Evaluation of New
Homelessness Support
Services in Tasmania
Report Four: Evaluation of the Stay-Keys to the Future
Program
Prepared by the Housing and Community Research Unit,
University of Tasmania
November 2013
1
This report was prepared by Dr. Michelle Gabriel, Joel Stafford and Dr. Barbara Lloyd.
Contact details:
Housing and Community Research Unit (HACRU)
School of Sociology and Social Work
University of Tasmania
http://www.utas.edu.au/sociology-social-work/centres/hacru/
Acknowledgements
The HACRU team would like to thank the service workers and clients who participated in the
evaluation. Their thoug.0htful reflections have enabled the team to gain a comprehensive
picture of the delivery of the program from a range of perspectives.
The team would also like to acknowledge the assistance provided by Housing Tasmania
staff in locating and collating information relevant to the program.
2
Contents
Acknowledgements ............................................................................................................... 2
Contents ............................................................................................................................... 3
ACRONYMS ......................................................................................................................... 5
EXECUTIVE SUMMARY ...................................................................................................... 6
1
2
3
Overview of the Stay-Keys Program .............................................................................. 9
1.1
Background............................................................................................................. 9
1.2
Special Issues Facing Homelessness Services .................................................... 10
1.3
Stay-Keys: Program Logic .................................................................................... 11
1.4
Service Outline ..................................................................................................... 13
Data Collection Method and Analysis ........................................................................... 14
2.1
Description of service activity data ........................................................................ 14
2.2
Service provider consultation ................................................................................ 15
2.3
Consultation with Stay-Keys clients ...................................................................... 15
Evaluation of Service Provision and Outputs ................................................................ 17
3.1
Service Activities Specified ................................................................................... 17
3.1.1
Service Activities Specified in the Funding Agreement ................................... 17
3.1.2
Performance Measurement of Service Activity ............................................... 18
3.1.3
Description of the characteristics of the personnel identified to undertake the
activities 18
3.1.4
Description of Service Levels ......................................................................... 19
3.1.5
Client Demographics...................................................................................... 21
3.1.6
Client Presenting Circumstances ................................................................... 24
3.1.7
Services Provided .......................................................................................... 26
3.1.8
Level of Attainment Measured ....................................................................... 28
3.1.9
Indicative Costs of Operating the Service ...................................................... 30
3.2
Implementation of Tenancy and Support Service .................................................. 32
Question 1: To what extent has the agency been able to implement effective
screening and needs assessment procedures that ensure that people who are at risk
of homelessness are supported? .............................................................................. 32
Question 2: To what extent has the agency been able to implement effective
allocation procedures that ensure that people who are at risk of homelessness are
supported? ............................................................................................................... 34
Question 3: To what extent have providers of the Stay service and Keys to the Future
program been able to implement processes that support residents to sustain their
tenancies? ................................................................................................................ 36
3
Question 4: To what extent has the Stay service provided opportunities for residents
to: reunite with and increase connection with family; improve independent living skills;
access a range of health and support services; and pursue education, training and
employment options? ............................................................................................... 39
4
Evaluation of Service Participant Outcomes................................................................. 41
Question 1: To what extent has the Stay service in association with Keys to the
Future program achieved stability of tenure for clients? ............................................ 41
Question 2: To what extent has the Stay service been able to improve client
outcomes relating to: family and community connection; independent living skills;
health and wellbeing; training, education and employment? ..................................... 43
Question 3: What are the key factors that have facilitated positive client outcomes? 47
Question 4: What are the key factors that have hindered positive client outcomes? . 49
5
Discussion of Service Implementation and Outcome Information ................................. 52
6
Recommendations to Stakeholders.............................................................................. 57
References ......................................................................................................................... 59
APPENDIX A ...................................................................................................................... 60
APPENDIX B ...................................................................................................................... 62
APPENDIX C ...................................................................................................................... 63
APPENDIX D ...................................................................................................................... 64
4
ACRONYMS
DHHS
Department of Health and Human Services
FG
Focus Group
HACRU
Housing and Community Research Unit
