WIREDGOV

Blog posted by: Caroline Bernard, Thursday, 5 March 2020.

The COVID-19 (Coronavirus) outbreak presents specific risks to the homelessness sector. The people that our members support are in the high risk group, with long term conditions that mean, should the virus affect a member of staff, or someone experiencing homelessness including individuals who are sleeping rough, there could be severe consequences for services.

Individuals living and sleeping in shared spaces such as hostels, night shelters, and day centres are at particular risk as they are unable to self-isolate, and services cannot close down as the people they support are then forced back to the streets, where they are at even greater risk.

As the membership body for the homelessness and supported housing sector, our responsibility is to advise our members on how to prevent the spread of the virus, and to prepare for different scenarios that may occur.

Our recommendations for action:

• Local areas ought to establish a homelessness and COVID-19 task force, including the police, housing, health, homelessness, people with lived experience, the wider voluntary sector, and other relevant stakeholders. 
• A local needs analysis should be undertaken, which includes the nature and location of homeless/rough sleeping cohorts; current intelligence on the demographic and the needs of current rough sleepers; the perceived risk in each of the main homelessness services (day centres, hostels and night shelters) including risk from staff and volunteers. This should include the numbers of people with no recourse to public funds in their area, as this is one of the groups that may be disproportionately affected.
• Services should be mindful that COVID-19 is more likely to enter the sector through staff than through clients, so it will be important that all local messaging by stakeholders avoids a focus on people using services as the source of any outbreak. Members can influence this locally.
• Services ought to establish a screening protocol for all staff, volunteers and others in regular contact with the service. At a minimum, outreach teams will need guidance on what to look for and training in what to do should they suspect the presence of COVID-19.
• A self-isolation protocol, and contingency plan should be developed, as well as a plan for priority treatment for rough sleepers found to have the virus who cannot self-isolate.
• Local authorities should look to use section 189 of the Housing Act in order to prioritise accommodation for someone who has been sleeping rough and is suspected of contracting COVID-19, in order for them to be isolated.

We are providing our members with as much information and guidance as is currently available, in order to support them with putting plans and practice in place to protect the people they support.

Frequently Asked Questions

How do we support those infected with the virus living in shared accommodation?

Where an infected individual is currently living in shared accommodation with communal facilities (bathrooms, kitchens and living areas), a suitable alternative, self-contained living space should be found until the person is fully recovered. This could be in the same building. Where more than one person is infected or infection is suspected, service providers should consider establishing a ‘safe zone’ within the accommodation for those individuals. The safe zone should be self-contained and away from other, non-infected people (e.g. a separate floor in a hostel or a particular set of bedrooms with shared facilities).

Where the majority of individuals within a shared setting are infected, it may be wise to consider finding suitable alternative accommodation for those people NOT infected, so as to contain the spread of the virus. Providers should restrict access into and out of a building where the majority of individuals are infected.

What is the advice in the event of significant staff Absence through sickness?

In the event of significant staff sickness or absence from work, providers should put in place arrangements to source suitable bank staff from an employment agency (those that specialise in health and social care agency staff). It may also be possible to put in place reciprocal cover arrangements with other local homelessness and/or social care providers. Former employees and volunteers may also be willing to step in at short notice.

There is an issue with self-isolation for people sleeping rough, by virtue of the fact that such individuals cannot self-isolate. What is the advice?

Where an individual who is currently sleeping rough is found to have (or is suspected of having) the virus, a multi-agency approach should be taken to identifying and commissioning suitable self-contained accommodation as a matter of urgency. This may include hostel accommodation where a ‘safe zone’ has been established (see above); self-contained private rented accommodation; housing association stock; or a self-contained room in a hospital ward. This accommodation should be sourced in the locality where the person presents as sleeping rough, so as to avoid unnecessary travel.

How do we support individuals who refuse to self-isolate?

Where an individual is sleeping rough or is in shared accommodation and is found to have the virus but refuses attempts to be isolated, a referral to public health and the police should be made on public safety grounds. This should only be done once all attempts at reassurance and persuasion have been made by suitably qualified and experienced support staff.

At the present time, a range of guidance is available:

Central government has published a list of guidance for various settings on the gov.uk website.

Public Health England general guidance (special guidance is being prepared by the Rough Sleeping Advisers at PHE and will be shared as soon as it is in the public domain). Until this is available, rough sleeping services have been advised to follow the government’s guidance for professionals in advising the general public on the virus. This includes advice on what action should be taken if a person has been to China or other specified countries in the last 14 days, or has been in close contact with a confirmed case of COVID-19.

National Council for Voluntary Organisations guidance (aimed at the wider charity sector).

We have had sight of specialist advice and guidance for homelessness services from Org-Code Consulting, in Canada.

Housing Justice has produced advice specifically for night shelters.

The Passage has prepared detailed guidance for volunteers, and their contingency plan, both of which have been signed off by clinicians.

Pathway has produced a press release which sets out some advice.