Evaluation of New Homelessness Support Services in Tasmania Report Five: Evaluation of Supported Accommodation Facilities – Common Ground Tasmania Housing and Community Research Unit, University of Tasmania June 2014 1 This report was prepared by Julia Verdouw, Joel Stafford and Daphne Habibis 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 thoughtful 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. 2 Contents CONTENTS .......................................................................................................................................................... 3 ACRONYMS ......................................................................................................................................................... 5 EXECUTIVE SUMMARY ........................................................................................................................................ 6 1 OVERVIEW OF COMMON GROUND TASMANIA ......................................................................................... 14 1.1 1.2 1.3 1.4 2. DATA COLLECTION METHOD AND ANALYSIS ............................................................................................. 25 2.1 2.2 2.3 3 DESCRIPTION OF SERVICE ACTIVITY DATA ............................................................................................................ 25 SERVICE PROVIDER CONSULTATION.................................................................................................................... 25 CONSULTATION WITH SUPPORTED ACCOMMODATION FACILITIES RESIDENTS ............................................................. 26 SERVICE IMPLEMENTATION AND OPERATION ........................................................................................... 28 3.1 3.2 4 INTRODUCTION .............................................................................................................................................. 14 SPECIAL ISSUES FACING HOMELESSNESS SERVICES ................................................................................................ 15 RECENT HOMELESSNESS POLICY REFORMS .......................................................................................................... 16 COMMON GROUND HISTORY AND PROGRAM LOGIC ............................................................................................. 20 SERVICE ESTABLISHMENT ................................................................................................................................. 28 PROGRAM IMPLEMENTATION AND SERVICE OPERATIONS ....................................................................................... 31 EVALUATION OF SERVICE PROVISION AND OUTPUTS ................................................................................ 40 4.1 SERVICE ACTIVITIES SPECIFIED........................................................................................................................... 40 4.1.1 Service Activities Specified in the Funding Agreement and Residential Management Agreements .. 41 4.1.2 Performance Measurement of Service Activity .................................................................................. 41 4.1.3 Description of the characteristics of the personnel identified to undertake the activities ................. 42 4.1.4 Description of Service Levels............................................................................................................... 42 4.1.5 Client demographic profile ................................................................................................................. 47 4.1.6 Client Presenting Circumstances ........................................................................................................ 49 4.1.7 Services Provided ................................................................................................................................ 53 4.1.8 Level of attainment measured ........................................................................................................... 56 4.2 IMPLEMENTATION OF TENANCY SERVICES ........................................................................................................... 59 4.2.1 To what extent does the organisation provide safe, secure and affordable housing for people at risk of homelessness? ............................................................................................................................................ 59 4.2.2 To what extent does the organisation provide effective assessment and allocation procedures designed to assist those who have recently been absolute or chronically homeless to secure affordable housing? .......................................................................................................................................................... 63 4.2.3 To what extent has the organisation been able to implement processes that support tenants to sustain their tenancies? .................................................................................................................................. 67 4.2.4 To what extent has the organisation been able to encourage tenant participation in service delivery and operations? .............................................................................................................................................. 69 4.3 IMPLEMENTATION OF SUPPORT SERVICES............................................................................................................ 71 4.3.1 To what extent has the organisation provided tenants with increased access to a range of health and support services?...................................................................................................................................... 71 4.3.2 To what extent has the organisation been able to deliver a positive environment conducive to social inclusion and participation, including opportunities for tenants to reunite with and increase connections with family members? .................................................................................................................................... 73 4.3.3 To what extent has the organisation provided opportunities for tenants to pursue a range of education, training and employment options? ............................................................................................... 75 3 5 EVALUATION OF SERVICE PARTICIPANT OUTCOMES .................................................................................. 77 5.1 OUTCOME 1: TO WHAT EXTENT ARE THOSE WHO ARE HOMELESS OR AT IMMINENT RISK OF HOMELESSNESS ACCOMMODATED WHERE THE ORGANISATION HAS THE REASONABLE CAPACITY TO DO SO AT EITHER OF THE SERVICE LOCATIONS? ........................... 77 5.2 OUTCOME 2: TO WHAT EXTENT ARE TENANTS ASSISTED IN THEIR TRANSITION TO INDEPENDENCE THROUGH A COMPREHENSIVE CASE MANAGEMENT PLAN TAILORED TO THEIR INDIVIDUAL NEEDS AND CIRCUMSTANCES; AND TO WHAT EXTENT ARE TENANTS SUPPORTED TO ACHIEVE THE GOALS IDENTIFIED THROUGH THEIR NEEDS ASSESSMENT? ........................................................... 81 5.3 OUTCOME 3: TO WHAT EXTENT HAVE TENANTS ACTIVELY PARTICIPATED IN EDUCATION, TRAINING OR EMPLOYMENT AS APPROPRIATE TO THEIR INDIVIDUAL NEEDS AND CIRCUMSTANCES? ..................................................................................... 83 5.4 OUTCOME 4: TO WHAT EXTENT ARE TENANTS ACTIVELY ENCOURAGED AND SUPPORTED TO MAXIMISE THEIR LEVEL OF INDEPENDENCE AND LIFE SKILLS ................................................................................................................................... 85 5.5 OUTCOME 5: TO WHAT EXTENT HAS THE ORGANISATION INCREASED FAMILY REUNIFICATION AND SOCIAL CONNECTION AMONGST TENANTS? ................................................................................................................................................ 86 5.6 OUTCOME 6: TO WHAT EXTENT HAS THE ORGANISATION IMPROVED RESIDENT HEALTH AND WELLBEING? ....................... 89 5.7 OUTCOME 7: TO WHAT EXTENT HAS THE ORGANISATION PROVIDED STABILITY OF TENURE FOR TENANTS? ....................... 90 6 DISCUSSION OF SERVICE PROVISION AND OUTCOME INFORMATION ........................................................ 93 6.1 CGT SERVICE MODEL ..................................................................................................................................... 93 6.2 OCCUPANCY LEVELS AND ALLOCATIONS .............................................................................................................. 98 6.2.3 Improving Targeting and Service Integration ................................................................................... 102 6.3 TENANCY AND REPORTING ............................................................................................................................. 103 7 RECOMMENDATIONS TO STAKEHOLDERS ................................................................................................ 107 REFERENCES.................................................................................................................................................... 110 APPENDIX A: COMMON GROUND ELIGIBILITY CRITERIA NEW YORK, SOUTH AUSTRALIA AND NEW SOUTH WALES ............................................................................................................................................................ 114 APPENDIX B: INTERVIEW SCHEDULES ............................................................................................................. 116 APPENDIX D: SERVICE ACTIVITIES AND PROGRAM PERFORMANCE MEASURES .............................................. 122 4 ACRONYMS ACGA Australian Common Ground Alliance AHURI Australian Housing and Urban Research Unit AHT Affordable Housing Tenant AIHW Australian Institute of Health and Welfare CHL Community Housing Limited CGT Common Ground Tasmania DHHS Department of Health and Human Services HACRU Housing and Community Research Unit HT Housing Tasmania NAHA National Affordable Housing Agreement NPAH National Partnership Agreement - Homelessness SAF Supported Accommodation Facility SHS Specialist Homelessness Services SP Service Provider ST Supported Tenant TAO Tasmanian Audit Office VI Vulnerability Index 5 EXECUTIVE SUMMARY This evaluation of two Supported Accommodation Facilities (SAFs) provided by Common Ground Tasmania at sites in Barrack Street and Campbell Street in Hobart, is the final output of the Housing and Community Research Unit’s (HACRU) Evaluation of New Homelessness Support Services in Tasmania. The report is part of the suite of evaluations on homelessness support services funded under the National Partnership Agreement on Homelessness in Tasmania, including the Northern Tasmanian Supported Accommodation Facilities (SAFs). The Common Ground Tasmania evaluation was undertaken between November 2013 and February 2014. The aim of this evaluation is to provide a description of the implementation and current service activities of Common Ground Tasmania (CGT), report on available service data, evaluate CGT service provision in relation to service implementation and service participant outcomes, and draw out the implications of the findings and provide recommendations for Common Ground Tasmania and Housing Tasmania. The report provides an overview of the implementation and operation of CGT, including service establishment, program logic and evolving service arrangements. It analyses service provision and outputs, focusing primarily on supported tenants. This includes the service activities specified in the Funding Agreement and performance measures, service data including service levels, client demographics, client presenting circumstances, service provided, and indicative costs of the service. The evaluation of tenancy and support service implementation and operation includes assessment and allocations procedures and tenant support and participation, including provision of an environment conducive to social inclusion and participation. The report also evaluates service participant outcomes including the match between service capacity and the extent to which the target group was accommodated, the extent to which tenants achieved independence and case management plan goals, participated in education, training and employment opportunities, maximised independence and life skills, increased family reunification and social connection and improved health, wellbeing, and stability of tenure. Methods included analysis of the available demographic and service activity data and consultations with service providers and clients. Between 19 November 2013 and 15 January 2014, the evaluation team interviewed eleven supported tenants and thirteen service providers from the two SAF facilities and the broader housing and homelessness sector. All interviews were audio-recorded with participants’ informed consent and subjected to content and thematic analysis. 6 This evaluation found that CGT is providing secure, safe and stable long-term housing to two groups of individuals: those with low-incomes, or affordable housing tenants (AHTs), and individuals with a history of chronic or episodic homelessness or who are at risk of becoming homeless, known as supported tenants (STs). The provision of this service is carried out across two modern purpose-built facilities in Hobart city, offering studio and one-bedroom apartments at income-based rent to STs, in addition to a range of indoor and outdoor communal facilities. On-site therapeutic support is provided to tenants with a history of homelessness. Supported tenant respondents generally reported high levels of satisfaction with their tenancy, including the facilities available to them, the safety and security of the sites, the support they received, and the availability of activities to increase social connectivity. They noted improvements to their health and well-being which they attributed to the safety and security of their tenure, or as the result of the support provided in conjunction with their tenure. They also described the development of personal life skills and independence, and for some tenants, reunification with family members which marked a significant achievement in their lives. The evaluation found that one of the key strengths of CGT’s capacity to assist residents to sustain their tenancies is the separation of tenancy, concierge and support services. All service provider respondents believed separating tenancy, security and support roles was a critical feature of service provision and that the service is prioritising care to its tenants and seeking to provide high quality services aligned with CGT service objectives. For example, collaboration between the services assisted in reducing tenant instability, and helped build a ‘normalising’ environment for tenants through increased informal social interactions. The evaluation found a number of areas where the service provided by CGT to Tasmania’s homeless population could be improved. In making this assessment it should be noted that the evaluation took place at a time when CGT’s service delivery model was changing from the contracting out of tenant support and concierge services, to one of direct delivery of all services apart from property management. The evaluation identified some issues concerning allocations procedures and outcomes. CGT has invested significant effort in developing policy and operational procedures for the allocation of properties to the homeless population. These include strict eligibility criteria and processes including initial screening, the use of the Vulnerability Index survey and an in-depth report on the history of potential tenants. Despite this, respondents in the broader housing and homelessness services sector identified a number of concerns relating to CGT’s allocations process that they believe impact on its ability to reduce homelessness. These included concerns about slow allocation processes, eligibility criteria, and a perceived 7 reluctance to accept the more hard-to-house tenants. This was regarded as problematic by most housing and homelessness sector respondents because CGT is funded to house high support needs individuals within the chronically homeless population. If this contribution is reduced it limits the capacity of the sector as a whole to house this group, and shifts demand to other services who are not funded to meet it.1 These concerns are supported by findings that allocations take four to six weeks, that some clients referred as eligible for a CGT vacancy are rejected, despite the availability of places, and that occupancy targets for STs have only recently been met. The Barrack Street facility opened in June 2012 with 47 units and the Campbell Street facility opened in December 2012 with 50 units. Under the Funding Agreement, occupancy levels for STs are a minimum of 40 per cent to a maximum of 50 per cent. At the end of December 2013, 23 per cent of ST units were still vacant (see Figure 4-1 and Table 4-2, pp.44-5). By comparison, the Queensland Common Ground 146-unit facility opened in August 2012 and was fully tenanted by November 2012, suggesting CGT ST units were filled relatively slowly. Vacancies in AHT units are similarly high, with 29 per cent of units vacant in March 2014 (see Table 4-2 and Figure 4-2, pp.45-6). Although this evaluation focuses on STs, high vacancy rates amongst AHTs impacts on the financial sustainability of the facilities as a whole. Our analysis of rental charges for AHTs shows that high vacancy rates may be due to the rent setting model. For example, to avoid housing stress, a single AHT in a 1-bedroom unit must be earning at the top end of the low-wage earner bracket, and in some cases must be earning more than the maximum allowed by CGT for AHT eligibility.2 Service integration and communication between CGT and the broader homelessness sector was also identified as an area requiring attention. There was a perception amongst sector respondents that one of the reasons why CGT was cautious about its capacity to support tenants with high and complex needs was that it is not drawing sufficiently on the depth of expertise and support available within the sector. In their view, improved referral, consultation and collaboration with the full range of available services across housing, education, health and family services, would increase the capacity of CGT to meet the demand within the chronic homelessness population for housing. They also believed that communication about allocation decisions and collaboration with referring services needed strengthening. 3 The interview data suggests that differences in service philosophy have contributed to these differing perceptions about CGT’s policies and procedures. Although all informants believed in the strengths of the Common Ground model for meeting the needs of the chronically 1 2 3 See Section 4.2.2 (pp.64-6), Section 5.1 (pp.77-79) and discussion in Section 6.2 (p.97-99 and p. 101-2). See Section 4.2.1 (pp.63) and discussion in Section 6.2 (p. 97). See Section 4.2.2 (p.65-6), Section 5.1 (p. 79) and discussion in Sections 6.2 (p.99-102). 8 homelessness, there are important differences between the homelessness sector’s clientcentred model of care and emphasis on supported housing and CGT’s service philosophy that aims to balance sustainable business practices with a supportive model of housing emphasising personal responsibility and pathways to independence. This difference seems to have been a contributor to the changes that were made in late 2013 from CGT’s contracting out of support services to Anglicare to its direct provision of support services. This development followed difficulties between CGT and Anglicare in reaching agreement on an appropriate and equitable service and funding specification, and an appropriate set of performance measures. No Funding Agreement between the two parties was ever executed, exposing both parties to risk and disputes. Although the new arrangement maintains a separation between tenancy and support services because tenancy management services are provided by Rock Property Management, there are a number of concerns relating to the new arrangement. Despite the efforts of both CGT and Anglicare to minimise the effect on tenants, the change did impact on the capacity of the service to provide support for a period. The loss of service continuity meant that, at the time of data collection, some tenants had not re-engaged with the new support providers. Further concerns are the capacity of the new arrangements to provide continuity of support to exiting tenants who need support to sustain them in their new accommodation, and the extent to which support workers have access to the specialist expertise and knowledge of the homelessness service sector.4 These issues of targeting, allocations and arrangements with third party providers point to a need to improve governance and performance management of the CGT SAFs, firstly in relation to providing clear lines of responsibility for delivery of service outcomes, and secondly, to ensure fidelity to a Housing First service model in relation to targeting the most vulnerable service users. This includes providing rapid access to housing, not requiring tenants to be ‘housing ready’ and meeting some of the principles that underpin the desirability of separating housing and support in relation to continuity of support, and access to homelessness service provision knowledge and expertise.5 Given the emphasis on service integration within the NPAH, and its importance for the integrity of the Housing First model, the concerns about the level of collaboration and communication between CGT and the housing and homelessness sector also require attention. The interview data suggests the implementation of Housing Connect is addressing some concerns around allocation and targeting, but strengthening co-operation between CGT and other homelessness services should be a priority for all stakeholders. This is especially 4 5 See Section 5.2 (p.81-2) and Section 6.2.3 (pp. 95-7). See discussion in Section 6.1 (pp. 92-97) and 6.2 (pp. 97-102). 9 important given CGT’s movement to a more direct model of service provision, since this arrangement has the potential to curtail collaboration with other services. Service capacity and client outcomes are maximised by sharing sector knowledge through referrals, strong networks and collaborative arrangements. Further recommendations relate to supporting tenants who are establishing or reconnecting with family, to move into stable and appropriate family accommodation without the loss of support, clarifying the permanent status of tenancies, and improving monitoring and data collection in order to improve quality assurance and an evidence-based approach to service delivery through robust evaluation.6 Recommendations CGT is a relatively new and innovative response to the housing of homeless people in the broader Tasmanian landscape of supported accommodation facilities. Its staff demonstrate a strong commitment to providing affordable and high quality housing along with quality support services to vulnerable clients. They do this with the intention of affording tenants secure, longterm and sustainable tenancies through which to build independence, and improved health and well-being. Innovation involves risk, trial and error, and to that extent we should expect that CGT could sustain improvements to assist in more fully addressing the needs of current and future clients in Tasmania. Our recommendations are that: 1. Housing Tasmania should strengthen its oversight of CGT and tighten performance management to ensure CGT delivers service outcomes as identified in the Funding Agreement. 2. Housing Tasmania should review its arrangements for oversight of contractors to ensure the contractor’s arrangements with third party providers will deliver service outcomes as identified in the Funding Agreement. 3. To strengthen targeting of the homeless population: 3.1 Housing Tasmania should consider changing its funding arrangements with CGT from block funding to activity based funding. The Funding Agreement should specify levels of support need for allocations. 6 See Discussion in Section 6.3 (p.102-5). 10 3.2 CGT should ensure robust, timely and transparent allocations of STs by improving allocation timeframes, eligibility criteria and allocations tools. Need assessments should be consistent with Housing Connect’s assessment process and with evidence-based industry practice for Housing First models of service provision. They should include identifying level of support need. Referring services should be provided with more detailed information on the reasons why a referral is rejected and what would be required for the client to be allocated a tenancy. 4. CGT should strengthen its collaboration and communication with the housing and homelessness sector and develop strategies for achieving this. Housing Tasmania should make evidence of service integration between CGT and the housing and homelessness sector a Key Performance Indicator. 5. To improve provision of support to tenants we recommend that: 5.1. CGT provide support arrangements that align with the Funding Agreement and the principles of tenant support that underpin the Housing First model in relation to continuity of support to exiting tenants with on-going support needs. They should identify strategies for transitioning STs who currently have, or desire family, including spouse and/or children, into stable and appropriate family housing facilities without the loss of support. 5.2. CGT provide support arrangements that align with the Funding Agreement and the principles of tenant support that underpin the Housing First model in relation to service provision by personnel with experience, expertise and knowledge of, as well as strong networks with, the homelessness service sector. 5.3. CGT ensure service specifications, including KPIs and funding arrangements, between CGT and third party support providers, are in place prior to service delivery. 5.4. CGT strengthen communication mechanisms between their support staff and STs with reference to key service goals. CGT should engage in meaningful and timely consultation and communication with STs about any proposed changes to tenant support arrangements to ensure they understand any new arrangements. 5.5. Housing Tasmania should ensure the Funding Agreement with CGT makes provisions for changes to the service model or service arrangements. 11 5.6. Housing Tasmania and CGT review the CGT service objectives to more accurately reflect the goals and priorities of STs as identified in their case management plans. This will enable the process of reporting against objectives to be meaningful and have potential to improve practice. The updated service objectives should be reflected in the Funding Agreement. 6. CGT should address the low occupancy rates amongst AHTs including reviewing its rent setting model because of the potential impact on the financial viability of the SAF facilities. 7. CGT should provide STs with clear, accurate information about the permanent status of their tenancy. This will require clarification about whether the objective of CGT is to provide permanent housing for STs or if supporting STs towards independent living includes an expectation they will transition out of the facility into independent rental/home ownership. The Funding Agreement should clarify the permanent status of the tenancies. 8. To improve monitoring and evaluation of service delivery we recommend that: 8.1. Housing Tasmania strengthen regular service monitoring of CGT. This may include the introduction of six-monthly reviews of CGT over the next 18 months to ensure operations align with Funding Agreement objectives and the needs of homeless people in the state are being addressed in a timely and optimal way. 8.2. Monitoring should include reviewing the program logic and service outcomes for their alignment with the objectives of the Housing First model of service delivery. 8.3. Housing Tasmania should tighten monitoring of CGT performance standards. Current reporting requirements are not sufficiently comprehensive, and there are gaps in KPIs as well as a lack of integration between datasets. We recommend that the current output performance specifications for CGT are updated, and that improvements are made to the internal consistency between purpose of funding, strategic objectives and consumer outcomes. Indicators and targets should be commensurate with the main purpose of the service. 8.4. To improve performance standards monitoring, Housing Tasmania should require CGT to improve data capture. It should introduce into its Funding Agreement a benchmark for maximum percentage levels for ‘’other/unknown entries’ in key indicators. Where benchmarks are exceeded, Housing Tasmania should require CGT to provide an explanation for this. Housing Tasmania should ask the Australian Institute of Health and Welfare to improve performance standards monitoring under the Specialist Homelessness Services data collection so that data 12 collected informs evaluation and reporting of service delivery outputs and outcomes more effectively than is presently the case. This should include reducing the use of ‘unknown’/’other’ response categories in service reports. 13 1 Overview of Common Ground Tasmania This Chapter provides background information on two of the Southern region’s supported accommodation services for homeless individuals in Tasmania, CGT. It provides an overview of the research evidence on special issues facing homelessness services and implications for service provision, a summary of the policy context including recent homelessness policy reforms, and an account of the introduction of Common Ground services into Australia and their program logic. 1.1 Introduction This evaluation of the CGT Supported Accommodation Facilities in southern Tasmania is the final output of the Housing and Community Research Unit’s (HACRU) Evaluation of New Homelessness Support Services in Tasmania. The Supported Accommodation Facilities evaluated in this report include the facilities and services delivered by CGT at Barrack Street and Campbell Street in Hobart. The services at these locations form one initiative amongst a suite of services developed by Housing Tasmania in accord with the requirements of the National Partnership Agreement on Homelessness (NPAH) to provide an integrated response to the needs of Tasmania’s homeless population. The NPAH was signed in 2008 and ended on 30 June 2013. A transitional NPAH is currently effective from 1 July 2013 to 30 June 20147, after which the future of the NPAH remains uncertain. 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 (NAHA) objective of supporting people who are homeless or at risk of homelessness to achieve sustainable housing and social inclusion. These initiatives emphasise: the timeliness of service interventions; increasing social integration of people at risk of homelessness; and moving people out of the crisis services system into stable forms of tenure. This approach is translated into the Tasmanian context through the Tasmanian Homelessness Implementation Plan (DHHS, 2009; 2012a; See also DHHS 2010, 2012b). According to the Tasmanian Homelessness Implementation Plan the initiatives of the NPAH are designed 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 over the 7 See http://www.dss.gov.au/our-responsibilities/housing-support/programs-services/homelessness/thetransitional-national-partnership-agreement-on-homelessness 14 2008-9 to 2012-13 period, 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), additional funding to reform aspects of Mental Health Services (approx. $47 million) and Drug and Alcohol Service (approx. $17.1 million) reforms focused on improving integration between specialist services, allied health and human service providers, and private and community based service organisations (DHHS 2009). 1.2 Special Issues Facing Homelessness Services There are a number of challenges associated with delivering services to people who are homeless or at risk of homelessness. One of the greatest of these challenges is service engagement. The characteristics of the homeless population are 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 often enter for reasons other than those involving tenure, are usually referred via a crisis or police service or invited in via the efforts of charitable organisations. Other people experiencing homelessness move through a social network of friends, relatives and associates and rarely present to homelessness 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 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 for clients and governments is another issue that faces the delivery of homelessness services (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 15 learned from current and prior attempts to address homelessness and translating these lessons into services better able to meet the needs of clients. Research provides strong correlations between homelessness and major contributing factors, including effective strategies for interventions by service providers. Evidence shows that there are strong correlations between homelessness, or unstable housing, or demanding behaviours leading to unstable housing, and a range of diagnosed conditions including mental illness, drug and alcohol disorders, intellectual disability, behavioural disorders, and in some cases, chronic health disorders. The literature indicates that between 30 and 85 per cent of homeless people have experienced or are experiencing some type of mental illness, and that this rate is highest amongst young people (AHURI 2013; Bisset et al 1999; Homelessness Australia 2011). Research also strongly attests to the need for early interventions in the form of secure housing (AHURI 2013) and pro-active support (Atkinson et. al 2007; Bisset et al. 1999; Seelig & Jones 2004) in the management of client conditions as an important aspect of the road toward recovery. Research also highlights the cost-effectiveness of providing permanent supportive housing to homeless people with a mental illness, strengthening the claim that stabilization of housing for people with mental health conditions reduces the overall cost to the system (McLaughlin 2010). Evidence also points to a number of other important factors service providers must consider in relation to the provision of housing for people with unstable housing histories. Community attachments (for example, feeling welcome and connected) are an important function of security of housing tenure, in particular for those recovering from a mental illness (AHURI 2013). Effective services should attempt to connect and refer clients to mainstream services whenever possible, with separate provision of housing and support services to minimise the perception by vulnerable tenants that support is part of ‘the system’ (Tsemberis and Amussen 1999). It is also critical for service providers to have in-depth knowledge and understanding of the factors that render tenants vulnerable to housing insecurity (Seeling and Jones 2004) and for strong co-operation and coordination across services within the housing and homelessness sector (Geller and kowalchuk 2000; O’Malley and Croucher 2005). The evaluation discussion in Chapter 6 of this report is informed by these and other special issues that form the evidence base for the delivery of effective homelessness services in Tasmania. 