MD2481 ‘Life off the Streets’ – Expanded rough sleeping services

Type of decision: 
Mayoral decision
Code: 
MD2481
Date signed: 
15 August 2019
Decision by: 
Sadiq Khan, Mayor of London

Executive summary

The GLA commissions and funds a range of pan-London rough sleeping services, which collectively form the Mayor’s ‘Life off the Streets’ programme. The Mayor has been expanding these services since taking office and has plans to continue doing so this year. This MD approves spending of £6.29m (comprising £2.2m of funding from the GLA budget and £4.09m the Mayor has secured from the Government) to support expansions of No Second Night Out (NSNO), Routes Home, the winter night shelter project, a mental health service, additional outreach provision, and a mental health pilot.

Decision

That the Mayor approves:

1. the receipt of grant funding of £4.09m from the Ministry of Housing, Communities and Local Government (MHCLG) for pan-London rough sleeper services and projects, of which £2.99m is Rough Sleeping Initiative (RSI) funding and £1.1m is towards a mental health pilot;

2. expenditure of £6.29m (the above £4.09m from MHCLG and £2.2m of GLA budget) comprising:
- £2.33m to support expanded No Second Night Out staging posts, floating hubs, and SWEP (via a variation to the GLA’s existing agreement with St Mungo’s which began on 1 April 2017);
- £0.22m for Routes Home to provide additional support to non-UK nationals (via a variation to the GLA’s existing agreement with St Mungo’s which began on 1 April 2016);
- £0.84m to for a new Rapid Response outreach service to Thames Reach (£0.49m by grant) and to nine boroughs for additional outreach (£0.35m by grant);
- £0.20m to the Enabling Assessment Service London (EASL) for mental health support (by grant);
- £0.30m to Housing Justice for winter night shelters (by grant);
- £0.05m for staff resources; and
- £2.35m for a mental health pilot working across four Mental Health Trusts (by grant and contract);

3. an exemption from the requirements of the Contracts and Funding Code to enable variations of existing contracts with St Mungo’s for the No Second Night Out and Routes Home projects.

Part 1: Non-confidential facts and advice

Introduction and background

During 2018/19, 8,855 people were seen sleeping rough in London - more than double the number in 2010/11. Of these, 62 per cent were new to the street, 51 per cent were non-UK nationals, and 31 per cent were from Central and Eastern European (CEE) countries. Around three-quarters had support needs, with 50 per cent having a need related to mental health, 42 per cent alcohol, and 41 per cent drugs.

Since 2016, the Mayor has coordinated efforts to help rough sleepers through his ‘No Nights Sleeping Rough’ (NNSR) taskforce to identify, implement, lobby for, and monitor the effectiveness of interventions to tackle rough sleeping. In his London Housing Strategy, the Mayor set out his aim that there should be a sustainable route off the streets for every rough sleeper in London. In June 2018, he published his Plan of Action which outlines the steps that need to be taken by City Hall, the Government, and others to achieve this.

Since taking office, the Mayor has been expanding the pan-London rough sleeping services the GLA funds and commissions. These services collectively form his ‘Life off the Streets’ programme. They are services for rough sleepers, or initiatives to tackle rough sleeping, that cannot or would not be provided at a London borough level, as they are pan-London or multi-borough in their remit.

The £6.29m spending approved by this MD will further expand the Mayor’s services. It comprises £4.09m that the Mayor has secured from the Government (of which £2.99m is Rough Sleeping Initiative (RSI) funding and £1.1m is towards a mental health pilot) and £2.2m from GLA budget.

The amalgamated budget will be spent as follows:

• No Second Night Out (NSNO) – one staging post, floating hubs, and increasing the funding of core NSNO services, including SWEP provision (£2.33m);
• Routes Home – further support for non-UK nationals including two members of staff to work in and alongside the floating hubs, and three additional bed spaces to accommodate non-UK nationals whilst this support is being delivered (£0.22m);
• Rapid Response outreach – a contribution to additional outreach provision across London, of which £0.49m to be paid to Thames Reach for the Rapid Response service in 24 boroughs, and £0.35m to nine London boroughs, or their outreach teams, to provide a local Rapid Response service (total £0.84m);
• mental health support – up to three specialist mental health workers in a minimum of eight London boroughs provided by Enabling Assessment Service London (EASL), working with outreach teams or at hostels and the floating hubs (£0.20m);
• Equipping Shelters Project - a minimum of four regional co-ordinator posts within Housing Justice to support a small grants programme (£0.30m);
• staff resources (£0.05m, approved under HOPS 0311); and
• a mental health pilot – operating across four Mental Health Trusts areas covering 16 London boroughs, to assist people with mental health support needs who are sleeping rough (£2.35m).

The detail of each of these services is set out in section 2 below.

