Healthwatch East Sussex Kendal Court Report: Reviewing The Results

Healthwatch East Sussex is a Local Authority and Independant grant funded charity organisation which scrutinises health and social care issues in Brighton and Hove and Sussex via Partners. They produced an a first report into Kendal Court Newhaven in 2018, which is where Brighton and Hove City Council place homeless people needing housing support. In 2021 following more deaths, Healthwatch revisited Kendal Court and produced an additional report into the emergency accommodation property, support services and most importantly the residents actual feedback. We will document and review the findings from the previous and the latest Healthwatch Report into Kendal Court Newhaven.

32% of the 28 residents surveyed from the 63 flats, reported that they have lived at kendal court for more than 12 months, with one resident reporting they have lived there for almost 6 years now. This is emergency Accommodation. 

graph showing 32% of residents have lived at kendal court for over 12 months the longest being 6 years

Key Kendal Court Healthwatch Report Findings

• Security: 24hr security provided by a contracted company, together with key code on entrance gates. Spy holes have been fitted to front doors. However, at least two assaults have been a reason for ambulance attendance at Kendal Court in 2021.

• Facilities: Residents can now buy electricity tokens out of office hours from the security staff. There is one domestic type washing machine available in a Portakabin type building; Wi-Fi access, windows and common areas are in better repair and there is one seating bench outside in the yard.

• Caretaker: In 2018 the caretaker operated out of one small caravan. There is now a Portakabin type caretaker’s office which is also used by security staff.

• Resident make-up: Women and children are no longer placed at Kendal Court

• Emergency response: Fewer attendances by emergency services

• Travel: Some provision of travel passes for some residents

• Welfare: BHCC welfare officer on-site once weekly

Historic Issues Still Present at Kendal Court

 ➢ Lack of appropriate mental health and care needs assessments and limited connectivity to appropriate support services.

➢ The caretaker and other on-site staff are not trained to support and refer residents who are in need to appropriate external services.

➢ Mental health emergencies are the most common reason for ambulance attendances to Kendal Court, both in 2018 and in 2021.

➢ No information about Kendal Court or the local area is provided to residents either prior to or on arrival at Kendal Court.

➢ Haphazard and insufficient supply of basic items on arrival. Both the lack of information and basic items is disorientating and causes significant deprivation to new arrivals especially those arriving from institutions such as prison or care settings.

➢ Three safeguarding concerns were raised by HWES in 2021 (collective concerns regarding women and children were raised in 2018)

Key Recommendations from the 2021 Kendal Court Healthwatch Report

1. Individuals with multiple and complex needs, or those who are extremely vulnerable, should not be placed at Kendal Court even if other recommendations are implemented. In order to prevent inappropriate placements at Kendal Court, robust assessments as stated in recommendation 2 should be undertaken.

2. Individuals should have their health and care needs assessed by mental health and/or social care professionals at the time of their housing placement assessment, and at the same be referred with consent to relevant VCSE organisations.

3. A multi-disciplinary assessment and referral pathway for people needing Emergency Temporary Accommodation should be established to identify and record the involvement, responsibilities and action status of all services involved with individual residents.

4. Comprehensive improvements to the provision of site information and essential items for residents entering Emergency Temporary Accommodation should be undertaken in East Sussex, including at Kendal Court.

We recommend the adoption of minimum standards as documented in The Emergency Accommodation Charter produced by Eastbourne Citizens Advice, Justlife & Fulfilling Lives in collaboration with both Brighton and East Sussex Temporary Accommodation Action Groups (TAAG).

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Kendal Court Report Findings in Detail

Still a large number as per the previous report not interacting

“We understood from site staff and some other residents that a few people barely leave their flat and avoid engaging with others when they do. The views of residents who, for whatever reason, are the most withdrawn, are therefore not represented in the findings of this report. We also learned that a small number of residents did not appear to live full time at Kendal Court; visiting only to collect post.”

Sent to Kendal Court with only an address only

• 78% of respondents specifically mentioned having received no information prior to their arrival about the facilities at Kendal Court or local services. They obtained verbal information from either the caretaker or other residents in the days following their arrival.”

Mental Health Worries At Kendal Court

• 53% of respondents spoke about lack of access to mental health support; either for themselves or expressed concern about the needs of other residents. One person said: “These people need care. This is not a care home.” Some residents said that mental health support should be provided locally and could even take place at Kendal Court.

