Supporting People Service Review

Julian House Night Shelter & Day Centre Manvers Street, Bath Service ID Number: 150 Service Provider: Bath Churches HA Service Provider Address: 55 New King Street, Bath National ID No:  10005978 Date: November 2005 Review Officer: Ann Robins

2. Introduction to Agency

Bath Churches HA was set up in 1987 to provide emergency night shelter accommodation. The organisation now runs a number of services for homeless, formerly homeless and vulnerably housed people. The Bath & North East Somerset Supporting People programme supports the following services:

• Simon House supported housing project
• The Community Support Team
• Barnabas House supported housing project
• Julian House Night Shelter and Day Centre

BCHA also runs The Shed, a meaningful occupation scheme, part-funded by Office of the Deputy Prime Minister grant.

2.1 Brief History and outline of service

Julian House opened in 1993. It provides a Night Shelter and Day Centre.

The Night Shelter provides emergency accommodation for up to 21 people. 18 beds for men are provided in a dormitory with 3 in a separate room for women. Facilities are provided for laundry (washing machines and driers), showers, toilets and personal washing. A cooked meal is provided every night and breakfast every morning.

The Night Shelter is staffed by 2 Night Project Workers. Volunteers assist with cooking and making beds in the early part of the evening.

The Day Centre provides a venue for several services.

Client Services Co-ordinators provide

• Advice and help on housing and getting accommodation, including liaising with the Housing Advice Team
• Advice and help in getting access to other support agencies and making appointments
• Help with paperwork
• Developing social activities

Client Services Co-ordinators also work with clients on support plans.

The Homeless Healthcare Team is based at Julian House and provides

• A Registered Nurse available on weekdays
• A GP practice for rough sleepers and Night Shelter users on 4 days a week
• Methadone scripts for up to 15 clients considered at risk

The Day Centre also runs a Women’s Group once a week.

2.2 Capacity

Units:   21 (18 men, 3 women)

Delivery Staff Hours:

244.6 per week.         

2.3 Monitoring Information

            KPI 1a - Percentage of service users who have been supported to establish independent living

            KPI 2a - Percentage of service users who moved on in a planned way

            KPI 3a - Percentage of new service users that have accessed SP through referral routes other than host

            KPI 3b - Percentage of new service users that have accessed SP and are from a BME group

            SPI 1a - Percentage availability (accommodation based services)

            SPI 1b - Percentage availability (support)

            SPI 2a - Percentage utilisation (accommodation based)

            SPI 2b - Percentage utilisation (support)

            SPI 3a - Percentage staffing levels

            SPI 4a - Percentage turnover

2.4 Existing Funding                                   

 5. Quality Assessment Framework (QAF) Outcomes 

7. Consultation with Stakeholders

Consultation was undertaken with the following stakeholders:

• Four service users, 3 male, 1 female.
• Roanne Musselwhite, Day services Team Leader
• Kev Edwards, Night Shelter Team Leader
• Mike MacFarlane, Manager, Big Issue South West (Bath office)
• Peter Brown, Housing Advisor, Housing Advice Team, Bath & North East Somerset Council

7.1 Consultation Findings

Service Users

All service users interviewed gave positive feedback.

The premises themselves are considered to be of a good standard. The location was generally felt to be good, though one person said that they had experienced verbal abuse from passers-by who assumed he was a drug-user. The proximity to the Police station was felt to be an advantage by one service user, providing peace of mind.

All reported that they were allocated a key worker within days of arrival and that they found their key worker effective and approachable. There were differing reports of how often support sessions took place, with 2 people stating these happened regularly and two saying they occurred on an ‘as & when needed’ basis. All felt the sessions took place with sufficient frequency, were of the right duration and could be instigated in between times if they felt the need for extra input. One person who had been in several other night shelters and hostels said that this was the first support plan he had had, that it was very useful and that other hostels should be using them.

The medical service was very highly valued. One service user who was using heroin prior to coming to Julian House said that without the service provided by the medical team, he and his partner would not be at the stage of recovery they had reached.

