From pillar to post: homeless women’s experiences of social care Ailsa Cameron, Karen Morgan, Hilary Abrahams, Emma Williamson & Lorna Henry. School for Policy Studies

Aims & methodology The TARA project was a longitudinal study of homeless women, its aims included exploring: the social care & health needs of homeless women. how support services can best be provided in both the short and long term. Methods included: qualitative interviews with women using homeless services, 3 times over 18 months & interviews with support workers.

Demographics Recruited 38 women for first round of interviews (thereafter 28, 22); Ages ranged from 19 – 59; Ethnicity: White British = 27 White European = 4 Black African = 2 Mixed Race = 5.

Context The causes of homelessness are multifaceted. Homelessness exacerbates existing problems. An increasingly precarious policy context.

Social work for homeless people A changing context for adult social work. Social workers are most likely to work with individuals/ families who have accessed statutory services for reasons other than housing (Teater 2014). Much of the traditional social work role is now carried out by agencies outside of the statutory sector (Manthorpe et al forthcoming).

Social Care for homeless people Refers to a wide range of services (DH 2006) including: tenancy support; emotional/ practical support, & specialist support e.g. drug and alcohol services. Increasing emphasis on ‘personalised’ services & recognition of services being provided across organisational boundaries (Cornes 2014).

Support All of the women received support from a range of services. Most women had key/ support workers based or linked to their accommodation, at specialist services and/or voluntary organisations. Many women had multiple key workers.

Key workers Lavender, was ‘getting all the support I need’ from workers at various agencies. Having different sources of support gave women the opportunity to discuss their concerns with people other than their hostel based key workers. However, some women wanted to have one key worker ‘…I think it’s easier just to have one person to talk to’ (Lilac).

What they appreciated Consistent, non-judgemental support, empathy, as well as practical and emotional support, and Holistic support, someone who linked services up for them.

But all too often …. Services were fragmented, uncoordinated and geographically diffuse. ‘…If I’m going to one organisation I’d like the information and the advice I’m given to be consistent, so I don’t come out even more confused than I already am.’ (Jacinta). ‘…its just when they pass you from pillar to post, from post to pilllar …’ (Daisy)

Experiences of counselling services Often a condition of their support, ‘.. You have to go out to the groups and stuff and the meetings.’ (Flora). While many appreciated one to one counselling, group sessions were universally disliked. ‘… you have a guy or a woman who’s in recovery who does a share and then people share back … and its war stories.’ (Jacinta)

Experiences of statutory social work services Women were reluctant to discuss experiences of statutory services but several revealed involvement with the child protection system, either in childhood or as a parent. Despite the complex nature of their needs none were in contact with adult social work services, possibly due to antipathy to services or the nature of their needs (Manthorpe et al forthcoming )

Women only services Many women told us that they wanted women only services, not just hostels but counselling and support services. As Pansy, talking about a women only morning at a drug agency, told us ‘…because it’s just somewhere you can go and have a cup of tea and paint your nails and there’s people there … if you need some support they can help you sort of thing.’

The current context Women were conscious of funding cuts and the subsequent reorganisation of services. ‘… I’ve had 3 key workers, and each key worker seems to be leaving every two or three weeks.’ (Fern) ‘…. And I think that’s just the way of the world at the moment unfortunately and its going to be that way for some time’. (Jacinta)

Conclusions Services were fragmented, and although women appreciated the support they received, having multiple support workers reinforced the sense in which they were seen through separate and un-coordinated professional lenses (Fitzpatrick et al 2011). Occasionally workers adopted a person centred approach, working across agency boundaries, but this was not the norm.

Recommendations The experiences of the women suggest: the need for a ‘pivotal’ worker, and for commissioners to take a more proactive approach to managing the context - encouraging services to be better aligned and ensuring that women only services are available.

Acknowledgement This presentation is of independent research funded by the National Institute for Health Research (NIHR), School for Social Care Research. The views expressed in this presentation are those of the authors and not necessarily those of the NIHR School for Social Care Research, or the Department of Health, NIHR or NHS.