Sitra Bulletin - Issue 4 by Sitra

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 1

bulletin THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

2013 – NO.4

Bridging the Gap

Social investment

Housing support data

Housing First

HOUSING FIRST – the best approach for chronically homeless people? www.sitra.org

A solution to homelessness

A busy end to 2013

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 2

Contents 03 04

CEO’s Comment Bridging the Gap – Emergency funding Michelle Kaye and Derek Hardy share their respective council’s schemes for local emergency assistance.

Cover Story

Social investment: a report from the front Chris Senior, tells us about a ground-breaking initiative that is helping to fund move-on accommodation in the East Midlands

Revealing national housing support data Adam Knight-Markiegi reports on the national housing data for 2012-13, that Sitra has just published.

Camden Housing First Nicholas Pleace and Joanne Bretherton, from the Centre for Housing Policy at York University discuss Camden Housing First, an innovative pilot project developed by SHP and funded by Camden Council.

Housing First – the first move from homelessness

HOUSING FIRST – the best approach for chronically homeless people?

Steve Goslyn shares his experience of a study tour in three Canadian cities, examining their approach to housing homeless people with complex needs

ABCD Working in Wandsworth – The Story so far Marc Mordey explains how the Vintage Communities project in Wandsworth is working towards success.

Social Value Measurement: What’s the big deal? Emily Crawford from The SROI Network asks their members about the issue of social value measurement and what exactly is has meant for them so far.

A busy end to 2013 Geoffrey Ferres looks at what could be in store for the rest of the year if exempt accommodation issues affect you.

Sitra training

Sitra Staff Chief Executive Vic Rayner Deputy Chief Executive Lisa Harrison Practice and Policy Officers Adam Knight-Markiegi Geoffrey Ferres Mike Ballard Sue Baxter Policy and Research Co-ordinators Dani Cohen Burcu Borysik

Business Development Manager Kathleen Egan Contracts Officers Anna Robertson Wendy Green Business Support Lana Lewis Sarah Pink Helen Northover Head of Finance & Central Services Berihu Mohammed

Finance Officer Ray Naicker Finance Assistant Alison Quinn Office Co-ordinator Gill Cotton Central Support Monica Antolin Interns George Painter Roselee Malloy

If you would like to receive the bulletin in large print or in other accessible formats, email post@sitra.org

Contributors

Sitra Offices

To discuss advertising opportunities within the bulletin, please email post@sitra.org

London 3rd Floor, 55 Bondway London SW8 1SJ Telephone: 020 7793 4710 Fax: 020 7793 4715 Birmingham BVSC, 138 Digbeth, Birmingham B5 6DR Telephone: 0121 678 8891 Email: adamk@sitra.org Southampton Fairways House, Mount Pleasant Road, Southampton SO14 0QB Telephone: 023 8023 0307

Editorial To contact the editor please email danic@sitra.org

Submissions and queries If you have any comments, queries or suggestions, a letter for publication or wish to submit a news story or article please contact us via one of the methods opposite.

Health & Social Care Partnership, part of Sitra

www.hscpartnership.org.uk

02 bulletin 2013 No.4

Charity Reg No 290599 Company Reg No 1869208 ISSN 0956-6678 Sitra is partly funded by DCLG.

www.sitra.org

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 3

CEO’s Comment

Building on Strengths Summer is coming to a close, and money continues to dominate the agenda – from all angles. As I write this column, the debate about payday lenders dominates the airwaves, and Housing Associations are quantifying the numbers of their tenants – particularly young tenants who have used short-term loan schemes. The numbers are high, and the long term implications of debt and the way in which housing support providers play an important role in supporting financial independence are ever present. With this in mind, this edition provides a timely insight into how two different local authorities have taken on their new responsibilities under the localisation of the Social Fund. The two schemes highlighted show how the this local funding has been brought into the wider preventative services arena, and now makes up part of a spectrum of support offered by the authority – seeing it as “part of our local authority agenda about empowering citizens, early intervention and prevention – all core values of Supporting People.” For those interested in a full round-up of what has happened to the Social Fund in different areas, the Children’s Society produced an excellent mapping tool which can be found at http://bit.ly/14qAJ1Q

Vic Rayner Chief Executive Email: vicr@sitra.org

This issue of the Bulletin also looks at money from the other end of the lens; bringing new funds into the sector through social investment. It focuses on a ground breaking initiative by Framework to bring social investors together to fund move-on accommodation. It is essential reading for those wanting to find out more about how to approach and work with social investors. Valuable experience to build on as we think about new and creative ways to fund and promote the preventative housing support agenda. Framework notes the critical importance of data, an issue close to our heart, and this issue includes the first in a series of articles looking at our early learning from our call for National Supporting People data. Head to http://bit.ly/SP-data to explore the data in more detail – and don’t forget we are still keen to hear from those authorities whose data does not yet feature. Finally, I am really pleased to have some detailed focus on Housing First. I have been aware of the Housing First model for a number of years, and was very interested to hear more about it at a recent OECD conference. Recognising that it has much more of a presence in other countries, Sitra was keen to support an evaluation of one of the first pilots of the model in the UK, the Camden Housing First project developed by SHP and funded by Camden Council. We know there is increasing evidence that Housing First approaches are effective in Europe, the US and Canada. Important longitudinal research which explains its growing prevalence is highlighted in an article following Steve Goslyn, Threshold’s CEO, on a recent trip to Canada where they have been trialling Housing First – and he notes that the findings show it to be “a cost effective solution especially for those who are high service users as it reduced demand and cost on other public sector budgets.” About Sitra Sitra is a membership organisation championing excellence in housing, support and care. Membership benefits include discounts on all services and events, access to free advice, an annual subscription to the bulletin and regular briefings on key policy developments in the sector. Sitra works with local and central government to ensure that the needs of its members are recognised, understood and met by resource providers. If you would like to join Sitra please contact the Membership Administrator on 020 7793 4710 and ask for an application form, or download one from www.sitra.org Content ©2013 SITR (Services) Ltd except where stated, All right reserved. All images © individual photographers & illustrators. Opinions expressed by individuals writers are not necessarily those of Sitra or the magazine’s Editorial Team. E&OE. Design: Aquatint BSC 020 8947 8571 www.aquatint.co.uk

Keep up to date with our Blog

Stay in touch with us on Twitter

Keep up with developments and add to the debate at Sitra CEO’s blog at www.sitraceo.wordpress.com

THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 4

Bridging the Gap – Emergency Funding Michelle Kaye Supporting People Manager from Barnsley Borough Council and Derek Hardy, Strategic Commissioning Manager at Dorset County Council share how the changes to the Social Fund have been met in their respective authorities. The Local Welfare Assistance (LWA) scheme in Barnsley, writes Michelle Kaye, sits within the Supporting People team to complement the preventative agenda for vulnerable people. The Supporting People team already had established contacts with a range of providers and agencies supporting vulnerable people, partnerships across service areas and the expertise to procure and set up the IT systems and train the staff. The project went live on 1st April 2013.