NGO
Non-Government Organisation
SHS
Specialist Homelessness Services
SITS
Specialist Intervention Tenancy Service
SP
‘Stay-Keys’ Service Provider
TAO
Tasmanian Audit Office
5
EXECUTIVE SUMMARY
This evaluation of two complementary housing and support services, Stay (formerly called
the Specialist Intervention Tenancy Service or SITS) and Keys to the Future (Stay-Keys),
is the fourth output of the Housing and Community Research Unit’s (HACRU) Evaluation of
New Homelessness Support Services in Tasmania. The Stay-Keys program commenced
operation in October 2010 with the aim of assisting people at risk of homelessness to access
and to maintain secure housing.
In Chapter 1, we provide an overview of the Stay-Keys program. This includes: background
information about the establishment of the program; a summary of special issues facing
homelessness services; insight into the logic of the program; and a description of the
parameters of the program.
In Chapter 2, we provide an outline of the data collection method and analysis for the
evaluation. The evaluation draws on data collected as part of a study of the Stay service,
Have We Reached a Tipping Point in Homelessness Support Service Delivery? As part
of this study, the HACRU team undertook interviews and focus groups with Keys to the
Future and Stay service providers and clients. Interviews and focus groups were conducted
between 3rd August 2012 and 21st May 2013. This information is supplemented by further
interviews with service providers conducted in September 2013. The team also collated and
summarised available demographic and service activity data.
Chapter 3, we provide an evaluation of service provision and outputs. In section 3.1, we
begin with a description of the Stay-Keys service levels and then review client
demographics, client presenting circumstances, services provided, client outcomes, and
indicative costs of operating the service. In Section 3.2 we evaluate the implementation of
the Stay-Keys program. Stay-Keys is evaluated in terms of: the provision of effective
screening needs, assessment and allocation procedures that ensure that people in need and
at risk of homelessness are supported; the provision of processes that support residents to
sustain their tenancies; and the provision of processes to ensure that clients improve their
independent living skills and their connection with family, community, health services, social
and economic networks within two years of entering the program.
In Chapter 4, we present the evaluation of service participant outcomes. Service participant
outcomes are evaluated in terms of: increased stability of tenure and reductions in
homelessness; increases in family reunification and connection with family among residents;
increased participation in education, training and employment among residents; increased
6
independent living skills among residents; and improvements in the health and wellbeing of
residents. The evaluation also identifies the key factors that have facilitated and hindered
positive client outcomes.
In Chapter 5, we provide a discussion of service provision and outcome information. We
note that the Stay-Keys program has successfully transitioned people who are homeless or
at risk of homelessness into secure housing. Key strengths of the Stay program include: the
empathic, non-judgemental support clients have received from Stay support workers; the
flexible duration of the service, which enabled clients to access support for up to two years
and to remain in contact with support workers following transition out of Stay should this
need be identified; and the fact that support could be tailored towards client-specific needs.
While the Stay-Keys program provided a valuable service and entry point to permanent
housing for people who had previously experienced difficulties in sustaining their tenancies,
service providers provided insight into some initial teething problems with the program.
These included: delays in allocating properties to the program; and inadequate processes in
place to respond quickly and effectively to rental arrears and property damage. In relation to
property allocation, the program’s property portfolio grew gradually over the two year period.
Unanticipated delays in property allocation created financial risk and potentially impacted on
the viability of the Keys program.
The desire for a clear separation of tenancy management and support was built into the
design of the Stay-Keys program. While the strengths of separate tenancy and support are
well-established, the experience highlights that there are some areas of risk with this model.
Service providers observed that in retrospect the tendering process for the Stay-Keys
program was problematic. Service providers suggested that a partnership approach during
the tendering process would have been highly beneficial in: minimising financial risk to
agencies; improving inter-organisation communication; and developing a fair and equitable
service model.
In relation to data capture and performance reporting, the evaluation highlighted that there is
scope for improving performance monitoring of the program and using this as a basis for
program innovation. An evidence-based approach to service delivery is being hampered by
gaps in the key performance indicators and a lack of integrated datasets. Moreover, the
specified service objectives are not sufficiently nuanced to capture the full range of positive
client outcomes for all client groups. There may be scope for reshaping the objectives of the
program to better reflect the priorities of clients as identified in their case management plans.
7
This has the potential to enhance the value and utility of monitoring processes and ensure
that the evidence-base is used to inform practice.
In Chapter 6, we identify several improvements that this model of service delivery could
sustain to better address the needs of current and future clients. They include:
1. Revising the separate tendering process in a way that supports a collaborative,
partnership approach to the delivery of tenancy and support programs.
2. Addressing inequities in the distribution of financial risk across partner organisations
responsible for the delivery of the program.
3. Ensuring that the agency responsible for tenancy management is adequately
resourced and that it has effective internal communication systems in place to deliver
a responsive tenancy service from the commencement of the program.
4. Examining the potential of tailoring the existing program to address the specific
housing and support needs of young people.
5. Updating the current output performance specification for the Stay-Keys program in
