Francis was in hospital undergoing an oper­ation on an infected leg when the friend he’d been staying with told him he needed to find somewhere else to live.

On leaving hospital and returning to the flat, Fran­cis found that his friend had changed the locks and he was left sitting in the road on his crutches. This was during the summer of 2020, during the middle of the coronavirus pandemic, and Francis had nowhere else to go.

He initially spent some time moving between dif­ferent hostels before coming into contact with our PLACE team — Pan London Accommodation & Community Engagement — who work with people who have been staying in temporary accommoda­tion and have been referred to Thames Reach by a local authority. The team helps people to access private rented accommodation across London, and provides initial support once the client has moved in.

PLACE were able to help Francis find a flat of his own, as well as helping him to furnish it, sort out bills and administrative issues, and provide further support to get him back on his feet.

‘When I first moved in here I didn’t have a bed, furniture, a washing machine, nothing,’ he says. ‘They’ve helped me get all of these things, though. I’ve got my own home now, which I’ve never really had before. Now my children can come to see me, my son comes to stay with me on weekends. That didn’t happen when I was in hostels.’

While Francis is still troubled by his leg, he’s recovered enough to work part time now, and mentally is in the best place he’s been in for a long time. His goal now is to learn a new trade.

Health inequalities are one of the main concerns for Thames Reach in our work to end street homelessness. We spoke with Yves, who manages our Robertson Street hostel in south London, on the work they are doing to ensure more people are getting access to the support they need.

Hi Yves, can you introduce us to your service?

Robertson Street is located in Lambeth, south London, and is what you would call a ‘first stage’ hostel, meaning we can get referrals from a range of sources through Lambeth’s Vulnerable Adults Pathway. We have a capacity for 42 residents and ideally each resident’s length of stay is between six months and two years.

What kind of support do residents have access to during that time?

We are an accommodation-based service to  people over 40, so provide access and signposting to support. We want to help residents to be able to move on to independent or semi-independent living following a stay here. We’re part of the Lambeth Vulnerable Adults Pathway, and accommodate residents with a range of different and complex needs. These support needs may have previously contributed to their homelessness or not being able to maintain tenancies or other forms of accommodation. Other hostels in the borough work with different age groups, which is why we specialise in over 40s. We do have a couple of people under 40 but this is because their complex physical, or other, needs cannot be met in other services.

What is your approach to addressing healthcare inequalities at Robertson Street?  

We strive to counteract inequalities and promote inclusion. Inequalities take several forms when we are working with people who have experienced street homelessness, as we must support people to bridge these inequalities, mostly in terms of healthcare. One of the things we do is work with the pathway manager and other external partnerships in order for people to move into needs-based accommodation. It is paramount that an individual can access the support they need. We have a nurse and GP clinic once a week at Robertson Street, as well as a prescribing clinic, and we have very good connections to community mental health services. We really make health a priority. Initial assessment work is carried out in-house when residents first move in, then we can signpost to physical, mental and other medical advice externally, meaning they can continue to get support in the community after they move on. We support residents to attend appointments, working with partnership agencies and Groundswell. This level of encouragement and support enables a smoother move-on into the community when the time is right.

What challenges has your hostel faced during the pandemic?

The main challenges were the move-on pathway becoming less mobile than usual. The repercussion for move-on being unavailable was that we couldn’t move people into the hostel either, so incoming and outgoing options were very limited. Community services that we always promote were facing closures and limited availability, such as day centres, mental health support, drug and alcohol services and other community-based resources, so we had to try our best to keep up momentum and motivation for move-on. While moving services online to Zoom is a good way of keeping people safe, many residents have found this difficult to engage with. We have been keeping residents motivated that their move-on will be happening eventually and kept preparation going. As a team we’ve accomplished this really well, and have been able to keep morale up. Aside from our normal work we had to implement extra cleaning on-site, but it made a big difference; we reduced risk of infection by sanitising the building twice every shift and educating residents about social distancing, risk management and maintaining safe practices.

What positive outcomes have emerged from overcoming these challenges?

We have a great team with good adaptability who can deal with and are supportive of a range of needs. There is a good balance between experienced members of staff and enthusiasm of people who have recently come to work in the sector. I’m proud that we’ve been able to provide a consistent and continual service throughout the pandemic, which reflects the project and Thames Reach as an organisation; we haven’t had to defer anything. Anything that wasn’t available in the community we brought in; our next step is now integrating residents and services back into the community.