“

The driving force behind the policy was to ensure the scheme focused on the needs of the Barnsley residents ensuring effective signposting was in place so that people are not dependent on the scheme but can effectively try to resolve the underlying problems

”

04 bulletin 2013 No.4

We based the initial policy loosely on the DWP Social Fund and Community Care criteria as we had no idea what demand would be and the things people would require support with. The scheme offers both Emergency Loans and Support Grants, against a set of flexible criteria. Interest Free Emergency Loans are facilitated through the local Credit Union to provide utilities and food. The maximum amount of a loan is based on the family composition and when their next income is due (wages, benefits etc.). As this is a loan, it is expected funding will be repaid, and figures suggest that most people are honouring this agreement. Loans are available to low income families and those on income based benefits. The benefits of working with the Credit Union are that it already runs a successful loan scheme for the Homeless Prevention Service; it works with clients to address their underlying budget issues – and sees the Local Welfare Assistance scheme as a way to engage with hard-to-reach clients. Support Grants are to provide essential household goods to help establish or maintain a tenancy. We procure and install the goods for the applicants, rather than give them money or vouchers, and have a list of available items. The main

target groups for these grants are people leaving other accommodation such as care home, prison, supported housing, hospital and setting up a new tenancy, or those who have an emergency or are experiencing exceptional pressures. This covers things like fire, flood, fleeing domestic violence, preventing children being taken into care, or sudden death of the main income provider. Grants are only available to people on income based benefits with a legal interest in their property. Other organisations that support our client groups have helped us set the criteria and decide the items to be covered by the loans and grants. We are constantly reviewing the scheme to ensure it meets client need; we will be extending the items covered by the grants and loans and broadening the client groups accessing the scheme. The impact of welfare reform is also highlighting new requirements such as meeting the cost of removals for people downsizing due to under occupancy changes. We have also used the LWA money to fund a paid foodbank co-ordinator as we were receiving an increasing number of referrals for food and wanted to be able to offer this as an alternative to providing a loan. That only really gives part of the story. What we always suspected

www.sitra.org

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 5

as we were planning the LWA scheme and what the statistics support, is that what the clients need is advocacy and effective signposting and information. For example, if someone comes to us with benefits payments problems we can look at their claim status and either contact the DWP on their behalf or advise them what they need to do to resolve the problem. We investigate people’s circumstances, both to validate the information they have provided,

and also to find the best way to help them. We take a holistic approach – not just a tick list or a means test. To that end, the team has the freedom to use its experience to help people. We very much see the LWA as part of our wider local authority agenda about empowering citizens, early intervention and prevention – all core values of Supporting People. We work closely with service providers, especially the Homeless

Dorset County Council’s Emergency Local Assistance (ELA) scheme was designed in response to changes in the social fund provision nationally. It aims to provide emergency assistance to those in crisis where all other avenues of support have been exhausted. The service is accessed via a telephone assessment and, in most cases, an immediate decision is given. If the customer is not eligible for ELA they are signposted to other relevant agencies or means of support. The system is cashless, providing items and services ‘in kind’. Provision takes a number of forms dependent on the presenting need. The Council works in partnership with third-sector organisations to deliver assistance including food, household goods and essential furniture. For other needs, there is a preloaded card system to cover costs for essential travel or clothing. As in Barnsley, the two client groups are those in immediate crisis and those without means to address their sustainable housing needs. The main causes given for crisis need are considerable financial hardship due to issues relating to benefits claims or housing related costs. The ELA is developing its provision in response to needs being reported.

Prevention Team and our ALMO, to ensure that we offer clients the best support. We are building good relationships with local agencies where we can signpost people and have developed strong relationship with the DWP and local job centre. It’s been a steep learning curve for us all but despite the challenges, there have been real benefits linking the scheme to the work of Supporting People.

The service is also designed to allow equity amongst Dorset’s widely spread rural population by providing assistance via telephone and then delivering resources to the customers directly. The ELA will be piloting floating support provision for specific cases. This will offer immediate one-to-one support and advice to address the underlying causes of the crisis. It aims to ensure the ELA response has sustainable effect on the lives of customers assisting them to apply for relevant benefits, to give budgeting advice and to ensure that the relevant support agencies are involved for on going support. The proposed plan is for the ELA to become part of a wider a project called Dorset Independent Living Support Service (DILS) aims to help people to remain independently in their homes for as long as they want and are able to, preventing the need for more costly interventions in the future. The service will unite three levels of support:

l Crisis intervention: ELA l Short term: Floating Support l Long term: Home Improvement Agency Services

These would be accessible via a single assessment so that clients’ needs can be addressed in a holistic manner from the outset with an understanding of the options available. Assistance could then be provided for immediate crisis needs while looking at the longer term support required to address the underlying causes. Service development is being led by customer voice and consultation work is underway. Options for the colocation of resources with housing authorities and health services, links with supported accommodation and Centres for Independent Living are being explored.

Sitra can help you to develop your local assistance scheme. You can contact us at policy@sitra.org or get some tips by reading the briefing on our website http://www.sitra.org/documents/risk-chart-social-fund

THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 6

Social investment: meeting the challenge Chris Senior, Capital Funding Director of Framework, explains the charity’s rationale for social investment, describes a ground- breaking initiative to fund move-on accommodation and reflects on the experience to date. Homelessness is increasing. Less rented accommodation is available and grant funding for house building has shrunk greatly. In 2012 this led Framework to consider a new approach to funding the development of muchneeded accommodation for the homeless and vulnerable people whom the charity supports in the East Midlands.

