'I was in a heap and they helped me in taking small steps to a better future.'
Vision
To maximise the outcomes and life opportunities for those experiencing or at risk of homelessness through a national quality framework (NQF) that delivers ongoing improvement and better integration of services delivered by specialist homelessness and allied and mainstream organisations.
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Setting the scene
Some 105,000 Australians experience homelessness on any given day. Many others are at risk of becoming homeless. People who are homeless or at risk are one of the most vulnerable and marginalised groups in our community.
All governments are committed to improving outcomes for people who are homeless and reducing the overall number of homeless people. A national quality framework will provide a platform for services to deliver an improved and more integrated service response to clients with greater national consistency. This will assist people who are homeless to get the help and support they need when they need it which will improve their long term outcomes.
At a meeting in September 2009, Housing Ministers from the Commonwealth and each state and territory agreed to progress the development of a NQF to improve the quality of services delivered to people who are homeless.
All governments acknowledge that the best way to develop a NQF is through a national consultation process in partnership with people experiencing homelessness and the organisations that deliver services to them.
People experiencing homelessness are a diverse group of people, many of whom have multiple and complex needs.
Services to address these needs are delivered by a variety of organisations across a range of sectors. Large agencies, church-based charities, small community-based organisations, local governments and state, territory and Commonwealth government departments all deliver services to people experiencing or at risk of homelessness.
Some of these organisations can be defined as specialist homelessness services - organisations that are funded to deliver services to people experiencing or at risk of homelessness.
Specialist homelessness services are critical to addressing the needs of people experiencing or at risk of homelessness. Services include crisis accommodation, supported accommodation, transitional support, crisis support, housing information and referral, etc.
Mainstream and allied services also have a central role in addressing the needs of people experiencing or at risk of homelessness. Centrelink provides income support, state and territory governments deliver housing outcomes through public and community housing, and hospitals, community health centres, mental health services and drug and alcohol clinics respond to the health needs of this client group.
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The policy context
In 2008, a national consultation culminated in the publication of the Australian Government's White Paper The Road Home: A National Approach to Reducing Homelessness. The White Paper sets the agenda for tackling homelessness in Australia and establishes ambitious Commonwealth targets of halving overall homelessness and offering supported accommodation for all rough sleepers who need it by 2020.
The White Paper also proposes new homelessness legislation to replace the Supported Accommodation Assistance Act. This issue was referred to the House of Representatives Standing Committee on Family, Community, Housing and Youth, who made a series of recommendations on how legislation might set out values and principles to underpin high quality homelessness services. These recommendations will be considered by Housing Ministers but will not, by themselves, determine the nature and scope of the NQF.
In 2009, all governments signed the National Affordable Housing Agreement (NAHA) which provides $6.2 billion nationally over four years and clarifies the roles and responsibilities of the Commonwealth, states and local government in the delivery of housing and homelessness services across the relevant sectors.
All governments also signed the National Partnership Agreement on Homelessness which provides a total of $1.1 billion over four years for services to prevent and reduce homelessness. Each government then developed Implementation Plans that set out their approach to meeting the objectives of the National Partnership Agreement.
Over recent years, state and territory governments have continued to refine their strategic approaches to addressing homelessness by developing action plans and strategies. These approaches have been grounded in commitments to address disadvantage and to advance improved health and wellbeing for marginalised community members.
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Purpose
The purpose of this consultation process is to work with people experiencing or at risk of homelessness and the organisations that deliver services to them, to develop a national quality framework that will, over time, ensure a consistently high level of service quality for people experiencing homelessness in Australia.
This consultation will be a two stage process:
The first stage is designed to start a discussion on the concept of a NQF and obtain your views and ideas on its content. It includes a series of discussions with people experiencing homelessness or at risk of homelessness and workshops in each state and territory with organisations that deliver services to people who are homeless. This step is aimed at obtaining your feedback on what quality service delivery is, what works well currently in assuring quality and what components could make up a NQF.
