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Case Study – Serena

The London Network of Nurses and Midwives in Homelessness is organising a conference in May 2016.  The theme is ‘How Safe is the Safety Net?’. We will be looking at how the current system works with vulnerable women; migrants and those with complex needs.

In the run up to the conference, we will be publishing a series of case studies of people we have worked with; people who can often get lost in the net.

For more information about the conference click here 



Serena is 24, and has learning disabilities. When we first met her she had 2 children who had been taken into care. Serena had been in foster care herself, but had left her foster care placement at 16 to be with her boyfriend, who then abused her. This led to a series of unsafe relationships. Her current partner was an older man who used heroin and crack.

Serena came to London from Manchester after losing her local authority accommodation as a result of rent arrears which had built up due to benefit sanctions and loss of housing benefit. She and her current partner said that they were being threatened in Manchester and could not return there.

We saw Serena first on a street outreach shift.  She was 36 weeks pregnant, begging outside a London supermarket along with her partner, and a dangerous dog. They said they got more money begging than from benefits.

Serena was pregnant when she left Manchester, but her team in Manchester did not know this. Apparently she had made threats to previous Social Workers, and had been ‘lost to follow-up’. No alert was put out on Serena. Enquiries at the Local Authority also revealed that she was considered ‘intentionally homeless’.

In London she had no local housing connection. Relationships with enforcement teams on the street in London had also broken down very quickly on account of difficult behaviour.

Serena is actually one of the lucky ones. She came into contact with an outreach health care professional who immediately referred her to the local safeguarding team, who then provided a swift response. The professional then worked tirelessly to join the dots in terms of pooling information. Serena was also fortunate that the local London borough agreed to house her, although she only accepted this after her partner was coincidentally arrested and imprisoned. Serena gave birth safely, but her baby was taken into foster care.

And now?  Serena is in a homeless hostel bed, but needs a period of intensive trust and relationship building, assessment of her cognitive state, trauma counselling, assistance with contraceptive choices and long term support to make positive choices. Will she get this? With services stretched to the limit, and Serena’s history, it is unlikely that she will get the level of support required, and she will probably slip through the net again.

At the conference we will be asking what we can do to make the net good enough to catch her.  How can we raise the profile of people like Serena? Should there be a troubled individual’s initiative like the troubled families initiative? How can we help?

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