. Here, it has reduced rough sleeping to very low numbers, and reduced all forms of homelessness to a ‘functional zero’.
Key to such large scale implementation of Housing First is the role of the Finnish national housing association, the Y-Foundation. This organisation specifically focuses on providing housing to people who have experienced homelessness. Between 2008 and 2015, approximately 3,500 new dwellings were built for people experiencing homelessness and 350 new social work professionals were employed to work specifically with them. According to FEANTSA, the European Federation of National Organisations working with the Homeless, Finland is the only European Union (EU) country where homelessness continues to decrease.
Denmark’s national Homelessness Strategy from 2009- 2013 introduced one of the first large-scale Housing First programmes in Europe. It housed more than 1,000 people and featured housing retention rates of between 74 per cent and 95 per cent.
There is further evidence of high levels of housing retention across Europe, North America and Australia. For example, in Canada the RCT study into the two-year Chez Soi programme found that Housing First participants spent 73 per cent of their time stably housed over the evaluation period. This is compared to 32 per cent of those receiving Treatment as Usual in the Canadian homelessness system. Similarly, two published studies on the Street to Home project in Australia show that after one year 95 per cent of clients sustained housing in Brisbane. Eighty per cent had been housed for one year or longer in Melbourne.
The high tenancy sustainment rates of international Housing First projects make the case for extending Housing First across Great Britain.
Table 9: Housing First: housing solutions
Threshold Housing First project
Threshold is a housing advice and support charity, part of the Jigsaw Group. Threshold Housing Project has been delivering a high-fidelity Housing First Service for women offenders with complex needs since 2015.
The pilot was originally set up to support 12 women. It has subsequently received funding for a further three years. The project works specifically with persistent and prolific female offenders who have a history of homelessness in three local authority areas in Greater Manchester. These are: Tameside; Stockport and Oldham. Between April 2015 to April 2018, 39 women used the Threshold Housing First service.
By April 2018:
A recent evaluation by the University of York noted that Threshold represented: “the first significant attempt to develop a specialist form of Housing First, targeted at homeless women who had a history of offending”.
“Women who were in sustained contact with Threshold Housing First appeared to show a marked reduction in convictions and offending behavior, compared to the patterns of convictions they reported prior to engaging with the service.
Statutory agencies spoke about how the service was providing ‘protective factors’ via stable accommodation and getting people out of abusive situations, and addressing other ‘criminogenic’ risk factors related to reoffending (such as addressing financial problems).
The research indicates that there is a case for exploring variants of the Housing First model which are specifically focused on homeless women with complex needs.
There is a case for Threshold Housing First to be integrated into the strategic response to homelessness across GMCA, where it has the potential to play a preventative role, deliver relief from homelessness at a crisis point and provide sustainable exits from homelessness for women with high and complex needs”.
Threshold’s work helps fulfil the ‘Transforming Justice and Rehabilitation’ work-strand of the Greater Manchester Combined Authorities Public Sector Reform programme. Within Threshold’s Housing First Model it has become apparent that treating women as ‘victims’ of trauma delivered better results than treating them as perpetrators of high levels of offending.
Turning Point Scotland – Glasgow Housing First project
This was the first Housing First project in the UK. It was developed to help people in Glasgow with substance misuse problems that were repeatedly becoming homeless. The project was evaluated in 2013, after three years supporting 22 people. The project has grown in scale since then, but at this stage of evaluation was described as below.
The Housing First project included six members of staff – three were peer support workers with histories of homelessness. Support plans were developed on a client-centred basis; assertive outreach and motivational techniques were employed.
Most participants were male, aged between 25 and 44. Almost all had experienced repeat homelessness and time in institutional care. This included prison, rehabilitation facilities, hospital and/or psychiatric wards.
Last year the Homeless Link Annual Review of Single Homelessness Support in England found that 42 per cent of homelessness accommodation projects had turned people away because their needs were too complex. Fifty nine per cent said they had turned people away because their needs were too high and 71 per cent had turned someone away because they were deemed to be too high risk.
We also commissioned a Housing First feasibility study in the Liverpool City Region. Here we found that the current hostel-based model, in this context, often does not work well for homeless people with complex needs.
This is because of a number of reasons, including living in an environment that is challenging because of other residents’ addictions or other complex issues. Some people also find it difficult to comply with the rules and conditions of hostels. They can find the lack of stability and security of short stay hostel placements distressing. They may also suffer if there is limited mental health, substance misuse and psychological support available.
