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“A matter of life or death”: why refuges are turning domestic abuse survivors away

38 out of 40 refuge managers surveyed by the Bureau of Investigative Journalism have had to turn away women in need.

The refuge manager told Tina that she had to wait a little bit longer - another 48 hours.

Tina had been referred to a refuge by her doctor after she broke down and admitted that she was trying to kill herself. She now had to endure two more days with her rapist and abuser, who was also her so-called partner.

During that period, the police visited her house four times. Armed robbers entered her home. They subjected her to a brutal attack and then seized money and possessions in the house to pay her partner’s drug debts.

Two days is a long time to wait when you’ve endured years of abuse. Tina knew that she had to pluck up her courage to survive the next two days.

***

Refuge managers are faced with cases like Tina’s every single day, but even in cases like hers, a two-day wait to find a refuge is seen as a good outcome.

In one instance, a woman in the Midlands was told that the nearest available space for her would be in the Orkney Islands, a 1,200-mile round trip.

The Bureau of Investigative Journalism has spent five months investigating the the state of domestic violence services in the UK and interviewing the women who run them.

Out of the 40 managers we surveyed, 38 said they had to turn away victims of domestic abuse in the past six months.

Choosing who to turn away

The Bureau has found that over a thousand women have been refused a refuge space in the past six months alone. Tasked with running a service on minimal funding, these managers are being pushed to the brink to keep their refuges going.

According to the staff across the country, women are being put at risk because of the funding situation. “When I hear women on the phone, I know that when I say no, it can be a matter of life or death,” Clare Phillipson, a refuge manager of Wearside Women In Need, told the Bureau.

While 30 out of 40 refuges reported that there had been no change to the number of bed spaces they offered, the need for refuge spaces has increased.

“We have had no increase in refuge funding, which in effect is a cut,” said Sarah Hill, the chief executive of Yorkshire Women’s Aid.

Dawn Redshaw, refuge manager of Salford Women’s Aid, told us that she has turned away 60 per cent of women and children asking for refuge in the last six months. “We had 180 requests for accommodation in the past year, and we could only accept 66,” she said to the Bureau.

In an attempt to house the increasing number of victims, women and their children are being placed in bed and breakfast accommodation.

In the London borough of Redbridge alone, 42 per cent of all domestic violence survivors were housed in bed and breakfast accommodation in the last year.

A survey of survivors by London's largest specialist refuge provider, Hestia, found 49.5 per cent of survivors said they would be scared to stay in bed and breakfast lodging. Places like that are not appropriate for victims of domestic abuse. They’re stuck with a bunch of people, including men, and they're stuck in a room with the children, then they're bound to want to go home because bed and breakfast is neither good nor safe accommodation for children,” said Dawn Redshaw, talking about such accommodation.

In September 2017, Lambeth council was ordered to pay compensation to a domestic violence survivor who had been housed in bed and breakfast accommodation for nearly two years. Her son, housed with her, has autism.

The Bureau spoke to one woman housed in bed and breakfast accommodation in south London. Susan explained that the service was run by men, and many of the residents were male. “I called housing [department of Kensington and Chelsea council,] and my therapist called housing and was like, ‘she shouldn’t be in a B&B, what are you doing, she is on suicide watch, get her out of there!’”

“The Bureau research has also found that some local authority 'refuges' are little more than hostels: insecure, completely lacking in support services, and completely inappropriate as a space for survivors to try and put their lives back together,” said East London Sisters Uncut, which campaigns against cuts to domestic violence funding.

Those most at risk

There are not enough spaces for women, especially those with complex needs. Refuge managers think of this group as being the most vulnerable of the vulnerable. Such women have additional difficulties, as well as attempting to flee domestic violence.

Needs range from support with mental health conditions, impairment needs, English as a second language or addiction. The women are often refused bed spaces because the staff are not trained or cannot cope with their additional issues.

One refuge in Lancashire has had to turn down 119 women in the past six months, due to their complex needs.

In London alone, there is just one dedicated complex needs refuge, with just ten spaces for women, in the entire city.

Funding cuts

Budgets are being cut back to the bone, the Bureau has found. More than three-quarters of councils have reduced the amount they spend on women’s refuges since 2010. Managers then face the challenge of running their refuge on a small and insecure workforce.

