Assessing Need

This section looks at the information that is needed to address older homelessness locally and introduces you to the tools available to do that.

A starting point for this work is to find out about the older homeless population in your local authority area. You will need to define the age threshold.  People who have lived a homeless lifestyle age prematurely and often have chronic health problems and care needs by the age of 50 years. 50 years plus is suggested but some authorities choose a younger or older age group.

What information is needed?

The Older Homeless Project recommends that the information you will need to tackle the needs of this population locally includes:

• How many people over the age of 50 years are living in hostels, or sleeping rough in our local authority area?
• What is the age, gender and ethnicity profile of older homeless people locally?
• How long have they been in temporary accommodation?
• What are their needs, in relation to health, independent living-skills, challenging behaviour etc?
• What kind of move-on accommodation would meet their needs?
• What is the resident’s opinion about move-on?

The Older People’s Needs Audit

Homeless Link have developed a toolkit,  the older people’s needs audit. The audit is a simple tool that will provide you with the mechanism to gather and collate the information outlined above and is available free from our website. Oxford, Brighton, Cambridge and Westminster and Blackburn and Darwen helped to develop the toolkit. It has helped them to plan to move-on the existing older client group and to look at the gaps in their provision. To get an idea of the type of information gathered look at the summary of results. 

Blackburn and Darwen describe below how Information from the audit has has informed their strategic planning:

•  to support the Homeless Strategy
• by the PCT commissioning team, in guiding the formation of a team of health access workers.
• by the Supporting People team for their forward planning
• by the DAT and Alcohol reduction team as evidence for the development of specialist housing.
• the information was inputted into ‘The Need for Support and Supported Housing Services in the Northwest 2008-2020’ model which will inform future investment by the Homes and Communities Agency
•  to inform a sheltered housing review and to support the development of extra care housing.

Cambridge City Council - as a result of undertaking the older people’s needs audit Cambridge City Council have made a commitment within their Homelessness Strategy 2009-12 to address the issue of older people with complex needs.

Key priorities include:

• increasing positive move-ons from hostels along with a commitment that no more than 5 % of residents should have hostel stays of longer than 18 months
• ensuring and demonstrating that the choice based lettings scheme is accessible to vulnerable groups
• developing a long term housing service for homeless people over 45 with complex needs to be delivered by 2012

 Detailed assessments

 The audit will give the authority an idea of the proportion of their older residents in hostels for whom the various housing and support options would work. The housing and support options as described in the audit are:

• sheltered housing or another independent option, with initial resettlement support
• sheltered housing or another independent option with additional long term support i.e. support worker helping to shop, cook etc. and to help manage support needs
• permanent supported housing specifically for people with complex needs
• accommodation with ongoing support and physical care on a daily basis. e.g. registered care

Dependent on the findings of the audit your authority may wish to explore some areas in more detail.

Westminster Audit - in Westminster the audit showed there were 30 residents who had been in the same hostel for more than 2 years, one-third of them are over 65 years of age and nearly half had been in the hostel for over 10 years.

Two of the issues that come out as dominant in this cohort are institutionalisation and difficulty in engaging in support planning. It was decided there to take a case management approach around the move-on of these particular individuals. Another suggestion was encouraging each hostel with older long stay residents to appoint a lead worker on older homelessness to help older people move on into appropriate housing and support. It was suggested this process would be reviewed through contract monitoring.

BME elders 

The audits that have been carried out so far have shown a predominantly white UK older population resident in the hotels. Older people who are homeless in the BME community are more likely to be hidden because:

• current services may not be appropriately accessible to this group
• they may have made interim arrangements with family/friends
• there may be a cultural stigma attached to homelessness and perception by ‘the community’ that they have done something wrong.

Effort needs to go into finding out where BME elders are and what the specific issues are for different BME communities, what provision there is locally in the voluntary sector in relation to BME elders. Those agencies may have insight into the issues and be able to reach this group. An Equality Impact Assessment should be carried out in relation to any proposed initiatives or changes to policy/procedure.