Report Four: Evaluation of the Stay-Keys to the Future Program
Prepared by the Housing and Community Research Unit,
University of Tasmania
November 2013
This report was prepared by Dr. Michelle Gabriel, Joel Stafford and Dr. Barbara Lloyd.
Contact details:
Housing and Community Research Unit (HACRU)
School of Sociology and Social Work
University of Tasmania
http://www.utas.edu.au/sociology-social-work/centres/hacru/
Acknowledgements
The HACRU team would like to thank the service workers and clients who participated in the evaluation. Their thoug.0htful reflections have enabled the team to gain a comprehensive picture of the delivery of the program from a range of perspectives.
The team would also like to acknowledge the assistance provided by Housing Tasmania staff in locating and collating information relevant to the program.
Contents
Acknowledgements 2
Contents 3
ACRONYMS 5
EXECUTIVE SUMMARY 6
1 Overview of the Stay-Keys Program 9
1.1 Background 9
1.2 Special Issues Facing Homelessness Services 10
1.3 Stay-Keys: Program Logic 11
1.4 Service Outline 13
2 Data Collection Method and Analysis 14
2.1 Description of service activity data 14
2.2 Service provider consultation 15
2.3 Consultation with Stay-Keys clients 15
3 Evaluation of Service Provision and Outputs 17
3.1 Service Activities Specified 17
3.1.1 Service Activities Specified in the Funding Agreement 17
3.1.2 Performance Measurement of Service Activity 18
3.1.3 Description of the characteristics of the personnel identified to undertake the activities 18
3.1.4 Description of Service Levels 19
3.1.5 Client Demographics 21
3.1.6 Client Presenting Circumstances 24
3.1.7 Services Provided 26
3.1.8 Level of Attainment Measured 28
3.1.9 Indicative Costs of Operating the Service 30
3.2 Implementation of Tenancy and Support Service 32
Question 1: To what extent has the agency been able to implement effective screening and needs assessment procedures that ensure that people who are at risk of homelessness are supported? 32
Question 2: To what extent has the agency been able to implement effective allocation procedures that ensure that people who are at risk of homelessness are supported? 34
Question 3: To what extent have providers of the Stay service and Keys to the Future program been able to implement processes that support residents to sustain their tenancies? 36
Question 4: To what extent has the Stay service provided opportunities for residents to: reunite with and increase connection with family; improve independent living skills; access a range of health and support services; and pursue education, training and employment options? 39
4 Evaluation of Service Participant Outcomes 41
Question 1: To what extent has the Stay service in association with Keys to the Future program achieved stability of tenure for clients? 41
Question 2: To what extent has the Stay service been able to improve client outcomes relating to: family and community connection; independent living skills; health and wellbeing; training, education and employment? 43
Question 3: What are the key factors that have facilitated positive client outcomes? 47
Question 4: What are the key factors that have hindered positive client outcomes? 49
5 Discussion of Service Implementation and Outcome Information 52
6 Recommendations to Stakeholders 57
References 59
APPENDIX A 60
APPENDIX B 62
APPENDIX C 63
APPENDIX D 64
ACRONYMS
DHHS Department of Health and Human Services
FG Focus Group
HACRU Housing and Community Research Unit
NGO Non-Government Organisation
SHS Specialist Homelessness Services
SITS Specialist Intervention Tenancy Service
SP ‘Stay-Keys’ Service Provider
TAO Tasmanian Audit Office
EXECUTIVE SUMMARY
This evaluation of two complementary housing and support services, Stay (formerly called the Specialist Intervention Tenancy Service or SITS) and Keys to the Future (Stay-Keys), is the fourth output of the Housing and Community Research Unit’s (HACRU) Evaluation of New Homelessness Support Services in Tasmania. The Stay-Keys program commenced operation in October 2010 with the aim of assisting people at risk of homelessness to access and to maintain secure housing.
In Chapter 1, we provide an overview of the Stay-Keys program. This includes: background information about the establishment of the program; a summary of special issues facing homelessness services; insight into the logic of the program; and a description of the parameters of the program.