“We do not know from one year to the next if we will receive funding,” said Lillian Burke, the assistant manager of a refuge in the North-West of England.

“Our commissioners said they believed that one member of staff working three days a week could support a 14-bed, 24 hour refuge and it would be safe,” a refuge manager based in South-East London told us.

“The amount of funding has been cut to such a degree really that I worry sometimes about the quality of the work that's carried out, because I remember times when the ratio of staff to resident was about one to four or five victims. Now it's much closer to one to nine survivors,” said Monica Tuohy, Solace’s Islington refuges manager.

Although the victims in refuges are being treated with care, managers are grappling with helping the same amount of women with scarce resources.

If I had to be honest I would say about no more than a quarter receive a form of therapeutic support when they’re inside our refuges”, said Monica.

“The police get very frustrated when we can't take people in, in the middle of the night, but we have to be very careful to do is make sure we manage,” said a refuge manager in South East of England, responsible for a space for ten women and up to 19 children.

Rather than training up new staff, managers are being encouraged to recruit volunteers to take on the workload. “There’s a push from higher up to train volunteers to do exactly what we do,” Gail Heath, the chief executive of Manchester Women’s Aid, told the Bureau.

She added: “And there’s so many great volunteers… but the emotional trauma and impact of the job deserves pay, and to allow women to do all levels of this job without a salary and time off is not healthy.”

“Theresa May's government need to explain or change their policy and commitment to refuges”, said Shadow Minister for Women and Equalities Dawn Butler to the Bureau. “I am concerned that Theresa May's Conservative government are penny wise and pound foolish. These cuts to services are costing extra money in emergency policing and care and in some very sad and tragic cases it may be literally costing lives.”

Short term contracts/ continual tenders

The impact of the budget cuts, lack of public funding and the surge of generic providers undercutting independent refuges to offer one-size-fits-all services casts doubts over the viability of many refuges.

Although Theresa May and the Department for Communities and Local Government announced a £20m pot to fund domestic violence projects in 2017, dozens of local authorities received nothing.

One refuge that did receive part of the pot has had to put its staff on notice as the government payment is eight months delayed.

Out of all of the refuge managers surveyed, every centre has told us that they face an uncertain future. “Generic services might be doing a job, but it’s a bit like knowing that if you’ve got a brain tumour, going to your GP is great, but it's not the person you really need to be seen by”, said Monica Tuohy, Solace’s Islington refuges manager.

In the case of Dawn Redshaw, she is tasked with running Salford Women’s Aid refuges on an estimated £150,000 deficit since the £220,000 Supporting People fund grant was taken from the organisation in 2014.

The refuge makes ends meet by running a charity shop, and a small £10,000 grant from the local mayor.

“We just worry all of the time, because we don’t know what Salford would do if the refuge shut down, because we’re always full,” said Salford Refuge Manager Dawn Redshaw to the Bureau.

Obtaining funding is fierce and competitive.

Now that national charities like the National Lottery and Children in Need are the best bets for extra cash, managers are having to repackage their services in a scheme of innovative box-ticking in order to receive more money.

“Recently, we were refused funding because we were told that we know the solutions to our problems. Of course we know the solutions, but we need to get the money in order to resolve them. If it’s not shiny and new many bodies don’t want to know,” she added.

No Recourse To Public Funds

With the added pressure of uncertain financial futures, refuge managers are struggling to help women who enter the refuge without recourse to public funds (NRPF).

Women in this category are not British citizens. They are not entitled to any housing benefit until their domestic violence exemption is processed through the Home Office.

As many women enter a refuge without any money to their name, they are entitled to housing benefit, which funds their place in the safe house. Women who have arrived on their husband’s visa or are not British citizens have to go through a stressful application process in order to receive any benefit.

Although the application process should take 20 days or thereabouts, refuge managers report that it can be as long as nine months for certain residents.

“So let's say a woman is fleeing Waltham Forest with two small kids, no recourse,” says Monica Tuohy, refuge provider Solace’s Islington manager. “We will negotiate with social services how that's going to be funded. They will normally give us something in writing in advance that says ‘yes, we will support you.’”

“It will be six months later, and still, some local authorities haven’t given us any money. So we'd bill them, and receive no reply. And what do you do in the end, march the woman out of the door? Of course we're not going to do that. So it's a very difficult position.”