Please Note: a large number of residents the most withdrawn did not participate

Kendal Court Living Atmosphere 

• A lot of residents report being content living at , calling it “calm” however 43% of responses expressed feeling isolated or fearful at Kendal Court

Lack of Facilities and Living Essentials 

• 42% of respondents said that the caretaker was helpful in providing them with both local information and basic items for daily living if any were in store. However, there appears to be significant variation in what tenants are provided with, which suggests the absence of an “essentials checklist” for new arrivals. Given that many new residents have arrived from either an institution such as prison, or rough sleeping, it is easy to anticipate that they will bring with them few or no household belongings

Feelings around Out of Area Placement

• More than third of respondents felt that the distance from their formal or informal support systems in Brighton and Hove impacted their wellbeing. Some mentioned travel costs on a very low income as an additional barrier.

It is worth noting there was previous commitments to provide all residents who needed travel concessions it is concerning to read many are still not receiving these travel passes. 

Welfare Officers Role At Kendal Court

• There was a mixed response regarding awareness of or satisfaction from contact with the BHCC welfare officer, who visits weekly. There seemed to be uncertainty about the kind of support they could provide. Two people said they were uncomfortable with having to discuss their problem with the welfare officer while other staff were present in the caretaker’s office as it lacked privacy and confidentiality

Residents useful facilities and service suggestions improvements 

• Residents made useful suggestions for improvements which included a common room/area for residents, weekly support sessions from the mental health team, gym equipment and better training for night security staff to support residents in difficulty.

The Review Picked up Safeguarding Concerns

• Three incidents involving safeguarding concerns were highlighted during the review. One was jointly shared with Safeguarding Teams in East Sussex and Brighton and Hove. The remaining two individuals were referred to the East Sussex Team

General Accommodation Comments

  • “Room is good sized but poor air circulation on top floor, even if window open. Odours from other flats.”
  • at least 10 people indicated they were very unhappy at Kendal Court. 2 people described it as “awful”. another 2 people said it was “stressful”.
  • 12 (43%) people made comments relating to fear, isolation & noise: Feels very ‘isolated’ at Kendal Court, only spoken to [caretaker] since arriving [2 weeks ago].

Themes and Quotes From Kendal Court Residents 

“Stressful, depressing and soul destroying”

“Most of the time I’m frustrated and having nightmares. I’m scared for my wellbeing.”

“I don’t get any support or help from anyone.”

“Grim – experiences bad anxiety and panic attacks.”

“Dumping ground.”

“Worse than prison.”

Comments about neighbours included; problems with noise levels, and another reporting that other residents taunted him about his religious beliefs.

Another resident observed: “Sometimes [people] bully others but it’s not bad at the moment there isn’t much confrontation between tenants”.

Was given a food parcel when I arrived but no tin opener, knives, forks etc It [the flat] had bed and mattress but nothing else when I arrived. The mattress is very old. [Caretaker] sorted out some bedding and the previous tenant left a kettle and toaster No bedding or anything, not even a kettle. One person described the caretaker as “amazing”, in terms of the help he provided when they first arrived.

Is there anything troubling you in your day-to-day life?

Prompts:

• Health and wellbeing? • Getting help and support? • Money or benefits? • Getting food, cooking equipment or bedding?

17 people (61%) reported that they had mental health issues and/or difficulties relating to substance misuse and addiction. 4 of these people said they were accessing support, but 15 (53%) of all respondents specifically mentioned lack of access to mental health support; either for themselves, or they expressed concern about the needs of other residents and that there was no support on site for such people.

“Not nice here – so many people with mental health issues, some so frightened they don’t want to come out of [their] room”

“It is hell to me being here but I have no choice. I wasn’t given any information by anyone but I was just dumped here by housing benefit.”

[paraphrased by interviewer]: Has a psychiatric nurse and a [recovery] worker. However, neither has been to see him or support him at KC, they only contact him by phone. They are both based in Brighton and Hove, so when he needs to see them, he has to go to them. This costs about £6 on the bus.

When answering other questions with our reviewers, some respondents also spoke of poor access to mental health services and mentioned specific concerns such as: • Feeling lonely and isolated • Needing more support from mental health (MH) services • Hears voices and waiting for mental health services. • Trying to get help with MH – been diagnosed with depression, PTSD and a personality disorder. • Anxiety and/or depression. • Panic attacks • Self-harming • Feelings of fear affecting his mental health. T

here was a marked difference between those people who were troubled but had good support and those who did not. 3 people said they were receiving effective support from either mental health services or a voluntary organisation. Some others had friends and family, usually in Brighton, who were able to support them.

Equalities Monitoring

As stated in the methodology, the characteristics of respondents were observed and
recorded by the researchers, although some information was pro-actively offered by the
participating residents.

