‘Everyone deserves to live with dignity and care’

People with lived experience of homelessness are missing out on the care they need and deserve because of a lack of specialist provision.

That is the conclusion of a new review by leading homelessness charity St Mungo’s published today (25 August 2022)

The report – entitled Life changing care: The role, gaps and solutions in providing social care to people experiencing homelessness – examines the provision of care services for people who have been homeless and makes eight recommendations about how to improve the current situation.

Care services can be defined as those able to carry out activities including administration of medicines and the delivery of personal care – and are regulated by the Care Quality Commission (CQC).

People who have experienced homelessness often have multiple and complex health conditions, which can result in their care needs being much higher and more prevalent at an earlier age, than the general population.

St Mungo’s runs two specialist care homes, for people who have experienced homelessness, which are both registered with the CQC.

The charity’s review, which was carried out in partnership with the Co-Clinical Lead of the Homeless Health Programme at Healthy London Partnership Dr Caroline Shulman, collates data from 31 of its non-CQC registered services and reflects the needs of 1,442 clients.

It identifies that there are many people in these services who require some level of care input, and some whose additional care requirements are not being fully met. These include people requiring support with dementia (5%), people with self-neglect/self-care issues (12%) and people with deteriorating health (29%).

The main barriers to accessing appropriate and timely care were identified as:

• A very limited supply of specialist care homes which can cater for the unique needs of people with complex care requirements resulting from their experience of homelessness
• Challenges in seeking and securing a Care Act assessment, which is the process by which people’s care needs are identified and addressed, and the
• Capacity and efficacy of adult social care provision in some areas to meet those needs.

St Mungo’s Interim Chief Executive Rebecca Sycamore said: “Health and homelessness are inextricably linked. It is a fact that people who have lived on the streets have significantly higher medical and care needs, and we know that the legacy of poor health resulting from sleeping rough can last a lifetime.

“As a result specialised accommodation, designed to meet both a person’s housing and care needs, is required but is currently sadly lacking.

“People with lived experience of homelessness should receive parity of provision, and not miss out because of lack of access. Everyone deserves to live with dignity and care.”

Ms Sycamore explained that St Mungo’s chose to undertake the review to identify where it can improve its service to its clients, and chose to publish it to highlight the issue, and raise awareness more widely in society. She also thanked Dr Shulman for her time and expertise in developing the review.

Ms Sycamore continued: “We know there is some excellent work already being undertaken in this area such as the guidance published earlier this year by the Local Government Association and the Association of Directors of Adult Social Services and we are keen this is built on.

“Over the coming weeks and months we’ll be ensuring the findings of our review are shared with those most able to make a difference across the health, housing and social care sectors; and discussing how we can work together to develop this important provision. And we thank Dr Shulman for her time and expertise  in helping us develop this work.

“We will also be sharing our recommendations with the Government to make sure people who have experienced homelessness are included in its plans for care provision, so as many people as possible can receive the life-changing care they need and deserve.”

Commenting in response to the review Michelle Binfield, Rough Sleeping Programme Director, London Councils, said: “As co-chair of the London Life Off the Streets partnership, I know first-hand the great work that London local authorities are doing to tackle rough sleeping, with a real focus on helping those with complex health and care needs sustain a life away from the streets.

“The challenges we face are immense – resources are stretched and demand for services is growing – but we are grateful to be able to work with partners like St Mungo’s, and social care teams across London, to better understand and respond to the care needs of homeless people.”