The most significant intervention that the government made in relation to homelessness and COVID-19 was the instruction to bring ‘Everyone In’ or provide emergency accommodation for everyone rough sleeping, at risk of rough sleeping, or in accommodation where they could not self-isolate throughout the pandemic. This was an enormous undertaking and in Coventry, approximately 92 individuals were housed in a range of hotels initially and thereafter in a single hotel which was staffed throughout the pandemic by the council’s Rough Sleeper team. The Rough Sleeper team engaged with six individuals who refused to be housed on a daily basis to check on their health. The Salvation Army also provided five free self-isolation beds to support those who were symptomatic or had had a positive test.
Many individuals who are homeless have complex needs such as substance misuse and poor mental health and in most cases they have more than one complex need. It was felt that there was a high risk of an outbreak of COVID-19 amongst the cohort as many may struggle to follow social distancing guidance and may not report or recognise symptoms of COVID-19 due to issues such as substance misuse and any outbreak was likely to be high impact as many of the cohort have long term conditions, that meant becoming infected with the virus could have severe consequences. Thus, a two-pronged approach was taken to mitigate the risk of COVID-19 within the cohort:
A weekly COVID-19 and Homelessness multidisciplinary team (MDT) was established with a range of partners such as the self-isolation unit housing provider and the housing commissioner, public health, West Midlands Police, CRCCG, specialist GP service for homelessness, safeguarding, drug and alcohol service. The MDT agreed policies/procedures such as the pathway for people who are homeless to ensure the individual was safe and had their needs tackled to support self-isolation and are COVID-19 symptomatic and the outbreak plan with each agency identifying the role they could plan. Incident meetings were called to discuss individuals who could not or would not self-isolate.
An information and advice presentation was made to a range of agencies working with the cohort.
The purpose of which was to:
- Support the workforce to regularly deliver key messages about the prevention of COVID-19 transmission and the importance of reporting any symptoms
- Monitor individuals for symptoms and have knowledge about who to contact if they had a case (or suspected case) of COVID-19 and what the workforce needed to do to protect themselves and the cohort.
Key lessons learned from Homelessness Engagement
- Upskill agencies that already work with this cohort and are more likely to be trusted/listened to
- Rigorous planning and provision of services in the most convenient locations – i.e. “going to” the individuals to provide testing and vaccinations
- Partnership working crucial in this area
- Be prepared for the worst-case scenario, ensuring outbreaks can be safely managed in hostel accommodations