Ethnicity
• 17 respondents either identified themselves or were estimated to be of white British
ethnicity.
• 9 respondents either identified themselves or were estimated to be of African,
Central/South Asian or European ethnicity.
• 2 – unknown

Age:
• 15 (53%) respondents were in 30-49 age group
• 3 were estimated as being under 30yrs old
• 5 were estimated as being 50+ years old
• 5 were unspecified

Disability & health conditions disclosed by residents included:
• Mental Health conditions: anxiety, depression, hearing voices, personality disorder,
Post Traumatic Syndrome Disorder (PTSD)
• Diabetes
• Epilepsy
• Learning difficulty (ADHD, Dyslexia) em sample content

Feedback from Citizens Advice Bureau

Healthwatch East Sussex was contacted by national advice organisation Citizens Advice (CAB) regarding a resident of Kendal Court who was in crisis over his electricity supply. Here is a copy of the correspondence received. Some information has been redacted to preserve individual’s identities.

“I am contacting you just to raise your awareness of an issue I faced this morning with an extremely vulnerable client who has been placed temporarily in Kendal Court, Newhaven by Brighton Council. I am actually based in xxxx but our advice line accepts national calls hence why the query came to me.

Our client has severe MH issues including psychosis plus suffers with epilepsy. He has previously attempted suicide and was literally at breaking point when I spoke with him.

Our client stated to me that he needed food to take his medication, but he had no electricity left with no means to purchase a top up voucher and was concerned that the only food he had left would ‘go off’ if he was left to wait till Monday. He also had no way of charging his phone which was on 4% battery, nor would he have any heating or hot water for personal hygiene reasons.

Our client tried to deal with this himself yesterday by approaching DWP for an advance payment through his Universal Credit (UC) but this was refused due to him already having a new claim advance that he is still repaying. The local welfare scheme who provided food stated they would not help with utilities.

Our client also contacted our adviceline, but this was again picked up by an out of area adviser who did try to raise a request for our local office to contact the client but unfortunately this was not picked up before close of business yesterday.

The apparent scheme for electricity top ups is that they need cash to purchase a paper voucher for the meter and this can only be done via the caretaker when they are ‘on site’ at Kendal Court.

Our client states that he was given vouchers by the council for food but was told he would need to sort the electricity himself.

Our client states that he purchased food that needed to be kept in a fridge due to his previous time spent in prison which put him off most packet food and he also did not think about the food going off without electricity.

When our client queried how he would purchase electricity with no funds he was just told that no assistance was available that would provide him with cash. Although I can appreciate the reasons for not doing this, it does not leave our client, or any other resident, any option when in an emergency situation.

Our client tried to speak with the Kendal Court caretaker this morning but stated that not only did they not speak great English, but he also indicated that he didn’t know who could help our client anyway. I asked our client if he had received an information pack with the electricity provider for emergencies included in it but our client stated that he had been sent this via email, but he could not read or understand it. I asked our client to go to the meter to see if he could locate the supplier and a reference number in the hope that I could reach out to them for assistance, but our client stated that there was no information whatsoever either on the meter or in the cupboard which it is housed in.

I spoke with a lady called xxxx in social care who tried to locate any organisation who could help but she also drew a blank. Unfortunately, due to not being based in the local area meant that I had no access to, or any information on, any local schemes that might have been able to offer emergency assistance. Upon trying to google information for local support networks in and around Newhaven, I noticed that there is no information whatsoever available on how you can contact Kendal House, let alone in emergency situations. I did however find a stream of complaints and/or concerns about this accommodation and the vulnerability of its residents including the report from yourselves ref: REP 7974 which also made reference to the electricity scheme.

I will be raising concerns internally via our social policy scheme about this location and also re the DWP and Local authority who both felt it was ok to turn our client away without assistance despite knowing of his vulnerability and mental health issues. I am unsure if this accommodation is still being investigated by Healthwatch but genuinely believe that the issue with this electricity top up is one that either needs investigating, or further investigation being raised.”

Report Recommendations

System Recommendations for Statutory Authorities and service providers

2. Individuals with multiple and complex needs should not be placed at Kendal Court even if other recommendations are implemented.

3. Individuals should have their health and care needs assessed by mental health and/or social care professionals at the time of their housing placement assessment. Where this is not possible an assessment should be completed within a few days of being placed. Placing authorities should consider attaching a member of their Adult Social Care team or a mental health professional to Homelessness Services for this purpose.

