Supported Housing Task and Finish Group Main Report

6. Future role of supported housing

6.1 The evidence

There is a growing evidence base that demonstrates the negative impacts of temporary forms of housing on people’s social and emotional wellbeing, especially when it is poor-quality, large-scale or shared. It is well argued in this paper [ref 24] that control over our living environment is foundational to a minimally decent life, but this is compromised in temporary living arrangements and especially in congregate accommodation.

However, there was a research gap on how to bring supported housing more confidently into the mix of housing options for the small proportion of people for whom mainstream housing is not wanted or has not been sustained. Therefore in 2020, a significant qualitative research project called ‘Shared Spaces’ [ref 4] was commissioned to explore the future role of supported housing as a response to homelessness.

The research was led by Anna Evans at Indigo House and jointly commissioned by Homeless Network Scotland, Action for Children, Turning Point Scotland and Crisis.

A Research Advisory Group was chaired by Dr Beth Watts-Cobbe from the Institute for Social Policy, Housing, Equalities Research (I-SPHERE) at Heriot-Watt University and with membership including national and local government, housing associations and providers of supported housing.

The agreed research questions were:

• In what circumstances, if any, is shared or supported accommodation the appropriate housing option for households experiencing homelessness?
• What should the shared and supported accommodation options required in these circumstances look like?
• What is the likely scale of such shared and supported accommodation options likely to be in the future?
• How well placed are local authorities and service providers to adopt these housing options at the scale required?

The researchers consulted with 52 professional stakeholders and 54 people experiencing homelessness across six case study areas – Aberdeenshire, Dundee, Edinburgh, Glasgow, Highland and South Lanarkshire. People with lived experience were purposefully sampled to include those who had stayed in supported housing, or who may need or want this type of housing based on their circumstances.

The research concluded that:

• Most people do not want shared accommodation that is defined by a shared bedroom, bathroom or kitchen.
• Some people want on-site support that is defined by self-contained homes with own bathrooms and cooking facilities, in a larger building and with an element of common and/or office space either on-site or nearby.
• People most likely to benefit from this type of supported housing were those facing severe and multiple disadvantages – and who don’t want, or haven’t been able to sustain, a mainstream housing option, including Housing First.
• That the scale of demand for this is estimated at approximately 2-5% of people who are assessed as homeless by their local authority each year.

The caveat to this modelling is that supported housing may be considered an option for some young people, who may not have high support needs but who do want to stay in a shared living environment with peers. As flat-sharing is more common among young people across the general population, this provision can offer a supported flat-share style housing option for young people that have experienced homelessness and could be considered ‘transitional’ rather than temporary or settled housing:

Case in point:

Flat shares help young people home in on life skills

Service Provider: Rock Trust

Service Name: My Place

Location: East Lothian

Young people who are care experienced or homeless are gaining invaluable life skills and stable supported housing without time limit through a peer flatmate project where they share a home with a volunteer. The My Place project led by Rock Trust and East Lothian Council partners young people in accommodation with a Peer Flatmate to provide a safe, stable home in the community. Peer flatmates are typically students at a nearby college or university and are offered training and support. They take on a mentoring role, providing practical support to help flatmates develop independent living skills and navigate the shared living environment.

The project is of benefit to people who are struggling to maintain a tenancy or battling isolation, care leavers and those who would benefit from living with other young people. Though there’s no time limit on the length of stay tenants are expected to move on to their own permanent tenancy once they are ready. And unlike traditional supported housing, they can stay in their home and choose not to receive support as long as there are no issues.

Housing is provided by the local authority; bills are shared, and tenants receive a £500 settling in budget along with weekly face-to-face support from The Rock Trust. As Peer Flatmates are unpaid, they don’t pay rent.

The project is supporting K and Q from Southeast Asia who were in vulnerable positions that led to their exploitation, abuse and trafficking to Scotland on the false promise of a better life. Homeless and without a main caregiver, they applied for asylum in the UK and moved into My Place in February 2020.

