| Many of our clients come to us with more than one problem. One issue can lead to another and so on. By the time we meet them, it is difficult to know where the problem started. But the solution is nearly always the same: someone to take an interest and encourage them to address their problems, with a little bit of guidance to point them in the right direction. We don’t usually have to give them anything, because they usually have the resources inside them: we just help them to realise that, to get those resources out and to put them to good use to solve their problems.
A is an ex-offender with a 30+ year history of alcohol misuse. He suffers from depression and paranoia: these mental health problems were exacerbated by his excessive consumption of beer and whisky. Following his release from prison in 1998, A lived in Norwich. When his offending history became known, however, he was the victim of threats and verbal and physical abuse. His fear and paranoia grew to an intolerable state and he felt his only course of action was to escape to a different part of the country where he was not known and could make a fresh start. With no clear idea where to go, he arrived in Penzance (about as far from Norwich as you can get), there he was sleeping rough until he came to the notice of the Street Services Team, who referred him to Cosgarne Hall. When A arrived here, he was in a very poor state of health and his personal hygiene was appalling: such was his paranoia, that he would not take a shower or bath because he was afraid of being attacked whilst in such a vulnerable position. He was allocated a room in a very quiet part of the house so he could feel as safe as possible. All the necessary paperwork was explained to A and he was assisted with registering with a local GP and obtaining the correct benefits. Staff helped A to obtain a complete change of clothing and after being a resident for a month, with gentle persuasion and encouragement from staff, his confidence grew and he felt safe enough to take a shower. During discussion of his Support Plan, he expressed a desire to make a change and to address his drinking habits. He was encouraged to engage with the on-site alcohol counselling sessions. With the support and encouragement of his Key-worker in tandem with the Counsellor from Addaction CADA, A reduced his drinking from 127 units per week to 24. This part of his Support Plan remains very much “work in progress”. As A grew in confidence. his Key-worker raised the subject of further education and the possibility of A taking a more active role in Cosgarne Hall’s programme of activities. Although reticent at first, he signed up for a horticulture course with the Heaven Scent group, which he enjoys and attends twice a week. Through St. Austell College, whose staff deliver various courses at Cosgarne Hall in our basement training facilities, he has gained a qualification in literacy and has now moved up to the next level: he is a member of the Progression to Life Skills group, another course run by St. Austell College and held weekly at Cosgarne Hall. A is also heavily involved with the Residents’ Café, which is run by the residents, for the residents. An enthusiastic “sous-chef”, he has applied for a basic food hygiene course so he can cook in the Café without supervision. During his time at Cosgarne Hall, A has changed from being reclusive and afraid, to a man willing to try new things and enlarge his life. He still suffers from depression and according to his medical advisors, will continue to do so, but it no longer gets the better of him in the way that it used to do. His paranoia has reduced to the point where he regularly goes out on his own, shopping, to see his GP, or just for a walk. A is now much more capable of living an independent life, but still lacks the self-confidence to make the move at this time, but is progressing towards that goal. |
| Although we are a Support service only (we are funded by the Supporting People programme to provide Housing-related Support, not Care, which is the duty of Social Services), from time to time we have no option but to go beyond our remit, because a client in need of care, is refused that Care by Social Services. Sadly, some people become homeless precisely because the Care that they need is not available to them and in some cases, their lives can be put in danger because this Care was denied them. D is a 54 year old man with a dual diagnosis - a 25 year history of alcohol misuse and a chaotic lifestyle with mental health issues. He had been living in St. Austell, in private rented accommodation, for many years, but eventually his lifestyle and excessive drinking took their toll on his health, physical and mental, which deteriorated badly. With benefits of almost £200 per week, however, he was able to afford a Care package, which was provided by Social Services. With this package in place, he was able to continue living independently in private rented accommodation. Social Services, however, decided that, as he was living an independent life, he no longer required a Care package and withdrew it. Without supervision, he stopped paying rent, forgot to take his medication, neglected his diet, personal health and hygiene, and suffered regular epileptic seizures. In due course, he was evicted from his flat for rent arrears and became street homeless. During the five month period D was rough sleeping he was subjected to frequent financial and verbal abuse and physical assaults. His health deteriorated to the extent that there were grave concerns for his life on the part of the Local Authority and the Police, who referred him to us. He obviously needed Care and we only provide Housing-related Support, but there was nowhere else for him to go. Although we were full at the time, we were not prepared to see him remaining on the streets, so we put him in our emergency room for a couple of nights, to give everyone some “breathing space” to find a better solution, more appropriate to his needs. With nothing else on the horizon, however, we decided to accommodate him at Cosgarne Hall when the next vacancy arose, in the hope that Social Services would soon find something more suitable and, in the meantime, supplement our service by providing a Care package to deal with his health issues and an Appointee to protect D from financial abuse. D’s needs obviously exceeded the services normally provided by CHL, but our SP Team were fully supportive of our decision to bend the rules a bit in this instance and we started on a structured programme for his recovery. Following a series of interviews and assessments it came to light that most of the financial abuse occurred when D collected his benefits from the Post Office, where his abusers lay in wait for their victim, so Cosgarne Hall staff agreed to accompany him on benefits day to withdraw his money, then take him to a supermarket to assist him with his weekly shop. On one occasion, the Police arranged for a constable to be at the Post Office at the time of our arrival, to deter D’s abusers, who did not give up easily. This simple action proved to be invaluable: not only did it dramatically reduce the amount of financial abuse, but it also ensured he was