1. Older Homeless People and Extra Care Housing Yvonne Maxwell

2. Rough Sleepers Strategy Cross Government Strategy lead by CLG. A focus on preventing rough sleeping, moving away from reactive to proactive and preventive services Partnerships at both national and local level, between Government Departments and locally with community groups, health and local authorities and homelessness agencies. Sustainable outcomes and a focus on building people’s skills to maintain tenancies, address underlying issues that have contributed to their homelessness such as mental health, substance and alcohol misuse and routes into training and employment. Improving the health of rough sleepers and their access to services User involvement and empowerment, including using individual budgets There are 15 actions points under 4 chapter headings : Right help, right place, right time Empowering communities Understanding problems/solutions Making it happen

3. Numbers and definitions: In relation to homeless people, due to premature ageing issues, we tend to define older people as those over 50 years of age. People who have been long term homeless have often sustained lasting damage to their health through their life style and/or alcohol and drugs dependence In the 1990’s the average age of death for a rough sleeper was 42 years

4. Numbers: - There are an estimated 42, 000 older homeless people in the UK. This figure covers: - People over the age of 50 who are sleeping rough - an estimated 300 (in England.) - Hostel dwellers- an estimated 5, 000 - People living in Bed and Breakfasts, an estimated 12,000 - An official number of 4,420 people accepted as statutorily homeless and vulnerable due to old age

5. Older Homeless people include those: sleeping rough living in hostels or equivalent, including those in hostels and accommodation designed for short-stay provision older people living in bed and breakfast or other temporary accommodation because they have no other option older people due for discharge/release from institutions, hospital, prisons etc, who have no accommodation to go to older people who are staying with friends or family because they have no other option and where their housing situation is unsatisfactory, i.e., harassment, domestic violence etc older people at imminent risk of eviction where a possession order has been issued older people who are about to lose their tenancy in the private rented sector and have nowhere else to live older people who have been homeless before and resettled but who are at risk of losing their tenancy and returning to homelessness

6. Health problems: November 2004 St Mungo’s survey of rough sleepers and those in hostels over 50 years of age: 56% are alcohol dependent 48% have mental health problems 47% have physical health problems 27% have challenging behaviour

7. Social exclusion The majority of older homeless people have a combination of those issues, with 43% having 4 or more problems. 74% had no next kin of details Of 36% who are known to be parents 52% have no contact with their children. 23% have no social network

8. Case study -Tom Became homeless in forties when marriage ended. Slept rough and in hostels frequently evicted, aggressive behaviour linked to heavy drinking. Liver failure, severe anaemia, needs prompting with personal hygiene, eating and medication. Assessed and placed in residential care, could not settle and left. Highly vulnerable-multiple interacting physical and mental health and alcohol problems.

9. Case study – Rose Rose has slept outdoors for at least 20 years She is a very frail slight woman, she suffers from infestations of all kinds, bad feet, bad eyes and chest infections. She can be cantankerous and her moods fluctuate greatly. The only service she will engage with is a soup kitchen where she goes each evening to get food.

10. Extra Care as an option ? For some older homeless people. Extra care offers an option of an independent tenancy with opportunities for social activity, meals and flexible care and support. Specialist or general extra care schemes ? Both needed.

11. Discussion What are the challenges ? What would extra care providers and commissioners need to make this happen? Specialist? General? Examples of good practice ?

12. Further Information Housing Info - www.networks.csip.org.uk/housingwww.networks.csip.org.uk/housing Yvonne Maxwell, Social Inclusion and Equalities Project Manager yvonne.maxwell@dh.gsi.gov.ukyvonne.maxwell@dh.gsi.gov.uk