JSNA Workshop Thursday 11 th December 2014 Anglia Room, Breckland District Council Offices Homelessness and Health in Norfolk
Role of Joint Strategic Needs Assessment Provides a picture of the health and wellbeing of a given area Only as good as what is included We have to have one Informs the work of the Health and Wellbeing Board (Strategy) Linked to annual Director of Public Health report Online JSNA with themes, profiles, reports and data that can be manipulated On the Norfolk Insight website and drawn from that data and analysis - (www.norfolkinsight.org.uk/jsna)
What the JSNA is used for The JSNA provides an evidence base on which commissioners can base their service development (full JSNA reports would usually be termed needs assessments ) Any needs assessment would expect to include findings and recommendations These reports are often requested by commissioners, or can feed into an overall picture of need Any action taken on meeting needs is the role of the commissioners
AIMS AND OBJECTIVES: PROJECT OVERALL To understand more about our homeless population in Norfolk - who are they, where are they, and what problems they are facing To map where we hold information, and where we don t To share knowledge and make contacts Agree to produce a health needs assessment for the homeless in Norfolk
A MEETING OF MINDS
WHAT WE ARE NOT HERE FOR TODAY
COLLATION OF DATA AND INFORMATION This is why we are all here In order to work out how can we be more effective we need to know what we are looking at; homelessness is about more than finding a roof
Roofless 1. People sleeping rough 2. People sleeping in a Night Shelter Houseless 1. People in accommodation for homeless people 2. People in refuges 3. People in accommodation for immigration 4. People due to be released from institutions (prison and hospital) 5. People receiving support (due to homelessness i.e. in supported accommodation) Insecure 1. People living in insecure accommodation (squatting, illegal camping, sofa surfing) 2. People living under threat of eviction 3. People living under threat of violence Inadequate 1. People living in temporary / non-standard structures 2. People living in unfit housing 3. People living in extreme overcrowding
WHO ARE WE TALKING ABOUT? For the purpose of the session and our work, we will be splitting homelessness into three core groups: Single Homeless Homeless Families The Hidden Homeless
SINGLE HOMELESS Single homelessness refers to homelessness among people of adult age without dependent children. It can affect anyone, but the research evidence suggests the experience is concentrated among people with support needs and/or who are on low or very low incomes and/or have a history of worklessness and poor educational attainment.
HOMELESS FAMILIES Homeless families are those homeless people of adult age with dependent children. This group would be deemed in priority need and eligible for assistance from a local authority
HIDDEN HOMELESSNESS This refers specifically to people who live temporarily with others but without guarantee of continued residency or immediate prospects for accessing permanent housing.
I d stay there only for one night at a time but it would be once a week with different friends so I weren t in the way. I used to meet up with different friends different nights, go back and early morning I d be gone. I used to tidy everywhere, to say thank you, coz I never had no money or any income...one night and that s it, leave a thank you summat like two bowls of cornflakes and milk for em. (Harvey, aged 33, talking about his late teens)
AIMS AND OBJECTIVES: TODAY To start the process of producing a JSNA for needs of homeless people in Norfolk and how it affects their health Identifying the gaps we want to fill We can t do everything: we need a start point and a focus group
ALL HANDS TO THE PUMP No one person or agency can do this piece of work All here because of a vested interest in the subject This work WILL benefit everyone
What do we already know about health and homelessness? By Chris Hancock, Housing strategy officer, Norwich City Council
What do we already know about health and homelessness?
Homelessness means loss, loss, loss.it is not just the loss of a home, maybe a partner or of family life, of supportive friends or of a known community. It involves the loss of confidence and self-esteem. The loss of opportunities. These losses are less obvious and the long term effects on children in particular, and the stigma of homelessness, are not ever really taken on board. It s not just the reasons why people become homeless that are important but what it does to you (Health worker in 1997)
What do we already know? What do we mean by homelessness? Statutory homelessness only covers a small proportion of the homeless population in Norfolk. The following table gives a wider definition of homelessness:
What do we already know? Roofless 1. People sleeping rough 2. People sleeping in a Night Shelter Houseless 1. People in accommodation for homeless people 2. People in refuges 3. People in accommodation for immigration 4. People due to be released from institutions (prison and hospital) 5. People receiving support (due to homelessness i.e. in supported accommodation) Insecure 1. People living in insecure accommodation (squatting, illegal camping, sofa surfing) 2. People living under threat of eviction 3. People living under threat of violence Inadequate 1. People living in temporary / non-standard structures 2. People living in unfit housing 3. People living in extreme overcrowding
What do we already know? There have been a number of studies carried out to highlight the links between health and homelessness.
What do we already know?
What do we already know?
What do we already know?
What do we already know?
What do we already know? From the records of all deaths in England between 2001-2009, 1,731 were identified as having been homeless people. Homeless people are more likely to die young, with an average age of death of 47 years old and even lower for homeless women at 43, compared to 77 for the general population, and 74 for men and 80 for women. What did these homeless people die from?
What do we already know? Causes of death East of England London Due to drugs 26.5% 12.5% Other diseases and disorders 14.7% 15.0% Cardiovascular 12.7% 24.5% Due to alcohol 11.8% 16.3% Other external causes 10.8% 4.3% Respiratory 9.8% 8.8% Suicide/Undetermined injuries 7.8% 6.9% Cancer 5.9% 11.8%
What do we already know? It is difficult to measure the real scale of homelessness. Local housing authority returns only give a limited picture of the true extent of homelessness.
