‘Creating psychologically informed ‘HOMES’: Reflections on the launch of Centrepoint’s new operational model in our Support and Housing Services…’
28.05.2021: This has been an exciting week in the charity, as it was marked by the launch of a new psychologically informed operational model (‘HOMES’) in our Support and Housing services! Therefore, for this week’s PIE blog as the Lead for Psychologically Informed Environments (PIE) at the national youth homeless charity: Centrepoint, I wanted to reflect on ‘HOMES’ and how it links to a PIE, as well as offer my gratitude to all my colleagues that have enabled us to get to this point this week. When I joined Centrepoint a little over two years ago to implement a PIE across the organisation, it was clear quite quickly during my initial scoping exercise that this was not something that I could do alone (and nor did I want too!). Centrepoint is a large national organisation and my one voice was not going to be enough to bring about the system change needed. Rather, as per a PIE, it was all about building relationships with others so we could bring about change together. It was listening to and working with others that was critical in shaping my thinking about what was needed for our ‘evolution’ into a PIE even if we did not need a full-blown ‘revolution’!
The launch of ‘HOMES’ this week is a significant step in this ongoing ‘evolution’ to become a more PIE organisation, and is the end result of almost a year of hard work, reflection and strategic change planning that hopefully will improve outcomes for the homeless young people that we support as well as the amazing staff that support them. ‘HOMES’ stands for ‘Housing Operational Model: Environments and Services’, and as per a PIE, it is about doing just that — creating ‘HOMES’ for some of the most vulnerable young people in the UK that would otherwise be without a place that they could call ‘home’. ‘HOMES’ is all about ensuring that our day to day practice is psychologically informed so that we can give homeless young people a start in life that many of us take for granted. This is the foundation and the opportunity to #changethestory and set them on a different path post their time in Centrepoint, in order that they can reach their full potential in society. Of course, this work can be challenging, as many of the homeless young people referred to our services have very complex needs, including adverse and traumatic early life experiences that lead to vulnerabilities, disengagement from education, training and employment, as well as mental health and substance use issues. However, our successes show we can make positive change (c.f. https://centrepoint.org.uk/youth-homelessness/real-stories/), but we can always do more and that is where PIE and ‘HOMES’ have such a critical role.
Therefore, what exactly is ‘HOMES’ and how does it relate to a PIE? In essence, ‘HOMES’ is our delivery model for our support and housing services, and it puts PIE at the centre of all that we do. It is a commitment to embracing a psychologically informed model of support, from improvements to the physical environments that we create for homeless young people to live in and staff to work in, through to the way we support and interact with each other (i.e. relationship building). It is about ensuring that our staff have the right training and support to do their roles as well as giving them reflective practice spaces to think about the work they are doing and the impact on them. Positively, it is a commitment from the organisation to invest in what makes our ‘frontline’ services the most effective they can be, which also involves us ensuring that our policies, procedures, systems and management processes are psychologically informed and based on the latest evidence based practice. This enables us to ensure that we reach the highest possible standards in the homeless sector and we create a culture of innovation and improvement as we move forward as a charity.
Specifically, immediate changes under ‘HOMES’ include a new psychologically informed training syllabus for staff, to be delivered by our PIE team, in conjunction with our Skills and Development team and our new specialist PIE trainer as well as other senior members of the support and housing, and health team(s) (e.g. Operational Managers). Alongside the need for staff support, staff training is highlighted by Keats et al (2012) (c.f. https://www.researchgate.net/publication/313365226_Psychologically_informed_services_for_homeless_people) as ‘central to the transition into psychologically aware services’ (p.21). Consequently, as well as our existing Centrepoint ‘PIE day’ training, which covers further details about a PIE way of working, basic counselling and relationship building skills, reflective practice skills, psychological formulation, attachment theory and trauma informed care approaches, and the importance of staff self-care, there will also be further specific PIE modules. These ‘bite size’ training sessions (around 2 hours) aim to provide ‘frontline’ staff with key psychology tools as well as an understanding of relevant topics to support them in their work with homeless young people. So far, the topics available include: ‘Engagement and Endings’, ‘Risk Assessment & Management’, ‘Motivational Interviewing’, ‘Professional Boundaries’, ‘Basic Counselling Skills’, ‘Bereavement Awareness and Support’, ‘Managing Difficult or Negative Thoughts’, ‘Managing Difficult or Negative Feelings and Self-Harm’, ‘Managing Challenging Behaviour and De-escalation Approaches’, ‘Anger Management for Young People’, ‘Mental Health Awareness’, ‘Drug and Alcohol Awareness’, ‘Strength Based Approaches and Building Self-Esteem’, and ‘Working with Autism and Learning Disabilities’ but we hope to add more in the future based on staff feedback and identified needs.
We will also be continuing our roll-out of reflective practice sessions under ‘HOMES’ to all our ‘frontline staff’ as well as the Senior Housing Team and National Operational Managers, as this is central to how a PIE can be part of improving our supported accommodation services. As Keats et al (2012) note reflective practice is ‘a key element to psychologically informed services’ because it creates the space for ‘continuous learning from professional experiences, which encourages problem solving and critical thinking skills’ (p.21). We know that ‘key working clients with complex trauma can be challenging and exhausting, but adopting a reflective approach, especially after difficult incidents, can enable staff to learn from experiences’ and reduce ‘the intensity of difficult emotions’ (p.21). In addition, to monthly team reflective practice sessions we have also introduced new supervision (and appraisal) forms. Not only are these forms shorter and more user friendly (a key request from our ‘frontline’ staff!), but they also have a stronger focus on creating space in 1:1 sessions for reflection and a consideration of our psychological well-being between the monthly team reflective practice sessions.
