Client Focus Group 2

North and West Metropolitan Region LASN Client Feedback Group

Client Focus Group Report

February 2011

Background

An identified priority of the North and West Metropolitan Region LASN Client Feedback Group is to model good practice in relation to client participation and feedback processes. In 2011, a practice forum and practice guide will be made available to staff of the region’s homelessness services to help them to involve clients more meaningfully across their organisations. A series of client focus groups will inform this work. The first client focus group was held in August 2010 and found that clients of homelessness services in the North and West Metropolitan Region

were not familiar with the concept of consumer participation in homelessness services, but were very supportive of the idea;
could not recall being actively involved in homelessness services (outside of individual case planning conversations); and
would like to be more involved in the homelessness services with which they were working.

The second focus group, held in February 2011, was intended to explore how clients would like to be involved in homelessness services, and what homelessness services can do to support this involvement, in practical terms.

The session was organised by staff of Wombat Housing and Support Services and the Community Programs Unit, North and West Metropolitan Region Department of Human Services. Two Peer Educators from the Council to Homeless Persons’ Peer Education Support Program were engaged to give advice on the focus group questions and facilitate the session. The session was attended by seven participants who had accessed a variety of homelessness assistance services in the region.

Whilst some participants were unfamiliar with the concept of consumer participation, much relevant information was provided during the session, or may be inferred from, participants’ responses.

Responses

Can you tell us about your experiences of being involved in homelessness services?

Firstly, participants explained their pathways into and through the homelessness service system. Their experiences were incredibly varied. For some, the homelessness service system was accessible and welcoming. Others felt that they had to actively securetheir own resources.

‘The staff were welcoming when I first came in.’
‘They were very helpful for a while.’
‘You have to be completely on alert otherwise I don’t know where I would have landed.’
‘You have to be very very active and keep pursuing to try to achieve your own outcomes.’

Participants also had varying impressions of the extent to which they were able to make informed decisions regarding their own situation.

‘I think you get to steer your ship to a degree’ (in reference to a particular service).
‘They said “go to the hotel” and I just grabbed it. You have no idea [what it’s going to be like there]. It was a nerve-racking experience. A whole week of torture.’
‘I went in to supported accommodation not knowing.’
‘I’ve been at the refuge for five weeks now. And it’s meant to be a six week stay. I think they’ve got somewhere for me to go next. I don’t really know.’ ‘It’s a very difficult situation, trying to give them back power, to be their own self guide.’

Participants were largely unfamiliar with the concept of formal consumer participation. Once explained, participants felt that there was a lack of formal opportunities for meaningful involvement in homelessness services.

‘We have house meetings but they go for maybe fifteen minutes and we only talk about the dishes. That’s a meeting? Get real!’
‘We don’t have the opportunity to be involved.’
‘I’ve only been to one place where they had complaint forms.’
‘There was no feedback options available when I went into crisis accommodation and transitional housing.’
‘I think that there is not enough feedback processes or opportunities in place for consumers to have a valid and ongoing voice.’
‘Things should be more equal (between staff and clients) and people should be heard. But I don’t ever give up.’
‘I feel like when I got to a service I have to stick to their rules. They’re in charge.’
‘It seems like each client’s experience (of being involved) is affected by the individual practice of the worker, which is a shame. There should be a service system approach to involving clients.

Two of the participants were glad to bemembers of a consumer advisory group.

‘I’ve been involved in feedback processes for over sixteen months now. Some of it has been giving feedback … On the flipside I’ve been involved in a consumer consultant role for a strategic plan where I helped facilitate focus groups and conducted interviews 1:1 with various peers.’
‘I’ve really quite enjoyed it. At first I was quite hesitant about it, but now I quite enjoy it. I’ve met people from all walks of life and it’s been just fascinating. We get together once a month and at the moment we’re organising some pamphlets, and just generally finding out what people want, doing staff induction…’

What decisions or projects would you like to be involved in?

Most participants were unsure about the level of involvement to which they were entitled.

‘What’s available to people in these services? What sort of options or avenues or projects?’

Following an explanation of the Homelessness Assistance Service Standards relating to client involvement, most participants were interested in having a say on systemic issues relating to homelessness.

‘We’re the experts.’
‘The input that we’d like to have is in the creation of safe housing. That’s it. That’s the key.’
‘Being involved in the safety of people who are homeless.’
‘Case management meetings are about how I’m going. I want to look at the bigger picture.’
‘I’d like to see a consultation process of how we can restructure the system in relation to recurring homelessness and how we can change the current situation from a realistic voice’ (i.e. from the clients’ perspective).
‘I would like to talk about broader issues.’
‘I’m concerned about the lack of exit options and the slowness of getting out of the service.’

However, some participants felt that being able to exercise individual agency is a necessary precursor to involvement in more systemic projects.

‘I’ve really benefitted from just having a place to rest. I’m more interested in just getting my life back on track.’
‘Sometimes people who have been through trauma can’t even cope with the assessment process.’

Participants felt that their perspectives could achieve a number of outcomes, from enhancing an organisation or sector, to helping others in a similar situation or educating the community.

‘I would love to educate people and use my story as an inspirational tool to help others.’
‘I would really like the opportunity to be able to use my experience to help others that are going through what I have been through.’

How would you like to have your say on these decisions?

Participants wanted to ensure that opportunities existed for them to be heard, rather than worrying about the mechanisms through which they could have a say. However, a number of activities were mentioned in which clients would be happy to be involved, mostly informal.

‘Having opportunities to discuss issues is important.’
‘I’m not really sure (about how I’d most like to have a say). I’d talk to anyone about my experiences.’
‘If there were problems, I’d like to be in environments where we can discuss them, like open tables.’
‘I also think follow up interviews are vital because it would give a clear indication of what has transpired and gone wrong during that time.’
‘The real way to have my voice heard is by speaking up. This involves participating in focus groups, maybe government reviews. Giving educational input in a training and advice capacity.’