Second stage consultation will occur later in 2010 after Housing Ministers have considered your views and ideas on quality service delivery. Your involvement in this second stage will be just as important. Your feedback from the first stage consultation will be used to identify several possible options for a NQF. Another, more detailed discussion paper will describe those options and provide an analysis of their relative benefits. The issue of sector support and resource implications of a NQF will be explored at this time.
This discussion paper provides the basis for stage one of the consultations. It attempts to promote discussion on the key concepts that are associated with a NQF, set out the principles that will guide its development and implementation, identify the scope of its application and describe some of its key elements.
This paper contains a number of key questions. Your responses to these questions will guide the shape and content of the range of options that will be considered as part of the second stage consultation process.
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Principles underpinning the development and implementation of a national quality framework
Principle 1: Services and government will work together to develop a national quality framework and accept joint responsibility for quality service provision.
Reducing and preventing homelessness is a huge challenge and requires the commitment of everybody including government, the specialist homelessness and allied and mainstream service sectors and the broader community.
Principle 2: Minimising red tape will be a key consideration in the development of the national quality framework.
It is important that a national quality framework does not place an unreasonable administrative burden on services. Also many services already participate in other quality systems and consideration will need to be given as to how participation in other systems can be recognised in a homelessness NQF.
Principle 3: A NQF will build on and add value to existing quality systems.
Many mainstream and specialist homelessness services already participate in some form of quality assurance system. It will be important to understand what works well in current systems and build on this in the development of the NQF.
Principle 4: There will be a supportive and enabling approach to implementation.
It will be important to adopt a supportive and enabling approach to implementing a national quality framework. Timeframes for implementation will need to take account of the starting position of the sector and differences across states and territories. Some jurisdictions may require longer transition times than others. Services may also require training to assist them in understanding their requirements under the NQF. Resources that explain the NQF will also need to be developed. Approaches to implementation will be discussed in more detail in the second round of consultations which will focus on NQF options.
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What is quality service provision?
In the context of service provision, quality relates to the characteristics of an organisation and its services that determine the organisation's ability to respond effectively to the needs of its clients. In any discussion on service provision, the degree of quality of that service is of prime importance to a broad range of stakeholders, particularly consumers.
It is important to recognise that quality service provision doesn't always look the same; often the needs of the client group, the location of the service and type of service delivered determines the way in which quality service is provided.
'The refuge kept us all together and that helped us to feel safe and protected. They provided activities for my children so they could be engaged and distracted from the situation. They were encouraged to have fun and be kids, which also made me feel better.'
Although quality service provision looks different depending on the local environment there are some key characteristics that are common amongst high quality services.
The following key characteristics could be considered as a starting point:
Quality service provision is:
- Professional, objective and outcomes focussed;
- Responsive and timely and relevant to the need of the client;
- Rights based, ethical, fair and equitable;
- Enables the client to participate in the decision making process and supports them to make their own decisions and achieve goals;
- Respectful to the client irrespective of age, gender, sexuality and gender identity, religion, race, language, country and culture of origin and for the consumer's relationships and networks;
- Delivered by a competent, trained and qualified workforce;
- Supported and enhanced through collaborative partnerships and networks with similar and allied service providers; and
- Provided by organisations that have strong governance, organisational and financial management processes and systems in place.
'I was referred to a homeless service that treated everyone fairly and with respect. For me that is really important. I have felt discriminated against because I am homeless and I have been to places where favouritism is shown. It makes you lose hope.'
We believe that collectively we can create a NQF that ensures these key elements of quality service provision are embedded in organisations delivering services to people who are homeless or at risk of homelessness.
What is needed in a NQF to take into account the scope and diversity of service responses across Australia and to ensure these are maintained?
Do you agree with the characteristics of quality service provision outlined above?
What other key characteristics or elements should be included to describe quality service provision?