The study found that people with complex needs are at high risk of frequent evictions from hostels, they may get stuck within the hostel system, or reject services altogether. Nearly one in three of those people with the highest needs were not receiving or accepting any accommodation placement.
In 2017, the homelessness charity Groundswell conducted a peer-led research project for the Hammersmith and Fulham Commission on Rough Sleeping. They interviewed 108 people with experience of sleeping rough in the borough.
This was approximately half of the total number sleeping rough. Of the 108 interviewees, only two people stated that they wanted to live in a homeless hostel. In two separate focus groups, participants agreed they would prefer to be in prison than in a hostel. Resistance to moving into hostels was common. Corroborating extensive qualitative evidence collected in the UK, 35 participants explained that the chaotic environment, poor quality accommodation and limited opportunities for moving on were key deterrents. Drawing on the evidence provided, the report concluded that the use of Housing First should be expanded.
These findings are reflected in the views expressed by people with experience of homelessness in the consultation we carried out to inform this plan. Participants strongly felt that more suitable accommodation for vulnerable groups was needed. They expressed concern that hostels and accommodation without support could create an unsafe environment and cause people to leave their accommodation because it feels ‘safer on the street’.
“People with different needs all end up in the same place –offenders, drug and alcohol users and people who are not. It is unsafe, chaotic, people get robbed, bullied – especially if they are vulnerable with special needs, young, not street wise).” (Consulation participant, Leicester)
This evidence comes at a time when investment in homelessness accommodation is declining. Last year, 39 per cent of homeless accommodation projects in England reported a decline in their funding from the previous year.
Aside from Housing Benefit contributions, funding for homelessness accommodation at a local level comes from housing-related support (formerly known as Supporting People). While spending specifically on homelessness has increased (by 13%) since 2010, reflecting the priority given to this area by government, overall spending on housing dropped by 46 per cent in real terms, with an even larger cutback (67%) in the Supporting People programme. Consequently, homelessness accommodation projects are providing services to an increasing number of people with less money for support and staff time. The Welsh Government’s proposal, to merge Supporting People with a wider series of non-housing grants and remove longer-term certainty about the funding level presents a similar risk, and is an area of major concern to the sector.
In Scotland, all eligible homeless people have a right to rehousing. However, rough sleeping, and other entrenched forms of homelessness, remain for people who face multiple exclusion. This demonstrates that for people with high support needs simply getting them into mainstream accommodation is not enough. They need the support package provided by Housing First to end their homelessness.
In Wales, last year (2017) there were 1,233 households legally defined as homeless, but for whom the local authority was unable to resolve their homelessness. Furthermore, rough sleeping continues to rise, indicating the gap in provision for those people often facing the higher levels of need.
Despite strong evidence of Housing First success in ending homelessness for people with higher levels of support needs, there are only a few and relatively new projects in Great Britain. A recent Homeless Link report found that there are only 32 known Housing First projects operating in England. While comparable data on the number of schemes operating in Scotland and Wales is not available, we know that the number of projects are limited.
Most of these projects in England operate on a very small scale (26 of the active services can support 350 people between them at any given time). Two thirds are local authority funded. Most of these projects are funded on very short commissioning cycles of two to three years. This provides very little certainty regarding the provision of long-term support.
It could be argued that the current funding and commissioning context undermines the need for flexible and open-ended support, one of the key principles of Housing First. Similarly, the piloting of Housing First is not really Housing First in its truest sense. This is because the notion of a pilot project undermines one of its key principles: that housing and support should be provided for as long as the participant needs it.
Housing First has been gathering strong political backing across England, Scotland and Wales. Ahead of the 2017 General Election, commitments to expand the use of Housing First were pledged by the Conservatives, Labour and the Liberal Democrats. This demonstrates the extremely strong, cross-party support for the policy. Following the General Election, the Westminster Government committed £28 million in the 2017 autumn budget 2017 to pilot Housing First in Greater Manchester, the Liverpool City Region, and the West Midlands.
In light of the increasing numbers of rough sleepers, interest is growing in developing an alternative approach to tackling homelessness for people with the highest support needs. The Housing (Wales) Act (2014) provides an important focus on prevention activity. However, it does not make suitable provision for people who are already homeless and not necessarily in priority need.
