Centrepoint’s Complex Case Team: 1st May 2023 – 30th April 2024
Grant Award: £80,000
Funding: Complex Case Workers in Manchester: Amy Campbell and Eliza Kendrick
Origin of the service
The Complex Case Workers were introduced into our housing service in Manchester in April 2022. Having delivered the homelessness prevention and relief service in Manchester for a number of years, our evaluation pointed to an increasing number of young people with serious and enduring complex needs who routinely returned to the service when housing placements failed.
The generic housing support service that we were delivering for young people was not having an impact on those with deep seated challenges such as mental health and substance misuse. We had to find a way to work more intensely with the young people with complex needs, and for a longer period of time to help them break the cycle of homelessness. We had to work more collaboratively with statutory health, addiction, and offending services and other charities to provide a coordinated and comprehensive response to their support needs.
The result of the homelessness prevention and relief service review was to introduce two Complex Case Workers. The two specialist roles would be able to invest more time in the young people with the most complex needs and bring together a range of professional support to help them overcome their challenges.
Overview of the Service
Most young people supported by the Complex Case Workers have been evicted from supported housing because of their inability to maintain their tenancy. This is often because the young people have multiple and complex needs including mental health conditions, substance misuse, undiagnosed learning disabilities, involvement in sex work, and repeat offending behaviour. They have become caught in a revolving door that routinely returns them to sleeping rough on the streets of Manchester because they cannot maintain a tenancy and have nowhere else to go.
The role of the Complex Case Workers is to break that cycle by helping to tackle the underlying problems that prevent the young people from maintaining a supported housing tenancy. The Complex Case Workers confront the challenges that go beyond the need for housing to make a step-change in the way that homeless young people live their lives. The young people who come for support from the Complex Case Workers have exhausted all other avenues with the homelessness prevention and resettlement service in Manchester.
The Complex Case Approach
Many of the young people the Complex Case Workers support have struggled to access and maintain engagement with statutory support services, and some have slipped through the net entirely. The Complex Case Workers provide an informal and welcoming environment for young people to come and talk with them at our recently refurbished support centre on Oldham Street. Young people’s basic needs are met first. They can have a shower, wash their clothes, and have something to eat. No time limit is set on the support a young person can receive. They work at the young person’s pace carefully building a positive and trusting relationship so that the young person builds confidence in the support they can receive. They make sure that young people are aware of the support they are entitled to and help them to shape and control the care and support they receive.
The Complex Case Workers that you are funding are the lead professionals for many of the homeless young people that access the service. They bring together a multi-disciplinary team to focus resources and coordinate support for the young people across a range of services. This includes the Community Mental Health Team, In-patient Mental Health, Homeless GP Service, the Learning Disability Team, Drug and Alcohol Teams, the Gangs Unit, the Probation Service, and the Police. In addition there are voluntary sector charities such as ‘Change, Grow, Live’ who support young people addicted to heroin, cocaine, crack, and spice providing methadone prescriptions and harm reduction interventions.
The Complex Case Workers create a comprehensive support plan for each young person to ensure they get access to the support they need. They work with the agencies who provide statutory services to make sure they collaborate and coordinate their interventions. The Complex Case Workers coordinate the care package the most vulnerable and troubled young people need to get their lives back on track.
Standard housing provision will not work for the young people that the Complex Case Workers support. Funded complex needs housing places exist for young people but they must evidence their needs to access that housing. The Complex Case Workers advocate for young people at to ensure that they can identify the evidence of need and access the specialist housing provision. They attend case escalation meetings and high risk protocol panels to support young people and their claims. The Complex Case Workers challenge professionals to provide the support young people are entitled to using legislation such as the Homelessness Reduction Act, The Care Act, The Mental Capacity Act and The Health and Social Care Act.
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Output/Outcome |
Apr – Sept 2023 |
|
Total number of young people supported |
69 |
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Number of young people with mental health issues (includes depression, anxiety , self-harm, suicidal thoughts and severe and enduring mental health issues) |
69 |
|
Number of young people receiving mental health support |
48 |
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Number of young people misusing substances (more than 3 times per week) |
32 |
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Number of young people receiving substance misuse support |
24 |
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Number of young people required housing support |
69 |
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Number of young people who were provided with housing (includes emergency to longer term accommodation) |
69 |
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Number of young people with learning disabilities (includes ADHD, Autism, dyslexia, global developmental delay etc) |
39 |
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Number of young people receiving support for learning disability from statutory services |
32 |
|
Number of young people with criminal convictions |
42 |
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Number of young people open to the Probation Service |
23 |
Case Study of a young person supported by the Complex Case Team
Ahmed is a Syrian national who came to the UK in 2020 after experiencing extensive trauma. Prior to coming to Manchester, Ahmed had been housed by the Home Office in London and Cardiff. Ahmed came to Manchester in 2021 to live with his brother.
At the beginning of 2022 whilst in Manchester Ahmed experienced a horrific assault which left him with life changing injuries. Ahmed was left unable to bare weight on both feet and relied on crutches. He was left with suspected neurological damage which resulted in him having a significant speech impediment and reoccurring fits. Prior to this attack, Ahmed had no issues with his physical health or speech and was a passionate boxer.
Ahmed came to Centrepoint in May 2022 fleeing gang violence associated with his brother’s address. He had been rough sleeping for a week before being made aware of our service and the support Centrepoint could offer to him.
Ahmed’s case was transferred to the Complex Case Team in November 2022 after he disclosed to his support worker concerns around his mental health and escalating safeguarding issues. When Ahmed first began working with the Complex Case Team, he was not working with any statutory services in relation to his mental and physical health needs. Ahmed had attended A&E on multiple occasions in mental health crisis and it was heavily documented by medical professionals that his presentation was disingenuous and therefore he was dismissed without support.
Alongside Ahmed’s housing need, the Complex Case team also prioritised addressing his mental and physical health needs and made referrals to begin this process. Ahmed became an open case to the Homeless Mental Health team who carried out extensive mental health assessments and diagnosed Ahmed with Psychosis and PTSD.
Ahmed has frequent appointments with his allocated mental health practitioner and undergoes psychiatric reviews to ensure he is continuing to take the correct medication. Ahmed has also received support from Physiotherapists and as a result of extensive work, he is now able to bare weight on both feet and only uses a crutch to aid his balance. Additionally, Ahmed has had input from Neurology and Speech and Language therapy who have determined his speech impediment has been caused by trauma following the assault and is now working with a Psychologist for support with this.
Ahmed was incredibly distrustful of services when he first began working with the Complex Case Team at Centrepoint. It took a prolonged period of time to build and establish a trusting working relationship with him. He is now engaging with all support available to him and remains in stable accommodation. We are providing Ahmed with ongoing support and he hopes to work towards obtaining his own tenancy. Centrepoint will assist him with this at the appropriate time via our Rent Deposit Service and also link him in with our Floating Support service which supports young people like Ahmed to establish and maintain a tenancy.
Summary
Our Complex Case Team provide vital support to homeless young people with multiple and complex needs. Without this service those young people will be trapped in a revolving door of street homelessness only escaping when they are hospitalised or imprisoned. This all comes against the backdrop of continuing cuts to homelessness services and other support services within the city. The number of young people presenting as homeless in Manchester is increasing, as is the number of young people presenting with multiple and complex needs.
Your support for our Complex Case Workers ensures that homeless young people with serious and enduring needs receive the support they need. These crucial interventions tackle mental health and substance misuse challenges, steer young people away from sex working, crime and exploitation, and help them to find long term housing solutions that are stable and secure. Thank you on behalf of the Complex Case Workers and the many young people whose lives you are changing for the better.