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Mainstream and allied services
One of the key issues this consultation needs to resolve is how a NQF can be applied to mainstream and allied services as well as specialist services. It must be recognised that many mainstream and allied service systems already have quality processes in place, such as hospitals which are subject to quite sophisticated quality assurance processes.
A Homelessness NQF however, can improve the way that allied and mainstream services identify and deliver services to people who are homeless, which is just as important as strengthening specialist service delivery and critical to improving overall outcomes.
One possible approach to addressing this issue is a NQF that includes service standards for specialist services and service charters for allied and mainstream services.
'The housing and support service were non judgemental and helped me to achieve independence without making me feel like an 'idiot' when I stuffed up. I didn't have the confidence to approach places and they helped me make the first steps. One good worker can make a huge difference.'
How can mainstream and allied services be encouraged and supported to identify and respond to people who are homeless or at risk of homelessness?
What quality approaches support stronger cross sector service integration and improved service delivery?
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Potential components of a national quality framework
A NQF positions the concepts and context of quality at a national level. The precise shape and structure of a NQF will depend on how the various concepts and components are brought together into a national level framework.
A NQF could be described as a multi-layered structure that incorporates a broad range of components and processes that will contribute to establishing and maintaining high quality service provision across Australia to people who are homeless or at risk of homelessness.
It is important to look at what these components may be and to consider how they interrelate.
Consumer charters set out the rights and responsibilities of consumers and are an integral component of any NQF.
Service charters are public statements about the services that are provided and what consumers can expect from that service.
Alliance models involve a commitment between different organisations (including mainstream, allied and specialist services) to communicating regularly and working together for the benefit of vulnerable clients.
Complaints management systems assess, manage and respond to consumer concerns and contribute to improved quality service provision.
Standards describe the expected outcome, processes and performance and can clarify expectations around service delivery. Standards can cover different aspects of an organisation's business and generally cover service delivery as well as organisational management and governance practices.
Accreditation is a quality measurement framework. Accreditation is a standards based recognition system that can use a quality assurance and/or a continuous quality improvement approach. It involves assessment against a pre determined set of standards and formal acknowledgement of achievement of expected performance against those standards.
Quality assurance (or minimum quality) can be described as a process of determining whether services meet expectations. It is very much a process driven approach that defines expectations and requirements and verifies that those requirements have been met.
Continuous quality improvement (CQI) is an approach to quality that builds on traditional quality assurance methods by focussing on organisations and systems. CQI emphasises the organization and its systems and is an ongoing cyclical process of self assessment, performance improvement and review.
A NQF can be supported by a range of other products and instruments such as workforce development strategies, policy and procedural manuals, evaluation programs, legislative requirements and program guidelines, most of which can be embedded through service standards. An effective NQF will also have mechanisms in place that ensure ongoing consumer feedback into the provision of quality services.
Which of these components could be considered in a national quality framework?
Are there other key components that should be included in a NQF?
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How would a NQF relate to existing state and territory quality systems?
It is important to recognise that many jurisdictions already have well established quality systems and processes in place that would contribute to a NQF.
Measures are in place that range from performance based contracting to mandatory accreditation. Some jurisdictions have introduced client or service charters and have established complaints management systems in place.
This development phase will explore existing jurisdictional systems and processes and how they could contribute to or form the building blocks of this NQF. Consideration will be given to a wide range of possible approaches including mandatory accreditation systems and non-legislative approaches.
The Victorian Government in partnership with the specialist homelessness sector has developed mandatory Homelessness Assistance Service Standards (HASS). The development of the HASS accreditation system is intended to ensure ongoing and improved service delivery to clients, to promote good practice and encourage ongoing business and service improvement.
The ACT has developed a non-legislative homelessness charter - a statement of rights. The document promotes a rights based approach to homelessness service delivery. It is accompanied by a service guarantee, which is an individual organisational commitment to ensuring any client receives a service irrespective of which organisation they present to.
