More than a roof: Housing Support Improving Health and Wellbeing Outcomes
This practice example is one in a series illustrating how initiatives and ways of working in housing, housing support and homelessness services have significant positive impact on the health and well-being of those people being supported and in so doing contribute towards the nine national health and wellbeing outcomesfor Integration.
Aspire Housing and Personal Development Services provides a wide range of supportive social care services across Scotland, many of which are accommodation-based. This example focusses on the outcomes being achieved through the pathway created by its Direct Access and Resettlement Service in Glasgow and centres on James.
What issue was being addressed?
The service works with individuals to help them identify and address underlying issues that have led to them being at risk of homelessness or actually being homeless.
James had been evicted from his tenancy and stayed with a friend before moving into Aspire’s Direct Access Service. He had a problem with budgeting and has issues with addiction, consuming on average 10 pints of larger per day. James did not initially perceive his alcohol consumption as being an issue. However, over time he decided that it was something he would like to address.
James moved into the resettlement service, which offers a high level of support, safety and security. An outcomes-focussed approach and a monitoring tool, Better Futures, was used to focus discussion and review progress. This led to a widening of areas that James asked for support in. Initially there were three outcomes areas (security of accommodation, addictions and money matters) where crisis responses or high levels of support was identified. Eighteen months on and outcomes were being achieved in twice as many categories including, significantly, life skills, and level of support required from Aspire was hugely diminished. Measuring and graphically illustrating ‘distance travelled’ using Better Futures  helped James to see his progress and he now feels ready to move on to his own accommodation.
What was the outcome?
The benefits to James of an outcomes-focussed approach within this Housing Support Service were evident in the improved control James now has over his addiction and confidence in his own abilities.
The correlation between the approach taken and the national outcomes for health and wellbeing can be identified as follows:
The table below illustrates how service users perceive health improvements over their period of support (sample based on 494 services users, 133 of whom identified health as an issue with which they wanted support).
Responsive Housing Support
The first two graphs set side by side below show the areas in which James was supported. Initially (when recorded at 16/05/12), James only accepted support in to help him manage his drinking better and his personal finances and to settle in his accommodation. As time progressed, support was asked for in an increasing range of areas, with greater emphasis on developing/re-acquiring life skills and progression to his own tenancy. This is shown in the graph for 6/11/14. The scale used, which runs from 0 to 4 indicates level of need, risk or service user concern depending on the outcome area. Generally, the higher the number the greater the level of support required in that area. On the graph, the highest level of support need (4) is the notch closest to the middle of the graph and the lowest level of support need is the outer most notch on the graph.
The amount of time invested in supporting James has similarly changed over this period, with lower amount accepted at first, then more as the range of areas increased, but tailored off as James has gained confidence and control in his life. The slight ‘flick’ of increasing support at the end could well continue upwards as James needs more support over the period of transition to his own tenancy.
Contacts – To find out more
Aspire – David Carr, Support Coordinator DCarr@aspireinc.co.uk – 0141 339 6148
Better Futures – Heather McCluskey, Information Officer firstname.lastname@example.org 0131 475 2676
 Better Futures is a web-based outcomes monitoring system organised around five goals: Accommodation, Health, Safety and Security, Social and Economic Wellbeing and Employment. Within these goals sit 20 aspects of life that a person may need support with. This system enables an individual to define personal outcomes and measure distance travelled towards or away from them.