As most did not have a local connection within the meaning of homelessness legislation, their key workers were looking at alternatives to housing association properties in Bath. One person was on the waiting list for supported housing in Bristol and expected to move on within the next few weeks. The others were actively seeking private rented accommodation with support from their key worker.

Personal safety and security were generally perceived to be good, though there were some concerns that more vulnerable people may not feel safe. Aggression brought about through drug or alcohol use from a minority of service users was the most commonly mentioned factor. This is not surprising, given the client group Julian House serves. Service users acknowledge such problems cannot be completely eradicated and that staff work hard to reduce their frequency and impact. All understood and appreciated the rules, which were explained when they arrived. The system of banning people who transgressed was also appreciated as a useful tool for maintaining order and safety.

Two of the service users interviewed were a couple. They were generally satisfied with the Night Shelter and Day Centre, but felt that there should be specific provision for couples.

All felt they were able to influence service provision. Service users are encouraged to attend weekly meetings, where they are able to have an input into how the Day Centre and Night Shelter are run. One of the 4 people interviewed attended these meetings. He found them accessible and was attending the meeting due later that day where he intended to take an idea for fundraising for the project. Others were aware of the meetings but chose not to attend.

3 of the 4 service users interviewed were also using The Shed and expected to be supported by the Community Support Team when they found more permanent accommodation. They all demonstrated an awareness of other services available to them and how to access them. As all were new to Bath prior to coming to Julian House, this can be assumed to be largely attributable to the support they receive from staff.

The only consistent, negative feedback concerned the men’s shower, which runs on a timer. All 3 male service users disliked this.

Stakeholders

Mike MacFarlane, Big Issue South West (Bath Office)

Mike MacFarlane is the manager of the Big Issue’s Bath office. He has been in post for only a short time and is new to the area, so his input was limited.

Communication between the Day Centre, Night Shelter and the Big Issue is good. Mike and his team share several clients and are in regular contact, though referrals tend to come from Julian House rather than the Big Issue. Mike considers the service to be accessible and the referral process straightforward. Physical access was identified as a problem, but acknowledged as a common one for services operating in Bath. (This point was raised by John Isserlis, Client Services Manager, during the validation visit.)

In response to a question regarding improvements to the service, Mike reported some negative feedback from vendors who are recovering from drug or alcohol addictions. They have told him they find it difficult to maintain their recovery because there are others using Julian House who continue to use drugs and alcohol, even if not on the premises. They also report that theft is commonplace, leaving them feeling unsafe and insecure. Some vendors also prefer to sleep rough due to intimidating behaviour from other service users. Mike suggested that staff review practice and procedure to prevent this. He also suggested that they consider CCTV in the dormitory, which is where most of the theft is reported as happening.

When asked about good practice, the medical service, support, showers & laundry and generally high quality facilities were all mentioned. Mike feels that Bath Churches HA is well-organised and ‘can always be relied on’.

Peter Brown, Housing Advisor, Bath & North East Somerset Council

Peter works in the Housing Advice Team and sees single homeless people on a regular basis. His experience of working with the staff at Julian House was described positively. He is satisfied that shared clients are given a good service, particularly by the key workers, whom he described as effective at moving people towards independence and assisting people in looking at all housing options. The referral process works well between the two agencies and is clearly understood by both teams.

Staff

Staff were positive about the services provided at Julian House, their skills and working within Bath Churches HA. Responses to questions asked about good practice and areas for improvement are detailed below.

John Isserlis, Client Services Manager

John’s overall assessment was that the Night Shelter provides a very good service for people in crisis and an opportunity to engage with the services they need.  However, he has concerns that the Day Centre service needs to be reviewed with the aim of identifying ‘who really needs the service’. He feels that the service needs reshaping as it ‘can’t be everything it tries to be’.

John also felt that the team needs to engage in more sessional work targeted to specific needs. An example of this would be a group that encourages service users to improve their budgeting skills. He also intends to promote peer support between service users.