1.3 Recent Homelessness Policy Reforms 16 The Australian Government White Paper on homelessness, The Road Home (Australian Government 2008) articulates three broad strategies for achieving a reduction or elimination of homelessness in Australia: Turning off the tap: prevention and early intervention to stop people from becoming homeless and to lessen the impact of homelessness. Improving and expanding services: improving and expanding the service response to homelessness to achieve sustainable housing, improve economic and social participation, and end homelessness. Breaking the cycle: getting people back on their feet and moving them through the crisis system to stable housing and, where possible, employment, with the support they need so homelessness does not re occur. The NPAH states that jurisdictions should aim to develop implementation plans that encode these strategies. The NPAH focuses on reducing homelessness by targeting key groups: rough sleepers, people experiencing homelessness more than once, people escaping violence (especially women and children), children and young people including those subject to or exiting care and protection, Indigenous people and people exiting social housing or institutional care such as health, mental health and juvenile justice institutions, or adult prisons. ‘Rough sleepers’ refers to the ‘primary’ homeless, and are also known as the ‘chronically’ or ‘absolute’ homeless. These are defined as people without conventional accommodation, who live on the streets or in other public places such as parks, squatting in buildings or using vehicles, for temporary shelter (NPAH 2008). The NPAH points to three key strategies for action by jurisdictions to effectively address homelessness: 1. More effort to prevent and intervene early to stop people becoming homeless and to lessen the impact of homelessness. Effective prevention and early intervention strategies need to address both individual and structural causes of homelessness. 2. Investments in services that can help people get back on their feet, find stable accommodation and, wherever possible, obtain employment. More effort is required to target people who are: unaccompanied children, regular rough sleepers, repeatedly homeless, living at high risk of homelessness, struggling with the impact of cycles of homelessness or disempowered due to mental illness. Causes of homelessness such as escaping violence and special needs must be responded to with better access to sustainable housing and significant follow up support. 17 3. Building a better-connected service system, including improved links between homelessness services, and between homelessness services and mainstream services to improve outcomes for individuals, reduce duplicate processing across agencies, and enable faster transition from temporary accommodation to stable housing. Improved integration of homelessness services, employment and training providers and Centrelink aims to lift economic and social participation outcomes for people who are homeless. The Tasmanian Homelessness Implementation Plan (2009-2013) initiatives, including the development of dedicated homelessness facilities, address the National Partnership outputs, identified through a number of outputs designed to address the above goals: a) Implementation of the A Place to Call Home initiative, b) Street to home initiatives for chronic homeless people, or rough sleepers. c) Support for private and public tenants to help sustain their tenancies through strategies including tenancy support, advocacy, case management, financial counselling and referral services, and d) Assistance for people leaving child protection services, correctional and health facilities, to access and maintain stable, affordable housing8. The Tasmanian Homelessness Implementation Plan established a benchmark figure of 385 for primary homelessness in the state and established a target of halving this number to 193 by 2010. Priorities included expanding the range of homelessness services including targeted specialist support to assist the most long-term and at risk homeless people to transition into long-term housing, building an integrated service system linking support services to ensure sustained tenancies and seamless pathways through housing options, and increasing sector capacity to support integrated service delivery through workforce strategies, systems and infrastructure. Five dedicated homelessness facilities have been established and delivered under the SAF programs chosen by Housing Tasmania to meet the NPAH core outputs9, three in the North and two in the South. Among other programs commissioned by Housing Tasmania to meet the objectives of the NAHA, the SAFs may be classified as ‘Housing First’ services and although variances in the current SAF models are evident, it is not unreasonable to read their main objectives and strategies as specified in the NPAH as Housing First in orientation. Key 8 The statement of the key strategies and core outputs appears in Part 2 of the NPAH. (a), (b) and (d). 9 18 characteristics of this approach to addressing homelessness include (Johnsen and Teixeira 2010): Targeting of the most vulnerable consumers10 Rapid access to permanent, independent housing (usually in scatter-site housing) No requirement regarding ‘housing readiness’ or conditions to housing Consumer choice Separation of housing and support services11 Recovery as an on-going process through provision of integrated and comprehensive community based support (generally located off-site, on-call) Community integration, with no more than 15 per cent of housing units in any single building used to accommodate clients. These features contrast with a ‘Continuum-of-Care’ model of homelessness service provision which instead offers a range of services organised to elevate clients out of their initially poor situation by progressively applying treatments designed to address specific pathologies. In return for participating in social, behavioural and health service programs, clients move progressively through emergency, temporary and permanent housing in a linear or step-bystep approach. Johnson et al. (2012) identify key differences between the two approaches to addressing homelessness. First, the Housing First model does not encode a program logic whereby access to accommodation is conditional on the client’s compliance with a regime of treatments and continued ‘good behaviour’ such as maintaining sobriety or recording no instances of violent behaviour. Housing First models are holistic in approach and Housing First services accept that a client may not follow a linear path to independence and stability. Second, the Housing First model provides support and accommodation services separately. This service principle is based on the argument that clients are better supported if the same service follows a client throughout their accommodation career whether or not that career consists of one or many tenancies (Johnson et al. 2012: 5-7). A simplified sequential representation of the SAF program logic is depicted in Figure 1-1: Specialist Homelessness Services Program Logic below. 10 Here, ‘vulnerable’ refers to those who find coping with or succeeding in traditional services or services interventions problematic. This group refers to the most chronic homeless individuals who are often unable to abide by the demands of housing readiness (for example, sobriety, basic livings skills, personal hygiene, willingness to engage in treatment) that are expected by many supportive housing models (Pearson et. al 2009 in Johnsen & Teixeira 2010). 11 Support services in a Housing First model are referred to as multidisciplinary Assertive Community Treatment (ACT) teams including a team of support workers who are located off-site, but on call 7-days a week and provide services in the client’s home or neighborhood (Johnsen & Teixeira 2010). 19 Figure 1-1: Specialist Homelessness Services Program Logic 1.4 Common Ground History and Program Logic Common Ground is a non-profit social service organisation whose supported accommodation model of homelessness services has been adapted in many countries. Common Ground was first established in 1990 in New York City by Rosanne Haggerty whose goal was to provide high quality, affordable, and permanent housing to low-income earners and the chronically homeless. Particular to the Common Ground approach is the 'Street to Home' initiative targeting the chronic homeless population, and the use of the Vulnerability Index (VI) survey as a tool to identify the most vulnerable and at-risk homeless individuals for housing. 12 Housing is targeted at the most vulnerable homeless individuals, particularly those who have established life on the streets, as opposed to seeking shelter and other support or assistance, and those who are most vulnerable due to debilitating medical and mental health conditions (Common Ground 2014). The program provides rough sleepers with direct access to stable and secure housing, through which clients are then connected with appropriate community services to prevent continuation of the cycle of rough sleeping (SA Gov 2011). 12 The VI survey, explained more fully in section 3.2 (Service Provision Processes), is a tool developed by Common Ground NY, to identify the medical vulnerability of individuals sleeping rough. Data is gathered through self-reports of health status and utilization. The first independent study (Cronley et. al, 2013) on the effectiveness of the VI indicates that official hospital records correlate with self-reporting for hospital use. It is not predictor of self-reporting for physical health conditions, mental health problems and substance use. 20 The Common Ground model aligns with a number of the defining characteristics of the Housing First model. The accommodation is not intended to be transitional in the sense of crisis or emergency accommodation, but rather is intended to provide rapid-access long-term accommodation in a ‘normalising’ approach to housing (Parsell et al. 2013: 3). This approach includes encouraging tenants to move on from their Common Ground tenancy (Reynolds & Fearn 2012). It emphasises ‘supportive’ rather than ‘supported’ or managed housing. This is a two-fold shift in focus. First, rather than managing a person’s homelessness through provision of short-term, crisis housing, the model seeks to solve homelessness through the provision of housing in conjunction with access to appropriate support services. Second, the housing facilities provided by the service are treated as any other type of housing in which tenants have their own apartments and are expected to hold and manage their own property leases (ACGA 2013). Housing First and Common Ground services also share a principle of separate provision of tenancy and facility management services and social and health support services. There is also an expectation that the tenant’s engagement with support services is for the most part voluntary and not a condition of their tenure. The Common Ground model differs from the Housing First model in two ways. First, the Common Ground model utilises the construction of congregate (or big building) settings through which to house and support tenants rather than scatter site, or mainstream housing, settings. Support for tenants in the Common Ground model is thus located onsite, within the building complex, rather than through visits by support staff. Second, Housing First models generally limit Housing First clients in any one building to 15-20 per cent (Johnsen and Teixeira 2010; Parsell et. al 2013) 13 whereas the Common Ground model operates on a social mix of approximately 50 per cent supported (previously homeless) tenants, and 50 per cent low-income tenants. The Australian Common Ground Alliance (ACGA) was formed in 2008, and provides a mechanism for the growing number of fledgling Common Ground organisations to network for support and the transfer of knowledge. As a relatively new model in Australia, Common Ground projects promised to deliver innovative supportive housing solutions to the most 13 This limit is used in determining the residential mix of the Northern Tasmania SAFs, where similar to other Housing First models, the (20 per cent) limit is based on a target client group with medium to high support needs. 21 Box 1: Common Ground Facilities in Australia South Australia There are four Common Ground facilities in South Australia, including two residential buildings in Adelaide city. Franklin Street opened in February 2008 with 37 units and Light Square opened in early 2011 with 52 units. Both facilities are managed by Common Ground Adelaide Limited, and overseen by a board of directors. The service offers a range of education and training programs, specialised health services, dietician, dental care and health, art and fitness programs for tenants. There are two housing sites in Port Augusta, comprising 35 newly renovated units at Boston Street and Augusta Terrace. These opened in early 2013 and are designed to address the needs of local homeless Aboriginal people. Wesley Country Housing provides housing management services and the Salvation Army provides tenant support services. New South Wales A 104-room residential building in Camperdown, Sydney, opened in November 2011. Housing NSW manages the project, MA Housing is the community housing provider, and the Inner city Homelessness Coalition (the Haymarket Foundation, Salvation Army, Wesley Mission, Vincent de Paul and lead agency Mission Australia) provide support services. A large ancillary network of support services provides (mostly) on-site services and activities to tenants and local neighbourhood residents, including psychology, GP, chiropractor, podiatry, substance abuse support, Centrelink services, Yoga & mediation classes, breakfast club, a food bank scheme, art classes and veterinary clinic visits. Queensland A 146 apartment-complex in Hope Street, South Brisbane, opened in August 2012 and was fully tenanted by November 2012. Common Ground Queensland provides housing management services, and Micah Projects is the support service provider. The Queensland Department of Communities provides on-going funding for support and 24hour concierge services. Micah Projects has developed a partnership between Mater health services, St Vincent’s health care, Greater Metro South Brisbane Medicare, Metro North Medicare Local and Homeless to Home (H2H) Healthcare to provide integrated support to tenants. ACT Plans for a facility in Canberra are currently underway, overseen by the Common Ground Canberra Board. Victoria Elizabeth Street Common Ground (ESCG) opened in Melbourne in August 2010, with 131 self-contained studio apartments. Community Housing is the property manager and HomeGround provides support and 24/7 concierge services. Staff are supported by the Allied Health and Ancillary Services program involving a range of partners who deliver on and off-site therapeutic, health, recreational, vocational and educational services to tenants. ESCG has also developed partnerships with a number of employment and education centres providing a range of on-site classes for tenant learning and skills development. 22 Tasmania Two purpose-built facilities opened in Hobart in December 2012 and are managed by CGT. Barrack Street CGT provides 25 studio apartments and 22 one-bedroom apartments, including a number of wheelchair access and universal access apartments. Campbell Street CGT provides 28 studio apartments and 22 one-bedroom apartments. Rock Property provides housing management services, and CGT provides support and the majority of security/concierge services (ACGA 2013). Facilities also include common room areas (indoor and outdoor), special purpose rooms such as art, computer, laundry, or training rooms. The Barrack Street CGT facility opened to tenants in June 2012, and the Campbell Street facility opened in December 2012. vulnerable chronically homeless people, with their mission to ‘end and prevent chronic homelessness in Australia’ (ACGA 2013). In an Australian housing sector frustrated with existing homelessness services, Common Ground promised a permanent end to homelessness through socially mixed communities and in collaboration with government, business and philanthropic sectors (Parsell et. al 2013). This development has led to the rapid growth of Common Ground organisations in Australia. Since 2008, nine Common Ground buildings have been constructed in five Australian capital cities, with one building in planning stage in Canberra. Nationwide this equates to over 600 supportive housing apartments currently offering accommodation to a mix of formerly homeless and low-income tenants. While following the Common Ground model of supportive housing, the corporate structures and management styles differ from site to site. For example, while Common Ground Adelaide Ltd and CGT are registered companies with a board of directors directly funded by the government, the New South Wales and Queensland facilities operate through separately funded services such as Mission Australia and the Salvation Army, who have adopted the supportive housing model alongside their other service programs. Similar to its New York parent model, the Common Ground organisations in Australia target primary homeless and low-affordability tenants. Key criteria for all Australian Common Ground facilities include (ACGA, 2013): High quality, permanent, affordable housing manifest in apartment buildings with selfcontained facilities, communal facilities, separate clinical facilities and staff offices for support services (visiting and onsite), tenancy services and security staff. The separation of support services from tenancy services, who together co-ordinate approaches for addressing tenant issues towards fostering sustainable housing tenure. 23 A safe, secure environment, including a 24-hour concierge service and other measures such as key-card access and double-door airlock entry. A social mix of former chronically homeless people and AHTs, generally in a 50:50 ratio. Pro-active on-site support services focussed on supporting tenants to sustain their tenancies and connecting them to the local community. Engagement with support services is voluntary and not a condition of tenancy. There are some differences in the implementation of Common Ground sites across Australia. The Victorian, New South Wales and Queensland organisations were developed by directors and managers within the housing and homelessness services sectors who advocated for the introduction of the model, in part by forming a national alliance through which to co-opt key political advocates and promote the model across Australia. In South Australia and Tasmania, the initiative was developed by their then Premiers who consulted directly with Rosanne Haggerty, the founder of Common Ground, and drew on a range of supporters including the national alliance (ACGA) to establish Common Ground services in their respective states (Parsell et. al 2013). Two factors assisted in the success of establishing the models in Australia with such rapidity. First, the ACGA was successful in promoting Common Ground through both the private and public sectors, enabling the state Common Ground organisations to distance themselves from the traditional state-based welfare model and garner the support of corporate, philanthropic and government sectors in the birth of each organisation. Second, the economic and political climate in Australia, including changes in state governments and the election of Kevin Rudd as Prime Minister, raised homelessness issues to public consciousness as a national policy issue. This resulted in national policy objectives to align growth in social housing stock as a core strategy to reduce chronic homelessness. This was facilitated by the economic stimulus measures, which included capital investment in public works introduced by the then Labor government in response to the global financial crisis (Parsell et. al 2013). In Tasmania, this was critical for the commitment of $17.5 million through the National Building Economic Stimulus Plan for the construction of Common Ground facilities in Campbell Street, Hobart. 24 2. Data Collection Method and Analysis This chapter describes the data collection method and analysis, which is based on numeric service activity data and qualitative interviews with service providers and residents. 2.1 Description of Service Activity Data The service activity data analysis is based on data provided by the responsible agencies, CGT and Anglicare (until August 2013), to the Australian Institute of Health and Welfare (AIHW) under the Specialist Homelessness Services (SHS) data collection. The main data elements in this collection include a descriptive statistical summary of various service outputs derived from the SAAP data collection. This entails: the number of clients assisted; the number of closed and on-going support periods; the average duration of support periods measured in days; and the number of support periods involving the provision of accommodation. Demographic data are also reported in the SHS collection including: the age and sex of clients; Indigenous status; mental health status; income source; the length of time since the client last had permanent accommodation; clients’ presenting region and referral pathway; clients’ reason for seeking assistance; and the number of times clients had experienced homelessness. In addition to the SHS collection the information described in Chapter 4 draws on CGT’s report submissions to Housing Tasmania, data reporting in support of AHURI research on supportive housing in Australia in May 2013, and summary analysis of a survey conducted by UTas School of Medicine on behalf of CGT during 2012 – 13. 2.2 Service Provider Consultation The HACRU team consulted with personnel involved in the provision of support services to CGT, including staff from CGT and Anglicare. Stakeholders in the homelessness sector who have an interest in CGT services (for example, allocations) or who work intensively with prospective tenants of CGT were also consulted. Interviews were conducted with 13 service providers between 19 November, 2013 and 15 January 2014. The interviews varied in length, in a range of 45 minutes to 2 hours. The interviews were conducted in the offices of the key agencies consulted. The interviews were audio-recorded with participants’ informed consent, and later transcribed. The data were then subject to content and thematic analysis. A generic interview schedule was developed (see APPENDIX B) but customised for particular services and respondents. 25 Service providers were asked to discuss: What their professional role entails, The strengths and weaknesses of the Common Ground (supportive accommodation) model, Factors that facilitate or hinder service delivery, Factors that facilitate or hinder collaboration between service providers, and the broader homelessness sector, Perceptions of tenant satisfaction with the support and accommodation offered, The effectiveness of the support and accommodation on resident health and wellbeing, and other CGT outcomes objectives, and How the service might be improved. Changes to personnel and arrangements for service provision at CGT meant that the number of service providers available for interviews was limited, and in some cases personnel had limited information about the service as they were so new. For example, only two support staff were available for interview as the other four support staff were too recently employed to provide meaningful data. The evolving nature of service provision also meant that staff were sometimes unable to describe the processes the service would be employing in the future, for example, what case management tools would be used, or the data reporting obligations, or provide the detail of what their role would entail. 2.3 Consultation with Supported Accommodation Facilities Residents The research team interviewed supported tenants from both Common Ground facilities. CGT staff facilitated this process by talking to residents about the evaluation and distributing information sheets. Staff subsequently invited at least five residents from each facility to participate in the evaluation. Eligibility was based on purposive sampling including length of tenure greater than 2 months, inclusion of both males and females, and variances in level of support need. CGT staff provided the team with a list of tenants and scheduled times for interviews, and also provided the interviewer and interviewee with a quiet interview room at the CGT site within which to conduct the interview. Residents were provided with $30 cash on completion of their interview in recognition of the costs associated with their contribution. Based on the above eligibility, tenants were selected for interviews on a first come basis. This may have created a bias towards tenants who were more likely to be engaged and satisfied with the facility and associated support services, rather than others experiencing difficulties and who were less satisfied. 26 Eleven interviews were conducted with residents; five from Barrack Street and six from Campbell Street. The interviews were conducted between 25 November and 3 December 2013. Purposive sampling ensured coverage of age (25 to 50 years) gender (7 females, 5 males) and a range of support needs (low, medium, high). The face-to-face interviews varied in length, ranging between 30 minutes to one hour. Prior to the interview, the interviewer confirmed that the participant understood why they were being invited to participate in the evaluation and obtained their written consent. The interviews were audio-recorded with participants’ informed consent and later transcribed. The data were then subject to content and thematic analysis. The resident interview schedule is provided in Error! Reference source not found.. Clients were asked to discuss: The process of applying for a CGT apartment, The things they liked/disliked about living at the facility, Any concerns they had about their tenancy, The types of support they received at the facility, Satisfaction with the support available to them at the facility, Significant changes in their life since moving into the facility, How the support and accommodation might be improved to better suit their needs, How long they anticipated staying in their unit. 27 3 Service Implementation and Operation This Chapter describes the establishment of Common Ground in Tasmania, the implementation of the service and its operational features. Drawing data from public documents, literature reviews and interviews with stakeholders, this chapter sets out the context in which CGT has established its services, the particular service model applied by CGT including the evolution of service arrangements since implementation, and service provision processes including tenant eligibility criteria, allocations procedures and service personnel roles. 14 3.1 Service Establishment CGT was established in 2008 as a not-for-profit social housing service. CGT is a corporate entity represented by a board of eight directors, overseeing the management of the two accommodation facilities and activities undertaken within the properties including tenancy management, security/concierge services and support services to tenants. CGT was initiated through the interest of the then Labor Premier of Tasmania, Paul Lennon, who assisted in the establishment of the first board of directors to oversee the inception and implementation of CGT. Similar to other Common Ground organisations, the establishment of the service was also made possible because of collaboration between State, Federal, and Local governments, and the private (business) and philanthropic sectors. For example, State and Federal funds were used for all CGT building capital expenditure, a range of donors contributed to building cash reserves ($474, 969) during 2011-12 to assist in meeting costs associated with full operation and the State government assisted in meeting the costs of the first year of operation. Funding for the design and construction of the buildings was provided through the Australian Government. The Barrack Street facility was jointly funded through A Place to Call Home initiative, Commonwealth Funding and the NPAH 2009, at a cost of $9.4 million. The Campbell Street facility was funded under the National Building Economic Stimulus Plan at a cost of $17.5 million. Implementation funding15 by DHHS included one-off operational costs and support for 2011-12 ($250, 000) and Vacancy Compensation Funding for 12 months post commencement ($200,000). The DHHS also provides on-going operational block funding16 of 14 This evaluation was completed at a time when the delivery of concierge and support services were changing from externally contracted, to direct service provision. It therefore can provide no comment on how these new arrangements are affecting service and tenant outcomes. 15 Outlined in the ‘Funding Agreement’ commenced 1 June 2012 – 30 June 2015. 16 Block funding refers to one-off payments, rather than activity-based funding which is the provision of funding based on effective completion of contracted activities as outlined in the Funding agreement. Activity-based funding is the most common funding model applied to housing service providers in Tasmania. 28 $500,000 (plus indexation) per annum to CGT for provision of support services to supported tenants at both Barrack Street and Campbell Street facilities. CGT also raises revenue through tenancy rental income and income from car-park leases. A number of initiatives within the homelessness services sector coincided with the implementation of CGT. Under the Tasmanian Homelessness Implementation Plan a survey of Tasmania’s homelessness population was undertaken in November 2011 as a joint initiative by CGT and the Salvation Army. The 50Lives/50Homes street survey aimed to identify how many homeless people were living rough on Hobart streets in order to establish the benchmark for the NPAH commitment to halve homelessness and to identify potential tenants for the CGT facilities. Level of need was established through the administration of the Vulnerability Index. To manage the survey and the response to its findings, the Homelessness Reference Group (HRG) was formed, comprised of specialist accommodation workers from a range of organisations. Its role included establishing eligibility and priority for the 50 new CGT facilities for rough sleepers that would become available when the facilities opened in 2012 (Donoghue & Smalley 2012). Of the 149 rough sleepers surveyed, 106 (71%) were identified as vulnerable and suitable for permanent housing (CGT 2013). Common Ground Tasmania Program Logic The primary purpose of funding, as outlined in the CGT Funding Agreement, is to provide high quality, long-term and affordable housing to individuals chronically or primary homeless immediately prior to accessing to the service, including access to specialist support services, tenancy and security services. The CGT Residential Management Agreements defines chronic, or primary homelessness according to the 2006 Australian Bureau of Statistics definition of absolute or primary homeless as being: “people without conventional accommodation (living on the streets, in deserted buildings, improvised dwellings, in parks etc.)”. Like other Common Ground organisations in Australia, CGT is a relatively new model for meeting the accommodation needs of the chronically homeless. Distinctive features include: An integrated package of tenancy, support and /concierge security services in a socially mixed, long-term housing environment. An emphasis on independent living and empowerment for clients to make choices and to engage with the community. This is captured in the term ‘supportive’ rather than ‘supported’ accommodation. 