In Chapter 2, we provide an outline of the data collection method and analysis for the evaluation. The evaluation draws on data collected as part of a study of the Stay service, Have We Reached a Tipping Point in Homelessness Support Service Delivery? As part of this study, the HACRU team undertook interviews and focus groups with Keys to the Future and Stay service providers and clients. Interviews and focus groups were conducted between 3rd August 2012 and 21st May 2013. This information is supplemented by further interviews with service providers conducted in September 2013. The team also collated and summarised available demographic and service activity data.
Chapter 3, we provide an evaluation of service provision and outputs. In section 3.1, we begin with a description of the Stay-Keys service levels and then review client demographics, client presenting circumstances, services provided, client outcomes, and indicative costs of operating the service. In Section 3.2 we evaluate the implementation of the Stay-Keys program. Stay-Keys is evaluated in terms of: the provision of effective screening needs, assessment and allocation procedures that ensure that people in need and at risk of homelessness are supported; the provision of processes that support residents to sustain their tenancies; and the provision of processes to ensure that clients improve their independent living skills and their connection with family, community, health services, social and economic networks within two years of entering the program.
In Chapter 4, we present the evaluation of service participant outcomes. Service participant outcomes are evaluated in terms of: increased stability of tenure and reductions in homelessness; increases in family reunification and connection with family among residents; increased participation in education, training and employment among residents; increased independent living skills among residents; and improvements in the health and wellbeing of residents. The evaluation also identifies the key factors that have facilitated and hindered positive client outcomes.
In Chapter 5, we provide a discussion of service provision and outcome information. We note that the Stay-Keys program has successfully transitioned people who are homeless or at risk of homelessness into secure housing. Key strengths of the Stay program include: the empathic, non-judgemental support clients have received from Stay support workers; the flexible duration of the service, which enabled clients to access support for up to two years and to remain in contact with support workers following transition out of Stay should this need be identified; and the fact that support could be tailored towards client-specific needs.
While the Stay-Keys program provided a valuable service and entry point to permanent housing for people who had previously experienced difficulties in sustaining their tenancies, service providers provided insight into some initial teething problems with the program. These included: delays in allocating properties to the program; and inadequate processes in place to respond quickly and effectively to rental arrears and property damage. In relation to property allocation, the program’s property portfolio grew gradually over the two year period. Unanticipated delays in property allocation created financial risk and potentially impacted on the viability of the Keys program.
The desire for a clear separation of tenancy management and support was built into the design of the Stay-Keys program. While the strengths of separate tenancy and support are well-established, the experience highlights that there are some areas of risk with this model. Service providers observed that in retrospect the tendering process for the Stay-Keys program was problematic. Service providers suggested that a partnership approach during the tendering process would have been highly beneficial in: minimising financial risk to agencies; improving inter-organisation communication; and developing a fair and equitable service model.
In relation to data capture and performance reporting, the evaluation highlighted that there is scope for improving performance monitoring of the program and using this as a basis for program innovation. An evidence-based approach to service delivery is being hampered by gaps in the key performance indicators and a lack of integrated datasets. Moreover, the specified service objectives are not sufficiently nuanced to capture the full range of positive client outcomes for all client groups. There may be scope for reshaping the objectives of the program to better reflect the priorities of clients as identified in their case management plans. This has the potential to enhance the value and utility of monitoring processes and ensure that the evidence-base is used to inform practice.
In Chapter 6, we identify several improvements that this model of service delivery could sustain to better address the needs of current and future clients. They include:
1. Revising the separate tendering process in a way that supports a collaborative, partnership approach to the delivery of tenancy and support programs.
2. Addressing inequities in the distribution of financial risk across partner organisations responsible for the delivery of the program.
3. Ensuring that the agency responsible for tenancy management is adequately resourced and that it has effective internal communication systems in place to deliver a responsive tenancy service from the commencement of the program.
4. Examining the potential of tailoring the existing program to address the specific housing and support needs of young people.
5. Updating the current output performance specification for the Stay-Keys program in order to improve the capacity to undertake quality performance monitoring.
6. Examining the capacity to reshape service objectives to better reflect the priorities of clients as identified in their case management plans.
