Women – Fulfilling Lives South East Partnership

In this blog we reflect on how effective partnership working can support new outcomes.

Stonewater and Fulfilling Lives South East (FLSE)

In 2021 Stonewater was awarded the new contract to provide refuge accommodation for women and children experiencing domestic abuse in Brighton and Hove

Stonewater is:

“…a leading social housing provider, with a mission to deliver good quality, affordable homes to people who need them most. We manage around 34,500 homes in England for over 76,000 customers, including affordable properties for general rent, shared ownership and sale, alongside specialist accommodation such as retirement and supported living schemes for older and vulnerable people, domestic abuse refuges, a dedicated LGBTQ+ Safe Space, and young people’s foyers.”

(source: https://www.stonewater.org/about-us/)

The FLSE project, hosted by BHT Sussex, is one of 12 partnerships funded by the National Lottery Community Fund to provide intensive support for people experiencing multiple and complex needs (MCN), involve people with lived experience at all levels and challenge and change systems that negatively affect people facing MCN. While this eight-year project will soon be coming to an end, we recognised the value of collaborating with Stonewater.

At FLSE, we were keen to collaborate with the Stonewater team as we saw a real opportunity, when they were awarded the new refuge contract, to work together to share our learning of working in a trauma-informed way with women facing MCN and domestic abuse to help this particular group of women to better access and sustain their stay in refuge.

The importance of defining MCN or multiple disadvantage

There is much disagreement in this sector about the merits of having a unified definition of MCN or multiple disadvantage. There are concerns in some quarters around the negative effects of labelling on people experiencing multiple disadvantage. At FLSE we understand and respect this viewpoint. However, from eight years of learning, when it comes to the design and commissioning of services for this client group, we know that there is more risk in not naming multiple disadvantage than providing a clear definition. We feel this is important so that services are designed with the specific needs of this group, who are often excluded from services, in mind. For women experiencing intersecting needs including homelessness, mental ill health, substance or alcohol use, repeat contact with the criminal justice system and the repeat removal of children, when domestic abuse is added to this complex array of issues, it is vital that services are equipped to work with these women, who will all have experienced trauma and require an appropriate response.

Recently, FLSE worked alongside the Sussex Police and Crime Commissioner’s Office that led on the Needs Assessment – a requirement of the DA Bill – to assess the need for safe accommodation and support for victims/survivors of domestic abuse across Sussex. We coproduced a written submission detailing the specific needs of women fleeing domestic abuse using case examples from our client-facing work. We were delighted to read in the final Pan-Sussex Strategy for Safe Accommodation and Support for Victims/Survivors of Domestic Abuse that FLSE’s definition of multiple disadvantage was included and ‘responsive to multiple disadvantages’ was cited as a key priority in the Strategy. We recommend that all agencies in Sussex use this definition when commissioning or designing domestic abuse services and safe accommodation options:

Multiple Complex Needs (MCN) has a variety of meanings in services and third sector organisations, depending on the needs of the client group. In general, MCN includes people on the edges of society who are often excluded from or who cannot access who is experiencing 3 out of 4 of the following:

What we did together

The FLSE team and Stonewater managers discussed ways we could work together to support improved outcomes for women with MCN.

In April and May 2022 the FLSE team delivered two training sessions for refuge staff. The first session focussed on complex trauma; its causes and how it manifests in behaviours and tools to manage potentially difficult situations and was informed by the refuge team feedback in a pre-training survey.

The second session focussed on deepening conversations around:

The window of tolerance.
Dissociation – being the most misunderstood responses and the most common in women and children experiencing domestic abuse and how to recognise and work with it.
Practising some grounding techniques and tools.
The working together tool.
Further reading and training that staff can access.

Impact

Following the two training sessions, the Stonewater refuge team felt they had a better understanding of:

The meaning of MCN.
What women experiencing MCN and domestic abuse might need.
Different trauma-related responses.
How to take a different approach to clients affected by alcohol and substances, including ways to organise a multi-agency meeting involving clients.
A number of staff reported feeling confident creating and using a Working Agreement.
All staff reported that they felt ‘completely comfortable’ now with using grounding techniques.

