On 18th of March 2020 in Edinburgh’s Holyrood Hub for the homeless, a male rough sleeper rocked off the streets with the first recognisable symptoms of Covid 19. Before lockdown, before pathways and before everything changed. The mould for rough sleeping and night shelter accommodation in the capital was to be altered forever. A new hotel and hospitality; influenced “PIE” reception service opened in October for this winter season. We do love a local “PIE” to meet local taste in Scotland.
Using the words of Maureen Lipman from a famous British TV advert, it wasn't the “ologists” or strategic operational planning that broke the mould. It was rough sleepers themselves by coming off the streets in their hundreds. The key factors in breaking the mould were the Edinburgh “Streetwork services”, “Street Credibility”, our Holyrood Hub relationships and trust. It was frontline workers from the third sector services who led the transformation and others have followed.
It was a Scotsman (musician), an Englishman (Graphic designer), an Italian lady (language skills), an Indian gentleman, and a Scot (Dancer) and a remarkable and unforgettable group of volunteers and fantastic support staff. They delivered excellent hospitality and compassionate care that was elevated to the next level by our partnerships and a Scots GP specialist who came to help, and enable access to NHS addiction, medical, mental, and public health support.
"Our first emergency hotel opened its doors on the night of the 23rd with 44 people coming off the streets that first night. It was like a scene from a movie"
Our first emergency hotel opened its doors on the night of the 23rd with 44 people coming off the streets that first night. It was like a scene from a movie, sadly not captured on film. An apprehensive hotel manager and terrified receptionist stood open mouthed almost in tears at what they witnessed, what the hotel manager later stated was the night that changed him forever. How polite, how gracious the new arrivals were, some quiet as a mouse, some scared with heads down at first.
Dirty clothes and faces, matted hair, hoody hidden faces often making little eye contact keekin (Translation – Glancing about) as they were booked in and helped to their rooms with their worldly goods on their back. We allocated each person a room using what rudimentary knowledge we had of each person on the night. I witnessed tears of relief, shock at the size and warmth of the rooms and wonder at the sparkling ensuite facilities fit for any traveller. It felt dignified and inspiring in equal measure.
Day two and the hotel was full. “Word of mouth” filled the hotel to capacity; not leaflets, posters or websites. Street folk, Polish, Romanian, Chinese, Scots, and staff and third sector partners spread the word and people kept coming until only 2 people were left seeking shelter. The streets were empty for the first time in living memory. People were safe, warm and the atmosphere was charged with a palpable excitement: - genuine nods of acknowledgement, friendly faces engaged, with hoodies removed to reveal fresh smiling faces, and combed hair. There was a new found self-respect, shoulders back, heads held high; the banter and confidence was obvious. All this restored my faith that the challenge we faced was manageable.
Our volunteers mobilised a veritable army overnight and our food partners began donating fabulous food, astonishing provisions; these remarkable efforts grew to supporting over 343 people with three great quality (often hot) meals every day until the end of August. We grew a second hotel and linked all our rapid access beds, pathways and dispersed accommodation across the city: a whole system approach was key to our success.
Our Holyrood HUB remained the assessment centre from day one separating the street, avoiding conflict and to manage risk at hotels protecting the local community. We avoided potential early disease transmission, detected symptomatic people in isolation, minimised risk and protected each accommodation block. Phenomenal, dedicated staff made COVID 19 alterations to processes and buildings helping us to stay open every day to enable homeless people to find the most appropriate accommodation available. Our five initial locations grew rapidly to accommodate everyone off the streets.
With foresight, we set aside 3 Georgian town houses close to the hotel, one for our staff to relax, isolate and stay on site when necessary. The others were secured as isolation units anticipating the need to separate potential ‘super spreaders’ away from the main body of the hotels. Public Health were later to adopt our Isolation units as part of the public health pathway supporting all homeless services across the city. We hosted twelve individuals from other homeless services with symptoms during lockdown in March to the end of August; none of our residents in our Hotel caught the virus or tested positive.
"none of our residents in our Hotel caught the virus or tested positive"
Our first Hotel service grew by reputation across the city” move-on” was limited to help people self-isolate. Something remarkable happened: our sector was allowed to lead, people listened, and service user’s wishes were met and exceeded. Astonishing new genuine partnerships and collaborations emerged out of the confusion and chaos of week three. Barriers to resources were by necessity, removed from statutory partnership boards, not renowned for their flexibility.
Having spent 2 years trying to improve preventative healthcare and harm reduction support for our 1800 service users, suddenly everything became available on site. Public Health recognition helped, but specialist NHS colleagues took some risks, showed flexibility around restrictive protocols supplying Naloxone and materials, PPE everywhere a collective effort not seen before. A special bond was created across sectors pulling together with service users at the heart of everything.
A true multi-agency HUB was delivered, and, for the first time, we equally shared risk and responsibility with cross-sector communication and team working. Same day prescribing, alcohol interventions, sexual health, virtual CBT sessions. A full vaccination programme where over 47 people received full vaccinations. Around 380 Vapes were distributed to our residents and life-saving interventions occurred repeatedly to keep everyone safe. Later we introduced sport and fitness, increasing employability and skills support. Digital connectivity was at the heart of everything with smartphones, laptops and tablets made available to connect family, friends and community.
"A new, more personalised, compassionate and caring model based on shared learning has emerged"
Everyone stayed safe despite many interventions initially for non-fatal overdoses and severe alcohol withdrawals. No one became infected with the virus and everyone who stayed was housed, no one was left behind. We celebrated the end with hotel staff and some bubbly. A new, more personalised, compassionate and caring model based on shared learning has emerged and is established in the city. The mould was broken, and to top the year, Simon Community Scotland celebrated becoming charity of the year 2020 in Scotland.
I will ensure the self-styled ‘six amigos’ who were there from day one, who all survived to the very last day ensuring everyone had a home to go to, will meet again. We will raise a glass and tell some stories of how it was, and no doubt explore what's possible now as a result of what has been delivered during Covid 19. I am grateful for everything I learned: this was an exceptional time, and thankfully, exceptional people came from all agencies. The frontline led the way but without our colleagues and some key collaborators none of this would have been possible.
Rankin Barr is The Manager of Managed Alcohol Programme @SCS.
email: [email protected] (SCS)