Preventing repeat homelessness - a housing-led alternative to Housing First

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The context

Scotland’s Homelessness and Rough Sleeping Action Group (HARSAG) installed the concept of Housing First “as the first response” for people with ‘multiple, complex needs’ – those most likely to experience long-term, or repeat, homelessness (or both). Housing First should therefore be the default option offered to this group, as opposed to the last resort when everything else has failed. HARSAG made this recommendation as evidence of the effectiveness of Housing First was found to be ‘overwhelming’. The Government’s Action Plan subsequently specified that every local authority must include plans for Housing First in its RRTP.

Yet as overwhelming as evidence in favour of Housing First is, there is a minority of people – around 10-20% - for whom the approach appears not to work, not to work right now, or just isn’t wanted. To truly embed rapid rehousing in Scotland, people who are most excluded from housing also need options – including options if Housing First fails or isn’t someone’s choice.

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The intervention

Edinburgh-based charity Rowan Alba set up its Thorntree Street project in Leith in 2005. It offers Scottish Secure Tenancies (SST) through Bield Housing Association, coupled with onsite 24/7 support from Rowan Alba, to 12 older men with histories of long-term rough sleeping, repeat homelessness and problematic alcohol use. It was the first project in Scotland to offer permanent homes to this group.

Rowan Alba’s values are “accept, support, include”. A guiding principle of Thorntree is that people have a right to a home, without needing to first change themselves or their behaviour, or meet conditions. All tenants have access to person-centred support, but they don’t have to use it, or ‘engage’ in any particular way. Support will be there if it’s needed. Importantly, tenants don’t have to stop or reduce their drinking before getting their tenancy. Instead, a harm reduction approach is used.

Thorntree also operates as a community: there’s a dining room, garden and lounge. Meals are cooked fresh according to tenants’ preferences, but they also have their own kitchens. Tenants have access to staff any time, and can have visitors, including overnight. But staff can also monitor and mediate access to the building and store and administer medication, sometimes multiple times a day, as many tenants have chronic and, at times, life-threatening, health conditions.

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The outcome

Since 2005, Thorntree has supported 87 men into a permanent home. Only one tenancy has ended in eviction (and repeat homelessness), with three other tenants moving onto other housing options (either more independent living, or residential nursing care). All other tenants (99%) have sustained their homes. This suggests an extraordinarily effective approach to preventing repeat homelessness for people with some of the very highest levels of past housing failure.

An independent evaluation in 2019 concluded that Thorntree offers a home where tenants feel safe, are more able to maintain self-control, think clearly, look after health, eat well and gain a sense of belonging. The evaluation completed a cost consequence analysis which found for each £1 spent on Thorntree, £3 is saved to the public purse on homelessness, health and criminal justice.

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Key insights

• with the right values, Housing First principles can also work in non-dispersed housing models
• in order to exercise choice and control in a rapid rehousing system, people - including those who are most excluded and who have multiple, complex support needs  require more than one housing option to choose from
• a communal setting with peers, in a context of individual homes, can help reduce loneliness and isolation and build social capital: areas Housing First tenants often struggle with

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Find out more…

Helen Carlin, Chief Executive, Rowan Alba
helenc@rowanalba.org