Five factors underpin good homelessness service implementation
Today the Centre has updated the Intervention Tool with summaries of the ‘why things work or not’ evidence. This new content can be used by practitioner leaders on the front line as well as commissioners and policymakers to raise implementation standards.
While we found many nuanced barriers and facilitators for each type of intervention, five crucial factors emerged that applied across all interventions:
Suitable and affordable accommodation must be available
Housing offers a stable environment from which individuals can address other issues in their lives and move on. A lack of move-on accommodation from many temporary accommodation projects limits the potential success of interventions.
Intervention programmes need appropriate, sufficient and consistent resourcing
Staff capacity and ability to meet service users where they currently are (physically and psychologically) is vital. Where resourcing is inconsistent across the timeframe of a programme, or policymakers/commissioners remove or ration entitlements to subsidies, programmes tend to become less effective.
Partnership working is paramount to programme success
When partnerships are effective, better outcomes tend to follow. When they are poor, or break down, both effectiveness and efficiency drop off. Partnership working can offer multiple challenges, but there are key factors that promote it:
- Commissioning arrangements that encourage collaborative working from the start
- Service-level agreements and Memorandums of Understanding between partners
- Regular meetings where all partners are represented – ideally beginning at the very outset of programme planning
- Data collection and sharing arrangements that are appropriate to programme goals and not overly complicated for any partner or service user
- Arrangements for collaborative working and ongoing communication between staff at different agencies - particularly when they are coordinating the day-to-day care of the same person
Person-centred support is vital
Services deliver better outcomes for people when they deliver personalised support and offer choices around both participation in the intervention, and in the services received throughout the programme.
No matter the intervention, people on the receiving end need to feel valued by staff and implementing agencies and feel their views matter. So the quality of the service is paramount. This human rights-centred approach underlies the interventions we increasingly know to be successful, such as Housing First. It is also the case that, to date, relatively little focus has been put on the rigorous evaluation of the quality of most homelessness interventions.
Recruiting and training the right staff
A quality service requires staff with the ability, training and capacity to deliver person-centred care, working in organisations with the right culture. As such, staff caseloads need to fit the aims of an intervention. The broader service culture and environment also matters. Without these things in place it won’t be possible to deliver effective care and ensure low staff turnover and high staff wellbeing.
We hope that through the new implementation issues section of the Intervention Tool we can emphasise that these five elements should underpin service design approaches and understood by all people involved in policy making, commissioning and implementing interventions to help improve the welfare of people experiencing homelessness or at risk.