Homeless people are missing out on vital, life-changing care because specialist accommodation is “sadly lacking”, a charity has warned.

Significant levels of care needs within homelessness services, and among people living on the streets, are not being met, St Mungo’s said.

It has published a review into the gaps and solutions in providing social care to homeless people, carried out with Dr Caroline Shulman, co-clinical lead of the Homeless Health Programme at the Healthy London Partnership.

It found that one of the main barriers to accessing appropriate, timely care is a “very limited” supply of specialist care homes which can meet the complex needs of people who are or have been homeless.

Staff at St Mungo’s services have also experienced challenges in securing assessments to identify people’s care needs, with many facing long delays, and some perceive social care teams to be unresponsive or inflexible.

St Mungo’s runs two specialist care homes that are registered with the Care Quality Commission (CQC) and can provide care services.

For the review, support managers at 31 of its non-CQC registered services were surveyed, with responses provided about 1,442 clients.

It found that a significant number of people in these services likely require a degree of care.

Around 5% of the clients were assessed by the staff to have dementia, around three in 10 (29%) had deteriorating health and 12% were experiencing self-neglect or self-care issues.

Six per cent require support with medication administration, 8% have poor mobility and 3% experience frequent falls, the responses indicated.

Overall, around 4% of the clients had a care package in place, receiving visits from home care staff.

But almost a quarter of those receiving care were not having their needs fully met, managers believe, while 5% of clients were not receiving care when staff believed they should be.

St Mungo’s interim chief executive Rebecca Sycamore said: “It is a fact that people who have lived on the streets have significantly higher medical and care needs, and we know that the legacy of poor health resulting from sleeping rough can last a lifetime.

“As a result, specialised accommodation, designed to meet both a person’s housing and care needs, is required but is currently sadly lacking.

“People with lived experience of homelessness should receive parity of provision, and not miss out because of lack of access. Everyone deserves to live with dignity and care.”

One of the people supported by St Mungo’s, whose life has been transformed by being given the appropriate care, is Lee.

He is currently living in a specialist care home in north London that is run by St Mungo’s and registered with the CQC.

Lee, who had been sleeping rough on and off since he was a young teenager, was admitted to hospital in late 2021 after a fall because of tremors in his arms and legs.

He had not been eating or sleeping properly, and without a care package in place had been in hospital repeatedly.

The 55-year-old said: “I ended up in hospital in a bad way. I was really ill. I didn’t realise how sick I was until they told me.

“I slipped into a coma. I was in hospital for two-and-a-half months learning how to walk again, getting the energy to walk.”

Lee was discharged into the care home in February, and since then he has not had to visit hospital.

He said staff helping him manage his medication are a “godsend” and having a good cook means he is “not quite as scrawny now”.

Lee continued: “I’m stable now. I’m not doing drugs so my health has improved. I’m eating and sleeping more regularly.

“It’s a relief to know I’ve got somewhere stable. I’ve got support and help if I need it.”

A government spokeswoman said: “We know many people experiencing rough sleeping have health and care needs and can struggle to get the support they need.

“We are taking action to address this by providing record funding, including £300 million to better join up housing with health and care, and tailored support such as improved access to mental health services and substance misuse treatment.

“Local authorities are responsible for assessing individual’s eligibility for support and, where eligible, determining how best to fund their care through care assessments.”