On 12 August, in partnership with Lewisham council, Deptford Reach hosted a health and wellbeing day for members of the community and users of Thames Reach services. The invite was extended throughout the organisation as part of our ongoing commitment to bridging the inequality gap created by street homelessness.

While Deptford Reach is known to be a day centre hosting various activities for its visitors, since the pandemic the team have been extending their reach to ensure those in the wider community know about their resources and means of support. This has included outreach at Lewisham food banks.

The day involved drop-in services including COVID vaccinations, nurse appointments for general health checks, CGL (drug and alcohol support); Hep C, Hep B, HIV and syphilis testing with results given on the day; STI testing; advice and demonstrations for lateral flow testing, including handing out test kits on outreach; and information and advice on infection control.

It was a successful and positive event, ensuring people felt welcome and safe in Deptford Reach’s building, at the heart of the community. There will be more similar events in the future as part of the service’s focus on more outreach work. In the meantime the team facilitate regular GP and nurse appointments in the building, as well as supporting people to register with GPs in the community.

Sive O’Regan, inclusion health clinicial nurse specialist, said: “Really happy with today’s turn out for our point-of-care blood borne virus testing at Deptford Reach. A really well organised health promotion event that we thoroughly enjoyed being a part of and look forward to the next.”

Jordan McTigue, lead manager at Deptford Reach, said: “It can be difficult for people with experience of street homelessness, as well as those at risk of street homelessness, to access health services, so this is such an important day to get people engaged and get them vaccinated and protected against COVID-19, as well as providing resources and information to prevent ill health where possible.”

In the period since the start of the pandemic, reporting on numbers of people sleeping rough has been varied, often not taking into account the various ways individuals can be, or can find themselves, homeless. While the most recent CHAIN statistics signal that there has been another increase in people being made street homeless, Thames Reach chief executive Bill Tidnam explains that understanding the issues faced by people experiencing homelessness requires more than numbers.

“The 3% rise in numbers of people seen sleeping rough compares with a rise of 21% the previous year. We need to remember that this covers the first quarter of 2020/21, where a record number of people were experiencing street homelessness as a result of the economic impact of the first lockdown. These figures also tell us that there was an increase in numbers of people sleeping rough with no support needs and more younger people, which seems to represent this same group who would not ordinarily have slept rough.

“Fortunately we have seen a significant rise in funding for services working with people sleeping rough. The resulting increase in outreach activity has meant that more people have been seen and recorded by outreach workers, making the data more reliable.

“We do have significant concerns for the future though; the European Union Support Scheme, with its deadline at the end of June, means that the 20% of people seen rough sleeping who are from Central and Eastern Europe now have even more limited options. This also includes people who have been housed in temporary accommodation and hotels as a result of the pandemic, projects which now face closure.

“A lift in eviction bans has not resulted in an immediate increase in people sleeping rough, but the impact of this will take time to show, as will the end of increased Universal Credit payments in the autumn.

“The availability of short-term accommodation through the ‘Everyone In’ initiative has been welcome, but it does not remove the need for the sort of specialist, high-support-need settings that will help people come off the streets and rebuild their lives.  Our outreach teams desperately need access to emergency accommodation that is immediately available, where need can be quickly assessed and suitable options can be identified for the individual.

“There are many reasons why people become homeless, and the accommodation available when people are helped off the street must cater to their needs and provide the right environment to gain stability and establish long-term options. The street is not the best place to achieve this.”

Thames Reach will not normally withdraw a service from individuals because they do not have recourse to public funds. However, most of our residential services require residents to pay rent and service charge, the majority of which is normally paid through benefits, and non-payment of these charges will jeopardise the future of the service.  This means that we cannot routinely provide accommodation to people without recourse in most of our residential schemes.

In the case of vulnerable people, and those experiencing homelessness, who do not have recourse to public funds, we will seek to provide accurate advice, assistance and support, including advice and support around employment. We recognise that in many cases this support will include referral to a qualified specialist provider of immigration legal advice, as at Thames Reach we are not qualified to provide this advice internally.