A new funding model Raising £10m from social investment to provide 150 units of move-on accommodation over the next three to five years marks a fundamental change in Framework’s financial model. Until 2013 the organisation was entirely debt-free and had resisted borrowing. Agreeing to use external, repayable finance to fund capital development is a pragmatic response to the challenges faced by social care organisations across the UK.

accommodation. The investment will fund self-contained, one-bed flats in small clusters to help former homeless people, with support, to develop the practical skills to live independently. In the process, it will: l free up places in specialist emergency accommodation centres – in which Framework has invested more than £10m over the past decade l give more homeless people access to those facilities l maximize the value of capital investment in emergency accommodation by the HCA and Framework l offer better value for money to local authorities investing in support services.

In addition, we are considering how to establish a special purpose vehicle to take the investment programme forwards and are seeking expert advice.

Learning to date Managing risk is key

What the investment will do

In tackling the £10m target we are being careful to manage the risk associated with this new financial model: first by breaking down the £10m into tranches of £1m-£1.5m to create a small and manageable pool of investors; then by engaging with organisations which share our social goals.

Framework’s particular need is to increase the availability of move-on

As a result we made a proposal to one of the pioneers of social

06 bulletin 2013 No.4

investment in the UK – the Esmée Fairbairn Foundation – which has committed to lend £500,000 if we can find matching funds.

1 Social investors are looking for a clear business case and well evidenced social impact. They want to know that their involvement will make a positive difference to the people we support and have a positive, or at least neutral, impact on our organisation. (See the article in SITRA Bulletin No. 255 by the Framework Quality & Monitoring Team on the value of data collection and analysis.)

www.sitra.org

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 7

2 Social investors know their business and respect that we know ours: they are interested in understanding it in great detail. Those considering social investment need to be prepared for this exhaustive examination.

The Nottingham takes the initiative

3 Be clear how the costs of capital – and the capital itself – can be repaid. 4 Keep it simple. Bringing together previously grantfunded activity with the world of commercial finance offers enough cultural challenges without adding the negotiation and management of exotic financial products. Asset-backed debt finance is a reassuringly straightforward place to start. 5 Social investment is not for everyone. There is no lack of capital; there is a lack of credible schemes and willing investees. 6 Social investment is unlikely to replace grant funding for much of the work we do but will be a useful adjunct. 7 Engagement with social investment is no different to involvement in any other partnership activity – it’s about relationships and trust. There is no standard model. Apply common sense and don’t bet the whole farm.

The first practical step towards our £10m target came from Framework’s leading corporate partner – Nottingham Building Society. The Nottingham is lending Framework £800,000 towards the £1.1m needed for 14 units of move-on accommodation and Lincoln, Swadlincote, Derbyshire. Framework is providing the remaining £300,000. The Nottingham has also waived its usual administrative and lending fees for a loan of this type. The Nottingham’s Chief Executive David Marlow also proposed to back the loan with an innovative scheme – believed to be the first of its kind in the UK – which gives the public the chance to take part. Savers will partly offset the cost of the loan by investing in special Framework savings accounts where the lower the interest rate paid on savings bonds, the cheaper the loan to Framework will be. Savers can choose from four accounts on various fixed rates and terms. If the funds were fully subscribed on an equal basis this would provide Framework with a saving of around £350,000 over the 20-year period of the loan – and more if savers preferred to sacrifice interest by choosing the philanthropic interest rates. The investment programme, spearheaded by The Nottingham, was launched in June 2013. By the end of August, savers had invested more than £130,000 in the specialist accounts. See www.thenottingham.com/savings/our-range-of-accounts/ for more about The Nottingham’s accounts.

For more information visit http://www.frameworkha.org/

Further information Web l The Investment and Contract Readiness Fund, administered by the Social Investment Business, offers financial support to help organisations prepare for investment. Details are available at www.sibgroup.org.uk/beinvestmentready l Big Society Capital website – http://www.bigsocietycapital.com/ Books l CAF Venturesome: Financing Civil Society: A practitioner’s guide to the Social Investment Market l City of London Corporation: A brief handbook on social investment l Funding Central: Introduction to loan finance l KnowHowNoProfit: Social investment made simple l NCVO: Sustainable Funding Project’s Guide to loans and other forms of finance l New Philanthropy Capital: Best to borrow? A charity guide to social investment

THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 8

Revealing national housing support data

Sitra has been striving hard for consistent data in housing support over the last few years. We’re now publishing national data for 2012-13, as Sitra’s Adam Knight-Markiegi reports. Thanks for your help Thank you to all the people who have been involved in the national collection of housing support data. Thanks to the clients and support workers who filled in the original forms; thanks to the staff who sent these to St Andrews University and commissioners; and thanks to all the council officers who submitted data to us. Without your input, there would be no valuable information. We have data about housing support and preventative services from over 100 authorities, more than two-thirds of all top-tier English councils. This covers some 4,000 services and over 419,000 units or people. It provides a rich picture of housing support across the country, looking at the number of services, their cost and performance as well as the client needs and outcomes.

104 3,974 councils involved

services

419,071 units or people

£1,291 98%

average annual cost per unit or person

of clients maintained independent living (KPI 1)

these. You’ll see a summary for your selection, as well as a graph comparing finances across councils, another page with performance data and a third with an outcomes heat-map (with varying colours according to relative performance – see opposite for a snapshot. This reporting tool helps you do the following: Benchmark services: At a local level, data on housing support helps commissioners and providers to quickly compare information and

Average Cost per unit, per region (based on responding authorities)

Open data You can now see and explore this data on our website: bit.ly/SP-data. You can filter by local authority, client group, service type and length of stay, or combinations of

08 bulletin 2013 No.4

www.sitra.org

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 9

benchmark yourself on capacity, costs, performance and outcomes. This will help in strategic reviews and tenders. Plan investment: This local data can also help plan investment and it supports good commissioning to meet local priorities. It is also useful to show the value for money of services to colleagues in social care, health and criminal justice. Raise your profile: At a wider level, the data helps show the impact of investing in preventative services for vulnerable people. This will help raise the profile of housing support nationally, including to government departments and ministers. There are marked differences according to client group, service type and length of stay, and by local authority. We’ll delve into the data over the coming weeks and will be reporting on different aspects online.