Certain comments, such as the above reference to participating in official reviews,also suggestthat participants felt their expertise should be used to complement the knowledge of an agency’s or government department’s staff.

‘I’d like to see a consultation process of how we can restructure the system’
‘They [staff members] have some projects that they should really share with residents. The more ideas the better.’

How much time and energy would you be willing to give these activities?

Only two clients answered this question directly.

‘I would give as much time and input as I’m allowed! I’m dedicated to making a difference for others so that they don’t have to ensure what I’ve been through.’
‘When things are ok you can open up your time to have a say.’

However, a great level of interest was shown when participants were sought for this focus group. The LASN Client Feedback Group had received advice from PESP and former focus group participants in order to make such sessions as accessible as possible. This could suggest that when client participation strategies are well planned and resourced it is not too onerous for a percentage of people experiencing homelessness to be involved. Indeed, some clients receive a great deal of personal satisfaction from doing so.

‘I really enjoy interviewing peers as it’s also inspirational to me to know that I’m not alone in what I’ve been through.’
‘I’d talk to anyone about my experiences. I think it’s good to get it out.’

How might homelessness services discourage effective client involvement?

Several participants noted that, logically, if organisations do not have established mechanisms for client participation, or if clients aren’t made aware of any such mechanisms, they will be unlikely give feedback or become involved in an organisation.

‘It occurred to me the other day though that there’s not an actual formalised system of complaints. Even the refuge, which I think is an excellent excellent place, and is so often responsive to anything that you need or want could have a formalised system. I’ve never had any real reason to complain but it occurred to me that if I had a major complaint that I didn’t feel was being dealt with properly I don’t really know what I would do.’
‘I’m empowered to have a say at the higher levels, but that level of involvement is out of my reach.’
‘When I was at my local homelessness service and receiving material aid recently, there was certainly no feedback processes that I had been told of nor been made aware of.’

Participants also explained that it is discouraging when staff members are not willing or able to incorporate client perspectives into their work or the work of the organisation.

‘The staff don’t always share the important information with clients.’
‘I have a new worker. She doesn’t really know me. She sorta talks about one thing too far that I don’t need to know about... like going to classes. I want to work.’
‘That worker can’t help because she doesn’t have enough information or enough time.’
‘People might be discouraged from giving negative feedback if they are still receiving help from a service.’

Clients were also discouraged when their feedback was not responded to appropriately.

‘I think that there are a lot of people to say something to, but whether it gets to the point it always should is another thing.’
‘They never got back to me about my complaint. They’re absolutely useless at looking after the clients.’

It is interesting to note that a number of clients spoke as though there was a direct correlation between having their opinions heard and respected, and being cared for by an organisation (for example, see comment directly above).

How might homelessness services encourage effective client involvement?

Participants were encouraged to give feedback to an organisation when opportunities to do so were visibly available.

‘We have information and feedback boxes at reception.’
‘The manager is always available to answer questions.’

A common thread underpinning most suggestions was the necessity of having friendly and knowledgeable staff available to clients at all times.

‘There should always be someone available to you to at least talk to you about what’s happening.’
‘We have a weekly case management meeting. I think, what on earth are they doing so much during the rest of the week that you can only give each client one meeting a week?’
‘Maybe support the workers that assist the residents. Make sure that they’re well equipped with all the skills that they need to work with the residents.’
‘They need someone there to talk to.’
‘She’s awesome. She’ll sit there and talk to you for hours about stuff.’

‘She’d never dealt with anyone like me before. But she put her heart and soul into helping me and she learnt about the service system in the process. I really appreciated that.’

Other suggestions were also made.

‘It would be good if you gave feedback to management and then management fed back to you.’
‘I think the most effective form of feedback for any homelessness service is negative feedback...If you interviewed people who are on the streets, chances are you will get the feedback that is really required for change.’
I believe you would only get the honest feedback from a peer consumer focus group.’

Do you have any other comments or ideas about the involvement of clients in homelessness services?

Throughout the session, a number of participants repeatedly expressed concern about the scarcity of resources which are available to people experiencing homelessness, and the inappropriateness of much crisis accommodation. Participants said that these inadequacies significantly contributed to personal hardship and mental ill health.

‘I can’t go to boarding houses because I know for sure that I’ll go right down.’
‘Twice I waited for three hours [at an access point]. They can’t do their work. They say “We’re short staffed.”’
‘What she told me made my heart fall to the ground. She said you might be here [in supported transitional accommodation] for two years plus.’
‘Some of us are still looking for that end solution.’

Outcomes

Participants in this session reiterated some of the findings from the first client focus group;generally clients are not aware of the ways in which they can be involved in homelessness services, but are willing to contribute to these organisations.

This session was intended to uncover practical and popular strategies for clients to increase their involvement in the homelessness service system. Whilst a number of suggestions were provided, participants were not terribly concerned about the mechanics of consumer participation strategies. Rather, they wanted to emphasise that it is important that such strategies are operational and accessible to all clients of homelessness services.

It was interesting that the participants almost unanimously agreed that they would most like to be consulted on systemic issues relating to homelessness. Participants felt that they had a level of expertise which could positively contribute to enhancing responses to people experiencing homelessness in a number of ways. However, it was suggested that some clients might only really be interested in contributing to their own case plan whilst they were experiencing personal crises.

Participants’ responses to a number of questions affirmed the integral role that staff members play in shaping the engagement of clients at all levels of homelessness services. According to the participants, clients are more likely to engage with an organisation when staff members are perceived to be friendly, knowledgeable and genuinely interested in responding to clients’ desires, needs and concerns.

February 20111