What currently works well in ensuring service quality in your state or territory?
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Other quality frameworks
The concept of a NQF is not new. Other sectors have quite mature systems that have been established for some time. An important goal of many quality systems in allied service sectors is to protect vulnerable client groups, for example aged care residents and children in child care are protected by quality systems.
Existing quality frameworks will inform our thinking through the development phase of the NQF.
What lessons can we learn from existing quality frameworks?
What would you change in existing quality systems to improve outcomes for people experiencing homelessness?
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How to participate in this consultation process
Workshops will be held in all states and territories. Individuals and organisations with an interest in the development of a national quality framework are encouraged to attend these workshops.
A schedule with dates and venues of where the consultation workshops are being held is available at FaHCSIA website (www.fahcsia.gov.au) or you can call us on 1800 300 125 to obtain details of the workshops in your state or territory.
If you are unable to attend one of the workshops, we would still be interested to hear from you. You can contribute your ideas in a number of ways by:
- sending an email to Homelessness Quality(homelessness.quality@fahcsia.gov.au) or
- writing down your ideas and posting them to:
- Ms Kate Gumley
Chair, Homelessness Working Group
Department of Families, Housing, Community Services and Indigenous Affairs
PO Box 7576
Canberra Business Centre
ACT 2610
Please get your ideas to us by 15 April 2010 to ensure they can be considered.
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Next Steps
The outcomes of this national consultation process will be made available on the FaHCSIA website (www.fahcsia.gov.au) by 30 June 2010.
The feedback collected in this consultation process will guide the development of a more detailed discussion paper that will be released later in 2010. It will identify several possible options for a national quality framework and provide an analysis of the relative costs and benefits of those options.
A second round of consultations based on this detailed discussion paper will lead to a preferred option for a national quality framework.
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Definitions
Homelessness: This discussion paper uses the ABS definition, which defines homelessness across three levels:
Primary homelessness, which refers to people who are sleeping rough or living in improvised dwellings.
Secondary homelessness, which refers to people with no usual address who are moving between various forms of temporary shelter such as staying with friends and family or specialist homelessness services.
Tertiary homelessness, which includes people who are living in boarding houses or caravan parks with no secure lease and no private facilities.
A person who is at risk of homelessness is someone whose housing, health, employment, personal, financial or other circumstances puts them at a heightened risk of becoming homeless.
A specialist homelessness service is an organisation that is funded to deliver services specifically to people who are homeless or at risk of homelessness. Specialist homelessness services deliver services that include crisis or supported accommodation, transitional support, crisis support, housing information and referral, etc. Specialised legal, employment or advocacy services may be considered a specialist homelessness service if that service (or that component of their business) is specifically funded for the provision of services to homeless clients or those at risk of homelessness.
Mainstream and allied services are organisations that are not restricted to service delivery to people who are homeless, but whose clients might include people who are homeless. Such organisations might deliver services to the general community or to a designated client group. Mainstream and allied services could include Centrelink, hospitals, community health centres, alcohol and drug services, mental health, disability services, children and family services, training and employment and many others.
A national quality framework (NQF) is a multi layered structure that incorporates a broad range of systems and processes that contribute to establishing and maintaining high level service provision across Australia for people who are homeless or at risk of homelessness. A NQF provides a systems perspective for understanding performance and identifying areas in need of improvement. It supports an ongoing process of change towards evidence-based good practice.
Quality is defined by Standards Australia as 'the totality of characteristics of an entity that bear on its ability to satisfy stated and implied needs'. In the context of an individual service provider, quality relates to the characteristics of an organisation that determine its ability to respond effectively to the needs of its clients. In the context of a Homelessness NQF, quality relates to the characteristics of the broader service system that determine the system's ability to respond effectively to the multiple and complex needs of people experiencing or at risk of homelessness.
A client or consumer is a person that is experiencing or at risk of homelessness and is accessing a specialist, allied or mainstream service.