29 An emphasis on the health needs of vulnerable clients, with the Vulnerability Index a critical tool in identifying vulnerability risk factors. The three core strategic goals of CGT are to ensure operational excellence; achieve financial sustainability, and to prepare the organisation for future growth (CGT 2011-12). Its constitution sets out the principles and objectives of the company which follow the broad principles of the ACGA criteria for a supportive housing model, including high quality permanent and affordable housing, a safe, secure environment, coordinated on-site support services and a diverse social mix. Objectives include: the provision of social rental housing for the previously homeless and low income seeking affordable housing the provision of support into the housing model to enable formerly homeless tenants to sustain independent tenancies supporting tenants to move into independent rental/home ownership where appropriate. promoting client independence within each person’s capacity and choice a self-sufficient life assisting people out of the homelessness cycle into independence provision of accommodation, services and facilities that promote dignity, purpose and wellbeing. Occupancy targets established under Housing Tasmania’s Residential Management Agreement (RMA) with CGT establish two target client categories. Category one is drawn from the recently or chronically homeless population (immediately prior to accommodation, as specified in the Funding Agreement), and these clients are eligible for a Commonwealth Health Care Card. Occupancy levels for category one tenants are a minimum of 40 per cent to a maximum of 50 per cent. Category two is drawn from the population of individuals who could not access ‘affordable’ residential housing and is established at a minimum of 50 per cent and maximum of 60 per cent of CGT property rentals17. These tenants are low-income wage earners whose eligibility is based on the National Rental Affordability Scheme (NRAS) income limits.18 Tenants from both categories must be: An Australian citizen or lawful permanent resident A Tasmanian resident 18 years or older 17 CGT percentages vary slightly from ACGA principles, which state the supported tenant/affordable housing tenant ratio is generally 50/50. 18 The 2013-14 household income eligibility limits are $45,956 for one adult and $63, 535 for a couple (DSS 2013) 30 Not have financial assets exceeding the specified limit as per Housing Tasmania’s Housing Assessment policy ($35,000 per household) Not owners of their own home. This evaluation considers CGT as a whole service, but focuses specifically on the first category of tenants who are eligible due to having recently been absolutely or primary homeless. These are the STs and it is for this group that CGT receives on-going funding from the DHHS ($500,000 per annum) to improve independent living skills and sustain tenancies and whose objectives and outcomes are identified in the Funding Agreement between CGT and the Department of Health and Human Services (DHHS). The following section draws on analysis of the service, and other literature, as well as interviews with service providers, to provide an outline of the implementation of the CGT service. It describes eligibility and allocation procedures for the ST population, service implementation and operationalization and changes that have been made over time. 3.2 Program Implementation and Service Operations Service Arrangements At service implementation the support, tenancy and facility management, and security and concierge services, were contracted by CGT to three distinct services: Anglicare, Community Housing Limited (CHL), and DCM Security Services respectively. This separation of service provision was designed to decouple the three tasks of providing accommodation, support services, and security services in order to maximise tenant capacity to maintain independent living arrangements. External contracting arrangements were developed as follows: Community Housing Limited undertook the inaugural contract of Property Management for CGT, and were shortly replaced by Rock Property on an interim basis. Rock Property were successful in a tender to CGT in November 2013 to continue contracting property management services to CGT until 2016. CGT property management is currently undertaken by one property manager who works at each (Barrack and Campbell street) site one day per week. The property management role includes allocating properties to AHTs, attending management meetings to discuss (new, ongoing, exiting) tenancy issues, providing support to new and on-going tenants regarding property/tenancy rights, responsibilities, problems or issues, and managing all tenant property leases. 31 Anglicare won the contract to provide support services to CGT with negotiations commencing in February 2012 and service provision commencing in June 2012. At the peak of their service provision, Anglicare provided one manager plus four staff as support to CGT STs. Support staff were introduced over time as required in accord with the filling of vacancies at each site, at a ratio of 1:10 (one support staff per 10 STs). Anglicare exited CGT as support providers on 30 September 2013. DCM Security Services were contracted by CGT to provide night-time security and day-time concierge services to the two CGT facilities. Five staff were employed at each site to undertake 24-hour security, including managing the front desk (concierge), CCTV system and building security. Changes to the contracting arrangements with DCM during November 2013 mean that DCM security will reduce their services to CGT over a three-month period, continuing in 2014 with one security officer employed per site during a night shift. For CGT management staff, there were two initial service implementation priorities: implementing the activities of the three contracted services (tenancy, support and security) in a collaborative working relationship toward the common goal of providing supportive housing to tenants; and filling residential vacancies with new tenants. The latter was staged, with two STs moving in within the first two weeks of opening, progressing to four per month over the following months. CGT intentionally staged the process due to the need to intensively support new tenants over the first three months, and ensure the sustainability of both the support staff and existing tenants throughout periods of new tenancies. Service changes in relation to concierge and support services created delays in the occupancy process from October 2013 with the termination of service provision by Anglicare on 30 September 2013. CGT management made the decision to delay the allocation of new properties to STs until new support staff were in place and the service was once again fully operational. At end December 2013, 30 STs occupied units, and at end March 2014, 42 STs occupied CGT units. Reasons cited for the exit of Anglicare support services to CGT pivot around the absence of a Funding Agreement between the two organisations through which to specify Key Performance Indicators (KPIs) for the provision of support services. While the Agreement was drafted in multiple stages between the organisations, no final contract was agreed. This proved a barrier to continued collaboration between the two organisations. The absence of a Funding Agreement prevented the establishment of a workable service framework for support practices and client outcomes to which both parties could commit. As a consequence, a lack of clarity existed around agreed approaches to homelessness support, and procedures for the transfer of data and tenant information between CGT and Anglicare. In addition, there were concerns 32 within both parties about how each organisation approached tenant privacy and duty of care toward STs. These factors contributed towards breakdowns in staff communication and tensions over funding and security of staff tenure. For example, Anglicare felt that the funding arrangement was inequitable. Their experience is that contractors are provided with a sum of money to deliver services, with any unused funds returned to the funder. In CGT’s case, Anglicare paid their own staff for the delivery of services and were re-reimbursed from CGT by invoice. In some cases, Anglicare increased staff according to their support worker: tenant ratio. Disputes over invoices arose when ST numbers fluctuated (for example, lowered), creating insecurity of tenure for Anglicare staff and a degree of financial risk for the service. These disagreements eventually led to Anglicare withdrawing the provision of support services to CGT’s supported tenants effective on 30 September 2013. To address this, CGT moved to a model of direct service provision, as outlined below. CGT and DCM Security Services arrived at a mutual agreement in November 2013 to decrease the provision of services at the CGT premises to night-time security because of CGT’s management view that the concierge role is to a greater degree a hospitality, rather than security, role. Although DCM provides concierge and security services, their core business is security, not hospitality services. DCM security services agreed to stage their withdrawal of services with the exception of two security staff during the midnight to 8am shift at both sites. This would allow CGT to improve their concierge model. In the interim, CGT have directly employed concierge and night-time security staff with an emphasis on concierge and hospitality duties. The model introduced by CGT management following these changes is one of direct concierge and support service provision. CGT is employing a team-based approach to support, drawing upon expertise across a range of professional backgrounds and employment histories. For example support co-ordinators include a psychologist, social worker, occupational therapist and personnel with case management skills from different sectors, including the justice system. 33 Box 2: Key Common Ground Tasmania Personnel (as at Feb 2014) Management: The Managing Director was appointed in October 2009 followed by the Operations Manager in May 2012. Together they oversee operational activities at the facilities, including HR, finance, security and tenancy issues, and building operations. In making these appointments the CGT board sought to employ senior management staff with corporate and business acumen rather than sector experience because of its commitment to a model of service provision that emphasised normalisation of housing provision and sustainable business practices. The knowledge of the homelessness sector was understood as being provided through the contracted support services. Support service manager. This fractional appointment provides the co-ordination of support services to all CGT tenants, performance management and support of the support co-ordinators, and the development of health interventions for tenants. Five support co-ordinators (including fractional and full-time staff). Three senior support co-ordinators provide support services and intervention to tenants, mentor support co-ordinators and manage data reporting requirements. Two support coordinators provide on-going support to tenants, including the co-ordination of access to external supports for CGT tenants. As with the Anglicare arrangement, support staff recruitment is based on the staff to ST ratio of 1:10 (one support staff member per ten STs). Tenancy Manager (Rock Property). The allocation of all AHTs to CGT properties is undertaken by Rock Property. The Tenancy Manager fields queries from potential AHT’s directly, checks their eligibility based on NRAS income limits, and allocates properties if mutual suitability is determined by Rock Property and the potential AHT. From January 2014, concierge staff comprise two security officers employed directly by CGT at each site during the 8am-4pm and 4pm to midnight shifts. DCM Security Services continue to provide one security officer per site for the midnight – 8am shift. The concierge staff are employed as part of the support team, including front desk and on-site recreational activities. Concierge staff also undertake cleaning of all common areas. 34 Common Ground Tasmania Service Provision Processes: Eligibility, Allocation and Tenant Support Clients present to CGT by referral through a range of sources including Housing Connect, which is currently the ‘front door’ for all clients presenting for housing needs in Tasmania. Allocation targets are established by the Funding Agreement as stipulated in section 3.1. Box 3: Housing Connect The current Tasmanian Homelessness Implementation Plan (2009-2014) includes reforms aimed at establishing a more responsive, sustainable and integrated affordable housing system whose goal is to improve client outcomes through easier access, earlier identification and intervention and more targeted support and accommodation assistance. ‘Housing Connect’ commenced implementation in July 2013 and provides two core services. Type 1 is a housing and homelessness ‘front door’ that provides centralised access points for immediate, integrated assistance, assessment and intake of all client housing needs and services at a single location rather than through multiple services. For homeless clients this incorporates streamlined early intervention brokerage, prioritised for those experiencing primary homelessness or violence or with complex needs. The aim is to provide a collaborative, integrated and partnership approach to homelessness between service providers including team meetings, case planning, referrals and policy development. Type 2 services provide specialist support for clients based on a three-tiered (low intensity, high intensity and variable intensity/long duration) system of needs identification and service provision (Housing Connect 2013). For example, Housing Connect policy includes client profiling and matching to suitable accommodation, providing the client with a plan that includes priority ratings (based on urgency, duration and severity of need) and identification of homelessness risk. Each client referral is allocated a specific timeframe by which service providers will need to respond (Housing Connect 2013). Although CGT have the final decision on who will be offered a vacancy, initial referral assessments and recommendations are undertaken by other service providers from within the housing and homelessness sector. The Vulnerability Index survey is completed by referring service providers upon request by CGT. The assessment procedures were developed in consultation with Anglicare who, until March 2013, were also involved in assessment 35 recommendations with CGT. This changed with CGT’s employment of a consultant psychologist to undertake intake assessments in collaboration with CGT, including researching client history and making allocation recommendations to CGT. This role was brought directly into the service from May 2013 with the consultant’s employment as the Practice Manager (now titled Support Services Manager) with responsibility for allocation assessments. With the implementation of Housing Connect in October 2013, allocations decisions are now made in meetings convened on a needs basis, comprising the CGT Support Services Manager, Operations Manager, Managing Director and Housing Connect Manager (Colony 47). Figure provides a summary of the CGT allocations process. When Housing Connect refers a potential tenant to CGT, the Operations Manager conducts an initial eligibility check. This includes addressing issues such as the person’s status as chronically homeless and their suitability to live at the CGT facilities, including ability to live independently, and in a community. For example, individuals with a criminal record for sexual assault, arson and/or physical violence are excluded from eligibility. If the individual is deemed ineligible through this initial assessment, the person is referred back to Housing Connect for alternative accommodation. If the person is deemed provisionally eligible, a Vulnerability Index (VI) survey is undertaken by the referring service provider, who is trained in how to complete a Vulnerability Index survey, to ascertain level of client need (based on 1-5 index, 5 being highest need). The Vulnerability Index survey is based on research (Hwang et. al 1998) identifying factors associated with increased risk of death amongst the chronically homeless. It is a health-based indicator only, and in Tasmania is used exclusively by CGT as an intake assessment tool for supportive accommodation eligibility. Upon completion of the Vulnerability Index survey, the referring service provider is emailed with advice of whether the person’s eligibility is prioritised or not prioritised. If prioritised, the Support Services Manager prepares a formal assessment in full written report style addressing four key eligibility criteria: 1. Eligibility as ‘chronically homeless’ 2. Identification and assessment of needs and circumstances relevant to the CGT supporting housing model 3. Fit with current CGT tenant profile and community environment (including no children or pets) 4. Capacity to sustain a CGT tenancy. This full report includes a thorough investigation into the individual’s health and therapeutic support history. Along with the Vulnerability Index survey results, it provides the basis for the acceptance or rejection of applications in allocations meetings between CGT and the Housing 36 Connect Manager. This panel meets when required, having received and familiarised themselves with the eligibility reports for discussion. Decisions are made by allocating tenancies to the highest need individual, based on the individuals Vulnerability Index score (rating 5 given highest priority) and meeting the other criteria for eligibility. Rejections are referred back to Housing Connect for an alternative route to suitable housing, and referring support workers are advised of the outcome. A letter may be provided if requested. In each case, the panel determines who is the most appropriate person to convey the offer (or otherwise) to the person. In most cases this is the referring support worker as they have a relationship with the homeless person and are also more likely to be exploring housing options with the person. Individuals accepted at CGT are contacted and allocated a suitable property at one of the CGT facilities. At this time the lease process is initiated by the Tenancy Manager (Rock Property). From first referral, the allocation process takes from four to six weeks. Examples of eligibility criteria for Common Ground New York, Common Ground Adelaide and Common Ground Camperdown (Sydney) are provided in Appendix A. Figure 3-1: Summary of Eligibility process for ST allocation at CGT Initial eligibility assessment (CGT Operations Manager) Decision-making Request to complete VI survey Completion of full investigative report (CGT management and Housing Connect manager) Upon allocation and acceptance into the CGT facility, tenants are supported to transition to their own furnished apartments, stocked with all tenant requirements include one week’s supply of food. The tenancy manager has one (or more, based on need) meeting/s with the ST to make sure the property lease is signed with adequate understanding of the rights and responsibilities associated with the lease. The tenant is also provided with support regarding the payment of the bond and rent, which may include facilitating direct debit payments. ST 37 rent is calculated on 25 per cent of income for a studio apartment (ranging between $135 and $160 per week) and 30 per cent of income for a 1-bedroom unit (approx. $180 per week).19 While the support needs of tenants are first assessed during the intake assessment process, support staff give tenants one week to settle in before encouraging them to participate in the development of a case management plan. Unlike other SAF’s, CGT does not categorise STs according to low, medium, or high/complex needs, stating that these categories are continually subject to fluctuation based on tenant circumstance. Currently, when supporting tenants, support co-ordinators utilise a range of tools and resources according to the needs of the ST. Subsequent to service changes to support provision with the exit of Anglicare, CGT are in the process of finalising the CGT Practice Model, which is in draft form and will be provided to DHHS once complete. The preferred tools and resources will be outlined in the final document. While tenants are assisted to understand that support is a key element in successful outcomes at CGT, the acceptance of support is not a condition of the tenancy. Support co-ordinators are available onsite at both CGT facilities during business hours. Two senior support co-ordinators are also on call after hours, on a rotating monthly basis, to respond to queries from a concierge should they arise. The support co-ordinator encourages the tenant to engage in on-going contact and regular communication with a range of support co-ordinators. The regularity of engagement with support co-ordinators is driven by the tenant, and may occur daily, a number of times per week, weekly, fortnightly, or monthly. Contact with support co-ordinators may be informal, over an ad-hoc conversation in the common room, or through more formal conversations where the tenant case management plan is discussed or assessed. Services provided by support co-ordinators include counselling, problem solving and assistance with daily personal issues (for example, domestic help, shopping, finance and budgets), assistance in identifying health issues and risks, and linking tenants with external support services (for example, GP, dentist, optometry, Drug and Alcohol intervention programs). Support co-ordinators also encourage tenants to make social connections, and reconnect with their families, and in relevant cases increase tenant capacity to engage in education, training, or skills upgrading through volunteer work. After having been placed in accommodation clients may exit the program by choice. It is also possible for a tenant to be evicted should he/she fail to meet the conditions of his/her tenancy agreement or (where specific legal conditions are breached) a resident is obligated to return to a custodial setting. CGT policy regarding CGT tenant exits is that no tenant will exit back into 19 AHT rentals range from $175 per week for studio apartments, up to $290 per week for a 1-bedroom unit. 38 homelessness. All STs are in principle supported throughout their housing transition, and should a tenant who has not achieved adequate levels of independence choose to leave CGT, the tenant is provided with appropriate supports and referrals to access alternative social housing20. Box 4: CGT Service Principles As the CGT service has evolved a number of service principles and practices have been established. These include: Tenant access to a range of professional expertise amongst the support coordinators by CGT in order to reduce the potential for dependence on a single worker and to encourage tenants to draw on a range of skills and professional expertise. An emphasis on the treatment of supported residents as tenants rather than clients as part of a service philosophy that the most effective way to assist tenants to sustain their tenancies is through support towards normalised and independent living. The use of provisional, 3-month leases, prior to signing of a 12-month lease. This reflects concerns within the organisation that the first 3-4 months of supported tenancies are the most precarious, with the potential for unaccustomed challenges for new and existing tenants. The provisional lease provides a mechanism for tenants and CGT to terminate tenancies should they be viewed as unsuitable. In summary, the implementation of CGT service operations has been characterised by an evolution of governance, service and staff arrangements. Changes to contracted support and security services have been replaced by the more recent establishment of CGT as manager of support and concierge services at the facilities, including the direct employment of CGT staff to these roles. Similarly, eligibility criteria, allocations procedures and support practice models have evolved in accordance with governance, service and staff changes at CGT, as well as changes in the broader housing sector. A number of these implementation processes are still undergoing full implementation. 20 Since the completion of this report, CGT have advised that they have implemented a transition plan for all exiting STs. They are offered up to three months of outreach support after the termination of their CGT tenancy. 39 4 Evaluation of Service Provision and Outputs In Section 4 we describe and evaluate the service outputs of CGT between commencement and 30 June 2013. We begin with a description of the Common Ground service levels and then review client demographics, client presenting circumstances, services provided, and client related outputs. The evaluation of service outputs is assessed within the context of the conditions set out in the Funding Agreement and Residential Management Agreement including the description of the concept of ‘supportive housing’. These conditions include the provision of effective assessment and allocation procedures designed to provide services to those with the greatest needs and risk of homelessness, 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 realise their potential for community participation to a greater extent. 4.1 Service Activities Specified CGT’s two main activities - those that pertain to the social supports provided to tenants and occupants accepted into the program, and those that pertain to the management of the accommodation facilities and tenancy agreements established with clients - are described in the Funding Agreement governing the program. The facility management role is specified in two separate Residential Management Agreements that accompany the Funding Agreement. The Residential Management Agreements specify, amongst other things, the conditions and parameters CGT shall meet as the manager of the facilities allocated to the program. Two of the parameters set out in the Residential Management Agreements are of particular importance to understanding the main characteristics of the Common Ground service model in Tasmania. First, clients who use the service must meet eligibility requirements that reflect aspects of Housing Tasmania’s ‘Housing Assessment System’ pertaining to income and asset limits, clients must be assessed against a ‘Vulnerability Index’, and clients must sign a residential tenancy agreement and pay rent 21 . These features make access to CGT’s services conditional. 21 The definition of such an agreement is set out in the Residential Tenancy Act 1997 with additional conditions stated in attachments to the RMA. 40 Second, the Residential Management Agreements set out conditions that permit CGT to use any income it earns from operating the facilities to acquire or develop additional property to meet the objectives of the program. Income includes rental income received from residential tenants and money paid in return for the use of car parking facilities22. Consequently, the CGT model, unlike other supported accommodation models established in Tasmania, includes provision to grow the size and scope of the amenities available for use by eligible clients. In addition to the separation of facility management and support services the CGT model also distinguishes between two categories of eligible clients: those who were homeless in the period before entering the program and those who were not homeless but could not access ‘affordable’ residential housing. Eligibility criteria are outlined in section 3.2. 4.1.1 Service Activities Specified in the Funding Agreement and Residential Management Agreements The activities specified in the service contracts can be organised into three areas: 1. Residential management of the facilities including establishing tenancy agreements with eligible clients to support them to achieve the objectives of the program. 2. Monitoring and reporting including implementing strategic plans, performance monitoring and reporting processes, administrative and financial documentation, and electronic information management systems to guide service delivery in pursuit of program objectives. 3. Client support service provision, either directly or through a third party including intake screening assessments, case management planning, referrals to allied social, legal, health and medical services and exit planning. 4.1.2 Performance Measurement of Service Activity According to the service specification contained in the Funding Agreement the performance standard of the activities undertaken in the CGT service, including any progress made by clients, are monitored by seven groups of compliance based performance indicators. The measures of each indicator are categorical and the Funding Agreement specifies that all relevant contracted organisations must demonstrate they comply with each indicator. In addition to demonstrating compliance with the performance requirements the CGT Agreement requires contracted organisations to provide periodic reports to a state government 22 RMA Section 6.2(c). 41 agency on continuous quality improvement activities they may undertake. In effect this requirement entails reporting on serious consumer related incidents (SAC1 and SAC223) that might occur during the normal operation of the service. The service activity performance indicators are listed in Table 2, Appendix E. 4.1.3 Description of the characteristics of the personnel identified to undertake the activities The Funding Agreement requires that employees, sub-contractors, or volunteers possess appropriate qualifications and skills, are provided with adequate support to deliver the specified services, and are ‘fit and proper persons’ to conduct the activities experienced by clients who may participate in the service. The agreement defines the attributes of a fit and proper person as a person: Capable of providing an adequate standard of care in relation to the Services; Who understands the needs of clients and their children; and, Is of good character and is suitable to be entrusted with the care of clients. The agreement then ties this definition to a stipulation that the funded organisation is satisfied that any person engaged in the provision of services under the agreement is a fit and proper person. In particular, the agreement asks the organisation to determine whether a person has convictions for any offence involving children or any action taken with regard to their guardianship or custody of a child by obtaining a police history record and by checking personal references supplied by an employee. The agreement does not specify a minimum level of certification on the qualifications appropriate to the service activities included in the agreement or make reference to the governing laws or professional standards applicable to the services to be delivered. 4.1.4 Description of Service Levels Service activity levels for CGT are reported to the AIHW under the Specialist Homelessness Services (SHS) data collection agreement. The main data elements included in the SHS collection include: a descriptive statistical summary of various service outputs derivative of the SAAP data collection including the number of clients assisted, the number of closed and ongoing support periods, the average duration of support periods measured in days, and the number of support periods involving the provision of accommodation. 23 Severity Assessment Code levels 1 and 2 of four SAC levels. 42 Demographic data are also reported in the SHS collection including the age and sex of clients, client Indigenous status, mental health status, income source, the length of time since the client last had permanent accommodation, clients’ presenting region and referral pathway, clients’ reason for seeking assistance, and the number of times clients had experienced homelessness. The data collection process that informs the SHS collection requires service providers to transmit activity data to the AIHW, who then analyse and publish reports for consumption by the service sector and by State Housing Authorities. In addition to the SHS collection the information described in this section draws on: CGT’s Annual Reports; CGT’s report submissions to Housing Tasmania in partial fulfilment of its reporting requirements for the periods January 2013 to June 2013, July 2012 to July 2013, and 1 June 2012 to 30 May 2013; Anglicare Tasmania service data for periods to 1 January 2013 and 30 June 2013; Information gathered via survey of STs and AHT’s (n=61) in support of AHURI research on supportive housing in Australia in May and October 2013; and, Summary analysis of an initial survey conducted by UTas School of Medicine staff on behalf of CGT during 2012-2013. The survey was conducted in March 2013, and involved 23 STs. A follow-up survey was conducted in November 2013, however the results were not yet available for integration into this report. The SHS activity reports available at the time of writing indicate that 81 clients entered the CGT facilities during 2012-2013 recording a total of 90 support periods (see Table 4-1). According to CGT’s Service Delivery report, at 30 June 2013 there were 85 clients occupying a total of 75 of the 97 units available (~77%). Between 1 January 2013 and 30 June 2013 Anglicare reports there were nine supported tenancy vacations. 43 Table 4-1: Common Ground Tasmania Summary data CGT Summary Data Total number closed support periods Total number ongoing support periods Number of support periods with no client information Number of clients (excluding those with no client data) Number of support days provided in year Total length of support periods closed during year Number of Support Periods for children Number of children Male Female Aboriginal (or Torres Strait Islander) Neither Aboriginal nor Torres Strait Islander Ever diagnosed with mental health condition 2012-2013* 57 33 7 81 10379 4672 0 0 55 26 6 34 19 *Campbell Street facility commences Jan 2013 Data Source: SHS Figure 4-1 shows the number of supported tenancies for each facility since July 2012, according to the data available. This is monthly to June 2013, with further snapshots at December 2013 and March 2014. The tenancy split between Barrack Street and Campbell Street was not available for the 31 March 2014 data collection point. Figure 4-1: Total Supported Tenancies July 2012-March 2014 *Sources: Anglicare Common Ground Support Services Report January – June 2013; CGT reporting December 2013March 2014. Note: Occupancy comparison assumes one tenant per unit. Figures reporting the number of tenancies after 30 June 2013 may not distinguish between a count of the number of occupied units and the number of occupants in all cases. We assume an occupied unit equals one tenancy agreement. 