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Supported housing and hospital admission

VOICES case study 11

*Names have been changed to protect identity.


There were two main bodies involved during the time Adam was noticeably exposed to complex exclusion barriers. These were the local authority and the last hostel that Adam’s bed was closed at whilst he was in hospital. Adam has been homeless or residing within hostels for many years, suffering from substance misuse and mental illness.

Recently Adam was admitted to hospital following serious health concerns. During his inpatient stay and subsequent operation his bed space at the hostel was closed leaving Adam homeless when fit for discharge from the hospital. The hostels reasoning was that Housing Benefit will not pay for more than 7 nights whilst absent from the hostel and therefore the bed was closed. This presented a major problem for Adam to get another form of housing in place to prevent homelessness. The barriers Adam faced were in line with the findings of Public Health England’s health profile of Stoke on Trent’, published in June 2015, which concluded that the health of people in the city is generally poor and stating People facing homelessness, who are often already struggling financially, have far less choice and frequently end up in poor quality accommodation.

Bruno Ornelas in his Thesis on ‘Exploring the relational dynamic between structural and individual forces that worsen exclusion and homelessness’ notes, “how the disconnect between housing and social care contexts in what they consider to be ‘vulnerable or ‘at risk’ is perpetuating oppressive practices that places blame on the individual”. This is reflected in how Adam’s case was treated by his last hostel and how his circumstances made it easy for the decision to close his bed to be arrived at.

Adam was in a precarious position as his bed being closed was beyond his control and he did nothing to end his tenancy of his own accord. Numerous referrals were then put in to other hostels, but some were rejected on the basis that his risks were too high following previous hostel stays and current ill health. This created multiple barriers for Adam to get rehoused and increased his anxiety during this period. Following discussions and assertive advocacy with the local authority about the customer’s needs they accepted a duty and will work with Adam to have him housed somewhere upon release.

The Laws around what duty the local authority has towards homelessness and how this is applied is not always clear in practice. On paper the laws come across modest in their criteria and intention but how this is then put into practice is not easy to follow for a person experiencing homelessness. How these decisions were made was not made clear and nothing was put in writing for Adam.

“Multiple exclusion homelessness describes how homelessness intersects with other forms of deep social exclusion, often linked to substances misuse, mental ill health, offending related behaviours and childhood trauma” Bruno Ornelas Oct 3rd 2018.

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