K and Q built a strong and trusting relationship with their peer flatmate M and would share cooking, gardening and maintenance of their home. Shared mealtimes gave them a chance to chat with their new friend about everyday life and discuss any issues they faced.

My Place project staff also helped the pair access grants to buy bikes and laptops to boost their wellbeing and opportunities. The bikes enabled the pair to exercise and explore the local area, while the laptops meant they could access an English as a Second Language course, supporting their development and increasing access to study and employment. Training and support are provided to peer flatmates and formal interviews are carried out to determine suitability. Though the role is unpaid, peer flatmates are not expected to pay rent and extra support is provided by the Rock Trust and After Care Service, East Lothian.

6.2 Best features of supported housing

Overall, supported housing must offer a settled housing option for people who have experienced homelessness or to prevent homelessness. Having a housing option that is ‘settled for as long as you want it’ is a vital component of providing the safety and ontological security that people need, but with the choice and autonomy to later move onto mainstream housing if things change. Supported housing is about the quality of the environment and the quality of the support delivered by a skilled and valued workforce. And it is about community, connecting people with social networks and with the wider community, combatting social isolation and the risk of experiencing homelessness again.

The following features are important if supported housing is to offer a secure and appropriate home of choice for people:

(i) Physical environment

• Self-contained home in a homely setting – no shared bedrooms, kitchens, toilets and washing facilities.
• Integrated into a community.
• Smaller the better, with up to 12-14 self-contained homes.

For example, a core and cluster housing model with care and support (the ‘core’) on-site. Individual homes may have the ‘core’ in the same building or individual homes may be scattered in the neighbourhood near the core.

(ii) Service design

• Promotes independence, choice and control.
• A progressive approach to safeguarding which protects people from harm and from discrimination due to characteristics protected by the Equality Act.
• Support is delivered by a skilled and valued workforce and meets or exceeds Care Inspectorate quality frameworks [ref 29].
• Has inclusive visitor policies and in line with Anne’s Law [ref 25].
• Accessible to all social work care groups, not a ‘homeless’ service.
• Routes to service from across all parts of housing, health and social care.

(iii) Legal and financial

• Maximises security of tenure – a private residential tenancy or Scottish Secure Tenancy (SST).
• Progressive commissioning partnership between strategic housing authorities and HSCPs.
• Combined funding model of affordable rent with care and support costs met through the general local authority fund, housing support and HSCP funding.

The key challenge is to find a model of funding that enables housing and support to be separated and for providers to find a stable core support model that is also sufficiently flexible to be person centered and meet the changing needs of tenants.

Case in point:

Compassionate support helps people put down roots

Service Provider: Rowan Alba

Service Name: Thorntree Street

Location: Edinburgh

Men with a history of alcohol addiction, rough sleeping and hostel stays are turning their lives around thanks to Rowan Alba’s model of long-term accommodation with personalised support. The charity’s Thorntree Street facility in Leith, Edinburgh, houses over-50s in nine self-contained apartments with lift access, a full kitchen, communal areas with entertainment and a garden. It is built on priorities people sleeping rough identified in a consultation: community, non-judgmental relational support and having peers in services.

Strong relationships between staff and tenants, secure tenure and tailored support for day-to-day activities have led to a track record of just one tenant being asked to leave since 2004.

Tenants who previously felt stigmatised by other services report that they feel safe, with a greater sense of belonging, better self-control, improved physical and mental health.

One tenant who was previously sleeping rough said: “I was in my late 60s and still on the streets. I could drink two or three bottles of vodka a day. It is a dangerous life. Alcohol led to me becoming homeless. I had a job, a wife and family, but I could be stubborn. I would get a flat, but then it would lead to eviction again and I was back on the streets. I now have a place to stay and some stability. I have somewhere to call home and my own key. If it hadn’t been for Thorntree Street I don’t think I would be here.”

Rowan Alba established the Thorntree model with building owner Bield Housing Association. Access is controlled and staff are on hand 24 hours a day. Tenants – referred by social work – come and go as they please and are not barred from bringing alcohol into the building.