44 Six months after opening, Barrack Street supported tenancies had reached 21 tenancies and were steady until February 2013 but then decreased from 22 to 14 tenancies by June 2013. For Campbell Street, six months after opening, at June 2013, supported tenancies were at 17 tenancies, dropping to 16 in December 2013. Figure 4-1 and Table 4-2 show that across both facilities, between February and December 2013, supported tenant occupancies were between 30 and 31 (of the available 39 ST units), which is just over 30 per cent of the total units. This increased to 42 tenancies by 31 March 2014, or 43.3 per cent of the total units. Table 4-2: Proportion of Occupied Units Occupancy and Vacations Total Units Total Units Occupied Proportion of units occupied Occupancy split Lease Vacations As at 30 Jun 2013 1 As at 31 Dec 2013 2 As at 31 March 2014 2 AHT ST Total AHT ST Total AHT ST Total 58 39 97 58 39 97 58 39 97 43 31 74 34 30 64 39 42 81 44.3% 32.0% 76.3% 35.1% 30.9% 66.0% 40.2% 43.3% 83.5% 58.1% 41.9% 100% 53.1% 46.9% 100% 48.1% 51.9% 100% 3 9 12* n.p. 16 16^ n.p. 2 2~ * Between 1 Ja nua ry a nd 30 June 2013 ^ Between 1 Ja nua ry a nd 31 December 2013 ~ Between 1 Ja nua ry a nd 31 Ma rch 2014 n.p. = not provi ded 1 Angl i ca re da ta 2 CGT da ta Note: Figures reporting the number of tenancies after 30 June 2013 may not distinguish between a count of the number of occupied units and the number of occupants in all cases. We assume an occupied unit equals one tenancy agreement. Figure 4-2 describes the number of Affordable Housing Tenancies at the end of the fourth quarter 2012-2013, and at the end of the second and third quarters 2013-2014. The number of tenancies at the end of the first, second, and third quarters of 2012-2013, the first quarter 2013-2014, and the split between facilities was not available. Figure 4-2 and Table 4-2 show that affordable housing tenancies were at 43 occupancies or 44.3 per cent of total units at 30 June 2013, declining to 34 occupancies at 31 December 2013 and increasing to 39 occupancies at 31 March 2014 or 40.2 per cent of total units. 45 Figure 4-2: Total Affordable Housing Tenants by Quarter Source: CGT reporting. Note: Occupancy comparison assumes one tenant per unit. Figures reporting the number of tenancies may not distinguish between a count of the number of occupied units and the number of occupants in all cases. We assume an occupied unit equals one tenancy agreement. Table 4-2 and Figure 4-3 shows that at 30 June 2013, occupancy levels for the units overall were 76.3 per cent, leaving 23 units vacant across all facilities and well below the target of 95 per cent occupancy. By December 2013, occupancy overall had declined to 66 per cent, with 33 units vacant. By 31 March 2014 occupancy levels had increased to 83.5 per cent with 16 units vacant. These low occupancy rates are a concern because they impact on the financial viability of the service as a whole. 46 Figure 4-3: Total Tenancies June 2013-March 2014 Sources: Anglicare Common Ground Support Services Report January – June 2013; CGT reporting December 2013March 2014. Note: Occupancy comparison assumes one tenant per unit. For supported tenancies, figures reporting the number of tenancies after 30 June 2013 may not distinguish between a count of the number of occupied units and the number of occupants in all cases. We assume an occupied unit equals one tenancy agreement. We note that reports by CGT and Anglicare on the number of occupants in each facility and the number of lease vacations were not consistent. Figures describing the actual rents raised and paid to CGT for the period have not been made available. However, the CGT Annual Report 2011-2012 states that approximately $42,000 of rental income was received during 2011-2012. It is reasonable to expect this figure to have increased during 2012-2013. 4.1.5 Client demographic profile The Funding Agreement includes a description of the target client group and the level of need they should display to be eligible for entry into the program. To be eligible for entry, clients must be: able to live independently, registered on the Housing Tasmania wait list, an Australian citizen and Tasmanian resident, 18 years or older, 47 Meet the financial asset limits specified by Housing Tasmania’s Housing Assessment System (HAS). The sex ratio of clients accepted into the program was approximately 68 per cent male to 32 per cent female. Approximately 7 per cent of clients identified as either Aboriginal or Torres Strait Islander. The distribution of ages of clients entering Common Ground ranges from 18 to 64 years. Approximately 65 per cent of clients were aged between 30 and 49 years (see Figure 4-4). Figure 4-4: Age distribution of clients Data Source: SHS Table 4-3 shows that during 2012-2013 clients’ main source of income in the week before service (where a support period was recorded) was either a disability support pension or Newstart allowance. A substantial number of clients were recorded with an unknown income source in the week before presenting for service. 48 Table 4-3: Main source of income Main source of income Newstart Allowance Disability Support Pension (Centrelink) Carer Allowance Employee Income Unknown Total Week before 9 31 1 1 48 90 2012-2013* Closed SP 4 14 0 0 39 57 Ongoing SP 7 25 1 0 0 33 *Campbell Street facility commenced Jan 2013 Data Source: SHS 4.1.6 Client Presenting Circumstances The most common referral source for clients entering the CGT service was a specialist homelessness or outreach agency (see Table 4-4). Table 4-4: Referral source Referral Source (CGT) Specialist Homelessness Agency/Outreach Unknown Other Hospital Mental Health Service No Formal Referral Social Housing Total 2012-2013* 80.0% 6.7% 5.6% 2.2% 2.2% 2.2% 1.1% 100% *Campbell Street facility commenced Jan 2013 Data Source: SHS Table 4-5 shows that the living arrangements experienced by clients in the week before entering the Common Ground service and when presenting to the service in 2012-2013 was for the most part unrecorded in the SHS collection (~58-60%). Of clients who recorded at least one support period, the largest proportion were living by themselves in the week before and on the day of presentation for service (>34%). Approximately 4 per cent of clients presenting for service were couples without children and a small proportion were living with family or with an unrelated group of adults. 49 Table 4-5: Living arrangements before program entry 2012-2013 week before when presenting 58.9% 57.8% 34.4% 36.7% 4.4% 4.4% 2.2% 1.1% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 100% 100% Living Arrangements before program entry Unknown Lone person Couple without child(ren) Group One parent with child(ren) Couple with child(ren) Other family Total Data Source: SHS Table 4-6 details the accommodation circumstances of clients prior to entering the program during 2012-2013. Approximately one third of clients entering during the year were either sleeping rough or in improvised accommodation (~27% at Campbell Street and ~35% at Barrack Street) in the month before entering the program. Approximately 14 per cent of clients stated they were living in emergency or short-term accommodation in the month before entry to the service and less than 10 per cent of clients stated they were not homeless in the month before entry to the service facility. However, the SHS records also show that approximately half of client interactions at the beginning of a support period did not record a response on this attribute. Table 4-6: Whether homeless in month before support Whether homeless in month before support 2012-2013 Campbell Street Barrack Street Number Percent Number Percent 8 27.6% 23 35.4% 4 13.8% 9 13.8% Not homeless 2 6.9% 3 4.6% Unknown 15 51.7% 30 46.2% Total Support Periods 29 100% 65 100% Sleeping rough or in non-conventional accommodation Short term or emergency accommodation due to lack of options Data Source: SHS 50 When asked about the length of time since they last had permanent tenure, approximately 65 per cent of responses across the two facilities were unknown (see Table 4-7). 13 per cent of clients stated that they had not accessed permanent tenure for between 12 months and up to five years prior to presentation to the Common Ground service. Almost one third of clients who recorded a support period during 2012-2013 stated they had not experienced permanent tenure between one week and one year before entering the program24. Table 4-7: Time since last permanent tenure Time Since Last Permanent Address Less than 1 week ago 1 week to 1 month ago More than 1 month to 6 months ago More than 6 months to 1 year ago More than 1 year to 5 years ago Don't know Not applicable Total 2012-2013 Campbell Street Barrack Street Number Percent Number Percent 0 0.0% 1 1.6% 1 3.4% 3 4.9% 0 0.0% 3 4.9% 0 0.0% 7 11.5% 5 17.2% 7 11.5% 21 72.4% 38 62.3% 2 6.9% 2 3.3% 29 100% 61 100% Data Source: SHS Figure 4-5 indicates the most common reasons for seeking assistance from CGT in the month before entering the service were inadequate or inappropriate dwelling conditions and mental health issues respectively. However, a significant proportion of responses were recorded as unknown. For Campbell Street this was just over half of respondents. For Barrack Street it was nearly 40 per cent. 24 None of the data made available to the evaluation indicated the extent to which clients had sought entry to other social housing services or supportive accommodation services funded under the NPAH. 51 Figure 4-5: Main reason for seeking assistance Data Source: SHS According to the School of Medicine Survey, the range of ages at which STs first experienced homelessness ranged from 11 years to 50 years with approximately 50 per cent of surveyed clients stating they were first homeless under the age of 20 years. Although the number of respondents is not provided, the report states that respondents stated they had changed location five times on average in the six months prior to entering Common Ground. Approximately 21 per cent of all clients who commenced a support period during 2012-13 had been diagnosed with a mental illness (see Table 4-8). Approximately half of these (~12% of total respondents) were in receipt of a mental health service or had been in receipt of a mental health service in the 12 months prior to the start of a support period. The School of Medicine survey indicates that common diagnoses reported by STs who experienced recent episodes of hospitalisation (~57% of 21 respondents) included generalised anxiety, post-traumatic stress disorder, depression and psychosis. Approximately 80 per cent of these clients are taking medication related to their mental health condition and compared with 6 months previously almost 60 per cent rate their mental health as somewhat or much, better. Almost 80 per cent stated they were on the way to recovery from their mental health problems. 36 per cent stated they would like additional mental health assistance, such as referrals to a psychiatrist or counsellor. 52 Table 4-8: Ever diagnosed with mental health condition 2012-2013 Ever Diagnosed with Mental Health Condition Campbell Street Yes No Don't know Not applicable Total In receipt of mental health services (%) Received mental health service in last 12 months (%) Received mental health services more than 12 months ago (%) Barrack Street Number Percent Number Percent 7 2 19 1 29 24.1% 6.9% 65.5% 3.4% 100% 12 1 14 34 61 19.7% 1.6% 23.0% 55.7% 100% 3.4% 8.2% 10.3% 3.3% 0.0% 1.6% Data Source: SHS The School of Medicine survey found that respondents presented with significant physical, mobility, dental, and visual/hearing problems. Approximately 73 per cent of respondents had dental problems, 36 per cent reported problems with their vision, 35 per cent reported hearing problems, and 48 per cent reported experiencing difficulty with mobility. The most common physical disorders included migraine headaches, asthma or bronchitis, hepatitis C, and gastrointestinal disorders. It should be noted that in data related to client presenting circumstances, high percentages (from 37 per cent up to 65 per cent) of ‘unknown’ responses are indicated in most measures, including ‘ever diagnosed with a mental health condition’. The high levels of ‘unknown’ responses result in key gaps in performance standard indicators. 4.1.7 Services Provided Figure 4-6 describes the top ten service needs of clients at the Campbell Street and Barrack Street facilities during 2012-2013. The most common need was assistance with basic living skills. However, a greater proportion of clients at the Barrack Street facility stated a need for health and medical support including access to mental health services than clients at the Campbell street facility. Clients at the Campbell Street facility recorded a greater need for outreach and assistance to maintain their tenancy than those receiving services at the Barrack Street facility.25 25 By way of comparison, the Northern SAF’s top need indicated by Grove House residents is ‘long-term housing’ and Thyne House residents top need is ‘assistance to sustain tenancies’. Thistle street residents indicated both these needs in their top ten needs. AT CGT, housing needs, particularly by Barrack street respondents, were low on the service needs cited by CGT tenants. 53 Figure 4-6: Top ten services needed by clients Data Source: SHS Data for 2012 and 2013 suggests there were almost no cases where service needs were identified but not provided (<1% of all needs identified). Anglicare reports that between 1 January and 30 June 2013 it provided an average of 15.4 hours of casework support per client at the Campbell Street facility (n = 19) and 14.1 hours of case work support per client at the Barrack Street facility (n = 26). According to Anglicare, support contacts with STs during this period took place via personal meetings at least once per week. Table 4-9 presents the top four types of contact recorded by Anglicare with STs between 1 January and 30 June 2013. 54 Table 4-9: Type of contact Number of ST Client Contacts by Type Case Coordination Phone Client Meetings Appointments Total Campbell Street* Number Percent 370 36.8% 320 31.8% 164 16.3% 151 15.0% 1005 100% Barrack Street* Number Percent 393 36.7% 393 36.7% 195 18.2% 89 8.3% 1070 100% *1 January 2013 - 30 June 2013 Data Source: Anglicare Table 4-10 shows that the most common reason a support period ended in 2012-2013 was the client no longer requested assistance (~30%, n=17), followed by the response of ‘other’ (or reasons unknown; ~28%, n=16). Support periods also ended when clients were referred to another specialist homelessness agency (~26%, n=15) or because the maximum service period26 had been reached (~5%, n=3). In a small number of cases client support periods ended when a client was incarcerated or died27. Table 4-10: Reason support period ended Reason Support Period Ended 2012-2013 Campbell Street Barrack Street Number Percent Number Percent Client no longer requested assistance Other 3 3 27.3% 27.3% 14 13 30.4% 28.3% Maximum service period reached 3 27.3% 0 0.0% 0 0.0% 15 32.6% 1 9.1% 0 0.0% Lost contact with client 1 9.1% 0 0.0% Client incarcerated 0 0.0% 2 4.3% Client died 0 0.0% 2 4.3% Total 11 100% 46 100% Client referred to another specialist homelessness agency Clients immediate needs met/case management goals achieved Data Source: SHS According to reporting by Anglicare, 9 STs exited Common Ground services between 1 January and 30 June 2013 (see Table 4-11). 26 Maximum Service Period is a term used in the SHS collection, and refers to the limit on the time made available for case management to ST’s under the service provision agreement. 27 Note that clients can record more than one support period in a reporting period and record more than one reason for ending a support period. 55 Table 4-11: Supported tenancy vacations Moved to Private Rental Move from Barrack to Campbell Eviction due to behaviour Client Incarcerated - Eviction due to rent arrears Client Deceased Client Abandoned Total *Data Source = Anglicare reporting ^Data Source = CGT reporting 1 Jan 2013 to 30 Jun 2013* 1 Jan 2013 to 31 Dec 2013^ 1 Jan 2014 to 31 Mar 2014^ 2 8 2 1 0 0 3 4 0 1 0 0 2 0 9 2 2 16 0 0 2 Anglicare state that the three tenancy vacations related to behavioural issues resulted in the clients exiting the service without having secured alternative tenure28. According to additional vacation figures provided by CGT, during the twelve months to 31 December 2013, 16 clients vacated their dwelling. Half of these clients left to take up private rental, two were deceased, and six were evicted or abandoned their tenancy. Between 1 January 2014 and 31 March 2014 CGT reports that an additional two clients had vacated their dwellings and moved into private rental. 4.1.8 Level of attainment measured Data supplied to the AIHW regarding the extent to which the goals identified in case management plans were achieved shows that of the 11 closed support periods recorded for the Campbell Street facility in 2012-2013, 9 (~82%) ended with no case management plan, one (~9%) ended without achieving any of the goals identified in the client’s case management plan, and one (~9%) ended with up to half of the case management goals achieved (see Table 4-12). At the Barrack Street facility, of the 46 closed support periods recorded in 2012-2013, 35 (~76%) ended with no case management plan, two (~4%) ended without achieving any of the goals identified in the client’s case management plan, and nine (~20%) support periods closed with clients achieving up to half or more of their case management plan. However, of the 18 support periods on-going at 30 June 2013 at the Campbell Street facility, 13 (~72%) had achieved up to half of the goals planned. At the Barrack Street facility 11 of the 15 on-going support periods (~73%) had achieved up to half of the goals planned. According to the SHS data collection no clients had achieved all the goals identified in their case management plan during 2012-2013. 28 Anglicare Common Ground Support Services Report January – June 2013 p 6. 56 Table 4-12: Extent to which case management plan goals achieved 2012-2013 Extent to which case management plan goals achieved Not at all Up to half Half or more All No case management plan Total Campbell Street Closed SP 1 9.1% 1 9.1% 0 0.0% 0 0.0% 9 81.8% 11 100% Barrack Street Ongoing SP 4 22.2% 13 72.2% 1 5.6% 0 0.0% 0 0.0% 18 100% Closed SP 2 4.3% 6 13.0% 3 6.5% 0 0.0% 35 76.1% 46 100% Ongoing SP 1 6.7% 11 73.3% 1 6.7% 0 0.0% 2 13.3% 15 100% Data Source: SHS Anglicare’s report suggests the supported client residents at the Barrack Street facility enjoyed greater goal attainment than residents at the Campbell Street facility between 1 January and 30 June 2013. Table 4-13 shows that of the total goals planned during case management at the Barrack Street facility approximately 35 per cent were fully achieved. However, during the same period no goals were recorded to have been fully achieved by clients at the Campbell Street facility. However, we note the discrepancy between the SHS collection report and the Anglicare synopsis of their case planning outcomes, suggesting some data quality issues. Table 4-13: Case plan goal outcomes Outcomes of Case Plan Actions Action Outcome Goal not achieved Goal slightly achieved Goal partly achieved Goal mostly achieved Goal fully achieved Total planned actions 2012-2013* Campbell Street Barrack Street Number Percent Number Percent 13 71 20 10 0 114 11.4% 62.3% 17.5% 8.8% 0.0% 100.0% 14 39 64 68 99 284 4.9% 13.7% 22.5% 23.9% 34.9% 100.0% *1 January to 30 June 2013 Data Source: Anglicare The data available from the SHS collection regarding the type of education or training programs in which clients were enrolled shows that the extent of client participation in education or training programs was either unknown or not applicable in almost all cases (see Table 4-14). For example, in approximately 95 per cent of cases where a support period was on-going at 30 June 2013 education and training enrolments were recorded as not applicable to clients in the Campbell Street facility (n=18). Similarly, 80 per cent of on-going support periods at the Barrack Street facility recorded that education and training enrolments were either not applicable or unknown (n=15). 57 Table 4-14: Type of education/training clients enrolled in Type of education/training clients enrolled in Not applicable Secondary School Student University Student Vocational education and training Unknown Other education or training Total 2012-2013 Campbell Street Week before (n=29) 41.4% 0.0% 0.0% 0.0% 58.6% 0.0% 100% Closed SP (n=11) 0.0% 0.0% 0.0% 9.1% 90.9% 0.0% 100% Barrack Street Ongoing SP Week before (n=18) (n=61) 94.4% 27.9% 0.0% 0.0% 0.0% 0.0% 5.6% 0.0% 0.0% 72.1% 0.0% 0.0% 100% 100% Closed SP (n=56) 21.4% 0.0% 1.8% 0.0% 76.8% 0.0% 100% Ongoing SP (n=15) 60.0% 0.0% 0.0% 20.0% 20.0% 0.0% 100% Data Source: SHS According to the SHS data collection, client incomes remained stable before and after entry to Common Ground services (see Table 4-15). Data from the SHS collection for 2012-2013 states there were no clients without an income either before or during entry to Common Ground services. However, a significant proportion of support periods record client incomes as unknown. Where income details were recorded, the SHS data suggests that the income source clients had before they entered the services did not change during the period they received services. Table 4-15: Main income source Main Source of Income Newstart Allowance Disability Support Pension (Centrelink) Carer Allowance Employee Income Unknown Total 2012-2013 Campbell Street Barrack Street Week before Closed SP Ongoing SP Week before Closed SP Ongoing SP (n=29) (n=11) (n=18) (n=61) (n=46) (n=15) 6.9% 9.1% 22.2% 11.5% 6.5% 20.0% 34.5% 9.1% 72.2% 34.4% 28.3% 80.0% 3.4% 0.0% 5.6% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 1.6% 0.0% 0.0% 55.2% 81.8% 0.0% 52.5% 65.2% 0.0% 100% 100% 100% 100% 100% 100% Data Source: SHS According to the School of Medicine survey, no STs surveyed were engaged in paid work in April 2013 (n = 23), although approximately 20 per cent of respondents had been engaged in paid work at some time during the previous 12 months and 32 per cent of respondents had been looking for paid work prior to entering CGT. An AHURI funded investigation of client perspectives on CGT services provides some data on levels of client satisfaction. Of 61 ST and AHT respondents surveyed during October 2013, 89 per cent (n = 54) said they were pleased with the housing they received from CGT with 87 per cent stating they felt settled in the facility (n = 87). 80 per cent agreed they were satisfied with the overall suitability of the facility to the needs of their household and most respondents 58 agreed the facility is well located, safe, and had resulted in a significant improvement in their quality of life. Approximately one third of 61 respondents agreed they would like the service to improve their level of health, wellbeing and life satisfaction and 84 per cent of respondents agreed the service had produced a positive impact on their life (n = 51). There was some dissatisfaction with overall suitability of the facility (13% of 61 respondents, n = 8). Reasons included the availability or cost of car parking space, availability of private outdoor areas, and the absence of universal access modifications for those with special needs. 4.2 Implementation of Tenancy Services In this section we evaluate the implementation of the CGT tenancy service. This includes the provision of safe, secure and affordable housing for people at risk of homelessness accompanied by the provision of effective assessment and allocation procedures designed to provide services to those with the greatest needs and risk of homelessness. It also refers to the provision of processes that support residents to sustain their tenancies and encourage tenant participation in service delivery and operations. 4.2.1 To what extent does the organisation provide safe, secure and affordable housing for people at risk of homelessness? Safety and Security CGT has been successful in providing safety and security for tenants at both Barrack Street (BS) and Campbell Street (CS) facilities. Both sites are secured facilities, purpose-built for high-level tenant security including 24-hour on-site CCTV surveillance cameras linked to the concierge throughout all entry, hallway and common areas. Access to facilities is limited to programmed key card entry for staff and tenants, and visitors are granted access via intercom introduction and sight identification by the concierge/security at the front desk. Visitors must be identified and accompanied by their tenant guest at all times. Concierge staff are also present at the front desk of both facilities throughout the day and evening (8am until midnight). This high level of security is noted as important by both tenant and service provider respondents: On all levels life has improved because I’m safe. I have somewhere I can go to everyday that’s mine, that I feel confident in, that I’m independent in. And that can only build your self-esteem and your self-respect. So on every level I feel better about myself, yes. (T03, BS).29 ‘…that peace of mind, you know someone is here 24/7’ (T08, CS)30 29 BS = Barrack Street 59 The other positive about living here is … they’ve got that sense of security. They’ve got the ability to change their peer group;… the peers that might have been encouraging them to drink or use drugs, so that’s been a great opportunity to say no, and have choice. That’s been a real positive and I think that’s something that they identify. (SP14) …the security is high and it’s good…I think it’s one of the most important things here. (SP05) Service provider and tenant respondents both observed that while the objective of CGT is to provide a safe and secure facility, this must be balanced with tenant rights to privacy, the ability to live without undue surveillance or intrusion, and with the rights of tenants to enjoy visitors freely. Some of these concerns have been addressed. For example, the tenant manager has provided on-going education to all CGT staff regarding the rights of tenants to privacy including protocols around arranging meetings with tenants. Another example is the easing of visitor restrictions. Tenants are no longer required to sign every visitor in and out of the facility although they must accompany their guests at all times. When allocated a property at Common Ground, tenants are provided with a document named ‘CGT Basic Rules’ in addition to their lease. While not signed by tenants, this document outlines the ‘house rules’ for living at the CGT facilities. These include no violence or drugdealing on-site, as well as the need to respect tenant privacy and right to quiet enjoyment. Tenant respondents communicated an awareness of these rules, citing that in most cases these behaviours were respected by all tenants. They did tend to emphasise everybody’s right to quiet enjoyment, I think is how they put it. (T09. CS) It’s just common sense. It’s just about being courteous, polite, you know...some people like to keep to themselves, some people like to you know, socialise....but I mean the majority of people here are fine (T02.BS) Some tenant respondents expressed unease about alcohol and drug activity on-site, suggesting this may restrict the CGT goal of increasing interaction between tenants across the two sites: T: I know Campbell Street and I won’t go to Campbell Street. I: Why is that? 30 CS = Campbell Street 60 T: Because there are people there from drug and alcohol and…not only would those people be around but the people who deal to those people would be around. And to me that’s putting myself in a situation that I don’t want to be in.(T03. BS) In seeking to address the issue of drug and alcohol use, the possibility of police patrols was raised by the Tenant Action Group (TAG). The TAG is a tenant-initiated group convened as a forum to discuss issues and problems related to tenancies. TAG Meetings, open to all (ST and AHT) tenants, are convened every month, and CGT staff (including CGT management, and tenancy management) are invited to attend. In this case, the police patrol proposal was rejected, and currently the residents are expected to negotiate respectful and acceptable behaviour between themselves regarding drug and alcohol consumption within the boundaries of the CGT Basic Rules. A further issue identified by both service provider and tenant respondents was the importance of the concierge service as a security presence and additional dimension of support.31 The concierge was described as “the eyes and ears of support” (SP17). The front-desk presence of the concierge was understood as a point of reference for tenants as a familiar, friendly and consistently available service provider, and the first point of contact when tenants require assistance due to tenancy issues such as disturbances or support-related issues. I feel very relaxed and comfortable with them. (T01, BS) I32: Who intervenes if there are problems? T: The concierge is the first line of defence usually. (T06, CS) Another tenant had like the same type of thing, same type of stress, and I say, “Would you like me to help? Would you?” “Yeah.” I check it out. You authorise me to go to the unit. We go, we check, it’s a mess. It’s a war zone. But you don’t say, “Wow!” You don’t. Easy. “Take this, put to make a pile, I’ll do the dishes. I’ll clean the bench. I’ll do that.” To that extent, they switch and they go, “I can take the vacuum,” they’re cleaning, they’re happy, they’re seeing someone… (SP03) Affordability The rental cost for CGT tenants is dependent upon the tenant’s eligibility category as specified in the Residential Management Agreements. Rent for category 2 tenants (AHTs) is based on market values with a maximum rent payable to CGT at 74.9% of the market value of the unit. 31 In outlining the rationale for recent changes to Concierge arrangements, the CGT Managing Director noted the importance of the Concierge to both Supported Tenants, and Affordable Housing Tenants (whose views are not represented in this evaluation). 32 I = Interviewer; T = Tenant. 61 For AHT tenants, payable rent ranges from $175 to $290 per week, with the higher-level Campbell Street apartments based on increased market values per floor level. This equates to an annual income range of between $30,330 and just over $50,000 using 30 per cent of income as the standard for an ‘affordable’ rent. Rent for category 1 tenants (STs), is calculated at a maximum of 30 per cent of their income, varying according to their pension type which means that rents begin at $135 and go up to approximately $180 per week. Setting aside rental subsidies, this equates to an annual income range between $23,400 and $31,200. 1-bedroom apartments are slightly higher in rent (by approx. $20) per week than studio apartments. Part of the support provided for STs includes assistance to manage their finances. This includes repayment plans for bond payments or previous debts, and assistance in establishing mechanisms to manage rent payments such as direct debit facilities. The equivalent annual income 33 from Newstart and the Disability Support Pension are presented in Table 4-15. Table 4-15: Selected annualised income rates as at February 2014 Single no children Single with dependent children Single 60+ Partnered (each) Single carer Newstart Allowance Disability Pension (max payment) (max payment + Dis. Supp.) $13,026.00 $21,148.40 $14,094.60 $14,094.60 $11,759.80 $15,940.60 $18,197.40 Many clients of CGT may be eligible for an additional payment by accessing Commonwealth Rent Assistance. The amount of rent assistance available from the Commonwealth varies according to the rent charged to the tenant. The annualised maximum payments at February 2014 are summarised in Table 4-16. 33 These figures reflect those available from Commonwealth income payments current at February 2014. 62 Table 4-16: Annualised Commonwealth Rent Assistance rates as at February 2014 Single no children $3,224.00 Maximum payment cuts in above (annualised rent charge) $7,158.58 Single with 1 or 2 children $3,774.68 $8,796.58 Single with 3+ children $4,269.72 $9,456.72 Couple no children $3,031.60 $8,696.22 Couple with 1 or 2 children $3,774.68 $10,605.66 Couple with 3+ children $4,269.72 $11,265.80 Maximum Payment per year Given the rental charges published by CGT the annualised rent charge for STs will range between approximately $7,020 and $9,360 per annum depending on the specific unit leased. Based on these figures, a single person without dependents who occupies a studio apartment as a Category 1 tenant (ST) for $135 per week will pay $7,020 per year in rent and may receive a rental support payment totalling approximately $3,000 per year. On that basis, rent as a proportion of income for such a client is approximately 29 per cent per annum if they receive Newstart Allowance and approximately 18 per cent per annum if they receive a Disability Support Pension (with the Disability Supplement Payment). However, the rent charged for a Category 2 tenant (AHT) is based on market value and type of unit (studio or 1-bedroom). Households are considered to be under housing stress when they spend more than 30% of their gross income on housing costs, for example a mortgage or rental payment (AIHW 2011). To avoid housing stress for the lowest priced accommodation ($175), a single AHT must be earning at least $30,330 per annum; or at least $42,500 per annum for an entry-level 1-bedroom unit ($245). To avoid housing stress for a 1-bedroom unit at $290 per week, a single occupant must earn at least $50,000 per annum, which is $4,000 per annum higher than the maximum earnings for eligibility for a single AHT. It is possible this could effect the attraction of the facilities for low-income tenants and be a contributor to high vacancy rates for AHT units. These vacancy rates are a concern because of the potential for this to impact on the financial viability of the facilities as a whole34. 