4. Brighton and Hove City Council (BHCC) and mental health providers should establish an effective system of support for people’s mental health needs based in Newhaven, ideally including on-site support at Kendal Court. This could be achieved through regular drop-in sessions from the Mental Health Team or by commissioning voluntary organisations to provide services.

5. A clear holistic needs assessment & referral pathway is needed for homeless people. This should detail who is responsible for what at each point in that pathway, involving the relevant disciplines (housing, physical and mental health, social care, safeguarding, criminal justice system, and emergency services) and across administrative borders. This would provide clarity for all staff and relevant parties and provide accountability at each stage in the process, particularly with out of area placements.

VCSE organisations to be referenced and included in assessment and referral pathways. Given that residents can become isolated and withdrawn in self-contained accommodation, early referral to and engagement with appropriate voluntary organisations offers a great potential for implementing a preventative care agenda.

The commissioning of voluntary organisations should therefore be fully explored for their viability to deliver preventative care and work in partnership to achieve best outcomes for residents. Options for partnership working with other organisations could include:

Obtaining client consent to refer and share information with key local services such as Foodbanks (SCDA in Newhaven) or other relevant voluntary services Page 30 of 43 responding to particular health conditions or disabilities.

Providing access to a menu of related services available at or near emergency and temporary accommodation sites e.g. social prescribing, Citizens Advice Bureau, financial literacy, substance misuse services and visits by GP based paramedics. These initiatives could provide an early and positive start in achieving long term wellbeing outcomes for individual residents and could achieve a system cost benefit compared to frequent and repeated use of emergency and more acute services.

6. Standardised information should be provided to all residents in Emergency Temporary Accommodation (including those at Kendal Court), both prior to and following arrival, including:

Amount of cash needed for arrival (electricity meter & key deposit) and ongoing expenses Public transport options, and caretaker’s hours

A checklist of household items which will be provided and those which are not

Key information about local services including: GP, Foodbanks, Dentist, Pharmacy, transport, other support services and advice, shops & post office.

Contact details for both statutory mental health services and for voluntary sector services such as Samaritans and Mind.

7. A number of site, staffing and placement management options should be considered by Brighton and Hove City Council in relation to Kendal Court:

Consistent provision of essential items for new arrivals, with a clear sanitising procedure and serviceability checks for the transfer of pre-owned items such as mattresses, bedding and electrical items. Future procurement of Emergency Temporary Accommodation in East Sussex should specify and deliver minimum standards for facilities such as laundry, wi-fi, communal space, confidential meeting space, security, service and utility charges etc.

Phone and email contact with on-site staff. Contact details for Kendal Court site staff and linked services should be provided to residents and made available to friends/relative and external organisations. This will allow contact to be maintained, enable delivery of support and allow concerns to be identified and responded to.

• More clarity and consumer rights information provided for residents about electricity and other cash charges made on site. The name of the electricity provider should be clear to residents, together with the unit charge. Receipts should be given for all cash transactions. 

Confidential meeting space: Another Portakabin could provide a communal area for residents, but also be used for health, care, VCSE professionals, or the welfare officer to meet with people in a confidential space. A transparent partition or door and an alarm button could be fitted as a means of keeping people safe.

Laundry facilities: The laundry facility is welcome but inadequate for the number of residents. There is only one domestic type washer and dryer and no outdoor drying equipment. Rotary driers could be easily installed in the site yard. These could be removable for daytime use only while the caretaker and security staff are active, to prevent damage or injury during the caretaker’s absence.

Exercise & wellbeing: Other suggestions for use of outdoor space could be a bike rack, benches for seating, a greened area, or a type of simple fixed base outdoor gym equipment.

8. Healthwatch East Sussex recommends that ‘The Emergency Accommodation Charter’ drawn up by Eastbourne Citizens Advice, Justlife & Fulfilling Lives in collaboration with Temporary Accommodation Action Groups (TAAG) in Brighton and East Sussex is fully implemented as it closely reflects the evidence leading to our recommendations. The Brighton Hove Draft Emergency Accommodation Charter was presented at the BHCC Housing Committee Sept 2020 with an agreement from committee members both then and at the BHCC Housing Committee Nov 2020 to progress and implement the principles it contains.

7.3 Recommendations for Healthwatch East Sussex (HWES)

9. HWES to seek reassurances that a response will be received when raising safeguarding concerns across Local Authority boundaries and that adequate support has been put in place.

10.HWES to take the learning from this study to inform how we carry out future reviews at other Emergency Temporary Accommodation establishments in East Sussex.

11.HWES to share the learning from this review with statutory and voluntary sector partners across Sussex, other local Healthwatch and with Healthwatch England.