Staff employed by homeless charity reveal shocking working conditions

Alex Seabrook, local democracy reporter

A Welsh homeless charity is being urged to provide more health and safety training and equipment for its staff who have revealed shocking working conditions.

Staff working at shelters in Cardiff run by the Wallich have claimed they regularly receive death threats and must deal with drug overdoses, sometimes with little or no training on how to respond.

A formerly homeless person who has stayed at Wallich shelters in Cardiff also called for better health and safety training for staff — but praised the support of staff in the projects.

The Wallich said it offers staff a full training package with more than 30 courses, a five-day induction, and role shadowing for new staff. First aid and CPR training is also offered.

The charity runs around 70 homeless projects across 18 council areas in Wales. The services range from offering a place to sleep to helping sort benefits, accommodation and education. In Cardiff, the charity runs five projects across the city, and outreach services.

Last month, the Wallich closed one project in Cardiff: the Nightshelter on Clare Road in Grangetown. This is due to homelessness support moving away from shared rooms for several reasons, including the coronavirus pandemic and the new need for social distancing.

Three former staff who worked at the Nightshelter before it closed are now urging the Wallich charity to offer mandatory training for all of its support workers. They also raised concerns about the lack of equipment in projects like defibrillators, naloxone and protective clothing.

The Wallich does offer a five-day induction for all new staff members. This includes an overview of the charity, why people become homeless, and how prevalent the issue is. But the induction is not specific: support workers are trained together with admin staff.

The former staff said training must be mandatory and specific to homeless projects, and include how to respond to drug overdoses, professional boundaries, violence de-escalation,  and suicide. They said this should happen before people start their first day of work.

All three support workers who spoke out asked not to be named for fear of reprisals in their new jobs.

“Working for the Wallich was the first job I had in the homeless sector, so I didn’t know what to expect initially,” one worker said. “The training was good, but very generic and covered a bit of everything. I was training with someone who never leaves human resources.

“[In the projects] there were quite frequently violent incidents between service users, so violence de-escalation would be ideal in that situation. We have had a number of overdoses, so you need training for that. And administering first aid for people who self-harm.

“I didn’t struggle too much because I have a lot of previous experience in challenging environments. But a lot of staff did struggle because they haven’t had the training.

“The training is ultimately there, but it’s too late when you’re in there. On your first day you could have someone who has overdosed, followed by someone who has self-harmed, followed by two service users fighting with weapons. It’s a difficult job.”

Heroin 

As well as putting staff at risk, a lack of proper training also leaves the homeless people staying in projects at risk, a second former support worker said. They gave two examples: administering naloxone and professional boundaries training.

Naloxone is an emergency medication that can reverse effects of overdoses on opioids, like heroin. Professional boundaries means keeping the relationship between staff and clients professional and not veering into inappropriate relationships, like going drinking together.

“Not having the correct training could put a lot of clients at risk,” the second support worker said. “We had an incident recently in the Nightshelter where a member of staff—who was quite a vulnerable person and an ex-client—had no professional boundaries training.

“He used heroin with the clients. He pressured clients to get heroin for him. He never had adequate training. He had the skills, empathy and understanding, but he didn’t know how to do that job because he had never been trained to do so.

“I had people put their hands around my throat or spit in my face. You’re not prepared for that with the induction. I asked for drug awareness training and overdose training, but had to arrange it externally. I had to buy some Naloxone for the Wallich.

“With overdoses, if you don’t know how to give naloxone, then that person can die. It’s quite easy once you know, it’s similar to an epi-pen. You would need to know that each syringe has three doses, knowing not to put the entire amount in straight away.”

A Wallich spokesperson said: “The Wallich has a long-standing commitment to the principles of harm reduction, particularly when it comes to substance misuse or other harmful behaviours.

“We have a robust client substance misuse policy, and training for staff to enable them to deal with the issues. Naloxone is available where there is someone trained to administer it.”

The charity does offer a lot of training on what’s called ‘psychologically informed environments’, which the former staff praised. This involves designing projects and services to take into account people’s past traumas and potential mental health problems.

Defibrillator

But a lack of equipment was another concern raised, like sharps gloves for picking up used needles, protective clothing, and defibrillators. A defibrillator gives a high energy electric shock to someone having a cardiac arrest, and can save lives if administered quick enough.

A third former support worker raised concerns to the charity about the lack of defibrillators, and formerly requested they be brought in. But the request was denied.

“I’m very concerned about the amount of deaths we have been having in projects over the last few months,” they said in an email to the charity. “As a first aider, I strongly believe all projects need defibrillators.

“As it stands, not only do we not have them, but most projects don’t have a map of where the nearest ones are, and realistically they are often so far away that they could not be used in an emergency anyway.”

An email from the charity’s health and safety coordinator at the time said the Wallich was unable to consider providing defibrillators for homeless projects in Cardiff, due to the pandemic. Defibrillators can cost less than £1,000 each.

The email said: “Only one client death reported since January may have benefitted from a defib being available. The provision of defibs is however something that is being taken seriously by the Wallich.

“However, due to the current situation and expense that Covid-19 is having on us as a charity, this is not something we are able to consider further at the moment.”

A Wallich spokesperson said: “We do not have defibrillators at all our buildings, but we do have a list of where they are publicly available in close proximity to our services.

“Our staff are offered training in emergency first aid, including how to deliver CPR. Police approved sharps gloves and sharps bins are available at our projects.”

Training

The third support worker claimed that most staff “haven’t had any training” and everything is “done on the hoof”.

“Naturally, this means most staff are completely unprepared for the hectic environments they’re put into,” they said. “There’s no naloxone or sharps training, even though we work with IV drug users everyday and have to deal with sharps.

“There’s no de-escalation training, despite working in a frequently extremely aggressive and confrontational environment. There’s also no first aid training, no defibs on site, no fire training, and no protective clothing.”

One formerly homeless person who has stayed at Wallich projects other than the Nightshelter joined the call for more training for Wallich support workers. They said first aid training would particularly be useful, as they self-harm. But they praised the support.

“The staff tried their hardest and the support was good,” they said. “But in the communal areas [in the Julian Hodge hostel] you would see someone injecting, or people there paralytic drunk. I tried to stay in my room as much as possible.

“Then I moved to the Riverside project. It was smaller and better, with fewer people. You didn’t get people doing drugs in front of you, and the support was a lot better.

“First aid training would be helpful. When I self-harm, I refuse to go to hospital. It would be better if [the support workers] could dress and bandage it. But I have a flat now anyway: I love it. There’s no trouble, and it’s really quiet.”

Help

Despite the claimed lack of training and equipment, the three former staff agreed the Wallich projects do offer great help for homeless people. One said: “The Julian Hodge and the Nightshelter were and are excellent projects with brilliant staff, and were great for residents.”

A spokesperson for the Wallich said: “The Wallich employs more than 400 people across Wales and supported more than 7,000 people experiencing homelessness last year, keeping services open throughout the pandemic.

“The nature of our work, and the issues facing the people we support, mean that staff are sometimes faced with substance misuse, aggression, violence or threats. It’s a very difficult and challenging, yet ultimately rewarding job.

“We offer a full training package of more than 30 courses, and a five-day comprehensive organisational induction as well as a local induction and role shadowing for our new staff.

“During the pandemic, we have had to move our formal training online, which has meant we’ve been able to adapt and continue to deliver training in these challenging times.”