4.2.2 To what extent does the organisation provide effective assessment and allocation procedures designed to assist those who have recently been absolute or chronically homeless to secure affordable housing? 34 CGT have advised that since this evaluation was completed they have taken a number of measures to address high AHT vacancy rates including reducing rent levels, offering incentives such as reduced car fees, broadening AHT eligibility criteria and increasing marketing of the units. 63 CGT and the broader homelessness sector respondents identified issues relevant to effective tenant allocation with reference to allocations tools, sector interface, and allocation timeframes. CGT have adopted intake assessment tools designed to capture tenants from the recent homelessness population most suitable to the CGT environment. These resources include a pre-intake assessment eligibility check, followed by a Vulnerability Index (VI) survey, which is a health indicator providing a scale (1-5) assessment communicating to CGT the level of health vulnerability a person is experiencing. The higher the scale, the greater the health needs of the individual. A comprehensive background check is subsequently undertaken to assess eligibility. A strong CGT focus for eligibility is independent living in a communal environment, reiterated to new tenants in the CGT ‘basic rules’ document as the ability to pay rent and conduct themselves as a good neighbour. Service provider respondents from the wider housing and homelessness sector identified concerns in two areas. The first concern relates to allocation procedures, including the use of the VI as a primary assessment tool, and CGT’s knowledge of, and collaboration and communication with, the broader homelessness sector in relation to tenant allocations. The second concern relates to the length of time taken to fill vacancies. Allocations The VI survey is used in CGT’s assessment process, as a tool to identify and prioritise those with the greatest health needs. That is, the sickest homeless people (and not necessarily the most difficult) are prioritised for supportive housing allocation. CGT service provider respondents explained that in additional to the VI, a rigorous assessment process is undertaken in which input from the sector (for example, mental health, hospital, GP records) aids in building an understanding of a person’s support needs. Three of the seven sector respondents highlighted the limitations of the VI survey tool in the broader context of identifying and prioritising the complex needs of homeless people. As a health-based tool, it was argued that the VI survey is limited in the information it can capture about a person. For example, the VI may draw attention to the conditions, primarily medical, symptomatic of homelessness, but cannot provide information about the underlying reasons and circumstances leading to homelessness, or the accommodation history/context of the person. One respondent argued that medical health is not the primary issue when it comes to homelessness. The VI was also described as ‘inadequate’ (SP11), a ‘tick and flick’ sheet, and a tool that misses ‘a whole chunk of that person’ (SP13). These respondents argued that assessment tools need to provide in-depth information about previous accommodation, mental 64 health histories, addictions, or disabilities, and that these are not provided by the VI and can only be uncovered through in-depth one-on-one discussions with clients. Everybody’s got a story to tell and until you actually start peeling back the layers and finding out what actually makes somebody tick and what has affected them so badly, you can possibly make some difference… We ask if people are homeless, how long they’ve been homeless, we ask what sort of services they’ve been accessing. We ask them about what’s actually going on for them. We ask them the most relevant questions, and sure they’re personal questions, but they’re the questions that we need to know in order to best support those people…(SP12) Two key sector respondents expressed the view that to adequately allocate housing to those experiencing primary homelessness, an in-depth knowledge, understanding and interface with homeless people, and homeless service providers, is necessary. These respondents viewed CGT as too independent from the sector, with consequences for sector integration and the appropriate and timely allocation of chronically homeless individuals to supported accommodation facilities. 35 All respondents indicated they had faced communication challenges with CGT staff, for example noting the reticence of CGT to provide feedback to service providers or prospective tenants regarding allocations. According to one provider, the ability to network with, and draw on the strengths and resources of other service providers across the state is one of the most effective ways to reduce homelessness. That’s the beauty of the collaborative work… Everybody’s having a slice of the pie to actually try and support somebody, because none of us can do it by ourselves… (SP12) In recognition of the challenges of introducing a new model into a well-established sector CGT developed a communication strategy that included contact with sector CEO’s, providing FAQ sheets and guided tours and presentations, publishing articles and using eShelter publications to disseminate information about vacancies. They also draw on sector knowledge in a number of ways including: Homelessness service providers conduct the VI survey A CGT staff member attends Homelessness Reference Group36 meetings They access information from other services about prospective ST histories The Housing Connect manager participates in final allocations decisions 35 Since the evaluation was completed, we have been advised by CGT that two thirds of the current support staff have experience with working with homeless people. 36 The Homelessness Reference Group was established in 2012 to ensure that the chronically homeless in Hobart are being provided with adequate housing services. 65 The support services manager networks with external service providers, including Housing Connect specialist support services They support sector development by hosting guest speakers, open home events, and attendance at sector forums. There are also factors limiting CGT integration with the homelessness sector including: The relatively recent establishment of the service in Tasmania The emphasis on provision of a service that operates as closely as possible to a mainstream accommodation provider in which STs are treated as tenants rather than clients The employment of relatively high numbers of staff who do not have existing links and experience in the housing and homelessness service sector. From CGT’s perspective there is also a need for other housing and homelessness services to reciprocate with their own initiatives to improve their integration with CGT. Filling Vacancies All the housing and homelessness sector respondents outside of CGT acknowledged and/or expressed concern that the filling of vacancies in the CGT facilities was slow and that this had a significant, or negative impact on the sector. A number explained that within the sector there had been an assumption, following the 50Lives/50homes survey and the completion of numerous Vulnerability Index surveys, that the new facilities would be quickly filled. They described their frustration when they experienced what they perceived to be ‘very slow’ allocation rates, and consequent disappointment for homeless people. A number suggested that better integration of CGT into the supports available through the housing and homelessness sector would have made it possible to fill the vacancies more quickly and that, given the vulnerability of the homeless population, this should be a priority for a service such as CGT. At the end of June 2013, 31 CGT tenancies were occupied by STs; remaining relatively unchanged by Dec 31, 3013 with 30 STs, and increasing to 42 ST’s by end March 2014. To provide a comparison with the Queensland Common Ground facility, which was opened in August 2012 with 146 apartments fully tenanted by November 2012, CGT vacancies have been filled relatively slowly. Two CGT respondents acknowledged that allocating STs to the facilities had taken longer than expected. In particular they noted the tension between having unoccupied units and the need to provide appropriate supports to new STs in order to establish sustainable tenancies; both for new (often vulnerable) tenants as well as existing STs. 66 This was new, no one had ever done it before. We started with - we opened and we took in two in the first two weeks, we took in four a month for the first two months, we then moved to eight. It moved to - it was staged over a six month period…. it was a carefully considered board position that we stuck to in spite of it being terribly unpopular. Because it wasn't just about ‘get them in”, it was about keeping them in. (SP17) An additional factor was the withdrawal of Anglicare’s support service in October 2013. The loss of support staff meant that existing STs were limited in their support provision for a period of time. The lack of available support through October and November 2013 caused CGT to slow allocations of CGT properties to STs until the replacement support arrangements were operating. Additionally, a high number of explained ST vacations (see table 3.11) meant that ST occupation numbers during 2013 were 46, but fluctuated with the vacancies. 4.2.3 To what extent has the organisation been able to implement processes that support tenants to sustain their tenancies? CGT has been successful in implementing processes that support residents to sustain their tenancies. Service Environment A collaborative working relationship between CGT and the support services (including tenancy manager, support co-ordinators and concierge) was regarded by all service provider respondents as the key to supporting tenants to sustain their tenancies. Collaborative problem-solving between these support services was regarded as critical for supporting tenants towards independent living. These respondents expressed the view that if the support worker or tenancy manager identifies a change in tenant behaviour affecting their tenancy, or an issue that requires intervention, they need to work together to find solutions that deescalate the issue. To facilitate this, CGT management hosts daily (informal) and twice-weekly (formal) meetings involving the tenancy manager, support co-ordinators and concierge. In these meetings tenancy-related issues are discussed in a problem-solving forum where decisions are collaboratively made. Our role is to keep people housed regardless of behaviours. We can try to support them in addressing these behaviours, but at the end of the day we want them to sustain independent living. So then what we did with Anglicare, is that we [tenancy manager and support] would write up support contracts with the tenants and get them to sort of agree to certain things. Don’t do this and this, we’ll support you with that, but you’ve got to do this, this, this. And obviously it’s voluntary, but for some that does work. (SP02) 67 Because it is so collaborative ... we have a consultative model where the tenancy manger and the support worker wouldn’t make a decision on their own in isolation. Those decisions go to the round table where there’s a senior support coordinator, the tenancy manager and ... operations manager, [and Managing Director] …Bringing the facts to the table and saying okay we need to make a decision here. (SP14) CGT service provider respondents cited some examples where the flexibility to change service policy or procedures has been an important aspect of assisting tenants to sustain their tenancies. For example, a number of support co-ordinators noted that for tenants who have been previously homeless and living in survival mode from day to day, a 12-month lease can be extremely challenging. The first three to four months of supported tenancies are the most precarious, as the new stable and supportive environment can raise unaccustomed challenges for tenants. CGT addressed this issue in collaboration with the Tenancy Manager, starting each new ST lease at 3 months, after which the lease is signed for a further 12 months. One of the barriers that we have addressed for tenants moving in is that it used to be a 12 month lease and now we make it a three month lease and that’s not quite as scary (SP14) From the tenants’ perspective, it could be argued that probationary leases compromise their security of tenure, although this has become a widespread practice throughout the social housing sector. CGT support service respondents also stressed the importance of collaboration between services in relation to tenant leases, in particular resolving tenancy issues that might otherwise result in evictions. For example, rather than issuing notices to vacate in the instance of a tenancy breach, various options are explored and discussed with staff and the tenant. If possible, an alternative solution to eviction is sought. We steered this person [who did damage their unit,] … away from returning to homelessness. [He was] extremely embarrassed and ashamed and devastated by [his] behaviour. [He was] given the opportunity to make things right. So that person has worked a period of hours and hours and hours to repay the repair of that unit... [and was] able to return to living at Common Ground. (SP04) Service Focus CGT’s current service focus shapes the environment in which residents are supported to sustain their tenancies. CGT’s orientation toward treating supported residents as tenants rather than clients and the accompanying view of CGT as a supportive, rather than supported housing facility orients the provision of support around movement towards the goal of 68 independent living. Tenants are informed of their rights and responsibilities of being a tenant and there is an emphasis on ensuring they understand they are free to make independent decisions and initiate choices. This emphasis is balanced between supporting tenants to sustain their tenancies and providing a supportive transition environment toward normalised, independent living. I try to [make it] clear to them that this is not an institution, it's not emergency accommodation, it's not a temporary thing. This is permanent housing for them and the outcome we hope is that they stay here and if they don't stay here that when they leave they're ready to leave into society in a normal rental… There are supported facilities for formerly homeless people but a supported environment is one where people get their meals cooked for them and it’s more of a boarding house set up. As for us this is about independent living and providing the support to have people reengage with community and empower them to regain that independent living and that power of choice and so forth. (SP14) I guess the whole point of this is for them to learn to do things themselves so quite often they'll just say, “Why haven't you – why have I got this problem and you haven't fixed it?” and that sort of thing. So it's just learning to deal with how to talk to them about how they could fix their problem … getting them out of the institutionalised type of thing, getting them to understand that this is their home…. They [CGT] want them [tenants] ... to be independent, normal - I think that will be the best thing for them, hopefully (SP05) 4.2.4 To what extent has the organisation been able to encourage tenant participation in service delivery and operations? Tenant participation is facilitated and encouraged in multiple ways across the two CGT facilities. Some initiatives have been implemented to encourage socialising, while others bring the CGT tenant community together to raise awareness around tenant-related issues. For example, Tenant Feedback forms are available at reception, providing a direct feedback mechanism for tenants to management regarding any issue affecting them. Monthly TAG (Tenancy Action Group) meetings have been established by tenant request as a forum to discuss any site issues affecting tenants and are attended by Campbell and Barrack Street tenants as well as the Rock Property tenancy manager and CGT operations manager. CGT service provider respondents explained that they encourage tenant participation in order to empower tenants to make and own positive changes to their own home environment. I see it as a way to help the tenants come to the realisation that they have the power to make things happen themselves and make decisions. So I guess they started off coming to the [TAG] 69 meetings saying, “We want this to happen!” and then we’d say, “Okay, well how would you organise that? Maybe you could try it for a couple of weeks and then come back together and say, yes, that's working or no, it's not”. Yeah, I guess the whole point is to have the tenants eventually being able to have these meetings and if they want something to happen they can probably organise it themselves. (SP05) Yeah we have one of them every month where we all get together and talk… just the long-term homeless. We all get together and have you know, all the issues come out and we all talk of what’s going on or whatever upsets us. Yeah, so they’re pretty good. (T01, BS) I always go to a tag meeting with a list of things. (T03, BS) CGT service provider and tenant respondents highlighted the involvement of tenants in establishing social and recreational activities. Service provider respondents talked of their role in encouraging tenants to initiate activities, and provide supports to facilitate their success. For example, tenants organise and prepare Sunday lunches (Barrack Street) and Friday dinners (Campbell Street), and this is available for all tenants to participate in at a minimal cost. As a [support] team we sat down with the tenants one-on-one and identified what they’d like to be involved in with activities or things they’d like to experience. Also what they could do, so that was a way of how they could value add. We’ve… actually ticked off a lot of stuff that was on there, so that was good. (SP02) Last year the discussion about Christmas was a bit – well for years I’ve gone down to the mall, to the colony 47 Christmas lunch so I’ll probably go there this year, you know. This year it’s completely different it’s like let’s have Christmas at home... And they’re doing it, the tenants are organising it themselves. (SP14) CGT staff respondents also cited the value of the facilities for supporting tenant participation, by encouraging social connections and tenant ownership over the sites. Common rooms are used for group meetings and informal support meetings with tenants. Kitchens are the focus of group meals. The art room in Barrack Street is used regularly by tenants who paint and sketch. Outdoor areas are utilised for weekly Tai Chi sessions at Campbell Street, and a large mural has been recently completed by tenants in the new outdoor garden area established in Barrack Street. The Wellness centre is a focal point for tenant health, for example, men’s group meetings, and the computer room at Campbell Street is described as a location for social interaction. At least six months ago, I said, “… you guys could use the common kitchen, cook a meal yourselves on the weekends, or of a night time, or just invite each other.” Anyway they picked up on that and 70 they did a Sunday lunch, which we monitored but we allowed them to do it, and it’s been operating for a number of months now quite successfully. It’s only like three or four dollars that they charge, they sort of get a list of how many are attending. Each week they decide who will cook the next week and what they’re going to cook, and that’s been really successful, plus it’s getting them to eat healthier choices and that sort of thing. (SP02) Staff and tenant respondents observed that the facilities are becoming a focal point for tenant participation and ownership within their environment. Given the relative newness of the facilities, some areas remain undeveloped, providing a means for staff to encourage tenant input and initiative in their on-going development. Through the TAG meetings tenants made collaborative decisions about where to locate a ping-pong table, planned and completed the mural and organised care of the garden. Service provider respondents noted that there are financial constraints that slow the implementation of some initiatives but the TAG meetings are operating to ensure tenants increasingly feel that CGT is their home. 4.3 Implementation of Support Services In this section we evaluate the implementation of CGT support services. This includes the provision of processes to ensure that clients gain access to health and support services, and education, training and employment options, realise their potential for increased connection with family, and increase their community participation and improve their independent living skills. 4.3.1 To what extent has the organisation provided tenants with increased access to a range of health and support services? CGT has been largely successful in providing tenants with continued, or increased access to a range of health and support service, although changes in 2013 have resulted in interruptions of support for some tenants. Along with the provision of safe and secure housing, the provision of support services to CGT tenants is the key to successful tenant outcomes at CGT. Tenants are assisted to understand that support is a key element in successful outcomes at CGT. Only one tenant has refused any engagement with support providers, although one service provider informant explained that some tenants do periodically withdraw from support before re-engaging. CGT has implemented a team-based approach to the provision of support to tenants, bringing a range of case management expertise histories. Tenants are encouraged to develop a case management plan with a support co-ordinator through which to measure improved outcomes 71 over time. Depending on the needs of the ST and the measures identified in the case management plan, support co-ordinators support tenants across a range of health, social and educational goals. This may include access to external health and well-being support services, tenancy support, educational and employment opportunities, and social networking both at CGT facilities and beyond. Service Provision Challenges Staff and tenant respondents identified challenges to the provision of support following the withdrawal of Anglicare in October 2013. During this period, one former Anglicare staff member was employed by CGT to provide support through the transition period. One support co-ordinator respondent noted that there was only one reported week between the exit of Anglicare staff and the commencement of re-employment of new support staff. It was also noted that Barrack Street was limited to only one support staff member for a number of months through the transition period. Consequently the exit of Anglicare resulted in a support gap of varying lengths for a number of STs and in some cases tenants 37 have yet to reengage in the support process. Oh look, there’s definitely negative consequences for the tenants because there was such a gap. Anglicare workers did try to continue working right up to the last day, because you’re working with people and their lives. And then they needed to employ people, so there was probably a gap before that happened. That might have been eight weeks’ gap for some people… Yeah, certainly there was, particularly if you’re working with someone quite intensely, and all of a sudden they’re not there. Who do they go to, what happens to those appointments, or that support that was happening? (SP02) Support service respondents expressed awareness of the effect of this changed environment on tenants. They explained that Anglicare developed an exit plan in collaboration with CGT in which communication with the broader support sector was prioritised to reduce the potential for disadvantage to tenants. This included advising all external stakeholders of the exit and encouraging them to continue supporting tenants through the transition. Written reports were provided for new support co-ordinators to ensure they were adequately informed about the tenant support history at CGT. The re-employment of support staff was also prioritised by CGT. Although CGT respondents acknowledged that re-establishing trust and rapport with tenants towards re-building support goals would take a number of months into 2014 there was also optimism about the changes. The new team-based approach and increased collaboration 37 As at the middle of December, 2013. 72 between service activities was cited as already bringing about effective outcomes for tenants38. I think we were really clear … that we would have an exit plan in place that did not disadvantage any of the clients. So that was our Number 1 principle. (SP06) [When Anglicare left] we had a team in place and you know, connections made with those tenants. The fact that was able to be achieved in that relatively short period of time demonstrates we did have the tenant’s interests absolutely foremost in our minds… (SP14) I think people will start to feel settled by mid-January but I don’t believe that we’ll have everything firmly in place and when I say firmly in place, things are going to continue to evolve and change. I can’t see it happening before February with regards to people feeling really settled as a team, as a full team.(SP04) 4.3.2 To what extent has the organisation been able to deliver a positive environment conducive to social inclusion and participation, including opportunities for tenants to reunite with and increase connections with family members? Since establishment, CGT has been successful in creating a positive environment where social participation and social inclusion is actively encouraged and facilitated. The high quality communal areas provide unique opportunities for all CGT tenants to engage in recreational and social activities conducive to community building and social participation. In Barrack Street this includes two common areas with outdoor courtyards, full kitchen facilities, and lounge and dining areas, as well as billiard table, audio and visual entertainment, art studio, and outdoor gardening areas. Campbell street facilities include a common room including full kitchen, dining and lounge, Ping-Pong table, audio and visual entertainment, a purpose-build computer lab, well-ness centre, and outdoor communal areas, including the potential to develop garden and recreation areas. At both facilities current events and notices are clearly displayed on pin boards, and a newsletter is circulated weekly to tenants regarding regular activities and news items relevant to tenants. Regular staff and tenant-initiated social activities (for example, cooking, art, tai chi, discussion based and learning based group activities) take place in both facilities, and are dependent on tenant interest and participation. It’s [Social activities] a huge part of their life and I think has been part of the huge success that some of them have been able to enjoy, particularly the opportunity to go into for example the arts 38 We have been advised by CGT that a survey of STs undertaken at the Goulbourn Street facility in June 2014 describes tenants as providing a positive account of the support provided by CGT. 73 studio or to be able to go into the kitchen and just start cooking. Yeah unbelievably significantly contribution because there’s just not that sense of isolation and that loneliness. (SP14) But yeah, like the Art Studio … one of the formerly homeless tenants has really taken to that over the 12 months so he’s in there a lot too, and what I’ve noticed, when they’re out smoking in the common smoking area, what’s transpired over the last 12 months is a lot of them are using that as a meeting area. They might just even just sit in there and chat while the others are painting, so it’s actually been a really good meeting area, and they play some music and whatnot. (SPO2) Special events, such as the art exhibition held in November 2013, enabled a number of tenants to exhibit their work, build connections with local community members, and successfully employ their skills commercially. I mean we had this art exhibition… One of the [Tenant name] the guy who did the painting … he earned $1000… [his] first independent income. (SP17) A positive environment is also facilitated through the on-going availability of support staff to assist in conflict resolution between tenants, and towards making healthy living choices (for example, reduce addictions, eat healthily, seek medical help when required). Similarly, the concierge is widely noted by staff and tenant respondents alike as contributing to a friendly and positive atmosphere. [The Concierge are] good people. They’ll sit there and talk to ya, they’ve always got a smile on their face, you know, and you can come up in a shit of a mood, be there for two seconds talking to a concierge and you’re walking away laughing. You know, and just plain and simple, I think they’re good value. (T04,BS, 26.11.13) CGT has also been successful in facilitating opportunities for tenants to reunite and/or increase connection with their families. 39 When invited by tenants, support co-ordinators discuss the issues that tenants identify as having caused relational breakdowns in families, connecting the tenant with external support (for example, child protection or drug and alcohol programs) to begin changes that may lead to family reunification; or providing on-going support appropriate to the individual situation (for example, communication skills, or financial planning towards interstate trips to visit family). In many cases, the stability of tenure itself provides a conduit for family reunification or improved relations. For example a number of (ST) mothers explained that unlike previous housing, living at CGT facilitated a safe environment for their children to visit without the threat of danger. Support staff respondents noted that they 39 This statement needs to be qualified in the context that CGT is unable to accommodate families, thus reunification is limited to visits rather than living arrangements. 74 encourage tenants to invite family to visit them in their apartments, or to join them at the communal dinners prepared by tenants. There was one chap that came in … and he’d just been through a relationship breakdown with [his parents] … But life changed, and yeah, just getting that stability, and knowing that he can ask for anything… And yeah, and he then got to the point he would meet his parents for lunch. He was really challenged by the fact that they were texting him to contact, and we talked through that and whatnot. And then he did meet them in town for lunch, and then over time, with progress that he’s actually invited them here. They’ve had meals here with him, and – so that’s really building. They’re not at the point yet where they’ve invited him back to their home, but with time, things have built up. He’s seeing his brother again, so I see that as a real positive. (SP02) All CGT staff respondents pointed to the social mix of residents as important to maintaining a socially balanced, normalising environment at the CGT facilities. The social mix of previously homeless tenants living alongside AHTs was an element of the model viewed by CGT as critical in facilitating social inclusion and developing a sustainable community. The social mix…the diverse tenant mix of both formerly homeless and working low-wage so having that social diversity is a critical element to making it work.(SP14) 4.3.3 To what extent has the organisation provided opportunities for tenants to pursue a range of education, training and employment options? Since the establishment of the facilities, CGT has provided opportunities for some tenants to pursue a range of education, training and employment options. CGT have also faced challenges in supporting tenants to engage in education, training and employment options. This is in part because the outcomes, including the proportion of support periods in which tenants are classified as ‘post-secondary student/employment training’, employed full-time’ or employed part-time’ 40 are in some cases inappropriately calibrated to tenant abilities and desires. During their implementation phase, CGT established an affiliation with the local polytechnic (TAFE), which offered a limited range of courses to STs. Subsequently it became clear that this approach to education and training was not proving effective for tenants, whose interests and abilities to engage in training were widely differentiated. Currently, tenants are supported to identify skill and employment aspirations, and where possible and appropriate, linked to available courses or activities. Support co-ordinator respondents also noted that for a number 40 As outlined in 2.2.6 of the Funding Agreement 75 of STs, depending on age or complexity of needs, formal training may not be within their capacity to undertake, at least at some points in time. In these cases support co-ordinators encourage engagement in activities such as volunteering or hobbies; activities that while not regarded as formal training or employment, also constitute an important step towards independence. …realistically, social community relationships, family relationships, meaningful use of time which could be starting employment, volunteering. For some people within their capacity it may not be something that as formal as that, it might be an activity or a hobby that they can engage in. And that’s – like even with the [Outcomes] Star [case management program], when we’re indicating change, because someone’s complaining that they’re bored, if we can link them into things within their interests and strengths, and get them attentive and participating, that to me is a meaningful use of time. So you’re using your time in a positive manner, less time then be distracted to possibly smoke so much marijuana or drink so much alcohol. I do understand we need to try to get people into the workforce et cetera, but for some of them if that’s too challenging, finding something else to do, that could be volunteering at the Salvation Army Hall. (SP02) 76 5 Evaluation of Service Participant Outcomes This chapter presents the evaluation of service participant outcomes. Participant outcomes follow the conditions outlined in section 2.2.4 of the Funding Agreement. These are evaluated in terms of provision of support according to their need based on their assessments, that consumers requiring accommodation are accommodated where the Organisation has the reasonable capacity to do so at either of the Service locations, increased stability of tenure and reductions in homelessness, reductions in resident social isolation and increased social connection, including 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. 