7. Investigating the possibility of Housing Tasmania retaining the role of specifying an output performance regime (in conjunction with the funded service provider where relevant), rather than outsourcing this role to third parties not directly responsible for achieving the aim of the services commissioned.
1 Overview of the Stay-Keys Program
In this chapter, we provide an overview of the Stay (formerly called the Specialist Intervention Tenancy Service or SITS) and Keys to the Future (Stay-Keys) program. This includes: background information about the establishment of Stay-Keys; a summary of special issues facing homelessness services; insight into the logic of the Stay-Keys program; and a description of the parameters of the Stay-Keys program.
1.1 Background
This evaluation of two complementary housing and support services, Stay-Keys, is the fourth output of the Housing and Community Research Unit’s (HACRU) Evaluation of New Homelessness Support Services in Tasmania. The evaluation draws on data collected as part of a study of the Stay service, Have We Reached a Tipping Point in Homelessness Support Service Delivery?, conducted by HACRU in early 2013. As part of this study, the HACRU team undertook interviews and focus groups with Keys to the Future and Stay service providers and clients. This information is supplemented by further interviews with service providers conducted in September 2013 and service activity data.
The combined Stay-Keys program is one initiative amongst a suite of integrated responses developed by Housing Tasmania in accord with the National Partnership Agreement on Homelessness (NPAH). The NPAH was signed in 2008 and ended 30 June 2013 and it provided $18.9 million dollars of joint funding to Tasmania over four years. Initiatives delivered under the NPAH are intended to contribute to the National Affordable Housing Agreement objective of supporting people who are homeless or at risk of homelessness to achieve sustainable housing and social inclusion. Initiatives developed under the NPAH are informed by the approach outlined in the Australian Government’s (2008) white paper The Road Home: a national approach to reducing homelessness.
According to the Tasmanian Homelessness Implementation Plan the initiatives of the NPAH are coordinated by the Homelessness Steering Committee[1] to complement other initiatives undertaken in Tasmania either to achieve the objectives of other national partnership agreements or in accord with reforms to the Tasmanian public service. The implementation plan cites several other initiatives including: reforms to the Department of Health and Human Services principally aimed at achieving better integration and co-ordination of the commissioning and delivery of family support services (approx. $35 million)[2]; and additional funding to reform aspects of Mental Health Services (approx. $47 million)[3] and Drug and Alcohol Services (approx. $17.1 million)[4], again with a focus on achieving integration between specialist services, allied health and human service providers, and private and community based service organisations.
1.2 Special Issues Facing Homelessness Services
There are a number of challenges associated with delivering services to people who are homeless or people who are at risk of homelessness. Perhaps the greatest of these challenges is service engagement. The characteristics of the homeless population are thought to be such that few will express their need for services in the proactive manner that populations have traditionally engaged with state housing services. Rather, people who enter the health, human and allied services system in a state of homelessness enter for reasons other than those involving tenure, are referred in via a crisis or police service or invited in via the efforts of charitable organisations. Other people experiencing homelessness move through a social network consisting of friends, relatives and associates and rarely present to homeless services (Mackenzie and Chamberlain 2003).
Engagement with services can also present a challenge even when people enter into a service program by choice. This occurs when a client resists engaging with psycho-social services offered in addition to an accommodation service.
Another special issue facing services for people who are homeless or at risk of homelessness is mobilising the resources of the right type, level, and for the right period of time to address the potentially diverse personal circumstances of clients. These circumstances can range from financial hardship, through addictive behaviours involving gambling, alcohol and other drugs, to significant physical disability, poor mental health, and traumatic disorders caused by accidents, childhood abuse or neglect or negative interactions within the justice system.
Identifying efficient and effective models of service delivery that are known to achieve the desired outcomes of clients and governments is also a critical issue (Eardley et al 2008; Flateau et al 2008; Johnson et al. 2012). There remains significant controversy over the best way to construct, resource, implement, and monitor services for people who are homeless or at risk of homelessness. Some of this controversy is driven by the underlying challenge of correctly identifying the causes of homelessness in a given population. Another driver involves correctly identifying the lessons learned from current and prior attempts to address homelessness and translating these lessons into services better able to meet the needs of clients.