order to improve the capacity to undertake quality performance monitoring.
6. Examining the capacity to reshape service objectives to better reflect the priorities of
clients as identified in their case management plans.
7. Investigating the possibility of Housing Tasmania retaining the role of specifying an
output performance regime (in conjunction with the funded service provider where
relevant), rather than outsourcing this role to third parties not directly responsible for
achieving the aim of the services commissioned.
8
1 Overview of the Stay-Keys Program
In this chapter, we provide an overview of the Stay (formerly called the Specialist
Intervention Tenancy Service or SITS) and Keys to the Future (Stay-Keys) program. This
includes: background information about the establishment of Stay-Keys; a summary of
special issues facing homelessness services; insight into the logic of the Stay-Keys program;
and a description of the parameters of the Stay-Keys program.
1.1 Background
This evaluation of two complementary housing and support services, Stay-Keys, is the fourth
output of the Housing and Community Research Unit’s (HACRU) Evaluation of New
Homelessness Support Services in Tasmania. The evaluation draws on data collected as
part of a study of the Stay service, Have We Reached a Tipping Point in Homelessness
Support Service Delivery?, conducted by HACRU in early 2013. As part of this study, the
HACRU team undertook interviews and focus groups with Keys to the Future and Stay
service providers and clients. This information is supplemented by further interviews with
service providers conducted in September 2013 and service activity data.
The combined Stay-Keys program is one initiative amongst a suite of integrated responses
developed by Housing Tasmania in accord with the National Partnership Agreement on
Homelessness (NPAH). The NPAH was signed in 2008 and ended 30 June 2013 and it
provided $18.9 million dollars of joint funding to Tasmania over four years. Initiatives
delivered under the NPAH are intended to contribute to the National Affordable Housing
Agreement objective of supporting people who are homeless or at risk of homelessness to
achieve sustainable housing and social inclusion. Initiatives developed under the NPAH are
informed by the approach outlined in the Australian Government’s (2008) white paper The
Road Home: a national approach to reducing homelessness.
According to the Tasmanian Homelessness Implementation Plan the initiatives of the
NPAH are coordinated by the Homelessness Steering Committee1 to complement other
initiatives undertaken in Tasmania either to achieve the objectives of other national
partnership agreements or in accord with reforms to the Tasmanian public service. The
implementation plan cites several other initiatives including: reforms to the Department of
Health and Human Services principally aimed at achieving better integration and coordination of the commissioning and delivery of family support services (approx. $35
1
A joint committee co-chaired by the Director of Housing Tasmania and the Director of the Social Inclusion Unit
of the Department of Premier and Cabinet.
9
million)2; and additional funding to reform aspects of Mental Health Services (approx. $47
million)3 and Drug and Alcohol Services (approx. $17.1 million)4, again with a focus on
achieving integration between specialist services, allied health and human service providers,
and private and community based service organisations.
1.2 Special Issues Facing Homelessness Services
There are a number of challenges associated with delivering services to people who are
homeless or people who are at risk of homelessness. Perhaps the greatest of these
challenges is service engagement. The characteristics of the homeless population are
thought to be such that few will express their need for services in the proactive manner that
populations have traditionally engaged with state housing services. Rather, people who
enter the health, human and allied services system in a state of homelessness enter for
reasons other than those involving tenure, are referred in via a crisis or police service or
invited in via the efforts of charitable organisations. Other people experiencing
homelessness move through a social network consisting of friends, relatives and associates
and rarely present to homeless services (Mackenzie and Chamberlain 2003).
Engagement with services can also present a challenge even when people enter into a
service program by choice. This occurs when a client resists engaging with psycho-social
services offered in addition to an accommodation service.
Another special issue facing services for people who are homeless or at risk of
homelessness is mobilising the resources of the right type, level, and for the right period of
time to address the potentially diverse personal circumstances of clients. These
circumstances can range from financial hardship, through addictive behaviours involving
gambling, alcohol and other drugs, to significant physical disability, poor mental health, and
traumatic disorders caused by accidents, childhood abuse or neglect or negative interactions
within the justice system.
Identifying efficient and effective models of service delivery that are known to achieve the
desired outcomes of clients and governments is also a critical issue (Eardley et al 2008;
Flateau et al 2008; Johnson et al. 2012). There remains significant controversy over the best
way to construct, resource, implement, and monitor services for people who are homeless or
at risk of homelessness. Some of this controversy is driven by the underlying challenge of
2
Commencing in 2008-09 and ending in 2012-2013.
Commencing in 2008-09 and ending in 2013-2014.
4
Commencing in 2008-09 and ending in 2013-2014.
3
10
correctly identifying the causes of homelessness in a given population. Another driver
involves correctly identifying the lessons learned from current and prior attempts to address
homelessness and translating these lessons into services better able to meet the needs of
clients.
The evaluation findings described in section 7 of this report are informed by these and other
special issues that face the delivery of homelessness services in Tasmania.
1.3 Stay-Keys: Program Logic
As noted in the Introduction, initiatives developed under the NPAH are informed by the
approach outlined in the Australian Government’s (2008) white paper The Road Home: a
national approach to reducing homelessness. The NPAH states that jurisdictions should
aim to develop implementation plans that address the three key strategies detailed in the
White Paper (Australian Government 2008: ix) for achieving a reduction or elimination of
homelessness in Australia. These include:

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 table housing and, where possible, employment, with the support
they need so homelessness does not recur.
This represents a shift away from emergency and transitional accommodation responses to
homelessness to an emphasis on the importance of rapid access to permanent housing
options and the necessity of providing comprehensive support in order to facilitate social and
economic inclusion. Initiatives delivered under the NPAH 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 Homelessness National Partnership
Implementation Plan for Tasmania (DHHS, 2009; See also DHHS 2010, 2012).
The logic of the Stay service commences with the identification of individuals and couples
from a pre-defined target group, who are then engaged in a tenancy agreement in suitable
social housing. The target group include: people with mental health problems; young people
11
leaving care; adults leaving correctional facilities; and those who have experienced chronic
episodes of street homelessness. As each client is accepted into the Stay program, the
client’s needs are assessed and a request is then made by the support provider, Centacare,
to the organisation responsible for tenancy management, Colony 47, for an appropriate
property. Colony47 then submits an individual application for a Housing Tasmania property
to be allocated to the Keys to the Future program. Once a property is allocated, the support
provider, in consultation with the client, will assess the appropriateness of the property and
accept or reject the property accordingly. When entering the tenancy agreement, a plan is
established to facilitate a client’s contact with services capable of increasing their capacity
and skills to maintain independent living. Colony47 manage the property during a two-year
period while clients continue to receive specialist support. Property management is then
transferred back to Housing Tasmania at the end of the two year period, with clients able to
continue accessing support if required. It is anticipated that at the point at which property
management is transferred back to Housing Tasmania, clients will have progressed to a
stage where independent living can be sustained outside the Stay-Keys program. However,
ongoing support is available to clients in accordance with ‘duration of need’.
A simplified sequential representation of the Stay-Keys program logic is depicted in Figure
1-1.
Figure 1-1: Stay-Keys program logic
Inputs
Activities and Processes
Outputs
Accommodation Facilities
Support Workers
Property and Tenancy Managers
Target Client Group
Intake and Assessment
Needs Identification and Planning
Client Engagement/Case Management
Lease Agreement
Tenancy Management
Property Management
Client Referral
Exit Planning
Specialist Interventions
Brokerage
Housing/Accommodation Services
Property/Tenancy Management
Services
Basic Information and Advice
Facilitated Access to Support
Services
Basic Personal and Life skills
Support
Specialist and Therapeutic Services
Counselling Services
People are integrated into their
community
People have increased selfsufficiency and self-reliance
Sustainable independence for target
client group
Family links are strengthened
Increased capacity for social inclusion
Increased financial security
Increased connection to community
Improved health and wellbeing
Increased connection to economic
networks
Increased personal and life skill
capacity
Clients have appropriate
accommodation
Clients receive accommodation
linked to support
Clients have long-term
independent accommodation
Outcomes Stages 1 and 2
Outcomes Stage 3
Outcomes Stage 4
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1.4 Service Outline
The Stay-Keys program commenced operation in October 2010 with the aim of assisting
people at risk of homelessness to access and to maintain secure housing. The Australian
and Tasmanian Governments through the National Partnership Agreement on
Homelessness (NPAH) fund the Stay-Keys program. The program complements existing
homelessness programs delivered by the ‘not-for-profit’ sector. The aim of Stay-Keys is to
provide intensive support to people who are homeless or at risk of homelessness for up to
two years based on the level of need.
The Stay-Keys program is delivered by two NGOs, Centacare and Red Cross, which employ
16 (full time equivalent) staff across four regions of Tasmania (N, NW, SE and SW). All of
the clients supported by Stay are accommodated in properties that are managed under the
‘Keys to the Future’ program coordinated by another NGO, Colony 47. Through the Keys
program, Colony 47 manages 25 properties in each of the four regions across the State (100
properties in total). A key feature of the model under which the Stay-Keys program is
delivered is an organisational separation between tenancy management and client support
services.
The client support services provided by Stay staff are intensive and may include:

assistance with shopping and life skills to support tenancy,

assistance to acquire basic domestic appliances, linen, furniture, cutlery and
crockery,

support around domestic violence issues, parenting issues, court support and
relationship support,

support around behavioural issues such as anger, grief and trauma,

support with maintaining medication regimes and doctors’ appointments,

liaising and advocating in regard to education, vocational training and potential
employment.
13
2 Data Collection Method and Analysis
In this chapter, we provide an outline of the data collection method and analysis for the
evaluation. In the first instance, the team collated and summarised existing service activity
data. This service activity data informs the evaluation of the effectiveness of the service in
meeting objectives. Secondly, the team consulted key service providers in order to gain
additional insights into the implementation of the service. Notably, the evaluation draws on
data collected as part of a study of the Stay service, Have We Reached a Tipping Point in
homelessness Support Service Delivery?, conducted by the HACRU earlier this year. As
part of this study, the HACRU team undertook interviews and focus groups with
representatives from agencies involved in the delivery of the Stay-Keys program. These
interviews are supplemented by additional interviews conducted with service providers in
September 2013. The discussion and recommendations presented in Chapters 5 and 6 are
based on integration and comparison of this data.
2.1 Description of service activity data
The service activity data analysis is based on data provided by the responsible agency,
Centacare, 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 derivative of the now
defunct 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.
The service activity data analysis also draws on six monthly reports provided by the
responsible agency, Centacare, to the funding body, Housing Tasmania. While these
reports provide comprehensive data from July 2011-2012, there are gaps in the dataset for
the period July 2012-2013.
14
2.2 Service provider consultation
As part of the study, Have We Reached a Tipping Point in Homelessness Support
Service Delivery?, conducted by HACRU earlier this year, interviews and focus groups
were conducted with key agencies involved in the delivery of the Stay and Keys to the
Future program, including Centacare, Red Cross, Housing Tasmania and Colony 47.
Interviews were conducted with 19 participants, between the 3rd August 2012 and 1st May
2013. The team also conducted focus groups with both Centacare and Housing Tasmania
representatives. Eight Centacare representatives participated in a focus group on the 14th
May, 2013 and 10 Housing Tasmania representatives participated in a focus group on the
21st May, 2013. The purpose of the focus groups was to enable participants to respond to
selected quotes and data analysis. More recently, supplementary information about StayKeys was obtained from two follow-up interviews with service providers from Centacare and
Colony47. These were conducted on the 12th and 13th of September 2013.
The interviews and focus group discussion varied in length, but ranged between 20 minutes
and two hours. The interviews and focus groups were conducted by telephone and in the
offices of the key agencies.
The interviews and focus groups were audio-recorded with participants’ informed consent
and later transcribed. In the case of one interview, the participant chose to provide a written
response the following day, rather than have their conversation audio-recorded. All data
were then subject to content and thematic analysis. Data obtained from interviews and focus
groups is distinguishable throughout the data analysis. We have used the code ‘SP’ to refer
to service provider interview participants and ‘FG’ to refer to focus group participant. The
interview schedule for the service providers is provided in Appendix A.
Service providers were asked to discuss:

What their professional role entails,

The strengths and weaknesses of the Stay-Keys model,

Factors that facilitate or hinder service delivery,

Perceptions of client satisfaction with the support offered,

The effectiveness of the service in supporting tenants to stabilise at-risk tenancies,

How the service might be improved.
2.3 Consultation with Stay-Keys clients
15
As part of the study, Have We Reached a Tipping Point in Homelessness Support
Service Delivery?, interviews were conducted with clients of the Stay-Keys program in early
2013. This evaluation draws on these interviews for insights about client experiences and
outcomes.
Fifteen interviews were conducted with clients who were currently accessing the Stay-Keys
program between the 1st February 2013 and the 10th of April 2013. Relevant agencies
provided the team with contact lists of clients. Clients who participated in the study received
a grocery voucher in appreciation of their time. The interviews varied in length, but ranged
between 15 and 30 minutes. The interviews were audio-recorded with participants’ informed
consent and later transcribed. The data were then subject to content and thematic analysis.
The interview schedule for the service users is provided in Appendix B.
The participants varied in age, from 19 to 47 years. Nine of the participants were female and
six were male. Eight of the participants had children.
Clients were asked to discuss:

The process of engagement with the service,

The ease or difficulty of engaging with the service,

The nature and benefits of the assistance received,

Satisfaction with quality and level of service,

Overall satisfaction with service and suggestions for improvement
16
3 Evaluation of Service Provision and Outputs
Chapter 3 we provide an evaluation of service provision and outputs. In section 3.1, we
begin with a description of the Stay-Keys service levels and then review client
demographics, client presenting circumstances, service provided, client outcomes and
indicative costs of operating the service. In Section 3.2 we evaluate the implementation of
the Stay-Keys program. Stay-Keys is evaluated in terms of: the provision of effective
screening needs, assessment and allocation procedures that ensure that people in need and
at risk of homelessness are supported; the provision of processes that support residents to
sustain their tenancies; and the provision of processes to ensure that clients improve their
independent living skills and their connection with family, community, health services, social
and economic networks within two years of entering the program.
3.1 Service Activities Specified
The supported accommodation service model Housing Tasmania has chosen to implement
separates major program activities into two categories: 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.
Centacare was contracted to provide the major social support components of the program
and Colony 47 was contracted to manage the accommodation facilities and tenancy
agreements.
3.1.1 Service Activities Specified in the Funding Agreement
While the two organisations contracted to establish and manage the Stay-Keys program
each agree to distinct service and funding contracts, it is clear from the significant overlap in
the content of the contracts that the organisations are to work collaboratively to achieve the
aims of the program. The service activities specified in the agreements are summarised in
Table 1, Appendix C.
The activities specified in the service contracts can be organised into three main groups.
First, the contracted organisations are to lease approximately 100 residential facilities from
Housing Tasmania and establish tenancy agreements with suitable characteristics to support
clients to achieve the aims of the program. Second, the contracted organisations are to
develop and implement administrative documents, processes and, in collaboration with
Housing Tasmania, an electronic information management system to guide service delivery.
Third, the contracted organisations are to provide specific property management and client
17
support services including: pre-release planning; intake screening assessments; case
management planning; referrals to allied services; and exit planning.
Reflecting on the main aim of the program the property management and client support
activities are the highest profile elements of all the service activities specified in the
respective agreements. The client needs identification and assessment process together
with the processes by which strategies are developed to respond to the needs identified
during assessment are stipulated to involve the application of a ‘psycho-social assessment’
process or tool. Clients who enter into the service setting are then managed in accordance
with a case management plan that is reflective of the issues and opportunities identified
during the assessment process.
3.1.2 Performance Measurement of Service Activity
According to the service specification the performance standard of the activities undertaken
in the Stay-Keys program, 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 respective funding agreements specify that the contracted organisations
must demonstrate they comply with each indicator.
In addition to demonstrating compliance with the performance requirements the funding
agreement requires contracted organisations to provide periodic reports to a state
government agency on continuous quality improvement activities they may undertake. In
effect this requirement entails reporting on serious consumer related incidents (SAC1 and
SAC25) that might occur during the normal operation of the service. The service activity
performance indicators are listed in Table 2, Appendix D.
3.1.3 Description of the characteristics of the personnel identified to
undertake the activities
The funding agreement requires that contracted employees: 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 Consumers and their children; and,
5
Severity Assessment Code levels 1 and 2 of four SAC levels.
18

is of good character and is suitable to be entrusted with the care of Consumers.
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 of any offence involving children or any action taken with regard to
their guardianship or custody of a child.
However, the agreement does not explicitly rule out engaging a person with prior convictions
or a record of action taken with regard to their guardianship or custody of a child.
Similarly, 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.
Last, the agreement does not mandate a ratio of service staff to clients.
3.1.4 Description of Service Levels
Service activity levels for Stay-Keys 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 now defunct SAAP data collection including 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, 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 proceed to analyse and publish reports for
consumption by the service sector and by State Housing Authorities.
19
Setting aside financial reporting, which is not dealt with in this evaluation, the service
agreement does not specify any other expected or indicative time-to-service characteristics,
expected levels of service throughput, or time-to-service exit characteristics6.
Table 3-1: Stay Summary data
STAY 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
* July 2012-March 2013
2011-2012
41
130
8
161
45236
11620
49
46
84 (52%)
77 (48%)
19
108
60
2012-2013*
27
158
4
181
41367
10502
43
41
94 (52%)
87 (48%)
23
118
69
The activity reports available at the time of writing indicate that 161 clients entered the StayKeys services during 2011-2012. In 2012-2013, 181 clients entered the service.
Data presented in Table 3-2 indicates that almost all clients who sought assistance during
2011-2012 received assistance (91.5%). A much larger number of clients are recorded as
unassisted between July 2012 and 31 March 2013. However, the reason recorded for not
assisting these clients suggests the funded organisation encountered issues with
maintaining an adequate administrative record and on that basis the figures presented for
the relevant period 2012-2013 appear to be unreliable. Of the 30 clients with a valid reason
for being unassisted, the majority (~47%) either refused service or wanted a different service
to those on offer, or were refused service because they did not meet the criteria for entry.
During this period, approximately 23 per cent of clients were unassisted due to a lack of
available accommodation at the time a service was requested.
6
A time-to-service metric involves taking account of how much time people spend or are expected to spend at
various points in the service system. Such metrics are of greater importance where time sensitive
interventions are part of the service specifications.
20
Table 3-2: Unassisted persons
Unassisted Persons
2011-2012
2012-2013*
11
130
8.5%
178
158
112.7%
2
1
2
0
2
0
3
3
1
14
156
6
4
0
7
1
2
4
6
186
Number of unassisted persons
Number of ongoing clients
Unassisted persons as % of all clients
Reason service not provided
Invalid or Missing
Person did not accept service
Person wanted different services
Innapropriate agency/target group
No Accommodation available
Agency had no other service available
Facility not appropriate
Refused service/did not meet criteria
Other
Total
*July 2012-March 2013
3.1.5 Client Demographics
The service 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 demonstrate all of the specified needs:

Multiple and complex needs:
o
Experiencing family violence or breakdown
o
Mental health issues
o
Trauma
o
Problem alcohol and other drug use
o
Intellectual disability, cognitive impairment and/or acquired brain injury

Repeat episodes of homelessness or significant risk of homelessness,

People apparently without the living skills to sustain independent tenancies.
They must also be from one of the following populations:

people exiting youth correction facilities,

people exiting child protection,

people exiting jail,

people leaving residential health facilities, or

people who are homeless or at risk of homelessness.
21
The funding agreement provides no indication of the expected size of the population
possessing these attributes who are exiting the facilities listed or the rate or, where
applicable, schedule of exits the funded organisation should expect to encounter during the
term of the agreement.
Moreover, the organisation’s synopsis of client needs on entry to the Stay-Keys program
indicate that few clients displayed all needs specified.
Based on the individual intake assessments conducted by Centacare staff between
commencement and January 2012, of 88 client assessments recorded, no client was
recorded to exhibit all the specified attributes and the majority recorded no more than three
of the specified attributes simultaneously. The following table describes the proportion of
clients assessed with an attribute relevant to level of need.
Table 3-3: Assessed needs of clients7
North
North West
South
% with attribute
Total
Mental
Health
Family
Violence
Homelessness
Alcohol
Abuse
Other Drug
Abuse
Acquired
Brain Injury
Offending
Behaviours
Financial
Hardship
18.2%
15.9%
31.8%
65.9%
100.0%
14.8%
12.5%
20.5%
47.7%
100.0%
10.2%
11.4%
26.1%
47.7%
100.0%
10.2%
3.4%
17.0%
30.7%
100.0%
11.4%
12.5%
26.1%
50.0%
100.0%
0.0%
1.1%
1.1%
2.3%
100.0%
10.2%
9.1%
29.5%
48.9%
100.0%
12.5%
9.1%
11.4%
33.0%
100.0%
The sex ratio of clients (excluding children) accepted into the program was approximately 52
per cent male to 48 per cent female. Approximately 12 per cent of clients identified as either
aboriginal or Torres Strait Islander.
The distribution of ages of clients entering Stay-Keys ranges from 10 to 59 years (excluding
clients accompanied by infant children). Approximately 80 per cent of clients were aged less
than 45 years with the most common ages falling between 20 and 24 years.
7
Client may have multiple needs identified at assessment. The percentage with an attribute represents the
percentage of the total clients assessed with that attribute.
22
Figure 3-1: Age distribution of clients
As detailed in Table 3-4, in 2011-12 and between July 2012 and 31 March 2013, the main
source of income in the week before service for clients (recorded with a support period)
when presenting to the Stay-Keys program was either a disability support pension or Youth
allowance, followed by Newstart allowance. Approximately 18 per cent of clients were
recorded with no income source at the time they presented for service.
Table 3-4: Main source of income
Main Income Source
Newstart
Parenting payment
Disability Support Pension (Centrelink)
Youth allowance
Austudy/Abstudy
Disability pension (DVA)
Other Government pension or allowance
Employee Income
Nil income
Unknown
Total
*July 2012-March 2013
2011-2012
2012-2013
Week before
When presenting
Week before
When presenting
21
11
33
28
1
6
1
1
30
39
171
22
10
32
28
1
5
1
1
31
40
171
24
16
31
31
0
7
1
1
30
44
185
26
16
32
30
0
6
1
1
32
41
185
23
3.1.6 Client Presenting Circumstances
The most common referral source for clients entering the Stay-Keys service was a Specialist
Homelessness Agency. Consistent with the eligibility requirements specified above,
approximately 80 per cent of clients entering the service were referred by a Specialist
Homelessness Agency, mental health services, a correctional facility, the statutory child
protection agency or another government agency.
Table 3-5: Referral source
Referral Source (STAY)
Specialist Homelessness Agency/Outreach
Mental health service
Adult Correctional Facility
Don't know
Youth/juvenile justice correctional centre
Child protection agency
Social housing
Other agency (Government or NGO)
Family and/or friends
Other
Family and child support agency
Drug and Alcohol Service
No Formal Referral
Disability support service
Legal Unit
Courts
Total
2011-2012
28.1%
14.6%
12.3%
9.4%
9.9%
5.8%
4.7%
2.9%
2.3%
2.9%
1.2%
1.2%
3.5%
0.6%
0.6%
0.0%
100.0%
2012-2013*
27.6%
15.1%
13.0%
9.2%
7.6%
6.5%
4.9%
3.8%
2.7%
2.7%
2.2%
2.2%
1.1%
0.5%
0.5%
0.5%
100.0%
