Working with individuals who have experienced homelessness. Stresses and Successes

Purpose Staff who work with vulnerable people with multiple needs are known to experience high levels of stress and burnout, as well as high levels of job satisfaction. This paper explores the experiences of staff working in a project with individuals experiencing long term homelessness in Lincolnshire. Design/methodology/approach An evaluation of a project working with individuals experiencing long term homelessness included a focus group set up to explore the experiences and well being of front line staff and managers. One to one interviews with staff were also held to provide more in depth data about the experiences of individual staff members. Findings Six key themes were identified from the discussions with participants. Decision latitude and the ability to follow service users on person centred journeys over long periods of time were positive aspects of the work which were highly valued and seemed to contribute to high levels of job satisfaction. Things which also made a positive contribution were elements of support provided by the employer and a number of personal coping strategies. Themes identified which had a negative impact on well-being related to high workloads and to the multiple and competing demands from service users and other agencies. Originality/value Few studies of any kind have explored the experiences and wellbeing of staff working in the frontline of homelessness services. This small scale qualitative study provides a number of suggestions for further research with this population. Findings cannot be generalised but match those of other recent studies which suggest high levels of stress but little evidence of burnout, and that carefully developed workplace support mechanisms play a key role in maintaining commitment to the role and preventing burnout

Implementing psychological formulation into complex needs homeless hostels to develop a psychologically informed environment

This study explored the implementation of psychological team formulation in two single-gender hostels for homeless individuals experiencing multiple complex needs. Nine hostel staff took part in two semi-structured interviews, before and after attending up to eight formulation meetings. Thematic analysis identified that staff perceived team formulation to increase their understanding of service users, led to some developments within the team, and encouraged staff to take a different approach to their work, perceiving themselves and service users more positively; however, the usefulness of formulation was restricted by the systemic limitations. Results suggest team formulation has notable benefits for staff in hostels supporting individuals with multiple complex needs

Not going it alone: social integration and tenancy sustainability for formerly homeless substance users

This article draws on findings from a study of a specialised tenancy support service for homeless substance users in a Midlands city, and contributes to debates about what makes solutions to homelessness sustainable. Two approaches to tenancy support are examined: first, a resettlement model based on risk management; and second, a restorative model which prioritises support that enables people to rebuild their lives in a more holistic sense. Conclusions point to a need for a broader training for tenancy support workers and a funding level that enables them to stay with their clients long enough to facilitate this fuller restoration

Outcomes of specialist discharge coordination and intermediate care schemes for patients who are homeless: analysis protocol for a population-based historical cohort

Introduction People who are homeless often experience poor hospital discharge arrangements, reflecting ongoing care and housing needs. Specialist integrated homeless health and care provision (SIHHC) schemes have been developed and implemented to facilitate the safe and timely discharge of homeless patients from hospital. Our study aims to investigate the health outcomes of patients who were homeless and seen by a selection of SIHHC services. Methods and analysis Our study will employ a historical population-based cohort in England. We will examine health outcomes among three groups of adults: (1) homeless patients seen by specialist discharge schemes during their hospital admission; (2) homeless patients not seen by a specialist scheme and (3)admitted patients who live in deprived neighbourhoods and were not recorded as being homeless. Primary outcomes will be: time from discharge to next hospital inpatient admission; time from discharge to next accident and emergency attendance and 28-day emergency readmission. Outcome data will be generated through linkage to hospital admissions data (Hospital Episode Statistics) and mortality data for November 2013 to November 2016. Multivariable regression will be used to model the relationship between the study comparison groups and each of the outcomes. Ethics and dissemination Approval has been obtained from the National Health Service (NHS) Confidentiality Advisory Group (reference 16/CAG/0021) to undertake this work using unconsented identifiable data. Health Research Authority Research Ethics approval (REC 16/EE/0018) has been obtained in addition to local research and development approvals for data collection at NHS sites. We will feedback the results of our study to our advisory group of people who have lived experience of homelessness and seek their suggestions on ways to improve or take this work further for their benefit. We will disseminate our findings to SIHHC schemes through a series of regional workshops