For the refuges which take the risk and accept women with no recourse, they end up running at a loss and then unable to rehouse the women when they are ready to move on.

“The refuge is becoming more of a place where people are left to live,” said a refuge manager in the Midlands to the Bureau.

“People are staying longer because of a shortage of accommodation in the city. We can't throw people out on the street. Some of them are becoming institutionalised. I've got a lady who's been with us for two years. That's not what it's about”, she added.

Some women are lucky enough to eventually find a space in a refuge. Tessa is one of them. But she remains concerned about the other women like her who were and are in desperate need but have been left destitute.

“I think the worst thing for me is to think that there are more women out there where I was, and there's just nowhere for them to go,” she told the Bureau.

Thinking about the situation in the refuge, she adds: “You know the phone's ringing in the office every day, and there are women needing places to be safe from perpetrators. They don't want to be with these men.”

Jasmine Andersson is a reporter at the Bureau of Investigative Journalism. 

CREDIT: PETER DAZELEY/PHOTOGRAPHER’S CHOICE
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The overlooked aspect of patient care: why NHS catering needs a revolution

The NHS performs so many miracles every day – in comparison, feeding the sick should be a doddle. 

A friend recently sent me a photo from her hospital bed – not of her newborn baby, sadly, but her dinner. “Pls come and revolutionise the NHS” the accompanying text read, along with a plaintive image of some praying hands. A second arrived the next morning: “Breakfast: cereal, toast or porridge. I asked for porridge. She said porridge would be ‘later’. Never arrived. (sad face).”

Contrast this with the glee with which another friend showed me his menu at a Marie Curie hospice a few weeks later. He seemed to have ticked every box on it, and had written underneath his order for syrup sponge and custard: “extra custard please”. It wasn’t fancy, but freshly cooked, comforting food that residents looked forward to – “like school dinners”, he sighed, “but nice”.

To be fair, though budgets vary significantly between hospital trusts, a reliable estimate suggests £3.45 per patient per day as an average – only slightly more than in Her Majesty’s prisons, though unlike in prisons or schools, there is no legally enforceable set of minimum standards for hospital catering. As Prue Leith writes in the foreword to a 2017 report by the Campaign for Better Hospital Food, “this means hospital food is uniquely vulnerable to a race to the bottom in terms of food quality, and patient care”.

Plate after plate of disappointment is not only demoralising for people who may already be at a low ebb, but overlooks the part food has to play in the recovery process. Balanced, appetising meals are vital to help weaker patients build up strength during their stay, especially as figures released in February suggest the number of hospital deaths from malnutrition is on the rise. According to Department of Health findings last year, 48 per cent of English hospitals failed to comply with food standards intended to be legally binding, with only half screening every admission for malnutrition.

The Campaign for Better Hospital Food’s report, meanwhile, revealed that only 42 per cent of the London hospitals that responded to its survey cooked fresh food for children – even though the largest single cause of admissions in five-to-nine-year-olds is tooth extraction. Less than a third of respondents cooked fresh food for adults.

Once the means to produce fresh meals are in place, they can save trusts money by allowing kitchens to buy ingredients seasonally, when they are cheaper. Michelin-starred chef Phil Howard, recently tasked by the Love British Food organisation to cook their annual lunch on an NHS budget, explained that this, along with using cheaper cuts and pushing vegetables centre stage, allowed him to produce three courses rather than the two he’d been asked for. Delicious they were, too.

Andy Jones, a chef and former chair of the Hospital Caterers Association, who was there championing British food in the NHS, told me the same principles applied in real healthcare environments: Nottingham City Hospital, which prepares meals from scratch, saves £6m annually by buying fresh local ingredients – “I know with more doing, and voices like my small one shouting out, we will see real sea change.”

Unusually, it’s less a question of money than approach. Serving great hospital food takes a kitchen, skilled cooks and quality ingredients. But getting every hospital to this point requires universal legal quality standards, like those already in place in schools, that are independently monitored.

Nutrition should be taken as seriously as any other aspect of care. The NHS performs so many miracles every day – in comparison, feeding the sick should be a doddle. 

Felicity Cloake is the New Statesman’s food columnist. Her latest book is The A-Z of Eating: a Flavour Map for Adventurous Cooks.

This article first appeared in the 18 April 2018 issue of the New Statesman, Enoch Powell’s revenge