The Welsh Government now funds ten pilot projects to test the impact of different approaches of delivering Housing First. The government has recently endorsed the use of Housing First to tackle longer-term rough sleeping, particularly for people unwilling or unable to live in hostels or other shared living situations. Housing First received significant coverage in the recent Welsh Assembly’s Equality, Local Government and Communities Committee inquiry into Rough Sleeping.
A highly effective Housing First project has operated in Anglesey since 2012. This is commissioned by the Isle of Anglesey County Council and run by the Welsh homelessness charity, the Wallich. Of the 119 Housing First recipients supported between April 2012 and August 2017: 78 per cent are still in accommodation; 43 per cent are in the original accommodation where the support was provided.
The first Housing First project established in the UK was developed by Turning Point Scotland in 2010. As in Wales and England, momentum has gathered to extend Housing First over the last couple of years.
More recently, the Homelessness and Rough Sleeping Action Group in Scotland recommended that housing-led approaches should be the default option for people experiencing homelessness.
Housing-led approaches focus on rapidly rehousing people into settled accommodation as quickly as possible. An accommodation package is accompanied by a package of lower intensity support than Housing First. This support is often time-limited, unlike Housing First which is open-ended. They also recommend that where the person has more complex needs the offer should be Housing First. The Scottish Government has accepted this principle. An implementation framework will be published in June 2018 to help all 32 local authorities develop, cost and schedule a local ‘Rapid Rehousing Transition Plan’ by December 2018.
These local plans will set out how to ensure all households spend less time in temporary accommodation. Housing First will be the default for households with more complex support needs. Local plans will also set out how they intend to integrate existing Housing First initiatives and their capacity planning for future need at a local level. The Scottish Government is also developing a national Housing First programme, which has been given considerable momentum and £3 million of funding by Social Bite.
The role of Housing First
Housing First is clearly a highly effective homelessness intervention that can powerfully change the lives of people with complex and multiple needs. Extending the provision of Housing First would, over time, also change the way homelessness services are delivered across Great Britain.
The introduction of Housing First does not mean replacement of the hostel and supported housing system; but it does allow us to reconsider the role and scope of hostels in reducing homelessness. Immediate reductions of supported accommodation would only increase rough sleeping. But Housing First, alongside a housing-led approach, presents a critical opportunity to help free up emergency accommodation for its stated purpose – short-term emergencies.
Specialist supported housing for homeless people needing extremely high levels of long-term medical support will also still be required. It is important to distinguish this level of support from traditional homelessness services, as it requires health and social care expertise, and must be inspected by the independent regulator of health and social care in each nation.
The implementation of Housing First at scale, also requires careful transition planning to ensure there are no gaps in service for homeless people. The Liverpool City Region feasibility study identified that to successfully switch to the Housing First model, a two-year period of double funding is needed. This is to ensure the continuation of existing provision and the successful adoption of Housing First and other housing-led solutions. The length of time required to switch to Housing First will vary across regions and nations depending on existing homelessness services offered.
What should Housing First look like?
Model of support
Housing First works effectively when a high-fidelity model is applied. A report from Homeless Link, examining evidence on the scale of Housing First in England, found that adherence – ‘fidelity’ – to the Housing First model is mixed. Some projects drift away from the core philosophy and provide a more housing-led approach accompanied by floating support. Participants in the extensive consultation we undertook to inform our plan also emphasised the importance of ensuring that projects remained faithful to the Housing First principles.
The Housing First Europe Hub also provides a useful guide on how the principles can be adapted to the context of each country. Homeless Link’s Housing First England project is developing and supporting a national movement of Housing First services across England. To help expand Housing First, the project has devised a key set of principles. These are to ensure that projects meet a high fidelity test and work most effectively to end homelessness for people with the highest level of support needs.
Similarly, the Welsh Government has published national principles and guidance for Housing First in Wales. Cymorth Cymru has established a Housing First Network for Wales, to support the delivery of high-fidelity Housing First in Wales. The Housing First Scotland partnership also aims to clearly define the guiding principles for Housing First in Scotland. The Imogen Blood study explored what these principles should look like across Great Britain.
Targeting Housing First – defining the people who need it
Housing First is for homeless people who have complex needs. As outlined above, the evidence shows that there are extremely strong housing sustainment rates for this group. Defining Housing First participants They are people who:
Calculating the numbers
Four sources were used to estimate and then cross tabulate the potential size of homeless populations with complex or many needs. A full explanation of the methodology is contained in the published report from Imogen Blood.