feeding himself. After shopping he was brought back to Cosgarne Hall, where he was encouraged to pay his service charge and buy electricity cards. Once this system was established he was rarely in arrears and never short of food or other essentials. A lockable safe was provided in our Drop-in Office, in which to store his medication, which he collected on a daily basis after his Key Worker had arranged it in suitable “blister packs”. Although he sometimes forgot to collect them, because we were able to keep a check and so noticed when he did not take them, we were able to go to his room and remind him. As a result, his seizures reduced significantly. Shortly after his arrival, Cosgarne Hall staff took D to the Salvation Army, where he was given clothing, washing materials, cooking pots and bedding. After that one time, when he was financially more stable, he was able to purchase all the necessary items himself, with help from Cosgarne Hall staff. His situation was discussed with the local Housing Options Team, a local Social Housing Provider, Shelter and, of course, Social Services. Several CMAAP meetings were held with a view to re-housing D in suitable accommodation and providing a Care package. Social Services steadfastly refused a Care package, but all other agencies, not least Cosgarne Hall staff, continued to press for D’s rights and Shelter engaged a solicitor to act on his behalf. Through these efforts D was given a full psychological assessment and legal support in his fight for a Care package. Throughout his stay at Cosgarne Hall, D was encouraged to reduce his alcohol intake. Although it was accepted that he would never stop drinking entirely, he went from a minimum of 1 litre of vodka per day, to just a few cans of lager. He was taking daily walks, sometimes 3-4 miles, his health returned to an acceptable level and his personal hygiene rivalled that of many other residents. Following an offer from Ocean Housing, he was taken to view a flat in supported accommodation with a full time warden. D accepted the offer and, with the support of the warden and Cosgarne Hall staff, who continued to visit for a month after the move, partly to give him some continuity, partly because the promised Care package had still not come through, he is now once again living an independent life. The struggle for a Social Services support package continues, but D is currently healthy, financially stable and most importantly, safe. If, however, he is unable to receive the Care he needs, then he may end up on the streets again. And again his life may be in danger. We shall, therefore, keep in touch with his progress, in case he needs us again – and if he does, we’ll be there for him. |
| Many people who are unfamiliar with our clients have a view of the typical “homeless person” as being someone from a low socio-economic class who “has never done a day’s work in his life” and made little or no contribution to society, merely living off the efforts of others.
By no means all of those who come to Cosgarne Hall conform to this perceived stereotype, however: many of them are simply people like you or me, but who have, for one reason or another, fallen on hard times – “there but for the grace of God go I” is the phrase that springs to mind. And if someone has been used to the respect of the community and the comforts that come with a well-paid job as a “professional”, then homelessness and destitution can be even harder to bear than for those who may not have had so far to fall. M is a 60-year-old retired primary school head teacher, who was referred to Cosgarne Hall by the local Police, after an extended period of homelessness following the death of his long-term partner and his subsequent eviction from his home. M had a long term enduring alcohol addiction problem, together with a number of physical and mental health issues and had been sleeping in shop doorways and on benches in the town. As someone used to a more comfortable way of life, he was particularly vulnerable both emotionally and physically. When he came to Cosgarne Hall, M was drinking approximately a bottle of whiskey per day and indeed drinking himself into what appeared to be oblivion. He was spending virtually all his benefits on alcohol and eating hardly anything. He was not keeping his regular GP appointments for his various health related issues. He had very few possessions and had considerable issues with maintaining his personal hygiene. All in all, he was in a very poor condition, both physically and mentally – a shadow of his former self and a typical example of how the life of a successful professional man can be completely destroyed by the misuse of alcohol. M was assessed and an offer of a room made to him approximately 7 months ago. The initial entry and assessment period was difficult. For the first few weeks, his drinking was so out of control that it was very obvious that it was seriously damaging his all-round health and well-being. During this time a number of key issues and personal triggers became apparent, with which he needed support. The death of his long-term partner was a major contributing factor to his current situation, together with other long-standing issues and misconceptions surrounding his family and the daughter of his partner. We helped M to access bereavement counselling (Cruse) and encouraged him to engage with our on-site alcohol counselling service (CADA) on a weekly basis initially. We showed him how to manage his limited finacial resources through effective budgeting and supported him in accessing and re-engaging with the local health services and GPs. This support enabled him to stabilise his life and and maintain a level of sobriety and self-awareness, which gave him the coping mechanisms that he could develop further to deal with his various issues. Following this period M has reduced his alcohol consumption to zero and has remained dry for the past three months. He has followed a personally very challenging path, dealing with alcohol addiction and emotional issues, especially coping with the bereavement of his partner. He has now re-forged relationships with some of his family and has visited them a number of occasions. He has also developed his coping mechanisms to enable himself to re-introduce himself to local community groups with which he and his partner had been involved in the past and he has also been very proactive in attending Heaven Scent - a horticultural project with which a number of our clients engage - on a weekly basis. We have now provided him with a computer and he is taking over the management of the accounts for the Residents’ Café. M has developed a feeling of self respect, and has really turned his life around, to the point that he now feels that he has a future. He is now looking to make a new start, maintaining all the relationships that he has worked so hard to re-instigate with his family, church, friends, etc. Hopefully he will be ready to move on soon: when he is, we shall be able to support him in his search for a new home. |
| Some clients’ problems can be so over-powering that they result in frequent relapses along the road to recovery and that road can be a long and arduous one – both for us and the client.