Needs and outcomes Top 5 outcomes needed by clients 1 Support in maximising their income 2 Support in gaining choice and control 3 Achieve settled housing 4 Make contact with family and friends 5 Support with maintaining their accommodation Top 5 most achieved outcomes by clients 1 Assistive technology 2 Contact with external services 3 Maximise their income 4 Make contact with family and friend 5 Gain choice and control The 5 least achieved outcomes by clients 1 Paid work 2 Work-like activities 3 Dealing with substance misuse 4 Training and education 5 Settled accommodation If your council hasn’t submitted data yet, we’re still happy to receive it at spdata@sitra.org.

THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 10

SHP and Camden Housing First: A Successful Pilot of ‘Housing First’ in London Nicholas Pleace and Joanne Bretherton, from the Centre for Housing Policy at York University discuss Camden Housing First, an innovative pilot project developed by SHP and funded by Camden Council. Drawing on the approach pioneered by Pathways to Housing in New York, Camden Housing First is focused on chronically homeless people. These are people characterised by recurrent, sustained homelessness with high rates of problematic drug and alcohol use, severe mental illness, long term worklessness and poor physical health. Camden Housing First targeted people who had been ‘stuck’ in the Camden hostels pathway for at least three years. Other Housing First projects have been used to replace similar, hostel-based, systems designed to train and support chronically homeless people to become housing ready and able to live more independently within the community. However, Camden Housing First was designed to help chronically homeless people who had not completed the existing Camden hostel pathway to housing readiness, i.e. they had never been assessed as reaching a point where they could live more independently. As with other Housing First services, Camden Housing First was designed to very quickly provide service users with a settled home without any requirement that to comply with psychiatric or other medical treatment, stop using drugs or alcohol (where that was an issue) or to demonstrate housing

10 bulletin 2013 No.4

readiness in other respects. Service users were provided with housing under their own tenancy in the private rented sector, with mobile support services being offered to them to help successfully sustain their new tenancies. Two specialist support workers, with a caseload of five people each, provided mobile ‘intensive case management’ (ICM) services during and following the rehousing process. Support was open-ended, within, the confines of the pilot projects two year duration. Alongside direct practical, informational and emotional support, the support workers also facilitated access to any care, health or other support required. This included working with the service user to tackle issues including poor social supports, isolation and boredom. As in other Housing First services, a harm reduction approach with a recovery orientation was used, supporting engagement with treatment and drug and alcohol services, but never making this a requirement.

Evaluation An independent evaluation of Camden Housing First, supported by the University of York and SITRA, was conducted over 18 months by the Centre for Housing Policy at the University of York.

This evaluation found that Camden Housing First was achieving housing stability among a group of people with sustained and recurrent experiences of homelessness, high rates of severe mental illness and poor physical health, histories of anti-social behaviour, criminality and sustained worklessness and often highly problematic use of drugs and alcohol. Many had not lived in their own home for many years or ever lived independently. Most were aged in their late 30s and 40s. The extensive use of hostels and supported housing by this group of service users over many years had been, cumulatively, very financially expensive.

Achieving benefits Alongside achieving housing stability, Camden Housing First service users also achieved gains in well-being, reductions in drug and alcohol use and anti-social behaviour and increases in engagement with treatment. The relatively intensive, flexible, tolerant and respectful ways in which support was delivered by Camden Housing First was viewed very positively by service users. While not a low-cost service, there was evidence that Camden Housing First was an efficient use of financial resources. Sustaining chronically homeless people in their

www.sitra.org

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 11

own homes was being achieved for no more, and sometimes markedly less, expenditure than keeping them in hostels and temporary supported housing. The Camden Housing First project had faced some challenges. The project, unlike other Housing First pilots elsewhere in London, did not have priority access to social housing. This meant a reliance on finding private rented flats with rent levels that would be covered by Housing Benefit. Given the clients’ high needs and instances, of historic anti-social behaviour, Camden Housing First did not house service users in groups. This meant securing affordable private-rented onebedroomed flats across London, a process that initially presented many hurdles.

Building Relationships The specialist support workers worked intensively to form working relationships with letting agents, persuading and reassuring them their service users would pay their rent and not exhibit anti-social behaviour. Over time, a network of letting agents was established and the service began to successfully access and use private rented housing. Service users were successfully housed in properties across London, though securing housing actually within Camden remained difficult. The Camden Housing First model has the potential for wider deployment across London. This model can support chronically homeless people ‘stuck’ in existing hostel-based pathways. Consideration should also be given to using this model along the lines that Housing First is usually employed as a replacement for hostel-based pathways or staircases designed to progress chronically homeless people to housing readiness. The Camden Housing First model has the potential to quickly and sustainably end chronic homelessness and to prevent it occurring among at risk groups.

Jane – A Case Study Jane is a 40-year old woman who became homeless following family trauma and drug and alcohol misuse. Jane has a history of violence, aggression and street activity which have resulted in custodial sentences. As an IV poly drug and alcohol user both her physical and emotional health have been detrimentally affected. Jane had no positive social networks and had a tenuous and volatile relationship with her family. Jane had been living rough or in hostels in Camden for the past 20 years. Between 2005 and 2012 she lived in eight hostels, and was evicted from six of these due to threatening behaviour or assaults on residents and staff. In her final hostel placement, Jane started to talk about wanting to get out of the hostel system due to her age, poor health and wanting to re-establish contact with her family. Given her chronic homelessness and inability to retain hostel accommodation, Jane was referred to Camden Housing First. For Jane, the idea of being able to live in her own flat gave her the necessary hope and motivation required to make it a tangible goal. Jane was supported to view flats and to have an element of choice when selecting her new home. As this was her first independent accommodation she was initially supported intensively, five days per week, with practical aspects of living on her own, linking in to the community and adjusting to the change on a psychological level. Jane has now successfully maintained her tenancy for 18 months. She has re-connected with family and established positive social networks, choosing to remain distant from previous damaging relationships. Her substance use has decreased and she is also starting to address some of her physical health issues which she had previously ignored. As Jane has grown in confidence and developed daily living skills, Camden Housing First has been able to reduce support to two days a week. In offering Jane a private rented flat prior to her being deemed ‘housing ready’, she has been given the opportunity to focus more on the positive aspects of living, learning to take responsibility for herself and accepting the support available in her community to address her various needs.