High Estimate: 32,261
Low Estimate: 18,376
High estimate – The total homeless population estimate from The Lankelly Chase commissioned Hard Edges study, undertaken by Heriot- Watt University was 186,012 people in 2010/11. It was then reduced to the numbers who had experienced substance misuse, offending behaviour, and known mental health problems. This totalled 23,751 people (12.8 per cent of the total homeless estimate).
The Joseph Rowntree Foundation destitution research was then used to provide estimates of the proportions of people with complex needs in each nation.
The Crisis Heriot-Watt core homelessness research then provided a multiplier of the data set between 2011 and 2016, producing new totals for each country in Britain. This added up to 35,844.
Applying the assumption that ten per cent of this population would not be able or not want to take up the Housing First offer, produced the final high estimate of 32,261 people. This group of people would still require a long-term supported accommodation option.
Low estimate – The same methodology as above. This is apart from the initial overall 2011 estimate of 119,900 people taken from the first core homelessness report.
We then applied the 12.8 per cent figure calculated in the previous set of calculations to this figure to produce a total of 15,310 people. This estimated the size of the homeless complex needs population in Great Britain in 2011.
Applying the same multiplier to uplift this to 2016 levels for each nation produced a total number of people of 20,417, reduced by ten per cent as above. This produced a final low estimate of 18,376 people.
Based on these definitions, our estimates of the current population who might benefit from Housing First in England, Scotland and Wales (aggregated) are as follows.
For the purposes of this report, and to align with the core homelessness estimates throughout, the low estimate for a potential cohort of Housing First is suggested as a starting point.
This addresses the backlog of need. Going forward, the use of Housing First as a preventative approach will require additional housing units to be procured and funded.
Strategic leadership from national government has been central to the successful implementation of Housing First in a number of international examples. And Housing First, where integrated within a wider homelessness strategy, has been extremely effective in reducing the overall number of people experiencing homelessness.
In many of these contexts, Housing First has driven the need for broader policy change relating to homelessness. This includes providing affordable and accessible housing, a robust welfare safety net, a stronger prevention agenda and housing-led solutions for people with lower support needs. A similar approach will be critical to rolling out Housing First successfully across Great Britain.
As outlined above, there is now strong political commitment from the Westminster, Scottish and Welsh Governments to deliver more Housing First to reduce homelessness. The following sections outlines suggested actions to ensure that these commitments for each government are realised.
A national director for Housing First
Strategic oversight of Housing First in each nation is necessary. This should ensure the successful delivery across different geographies and that the overall programme is successful in its fidelity, housing targets, evaluation etc. Given the need for co-ordination across government departments in each nation, this role would provide leadership and focus to those efforts. This is a highly recommended approach and has recently been adopted in Ireland, as part of the Rebuilding Ireland strategy.
National and local targets for the delivery of Housing First projects
Overall targets for the delivery of Housing First, should be set and monitored by a national director, and then fall to local authorities. As set out in Chapters 7 ‘Rapid rehousing’ and 11 ‘Housing solutions’, they should align with local strategies that identify the housing and support targets for rough sleepers and other homeless groups and national targets for the supply and accessibility of affordable homes for people with experience of homelessness. Identifying the people eligible for Housing First within this is crucial and will guide the commissioning of ICM support teams, and accessing the requisite accommodation. In Scotland, these targets should be identified as part of the new Rapid Rehousing Transition Plans.
Help deliver the housing supply needed for Housing First tenancies
To fulfil the additional housing requirements needed to scale up Housing First (and other housing-led approaches), new and bold measures are required to acquire additional accommodation. This accommodation should be both in social housing and the private rented market. A lack of affordable, accessible housing stock is frequently cited as one of the key challenges in extending Housing First across Great Britain.
Any target for numbers of homeless people accessing Housing First, must bring with it a corresponding target for housing units. Finland’s Housing First success has all-but eradicated rough sleeping, and led to the decommissioning of hostels and night shelters. It has done this, in part by building new housing stock and setting targets for local areas to do so.
The Finnish Government has played a direct role in increasing the supply of new housing stock specifically earmarked for Housing First tenancies. In Finland, housing is principally provided by the Y-Foundation. This is a housing association specifically for people who have experienced homelessness.
