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

Abstract

Background: Co-location and integration of services within a psychologically informed environment (PIE) is recommended for people experiencing homelessness (PEH) but there are few examples of this in the UK. Such a centre opened in Edinburgh, Scotland in November 2021.

Aim: To evaluate progress of the new centre.

Design & setting: This was a mixed-methods pre-post-test design study before (baseline) and 2 years after (follow-up) the move to the new co-located centre. The study took place in Edinburgh, Scotland. The baseline evaluation was conducted at two separate homelessness services and the follow-up evaluation at the new co-located centre.

Method: Baseline and follow-up staff surveys measured knowledge of trauma-informed care (TIC), wellbeing, 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-user survey was also conducted.

Results: The staff survey showed significant improvements between baseline and follow-up in TIC, 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 PIE, better staff support, and improved opportunistic multidisciplinary working over the 2 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 PEH in Scotland has led to reductions in staff burnout and improvements in team climate and service users' satisfaction over the first 2 years of opening. However, barriers remain and full integration requires a clearer vision and 'roadmap', requiring collaborative leadership and sustainable funding.