Full and summary reports of the research results will shortly be available available from the Centre for Housing Policy (www.york.ac.uk/chp), SHP (www.shp.org.uk/) and Sitra (www.sitra.org) websites.

Sitra will be hosting a breakfast briefing to discuss the findings from the evaluation of the Camden Housing First project. To register your interest for this event please email

sarahp@sitra.org

THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 12

Learning from Canada’s radical Housing First programme as a solution to homelessness? Threshold’s Chief Executive Steve Goslyn shares his experience of a study tour in three Canadian cities, examining their approach to housing homeless people with complex needs.

The cost of renting a home in Canada has skyrocketed over the last couple of decades whilst wages and limited welfare provision have not kept pace. The result has been something of a homelessness crisis in many cities. But some policymakers have been trialling a very radical solution, in the form of the Housing First model. A five year study of the project and its impact has recently been completed. I travelled to several cities along with John Weetman from the Greater Manchester Probation Trust to take a closer look.

What is Housing First? Housing First, as the name suggests, is an approach offering independent housing to homeless people with complex needs in the first instance rather than expecting them to graduate through a range of hostel or supported housing services – the “treatment first” approach.

12 bulletin 2013 No.4

It was pioneered in New York during the 1990s by Sam Tsemberis of the Pathways to Housing organisation. Now Sam is one of the advisors behind a huge research programme into the ‘At Home’ (or ‘Chez Soi’), Housing First programme in Canada, and he was one of many interesting people with a great deal of knowledge and experience that we came across during our trip.

The Canadian Initiative The At Home programme covers five cities and was launched against the backdrop of very limited supplies of affordable housing. Subsidised social housing makes up only 5% of the housing stock in Canada, and is heavily oversubscribed. Private sector rents are often well above the benchmark of 30% of people’s income, whilst income from welfare is insufficient for many to afford to live even in a multiple occupancy “rooming house” (HMO). Large numbers of homeless people with mental health and addiction issues live precariously on the streets, sofa surfing, and in shelters.

Consequently they put additional strain and costs on to hospitals, social services and the criminal justice system. It is estimated that on any given night in Canada, for every one person sleeping in a shelter, another 23 are living with housing vulnerability, putting them at risk of devastating health outcomes.1 John and I visited Housing First services in Toronto, Ottawa and Montreal. Ottawa was outside the At Home study but has a very interesting and successful Housing First service run from a Community Health Centre, Sandy Hill, which focuses on harm reduction with chaotic drug users. Typically a Housing First service has a housing team who source accommodation and liaise with private landlords and a support team who adopt a person centred approach to their work with clients. At Home had two models of support service. Intensive Case Management teams worked with individuals with ‘moderate’ needs. Teams are available 12 hours per day with a staff to client ratio of 1:15 to 16.

www.sitra.org

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 13

Assertive Community Treatment provided a multi-professional intensive service for people with serious mental health issues. ACT teams are available 24/7 with a staff to client ratio of 1:10. There are parallels with floating support although the support is more long term. Interestingly, At Home was led at a federal level by the Mental Health Commission of Canada – acknowledging the importance of housing in addressing health needs.

services in the long term. If they accepted they then joined the programme's experimental group or a control ‘treatment as usual’ group through a randomised selection process. The ethical dilemmas raised by this approach were rationalised by the fact that that the findings would justify the process, no one would be worse off, and some individuals would benefit from the project.

people’s “golden ticket” out of the shelters. Housing subsidies are not universal like our Housing Benefit system, but do allow eligible clients to afford rents in mainly selfcontained private rented flats, something which appears to be rolling back in Britain today.

So what else can we learn from the Canadian experience?

Outcomes The At Home initiative has recently completed a five year longitudinal study with a published Interim Report2. Among its recommendations is that a “cross ministry approach that combines health, housing, social services with non-profit and private sector partners is required to solve chronic homelessness.” UK take note! The research programme costing $110m was led by Professor Paula Goering from the Centre for Addiction and Mental Health in Toronto, and set up new Housing First services in the five cities of Vancouver, Winnipeg, Toronto, Montreal, and Moncton. Participants were drawn from the streets and homelessness shelters. They were advised that the programme was time limited and therefore, if selected, they might not benefit from their chosen home and support

The Interim Report found that Housing First significantly improves the lives of people who are homeless and who have mental health needs. It found Housing First to be a cost effective solution especially for those who are high service users as it reduced demand and cost on other public sector budgets. Clients highlighted the changes that having a Housing First home made on their ability to recover and thrive in their communities. Many of their stories are told through an excellent collaborative project run by the Canadian Board of Film Making3. Continuing success of the Canadian programmes depends on the funding of individual housing subsidies referred to by Rob Boyd, of the Sandy Hill programme in Ottawa, as

The key features of Housing First are: l No conditions on housing readiness – People are not expected to prove they are housing ready by taking part in treatment or being drug or alcohol free. l Choice – Clients are offered a choice of housing including location and type. The At Home/Chez Soi housing is in self-contained units, mostly dispersed in the private rented sector. l Individualised support services – providing a range of treatment and support services that are voluntary, individualised, culturally-appropriate, and flexible (e.g. in mental health, substance use, physical health, employment, education) l Harm reduction – which aims to reduce the risks and harmful effects associated with substance use and addiction (encouraging but not requiring absolute abstinence) l Social and community integration – providing opportunities to engage in local communities through opportunities for meaningful activities. 1

