Prevention is as important as cure

On the doorsteps of London's West End and on the pavements of big cities, there are far fewer rough sleepers than there used to be. Only two years ago, every shop doorway in the Strand or around Charing Cross Station seemed to boast its resident sleeper swathed in old sleeping bags and tucked inside a cardboard box. But in the spring of last year, the Government's Rough Sleepers Unit (RSU), started an ambitious programme of working directly with rough sleepers to get them "in out of the cold"; an example of "joined-up government" to address a problem that has been a sore point for years.

On the doorsteps of London's West End and on the pavements of big cities, there are far fewer rough sleepers than there used to be. Only two years ago, every shop doorway in the Strand or around Charing Cross Station seemed to boast its resident sleeper swathed in old sleeping bags and tucked inside a cardboard box. But in the spring of last year, the Government's Rough Sleepers Unit (RSU), started an ambitious programme of working directly with rough sleepers to get them "in out of the cold"; an example of "joined-up government" to address a problem that has been a sore point for years.

In London and several large provincial centres, contact and assessment teams, mental health experts and other specialists have worked to find the right alternatives to a bed on the pavement. Hostels and day centres have been extended, halfway houses opened, housing associations and voluntary bodies roped in. On a different level, tenancy "sustainment teams" have been on hand to help people adjust to a new life under their own roof.

It seems to have worked. According to the latest figures, two thirds of rough sleepers have now moved "inside" – at least for the time being. But this is not the end of the problem. The RSU's three-year programme ends in 2002 and consultation is already under way to decide how the Unit's progress can be carried forwards. Sleepers who have "gone indoors" have to be supported to rebuild their lives. But most important of all, new objectives have to be put in place to prevent the problem from occurring in the first place.

What makes someone choose a life on the street? Rough sleepers come overwhelmingly from three backgrounds: young people who have left local authority care; those who have been in prison; and ex-servicemen. A significant number are also problem drinkers or substance abusers. In each of these areas, the new challenge is now to prevent a new generation of young people at a crossroads in their lives from dropping out of society into the street.

The next priority area will be to reach young people before they arrive on the streets, by targeting services at the most vulnerable groups. The RSU is now working with charities, voluntary groups, statutory bodies, and permanent staff at prisons, care homes, young offenders institutions and in the armed services, in order to achieve these aims. Voluntary organisations such as Centrepoint, St Mungo's, Aspire and the Cyrenians are as much part of the enterprise as are housing associations and government departments.

For care leavers, the charity Centrepoint is now working closely with local authority care officers in, for example, the London borough of Redbridge. "Some studies suggest 30 per cent of rough sleepers have experienced care, and that two thirds of care leavers have experienced homelessness," says David Woods, Centrepoint's strategy development manager for leaving care.

Woods points out that in the past, local authority social service departments have all too often adopted short-term solutions for young people leaving care. "Often they are moved into some sort of accommodation, such as a bedsit. But there isn't any ongoing support to deal with issues like isolation among young people in their own home for the first time.

"Often people have just been tipped into whatever accommodation is available at the time. They don't have social skills. They need help to get along with their neighbours and landlords. If there is a dispute, it's often easier just to leave, and that's when they begin 'sofa-surfing' – the first step to ending up homeless. They become labelled as 'intentionally homeless' and then it is much more difficult to get them permanently housed.

"Young people leaving care are not a special group, they are just like other young people who need time to mature and find their level, and to move towards what is best for them. Local authorities have got to be much more flexible."

Much of Centrepoint's work for the RSU has involved "knocking heads together" by arranging meetings between different care providers and local authority departments. "We try to get agencies talking to each other," says Woods. "Sometimes they haven't done so for years. We can be very clear about what young people need, what accommodation is available and find accommodation with the right level of support. It's about knowing your client group, identifying the right services and maximising that."

In Redbridge, managers are enthusiastic about the new cross-agency approach and are looking for ways to promote more independence among older care leavers. At one Redbridge care home, the top floor has now been converted into a self-contained flat with its own access, where young people soon to leave can experience living independently, but close to social services support if they need it.

By working with prisons and inmates before they leave, voluntary agencies can achieve similar successes. One prisoner serving a four-month sentence was threatened with eviction by his landlord for non-payment of rent. A Housing Advice Centre negotiated with his landlord to secure his accommodation. A 30-year-old drug user facing a return to his family home – where drugs were used – was found a place at a secure hostel two days before he left, so securing a better future.

The Ministry of Defence is working closely with the RSU to provide welfare, advice and practical help for services personnel before discharge, and a project at Catterick Garrison is targeting vulnerable service personnel into accommodation before they leave ( see panel, right).

Tackling substance abuse and alcoholism are further areas where the RSU hopes the network it has put in place can be sustained in future. Detoxification and counselling is being made available at hostels, and rough sleepers who seriously abuse alcohol are no longer necessarily excluded from care and support (see pages 4-5). The aim is to extend the work backwards so that abusers do not necessarily end up on the streets – another step towards preventing rough sleeping in the first place.

Only a short while ago, soup kitchens and mobile sandwich vans at railway stations were the most visible measure of support for rough sleepers. Now, controversially, many are shutting up shop. Even the Salvation Army has stopped most of its soup runs in favour of helping people indoors and persuading them to stay there. The question is whether enough can be done to prevent people from going on to the streets in the first place.