Our work must be person-led, not systems-led

We’re working to help fix a broken system

‘Pre-diabetic, does not eat a healthy diet, has little family contact but would like more, does not drink a lot as can be argumentative, stated has never used drugs, no issue with budgets.’

This would never have been a way that I would have thought of introducing myself a couple of years ago. But more and more this is becoming my norm. It’s all part of my attempt at convincing the homeless and supported housing sector to sit up and reflect on how issue led we have become, how we are letting the system we have in place to lead decisions, not people. To illustrate that sitting with a total stranger that is asking questions about their needs and risks has only managed to at best re-traumatise and at worst institutionalise a decade or more of ‘homeless people’.

It turns out that people experiencing homelessness have learned to adopt this ‘client persona’: one where they are able and expected to disclose their most personal information at the drop of a hat. Where they have become so accustomed to doing this that they automatically reel it out with anyone who takes the time to sit down and chat. Why after nearly 30 years in this sector had I not seen this before?

It turns out that people experiencing homelessness are able to disclose their most personal information at the drop of a hat.

I would like to have said that Mayday recognised these things, and decided that things needed to change in our approach to tackling homelessness from recognition of these issues. The honest answer is that, really, austerity was the initial driver. But soon enough, our mission became the purpose.

Being bold in the face of austerity

In 2011 Mayday was a medium size supported housing provider, trying to tackle homelessness. We watched larger housing associations lose contracts in one area and pick them up in another. Our dilemma was that there were actually people dangling at that end of these contracts. From our research, 70% of those people who were non priority homeless were unlikely to get any sort of support as a result of austerity and change in government thinking.

At that point, Mayday was 100% state funded with a £3m turnover. The sector experience was that the state provided for those most vulnerable, there was a moral obligation to do so and the scale of the problems was way too massive for communities and civil society to cope. But it was clear that things were changing and I remember meeting a MP from Bedford who challenged me when I said Mayday was a voluntary sector organisation: how could that be when all our money came from the Local Authority?

Listening to the people we’re trying to help

So in 2011, we had predicted that this was not a rainy day this was climate change. I was taken on to look at merger and acquisition as the Board of Directors knew that even as a medium size charity we were too small to survive. We came close to a merger but before we took that final step we decided to review what we did. We started talking to people experiencing homelessness, both on the street and those living with Mayday. Properly talking to them.

We simply asked people what they thought of homeless services and what impact these services had on their lives.

We spoke with several hundred people and collated over 100 accounts in a series of blogs, which we printed in a booklet called Wisdom from the street. We didn’t ask what people needed or why they had become homeless. We simply asked what they thought of homeless services and what impact these services had on their lives. Little did we know the impact that these blogs would have on Mayday’s future vision and direction.

Changing direction based on what’s needed, and what works

Contained in Wisdom from the street is a very powerful account of what people had to say. Two things that came through very clearly:

1. The current system and processes are not working for people who become homeless. The humanity and individuality of people’s situation is lost. People’s experience of the system reinforces helplessness, hopelessness and exclusion from community.
2. The outcomes aren’t good enough. Too many people are either trapped in the system or move on only to return with a feeling of another failure under their belt.

That started us on a very different journey and we made a wholly pivotal decision then not to survive for survival’s sake and not to campaign to keep a system going that was clearly broken.

People we worked with started to move on positively and many of those who had been homeless for years were getting involved and starting to thrive in their local community.

We set about researching ‘what works’, what evidenced based work was out there that we could develop to respond to what people experiencing homelessness were saying. We developed a new, personalised, and what we call ‘strength based’ way of working. For us at Mayday, strength based describes a system of support that allows the person to have control over their own life, and find their own resources to help them get back into their community.

So before we faced any cuts, we got everyone, all the staff in one room and we presented our new vision and direction. We told staff the reason we were changing, we were very open and honest. We gave staff the option to buy into a new way of working or take their redundancy. We didn’t want staff to be redeployed into what was fast becoming a collaborative of social activists from what had been a very structured organisation. We lost 50% of the staff at that time. But within four weeks we had re-recruited and we set about what we now understand to be called ‘co-producing’: working with people living with us and staff to develop a radically different response to tackling homelessness.

We were very fortunate that our Northamptonshire commissioner came on board and varied our contract so we were able to do what we needed to do. We threw out pretty much all of how we had worked before. We learnt hard lessons but the results were staggering. People we worked with started to move on positively and many of those who had been homeless for years were getting involved and starting to thrive in their local community.

We meet people wherever they want to meet and talk about whatever they want to talk about.

The new model focuses on 3 key interventions:

• one-to-one coaching, which focuses on people’s strengths and allowing them to take control;
• building positive networks outside the housing and homelessness sector, as many people told us they has been alienated from ‘normal’ society; and
• brokering individual opportunities, as people experiencing homeless are not a homogenous group so need personal escape plans from homelessness.

