‘Doing the same thing over and over again but expecting different results is the definition of stupidity’ is a quote often (incorrectly) attributed to Einstein. He didn’t say this but whoever did coin this phrase was correct. Sometimes we all need to give ourselves a shake and question why we repeatedly do a task but expect the results to be different. Chances are, they won’t be.
Like many things now, the commissioning and provision of homeless services could be referred to as broken. Even though there has been more spending on services in recent years the number of people sleeping rough is steadily increasing. More people are dying on our streets, and more people are presenting with complex needs.
Thankfully the government have given themselves a shake and recognised that they need to do something different to reduce the number of people sleeping on the streets. However, they aren’t quite sure what that something different might be. Had they asked the experts in the sector the responses would have included the need for more social housing, more effective prevention services and improved mental health and drug and alcohol services.
The government announced a significant investment in ‘Test and Learn’ pilots, and it’s certainly one of their better ideas of late. A Test and Learn approach encourages innovation by looking at what is working outside the box and exploring if it could be a successful model if it was scaled up. Test and Learn as an approach in our sector could lead to some positive new ways of working if it is bold in design, agile in approach and thoroughly evaluated.
One of the areas under consideration in the Test and Learn initiative is related to the use of Personalised Budgets. A system which has been used in social care for many years with varying levels of success.
‘No strings attached’ free cash
To test the effectiveness of personalised budgets in the homeless sector the Centre for Homelessness Impact are conducting a randomised, controlled trial and comparing outcomes from a group of 360 people who receive financial support through personalised budgets with those from an otherwise identical group who did not.
The BBC recently reported on the trial highlighting how successful it had been for a woman who had been using local homeless services. In this instance the personalised budget had been used to purchase items for a new home to make it feel welcoming for her children and grandchildren. Clearly this use of a personal budget was a success but what if someone used the personal budget in a way that wouldn’t support their recovery journey or their independent living?
It isn’t unusual for the public to think that the people on the streets have ‘brought it on themselves’; when I am doing talks for groups about St Martins work I often tell the story of the lady that rendered me speechless (not generally an easy task!). The story goes like this…During our December street collection (St Martins biggest fundraiser) I was standing outside Jarrolds, a well-loved, local department store while a very generous man was struggling to put a £20 note into my tin (these new notes don’t fold like the old ones!!) when an older lady came up to me. I thought she was poised to donate but instead she said to the man ‘you don’t want to do that they’re all druggies and alkies’. …………and there I was speechless!
There can be no denying that some people on the streets may have addictions. These addictions may be the reason they ended up on the streets or it could be as a direct result of being on the streets. We know it’s seventeen times more dangerous for people living on the streets than for those of us fortunate to have a roof over our heads. We know the average life expectancy of a man on the streets is 47 and for a woman it’s 43. Being on the streets is not pleasant and some people may use substances to blot out the sheer hell of being on the streets.
People in the grip of addictions are often living for the next drink or the next hit. Their thought processes are consumed by the drive for more substances to help them to blot out reality or feel better than they do without the substance. In this instance they are not ready to use a personalised budget in the way that it would be intended to be used. Whilst there is the age-old argument that people should have choice and independence, and we have no right to decide how someone lives I do believe we have a duty of care to try to ensure that they don’t die and that they have the best chance of recovery.
One size never fits all
For me, the concept of a personalised budget in the homeless sector can work but it isn’t a one size fits all. People who are in receipt of personalised budgets should be well along the road to recovery and independent living. We must accept that there will be situations where people use their personalised budgets to buy substances, but we should be trying to put some safeguards in place where we can. Every person experiencing homelessness is unique and the solutions to support them out of homelessness should be unique to them.
I will be awaiting the evaluation of the personalised budgets with interest. How the criteria are set for people to be considered for a personal budget will make the difference between it being a total success or a complete disaster for some people.