Chapter 9: Create and develop healthy and sustainable places and communities

The pandemic has highlighted just how much our health and wellbeing are influenced by where we live and the communities and homes that we live in.

The need for a safe place to live was a priority as the first lockdown was introduced. 

We received additional funding from the government at the beginning of the first lockdown to provide accommodation and support for rough sleepers and people at risk of rough sleeping.

To deliver on the programme and provide direct access emergency accommodation in Gateshead, we block booked hotel accommodation so there was somewhere safe for people to stay, with floating support provided by Oasis Community Housing. From there we were able to support people into dispersed temporary accommodation or, in some cases, straight into permanent accommodation. The programme was very successful.

Some of the people had complex needs and required a lot of support and it was quite challenging to accommodate them in hotel accommodation.

We were also successful in bidding for government funding for the Next Steps Accommodation Process. This money was used to bring 15 long-term empty properties into use (and decorate and furnish them) for people at risk of rough sleeping and two outreach workers to support them in becoming ready for permanent accommodation.

The pandemic has highlighted the need for direct access emergency accommodation in Gateshead and this has fed into our Homelessness Review.  

Deborah Ewart, Head of Housing Support, Gateshead Council

As a result of the 'everybody in' approach, there were many people occupying hotel accommodation, other temporary accommodation, and mainstream flats following offers being made, with support needs impeding their ability to manage their new accommodation. Outreach support aimed to meet basic needs like food, clothing and telephones, as well connect people to the right services in the community and carry out other aspects of practical resettlement support. An important aspect of this work was the emotional support offered to clients managing difficult transitions and traumatic circumstances. As could be expected, the needs and histories that clients brought with them varied massively.  

Basis Gateshead (drop in)  

Basis is a drop-in centre, in central Gateshead, open to support rough sleepers and the vulnerably housed, to access housing, support and to meet basic needs. Clients are able to make use of shower facilities, computers, washers and dryers etc. Pandemic restrictions meant much of the support moved to being delivered over the telephone. As society opened up, it became possible to bring service users back into the project with safety measures in place, and support operated on a 'one in, one out' basis. Although footfall was dramatically reduced, staff reported that engagement was more productive and led to better outcomes, as they could focus more time and energy on some people. As some restrictions on numbers are still in place, this positive effect has been maintained. Drop-in staff reported a decrease in rough sleeping levels, but they were still able to support people who had failed to manage hotel and other temporary accommodation and ended up homeless.  

Basis Beds  

The Basis Beds project is our housing led approach to house vulnerable individuals, with complex experiences of homelessness, in self-contained, supported flats in the community. The pandemic meant that support had to adapt, with much delivered over the phone, with a face-to-face presence for essential work such as welfare checks, practical support, facilitating essential repairs and managing antisocial behaviour. Some residents responded really well to a move to phone-based support, particularly those with anxiety issues. Staff reported that they were able to invest in building relationships with residents through having the time to listen and understand their stories.

Massive changes to how probation services, recovery services and medication dispensation services were operating had a profound impact on many residents and, therefore, on how we were able to manage and support them in their accommodation. In practice, we found that a lot of residents struggled to adjust to changes in dispensation of their medication (opiate replacement in particular) and issues around drug related harm escalated in a lot of cases Less contact with probation services, where this was a factor, made the joint challenging of antisocial behaviour more difficult. Opportunities for begging and low-level acquisitive crime were also reduced by the pandemic. It does not feel coincidental that five of our flats were stripped of their kitchen appliances during April 2020. Evictions were also put on hold, which made the management of high-risk situations very difficult. We found positive outcomes with new residents who had struggled to manage accommodation in hotels, including one man who came to us having been evicted from a hotel within a matter of hours for his behaviour who remains in the project today and who is awaiting move on.  

Luke Elton, Project Team Leader, Basis Beds, Oasis Community Housing 

People's housing environments have affected their ability to shield themselves and others from Covid-19, as within-household transmission has played a serious role in the spread of Covid-19. People's housing situations have also affected their ability to weather the challenges of a prolonged lockdown. People in larger homes have had more space to adapt to working from home (if their jobs permitted it), as well as having greater privacy. When children could not go to school during lockdowns, there were additional demands on space.

Access to outside space was also important. Research, (Hubbard, G., den Daas, C., Johnston, M., Murchie, P., Ward Thompson, C., and Dixon, D. (2021). Are rurality, area deprivation, access to outside space and green space associated with mental health during the Covid-19 pandemic? A cross sectional study from the Covid-19 Health and Adherence Research in Scotland project (CHARIS-E). International Journal of Environmental Research and Public Health, 18(8), [3869]), found that people, without patios and gardens, experienced greater mental health challenges during the Covid-19 pandemic, than those who have access to their own outdoor space. 

