WIREDGOV

Tanya Barrow introduces You First, a new programme from Fulfilling Lives which supports adults with multiple needs, and the huge impact it has had on one of the people they support.

Many Homeless Link members will be used to seeing the same faces appearing again and again; people whose needs are too complex for one service to address; who find themselves trapped in a never-ending cycle of services, while their underlying issues remain unmet.

It was to address the needs of these most ‘chaotic’ adults that the Big Lottery Fund established the Fulfilling Lives programme for adults with multiple and complex needs.

Lambeth, Southwark and Lewisham Fulfilling Lives is one of twelve partnerships launched in England this year. Resolving Chaos leads a public/voluntary sector partnership which includes three local authorities, South London and Maudsley NHS Foundation Trust and charities St Giles Trust, Thames Reach and Certitude.

The programme will work with 300 of the most vulnerable adults living in Lambeth, Southwark and Lewisham during the lifetime of the 8 year project. Since Summer 2014, a small team of highly experienced key workers - the ‘You First’ team - are providing intensive support to adults, identified by a joint group of over 70 local agencies, who most frequently rotate through the welfare and justice systems at immense cost to themselves and to society. The focus is on providing joined up, one on one support that will help them start living more stable lives.

System change and shared learning are at the heart of the programme; exploring whether tailored support with access to a personal budget will produce better outcomes for clients and also make savings by avoiding frequent recourse to costly emergency services.

“I’m here to see if I can help”

Katy is a You First key worker. Her background includes working in homeless hostels with people with drug and alcohol dependency. She has been working with 32 year old Sarah* since September.

When Katy met her, Sarah was living in a hostel and she was considered to be ‘not engaging’ with any agencies or services.

The programme’s partnership approach means that the team had a comprehensive picture of Sarah’s chaotic history before Katy met her. Sarah has had a difficult life. She and her siblings were removed from family care as young children. Social workers believe she may have been sexually abused from a very early age. It’s not surprising to hear that upon leaving school, she was extremely vulnerable and got involved with an older crowd who were into drugs. Things spiralled very quickly for Sarah. She became an injecting crack and heroin user, a heavy drinker and was street homeless. Her children were removed from her and have since been adopted. She has been in and out of prison many times and currently wears a tag. She was not claiming benefits, falling in and out of drug treatment and was heavily in debt.

“The first meeting was very brief, no pressure. I was introduced by a drugs worker.” says Katy. “I explained that I worked for a new team and that lots of services had told us they thought she could do with some extra support. I suggested we have another chat some time if she wanted to.” Sarah decided to give it a go and she agreed to a quick cup of tea.

Building trust – a day in the life of a You First worker

Once Sarah had decided she wanted Katy around, they initially met most mornings: “First things first, I helped Sarah get the basics sorted, like setting up her benefits, so she stops getting into arrears at the hostel. We registered with a GP, got her back onto a script and I’ve been with her to appointments to get her into a routine.” Katy also accompanied Sarah to court for a bail hearing. “Explaining my role to the judge definitely stopped her from going back to prison,” says Katy.

Three months later, Sarah is starting to do it on her own. She meets her drug worker fortnightly and tries not to miss appointments. “Sometimes I still go with her but I don’t have to and I always follow up with a phone call to see how things went,” says Katy. “Now she’s more stabilised we can focus on addressing her drinking. She has started to attend a weekly group at a local alcohol service. Once she’s used to that, I’d like to get her into a residential detox programme.”

When asked about Sarah’s long term plans, Katy’s response is heartbreaking.

“Sarah main goal is to get herself ‘together’ enough so that if her children decide to search for her when they’re older, she won’t be in a mess,” says Katy. “It’s almost a dream. But we are breaking that down into achievable steps - what do we need to do today to get there? We take it day by day. She also talks a lot about the abuse she suffered as a child and realises that she needs help with that. She still has nightmares.”

Katy explains that it’s not just about being there for formal appointments, but about building a trusted relationship so that Sarah has someone to turn to when times are tough. “I try to see Sarah three times a week. Sometimes we have a fry-up in her favourite café, or we go shopping for small things to make her feel more comfortable, or we sit and talk - just everyday, normal things.”

“Services sometimes say that chaotic people won’t engage but that’s not the case – they’re desperate to engage when it’s done right!” says Katy. “Sarah wants me around. My job is to ensure the help I provide is consistent and works for her.”

“You are nothing short of brilliant”

The team recently received a card from Sarah. On the front, in bold writing, it said “You are nothing short of brilliant.”

Inside, Sarah had written: “Don't really know where to begin because I've got so much to thank you for. I know you've not been working with me all that long but so much has changed in my life since you have been in my life such as I have a pure routine mon-fri, my looks have got a lot better and I go to all my appointments  (try) which all that wasn't really happening.  You just give me the confidence  and will power to change.”