5.1 Outcome 1: To what extent are those who are homeless or at imminent risk of homelessness accommodated where the organisation has the reasonable capacity to do so at either of the service locations? Since the implementation of CGT service, CGT has provided accommodation to those who are homeless or at imminent risk of homelessness at both CGT locations. SHS data on the extent of accommodation of the target group is inconclusive, and qualitative data suggests differences between the CGT service expectations and those of the housing and homelessness sector. Target Group data A summary of the quantitative data with reference to a range of indicators regarding client presenting circumstances can be found in 4.1.6. A significant proportion of responses pertaining to client presenting circumstances, such as client living arrangements the week before being housed at CGT, or reasons for seeking assistance by CGT in the month before entering the service, are unknown or unrecorded. There is also no data available to measure clients presenting but not tenanted. There is therefore inadequate information on the extent to which those who were homeless or at imminent risk of homelessness are being accommodated. However, there are a high number of referrals from specialist homelessness services, as well as a significant proportion of known responses citing reasons for seeking assistance as inadequate/inappropriate dwelling conditions. Together, these suggest that a 77 significant percentage of CGT STs were sourced from the homeless or at risk of homelessness population. Interviews with tenants demonstrated a consistency with the suggestion that prior to being accommodated STs experienced inadequate or inappropriate dwelling conditions. A range of previous accommodation types were cited by tenant respondents, including: boarding house, van or tent, sleeping rough, couch surfing and house sharing (private rental or relative). All interviewed tenants stated experiencing two or more of these types of accommodation circumstances during the two years previous to CGT tenancy, also suggesting instability in addition to housing inadequacy in recent housing tenures. Allocations & sector integration in referrals and allocations While evidence suggests that CGT is allocating properties to those who are homeless or at imminent risk of homelessness, the extent to which properties are allocated to those who were chronically homeless immediately prior to accommodation is less clear. This lack of clarity is due, in part, to the high numbers of tenants whose circumstances prior to presenting to the service remain unknown. It is also due to differences between CGT and sector perceptions and expectations of the purpose of the facilities in respect to housing the chronically homeless. From the perspective of CGT, senior management respondents stress that CGT is a supportive - not supported - accommodation facility, suggesting that from the point of service entry STs should have the ability to live independently and in a community environment. From an operationalization perspective, two consequences have followed from this. First, client applications are vetted before a VI survey is requested, with a primary criterion for continuing eligibility assessment being the individual’s ability to live independently and in a community setting (among others). Second, since support provision by CGT is targeted at individuals who are assessed as having the capacity to live independently and in community, the facilities are consequently considered unsuitable for those with needs requiring intense and prolonged one-on-one support. Because it is about independent living (because it’s supportive not supported) and do we believe that they can live within this communal environment and for some people it’s not suitable, it’s just not suitable. It’s high density apartment living and we recognise that it’s not always going to be suitable for everyone.(SP14) I've found it really difficult the other day to say no to this fellow. Because I can't line up what five hours, ten hours mental health support ... Because without that I can't guarantee the workplace safety of my staff. So I just can't say yes... (SP17) 78 Of the wider sector interviewees, six respondents expressed concerns that CGT are not allocating properties to the intended target group. They noted that in the context of the continuum of homelessness services available in Hobart, sector expectations of the purpose of the SAF model was that CGT’s provision of supportive accommodation to the chronically homeless was the principle strategy for ending chronic homelessness in Hobart. The participation of service providers in referral and assessment, through their use of the VI assessment tool, and in the Homelessness Reference Group, was undertaken with this expectation. CGT is not perceived by these respondents as allocating tenancies to the chronically homeless individuals who are in most need of access to higher levels of on-site and multidisciplinary support. In addition to concerns about the adequacy of the VI survey for assessing level of need, issues raised included the emphasis in the CGT eligibility criteria process on a person’s ability to live independently, in community and without a history of violence, sexual assault and arson. The concern of these respondents is that this selection process effectively screens out many of the most difficult cases for whom they understand the facilities were purpose-built. Their perception remains that CGT is housing those who are at risk of homelessness, or the primary homeless who have fewer demanding behaviours or less intense support needs. Service provider respondents working with the chronically homeless expressed frustration at how few of their most vulnerable clients, including those identified by the Homelessness Reference Group, have been deemed eligible for property allocation at CGT. One example cited was that 43 VI’s were completed by one worker over a 10-month period but had resulted in only 4 property allocations at CGT. Another respondent stated that they now refer very few chronically homeless clients to CGT for eligibility screening in order to avoid client disappointment. One of the concerns raised by these service provider respondents was the effect this had on other SAF facilities because clients who were assessed by CGT as unable to meet its criteria for independent living and had high and complex needs, were eventually housed in housing facilities funded for low support need clients. A critical point was their view that the allocation process was inadequately adjusted to take account of one of the key features of the chronically homelessness which was that they had difficulty in sustaining a tenancy: Traditionally the cohort we work with have always had difficulties maintaining tenancies, living with people, getting on with neighbours, all of those sorts of things. So that [CGT] model doesn’t necessarily suit all the people that we work with, but it’s not to say that it can’t. I think it takes a little bit of courage and a little bit of dipping your toe in the water and doing some hard yards, and 79 doing some intensive case management and support, [that] can alleviate some of those problems. (SP12) Issues raised by some respondents in the wider homelessness sector also included concerns around the lack of interface with, and/or transparency between, CGT and the homelessness sector in relation to communicating the criteria by which properties are allocated, and reasons why or why not individual clients are refused allocation to a CGT property. CGT respondents expressed awareness that ST allocations were not always commensurate with sector perceptions of who CGT should be targeting. Those involved in property allocation noted the effort CGT staff were making to reduce barriers to the allocation of chronically homeless individuals, and identified a tension between allocating properties to those with high level support needs, and providing the resources to sustain these, and other, tenancies. There are some tenants that we could never support because they need a level of forensic mental health services for example that we would just never be in that space. I suppose there are certainly people who have been through that assessment process who we’ve said we just don’t have the capacity, the resource to actually be able to support that person, and we say that’s okay because we can’t be all things for all people but it may well inform in terms of do we need to buy in that support or can we get that support from somewhere else so we certainly explore those barriers? (SP14) [We've] got AHT's to consider, [We've] got staff to consider, [We've] got the community to consider. Does that mean [we’re] soft targeting? No way, because it means all three of these [ST] guys are still there. (SP17) When I got on that table they brought you know, nine or 10 extremely difficult cases to the table and they said, you know, "This fortnight we want to allocate two people, who do we look at?" And you talk through all the cases and talk about what the current mix is like and then you allocate and every single person I've seen them allocate has been hard [high need]. (SP11) It is important to note here that the recent establishment of Housing Connect has led to improvements in collaboration between CGT and Housing Connect in the tenant allocations process. This has been perceived positively by the broader homelessness sector who view this step as providing greater transparency about which tenants are housed. 80 5.2 Outcome 2: To what extent are tenants assisted in their transition to independence through a comprehensive case management plan tailored to their individual needs and circumstances; and to what extent are tenants supported to achieve the goals identified through their needs assessment? STs at CGT are assisted towards independence through the provision of a case management plan tailored to their individual needs. Tenants are also supported through on-going support periods to achieve the goals identified through the management plan. Some successful outcomes were tempered by tenant respondent concerns due to the loss of the support worker-tenant relationship resulting from the exit of Anglicare. Case Management Goal and Support Data Data for 2012 and 2013 regarding services provided and level of tenant attainment measured is available in section 4.1.7 and 4.1.8. In general, residents interviewed across the two facilities observed feeling supported through the development of, and support to achieve, case management plans. Tenants noted both the provision of weekly or fortnightly formal meetings with support workers, and/or the ability to ask for support on a needs basis. Respondent descriptions of the types of support received ranged from requests for basic assistance with domestic duties such as cleaning or shopping to help with finances, accessing external service such as the dentist or GP, assistance with mental health goals such as reducing anxiety, accessing children, or support in reducing addictive behaviours, for example through detoxification programs. With the exception of a small number of those interviewed, tenants were satisfied with the support provided, citing the usefulness of the Star Outcomes case management plan tool, the development of good relationships with support staff, and citing a range of positive support outcomes. And when I first come in, we used to do a star chart, we’d have between 1 and 10 in a star and they were questions, you know, like how’s our drinking going? How’s our social activities going? How are our support tenancies going? And all these questions around a star and we had this meeting every three, six months and she’d mark up how well we’re doing from 1 to 10 and each time I did we got better and better and become more stable and settled.(T01, BS) Yeah, [I’ve received] a huge amount of support. My social worker [name] has helped me out immensely and other members of Common Ground have really helped me out and so that's been, that’s been really good, yeah. (T02, BS). 81 I had [Support worker name] who was really good. He helped me with the doctors, he helped me with my methadone programme, he helped me with everything, he was great. ... We had this thing and it’s got like health, income, about ten different things and then one to ten and you fill it in and then say a couple of months later you do it again and see how it’s changed. It worked well. (T10, CS) For the few respondents unsatisfied with support, reasons cited were primarily with reference to a lack of support in the development of basic daily living skills, such as shopping. I’ve asked for help about food and they still haven’t … helped me since I’ve been here the whole year. It’s pretty slack. I need the help, I need someone to help me budget my money, I need someone to take me shopping, I’ve got no idea. I haven’t eaten properly except noodles since I’ve been here. (T11, CS) I could do with a little bit more support with [support worker name] from my shopping. It's not going too good at the moment. (T07, CS) Changes in Support Services Tenant respondents raised a number of issues related to service changes through the exit of Anglicare and re-employment of a range of new support co-ordinators. For those tenant respondents whose primary Anglicare support worker was re-employed by CGT, changes to their support were minimised and the stability of support provision through this transition was expressed as a relief. So thank God for that because we put all our effort into [name of support worker] and then they’re going to pull the pin on it and we’re all freaking out, yeah. And then they’re going to pull the pin on the Concierge’s, hire their own mob, you know, and we’re thinking, you know, all our friendship and all our year of chatting and getting to know each other and that’s going to change it, so yeah, drastic changes like that affect us. (T01, BS) The only issue that came up for me was if [name of support worker] left. That was going to be a major issue for me. I talk to [support worker] about it before she got offered another thing. I just thought that her leaving and someone else coming in there it just would have been – it would not have worked. And [name of support worker] worked with me since I’ve been here and she’s an older woman, she’s a mature woman, she certainly understands where I’m coming from and where I’ve been. (T03, BS) For a number of tenant respondents whose support underwent a change in personnel, the shift was marked by anxiety or a complete disengagement in the support process. In 82 particular, some respondents noted the need to re-explain their story again as emotionally difficult. I: When [support worker name] left, did that have consequences for you? T: Yeah, I think that's how I sort of got - my schooling went downhill. I got a little bit - smoked a bit more dope and just withdrew from people here. But it's all right now. (T07, CS) I was a bit funny on that because the new people came in so we had to start all over again do we and that, and I thought, no I can’t be bothered with this. I’ll speak to them when I have to. I had a good relationship with the other mob. You get attached and then they f------ piss off. (T10, CS) T: No I haven’ [re-engaged with the new support co-ordinators], just because I hate re-explaining myself. Because I’ve been in foster homes and stuff like that I’ve just explained myself that many times that when it’s someone new I just think here we go again. She didn’t know anything about me or anything and I was like now I’ve got to tell her. So I find that hard. I: Do you think you might engage in the future? T: Yeah definitely, I’ve just got to get used to it, just lightly tread and see how I go. (T08, CS) 5.3 Outcome 3: To what extent have tenants actively participated in education, training or employment as appropriate to their individual needs and circumstances? While increased participation in education, training and employment has occurred in some cases where desired by tenants themselves, not all CGT tenants are able to, or are interested in, pursuing these activities. Data regarding the type of education / training CGT tenants are enrolled in, and their source of income can be viewed in section 4.1.8. Tenant respondents reported on various strengths of the CGT environment in increasing access to work, education and training opportunities. These positives included: increased security of tenure providing the context to focus on study or continue building skills (often contrasted to previous unstable living environments); improvements in health and wellbeing building capacity to consider undertaking future education; and encouragement from support providers to undertake study, including the identification of appropriate education opportunities and means to access them. I: Do you still feel like you’re moving towards some of the goals that you’ve set earlier, in that case? T: I have. I do plan to do a horticulture course next year across the river. I’ve just… made that start. (C06, CS) 83 I'm pretty much trained in [qualification] so I didn’t really need any more training it was just getting back onto the computer. Because ... now I can use my laptop and know that it's secure in my unit so that’s been really good, yeah. (T02, BS) Yeah well there’s a few people who started going to school after they moved here and the thing is too we get paid to go to school. I think that’s wonderful. (T03, BS) However some tenant groups, particularly older tenants and those with chronic or mental health conditions, do not desire to participate in work, education or training. Some respondents felt they already have adequate skills, and others noted that their mental health issues prevent them from engaging in education or training. I’ll just stick to my artwork I think. I think I’m getting over the hill now, there’s no profession and my artwork’s my career so I’ll stick with what I know, because I’ve got a good resume and that from the past. (T01, BS) I’ve got a bit of a short attention span so I can’t sit in a classroom for very long. I’m on a pension from Centrelink ‘cause Centrelink done a test on me and, to them, for me to sit and think and concentrate, I’m no good but for me to be hands on, I’m 100%. ... To me, I feel I didn’t have the time to be a teenager or be a young adult ‘cause I have literally worked most of my life so I feel, at this point in time, it’s me time. It’s time to work out what I want in life and I just don’t feel, at this present time, work is what I need. (T04, BS) Another group of tenant respondents noted that they have moved in and out of education, based on circumstance and level of support required. For example, prolonged periods of anxiety, or the choice to undertake detoxification through an off-site program may be disruptive to study, and cause a tenant to defer training for a period. I give up [study] this year. I've got a lady from Centrelink coming here today and I have to say that I'm giving up. But I know what I'm going to do next year. I've got some voluntary work through Tasmania's Voluntary Centre, which is just next door here. When I get out of my rehab and everything, I'm making an appointment with him to try and get into some op shop - volunteering in the op shop. Maybe that might help me to meet people and make some friends and stuff. Yeah. (C07, CS) Consequently, as noted in section 4.3.3, CGT goals of increased tenants participation in education, training and work may not have been successful primarily because the outcomes are not well aligned with tenant needs. But it should also be noted (see Table 3-15) that prior to moving into the CGT facilities, 20 per cent of tenants were engaged in employment and 32 84 per cent were actively seeking work. It may be that there is some scope for improvements on current levels of achievement by CGT staff in relation to supporting tenants to find work. 5.4 Outcome 4: To what extent are tenants actively encouraged and supported to maximise their level of independence and life skills Tenants at CGT are actively encouraged and supported to maximise their level of independence and life skills. A key objective of support provision at CGT is directed towards the development of independent livings skills through the achievement of goals. The data on the extent to which all the goals identified in case management planning (stability of tenure, health, education, training and employment, and social/familial connections) are relevant here and can be found in section 4.1.7 and 4.1.8 above. Tenants arrive at CGT with varying degrees of interpersonal and independent livings skills, which also may fluctuate depending on tenant circumstance and health. Tenant respondents are acutely aware of the benefits of increasing independent living skills, and highlighted many aspects of CGT as contributing to this attribute. Many tenant respondents cited stability of tenure as central to increased independence, alongside aspects such as safety and security, increased hygiene and cleanliness, receiving support to improve basic domestic skills, budgeting and financial planning, or having one’s own facilities to cook in. Because I lived at home for so long, we didn’t have many domestic skills and so that cleaning, washing, cooking ... she [support worker] helped me with in regards to like I said, yeah, domestic things and things like that. Just my overall lifestyle's changed, yeah, and that's been really good and be able to kind of have a good perspective on things... That's probably the main thing, yeah. (T02, BS) One day I just - I went to get a packet of smokes and I had a little bit of money or something. I thought, I'll grab something for tea. He [partner] got quite a shock, because he thought, well, yes, he said, "You are improving, because you wouldn't have done that six months ago". Just – yeah... [so] probably my confidence, just being able to do little things myself, like shopping and that. (T07, CS) On all levels my life has improved because I’m safe. I have somewhere where I can go to every day that’s mine, that I feel confident in, that I’m independent in. And that can only build your selfesteem and your self-respect. So on every level I feel better about myself (T03,BS) 85 While many tenant respondents indicated an increase in independence skills, the School of Medicine survey also indicates that close to 50 per cent of tenants continue to require additional assistance with daily activities, such as internet and computer use, change management, transport, access to children, budgeting reading or domestic skills such as cooking. A key challenge noted by tenant respondents to increased independent living skills was a perceived lack of agency and ownership over issues related to their tenancy, including: improvement to facilities, decisions about staff changes, or suggestions for social activities or social events by tenants. Tenant respondents raised the issue that while CGT staff and tenants had established a number of suitable feedback mechanisms, such as feedback forms or TAG meetings, suggestions for improvement or concerns about current issues were perceived to be not heard or acted upon by CGT staff. Some tenant respondents stated that in having suggestions repeatedly ignored, their ability to act with a degree of agency in their own home environment was limited. Other respondents felt that delays in the development of outdoor communal areas, for example the Campbell street garden area, curtailed their ability to become involved in the use of, and further development of their skills (for example, gardening). We have TAG meetings and I feel like it’s more to make Common Ground feel better about themselves than actually us being listened to. And the fact is we live here. We see everything and there’s underlying things that aren’t being seen and we’re not actually being listened to. (T03,BS) I’ve been to probably three [TAG meetings] and after I realised that they aren’t fully listening and don’t want to do anything to help them problems, I thought what was the point of me coming up and trying to voice my opinion if they’re not going to do anything about it.(T04, BS) I think they've got - people like [manager] and that have got to listen to us a bit more. Listen to the people that actually live here. Because they don't, if you know what I mean. They go home. They knock off. We live here. (T07, CS) The next TAG meeting I think is today and everyone’s like “Are you coming to the TAG meeting?” and it’s like what’s the point? No one’s listening. (T11, CS) 5.5 Outcome 541: To what extent has the organisation increased family reunification and social connection amongst tenants? 41 Outcomes 5-7 are not specified as pursuant Consumer Outcomes in the Funding Agreement (2.2.4). They have been included as inferred desired outcomes based on the Purpose of Funding and Strategic Objectives (2.2.1 & 2.2.3). 86 There is limited quantitative data related to this outcome, however qualitative data suggests that CGT has been successful in increasing family reunification and connection amongst tenants where the tenant has desired this outcome. The first bi-annual School of Medicine survey found that more than half of the STs had spent time with family members at least once a month in the prior 6 months (to April 2013). Satisfaction with current family relationships by tenants is moderately low at approximately 30%. However there is limited CGT data available with respect to whether rates of family connection have increased or decreased. CGT facilitated (re)connection with respondents’ families in a number of ways. Primarily, the safety and security of CGT provided a basis for (re)facilitation of family contact and the (re)building of family relationships. In addition, tenant respondents noted improvements in health and well being as a foundation from which to reconnect with family, citing support as important towards the re-establishing of familial/social relationships in healthier ways. Yeah he’s [father] had a visit. Yeah, oh he came down. He can hardly walk, he’s on a walking frame and that, but he was pretty happy with it. He’s seen me in a lot of different places and he knows I’m a lot happier here. (T01, BS) And I’ve talked a lot with [support worker] about that and about what to do, how to re-establish a relationship with my son and not do the same thing to him that his father’s doing that kind of thing. Now I needed help in that and she was very good in helping me with that stuff. (T03, BS) My mother visits quite regularly. (T06, CS) Tenant respondents cited similar reasons for why support at CGT facilitated increased social connectedness: stable housing tenure, increased health and wellbeing, and increased support to cope with the emotional and mental health issues arising from relational challenges. Well I suppose the main thing is because I've got a place of residence, I've got - I can say to a friend, "Look, you know, do you want to come around and meet me here and then we'll go to the city," or et cetera. So, yeah, it does, yeah. (T02, BS) A primary objective of CGT is to facilitate social connectedness between tenants through the utilisation of their facilities. For example, social initiatives to foster community at CGT includes both tenants and external members of the local community in activities ranging from cooking classes and communal meals to health and art classes and exhibitions. While the extent to which tenant respondents chose to be involved in these social activities varied from no 87 involvement to extensive involvement, all respondents demonstrated an awareness of the social activities available to them as CGT tenants. Many tenants were willingly involved in one or more of these initiatives. Yeah, they’re growing food down there, so they’re doing that. Meetings with the volunteers. The volunteer people were here just earlier this week and they were talking to us about volunteer work and getting part of the community and that’s one of the issues, being part of the community, seeing it like a community based thing to try and steer us to a community sort of individual, not lock yourself away and do nothing (T01. BS) We sit and have coffee together, we go into the common rooms and sit down... It’s starting to become a community and I think that that was probably the idea of it in the beginning was that they set up a positive community. ... People who don’t know anyone get to know people here. I mean I didn’t know many people down here. Hobart’s not really my stomping ground. But in terms of seeing people and talking to people and there being company yeah this is a really good place for that. (TS03, BS) Well just that warm, a sense of community with the other residents here, was one of the main aims. There’s weekly meals. They cook a meal, it’s by volunteers, they cook a meal every week, so we get together and some nights there’s more people, other times there isn’t. That’s one of the community things. Also there’s, in the common rooms there’s a table tennis table, so I play table tennis occasionally with some of the other residents. So there’s opportunities to interact. (T06, CS) Tenant respondents were divided about whether the social mix at CGT facilitated social connections. While some respondents enjoyed living with a socially diverse group of tenants, others felt animosity or disinterest towards STs from the AHTs. There’s people here who I enjoy spending time with and who I can talk to and I think that mixture is really good. When you’ve got a mixture of people then that’s how you learn too. Different people and different experiences, different lives and I mean that’s what keeps you going is learning. And you know I learn things from people here all the time. And I enjoy most of their company. So I think it’s a good thing. (T03, CS) They [workers] think they're better than us. Simple. They never try and make friends with us or anything. (T07, CS) Well, you cannot have a community if you’ve got people [AHT’s] that will plain and simply ignore you and turn their nose up at ya. You can’t make a community with people like that, plain and simple. (T04, BS) 88 Yeah well I think it works really well. Yeah we never see them. We never see the workers. They’re either out working or you they just never come out. They don’t become of the community, but that’s not to say that they’re no good, it just means we don’t know them. (T01, BS) It is noteworthy that the School of Medicine survey highlighted that over 60 per cent of tenants would like further assistance to participate in community or leisure events in addition to what is already in place. This included activities like going to see a band perform, attending a museum, exercise and information about, or transport to, other community events. 