When the Mayor came to office, the GLA was spending £8.45m a year on its rough sleeping services. Through a combination of the above and other increases in spending, this year the total GLA budget for rough sleeping services will be more than £18m.

Objectives and expected outcomes

The details of the services that will benefit from the £6.29m approved by this MD are set out below.

No Second Night Out (NSNO)

NSNO was commissioned with a 2+1+1 contract duration (two years, plus two discretionary extensions of a further year each) from 1 April 2017, and with a cost review point at the end of two years (see MD2031). It is an assessment and reconnection service. People who are seen sleeping rough for the first time are supported to access the service by outreach teams, and once at a hub they spend time with specialist staff who will establish their current situation and the best options available to them. The NSNO team then make people an offer of help based on their specific circumstances and needs and support them to take up that offer.

The core NSNO contract comprises three ‘assessment hubs’, two ‘staging posts’, and Severe Weather Emergency Protocol (SWEP) provision. The staging posts provide short-term accommodation and 24-hour support to people coming through NSNO who require additional support or time to achieve a sustained outcome. The Mayor has also significantly improved SWEP in the capital in recent years. Improvements include changing the trigger for emergency shelters to open from a forecast three consecutive nights of freezing weather to just one, and championing through his NSNO service the ‘In for good’ principle that all boroughs have now signed up to.

During 2018/19, NSNO worked with over 1,600 people who were sleeping rough of which 79 per cent were not seen rough sleeping again in that year. However, there are limitations on the success of NSNO, for example, some people refuse to attend the service due to the journey time to get to the hub. In addition, the length of time people spend in the assessment hubs is often considerably beyond the target times, meaning new people cannot enter the service. This is because move-on options such as supported housing and adequate privately rented properties for people to move into, are so limited.

Last year, to help address the above issues, NSNO provision was expanded to include floating hubs and two additional staging posts. Floating hubs provide emergency assessment at hotspots of rough sleeping and for specified cohorts of rough sleepers, such as people involved in street drinking, those with mental health issues, or non-UK nationals. By the end of March 2019, seven hubs had operated in Newham, Westminster, Hackney, Islington, Haringey, Kensington and Chelsea, and Hammersmith and Fulham, assisting 142 people, with more than 77 per cent successfully moving on to accommodation following the hub.

The two additional staging posts have provided extra places to stay for those people who had visited NSNO and were awaiting a longer-term offer. Last year the additional staging posts helped support 120 people off the streets and 84 people into permanent accommodation. Following the introduction of the additional staging posts in September 2018, the proportion of new rough sleepers who were not able to be referred to NSNO because the hubs were full had declined from 26 per cent to eight per cent.

There is a clear moral and financial case for continuing the enhancements to the NSNO service, and this MD approves £2.33m extra spending to:

• continue the ’floating hubs’ model, at a cost of £0.48m, to run nine floating hubs from April to December 2019, with a target of to support 200 people of which at least 70 per cent will not return to rough sleeping;
• continue the additional staging posts, at a cost of £0.9m, to provide 28 bed spaces from January to March 2020, supporting at least 245 people into longer-term accommodation;
• vary the core NSNO contract with St Mungo’s over two years at a total cost of £0.33m (from £3.68m a year to £3.79m in 2019/20 and £3.90m in 2020/21, to be covered by GLA budget); and
• expand the SWEP provision of the contract at a cost of £0.62m over the contract period because of the improvements in practice across the capital led by the Mayor.

It is proposed that there is variation to the NSNO contract with St Mungo’s for the services that will be delivered with the 2019/20 funding outlined above, rather a new tender process. There are sound reasons for this. First, the current provider is the only one with access to the required buildings and the appropriate staffing structure in place. Second, retendering would result in a significant and unacceptable delay, and would affect the continuity of the service. There is also unlikely to be competition from other service providers because of the above reasons and the constrained timeframe in which funding is available.

The NSNO contract was entered following an OJEU procurement exercise to identify a provider. The initial NSNO contract value was £14.72m over four years (£3.68m per annum). This contract was subsequently varied by an additional £1.53m approved under MD2333. As a result of the changes above, a variation to the NSNO contract is required to ensure that additional investment of £2.33m is captured.

Routes Home

Routes Home assists non-UK national rough sleepers with support needs to find a route away from the streets. It helps them to access advice, accommodation and work in the UK, or supports them to voluntarily return to access accommodation and support in their home country. The service provides 16 bed spaces as part of its core contract.

In 2018/19 the GLA used funding secured from the Government to expand the Routes Home staffing team, the level of immigration advice and accommodation options, including the provision of three additional bed spaces.