Housing Vulnerability and Health: Canada’s Hidden Emergency Authors: Holton, Emily; Gogosis, Evie; Hwang, Stephen W. Organization: Research Alliance for Canadian Homelessness, Housing and Health (REACH3) Publication Date: 2010 2 At Home/Chez Soi Interim Report Authors: Goering, Paula; Veldhuizen, Scott; Watson, Aimee; Adair, Carol; Kopp, Brianna; Latimer, Eric; Ly, Angela Organization: Mental Health Commission of Canada Publication Date: 2012 3 National Film Board of Canada -Here at Home – In search of the real cost of homelessness www. athome.nfb.ca/#/athome

The Housing First model is based on excellent principles including client choice of where they live, person centred approaches, recovery, and perseverance with individuals. Supported housing and floating support services would do well to refresh their support philosophies through reflecting on this model; if not by adopting a fully-fledged Housing First approach. There is a dearth of decent affordable housing and supported housing in Canada for vulnerable people. The UK has moved a long way from the reliance by homeless people on large hostels and shelters. This Canadian model appears to leapfrog to a more personalised and person centred approach which recognises the significant benefits to health and wellbeing of having the choice of a good place to live. At a time of increasing homelessness and cuts to health and social services in the UK, the question now posed is whether we will drift back towards the prevalent homeless shelter system in Canada (and the US), or if we protect existing services and move more towards the evidenced cost effective and humane Housing First approach starting to taking root in Canada and other progressive economies. To learn more about homelessness in Canada visit The Homeless Hub www.homelesshub.ca Steven Goslyn would like to hear from organisations running Housing First projects or thinking about starting one, with the view to setting up a network of projects in the UK. Contact him via email stevegoslyn@thp.org.uk

THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 14

Working in Wandsworth –

the story so far Bringing new models of working to community settings poses unique challenges. Marc Mordey explains how everyone involved in the Vintage Communities project in Wandsworth is working towards success. Vintage Communities is a Community Interest Company. The London Borough of Wandsworth commissioned us to work with people who live and work in the Bedford ward of Balham to make it a better place to live for all ages. Vintage Communities’ plan was to work with local people for six to nine

“

We understand that most communities are places overflowing with assets, and that our job is to issue an invitation to citizens to enter into conversations that matter, with each other. These conversations matter because they deepen relationships and lead to actionable change.

”

(Cormac Russell)

14 bulletin 2013 No.4

months, enabling them to establish self-sustaining initiatives that make use of what is already available in the area to achieve their goals. Our basic premise and core value is that everyone in a community or neighbourhood has knowledge, talents, skills and enthusiasms. We work to the Asset Based Community Development (ABCD) model.

How we work: identifying the connectors Our first task is to identify the people we define as being ‘community connectors’, those people who others naturally go to in order to find someone who can help and support them. The kind of person who knows and has links to problem solvers and enablers; the kind of person who says “I know a person who...”. We want to try to reach out to and capitalise upon the assets and ideas of those within communities whose voice is least often heard. We aim to engage the skills, knowledge and talents of every community member.

Knowing our ABCD We have a method for community engagement which follows the

ABCD approach. This involves identifying the community connectors and working with them so that they make contact with individuals and groups or associations. They will talk to people to find out what it is that people care about changing in their community and what skills or gifts they can contribute. They will put neighbours in touch with each other where they can see mutual benefits can be achieved. For example a school that wants to involve students in community work could help residents in a care home who want to learn computer skills to keep in touch with family and friends. Our purpose is to enable and support older people to transform their communities as community builders using an asset-based approach.

Who should provide services? We believe that the fabric of state provided services is altering irrevocably: there will be more and more need for local people to find local solutions, to draw upon their own collective resources and to discover community connections and a sense of living somewhere where the people who care about and possibly for you are your friends and neighbours. We

www.sitra.org

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 15

recognise the important role that statutory, community and voluntary organisations provide but believe that there are some things best provided for by the state, some things that are best provided in partnership with citizens and other things that are best provided by citizens themselves. We aim to motivate, inspire and help prepare people within local communities to decide what things are most important to them, to discuss how they might improve things, to recognise what skills and talents are available from within their neighbourhood, be that individuals, small groups of people or organisations (both voluntary and statutory) and to work out how they can get the best out of, and for the benefit of, local people.

The Balham (Bedford Ward) story so far... The group has named itself Neighbourhood network. It has an email account, facebook page and www.streetlife.com has offered a page for keeping the neighbourhood connected. The following initiatives are now well underway: l A computer skills class for older people run in conjunction with Balham Library, Streetlife.com and our volunteers. At the first session of this group seven older people came along to learn about email, Skype, internet shopping and so on. Students from Streatham Girl’s High School and some Neighbourhood Network volunteers ran the session. l An oral history project with local schools participating led by group of

volunteers. The Neighbourhood Network group is liaising with Ravenstone Primary School and Chestnut Grove Academy with the aim of developing a menu for The History Project.

What’s next? Vintage Communities’ involvement will become more arms-length from the end of September 2013. A mentoring support role will continue beyond this date. We hope that the core group will assist other neighbourhoods following a similar journey by sharing their experience and expertise.

An inspirational approach What is so heartening about being involved in this work is that there appears to be a genuine appetite for rekindling a sense of community that people refer as a ‘bygone age’. Far from having disappeared completely, our experience is that there are people waiting to be contacted, people with all sorts of gifts to share with one another and that the ‘currency of caring for one another’ is in far less a parlous state than the media and indeed, ourselves, might like to think. ABCD is one way of opening doors literally as well as metaphorically into a community that can really begin to help itself.

How could ABCD relate to housing work? We feel that the ABCD approach is applicable many settings, including housing schemes such as sheltered housing/extra care, communal settings, small communities of interest, and small geographical areas. With regard to general housing stock, we would hope that ABCD initiatives would be especially relevant for social housing tenants. For example in the Bedford Ward, one Housing Association alone has over 700 properties and we believe at least some of the tenants will be isolated and lonely, and have skills to offer their community. In Barking and Dagenham where we are also working, two local Tenants’ Associations are using the ABCD model approach to try and bring greater sharing and unity to a diverse neighbourhood.