The Stonewater team felt that the collaboration and sharing learning had a positive impact on their work, with one staff member sharing:

“The training was absolutely excellent, I felt as though I learnt a lot and I have already used the working together agreement and the window of tolerance work sheets in my case work sessions”.

Looking to the future

As FLSE is now reaching the final stage of the project, we are proud to know that Stonewater will continue influencing the system to make refuge accommodation more accessible to, and impactful for, women experiencing MCN.

Sandra Sylvester from the FLSE team reflected that “it is so positive to see what can be achieved when working in a strengths-based way with a partner such as Stonewater, who have been open to learning from our 8 years’ experience to develop the tools they need to successfully accommodate women with complex intersecting needs, but also how to give the amazing staff the space to reflect on the difficult work and to provide opportunities to attend relevant training. It has been an honour to be part of this project.”

Wendy Sheehan from Stonewater, shared how enthusiastic the staff were to attend the two training sessions and how they really appreciated them being in person.

“The support and training that the Refuge team have received from Fulfilling Lives has been invaluable. The training was tailored to the specific needs of the team and was based on real life case studies. The feedback from the team has been extremely positive and has improved their confidence with supporting women with MCN’s. This will ensure that we can support more women with MCN a group that is often excluded from accessing many refuge services.”

Sarah Pugh, also from Stonewater, is in the process of developing the organisation’s training package and is using the learning from the training and partnership to inform the content of this framework.

“Refuge has to be more than just bricks and mortar and the practical and therapeutic support survivors, including children, receive is crucial to their recovery. Stonewater are dedicated to ensuring that refuge staff have the opportunity for continual professional development and are equipped with specialist knowledge and confidence to support the multiple and complex needs that residents present with. The feedback from staff who attended this training is overwhelmingly positive and has whet their appetite for more! Learning in the field of domestic abuse and its radiating impact on all aspects of its survivors lives is continuous and we’re working on a Domestic Abuse training plan for all Stonewater employees, incorporating what we’ve learnt so far and utilising all the resources you have provided. Knowledge is power, and effective training results in knowledgeable, skilled staff resulting in improved outcomes for survivors. Thank you Fulfilling Lives, for your time and energy!”

Authors:

Sandra Sylvester, Systems Change Officer

Rebecca Rieley, Systems Change Lead

For further information about Fulfilling Lives work in this area, please contact:

rebecca.rieley@sefulfillinglives.org.uk

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Ideas about who uses drug and alcohol services and how they use them need to be challenged. In Hastings, the CGL Women’s Hub has been quietly doing this. However, in the run up to the publication of a report on its work, the noises coming out of the Women’s Hub are getting louder.

In a way it’s a simple idea. Create a place where service users want to go, that meets their needs… and meet them there.

CGL (or Change Grow Live to give it it’s full name), is the main provider of drug and alcohol support services across Sussex. In August 2021, a new initiative with Fulfilling Lives saw the appointment of Rachel Payne, a practice development worker who identified a need for better treatment pathways for women. Nationally, treatment services have seen considerably more men access their services than women (69% to 31%, PHE 2020). For many this has reinforced the idea that men are more likely to need the service. However, there are a few working in these services who have been questioning whether the way a service is offered can be a barrier to more women accessing effective treatment. The CGL Women’s Hub seems to suggest this is the case.

Katie Lowe went to the weekly Women’s Hub to see first-hand what is happening at a service which is seeing a 78% increase in engagement compared with keyworker meetings and a nearly 300% increase in their participation compared to groups run out of their high street offices. As a psychology student on placement with Fulfilling Lives, Katie had no previous experience with drug and alcohol services and really didn’t know what to expect:

When I got there, I was given a warm welcome and encouraged to get involved in the craft session that had already started. I later found out this is run every week by one of CGL’s volunteers. What struck me early on was how much everyone seemed to want to be there. Not just the women but the staff too. Rachel filled me in on the details: The Hub meets every Tuesday at a local community venue. This allows the service to provide an inclusive women-only space. This neutral venue is not associated with medical treatment, men who may or may not pose a risk or the stigma of being seen walking in from a busy high street. Deciding to run it on a Tuesday was not an accident. Rachel mapped out the other services women might want to attend and found a space that didn’t clash. Staff at the Hub have encouraged women to try out these different services, with small groups arranging by themselves to go together. In some cases, their participation has gone from just turning up for a required medical appointment to attending multiple support groups across the week.