Where users of residential services are responsible for rent and charges, they will need to be able to demonstrate how they will be able to pay before they move in. We will continue to advocate for a range of emergency provisions that will allow people who are sleeping rough, who do not have the means to pay for accommodation, access to short term shelter; this will allow more sufficient time to more effectively resolve their homelessness. During their time in this short-term accommodation, we can also provide support from different teams within Thames Reach and our partners, whether this is to resolve their immigration status, find employment, or voluntary reconnection to an appropriate country. This short-term accommodation could be specialist shelter accommodation, safe spaces in existing hostels, or other appropriate settings.  Access to this accommodation is limited and we will prioritise access on the basis of vulnerability in conjunction with commissioning authorities.

Where people who are living in Thames Reach-managed accommodation lose entitlement to support through public funds they will normally begin to accrue arrears.  When this occurs, managers are asked to look at each case on its own merits, looking particularly at the vulnerability and needs of the individual.  Options should include the use of local authority support, advice and support to access more appropriate accommodation, and referrals to specialist agencies and other charities, and welfare funding to support these courses of action.

Thames Reach are committed to providing support to non-UK nationals facing street homelessness in London. We will continue to publicly highlight particular challenges faced by vulnerable people and those experiencing homelessness, who do not have recourse to public funds.

At Thames Reach, we welcome the new RSI (Rough Sleeping Initiative) funding provisions for rough sleeping services, with the government’s announcement last weekend that councils will receive a further £200million in this stage of their plan to support people experiencing rough sleeping. This is positive news that will help continue our efforts to reduce rough sleeping in London.  However while we welcome this investment we believe that there is an urgent need to review the national Rough Sleeping Strategy, learning from the lessons of the pandemic, both positive and negative.  Alongside this we would like to see a return to multi-year funding that can provide the sort of stability that will help us feel confident that we can offer lasting solutions to street homelessness, and help people along the journey of moving on from the streets, which only starts once an individual has been housed.

As part of this we would like to see an increased focus on the prevention stage of street homelessness, working with people to divert them away from the street and into more secure accommodation.  The last year has shown how precariously many people are housed, and highlighted the need to intervene earlier. We know that street homelessness is a huge cause of trauma and anxiety, and causes lasting damage, and it is crucial that we are able to work effectively to prevent this.

Any revised strategy will need to address the needs of people without recourse to public funds, particularly those with complex support needs.  Without this help for people who are currently largely ineligible, street homelessness will continue and numbers will increase.

How has the City of London outreach been going since Thames Reach took over the service in November 2020? Are there any experiences or outcomes unique to your team?

I think that it has been going really well! It has been exciting to join a team where we can really build the team from the ground up. We are fully recruited with seven members of staff, so now we can look at how best to utilise our resources. It is only a square mile but there is a lot to do!

Something that is unique to the City of London is that it is not an area where many people actually live. The residential population of the city is around 9,000 so it may not necessarily be somewhere that people have lived for a long time or have links to. With this in mind we work hard to support people back to their borough of local connection or set up new foundations in other areas.

We also enjoy many partnerships with external agencies supporting us in our outreach shifts. Weekly we go out with Doctors of the World, RAMHP (mental health assessments provided by the East London Foundation Trust), the Parkguard, Adult Social Care and there is also a new outreach psychotherapist provided by Providence Row. This amount of specialised support has been invaluable in helping people access healthcare quickly and safely, which can often be a barrier in helping them off the streets.

You’ve worked in various teams at Thames Reach before leading the City of London outreach team; does your approach differ at all to elsewhere in the organisation?

I started in Thames Reach working in the Social Impact Bond (SIB) team, working with people in Camden and Islington with complex needs. This gave me a good experience of how we can engage with people with complex needs, providing a personalised service. Especially helping those who may have experienced homelessness for a number of years and have become disenfranchised with services.

Now I am in the City, I am able to see the similarities in the approaches of the previous teams I have worked in and use them to our strengths in developing our outreach team. In the City one of the sections of our cohort are people who have been experiencing long-term street homelessness, who may find it difficult to engage with mainstream services, similar to those in the SIB cohort. We also work with those who may be new to rough sleeping or ‘transient’ through the City, and this element reminds me of some of the prevention work I was involved with in my role in the Greenwich Navigators team, working closely with external agencies to maintain engagement with services in order to access or sustain accommodation.