Roanne Musselwhite, Julian House Day Services Team Leader

Roanne pointed to improved links with DHI and training provided to the Lifeline Centre (run by Genesis) as examples of good partnership working. She identified earlier opening times and Winter activities as areas for improvement. Currently, there is a gap between the Lifeline Centre closing at 4.30pm and Julian House opening at 8pm. This means that service users are on the streets between these times, with no access to meaningful occupation activities. This can have a negative impact on both the service users and the general public. Whilst there have been some very popular activities taking place during these times in the past, they were suspended due to staff cover issues. Art evenings are still held bi-weekly and games evenings are planned, but Roanne would like the Day Centre to open and offer activities earlier in the evening.

Julian House no longer issues life-long or 6-month bans. This allows staff to work with more vulnerable and chaotic clients, encouraging them to engage with services. Roanne felt this was more effective than banning and excluding for long periods or indefinitely.

Kev Edwards, Julian House Night Shelter Team Leader

Kev cited the need for wet provision and an intermediate hostel as gaps in local provision. He also highlighted the support planning process as a useful tool in helping move on some clients who may have otherwise been very happy to stay at Julian House indefinitely. This is apparently particularly relevant to some older men with mental health problems. Kev feels that the key workers are very effective at engaging service users in the support planning process.

 9. Value for Money  

10. Review Outcome / Recommendations and Impact

• It is clear from the validation visit and interviews with the manager and staff at Julian House that the QAF has been used very effectively as an assessment tool. A substantial amount of preparation had gone into the review process, including peer reviews conducted by the Client Services Managers prior to submission of the Self Assessment. This meant that managers were able to address any gaps in policy and procedure before the validation visit. It also meant that both managers were confident of the content and accuracy of the QAF. This approach has been particularly useful and is recommended as good practice for other organisations planning for review.
• The review validated the self-assessment at Level B.
• Staff are well-trained and show a high level of competence. Personal Portfolios are established for all members of staff and provide a record of training and key competencies, with an annual budget of £500 allocated to each member of staff. Portfolios are used as a basis for performance review 3-4 times a year and on an ad hoc basis during supervision sessions. All staff consulted expressed the view that they felt the organisation offered opportunities for professional development.
• The cost to Supporting People per unit per week is within the National Quartile. The service represents good value for money.
• Two members of staff expressed the view that the Day Centre service could be improved, either by reviewing the target client group or adjusting opening hours. It is recommended that this review is undertaken as soon as possible. An expansion of opening hours would be a welcome improvement in service provision, especially during the winter months. Revisiting the question of who the target client group should be would serve as a useful strategic review which could lead to improved service delivery for the most vulnerable service users.
• The range and quality of services provided at both the Night Shelter and the Day Centre is commendable. Service users are enabled to access services that make a significant difference to their lives, in particular, their housing status and social lives. Service users cited this as a particular strength.

11. Funding Recommendations

The review recommends contract renewal at the following value:

Supporting People Annual Contract Value, commencing 1/4/05: £195,738

 Per annum, net of any inflationary uplift for 06/07:  £195,738

12. Action Plan

The Client services Manager at BCHA submitted the following update on actions taken in response to draft recommendations:

Services at Julian House have been adjusted to increase overall opening times and in order to focus the service on the needs of the client groups served.

This has seen an increase in the number of Meaningful Occupation sessions taking place at Julian House, with the benefit of clients looking to engage in activity rather than using the building solely as a social centre. Clients engaged in activity at Julian House are encouraged and supported in accessing similar services elsewhere in the city such as Meaningful Occupation at BCHA Shed and DHI.

Julian House now has a pattern of regular early evening opening to encourage clients off the street and into the shelter. This has been achieved through video nights, games and quizzes. The take up by clients has been encouraging.

At the beginning of 2006 a new policy regarding access criteria was implemented. Housed clients with no support needs or support needs which cannot be met by Julian House are excluded from accessing Julian House. This revision was made in consultation with clients and other stakeholders and has been well received. If housed clients participate in a full Needs Assessment with us and there are needs which we can still support them with then we continue to work with them, but with a view to moving them on from Julian House use at the earliest time possible.

Reducing the number of housed clients and those with no support needs in the building has allowed a greater focus to be made with those who are in need of crisis support and ongoing work. The policy will be reviewed in March 2006.