Overall we knew we needed to shift the power from the services and the system to the person.

Taking a new approach, with better results

Now, Mayday’s approach is to meet people briefly, tell them what we are about and give them the option if they want to get involved. We don’t talk to people about their ‘issues’ but begin with conversations that are just about getting to know the person. So we meet people wherever they want to meet and talk about whatever they want to talk about.

In a short space of time we have seen so many examples of significant individual outcomes. Dave, for example, who agreed to meet up with a coach for a coffee where they talked about remote controlled cars. No ‘fixing’ Dave’s issues, no focusing on his weaknesses. We didn’t talk about his drug use or living in a tent, we didn’t say he had to attend sessions with his coach. We let Dave have the choice and control. Meanwhile, we worked to empower him to get in contact with his passion, who he was, what he wanted.

Dave applied for a personal budget and got a car kit. That Christmas he went home to his family who he hadn’t seen in 12 years. Within 8 months he had accessed his own flat where he has lived for the last 2 years. More recently through his attendance at a car rally, he met someone at BMW who encouraged him to apply for a position there. He has now been working for some months in his dream job. Over time, he slowly saw what was possible and made it happen.

Here’s how we did it

The experience of delivering the new personalised work was transformative and not just for the staff delivering on the frontline. The model necessitated change at every level within the organisation, how we selected and recruited staff, our financial reporting, the board appetite for risk, the language we used, cultural, structural and total system change.

So we slowly got braver and decided to move away from just chasing statutory contracts. By then, these had become about delivering more for less, a race to the bottom on price, all of the terms used to describe how many local authorities were trying to respond to austerity. We began to seek investment into our new way of working and we were fortunate to attract investment for a proof of concept in Oxfordshire.

The model necessitated change at every level within the organisation.

When we started delivering this proof of concept, we discovered that the work not only needed our internal transformation but that our approach wasn’t fitting in with how other organisations were working. We were starting to disrupt the norm. We were trying to deliver a person first service in an issues focused and needs led system.

So in collaboration with Homeless Link, we held two national conferences in London and Manchester. These were to promote Wisdom from the street, and to share the lessons that we had learnt from co-producing and delivering a personalised, strength based way of working.

And how we’re making the changes stick

In October 2015, Mayday’s Board of Trustees made the decision to focus the future vision and direction of the Trust on 2 strategic goals:

1. Deliver the new model of work developed by Mayday named a Personal Transition Service (PTS): being the first personalised and asset/strength based approach to tackling homelessness, developed at the grass roots; and aiming to become a catalyst for change by empowering individuals experiencing homelessness to take control of their life and environment.
2. Use the learning from the Wisdom from the street to influence nationally the need for system change and the need to transform services to embed personalised and asset based approaches.

2016 became a very tough year for us all. In delivering just the new work, it meant that we had to withdraw from contracts and services that we had delivered for years. We did the best we could do for the people and staff in those areas but it was a hard time. There is no doubt that this process had a huge human cost. The organisation reduced in size and turnover from 70 to 45 staff and turnover of £4m to £2.2m.

Mayday had no great ambition to become a large national provider, so in 2016, we developed what we call ‘innovation partnerships’ to deliver the new model and in that way try to affect system change. These partnerships were with people who were as passionate as we were to create the paradigm shift that needed to happen. We found people who were frustrated with the system, who weren’t afraid to speak up, to change and transform their organisation from top to bottom. We have come together through a common goal and set of values rather than a willingness to survive. By doing this Mayday halved in size in the first year. But with our partners we intend to double our impact.

Change will come from listening to people, getting to know people’s context, and always knowing that we are all different.

There are also many organisations saying that they have been doing similar work. Indeed many new great initiatives evolved from many disciplines such as Housing First, PIE (psychologically informed environments) trauma informed care, so that gradually a movement for change is building.

What Mayday believes—and will continue to inject into the discussions—is that the solution to homelessness will fundamentally not come from psychiatry, sociology, psychology, the housing sector—although all the focus and thinking at this time is invaluable. Change will come from listening to people, reflecting, getting to know people’s context, understanding, and always knowing that we are all different. So let’s keep it person-led not system-led.

This essay is part of a series on transformation from the boldest voices in the sector.

About the author

Pat McArdle is the CEO of the Mayday Trust, and has been for six years. She has worked with people facing disadvantage and experiencing homelessness in the UK and Ireland for 30 years. Her first position was in a drop in centre for people with mental health problems in Handsworth in Birmingham. She then held 2 national positions working with the Foyer Federation as Head of Network Services and Director of Services for YWCA.