‘HOMES’ also fits with PIE in terms of the emphasis on improving the physical environment of our supported accommodation services to ensure that they are more like a ‘home’ rather than an institutional hostel type setting, and are a ‘safe place’ for staff and homeless young people to be supported. As Keats et al (2012) note ‘designing and managing the environment is central to developing a psychologically informed service’ (p. 17). This not only involves a significant financial investment in some areas (e.g. https://centrepoint.org.uk/what-we-do/housing/manchester/future-foundations/) but also the implementation of a set of PIE standards for our repairs and maintenance work across all of our supported accommodation services. Some of this work has already started, and it has been so satisfying to get out again post lockdown and visit services, where walls have been painted or new furniture and other appropriate items have been purchased to significantly improve the spaces. As part of our PIE physical environment fund, as well as other funding streams, importantly we are planning to continue to work with the staff and young people that use the spaces to ‘co-produce’ these improvements. Already, I have started to see the impact of this work and the difference that even small changes can make to a previously tired and run down space, which in turn can have a significant impact on psychological well-being and behaviours for those who are using it.
Finally, as part of ‘HOMES’, the PIE team will also be working with key others in the Support and Housing directorate to look at other ways we can improve our working practices to be more psychologically informed. For example, how we monitor our outcomes, because as per a PIE (Keats et al, 2012), ongoing review and evaluation is important in order to ‘know which things you do or say are effective, in what situations and with whom’ (p. 26). A centralised information system has also been created (e.g. SharePoint) so staff can quickly and easily access the information that they need to support their homeless young people in ‘that moment’. Moreover, we will continue to work with other relevant stakeholders to review key policies, procedures and processes to ensure that they are in line with the latest psychological evidence. Importantly, we are also strengthening the role of the ‘Keyworker’ by updating the job description, career progression opportunities and induction processes so that we can ensure that our staff are valued professionals for the important support role that they do with our young people. Under a PIE, the relationships that a Keyworker forms with a young person are often the catalyst for change that underpins many of the positive outcomes, and arguably should be recognised as crucially important within the organisation.
Of course, ‘HOMES’ is a marathon not a sprint, and it will take time to make change happen and embed all the psychologically informed changes we have started and have planned across the services (Kotter, 1995). However, particularly over the past year, when we have all been reflecting on how we work in this new post pandemic world, it feels timely that we don’t’ just continue to do what we have always done but take some time to honestly reflect about what ‘works’ within the organisation and what we need to change or improve. What has been so positive for me is the use of ‘co-production’ in creating ‘HOMES’, wherein many staff across the ‘frontline’ as well as the wider organisation have been encouraged to have a voice, and will continue to be encouraged to speak out in the future. As per a PIE, it is critical that as ‘HOMES’ develops, we continue this ‘do with’, not ‘do too’ culture that also includes expanding our previous ‘PIEineers’ young person involvement initiative to create more opportunities for meaningful young people involvement in all that we do in the charity.
Change can be a challenge, it can throw up ‘blocks’ and ‘resistance’ and can often cause anxiety. It has, unsurprisingly, not always been a straightforward journey to get to this point. However, psychological theories, and my own reflective supervision, have been helpful for me to understand these processes and challenges, and also to consider how to move past them to ‘push where it moves!’. In particular, Kotter (1995), a Harvard professor and arguably the ‘change management guru’ notes that meaningful change not only takes time as noted above, but has some steps in the process that can be helpful to bear in mind. Once again, as per a PIE, his ideas also highlight the value of relationships in creating change. Kotter (1995) suggests that change starts with creating a sense of urgency for the change (Step 1), and then forming powerful coalitions or allies to support your changes (Step 2). It is then key to ensure that you have a vision for that change (Step 3), which needs to be effectively communicated in both your words and your actions (Step 4). In other words, we need to be the change we want to see, and that includes all of us in Centrepoint. For HOMES and PIE to work, we all need to support the change process, and try to identify and remove any obstacles when they naturally may appear (Step 5). It is also helpful to create some short term wins (Step 6) such as the immediate improvements to our training programme as well as the wider physical environments so that we have something to build on (Step 7) and ensure that we can fully anchor the changes in our organisational culture moving forward (Step 8).
Reflecting back on the past two years, I am really excited by the launch of ‘HOMES’ because of the importance it places on PIE to create change in our supported accommodation services. I believe that Centrepoint as an organisation has come a long way in even the short time I have been here, and as a result has weathered the recent COVID-19 storm despite the significant challenges that this created. It has been a difficult year for many of us in many different ways, but I am optimistic about the future, and what other change programmes (e.g. the People Strategy) that a PIE approach can influence across the wider organisation. Although at times creating psychologically informed change can feel a bit like an overwhelming challenge, I have not been alone in the organisation and it is because of the wider support from many different individuals, not just in our Support and Housing teams, that we are where we are now on our Centrepoint PIE journey. I cannot name them all in this PIE blog, but I hope they know who they are and know I am sincerely grateful.
However, whilst this week has been an exciting week with the launch of ‘HOMES’, I am also sad to report that one of the key influential figures in our PIE journey so far; Rob Cade (Director of Strategy and Performance) is moving on from Centrepoint next week. He has always highlighted and championed the role of PIE within the organisation, and I am extremely grateful for his support over the past two years. There is no way we would have got this far without him, and on a personal as well as professional level, he will be greatly missed by myself, the PIE team and the wider organisation. Nevertheless, as the Greek philosopher Heraclitus apparently stated; ‘change is the only constant’. Therefore, with ‘HOMES’ as well as our wider strategic PIE objectives, I am confident that Centrepoint will continue to adapt, develop and change as it has done over the past 50 years, in order to continue to meet the current needs of homeless young people in the UK and hopefully even #endyouthhomelessness by 2037…
