Agenda item

Sonia Bernard (L&Q), Moira Griffiths (Family Mosaic), Martin Pearce (Family Mosaic), Phil James (Phoenix Community Housing) and Annabel Davidson (Phoenix Community Housing) introduced themselves and spoke about their work. The following key points were noted:

·         L&Q provide a range of services for residents struggling with a range of issues. This includes a tenancy sustainment service, which provides up to six months of support to people whose tenancies are at risk. L&Q also offer services to help tenants manage their money better.

·         L&Q said that mental health problems are often one of the reasons someone might be struggling to maintain their tenancy. Issues with anti-social behaviour are also often found to relate to mental ill health.

·         Family Mosaic said low-level mental health issues are becoming increasingly common. There’s plenty of anecdotal evidence of increasing numbers of vulnerable people in general needs housing – people with multiple needs, who don’t quite reach the level for statutory intervention but are struggling to maintain their tenancies.

·         With welfare reform, Family Mosaic recognise that they have a role in their tenants’ health and wellbeing. It’s now part of their mission statement and they’re trying to shape their interventions so that they’re targeted at people they recognise as vulnerable.

·         Family Mosaic are paying increasingly close attention to the first year of a tenancy. As well as assessing affordability, they’re trying to better understand people’s wider needs and provide more targeted interventions. They said, however, that much of this relies on further income.

·         Family Mosaic noted that while low-level mental health issues are affecting all housing providers, at the moment, it is too often allowed to escalate to crisis point. They agreed that more prevention and early intervention work is needed. 

·         Phoenix Community Housing are also seeing high numbers of vulnerable tenants with mental health issues of various levels. They find it particularly difficult to get the right support for those with low-level mental health needs.

Witnesses answered questions from the Committee. The following key points were noted: 

·         Family Mosaic provide all frontline housing managers with mental health training – looking at pathways, possible trigger points, signs and symptoms, and making the right referrals.

·         L&Q frontline housing officers receive introductory mental health training. Tenancy sustainment officers receive more intensive training. Organisations such as Mind have also come to team meetings in the past.

·         Phoenix staff are trained on a range of issues from hoarding to domestic violence – sometimes by external people and sometimes by e-learning. Staff also get training on having challenging conversations, to give them the skills to deal with a variety of difficult and sensitive situations.

·         Phoenix Community Housing carry out a vulnerability assessment at the start of a tenancy, consisting of a number of questions about physical and mental health, including whether they have a support or social worker. There are then at least three home visits during first year – one at six weeks to make sure the tenant’s settled in, and again at three and eight months to make sure the tenant’s accessing appropriate services on offer. These visits also provide an opportunity to pick up any signs of mental ill health.  

·         L&Q said that they’ve had to get to know their residents and understand their vulnerabilities better since welfare reform. During a recent pilot, for example, they found that around 50% of residents in general needs housing had some sort of vulnerability.

·         L&Q explained that it’s in their interests to understand their tenants and that if they can support a resident to stay in their home they will. The eviction process is expensive and they will explore all other options before going down this route. The earlier problems are picked up, the more likely – and sometimes more able – people are to engage with the support on offer.

·         L&Q said that information sharing can be complex and that getting information about tenants’ needs is a problem. It is often difficult to get consent – some people are reluctant to provide information that they think might affect their tenancy.

·         Family Mosaic have also found information sharing difficult – and that the law around data protection is frequently misunderstood and allowed to get in the way.

·         Family Mosaic have a confidential helpline people can call if they’re particularly worried about someone. Repairs teams, for example, will often see things that others won’t and this confidential helpline allows them share this information.

·         Phoenix have signed up to several information sharing protocols, but they also rely on good stakeholder relationships and building trust with tenants.

·         Phoenix have had problems trying to establish how many people in their properties have mental health issues – often people won’t admit, or perhaps realise, they have a problem.

·         Family Mosaic explained how familiar their more experience staff are with local sources of help and support, and noted how this can help to get the right help and support as early as possible. They said it is something they can still get better at though. They also said it’s important to try to work with local GPs and pharmacies.

·         Phoenix said they often have problems with making referrals and not hearing back. They said that they’ve made referrals in the past, expecting that service to make contact with the individual, only to later find out that the case has been closed. Phoenix said this makes it very hard to keep track of what’s going on with their tenants.

·         Phoenix said that hoarding is still a significant challenge. They noted that Lewisham had a hoarding protocol and panel in place some time ago, and said it would be good if it could be refreshed.

·         The council’s Head of Strategic Housing said that the hoarding protocol still exists. The council are also currently setting up a multi-agency safeguarding hub, which will include a dedicated person from housing – so there should be a vast improvement in the way referrals are handled.

·         Family Mosaic said many people with low-level mental health needs, like anxiety and depression, or where they are out of work, have problems with motivation, and suggested that housing providers need to find ways of “nudging” people into higher levels of personal motivation.

·         Family Mosaic are looking into conditional tenancies and whether rather than just offering people support, they can say that a tenancy comes with the requirement for you attend certain support programmes – employment coaching, for example. They acknowledge that it’s a tricky approach to take. 

·         Family Mosaic mentioned the PAM (Patient Activation Measure), which is about encouraging resilience and self-management. They also spoke about research on how creating communities with more befriending and volunteering opportunities can help with personal motivation.

·         Family Mosaic are developing a way of categorising people and tailoring interventions as they’re housing more people who may struggle to manage their tenancy. L&Q are also looking at adding conditions to tenancies and categorising people according to vulnerability to tailor interventions.

·         Phoenix would be very interested in finding ways for local housing providers to share more information and best practice. Something like a workshop would help, but questioned who would be responsible for setting it up and running it.

·         L&Q expressed support for a workshop of some sort – noting that housing providers are all facing the same challenges. It would be a good way to come to some sort of common understanding about how best to handle things, rather than trying to work it out individually.

·         Family Mosaic were also supportive of a workshop. They felt it could help to build an evidence base about what works. It may also be helpful to involve partners from across the whole mental health pathway – from prevention to statutory intervention.

·         Family Mosaic said there would likely be some challenge from housing providers if they were told that they had to do provide extra support or services. Where responsibilities fall between housing providers and other services, such as social care, needs to be carefully looked into.

·         The Executive Director for Customer Services said that the council should be agile enough to pick up and support people with mental health problems in the private rented sector too.

The Committee made a number of comments. The following key points were noted:

·         The Committee suggested that there’s a need for a more formal working protocol on how to handle tenants with low-level mental health issues – noting that it feeds into other work the council are doing to prevent homelessness.

·         The Committee noted Phoenix’s approach of assessing vulnerability at the start of a tenancy and following up at regular intervals during first year.

·         The Committee suggested that low-level mental health problems are likely to increase as an increasing number of people face housing and other money-related problems.

·         The Committee noted that many people in the private rented sector will also be coping with low-level mental health problems and facing similar housing-related issues.

·         The Committee pointed out that in some cases it may not be until after eviction that mental health problems are triggered, and queried what housing providers can do identify and help these people.

·         After meeting with the housing manager at Southwark council, one member spoke about the hoarding and anti-social behaviour panels and homeless forum in place there – explaining how these allow people from different organisations to come together and address situations and people’s needs holistically.

·         The member also mentioned that Southwark have found becoming a “Mindful Employer” to be a very helpful influence on services – which has also given them access to a number of good practice guides covering a range of topics as well as online training for staff.  

Resolved: the Committee noted the witnesses’ evidence.