Finland’s Slot Machine Association has provided 50 per cent grants for purchasing flats from the general housing market. The Y-Foundation has also received funding from the Housing Finance and Development Centre (ARA) to help build new housing. ARA sets regional targets for affordable house building. It also provides state guarantee and interest subsidies for building social housing and investment subsidies for improving housing conditions for groups with special needs. This includes people who have experienced homelessness. Between 2008 and 2015, approximately 3,500 new dwellings were built for people experiencing homelessness and 350 new social work professionals were employed to work specifically with them. Key to such large-scale implementation of Housing First is the national partnership of state authorities, local authorities and NGOs. The role the Finnish national housing association, the Y-Foundation, is crucial.
Similarly, the Australian Government has committed $10 billion to invest in social housing as part of a broader package of spending and policy reforms. These are set out in the National Affordable Housing Agreement to tackle homelessness and include the expansion of Housing First.
Chapter 11 sets out a range of solutions that national governments should implement to increase the supply of affordable and accessible housing. Implementing these solutions will significantly increase housing options for homeless people. They are critical to the successful implementation of Housing First.
It is, however, necessary to allocate a proportion of housing units in the social rented sector for use in Housing First projects. This is to ensure sufficient access to properties as quickly as rough sleepers and others can be offered them. It is also to ensure a dispersed stock across different cities, and local areas.
Collect and publish data on the fidelity and outcomes of Housing First projects
A shared outcomes and fidelity framework for the three nations is critical. The framework will provide a consistent way of collecting and sharing information and measuring success. Outcomes should relate to housing sustainment rates, health and wellbeing, and reductions in criminal activity and anti-social behaviour. It should be noted that a framework will also be needed to collect information on the adherence to the principles of Housing First. Rigid outcome-only measures rarely account for the ‘distance travelled’ by an individual. This can often lead to the ‘parking’ of people who require greater and more specialist levels of support.
Statutory provision of housing and support
As set out in Chapter 8 ‘Ending rough sleeping’, a complete statutory safety net is needed to deal with all circumstances of homelessness and household types to ensure access to long-term rehousing.
In England and Wales, housing and support services for single homeless people are largely provided outside the statutory system. While both England and Wales have introduced prevention and relief duties that apply regardless of household type, local authorities have no duty to provide people with settled housing unless homeless people are deemed a ‘priority’. This is even if people have very high and complex needs.
Unlike other forms of social care support provided by local authorities there has been no statutory protection for the support services provided to single homeless people. These include hostels, day centres and floating support. It is essential that statutory protections are provided for both housing and support, so that the Housing First model can remain true to its principles.
Universal statutory duty to provide housing.
The priority need criteria must be abolished in England and Wales. Scotland has already abolished priority need. Scrapping priority need is an important step to ensuring a statutory guarantee of settled housing for people who are made a Housing First offer.
Universal statutory duty to provide support to people who have experienced homelessness.
In addition to abolishing priority need, the support element of Housing First must also be protected as part of the statutory system. This is through a new ‘duty to support’, applicable via legislation in England and Wales. Scotland already applies such a duty.
Wider reforms necessary for the successful implementation of Housing First
Housing register eligibility.
In England, The Localism Act (2011) gave councils the power to exclude groups of people designated as nonqualifying from housing registers. Between 2012 and 2017, council housing registers lost 700,000 people. The use of exclusion categories, based on historic rent arrears, a history of anti-social behaviour, local connection, or a previous offending history, have introduced an element of conditionality to eligibility criteria.
Evidence from Wales illustrates the parallels between homelessness intentionality decisions and the exclusion of households from housing registers.
An examination of Housing First projects in England by Homeless Link found that this was one of the biggest barriers for projects trying to set up tenancies. It is highly likely that people most needing Housing First are also likely to have historic rent arrears, a history of anti-social behaviour or a previous offending history. The Westminster Government should revise national allocations guidance to ensure homeless people are not excluded from registering for social housing.
Many local authorities have expressed concerns that a growing proportion of homeless nominees are not being accepted for rehousing by housing associations on affordability grounds. Evidence from all three nations shows that affordability tests and inflexible requirements of some councils and housing providers are having a negative impact on homeless people and restricting their access to social housing. These can include requiring the first month’s rent in advance or repayment of historic rent arrears.