Indicators of homelessness Norfolk 1400 Norfolk and England: Nos of homelessness decisions England 120000 1200 100000 1000 800 600 400 80000 60000 40000 200 20000 0 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 0 Norfolk England
East Indicators of homelessness Norfolk and East of England: Nos of households accepted as homeless Norfolk 1600 1400 1200 1000 800 600 250 200 150 100 400 200 50 0 2009 Q1 2009 Q2 2009 Q3 2009 Q4 2010 Q1 2010 Q2 2010 Q3 2010 Q4 2011 Q1 2011 Q2 2011 Q3 2011 Q4 2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q4 2014 Q1 2014 Q2 0 East Norfolk
Indicators of homelessness 2500 East 2000 1500 1000 500 Norfolk and East of England: Households with dependent children in temp accommodation Norfolk 180 160 140 120 100 80 60 40 20 0 09 Q1 09 Q2 09 Q3 09 Q4 10 Q1 10 Q2 10 Q3 10 Q4 11 Q1 11 Q2 11 Q3 11 Q4 12 Q1 12 Q2 12 Q3 12 Q4 13 Q1 13 Q2 13 Q3 13 Q4 14 Q1 0 East Norfolk
Indicators of homelessness Norfolk 2000 1800 1600 1400 1200 1000 800 600 400 200 Norfolk and East of England: Nos of households helped to obtain alternative accommodation 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 East Norfolk East 0 2009-10 2010-11 2011-12 2012-13 2013-14 0
Indicators of homelessness There are other sources of information that give an indication as to the number of homeless households.
Indicators of homelessness Norfolk 500 450 400 350 300 250 200 150 100 50 Norfolk and East of England: landlord possession orders East 3500 3000 2500 2000 1500 1000 500 0 2009 Q1 2009 Q2 2009 Q3 2009 Q4 2010 Q1 2010 Q2 2010 Q3 2010 Q4 2011 Q1 2011 Q2 2011 Q3 2011 Q4 2012 Q1 2012 Q2 2012 Q3 2012 Q4 2013 Q1 2013 Q2 2013 Q3 2013 Q4 2014 Q1 2014 Q2 2014 Q3 0 Norfolk East of England
Nos. of service users Indicators of homelessness 400 350 Nos. of new service users supported within each district in single homeless with support need services 300 250 200 150 100 50 0 Breckland Broadland Great Yarmouth King s Lynn & West Norfolk North Norfolk Norwich South Norfolk 2012/13 126 29 185 105 35 380 112 2013/14 115 27 168 104 32 370 127
Rough sleeping counts and estimates In England rough sleeping figures have been increasing: 2,414 in Autumn 2013 a 5% increase and 37% higher than the count in Autumn 2010.
Nos of individuals Indicators of homelessness 250 Norwich: Yearly total number of rough sleepers verified by outreach team 2008-14 200 150 100 50 0 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 Total 173 110 116 142 218 230
Indicators of homelessness 180 160 Norwich: Presenting issues of clients assessed by street outreach team 163 140 126 120 100 80 68 93 2013/14 60 51 40 20 0 Drugs Alcohol Mental health Dual diagnosis None declared
Greater Norwich homelessness review Our recent homelessness review showed that: There has been an increase in numbers of rough sleepers seen on the streets of Norwich; this reflects what is being seen nationally. 13 at our last count in November 2014. Over the past two years (12/13 and 13/14) the most common housing status of a person seeking housing advice at Norwich City Council is No Fixed Abode (NFA). This category is likely to include people who are sofa surfing, sleeping rough or living at friends/relatives. Increase in numbers of people being seen by homelessness services who are affected by sanctions to their benefit entitlement. This means that people are more reliant on free food hand outs such as the FoodBank. We know that around 11% of Norwich Job Centre s current caseload is subject to sanctions. National research has shown that 1 in 3 homeless people have been affected by sanctions to their benefit entitlement. Increase in the number of people being excluded from services because their needs are too high and complex.
NOW FOR THE FUN PART The golden rules: Work individually to answer each prompt, BUT this is an active brainstorming session; get up and walk around, and talk to each other! Write on post-its, but only one idea/answer per post-it You can say as little, or as much about each prompt If someone else has said what you were thinking-say it again! But, above all - follow the guidance for proper use of the Post-It notes
POST-IT: CODE OF GUIDANCE ONE IDEA/COMMENT PER POST IT NOTE PUT YOUR INITIALS AND ORGANISATION ON THE BOTTOM RIGHT CORNER OF EACH POST-IT PLACE POST IT HORIZONTALLY ON THE FLIP CHART DON T COVER ANY OTHER COMMENTS, MORE PAPER WILL BE ADDED WHEN NEEDED
EXAMPLE
LETS GET CRACKING
QUICK CLUSTERING In small groups, pick a flip chart and cluster your answers by similar type. Give each cluster a heading Put any which need further clarification to one side Be prepared to provide the group with feedback, just an overview of the main themes.
CLUSTERING SESSION
FINDING OUR FOCUS
So what next? Agree the focus for the JSNA Chapter what do we think we need to do first? Are there any volunteers who can help to plan and write sections of the report? Plan the work in January 2015 with aim of writing it by April 2015 Publish presentation and notes of workshop on JSNA by mid January 2015 Report findings of needs assessment to Health and Wellbeing Board in spring 2015
Contact details Judy Lomas Joint Strategic Needs Assessment Manager Public Health Room 210, North Wing Norfolk County Council County Hall Martineau Lane NORWICH NR1 2DH 01603-223442 e-mail: judy.lomas@norfolk.gov.u k Kerrie Gallagher Housing and Public Health Partnerships Officer South Norfolk District Council T: 01508 533783 e-mail: kgallagher@snorfolk.gov.uk www.south-norfolk.gov.uk
Contacts (cont.) Chris Hancock Housing Strategy Officer Norwich City Council City Hall Room 429 Norwich NR2 1NH Ext 01603 21 2852 mailto:chrishancock@norwich.gov.uk