It is great to be at the start of the City Outreach contract and to think of how we can use not only my experiences of working in other teams, but also drawing on the strengths of the team as a whole and their experience of working in the sector. Everyone has their own background to bring to the team and it has created a very diverse group with a shared determination for the new project, which is very exciting!

Which other teams in Thames Reach are you working closely with to help people leave the streets?

It has been really helpful for the team and especially new members of staff to be around other Thames Reach outreach teams in our new office to discuss ideas and approaches. With the transient nature of people in City who may have come from other boroughs, it’s really helpful to be based in a hub of other outreach services. Even though we may be supporting someone who has crossed over to another borough, team members from those boroughs may be sitting next to one another – which can make communication much easier!

With the current need to support those who are housed in emergency accommodation, we have been doing a lot of work helping people gain employment if they are not eligible for benefits in the UK. Luckily, the Employment Academy have been supporting us greatly with these cases and we are now seeing more people we work with access employment, now that lockdown is easing, and businesses are recruiting.

As a new service to Thames Reach we are establishing links and pathways for clients to make the most of the other teams in the organisation. We are looking to actively refer people to the Private Sector Lettings team so those who are ready can access housing in the privately rented sector. With general tenancy sustainment support needed as well to make sure that the housing solutions we create are long-term, we will be also referring to the TST PRS [Private Rental Sector] teams at Thames Reach to make sure that people we work with remain supported through moving on, which is a big change to adapt to.

How do you see the service developing, and what are you looking forward to?

Despite the workload that goes in to setting up a new service, I enjoy the early stages of a project! The process of getting a team together, setting goals, and thinking about what works well and what may need some change is a welcomed challenge. Now we have the team recruited and targets set, it is now time to keep focused and moving forward.

I’m looking forward to the next few months and supporting everyone who has come in under ‘Everyone In’ and SWEP (Severe Weather Emergency Protocol) over winter and helping support them into longer-term accommodation with appropriate support. I am also looking forward to the challenge of working to reduce the amount of long-term rough sleepers in City as a whole. We have had some really positive outcomes this year so far in this area. I definitely recognise and appreciate all of the hard work from various teams and professionals that came before us. This has led up to the point of people with complex needs finally accessing accommodation. I am hoping to continue with this progress and see more of the positive changes in the City cohort as a whole.

In terms of development, it seems like the City team keeps growing! We will be providing in-reach support with two dedicated support workers who will be based at the hotels where our emergency accommodation is. With more members of staff, we have more dedicated time with each individual, and therefore provide intensive support that may not always be possible for outreach services.

In our monthly street counts we have been seeing reductions in the number of people sleeping rough, so I am hoping that we will be ready to face the challenge. I am positive that we seem to be going in the right direction overall.

The London Assembly Housing Committee has released its report on ‘Five Steps to Build on Everyone In in London’. It takes a thorough look at the current landscape of rough sleeping in London, and the legacy left behind by the ‘Everyone In’ initiative. Highlighting that rough sleeping in London has increased by 170% in the last decade, the committee has produced at set of recommendations for the Mayor of London and government alike in order to reduce the devastating impact of street homelessness on people’s lives.

The cross-party Housing Committee examines matters relating to housing in London and takes a lead on scrutiny of the Mayor’s Housing Strategy.

The report takes a close look at numbers of people spotted rough sleeping in each quarter of the year, and breaks down these statistics to understand more about the people behind the numbers: their demographics, their support needs, and what brought them to the streets. This report has a particular focus on the first three months of the year, when the economic and social impact of the first lockdown manifested in an unprecedented increase in the numbers of people seen sleeping on the streets.

The report also deals with the response to this, particularly the provision of temporary accommodation (the ‘Everyone In’ initiative), and the Greater London Authority (GLA) and charity response to this.

Audrey, a Thames Reach support worker at Deptford Reach who was seconded to one of the hotels we ran during ‘Everyone In’, is interviewed on page 18 of the report:

“While supporting clients in the hotel, I was able to see that clients engage more with support staff than they do while working at the day centre. A client that I had difficulty engaging with before COVID was identified by the London Street Rescue team as a rough sleeper. The client had no identification, no bank account, and no job. The client was in the hotel from April to September. I met him in the hotel, and he engaged with me rather quickly. After completing an assessment with him, and understanding his predicament, I was able to support him to obtain an ID, a bank account, and Universal Credit. Currently, the client is living in private rented sector accommodation.