The circumstances that led to someone’s homelessness can mean they will not have savings to cover the upfront costs of rent in advance. The Scottish, Welsh and Westminster Governments should develop and share best practice for councils and housing providers on using pre-tenancy assessments, including affordability/financial capability assessments.
Exemptions from the Shared Accommodation Rate.
In the private rented sector, the lower rate of benefit for the Shared Accommodation Rate (SAR) is problematic for younger homeless people with a Housing First offer. Because Housing First requires intensive support to be offered within someone’s home, shared accommodation is not appropriate to their needs because of the confidentiality and privacy issues involved.
Over 25s who have lived in homeless hostels for at least three months and accepted rehabilitation or support services before moving to the private rented sector are already exempt from the SAR. This is because it was felt this group would benefit much more from living in independent tenancies.
It would make sense for a similar exemption to apply to those moving into Housing First, whether they have come directly from the streets or from a hostel. This should apply to all under 35s.
The wider benefits system must support a flexible, person-centred approach given the high success rates that can be achieved using Housing First.
Research shows that homeless people are twice as likely to be sanctioned as the general population. This is despite homeless people usually being unable to comply with conditionality requirements, rather than not wanting to comply.
Homeless people with more complex needs including mental ill health, dependency issues and poor literacy are also more likely to be sanctioned than homeless people without these vulnerabilities. This is problematic, as a Housing First offer is likely to be the most appropriate response to their homelessness.
The application of conditionality is likely to undermine any serious and targeted response to homelessness for people with very complex needs. Benefit conditionality should be automatically suspended for all homeless people that are made a Housing First offer. This will prevent a risk of return to homelessness and rough sleeping. For more information on sanctioning and its impact on homelessness see Chapter 10 ‘Making welfare work’.
Exempt Housing First participants from the benefit cap.
If Housing First tenants are exempted from the benefit cap, Housing First becomes possible and sustainable in the private rented sector. This particularly applies to areas of high-cost housing. It will also mitigate the risk of rough sleeping for those made a Housing First offer. This is because it takes away any pressure of having to manage a gap between Housing Benefit and their rent, particularly given that this group is highly unlikely to be able to gain an exemption from the cap by entering work for a minimum of 16 hours per week.
Investment in personalised budgets for people with complex needs.
The ‘what works to end rough sleeping’ review, commissioned by Crisis and carried out by Cardiff University and Heriot-Watt University, highlighted the key role that personalised budgets should play in delivering a person-centred approach. This is particularly for people who have slept rough for longer periods of time and have higher support needs.
As detailed in Chapter 8 ‘Ending rough sleeping’, this approach must be taken to scale and appropriately funded, alongside assertive outreach teams, to successfully apply Housing First. In Scotland, the Homelessness and Rough Sleeping Action Group has recommended that the Scottish Government establish a national personalised budget fund. This can be used by local teams based on reliable data on the nature and number of rough sleepers in their area.
A wider housing-led approach
As the recommendations above demonstrate, Housing First cannot be implemented as a policy in isolation. It requires much wider changes. These include: stronger prevention polices; a robust welfare safety net; the supply of affordable and accessible housing and a housing-led approach to tackle all forms of homelessness.
Chapter 7 ‘Rapid rehousing’, sets out the reforms necessary to enable a rapid rehousing approach. Both Housing First and lower intensity housing-led services should reduce the need for emergency accommodation over time, and represent a bold shift in tackling and ending homelessness.
The Imogen Blood commissioned study highlights a number of other groups experiencing homelessness who would also potentially benefit from a Housing First offer. These groups include people fleeing domestic abuse, young people and prison leavers.
The evidence showing successful outcomes for people with complex needs is very strong. But further research is needed to explore the benefits for other groups and any adaptions that need to be made to the Housing First model. For example, further research could explore whether shared Housing First tenancies would work better for some groups of young people.
The case for improving the way data is linked and shared across a range of statutory and non-statutory services is detailed in Chapter 14 ‘Homelessness data’. The ability to track people who have experienced homelessness across a range of services would be extremely useful. It could identify their support needs and whether, given their history, they would benefit from a Housing First offer.Furthermore, tracking people across a range of services would help better understand how people’s lives are improving in Housing First tenancies. This is particularly the case for nonhousing related outcomes such as changes to physical and mental health for which the evidence base is not quite as strong.