Housing management, independent living, health, addiction and disability support are offered along with inclusive wellbeing and learning activities and a Care at Home service if needed. Rowan Alba says the model saves £3 to £4 for every £1 invested by the local authority as tenants’ interaction with criminal justice and health services is reduced. The charity also provides settled homes for younger men and women with complex needs caused by early trauma, violence and aggression at Thorntree Mill, also in Edinburgh.

Karen Barr, CEO, says: “Making such a positive impact on the lives of marginalised people by providing them with a safe place, acceptance and a tolerant attitude is literally saving lives. We address their health, addictions and financial challenges with human kindness, making them feel cared for, sometimes for the very first time in their life. We extend this to our communities with our prevention service through befriending with people in crisis. We are proud to declare our model works.”

6.3 The circumstances in which it would be used

There are two main circumstances in which supported housing offers an option for people who have connected with homelessness services. These categories are adapted from the evaluation of Scotland’s Housing First pathfinder [ref 26]:

(i) As a health and social care centred response for:

a. Some people who lack capacity at this time to comprehend a standard tenancy agreement and/or the consequences of not meeting its conditions (such as an acquired brain injury resulting in severe cognitive impairment).

b. Some people whose health or social care needs exceed what can realistically be catered for in mainstream housing.

A person should be able to choose to opt out of a supported housing option, even if they meet one or both of these descriptions. A harm reduction strategy should be put in place for people who choose to opt out.

Or:

(ii) As a housing and homelessness centred response for people who do not fit the description at point (i) above, but who:

a. Expressly do not want (or have not sustained) mainstream housing, including Housing First.

b. Expressly do want shared and supported housing.

c. Are a young person under 25 who wants to stay in shared and supported housing (which can be considered transitional, not temporary).

While the routes to supported housing and reasons for choosing it will be unique within and across both categories, we intend no differentiation between the type of supported housing service. This overarching approach is what will enable consistency in quality of environment, care and support. And to provide a settled housing option (for as long as someone wants it), ending the legacy of providing ‘homelessness’ supported housing.

Case in point:

A supported transition to settled housing

Service Provider: Blue Triangle

Service Name: Working to Reconnect + Achieve Potential

Location: Renfrewshire

A support worker’s insights on supporting Peter* in local authority supported housing.

Peter was referred to our service after being liberated from prison following a 7-month sentence for knife crime. A support worker from Renfrewshire Council carried out an initial assessment of support needs before his details were passed to me.

When I first met Peter in his local authority supported accommodation, I was able to spend time speaking with him, hear his views on his situation and began to build a therapeutic relationship. I was able to understand that he was feeling isolated from his family and wasn’t connected with any support services. Peter was struggling with his mental health and wasn’t taking recently prescribed medication as he didn’t know how to access it. He mentioned he found it hard to read and respond to letters. I also discovered that he didn’t have an income.

We agreed to meet every Tuesday and Thursday afternoon initially, where I supported Peter to achieve his chosen goals. As the weeks passed, it became evident that he was progressing toward his goals and beginning to build trust in our service - he registered with a local GP, linked in with local drug services, accessed benefits online and applied for his bus pass entitlement card to visit family. As Peter had a history of tenancy breakdown linked to offending, his move to settled housing was phased with a short Scottish secure tenancy initially. However, Peter will be signing a Secure Scottish tenancy in the coming weeks and feels he has benefited greatly from working with the supported accommodation team.

*Not his real name

6.4 The estimate scale needed

The Shared Spaces research [ref 4] triangulated data sources to set the percentage range of an estimate annual demand for supported housing at 2-5% of people who make a homeless application to the local authority each year.

The approximate range is between 796 and 1,964 people each year across Scotland, based on 2022-23 homelessness data published by the Scottish Government [ref 27] - see appendix iii for breakdown.

