Staff and service user perspectives of a co-located homelessness centre in Scotland: a mixed-methods evaluation

Background
Co-location and integration of services within a psychologically-informed environment is recommended for people experiencing homeless but there are few examples of this in the UK. Such a centre opened in Scotland in November 2021.

Aim
To evaluate progress of the new centre.
Design and Setting
Mixed-methods pre-post-test design before (baseline) and two years after (follow-up).

Methods
Baseline and follow-up staff surveys measured knowledge of trauma-informed care, well-being, team climate, and job satisfaction. The follow-up staff survey also evaluated staff support and service improvements. In-depth staff interviews were conducted at baseline (n=25) and follow-up and analysed thematically. A service users survey was also conducted.

Results
The staff survey showed significant improvements between baseline and follow-up in trauma-informed care, burnout, and team climate, together with improvements in support, service integration, and service user care. Service users reported high satisfaction with the new centre.
Staff interviews identified a more psychologically-informed environment, better staff support, and improved opportunistic multidisciplinary working over the two years of the centre opening. However, a number of barriers were also identified relating to the building and the IT systems. Further work on the centre’s vision; short- and long-term integration plans; workload, and sustainability were felt to be needed.

Conclusion
Co-location of services for people experiencing homelessness in Scotland has led to improvements in staff burn-out and team climate, and service users’ satisfaction over the first two years of opening. However, barriers remain and full integration requires a clearer vision and ‘road map’, requiring collaborative leadership and sustainable funding.

Keywords
Integrated Care, Homelessness, Psychologically Informed Environment.