ABCD: any room in the housing world? Briefing session on Asset Based Community Development October 2nd 2013 / 1.30-4.30 pm You will: • Understand the ideas and principles underpinning ABCD • Understand the ABCD process • Explore examples of ABCD in action • Engage in discussions on the potential for applying ABCD in your world of work Session by Marc Mordey, Director of Vintage Community. Vintage Communities’ purpose is to enable and support people to transform their communities as community builders, using ABCD. Marc has a background in the social housing sector, having been CEO of a homelessness charity and Director of ROCC in the past.

for further information email sarahp@sitra.org

THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 16

Social Value Measurement: What’s the big deal? Emily Crawford of the SROI Network asks three member organisations what social value measurement has meant for them.

What is Social Return on Investment (SROI) ‘Social value’ refers to wider non-financial impacts of programmes, organisations and interventions, including the wellbeing of individuals and communities, social capital and the environment. These are typically described as ‘soft’ outcomes, mainly because they are difficult to quantify and measure.’ DEMOS. Social return on investment (SROI) is a methodology for measuring the value of ‘soft’ outcomes. It can be used to evaluate impact on stakeholders, identify ways to improve performance, and enhance the performance of investments. SROI aims to increase social equality, environmental sustainability and wellbeing. The SROI Network was formed in 2006 to facilitate the continued evolution and standardisation of the method. Over 570 practitioners globally are members of the SROI Network. Below three housing sector members of the SROI network explain what social value measurement has meant for them so far.

HACT www.hact.org.uk Do you provide sheltered housing or advice to those who do? HACT is not a direct service delivery organisation. We work with Housing Associations (HAs), the major providers of housing care and support in the country. Around £1bn a year is spent by HAs on supporting people to live independently in their communities and sustain their tenancies. HACT currently has a strong interest in housing and health and works with HAs to develop new partnerships with the NHS, often from within their care and support business. Why do you think SROI is important to the supported housing sector? SROI (Social Return on Investment) is important to supported housing for the same reason it is important in other sectors: to be able to understand and measure what is really important. The social value of housing and the additional support received by some tenants are also crucial to be able to measure different areas of investment in the same terms. For HAs with major care and support businesses (such as Midland Heart), more staff are employed in this area of business than in the mainstream. Even those organisations which consider themselves not to be care and support providers have a significant proportion of vulnerable and older people living in their general needs housing. Over 50% of new lettings are now going to people who are vulnerable or older. Many HAs continue to provide specialist housing for older people (Sheltered Housing and Extra Care Housing). The financial climate for supported housing is becoming increasingly difficult, with some local authorities having reduced their Supporting People budgets by up to 60%. Although the environment is moving more towards price being the main determining factor, providers need to think about how else they are able to stand out from the crowd. With housing associations increasingly stepping in where local authority services are reduced or cut, the importance of understanding where investment has the greatest impact has never been more relevant. Some of the earlier adopters of SROI and other forms of social value measurement have been supported by housing organisations, for example, P3 did a full SROI account of its business around four years ago.

16 bulletin 2013 No.4

www.sitra.org

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 17

What advice would you give an organisation looking to measure their social value in the supported housing sector? SROI is a framework and unlikely to become the main reason why commissioners contract with a certain organisation, though it could help an organisation stand out from the crowd. The organisation that can measure its social value should be more attractive than one that doesn’t. Understanding social value across the business is important; this includes both the delivery of a safe and secure home, as well as the support and other activity that takes place. Be careful about how SROI assessment is presented to other commissioners – it is unlikely to be well received by health as a way of encouraging integration or of promoting the benefits of supported housing – it doesn’t get to the core of the issues around productivity, efficiency and cost savings and too much emphasis will make the sector irrelevant to others.

Orbit www.orbit.org.uk Why do you think SROI is important to the supported housing sector? SROI and measuring impact are important for housing as a whole, not just supported housing. Housing has significant amounts of resources – monetary, assets and time that it invests, but we don’t always know or can demonstrate what impact it has. All we know is that it is the right thing to do. In a world where resources are getting scarce it is important to understand and demonstrate the impact organisations have. Has working with SROI impacted the delivery of the work you do for tenants, specifically those in sheltered housing and if so why? We are still identifying potential projects for SROI. One possible project is a dementia worker project within sheltered schemes that begins in the autumn. We are doing the groundwork for this at the moment using SROI. What advice would you give an organisation looking to measure its social value in the supported housing sector? I would say that it is important to know what you want your supported housing to achieve and to engage with stakeholders to see if they feel that you achieve that or not, or if you achieve something that you hadn’t expected. Clear communication is key!

Aspire www.aspirehousing.co.uk Do you provide sheltered housing or advice to those who do? Yes, we provide a sheltered housing service and support to about 600 older people. We also provide an over55s floating support service. Why do you think SROI is important to the supported housing sector? There are some clear links with how SROI focuses on outcomes from a stakeholder point of view and with how we develop our support plans around out service users. Our support services are outcome focussed in terms of results, therefore SROI provides an additional layer with regards to impact on customers, which assists in-house reviews of our support services, but also provides richer supporting evidence to support tender submissions for new services. Has working with SROI impacted the delivery of the work you do for tenants, specifically those in sheltered housing and if so why? Our initial SROI evaluations identified new areas we needed to focus on in terms of data collection to ensure we captured ‘soft’ as well as ‘hard’ outcomes. Because our support services already operate through a person centred approach, this was not a significant a change as other services. However reviewing our evaluation templates using SROI methodology has reinforced this further. The results of our SROI evaluations have also been used to identify future service enhancements, a number of which we are reviewing with customers. What advice would you give an organisation looking to measure their social value in the supported housing sector? Comprehensive Stakeholder engagement is always key to any social value evaluation and no more so within the supported housing sector to capture impact on service users but also the wider environment Providers of housing related support need to be able to demonstrate the value of the services they provide, the contributions they make to local priorities and the benefits for users. Sitra has identified there are a number of ways in which to do this and have developed a toolkit and factsheets to support providers and commissioners of housing related support in doing this. You can find all the details on our website http://bit.ly/SitraSROI or contact sueb@sitra.org if you would like our help in measuring your social value.

THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 18

A busy end to 2013 If the exempt accommodation issue affects you, the rest of 2013 looks as if it could keep you pretty busy, writes Sitra’s Geoffrey Ferres. The housing, care and support world has been waiting since April for Lord Freud to make good his promise to protect all supported housing from the unintended consequences of three changes: l “Bedroom tax” l Household benefit cap l Universal Credit’s way of calculating and paying claimants’ housing costs.

Why are we waiting? The “bedroom tax” came into force in April 2013 without anything being done. The household benefit cap will be in force everywhere by the end of September 2013 without anything being done either. So what went wrong? There has been a lot of talk in relation to welfare reform about changes fulfilling the criteria of being ‘cost neutral’. If it is recognised that these changes may in fact not

18 bulletin 2013 No.4

make the savings expected, then it will fall to Lord Freud to make the case for change to the Treasury.

Not with a bang but a whimper It could have been much worse because non-exempt supported housing1 would have been badly affected by the national roll-out of Universal Credit which was supposed to go live in 185 Jobcentres on 29th October. But it won’t. After the four Greater Manchester Pathfinders had finally gone live by the end of July, instead of April, Ministers eventually announced the October national roll out will consist of just four more Jobcentres across England2 (See Table). It seems these extra four Jobcentres may not all go live in October 2013 but at various dates

before the end of March 2014 and they are likely to try out the new benefit only on single, newly unemployed claimants (the sort who would have otherwise made a new claim for Jobseeker’s Allowance) without mortgages “or other complexities” (as the Government has put it in the past). All six Jobcentres were chosen as being in comparatively affluent areas. This means most readers have more time to prepare for Universal Credit – unless, of course, you operate in one of these areas: consult the flowchart to see if you should be making urgent plans to cope.

Change is finally on the table The big news on the exempt accommodation rule is that changing it is finally on the table – but for the wrong reasons. It’s not that Ministers now agree the rule

www.sitra.org

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 19

Table 2

Do you have stock/clients in the areas covered by any of the first eight English Jobcentres to go live with Universal Credit?

needs to be brought up to date. No, Lord Freud has been convinced by one of his own MPs, Mark Reckless, MP for Rochester and Strood, that the rule is being abused and must be tightened. How will it be tightened? We’ll have to wait and see but on past experience we can expect two things: l Any new rule will be easy for the Government itself to administer l Any problems will be passed to local authorities – not necessarily with the cash to deal with them.

If yes, are any of your clients living in properties that are possibly or definitely “nonexempt”?

If so, is it likely any of your residents/clients will find themselves in a situation where they might have to make a new claim before the end of March 2014 for what would have been Jobseeker’s Allowance had the local Jobcentre not already started Universal Credit?

If yes, you need to be UC-ready now or urgently find a way of changing the arrangements to achieve “exempt accommodation ” status.

English Jobcentres that will be live with Universal Credit by the end of 2013/14.

But any consultation the independent Social Security Advisory Committee decides to conduct should be an opportunity for a thorough airing of all the issues about the rule. It was the Committee who first proposed the rule back in 1995. It’s their baby!

Better late than never? We can also expect some proposal finally to deal with the problems mentioned earlier plus the first discussions on the Government’s latest attempt to design future arrangements for handling the housing costs of supported and sheltered housing.

1. Read Sitra’s briefing on exempt accommodation http://www.sitra.org/documents/exemptaccommodation-briefing-updated 2. Department of Work & Pensions – Housing Benefit Reform – Supported Housing http://bit.ly/1ccu9Bn

Asterisk indicates four Jobcentres that have already gone live with Universal Credit.

Sitra has organised briefings in London 21st Oct and Southampton 7th Nov to provide an update on the benefit changes that affect you most. Further details can be found on our website www.sitra.org or contact sarahp@sitra.org for further information

THE MAGAZINE FOR HOUSING WITH CARE, HEALTH AND SUPPORT

81451 Sitra Newsletter No.4v2_Layout 1 13/09/2013 10:43 Page 20

Sitra Training

Cognitive Behavioural Therapy: An Introduction

Mental Health in Later Life

9th October in Southampton

30th October 2013 - London

You will learn: • Be provided with an overview of CBT: its origins and its applications today. • Understand and be able to apply the links between thoughts and feelings: A-B-C model • Explore and understand core beliefs and assumptions • Understand Negative automatic thoughts (NATS) and thinking errors • Practice applying basic CBT using worksheets / Node-Link maps for common problems such as Depression, Anger and anxiety

You will learn: • What are the common kinds of psychiatric illness facing older people • How to develop a deeper understanding into illnesses such as schizophrenia, paranoid states and depression • How to respond to common psychotic symptoms such as delusions and hallucinations • What treatments and professionals can help older people with the above disorders

2 1

Lone Working & Risk Assessment

Welfare Reform & Exempt Accommodation

16th October 2013 – London

Half Day Briefing 1.30 – 4.30 31 October 2013, London

You will learn: • What we mean by risk assessment • Potential risks to staff and risks to service users • An awareness of safe lone working practices • Ways to share and record information to manage & minimise risks • The minimum QAF requirements on managing risks and lone working • Coping strategies in potentially difficult situations

You will discuss: • The measures promised to protect supported housing from the consequences of the “bedroom tax”, The household benefit cap and the way Universal Credit deals with claimants’ rents. • Update on any government response on exempt accommodation • Findings from Sitra’s recent research project on Housing Benefit for people of working age in supported and sheltered housing • The Government’s plans for switching help with older people’s rents from Housing Benefit to Pension Credit

Key

Prices New prices with increased discount for members: Half-day: Sitra members £55/Non-members £89 One-day: Sitra members £89/Non-members £149 For a full list of forthcoming courses please visit our website

www.sitra.org

1 Courses suitable for new workers suitable as part of l an induction programme 2 Courses suitable for frontline staff, also suitable as l refresher courses for managers 3 Courses suitable for new managers or frontline staff l moving into management 4 Courses suitable for experienced and senior l

managers Courses suitable for local authority commissioning and monitoring staff

bulletin No.3 WITH CARE, HEALTH AND SUPPORT THE FOR 2013 HOUSING 20MAGAZINE