This MD approves extra spending of £0.22m to continue this work for one year to fund:

• two members of staff to work in and alongside the NSNO floating hubs with EEA nationals who need assistance to access work and accommodation, or want to return to their home country;
• three additional bed spaces to accommodate non-UK nationals whilst this support is being delivered; and
• work with non-UK nationals who need support and advice regarding immigration.

This will support an additional 60 people to exit rough sleeping.

The current provider has the technical expertise to provide this service. If this additional provision were commissioned by competitive tender, the project would be significantly delayed. Furthermore, this would increase the risk of two contractors working with the same client group, which would be inefficient and costly due to duplication of services. The Routes Home contract was entered following an OJEU procurement exercise to identify a provider. Its initial contract value was £3.00m over five years (£0.599m a year). This contract was subsequently varied by approval of an additional £0.127m under MD2333. The changes above will result in a variation of contract to capture additional investment of £0.22m. The proposed variation is for services included within the scope of the original contract.

Rapid Response outreach

Currently, outreach in London is commissioned either locally by a borough or by the GLA through London Street Rescue (LSR). In all cases, outreach teams respond to both StreetLink referrals and provide intensive case management. The pressure on resources means that responding to StreetLink referrals is not always prioritised by teams and response times are variable. As set out in the Mayor’s Rough Sleeping Plan of Action, the GLA wishes to pilot an outreach response across London to respond to StreetLink referrals in a consistent way. This will ensure that local outreach teams and LSR can focus on supporting and helping those living on the streets, whilst StreetLink referrals are responded to more quickly by a new team.

This MD approves £0.84m extra spending to:

• grant-fund Thames Reach to contribute to the new ‘Rapid Response Team’ working in 24 boroughs (proposed GLA match funding to ensure full coverage of these boroughs will be sought in a separate approval) (£0.49m); and
• support the City of London, Westminster, Camden, Tower Hamlets, Lambeth, Richmond, Wandsworth, Kingston, and Sutton, or their outreach providers, to work toward the same principles of this service (up to £0.35m).

The Rapid Response team will look for every StreetLink referral at least twice on average. They seek to offer an immediate route off the streets for every person they find sleeping rough, and prioritise people sleeping rough who contact StreetLink directly.

Mental health support (EASL)

Half of people seen rough sleeping in London have a recorded mental health support need. However, their circumstances and the uneven distribution of specialist mental health services across London mean that it is often difficult for outreach workers to access appropriate mental health support for the people they work with.

To better provide expert multi-disciplinary mental health assessments through working alongside existing outreach services, this MD approves additional expenditure of £0.2m to provide:

• one year’s grant funding to Enabling Assessment Service London (EASL) for expert multi-disciplinary mental health support.

This work should result in at least 50 additional people with mental health needs exiting rough sleeping.

Equipping Shelters Project

Winter night shelters play a key role in tackling rough sleeping in London. In 2017/18 there were at least 39 shelters. The majority are staffed by volunteers, operating only in winter months and generally have limited capacity to carry out daytime case management to resolve the circumstances of an individual rough sleeping.

Last year, a £0.6m grant-funding programme (the Equipping Shelters Project) was delivered by Housing Justice to develop the capacity and quality of winter night shelters. In 2018/19, 173 additional bed spaces, supporting 363 people, were provided through the Equipping Shelters Project. This year, RSI funding from government was halved to £0.30m for this work.

This MD approves £0.3m extra spending to replace the funding cut by the Government. It will:

• grant-fund Housing Justice to administer the Equipping Shelters Project to improve winter shelter throughput, provide more sustainable solutions for rough sleepers, and enable more shelters to open and others to open earlier.

It is estimated that an additional 125 people will be supported in shelters across London through this project.

Mental health pilot

Last year, half of all people sleeping rough in London were recorded as having mental health support needs, making it the most prevalent support need among rough sleepers. However, outreach teams and mental health trusts report that the support and treatment people need is often not available.

There are already a small number of London boroughs which have a dedicated homeless mental health team operated by the mental health trust. In these areas, rough sleepers with mental health issues are reported to have much better access to the services and support which they need, and partnership working between the homelessness and mental health sectors is much stronger.

This MD approves additional expenditure of £2.35m (£1.25m GLA funding and £1.1m Government funding) to boost mental health provision. This funding comprises:

• £2.14m to grant-fund four Mental Health Trust areas, covering 16 London boroughs, to assist people with mental health support needs who are sleeping rough. These are East London NHS Foundation Trust (ELFT), North East London NHS Foundation trust (NELFT), Central and North West London Foundation NHS Trust (CNWL), and West London NHS Trust (WLFT). Each Trust will develop their own specialist area team within their existing structures whose aims, and objectives fit with those of the Mayor’s rough sleeping and mental health programme;
• £0.01m to grant-fund EASL to develop a training programme;
• £0.03m apportioned to central costs and an evaluation of the programme, the latter to be competitively procured with authority of award delegated to the Executive Director for Housing and Land; and
• £0.17m which has been previously approved to fund the initial development (through DAR approval) the implementation of the programme (ADD2327), and the Evaluation Monitoring Framework and Programme Coordinator (DD2360).