Throughout 2020, public demand soared for outdoor recreation. Mental Health Foundation research, (Rowland M, Mental Health Foundation (2020) Blog: Why Nature was the theme for Mental Health Awareness Week 2021.), shows that, during the long months of the pandemic, going for walks outside was one of our top coping strategies, and 45% of us reported being in green spaces has been vital for our mental health. Research has also highlighted the importance of physical activity and engaging with nature in supporting people to maintain their wellbeing during restrictions and the pandemic. (O'Brien, L and Forster, J. (2020) Engagement with nature before and during the Covid-19 restrictions (opens new window). Quantitative analysis 2020. Forest Research, Farnham) 
Lucy Brenkley, Active Forests Coordinator, Forestry England 

At the beginning of 2021, a YouGov survey, (Wright O (1 January 2021) Our sense of community restored by Covid pandemic, The Times.), found that the coronavirus crisis has brought communities together and made Britain more cohesive as a society. Nearly 40 per cent of the public believed that Covid-19 had enhanced the 'sense of community' in the UK, as people came together to support one another.

People talked to neighbours they had barely met before, there was the weekly doorstep clap, the 'thank you' rainbows in windows and neighbourhood window trails at Christmas and Halloween. Mutual aid and community groups shopped and brought food to the vulnerable. People found new meaning in volunteering. Local businesses and schools have come to the fore as focal points for the community. 

At the start of the pandemic, I was furloughed from my job of nine years. This gave me a lot of spare time which was a novelty at first but after a while I realised, I was very lucky to still have an income from the Government furlough scheme and a lot of spare time and wanted to give something back. I saw a shared Facebook post where Gateshead Community Organisation were looking for volunteer drivers for a few hours once a week to deliver food parcels made up from Fareshare produce which they were distributing locally to those in need - for a small donation if possible, but free if necessary. Food waste has always been something I hate and for produce that would otherwise to go landfill to be made available to those that needed it made my decision to volunteer easy. Along with the fact it was only a few hours a week. I got chatting to people I delivered to and they were all very grateful - not just financially but also to have something delivered, especially during the times when people were wary of leaving the house because of the Covid risk.
 

Over a year later I am still helping out! I ultimately lost my job because of the pandemic and I now have a different job but can still spare a few hours once a week so I continue to volunteer. I have made new friends and I am proud to tell people I volunteer and get a lot of satisfaction for doing something to help others. 
Diane Malloy, Volunteer, Gateshead Community Organisation 

Local community services have really made a difference. Although people are turning to the internet, it shouldn't be forgotten that in times of need, it was local services like the community greengrocer or community pharmacies, local supermarkets that were really supporting people both physically and mentally. 
Community Pharmacist 

I think that the pandemic has made our role and relationship within the community much stronger. I think we've really made a difference to a community who needed it. That shared experience, we've all lived something really unique and appalling. We have done this together, with a clear focus to make sure children, staff and our community stayed healthy, happy, and safe whilst continuing to offer quality educational opportunities. I think there is now a different level of appreciation for the school in the community. 
Paul Harris, Headteacher, Gateshead Council 

Community organisations have experienced many challenges during the pandemic. 

Before Covid the centre was a lifeline for people. It was part of their lives. That changed in March 2020. Our lead volunteers were all on the vulnerable list. We were still providing support to groups and using Zoom. Shirley Bain, Volunteer Secretary, Leam Lane Community Centre. 

Now that the different groups and classes are back up and running, it is amazing that we can again provide that support. From service users turning up at our door in crisis, to be able to solve that, as well as then offer them ongoing support is immeasurable. The happiness they feel is visible through the change on their faces.
A lot of our service users are new to the area and, this, alongside the pandemic has meant it has been a very lonely time for them. Having our English classes back, has been a great way for them to not only improve their language skills but make friends and become more comfortable in their new community. 
Kate Meldrum, Deputy Manager, St. Chad's Community Project 

The success of communities coming together is leading to new thinking about how this can be built on moving forward. 

We need to broker a relationship between people, who are making decisions, and those people who are receiving those decisions. We need to get people out and about in the community to understand it. 
Sarah Gorman, Chief Executive Officer, Edberts House 

Next - Chapter 10: Strengthen the role and impact of ill health prevention