The Housing (Scotland) Bill introduced to the Scottish Parliament in March 2024 places a duty on local authorities to undertake a strategic assessment of housing support needs in their area. This is a hugely important development that can help to ensure that local housing support needs are adequately met. The task and finish group considered that:

• A standardised approach to identifying support needs at the person-level is needed, which should correspond with a strategic tool at a local authority level.
• The 2-5% range for supported housing is the best available measure and should be incorporated into how housing support needs are forecast in each area.
• This range of people identified by the local authority homeless service as best-fit for supported housing should be measured alongside the level of need for supported housing among people using health and social care services – moving away from commissioning ‘homeless’ supported housing in Scotland.
• The local authority retains overall responsibility for people who are homeless or at risk of homelessness.

6.5 Where it fits with other housing options

The task and finish group recognises that most of us, with the right support if we need it, can build and live our lives in an ordinary home as part of an ordinary community.

The group also highlight the expert contribution from Sanctuary Housing Association (appendix ii) on the fuller potential for RSLs to support people to sustain mainstream housing. For example, to actively assist transitions through community or residential care for people in recovery from addiction while ensuring mainstream housing is sustained.

The best available evidence enables the following breakdown of broad housing options among households who make a homeless application to their local authority:

• Around 50% do not have support needs beyond their need for housing which can be met in mainstream housing [ref 27].
• Of the 50% who do have support needs, most of this can be met by housing support services provided at home in mainstream housing [ref 27].
• Around 10-15% would be considered best-fit for Housing First [ref 28].
• Around 2-5% would be considered best-fit for supported housing [ref 4] [ref 26]

The need for support can also diminish over time once settled housing is secured. Health and homelessness research from Andrew Waugh in 2018 [ref 30] showed that over 70% of people never returned to the homelessness system after they had settled housing. Scottish Government homelessness data also shows the long-term reduction in repeat homelessness in Scotland.

Case in point:

Transitional community based supported housing

Service Provider: Queens Cross Housing Association

Service Name: Queens Cross Wellbeing

Location: Glasgow

This service provides transitional supported housing for young people aged 16-25 with experience of homelessness or care and consists of accommodation for 10 young people in a shared residential setting, 3 transitional flats and 40 secure tenancies where young people are supported in their own homes.

Queens Cross Wellbeing avoids a staircase model by enabling young people to go into accommodation that matches their needs. Young people within the residential setting and transitional flats are funded for 19 hours of support. Young people in their own tenancies are funded for 7 hours of support. Support is provided 24/7 no matter what part of the service young people are in. Night service support is critical as often young people need support outside of normal working hours. In addition to being a support provider the service provides enhanced housing management to help young people set up a tenancy, claim housing benefit, maintain rent payments, access support for repairs and maintenance, and receive support if there are anti-social behaviour issues.

The service demonstrates broader outcomes around personal growth, employment and helping young people develop social skills and emotional resilience. The service aims to help reduce interaction with the criminal justice system and develop tenancy sustainment skills until young people are able to manage independently.

The Care Inspectorate recognised the quality of care and support, and management and leadership, grading the service 6- excellent. Young people in the service reported how the supported accommodation had made a difference to their skills:

“Before I came here, I didn't know how to cook or wash. Staff really helped me. They helped to budget. I used to spend my money the day I got it. I'm much better now at managing this. I think along with all the other things they've helped me with, I could manage my own house.”

“I had my own tenancy, but I couldn’t keep it, so I came here. The staff are extremely helpful. Always available and very nice people.”

“I’m very happy with my support. I like it here. It’s not where I thought I’d be, but the staff are extremely helpful. They got me on a course, and I got a bike that I helped to refurbish. It gets me around.”

The Care Inspectorate report makes clear that the service is supported by a committed and passionate team of staff. The Inspection also picked up on the culture of self-evaluation within the service that meant that the young people using the service had a key role in shaping provision. The service has an Investor in Young People accreditation and invited young people to lead assessment of the support. The Care Inspectorate reported that this meant the service delivered tailored support and ‘excellent outcomes for each young person.’

The service is part funded through the local Health and Social Care Partnership, in addition to Housing Benefit funding which covers the eligible service charge. It provides an example of high quality supported exempt accommodation focused around the different needs and expectations of young people.