Working with the client helped him to realise that he neglected himself and had not taken care of himself properly. He told me that he would “take care of myself now,” and this goes to show how much he has learned from his experience rough sleeping.”

At Thames Reach, we find it encouraging that the Plan Points stated at the end of the report are already very much engrained in Thames Reach’s mission of ending street homelessness, in particular the cross-sector collaboration and the tailored solutions for people with high support needs, which we outlined in our recent statement outlining our vision for 2021.

Thames Reach have seen that people have continued to come onto the streets since the first lockdown, and while ‘Everyone In’ has ensured that the first group of people experiencing homelessness were temporarily housed and provided with support from our teams such as Private Sector Lettings (PSL), the people we work with are not a static population, and that the need for effective prevention work is greater than ever.

2020 was a year of great challenges for Thames Reach and the wider world, but it was a time where it was most clear that our vision of ending street homelessness is an urgent social and health priority. Thames Reach’s community of staff, volunteers and supporters came together throughout the year to ensure that vulnerable people were not left behind, from the Everyone In initiative in the Spring, through to maintaining and adapting all our services to respond to the impact of the pandemic.

Our core mission remains as it always has: to help people who are homeless or vulnerable find decent homes, build supportive relationships and lead fulfilling lives. While we need to respond to a world that is changing fast, our priorities for how we work to end street homelessness are now even more urgent.

A tailored approach to housing and accommodation. While there is a shortage of housing in London that is available to the people we work with, we recognise that it is not enough just to build more. Housing is not a one-size-fits-all solution, and there is a need for a range of accommodation models that can meet specific needs for independence, security and affordability and which complements the support that people will need at different points in their lives.  We know that this is not something that we can do on our own, and that we will need to continue working in partnership with other groups to achieve this.

Increased awareness of and access to healthcare for homeless people. Homelessness and rough sleeping has a catastrophic impact on the health of people affected by it. This can continue long after people are securely housed. The impact is worse, because the people we work with often do not get access to the health services that the rest of us take for granted.  We will work with health services to remove barriers to access, and to help services respond better to their needs.   Services such as the Lambeth Living Well Network, and our own Social Inclusion Project, are able to break down unhelpful barriers between clinical and social support and by doing so provide more effective and  sustainable recovery.

Providing support for non-UK nationals sleeping rough on London’s streets. Non-UK nationals, particularly those from the European Union, are disproportionately represented amongst people on the streets and in insecure accommodation.  With precarious immigration statuses and limited access to  support available, this is set to continue. The majority of the people we have been working with have called London their home for a significant amount of time, and have contributed to our communities in many ways. They have been particularly severely affected by the pandemic, often losing work without the safety net of benefits available to others.  We can help by supporting them into employment and affordable accommodation, and ensuring that they receive the advice that they need.

Pascal originally came to London in 2008 from Spain, where he was living after moving from Cameroon. In 2012, he lost his one-bed flat in Abbey Wood, so went back to Cameroon before later returning to the UK, working as a general operative in Leicester for two years. Pascal first needed support from Deptford Reach in 2017 after he became homeless and was staying in a night shelter. In the following years, he was able to develop connections in the community and access private rented sector accommodation, as well as receive help with Universal Credit.

As a dual citizen of Spain and Cameroon, Pascal soon had to apply for his indefinite leave to remain in the UK, so Deptford Reach referred him to Fernando in the EU Settlement Scheme (EUSS) team at Thames Reach. He deeply appreciates how much Fernando has helped him with multiple aspects of the application, including the language barrier as Pascal’s main language is Spanish, although generally his English is very good. The application process went well, and his indefinite leave to remain was granted. This outcome completes his work with Fernando.

His plans now are to get a good job and have his family, who are currently living in Spain, join him. In his spare time he loves to watch football and tennis, and is an avid reader of spy novels. 

Pascal says it was great to find an organisation that helped him, and the support he received has given him confidence to move on with his life. He says he wishes more people knew about the services offered at Deptford Reach and the EUSS team, so more people like him can find the right support.

This winter, we’re highlighting the work we’re doing to help people move on and live more fulfilling lives. You can find out more about our Moving On From Homelessness campaign and the services supporting people like Pascal by clicking the link here.