Guest blog: Brian Holman, Manager of Cambridge Cyrenians

Cambridge Cyrenians is a local charity which has been providing accommodation and support to homeless men and women for 50 years. We currently offer 101 bed spaces across 20 different schemes. This includes specialist accommodation for ex-offenders and women only accommodation. In addition we have a Registered Mental Nurse on the staff team to support the many residents with mental health issues, we provide dedicated help with access to employment and other meaningful activity and we also provide support for those over the age of 50 to help them move on, or retain their existing accommodation.

Having found that large numbers of older homeless men and women were becoming trapped in our accommodation due to landlord’s perceptions, possibly justifiably, that many of our older residents required a greater level of support then their accommodation could offer, Cambridge Cyrenians introduced our Older Homeless Service, which offers tailored support to older individuals to enable them to move on. The support is person centred, flexible and is not time limited. 

The service was established in 2003 and has been extremely successful in moving on older residents, with virtually no tenancy failures since it started. Following the withdrawal of statutory funding in 2011 the service was forced to temporarily cease, but trust funding granted in 2014 enabled the re-establishment of the programme.

When relaunched, the focus of the service shifted slightly to also support older tenants, usually City Council tenants, who were at risk of eviction. The reasons for tenancies being at risk are numerous, but often include an element of anti-social behaviour, debt, substance misuse and in many cases tenancy take over.

Whilst the new service continues the success of the original service, it was clear from the start that the long term future of the service would only be assured if we could demonstrate the cost benefit, as well as the benefits to the individual clients.

Cambridge Cyrenians simply does not have the skills or resources to carry out a review of the economic value of the service. We also felt it was important that such a piece of work be carried out by an external, independent body.

Recognising these needs we applied to PBE, who agreed to undertake a cost benefit analysis of Cyrenians Older Homeless Service, to provide a quantitative analysis of the potential benefits of the service interventions to their clients and hence the cost savings to the state. 

The report would provide an analysis of the current data and client demographics, identify notional cost ranges to the cost of non-intervention and to indicate the potential ranges of net benefits. It would also to guide Cambridge Cyrenians in the nature of data that needs to be collected to establish in greater detail the overall cost benefits of the interventions of the service.

The study was unfortunately delayed as the first volunteer was unable to complete the work, but the subsequent PBE volunteer also faced various challenges, including the relatively small sample size of service clients, even over three years, plus the fact that there was no direct control group to compare against.

However, we found working closely with PBE and the volunteer very straightforward and through open and honest communication they were able to gain a good understanding of the service and what it is trying to achieve for clients; this understanding informed a report that demonstrates the value of the programme. From the perspective of the men and women being supported by the service, they are in no doubt about the positive impact the service is having on their lives, but the final PBE report also clearly demonstrates the economic effectiveness of this approach.

With this independent assessment in hand, we will be presenting to partners and commissioners alike to highlight what has been achieved and how we want to continue to gather information to build on the evidence.

We would very much like to thank PBE, our volunteer economists and all those involved in the preparation of the report for their contribution and support, without whom this report would not have been possible.

Elizabeth Belham, General Practitioner:

"This service provides daily minor miracles to those it serves. As a GP for people who are homeless in Cambridge I could see a significant unmet need for older people who have experienced years of cyclical homelessness often with complex physical health, mental health, substance misuse and social needs. They are usually 'too young' for mainstream services for older people and 'too complex' or 'don't quite meet the criteria' for mainstream adult services. They fall through the gaps, their support needs unmet putting them at risk of deterioration in health and a return to rough sleeping. The Cyrenians Older Homeless Project has accepted referrals for support for patients who would otherwise 'fall through the gaps' and they provide an invaluable service to these individuals. I am all thanks for the work they do with my patients, I cannot praise enough. They do not walk away, even when the needs are extremely high."

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29th October 2018