Women can come and go as they please, take part in any of the available activities or just sit and chat. It’s their choice. With an average of 2.6 hours spent at the Hub when they do go, it suggests they get involved in a lot. Local charity Dom’s Food Mission provides supplies for breakfast and lunch. There’s the 2-hour creative group which I dropped in to, often running alongside a beautician offering hair and nail treatments and once a month a hairdresser. After lunch there is an accommodation specialist on hand for drop-in advice, a space to generally chat and get support and regular visits from an NHS sexual health nurse (who reports being able to see as many clients in an hour at the Hub as a whole day trying to meet them in the community). Then there’s acupuncture with a guided meditation followed by a yoga session before everything ends at 3pm. Coming together in this way has allowed women to meet with friends and make new ones in a place that feels safe. It seems to restore social and relational experiences in a way that feels normal in a sector where treatment can be retraumatising for many women.

Friendships, community, meals and clothes are all things we can take for granted if we are not dealing with multiple complex needs. However, Rachel will tell you this busy schedule wasn’t always the plan. Local services have been as much drawn to the Hub as the women themselves, offering support and staff time, all focused on a shared desire for women to get the service they need. Outreach workers, care coordinators and keyworkers from CGL, Seaview and Project Adder have all been involved in running and planning activities. Others have provided quality clothes donations and the combination of a local branch of Tesco and the Hygiene Bank provided items to give to women for free.

Taking this approach has the potential to make a huge impact on the way substance misuse services are structured, and how clients access treatment. There are spaces at the Hub for care coordinators and outreach workers to meet confidentially with women. The Women’s Hub has also been used by occupational therapists, domestic violence workers from Respite Rooms, HomeWorks and the Rough Sleepers Initiative, to meet clients and connect them to CGL’s treatment pathway. So far there’s been cases of women accessing CGL treatment by coming along to the Hub, assessments being carried out at the Hub, and this has even led to women going to detox and rehab. In a way it’s a simple idea. Create a place where service users want to go, that meets their needs… and meet them there. The statistics back this up as a place women with multiple and complex needs want to go. Since it began in November 2021, the Hub has seen 47 different women with an average attendance of 63% – no mean feat for a weekly programme with a service user group often considered ‘difficult to engage.

With Rachel’s own interest and the years-long investment of Fulfilling Lives in specialist women’s services, this approach made sense. However, there is already talk of how this approach might better meet the needs of other marginalised and minority service user groups who are not accessing treatment at CGL’s main offices. With 65% of service users accessing treatment by self-referral or through family and friends (PHE 2020), creating spaces that feel safe for marginalised people will be vital to genuinely inclusive treatment pathways.

Providing the service is inexpensive, with activities and groups being offered free of charge by the different services involved. Many of the staff can use the space to do work that they would have been doing anyway and reach several clients at the same time. There is a small cost for venue hire and arts and crafts projects but that is easily justified by the reach of the service. Creating and chatting with other women is what makes the Hub what it is. Rachel and the team are using these activities to engage with some of the most marginalised and excluded women, reaching out and connecting in a meaningful way.

It’s early days but all the indications are that the Women’s Hub is demonstrating a model of drug and alcohol treatment that is meaningful. There are many positives to this approach; building a safe, inclusive environment for women to access services which otherwise might have felt unsafe. Of course, moving from centralised office spaces would be unfamiliar to most in substance misuse services. There are also some logistical challenges to booking suitable community venues (made easier in the wake of the pandemic as bookings dried up leaving space for new initiatives like this). However, the early signs present an exciting challenge to drug and alcohol services that will be hard to ignore.

Authors:

Katie Lowe, Psychology student on placement with Fulfilling Lives

David Garret, Practice Development Coordinator

For further information about Fulfilling Lives work in this area, please contact:

david.garret@bht.org.uk

For more information sign up to our newsletter:

https://bht.us6.list-manage.com/subscribe?u=b43e61c311da27ad5194daffe&id=148d2193de

Fulfilling Lives South East Partnership

Supporting people with multiple and complex needs

Tag: Women

Stonewater and Fulfilling Lives South East- Supporting Women experiencing Multiple Disadvantage in Refuge