Home > Uncategorized > We need more Elmores!

We need more Elmores!

In the last week I’ve found out a great deal more about homelessness that I was hoping ever to have to know. This came about because the son of a friend of mine has just become homeless, having lost his private rented flat.

There’s a complex history to this, as you might expect. It revolves around this guy being ADHD, short attention span, bored, lonely, needing social interaction and not having much day-to-day support. In a nutshell he was ‘spotted’ by a bunch of drifters who realised he had something they could make use of – his flat. He was gullible enough to invite them home, they were manipulative enough to use it as a drinking den and then ran riot. When he ran into trouble with the landlord and tried to get them out, the vindictiveness started – burglary, smashed windows, people breaking in and refusing to leave, etc.

The landlord hasn’t been much help either. It’s not a ‘social landlord’ so they don’t have obligations to support tenants, and as best I can tell there’s been a certain amount of chicanery in terms of trying to get him to move out without actually issuing an eviction notice.

The result has been meetings with the local authority housing people, welfare rights, etc. etc. trying to negotiate a housing maze that revolves around whether he is ‘voluntarily’ homeless (I’d say the police incident numbers prove not) or otherwise. If he is, he can’t access locally authority controlled housing or hostels. Not that there are many places available anyway, and a long queue for them (and some of the people who caused the trouble in them…). However ‘supported’ accommodation is outwith the control of the local authority waiting lists so he’s potentially eligible – but even finding the trusts that run such places, checking their eligibility criteria, and sorting out applications is a huge job.

He has complex needs, which essentially amount to day-to-day support and patient, wise people who know how to get him motivated and arrange access to the services that can address at least some of his problems.

And this is where the Elmore thing comes in. In 1988-9, I was asked to be an in-house researcher to evaluate a then-new voluntary sector project in Oxford. Named for a local notable who had the original inspiration, the idea was for a small team of people who would deal with those who fell through the ‘cracks’ between agencies.

For example, it would arrange shared-care between two hostels, when people were challenging and regularly blew out their accommodation. If you could find two hostels and two people who were problematic, you could get an agreement to give each one a couple of weeks in one hostel and swap them over before they blew it. The new situation would help them remain stable and certainly give the staff in both places a respite.

When homeless mentally-disordered people were arrested and charged, the team would try to find temporary accommodation for them so they could be bailed, some attempt made to deal with their needs, and if necessary a worker dispatched to bring them to court so they didn’t forget the court date and wouldn’t then have an arrest warrant issued for non-appearance.

They were able to connect people to an outreach health team (which at that time ran out of a Portakabin on a night shelter car park, if I remember rightly) that dealt with underlying health issues – many of the homeless had, probably still have, conditions ranging from shingles to scabies to TB that often impaired their ability to even think straight – and also had a community psychiatric nurse who was experienced in locating homeless mentally ill people and getting them to take their medication so they wouldn’t end up doing stupid things that got them into court.

The bottom line was that the team didn’t itself offer much in the way of services but did enable people with complex needs and difficult problems to connect with agencies – it put together, jigsaw fashion, care packages in which each of a number of agencies agreed to take on a defined role in relation to part of the problem, against the assurance that other agencies were addressing other parts of the whole situation. It was person-orientated rather than agency orientated, and that was its strength.

And it worked.

But it was in Oxford, and my friend’s son isn’t.

I did the evaluation in 1988-9, on a short term contract, and then moved on. But I’ve just caught up with the Elmore thing again. It’s grown into Elmore Community Services (yes, that’s a link) and has expanded to deal with a much wider range of problems than it could tackle when it first started, such as antisocial behaviour and parenthood problems.

The original report I wrote (I still have a copy somewhere) clearly hasn’t survived the transition from print to online publishing, but obviously is just a little outdated now anyway. However there are several worthwhile and recent publications available on the website.

This whole experience with my friend’s son, and my memory of the early Elmore work, leaves me with this thought. We proved the Elmore concept worked, twenty years ago. It’s still there and still working. It must save all the agencies involved significant amounts of money by ensuring that people with complex needs actually get them addressed, don’t fall through gaps in service provision, don’t end up receiving unco-ordinated and ineffective care that breaks down every two minutes, and don’t end up going through the revolving door syndrome of repeated short prison sentences for stupid things they do when care breaks down.

So if it’s good for the people with these needs and arguably cost effective in the long run for all the agencies involved, why on earth isn’t there an Elmore type service in every city?

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