P is a man in his mid-forties who came to Cosgarne Hall with a long history of alcohol misuse. His wife had died of alcoholism and his daughter was taken into care by Social Services due to P’s alcohol problems. P had a strong desire to keep in contact with his daughter and for this reason wanted desperately to become alcohol free. Easier said than done, however. P had also had a stroke 6 years previous to coming into Cosgarne Hall, which had left him with some balance problems and a slight weakness in his left hand. P was also suffering from clinical depression and was under the supervision of the local GP. However, he frequently failed to take his prescribed medication. We contacted The British Legion on P’s behalf, as he had been in the forces and they kindly helped with buying him a number of essentials and a TV. P had a significant debt which had caught up with him and with the support of his Key-worker he made contact the debt collection agency and we helped him to negotiate a payment plan. However, P found it difficult to keep to the agreement and also at this time was also falling behind with other financial commitments. The reason was, of course, a simple one: too much of his income went on buying alcohol. During his time at Cosgarne Hall (because of continual relapses, somewhat more than the two years normally allowed), P fought a continuing battle with his drink problem. P frequently missed key-work meetings on a regular basis and when his Key-worker went to find him, he was often found hiding in other residents’ rooms, drinking. He was told that he must attend these meetings if he was to keep his place here, as these were part of his support plan, but even this did not seem to make a difference. On several occasions, it was decided that a change of Key-workers should take place. This was no reflection on his previous Key-worker, but sometimes we find that a new start can be helpful to a client and some clients respond better to different styles of support. Almost every member of staff looked after P at one time or another while he was at Cosgarne Hall. Another new Key-worker took over and a new support plan was agreed with P, giving more structure to his day in order to keep him occupied for longer and simultaneously a reduction plan for his drinking was agreed. Unfortunately, however, he was still very much out of control and it was hard to persuade him to stick to it. He was failing to take his medication on a regular basis and even had some of his medication stolen, because he was too careless to lock his room where he kept it. We arranged for him to keep his medication locked in a safe in the Drop-in Office, where P would come every day to collect and self-medicate in front of staff, who could remind him if he failed to turn up. P’s personal hygiene was becoming a serious problem, but his Key-worker agreed with him a weekly schedule and encouraged him to stick to it. P’s daughter, who was in care, was very important to him, but his drinking, lack of a permanent home and chaotic lifestyle were preventing him form maintaining effective contact with her. His Key-worker put this fact to good use, however, setting P a goal on which to focus: a home of his own, where he could re-establish his relationship with her. Before he could achieve this, he would need at least to reduce his drinking and address his other personal issues. She agreed with P a move on programme where each fortnight they would go through the Homefinders List, as well as looking in the local paper every week for private rented accommodation. It was apparent, however, that P would find it difficult to find a privately rented place due to his being on benefits. A few months later, P received a phone call from a Housing Association to say that a 1 bed flat had come up in Launceston, which they may be able to offer him a tenancy, but first he would have pass an interview. This would be held at Cosgarne Hall: his prospective new landlords wanted to see how well he looked after his existing accommodation! While undoubtedly a challenge (his accommodation was hardly a model of tidiness) this seemed to give P the incentive he needed to get his act together. His Key-worker discussed the state of his room and that the Housing Association would want to look at how well he kept it. P rose to the challenge and started to clean and tidy his room. P told his daughter about the flat, but she became upset, as her father would be moving away from St. Austell where she lived. P asked if his Key-worker could speak to her, and she explained to his daughter that the move was a positive one, as his daughter would be able to visit him in a proper place of his own: a bed-sit in the environment of Cosgarne Hall had been far from ideal, especially for young visitors, so they had often had to meet in town, walking around from place to place, as no provisions had been made by Social Services for a meeting place. P’s Key-worker supported him during the interview process and he was offered the flat. She went with him to have a look and P was offered the tenancy and given the keys. His Key-worker helped him to sort out his housing benefit while they were in Launceston and she arranged a floating support referral for him as it was clear that he would need help to maintain his tenancy in the early stages. Every thing was put in place before P moved and he kept in contact with us for a little while after the move, reporting that he was doing well and had continued to keep his drinking under control; his daughter was visiting him regularly and things were going well for him. |