Each of the above-named trusts has locally designed their proposal – all of which aim to improve access to statutory mental health services and align with the Mayor’s ambitions to improve support for people sleeping rough in the capital. Each service has also been co-designed by statutory mental health services, homeless outreach teams, London boroughs, people with lived experience of homelessness/mental health and other key stakeholders in each local area. This approach will ensure a service which meets local needs and builds on existing assets.

The pilot will run until the end of June 2021, and the longer term aim of the pilot is to demonstrate the value of providing the type of support outlined above, thereby encouraging the NHS to fund similar initiatives in the future.

Equality comments

Under section 149 of the Equality Act 2010, as public authorities, the Mayor and GLA are subject to a public-sector equality duty and must have ‘due regard’ to the need to: (i) eliminate unlawful discrimination, harassment and victimisation; (ii) advance equality of opportunity between people who share a relevant protected characteristic and those who do not; and (iii) foster good relations between people who share a relevant protected characteristic and those who do not. Protected characteristics under section 149 of the Equality Act are age, disability, gender re-assignment, pregnancy and maternity, race, religion or belief, sex, sexual orientation, and marriage or civil partnership status (all except the last being “relevant” protected characteristics).

Of those seen rough sleeping in 2018/19:

• 51 per cent were non-UK nationals;
• 50 per cent had a mental health need;
• 16 per cent were women;
• most of those seen rough sleeping (56 per cent) were in the 26-45 age group;
• eight per cent were under 26 years old;
• 12 per cent were over 55; and
• five people were under 18.

Those with protected characteristics of race and disability are over-represented among rough sleepers, as the client group for these services is people with a history of sleeping rough the proposals in this paper are likely to have positive impacts on these groups. Further it is likely to foster good relations between people who share a characteristic and those who don't via the new workforce.

Other considerations
  1. Key risks and issues

Risk description

 

Impact

Likelihood

Mitigating action

 

Insufficient staff resources within the GLA to develop, deliver and monitor the new services and projects will reduce the effectiveness of current services and mean that new services are not developed and delivered effectively. There is a potential risk to the safety of clients if services are poorly designed and delivered, or providers are not effectively monitored.

High

Low

There are dedicated GLA leads for each new service and this funding allows for the recruitment of an additional member to the team. The providers are sending weekly updates to the rough sleeping lead and the rough sleeping team manager.

The providers may perform poorly, negatively impacting on the achievement of key Mayoral objectives and more detailed service-specific KPIs.

Medium

Low     

Robust contract and rigorous contract monitoring by the GLA of service providers will ensure that poor performance is identified and rectified quickly and appropriately.

The number of rough sleepers may reduce to the point where the services are no longer required, or required at the levels envisaged, or the nature of rough sleeping may change, making the services and projects less relevant

High

Low     

The GLA Rough Sleeping Team constantly monitors the rough sleeping landscape, through detailed quarterly CHAIN report and through strategic and operational interactions with key stakeholders from boroughs, service providers, central government and others (including through the Mayor’s No Nights Sleeping Rough Taskforce). The funding is only for eight months so any changes necessary can be made during this time.

  1. Links to Mayoral strategies and priorities

 

  1. See paragraph 1.2 above.

 

  1. Impact assessments and consultations

 

  1. The bids for the proposed new services and project were developed in partnership with the Mayor’s ‘No Nights Sleeping Rough’ taskforce and were informed by in-depth consultation with stakeholders from London boroughs, voluntary sector providers and the wider homelessness sector.

 

  1. There are no interests to declare of any of the reviewers of this approval.
Financial comments

This decision requests an approval for the receipt and expenditure of £4.09m from the Ministry of Housing, Communities and Local Government (MHCLG) for projects until 31 March 2020.

This decision also requests approval for the expenditure of £2.2m of GLA funding; £0.95 from the £6m allocated to Rough Sleeping initiatives from the additional Business Rates and Council Tax in February 2019 and £1.25m from roll forward from 2018-19 underspend.

The total of £6.29m will be spent on providing the services for rough sleepers as set out in paragraph 1.4 above.

Activity table

Milestones

Indicative date*

Mayoral approval secured/CIB

12 August

RSI services continue for one year

RSI funded projects 1 April (providers running at their risk)

New GLA staff in place

August 2019

Quarterly contract monitoring meeting and reporting

August 2019 onwards

Mental Health Pilot

1 September 2019- August 2021

Funding local authorities to meet Rapid Response principles

commences

1 October 2019


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