5.6 Outcome 6: To what extent has the Organisation improved resident health and wellbeing? The health and wellbeing of tenants is liable to significant fluctuations subject to a complex range of factors including mental health conditions and health and wellbeing histories. Data related to tenant health and well being prior to, and during their supported tenancy at CGT can be viewed in section 4.1.8. Due to data limitations the impact of CGT on tenants’ health is impossible to ascertain definitively. However, it is clear from respondents that the supports available at CGT have improved tenants’ capacity to manage their own health and wellbeing. Tenant respondents noted both increased health and a positive sense of wellbeing since tenure at CGT. Health improvements cited included physical health, for example through access to a range of specialist services including gastroenterology, dental or drug and alcohol programs. While tenants did not always use the term ‘wellbeing’ explicitly, many descriptions used by tenants encapsulate its meaning, for example, being happier, feeling better about themselves and their circumstances, feeling a sense of freedom and independence, an absence of anxiety or worry, or increased sense of self. [I’ve enjoyed] just having a roof over my head. Not having to worry. (T07, CS) Apart from that, there’s just having me own life, having somewhere that I can lay my head of a night and not worry about what tomorrow’s gonna bring. Being able to access cooking facilities, you know, that’s awesome. (T04, BS) Just the stability. I don’t have to - before I had to take around all my stuff when I was homeless. Now I can leave my stuff, I've got - you know, it's secure and so that’s one of the good things. And again, it's just piece of mind. (T02, BS) 89 Well probably most of my life has improved in that I’m not having to live in an unknown house and a known drug house. I do not have to have anybody in my house that I don’t want in there. ... On all levels my life has improved because I’m safe. (T03, BS) 5.7 Outcome 7: To what extent has the Organisation provided stability of tenure for tenants? CGT has been successful in achieving stability of tenure for tenants. CGT is committed through both of its facilities to provide long-term or permanent, secure housing for tenants. Data on the extent to which tenants were chronically homeless prior to GGT tenure is presented in section 4.1.6. Additional data presented by School of Medicine survey suggests that for close to 70 percent of respondents, Common Ground feels like home, and more than 75 percent agreed that they would like to live at Common Ground long term. For over 50 percent of the STs in the survey (n = 23), the most positive difference to wellbeing over the last six months was related to securing a property at CGT, including the stability it enabled and finally having a place to ‘call their own’. Tenant interviews corroborated with this evidence; in particular female tenants whose previous housing arrangements had been unsafe. Just the stability... it's just piece of mind. (T03, BS) Stability is very important to me because my whole life I’ve just moved and moved and moved. The previous house before this one I was in for two years and that’s the longest I’ve ever been anywhere. I’m coming up to a year here, I’m re-signing my lease today at some stage for another year so I like that stability factor. (T10, CS) Tenant respondents also expressed a sense of pleasure in the facilities available to them. Many described previously living in unsavoury, often overcrowded and unkempt buildings, so that moving to CGT with the newly decorated facilities was a taste of luxury. A small number of tenant respondents noted that the studio apartments were too small, and in some cases tenants had transferred (at the renewal of a lease) to a one-bedroom apartment. In most cases however, respondents commented on the pleasures of having their own space, including a large bed, their own bathroom, their own cooking facilities and modern appliances in good condition. Yeah definitely it’s the best place I’ve ever been in and the studio’s really good, you know, I’ve got my art up and I just feel at home as if I’m living in an art studio. … It’s like a motel, I’ve never lived in such luxury. (T01, BS) 90 Beautiful. Double shower, the shower is massive. The bathroom would literally be three quarters the size of this room and then most of its just open plan, bed, kitchen, window…It’s grouse and I’ve decorated it how I want. Well if you want to nail things in the wall of course you’ve got to ask but I’ve got this beautiful tiger hanging off my feature wall… (T10, CS) Tenant respondents felt that the procedures for establishing a tenancy with CGT were transparent, including property induction and clarity around their rights and responsibilities under the RTA and the rules for living at Common Ground. For example, respondents commonly cited prompt payment of rent and good neighbourly behaviour as key to sustaining their tenancy; and that a number of tenants had been evicted42 in the past due to breaches of these rules. Many respondents had sought assistance in establishing direct debit to automatically pay rent, or a payment plan to pay off the bond payment. Tenant respondents reported few problems related to their tenancies, with the exception of minor disruptions to peace due to loud music, or occasional interpersonal conflicts. Many tenants indicated that if problems did occur with their tenancy, they could talk to the tenancy manager, their support worker, or the concierge. [If I had a tenancy problem] I’d just come down here and give her a call or… just ring up Rock Property myself. (T06, CS) Like, there has been a time, because I had a next door neighbour and her music was loud. I just went to the concierge and said, "Could you please do something?" (T07, CS) I’m alright with rent. I get it direct debited straight out, there are no worries there (T08, CS) They did tend to emphasise everybody’s right to quiet enjoyment I think is how they put it. (T09, CS) A small number of tenant respondents desired to leave CGT in the near future. Younger respondents tended to view their CGT tenancy as a secure and stable foundation from which to establish health stability or undertake study or training. Women respondents of all ages with a history of violent or dangerous housing contexts, as well as older tenants, anticipated staying in CGT facilities permanently. I’m over it. I don't think I’ll even stay here for a whole year (T11, CS) 42 The Anglicare report January – June 2013, along with updated data provided by CGT states that 4 tenants have been evicted from CGT tenancies during 2013 due to behavioural breaches. 91 I'm hoping to get another place. But if I did renew my lease, I was probably going to try and renew it for six months and look around. I don't want to rush into anything, or anything like that. I don't want to - I want to take it slowly. Find something that I really like, yeah. (T07, CS) My master plan is to… work full-time, get off the disability pension and to be un-medicated... Maybe [stay at CGT] a couple of years until I gain full-time employment. (T06, CS) I want to be here forever and that’s what I said to [friend], I said “If … I move into Common Ground, it has to be permanent because I’m not moving again”. (T10, CS) No - moved enough in my life. No I see [CGT] as a very long term. (T03, BS). 92 6 Discussion Information of Service Provision and Outcome CGT is providing secure, safe, and stable long-term housing tenure to individuals with lowincomes, and individuals with a history of chronic or episodic homelessness, or who are at risk of becoming homeless. The provision of this service is carried out across two modern purpose-built facilities in Hobart city, offering studio and one-bedroom apartments at lessthan-market prices to STs in addition to a range of indoor and outdoor communal facilities. On-site therapeutic support is provided to tenants with a history of homelessness. Tenants generally reported high levels of satisfaction with their tenancy, including the facilities available to them, the safety and security of the sites, and the on-going support available to them. Most tenants also noted improvements to their health and well being, either arising due to the safety and security of tenure, or as a direct outcome of the support provided in conjunction with their tenure. This discussion highlights the strengths of the CGT service, as well as some challenges identified during the evaluation. These challenges relate to: the change from an externally contracted model of support service provision to one in which services are provided in-house; service targeting; the effect of tensions inherent in the governance arrangements of the CGT service on tenant and service outcomes; and issues relating to contracting, reporting, and data capture processes. 6.1 CGT Service Model Recent homelessness policy reforms in Australia have been identified with the Housing First approach, into which the Common Ground model of tenancy, security and support provision fits. There is evidence that the direct provision of secure housing for previously homeless tenants, combined with support services to assist tenants in improving a range of health outcomes, has enabled previously homeless individuals to sustain their tenancies and move towards independence through improvements in health, well being and social connectedness. This evaluation has found that at the level of on-the-ground service delivery, the separation of tenancy, concierge and support services is a key strength of CGT’s capacity to assist residents to sustain their tenancies. All service provider respondents noted the advantages of clear demarcations between tenancy, security and support roles. Each service endeavours to provide high quality services to tenants at CGT, and demonstrated a commitment to the 93 tenants and the service delivery objectives. Evidence of each service’s commitment to provide high quality outcomes for tenants was clear from their collaboration in relation to individual tenant objectives, and the extent to which there was encouragement to leverage the tensions inherent in collaborative practice to affect the best outcomes for tenants. For example, the tenancy manager has utilised expertise with the RTA to educate and support concierge staff regarding their rights and responsibilities to tenants. Similarly, support workers are able to assist the tenancy manager to gain a deeper understanding of why a tenant might be causing minor disturbances, and collaborate in strategies to reduce instability. The interfaces between the various services provide critical points of collaboration through which tenant care is prioritised. The separation of support services from tenancy management in the tripartite arrangement was accompanied by clarity about the mechanisms for tenants to address any concerns to the appropriate staff member. For example, tenants were aware of who to talk to for tenancy related problems, and understood that the concierge would be able to help them at night to address any disturbances or anti-social behaviour. Importantly, tenants and staff noted that the on-site support environment facilitated the growth of spontaneous, fluid relationships between staff from all services and tenants. This did blur boundaries between professional roles in some cases, but tenants in particular felt strongly that this was an important and productive element of their home environment. Many tenants, for example, noted the friendliness of the concierge staff, to the extent that some tenants named them ‘friends’. CGT service provider respondents indicated that while many contacts with tenants were formal (for example, in relation to a service activity, such as a tenancy issue or a support issue), the informal contacts with tenants were important for building trust, rapport and a positive living environment for tenants. The concierge cited examples of providing assistance to tenants in maintaining their apartment, or being a supportive presence if a tenant was feeling anxious. The tenancy manager similarly noted that her interactions with tenants went beyond tenancy issues, to include casual, friendly conversation and at times a supportive companion. While the benefits of delineating service provision roles is evident and the expert provision of services appropriate in its context, informal social interaction was also sought by tenants and extended to them by staff. We suggest genuine friendships and sincere social interactions based on respect are critical factors contributing to the ‘normalised’ experience of tenure for clients at CGT. As the Housing First model has evolved, the way in which the principle of separating tenancy management from tenant support has been implemented has varied. In northern Tasmania the SAFs are delivered collaboratively by two separate agencies, CHL and Anglicare, and the 94 Specialist Assessment and Intervention Practitioners Program (SAIP) directly contracted with Housing Tasmania. In the south, CGT has operated two service models in succession with the first involving external providers contracted for concierge and support services and the second involving an external provider for tenancy management services and direct provision of concierge and tenant support services.43 The agreement to end the external provision of support services was negotiated between Anglicare and CGT in a co-operative way, but the interview data suggests attempts at collaboration between the two organisations encountered a number of challenges. A central challenge was establishing agreement on an appropriate and equitable service and funding specification and an appropriate set of performance measures. In most such arrangements, a contractor is provided with a sum of money to deliver services, after which unexpended funds are returned to the funder or additional funds are made available in line with pre-defined terms. This was not the case with the relationship between CGT and Anglicare and as a result Anglicare encountered issues maintaining its workforce commitments on what amounted to a fee-for service basis. These challenges appear to have been particularly pressing in cases where Anglicare increased staff numbers to maintain the desired ratio of support workers to tenants only to find the number of Supported Tenancies was fragile and that a downward trend in the number of Supported Tenancies would place client support workers continued employment at risk. Our analysis of the responses received during the evaluation indicate the need for firm agreements between CGT and the support provider on how to achieve the objectives specified in the Funding Agreement and that the absence of an adequate service agreement specification between the two organisations required greater prioritisation and attention by all stakeholders including Housing Tasmania. The interviews suggest that one of the barriers to achieving greater consensus were differences in service philosophies on the most effective practice models for providing accommodation to the chronically homeless population. The interviews with Anglicare respondents suggest that although they accept the principles of Housing First they position these principles within a client-centred model of care in which there is an assumption that achieving independence and empowerment may mean different things for different clients and that some clients will require intensive support for significant periods of time while others clients will not. In contrast, CGT’s service philosophy locates these principles within a service delivery framework that aims to balance sustainable business practices, the enhancement of personal responsibility, and a managerial paradigm in which objectives and targets are met by identifying and installing the most appropriate governance structures. The interviews suggest that these differences were a critical barrier to achieving collaboration. For 43 DCM still retains the contract to provide one security personnel for each site during the 24.00-08.00 shift. 95 example, in cases where Anglicare’s support workers felt micro-managed, CGT expressed a duty of care towards their tenants. When CGT felt unable to make flexible decisions around tenant support, Anglicare’s support workers cited the need for tenant privacy and confidentiality according to industry approved, practice-based procedures. Although critical of a number of aspects of the operation of CGT, service respondents working outside CGT were uniform in their support of, and commitment to the Common Ground model of care, with its principles of housing first, emphasis on client independence and empowerment, and the normalisation of accommodation provision through strategies such as tenant support, a varied residential mix and the security of the physical environment. From their perspective, there is nothing wrong with the Common Ground model itself. Instead the challenges preventing sector collaboration, which are critical for effective service provision, seem to arise from the divergent service cultures in terms of understanding how the Common Ground principles are translated in practice. This divergence seems to go some way towards explaining why the parties involved asserted that no KPIs had been agreed despite their inclusion in the Funding and Residential Management Agreements. The exit of Anglicare and DCM (concierge) contractors from CGT raise some issues that appear to have impacted on service delivery and the achievement of service and client goals. First, tenant feedback in this evaluation suggests that the change to support arrangements may have compromised outcomes for some tenants. A number of tenant respondents spoke articulately about the way that these changes affected them by generating anxiety, invoking feelings of insecurity, leading to a loss of continuity in support and/or other activities such as education, and the frustration they experienced in needing to repeatedly retell their stories to new faces. A number of tenant respondents were unsure about whether to take up the services offered by the new support co-ordinators. These responses reiterate the importance of continuity and predictability for vulnerable tenants. The changes jeopardised the goal of providing tenants with stable and secure tenure due to inconsistencies and gaps in the provision of tenant support. For CGT supported tenants, it is imperative that in the context of vulnerable tenants’ own home environment, services are put in place in a way that minimises any risk to their longterm sustainability. This requires Funding and Service Agreements for support providers to be in place at the earliest stage of service provision and a requirement for CGT to keep Housing Tasmania informed and involved in resolution of any risks to support services. When changes to service arrangements are necessary, these should only occur after an adequate period of extensive and meaningful communication with all affected tenants. 96 These issues indicate reduced transparency in relation to CGT governance structures, particularly in relation to responsibilities for service and support delivery to tenants. The Funding Agreement states that CGT is to achieve its strategic objectives by ‘providing or arranging for the provision of support services…’ to consumers. 44 This appears to grant CGT the right to either create a sub-contract or retain direct provision of support services to consumers. However beyond the requirement that the Director of Housing gives consent for sub-contracting, there are no additional specifications covering the sub-contracting process or the content of sub-contracts, including the role of the Director of Housing in establishing these. Nor is there provision for dispute resolution processes or the limits to the sub-contractual arrangements. For example, it is possible, given the lack of specificity in the Funding Agreement, that CGT could create a ‘cooperative agreement’ with a supplier for support services rather than a sub-contract. Any positive requirement for CGT to ensure that the subcontracting organisation complies with all the obligations of the Funding Agreement is remote from the service specification that sets out what Housing Tasmania wishes to procure. In the case that a sub-contract is implemented, we suggest that currently the structure of the Funding Agreement obscures the line of accountability between the Director of Housing and the Director of Housing’s duty of care to customers. In addition, although the Funding Agreement identifies the NPAH as the overarching framework for its operation, and the NPAH is informed by Housing First principles, it does not specify that tenancy management and support services should be provided in a way that is consistent with a Housing First model of addressing homelessness. Consequently, the benefits of and reasons for engaging distinct organisations to provide tenancy management and support services respectively do not form part of the service specification. This makes the purpose of the Funding Agreement less transparent than it otherwise might have been had the defining elements of the Housing First model been included. Under the current arrangements of direct provision of support and security services by CGT, which limits the separation of services from CGT to tenancy management only, the extent to which the Common Ground operation in Tasmania is an implementation of the Housing First model of homelessness service provision is open to question. The separation of support services from tenure are recommended under the Housing First model for three main reasons. Firstly, to ensure that the advocacy role of support workers is not compromised by the delivery of support and other (e.g. concierge) services within the same organisation. Secondly, to ensure there is continuity of support services in the event different accommodation arrangements are made. In this way the support services are not constrained by any conditions arising from a tenancy agreement and may ‘travel’ with the client should their 44 See 2.2.3 Strategic Objectives of the Funding Agreement. 97 tenure needs change. Thirdly, to ensure that adequate expertise, sector knowledge and integration is maintained in the provision of support to tenants (Johnson et. al, 2012). Because tenancy management services at CGT are provided by an external provider the first requirement is met, but there are potential difficulties with the second and third requirements. It is not clear how continuity of service will be provided to tenants who leave, nor how well the in-house model of support facilitates integration with the homelessness sector and ensures access to its expertise. The latter is especially important given CGT’s corporate model of service delivery which, in its original formulation was to be balanced by bringing in homelessness sector expertise through the arrangement with Anglicare. Given that CGT’s strengths are its business practice and networks, Anglicare’s strengths in industry-approved support practices, networks and knowledge were regarded as essential to meet the needs of CGT STs. Under the new arrangement of direct provision of support services it is possible that homelessness sector knowledge within the service, and CGT’s capacity to integrate with the homelessness sector, are diluted. 6.2 Occupancy Levels and Allocations A key set of issues raised by this evaluation relates to concerns about occupancy levels and property allocations. These issues relate to vacancy rates, allocation timeframes, CGT allocations tools, eligibility policies, and targeting of the client group. The issues are complex and situated in a specific service context but they are important for the housing and homelessness sector in Tasmania, especially CGT and Housing Tasmania. They point to the need for all stakeholders to collaborate in ensuring the needs of Hobart’s chronically homeless population are met. Both of CGT’s two facilities in Hobart were fully operational by the end of 2012 but by March 2014 they had yet to achieve full occupancy, and for most of the period were well below minimum levels for both STs and AHTs. In the case of STs the explanation for this lies partly in CGT’s concern to increase occupancy slowly to ensure a stable tenant environment and the need to manage the change in support arrangements for tenants following the departure of Anglicare. However, these factors are no longer operational and it is essential to improve occupancy levels given the level of housing need amongst the homeless population. The high vacancy rates amongst the AHTs are of equal concern given their impact on the financial viability of the facilities. For both STs and AHTs there is an urgent need to improve vacancy rates. For AHTs, this may require a review of the rent setting model to ensure it is set at optimal levels. 98 Timeframes for allocating properties are reported as four to six weeks from first referral. There was a perception amongst some service provider respondents outside of CGT that this was lengthy, given the vulnerability of this population. The contractual documentation for CGT with Housing Tasmania states that a minimum of 40 per cent of property allocations at the Common Ground sites are to be allocated to individuals: ‘who have been absolute or primary homeless in the period before they become a resident’ (RMA, p.39); or ‘who were chronically homeless in the period immediately before they were accommodated’ (FA, p. 38). This is generally consistent with other Common Ground services in Australia in which the target population for long-term accommodation provision is the most vulnerable from the primary or chronically homeless population. Within CGT a key operational principle is that not all chronically homeless individuals are suitable for accommodation at CGT, and they are confident that their allocation tools and decisions are appropriate for the objectives set out in the Funding and Residential Tenancy Management Agreements and are appropriately calibrated to the resourcing levels, facilities and tenant mix that characterise the service environment. The organisation has invested significant effort in developing policy and operational procedures for ST property allocation through strict eligibility criteria and processes including initial screening, the use of the VI survey and an in-depth report on the history of potential tenants. CGT respondents agree they are ‘selective’ in tenancy allocations and require screening of all prospective tenants to ensure they possess a level of independence and ability to live within a socially mixed community setting. CGT respondents explain this is necessary to maintain a balanced and healthy ‘normalising’ accommodation environment into which new tenants can integrate with adequate support. In response to concerns about whether they are appropriately targeting the intended client group of primary and chronically homeless their view is that the VI determines who are the most vulnerable of those undertaking intake assessments and this is used to decide on whether they will be offered a vacant property. In their assessment their tenants have high and complex needs. This view was supported by one informant outside CGT who believes that, with the establishment of Housing Connect, CGT are allocating tenancies to an appropriate proportion of high needs clients. Other respondents in the broader housing services sector highlighted the following points: Targeting: The perception of these respondents is that despite their referral of homeless clients who they have assessed as suitable for CGT tenancies, a high percentage are rejected. They believe this is because the allocation processes are, in some cases, screening out high needs and chronically homeless clients from eligibility at CGT and that this is problematic because CGT is funded to house high support 99 needs individuals within the chronically homeless population. From their perspective, the pre-screening process to ensure eligibility to live independently at CGT operates in a way that excludes the most difficult homeless clients from CGT tenancies. This perception was held particularly strongly by those respondents who were engaged daily in supporting the primary or chronically homeless. They regarded characteristics of high needs, difficulty maintaining social relationships, and high support requirements to transition to independent living as inevitable features of many of their homeless clients. To screen out those who may experience difficulty conducting themselves as ‘good neighbours’, living independently, or who carry a record of violence/assault, arson or drug dealing, immediately screens out many of their most vulnerable homeless clients from accommodation at CGT facilities despite their understanding that the facilities have been designed for this group. There is a consistency in these accounts that is also supported by the available data from the HRG that suggests high numbers of referrals are refused accommodation by CGT, as well as the continuing high vacancies at the two CGT facilities. Service Integration: Another area of concern was perceptions about limited collaboration between CGT and other housing and homelessness services within the region. This was believed to hinder the capacity of both CGT, and the sector as a whole to achieve its objectives and, in their view, made inadequate use of the depth of experience and knowledge the sector has to offer. These respondents experienced CGT as reticent to communicate its reasons for refusing allocation to clients who had been assessed by them as appropriate, and as unwilling to work with the referring service for their re-application. These respondents also sought more engagement from CGT in relation to addressing their concerns that the assessment processes for allocations needed adjustment because they did not capture key reasons for homelessness. These respondents believe that there is limited collaboration and communication between CGT and the housing and homelessness sector, and that this, together with slow allocation of properties, and the rejection of the more resource intense homeless individuals, has meant that other services within the sector have to meet their needs despite not being funded for this. They provided examples of vulnerable and high needs clients being housed and supported in accommodation designed for individuals with low support needs due to their rejection from CGT facilities and the lack of appropriate alternatives. They were concerned at what they saw as some mismatch between the funding received by CGT and the level of service it provides to the 100 homeless sector. They also believed that one of the reasons why CGT was cautious about its capacity to support tenants with high and complex needs was that it was not drawing sufficiently on the depth of expertise and support available within the sector. In their view, improved referral, consultation and collaboration with the full range of available services across housing, education, health and family services, would increase the capacity of CGT to meet the demand within the homelessness population for housing. Importantly, all stakeholders including CGT, agree there is a gap in the homelessness sector’s capacity to appropriately provide housing for the most difficult, long-term, and chronically homeless population, and that within this group there will be some who may not be suitable for accommodation in a community-based facility such as CGT. The extent to which CGT sits apart from other housing and homelessness services is most likely influenced by its distinct service philosophy. Its principles of financial sustainability, supportive rather than supported housing, and emphasis on being a mainstream housing provider, infuse the service culture of CGT, including the design of eligibility criteria and allocations procedures. Although CGT has been developed as a Housing First approach there is a tension between Housing First principles of providing housing regardless of whether clients are drug-free, debt-free, or ‘housing ready’ and CGT’s requirement that tenants are able to live independently, with some provision for training, education, or external support to assist them to achieve this. This requirement to live independently implies a degree of housing readiness that may, at times, be at odds with the Housing First emphasis on providing stable, permanent housing as quickly as possible. CGT service provider respondents expressed the view that they operate differently from previous models of homelessness service provision and this differentiates it from other services in the sector. This is evident in the observation of a number of CGT respondents that it is not a homelessness service. This is not necessarily a cause for concern in itself, but becomes one if it is associated with low levels of communication and collaboration with other services, as is suggested by the interview data. CGT’s Funding Agreement specifies (Activities 2.2.5) that to provide seamless support to tenants, CGT must ‘establish close working relationships and good linkages with other support services and work with these services’. Further, a core aim of both the NPAH which is underpinned by the Housing First model, and Housing Connect, which provides the immediate service provision context into which CGT fits, is improved service integration. In this case CGT’s limited integration with the sector appears to have limited its capacity to meet its goal of housing the most needy chronically homeless. 101 The changes that have been made to CGT’s model of service delivery from a mixed provider model to one of direct service delivery is a further factor contributing to perceptions within the sector that it is operating in a way that is somewhat detached from the broader homelessness service sector. 6.2.3 Improving Targeting and Service Integration The sector’s concerns about client targeting and service integration at CGT finds some resonance in overseas evidence where new housing service providers broadly following the Housing First model have been found to be reluctant to work with those who are traditionally ‘difficult to house’ and not always successful in predicting which applicants will be able to sustain their housing tenures (Stefancic and Tsemberis 2007). Some Housing First projects have also reported lower rates of housing retention in spite of the extensive selection criteria applied in recruitment strategies (Johnsen & Teixeira 2010). An example of this is Common Ground New York, which adapted its initial intake to create greater flexibility in the allocations process including removing some behavioural and legal exemptions. This enabled the organisation to capture a greater number of primary homeless individuals for tenant eligibility (Johnsen & Teixeira 2010). It is possible there are tools within the Common Ground network and other Housing First models that should be considered by the service to ensure its allocations procedures are aligned with current evidence-based industry practice. The Funding Agreement and the Residential Management Agreements provide basic parameters for the target allocations group in the requirement to house individuals who have been absolutely or primary homeless immediately prior to presenting at the service. However, to reduce confusion or disagreement about who CGT should be targeting, the target group should be more precisely identified, including identifying the level of service need. This should be stated in the Purpose of the Funding with corresponding consumer outcomes specified in the Funding Agreement. This recommendation is different from the recommendation for the Tasmanian SAFs because in that case the identified need was to provide more flexible targets so that they did not prevent the service from increasing its intake of high needs individuals in response to periods of increased demand within the homeless population. Given the emphasis on service integration within the NPAH, and its importance for the integrity of the Housing First model, the concerns about the level of collaboration and 102 communication between CGT and the housing and homelessness sector require attention. Particularly problematic is the suggestion that service provider respondents may be declining referral of clients for application to CGT due to their experience of allocation refusals. The interview data suggests the implementation of Housing Connect is going some way towards improving some concerns around allocation but strengthening co-operation between CGT and other homelessness services should be a priority for all stakeholders. Strategies include reviewing mechanisms for improving information sharing, such as data monitoring as a site for integrating CGT allocations decisions with Housing Connect 45 . Housing Connect is also developing a Common Assessment Framework (CAF), which may provide an opportunity to align CGT eligibility assessment and referral protocols with those of Housing Connect and the broader housing sector46. Other strategies include co-funding or co-resourcing of programs, and participation in formal and informal forums that aim to improve understanding and knowledge exchange between CGT and other housing and homelessness services. This could include workshops designed to improve alignment across the sector in relation to service expectations and objectives, and allocation criteria and processes. This is especially important given CGT’s movement to a more direct model of service provision, since this arrangement has the potential to curtail collaboration with other services. Service capacity and client outcomes are maximised by sharing sector knowledge through referrals, strong networks and reciprocal collaborative arrangements. A particular focus of attention is ensuring exiting clients do not lose any supports that have been identified as important for sustaining them in appropriate and stable accommodation. 6.3 Tenancy and Reporting There are a number of areas related to tenancy and reporting we suggest need attention:47 There are questions about the sustainability of the CGT SAF model because CGT clients view their tenure as long-term or permanent when in fact only shorter-term or mediumterm state service funding for support and tenure is guaranteed. For example, the current Funding Agreement for the provision of support to tenants will expire mid-2015, and the Residential Management Agreements will expire mid-2022. Despite the obvious policy intentions of Housing Tasmania and CGT to provide continuing tenure and support to 45 Housing Connect is developing a framework for monitoring client pathways through the housing system See 1.6 & 1.7 (ww.dhhs.tas.gov.au/__data/assets/pdf_file/0005/141863/Housing_Connect_Service_Implementation_Plan.pdf) 46 See 3.4 & 3.5 (ww.dhhs.tas.gov.au/__data/assets/pdf_file/0005/141863/Housing_Connect_Service_Implementation_Plan.pdf) 47 Some of these areas have been identified in the evaluation of the SAF facilities in northern Tasmania, namely Grove House, Thistle Street and Thyne House and are therefore covered in less detail here. See Gabriel ,Lloyd and Stafford 2013. 103 residents, this potential insecurity is not necessarily communicated to or understood by tenants. There is a need to provide a commitment to on-going and adequate resourcing for the CGT support services to ensure security of tenure for ST residents. Alternatively, the FA and RMAs should reflect the intention rather than commitment of Housing Tasmania and CGT to provide permanent, secure tenure and access to support services for supported tenants. There is some tension between service goals of achieving client independence and the long-term nature of the accommodation facilities. CGT service provider respondents and tenants place high value on the security of tenure provided by living at CGT, but staff and management also have an expectation, outlined in CGT objectives, that where appropriate tenants will eventually be sufficiently independent to move to mainstream accommodation not linked to a homelessness service. Currently, intentions around the optimal level of independence achieved for transitioning people from the facilities remains unclear and unarticulated within the service, but if independence is interpreted as moving out of CGT facilities this raises questions about the appropriateness of terms such as ‘permanent’ accommodation. There is a need for this anomaly to be clarified so that the status of their long-term security of tenure at CGT is transparent to tenants. This issue is brought into sharp relief in the case of tenants who form partnerships or who have children. Eligibility for STs is based on individual tenancies because CGT apartments are not resourced for couples or families. This restricts intake eligibility and security of tenure. The goal of moving tenants towards independence and normalisation should also include entering into relationships and desiring family, but this is limited by these eligibility criteria. CGT tenants would benefit from the availability of facilities that encourage physical family integration without the loss of the support structures provided at CGT. Strategies for achieving this may include partnering with alternative appropriate housing accommodation providers and negotiating the on-going provision of support for tenants with families. CGT service provider and tenant respondents demonstrated disparity in their views on two key residential issues. Firstly, CGT service provider respondents felt that feedback mechanisms for tenants were adequate, expressing a sense of satisfaction with the steps CGT and tenants had taken to ensure that tenant voices were heard (for example, TAG meetings, feedback forms). A significant number of tenant respondents cited staff and management as unresponsive to feedback provided. Service provider respondents had some awareness of this and located any perception of a lack of response as motivated by their concern to minimise tenants’ reliance on staff by requiring them to build their own 104 skills and independence. The tenant respondents, however, interpreted this as inaction by staff, and felt their ideas were not heard. Secondly, service provider respondents generally viewed the tenant mix as a healthy and positive feature that was an important contributor to the success of the CGT model. The diversity of ages, ethnicities, and income backgrounds was valued as a normalising experience for STs. However, most tenant respondents expressed a sense of unease around the presence of the AHTs and described feeling stereotyped by them, and an absence of social connection. This difference in tenant and staff perceptions points to some communication barriers that may need to be addressed. The service objectives of CGT’s program detailed in the Funding Agreement are based on the objectives of the NPAH. This evaluation found that these objectives are not sufficiently nuanced to reflect or capture the full range of positive tenant outcomes, for all tenant groups. For example, family reunification was not desired or sought by all tenants; nor was paid employment, training or education available as an option, or desired by all tenants. Non-systemic solutions such as volunteering were reported as a positive and viable option in building social and other skills for some tenants. There may be scope for reshaping the objectives of the program to more adequately reflect the values and priorities of clients as identified in their case management plans. There is scope to improve performance monitoring, quality assurance and program innovation through more regular evaluation to ensure operational goals are being addressed and targets are on track. This is especially important for a new service. Work is also required to address shortfalls in data capture. Our review of existing datasets indicates that: o The output performance specifications are fragmented across multiple data collections. o Output performance data does not always include indicators or targets commensurate with the main purpose or objectives that define the service objectives. For example, there are no indicators of the time taken to establish tenancies from point of service entry. Additionally, the quality of the captured output data is in some cases poor with high levels of únknown’ or óther’ category responses. This renders the reported data ineffective for analysis. There is scope to improve response categories so that they reduce the use of responses such as ‘other’ or ‘unknown’, or where this is not possible, require open responses that provide more information. o There is scope to improve the Funding Agreement so that it provides more specific indicators/targets from the primary activities/objectives and improves consistency 105 between the purpose of funding, strategic objectives and consumer outcomes. For example, where the objective to provide services to support tenants towards reconnection with family is a key goal of the strategic objectives (2.2.3), it is not identified in the purpose of funding or specified as a consumer outcome (2.2.4). Similarly, support to assist tenants towards transition to independence is identified in two consumer outcomes, but not identified in the purpose of funding. o The KPIs could be improved to ensure consistency across contractual instruments. They currently appear in both the Funding and Residential Management Agreements. This should improve compliance with reporting requirements as currently CGT reports presented to Housing Tasmania inform only some of the KPIs. There is also scope to improve the relevance of the indicators in order to monitor service delivery effectively. CGT performance specifications have no integration with the larger system in which CGT operates. For example, due to lack of data integration across funding agencies, there is no means to assess the effectiveness of the CGT facilities in the broader context of the provision of homelessness services. Therefore, the extent to which specific services, such as CGT, alleviates the caseload capacity of other key homelessness services (mental health, drug and alcohol services, other NGO services) or impacts on the costs accrued by crisis and emergency services through the reduction in access to these services, remains underutilised. This is a problem acknowledged as national in scope; however, integration of CGT performance specifications could provide some evidence of service effectiveness at a local level. 106 7 Recommendations to Stakeholders Recommendations CGT is a relatively new and innovative response to the housing of homeless people in the broader Tasmanian landscape of supported accommodation facilities. Its staff demonstrate a strong commitment to providing affordable and high quality housing along with quality support services to vulnerable clients. They do this with the intention of affording tenants secure, longterm and sustainable tenancies through which to build independence, and improved health and well-being. Innovation involves risk, trial and error, and to that extent we should expect that CGT could sustain improvements to assist in more fully addressing the needs of current and future clients in Tasmania. 1. Housing Tasmania should strengthen its oversight of CGT and tighten performance management to ensure CGT delivers service outcomes as identified in the Funding Agreement. 2. Housing Tasmania should review its arrangements for oversight of contractors to ensure the contractor’s arrangements with third party providers will deliver service outcomes as identified in the Funding Agreement. 3. To strengthen targeting of the homeless population: 3.1 Housing Tasmania should consider changing its funding arrangements with CGT from block funding to activity based funding. The Funding Agreement should specify levels of support need for allocations. 3.3 CGT should ensure robust, timely and transparent allocations of STs by improving allocation timeframes, eligibility criteria and allocations tools. Need assessments should be consistent with Housing Connect’s assessment process and with evidence-based industry practice for Housing First models of service provision. They should include identifying level of support need. Referring services should be provided with more detailed information on the reasons why a referral is rejected and what would be required for the client to be allocated a tenancy. 4. CGT should strengthen its collaboration and communication with the housing and homelessness sector and develop strategies for achieving this. Housing Tasmania should make evidence of service integration between CGT and the housing and homelessness sector a Key Performance Indicator. 107 5. To improve provision of support to tenants we recommend that: 5.1. CGT provide support arrangements that align with the Funding Agreement and the principles of tenant support that underpin the Housing First model in relation to continuity of support to exiting tenants with on-going support needs. They should identify strategies for transitioning STs who currently have, or desire family, including spouse and/or children, into stable and appropriate family housing facilities without the loss of support. 5.2. CGT provide support arrangements that align with the Funding Agreement and the principles of tenant support that underpin the Housing First model in relation to service provision by personnel with experience, expertise and knowledge of, as well as strong networks with, the homelessness service sector. 5.3. CGT ensure service specifications, including KPIs and funding arrangements, between CGT and third party support providers, are in place prior to service delivery. 5.4. CGT strengthen communication mechanisms between their support staff and STs with reference to key service goals. CGT should engage in meaningful and timely consultation and communication with STs about any proposed changes to tenant support arrangements to ensure they understand any new arrangements. 5.5. Housing Tasmania should ensure the Funding Agreement with CGT makes provisions for changes to the service model or service arrangements. 5.6. Housing Tasmania and CGT review the CGT service objectives to more accurately reflect the goals and priorities of STs as identified in their case management plans. This will enable the process of reporting against objectives to be meaningful and have potential to improve practice. The updated service objectives should be reflected in the Funding Agreement. 6. CGT should address the low occupancy rates amongst AHTs including reviewing its rent setting model because of the potential impact on the financial viability of the SAF facilities. 7. CGT should provide STs with clear, accurate information about the permanent status of their tenancy. This will require clarification about whether the objectives of CGT is to provide permanent housing for STs or if supporting STs towards independent living includes an expectation they will transition out of the facility into independent rental/home ownership. The Funding Agreement should clarify the permanent status of the tenancies. 108 8. To improve monitoring and evaluation of service delivery we recommend that: 8.1. Housing Tasmania strengthen regular service monitoring of CGT. This may include the introduction of six-monthly reviews of CGT over the next 18 months to ensure operations align with Funding Agreement objectives and the needs of homeless people in the state are being addressed in a timely and optimal way. 8.2. Monitoring should include reviewing the program logic and service outcomes for their alignment with the objectives of the Housing First model of service delivery. 8.3. Housing Tasmania should tighten monitoring of CGT performance standards. Current reporting requirements are not sufficiently comprehensive, and there are gaps in KPIs as well as a lack of integration between datasets. We recommend that the current output performance specifications for CGT are updated, and that improvements are made to the internal consistency between purpose of funding, strategic objectives and consumer outcomes. Indicators and targets should be commensurate with the main purpose of the service. 8.4. To improve performance standards monitoring, Housing Tasmania should require CGT to improve data capture. It should introduce into its Funding Agreement a benchmark for maximum percentage levels for ‘’other/unknown entries’ in key indicators. Where benchmarks are exceeded, Housing Tasmania should require CGT to provide an explanation for this. Housing Tasmania should ask the Australian Institute of Health and Welfare to improve performance standards monitoring under the Specialist Homelessness Services data collection so that data collected informs evaluation and reporting of service delivery outputs and outcomes more effectively than is presently the case. This should include reducing the use of ‘unknown’/’other’ response categories in service reports. 109 References ACGA (2013) ‘State by state’, Australian Common Ground Alliance. Accessed 22 Jan, 2014: http://www.commongroundaustralia.org.au/index.php/state-by-state.html ACGA (2013) ‘About Supportive Housing’ Australian Common Ground Alliance. 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(2004) “Sustaining Tenancies in Public Housing: Motives, issues and options”, Parity, 17(10) and Housing Works, 2(2). 112 Stefancic, A. and Tsemberis, S. (2007) ‘Housing First for long-term shelter dwellers with psychiatric disabilities in a suburban county: a four-year study of housing access and retention’. Journal of Primary Prevention, 28, 265-279. TAO (Tasmanian Audit Office) (2013) Report of the Auditor-General No. 8 of 2012-13 National Partnership Agreement on Homelessness, March, Hobart. Tsemberis, S. & Amussen, S. (1999) ‘From Streets to Homes: The pathways to housing consumer preference supported housing model’, Alcoholism Treatment Quarterly, 17(1-2), pp. 113-31. 113 APPENDIX A: Common Ground eligibility criteria New York, South Australia and New South Wales New York Common Ground: Common Ground New York has implemented three key programs to address different needs sectors of homelessness: the ‘Street to Home’ program is for those physically and mentally at risk; the ‘Brownsville Partnership’ is directed towards the homeless in need of educational and legal assistance) and ‘Homelink’ assists homeless families. Common Ground in New York partners with ‘Street to Home’, an initiative employing an assertive engagement, systematic method by which to identify and prioritise the chronically homeless (who have been sleeping rough for the longest and who are identified as having the highest risk of premature death on the streets), assess and negotiate housing options with those identified, and then house and retain those individuals in permanent housing (Liou et. al 2011). Common Ground (through the Street to Home program) utilises resources such as a registry to identify those who live permanently on the streets, and the VI index to measure risk factors and vulnerability. The program also employs community outreach workers to gain the trust of the chronically homeless and offer housing without conditions (for example, sobriety). Each year, Common Ground makes contact with more than 1,000 street homeless people and connects at least 300 people to housing and support services (medical, psychiatry, counselling and essential supports). Individual focus on needs has resulted in over 90 per cent of housing placements remaining stable and less than 1 per cent eviction rate (Common Ground org 2014). Since the development of the Street to Home program, Common Ground has discovered that its own eligibility criteria has proved prohibitive for many homeless people they were coming into contact with. Consequently, intake criteria was adapted, including removing exemptions for people with recent housing evictions or felony convictions; removing requirements for sobriety, compliance with mental health treatment, or full disclosure and consistent responses during intake (Johnsen & Teixeira 2010). Adelaide Common Ground: To be eligible for housing, people must meet the following requirements (Common Ground Adelaide, 2014): Be a single adult aged 18 years or older Be a resident of South Australia Not own a residential property Be able to pay rent Have an independent income, for example, be receiving Centrelink payments, or working, or both 114 Your income must not be greater than $45,496 per year Be able to abide by the Tenancy Agreement Be able to live independently – not need in-home care Be willing to be involved in the Common Ground Community, which is about contributing to the program, either by sharing your ideas, taking part in or leading community activities. Common Ground Adelaide maintains a housing application register. recorded in the CHCR (Community Housing Central Register). Applications are Before being offered housing with Common Ground, people are contacted for a housing interview. They may also be requested to provide the contact details of two other people to be a referee. Following the housing assessment, applications will be placed in the following categories: At Risk. Single adults who are homeless, at risk of becoming homeless, rough sleepers, boarding house residents, shelter and transitional housing users, couch surfers At risk with complex needs- single adults with a diagnosed substance use disorder, serious mental illness or a disability. Low Income- single adults earning up to $45,496 per year, including people who are unemployed, studying, part-time and full-time workers. Common Ground Sydney / Camperdown: Eligibility for housing at Common Ground Camperdown includes (Reynolds & Fearn 2012): 1. Residing in the Inner City area 2. Over the age of 18 years; 3. Experiencing primary homelessness (for a period greater than 6 (six) months continuously); 4. Eligible for priority approved social housing under Housing Pathways; 5. Vulnerable or at risk (i.e. have a significant health issue, disability, mental illness, substance misuse disorder, etc); 6. Suited to congregate apartment living with available onsite support; 7. Understand that children under the age of 18 years are not permitted to live in the building; 8. Understand that the building is pet-friendly, and be accepting of animals residing in the building 115 APPENDIX B: Interview Schedules Support co-ordinator Consent obtained. Recorder on. 1. Can you describe your role as the support co-ordinator at CGT? What does your job entail? 2. What do you think are the strengths and weaknesses of the Common Ground model for residents? 3. How does the relationship between support staff and the tenancy manager or concierge work? Have you experienced any problems with communication or collaboration between you? How are these problems addressed? 4. Can you tell me about your understanding of the need to separate Tenancy Management from Support Services Provision as part of the Common Ground model of Supported Accommodation Facilities? 5. Can you describe the intensity, the duration and the type of support provided to residents of Common Ground? When does support begin for new tenants? What case management plan and assessment tools do you use? How often are outcomes assessed? Is there anything you would improve about the support process? 6. Do you think the facility has been successful in terms of providing: Safe, secure and affordable housing? Opportunities for a range of employment and training options? Opportunities for social connect or family reunification? Linkages with a range of health and support services? 116 7. Can you identify key ways that the service might be improved to improve client outcomes relating to stable tenancy, health, housing, training, life skills and independence? 8. Can you tell me about the changes since Anglicare have exited as support providers? Has this had any consequences for STs? 9. Have you experienced any difficulties or challenges in providing support to residents? 10. Are there any client groups that pose particular challenges for service delivery? 11. Are there any groups or individuals who do not benefit from this type of secure, supportive accommodation? 12. How important is the relationship between the support worker, tenancy manager and concierge/security? Have you experienced any problems with communication or collaboration? Could you describe any factors that have facilitated or hindered this collaboration? 13. Do you require any additional support in order to increase your capacity to support residents? 14. What more do you think could be done to improve this service and support services generally for people with high and complex needs whose tenancies are at risk? 15. How do you deal with the interaction between the goals of long-term / permanent housing for those at risk of homelessness and the concurrent goal of moving people toward independence and out of supportive accommodation? 16. What do you think are the most important factors that cause a service intervention to succeed or fail? 17. Is there anything else that you would like to add? Thank you for participating – we appreciate your time and contribution to this project. 117 Tenancy Manager Consent obtained. Recorder on. 1. Can you describe your role as tenancy manager of CGT? 2. What does your job entail (typical tasks)? 3. What training have you received to undertake this role? 4. What is your understanding of the CGT model of Supportive Accommodation? 5. Can you tell me about your understanding of the need to separate Tenancy Management from Support Services Provision as part of the Common Ground model of Supportive Accommodation Facilities? 6. How closely do you work with CGT and the other services employed by CGT? 7. How important is the relationship between the tenancy manager and the onsite support worker? Have you experienced any problems with communication or collaboration? Could you describe any factors that facilitated or hindered this collaboration? 8. Can you tell me the process of supporting new STs to reach a good understanding of their rights and responsibilities as tenants of Common Ground? 9. What difficulties or challenges do you face in providing tenancy management to residents? For example, wilful damage to property, rent arrears How were these issues addressed? Does CGT become in involved in these issues? 10. Does the mix of client groups with varied levels of tenancy support needs pose particular challenges for tenancy management? 11. What is the process around repairs and/or maintenance in the CGT facilities? (E.g who attends to this; timeframes, satisfaction reporting etc.) 12. Do you think CGT has been successful in terms of providing: Safe, secure and affordable housing? Opportunities for a range of employment and training options? 118 Opportunities for social connect or family reunification? Linkages with a range of health and support services? 13. Are there any groups or individuals who do not benefit from this type of secure, supported accommodation? 14. Are there any client groups that pose particular challenges for service delivery? How might this be addressed? 15. Can you identify key ways that the service might be improved to improve client outcomes relating to stable tenancy, health, housing, training, life skills and independence? 16. What do you think are the strengths and weaknesses of the Common Ground model? What are the advantages and disadvantages for clients? 17. What more do you think could be done to improve support services for people with high and complex needs whose tenancies are at risk? 18. Are there any barriers to increasing security of tenure for Common Ground tenants? If so, what are they? 19. Is there anything else that you would like to add? Thank you for participating – we appreciate your time and contribution to this project. 119 CGT Supported Tenants Background: Ascertain age, partner or no partner. Tenancy at Common Ground: 1. How long have you been living at Common Ground? 2. How did you find out about Common Ground? 3. What other accommodation options were available to you at the time? 4. Was it easy getting a place at Common Ground? Did you have to wait? Do you think Common Ground could make any improvements to the application process for tenants? 5. Where were you living before moving into Common Ground? 6. Can you tell me about living at Common Ground? What are the best things about living at Common Ground? Is there anything that you don’t like about living at Common Ground? Is there anything you would like to change about living at Common Ground? 7. Have you experienced any problems with your tenancy at Common Ground – any concerns about rent arrears, property damage, neighbour disputes? If so, how were those problems handled? Were satisfied with the outcome? 8. How important is having security and a concierge at Common Ground? What services do they provide? 9. Were you informed about what it would be like to live at Common Ground, when you were deciding to move in? 10. How have you found living in a community environment? Have you experienced any problems relating to maintaining your privacy? 11. Do you get involved with social or community events at Common Ground? If so, what are you involved in? Is this an important part of your social life at Common Ground? What else would you get involved with if it were offered? Support at Common Ground: I now want to ask you about the support you receive at Common Ground: 120 12. Do you have regular access to a support worker? How often? 13. How has the support worker helped you? Has the support available at Common Ground helped you to get in touch and stay in touch with people you like to spend time with (family/friends/community)? Has the support available at Common Ground helped to improve your health? Have you been doing any education or training courses since moving in? 14. Has any part of the support provided at Common Ground been difficult, upsetting or intrusive? If so, can you think of anything that could have improved the situation? 15. Do you think the help that you have received at Common Ground has made you feel better about your life? If so, how? If not, why not? 16. How much of the improvement in your life do you think is due to Common Ground – including stable accommodation and support, and how much from other things? 17. Overall, do you think you have received enough support, not enough or too much? 18. How are you treated by staff working at Common Ground? 19. Do you think you could have received the same kind of help from a different service? 20. If you could change anything you wanted about the help you have received from the staff at Common Ground, what might that be? 21. How long do you anticipate staying at Common Ground? 22. Is there anything else that you would like to add? Thank you for participating – we appreciate your time and contribution to this project 121 APPENDIX D: Service activities and program performance measures Table 1: Service Activities Service Establishment Establish supported accommodation facilities at: Barrack Street/Liverpool Street Hobart Campbell Street Hobart Administrative Documentation Property Management and Client Support Develop and implement policies guidelines and procedures with Housing Tasmania that include: Eligibility, intake assessment, waitlist management Rent setting, collection and arrears management Tenancy management Appeals, complaints and dispute resolution Facility security policy and processes Provide general facility management functions including: 24 hour staff coverage (regular work hours + after hours on call) Maintenance services and planning Obtain property insurance and public liability insurance Property repairs Deliver client support services including: Psycho-social assessment of client suitability, level of need and allied support services requirements Case management planning, identification of client aspirations and service response strategies Coordinated access to allied services Life coaching and practical skills development for independent living Exit planning Measurement of pre and post service intervention indicators of trauma, mental and physical health, family and community inclusion Pre-discharge planning and handover and allied support services liaison Additional Activities Required Respond to and align with initiatives of the NAHA, NPs and other reforms including: as Common assessment and allocation framework Tasmanian Housing Register National Quality Framework National data collection 122 Program Performance Measures Safe Environment Consumer Focus Workforce Incident Feedback Consumer Information Governance Service Specialist Standards Obligations Is fire compliant Is food safety compliant Safe medications management Adheres to health and safety requirement Active engagement in health and wellbeing of consumers Engagement in processes supportive of consumer lifestyle needs Responsive to consumer cultural needs Supportive of consumer community inclusion Possess processes in support of consumer safety Possess processes to manage consumer finances and assets Engagement in processes supportive of consumer rights and responsibilities Possess processes in support of co-ordination and appropriate service delivery to consumers Possess robust staff recruitment, induction and orientation processes Possess professional development priorities supportive of attaining consumer outcomes Active management of future workforce requirements Possess clearly defined role expectations and accountabilities for all staff and volunteers Possess robust compliments and complaints management processes Adherence to incident monitoring systems policy Possess robust systems for collection of consumer information Possess robust systems to ensure consumer privacy and confidentiality Possess robust systems for managing consumer personal information Possess clearly articulated vision and set of values Possess systems to support inclusive decision making Possess and effective policy cycle Provision of financial reports in accord with Funding Agreement Possess systems to identify emerging legislative requirements Possess risk management systems and processes Possess robust communications processes Case planning occurs for each consumer Financial Accountability Reporting Service Delivery Reporting Quality and Safety Standards Framework Reporting 123 124