The living arrangements of clients in the week before entering the Stay-Keys service
between June 2011 and March 2013 was relatively diverse. 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 (>35%). Approximately 15 per cent of clients
presenting for service were single parents with children and between 6 and 10 per cent were
living with family or with an unrelated group.
Table 3-6: Living arrangements before program entry
Living Arrangements before program entry
Lone person
One parent with child(ren)
Couple with child(ren)
Couple without child(ren)
Other family
Group
Unknown
Total
*July 2012-March 2013
2011-2012
week before
on presenting
35.7%
37.4%
14.0%
15.2%
8.8%
7.0%
2.3%
3.5%
6.4%
6.4%
9.4%
7.0%
23.4%
23.4%
100.0%
100.0%
2012-2013*
week before
on presenting
37.8%
38.4%
14.1%
15.1%
5.9%
4.3%
2.2%
2.7%
8.1%
8.6%
5.9%
5.9%
25.9%
24.9%
100.0%
100.0%
24
Table 3-7 details the accommodation circumstances of clients prior to entering the program.
Approximately a third of clients were residing in short term or emergency accommodation
(~36% in 2011-2012 and ~34% between June 2012 and March 2013) a month before
entering the program. Approximately 20 per cent of clients stated they were homeless or at
risk of homelessness in the month before entering the service and a similar proportion were
sleeping rough or living in non-conventional accommodation.
Table 3-7: Whether homeless in month before support
2011-2012
Whether homeless in month before support
2012-2013*
Number
Percent
Number
Percent
35
18.72%
43
21.2%
67
35.83%
69
34.0%
Not homeless
41
21.93%
38
18.7%
Unknown
44
23.53%
53
26.1%
Sleaping rough or in non-conventional
accommodation
Short term or emergency accommodation
due to lack of options
*July 2012-March 2013
When asked about the length of time since their last permanent tenure, approximately 25 per
cent of clients stated that they had not accessed permanent tenure for between 12 months
and up to five years prior to the time of presentation. A similar proportion had not accessed
permanent tenure during the 12 months prior to entry into the Stay-Keys program.
Table 3-8: Time since last permanent tenure
Time Since Last Permanent Tenure
Less than 1 week ago
2011-2012
5.8%
2012-2013*
5.4%
1 week to 1 month ago
1.2%
2.7%
More than 1 month to 6 months ago
17.5%
15.1%
More than 6 months to 1 year ago
9.4%
11.4%
More than 1 year to 5 years ago
25.7%
24.3%
More than 5 years ago
8.2%
8.1%
Don't know
31.0%
30.3%
Not applicable
1.2%
2.7%
100.0%
100.0%
Total
*July 2012-March 2013
Figure 1-1 indicates that the most common reasons for seeking assistance from Stay-Keys
in the month before entering the service were: inadequate or inappropriate dwelling
condition; transitioning from custodial arrangements; or issues associated with poor mental
health. For the most part, these reasons reflect the eligibility requirements specified for the
service.
25
Figure 3-2: Main reason for seeking assistance
Available data suggests that approximately 35 per cent of all clients accepted into the
service during 2011-12 and 37 per cent of clients accepted into the service between July
2012 and 31 March 2013 had been diagnosed with a mental illness. The majority of these
clients were in receipt of a mental health service or had been in receipt of a mental health
service in the 12 months prior to entering Stay-Keys.
Table 3-9: Ever diagnosed with mental health condition
2011-2012
Ever Diagnosed with Mental Health Condition
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
2012-2013*
Number
Percent
Number
Percent
60
22
59
30
171
28
21
15
35.1%
12.9%
34.5%
17.5%
100.0%
16.4%
12.3%
8.8%
69
22
70
24
185
36
22
15
37%
11.9%
37.8%
13.0%
100.0%
19.5%
11.9%
8.1%
*July 2012-March 2013
3.1.7 Services Provided
According to available data the top ten service needs of clients included: assistance with
basic living skills; advice and access to information or advocacy; and assistance with
behaviour and mental health, familial relationships and assistance to sustain a tenancy.
Client needs in these categories accounted for approximately 78 per cent of all needs
identified with clients between July 2011 and 31 March 2013.
26
Figure 3-3: Top ten services needed by clients
In addition, data for the period between July 2011 and 31 March 2013 shows that in a small
number of cases, service needs were identified but not provided (~4% of all needs
identified). Needs identified but not provided included: access to specialised services,
psychological and mental health services; long term housing; and training and employment
assistance.
Figure 3-4: Top 10 service needs identified but not provided
27
According to reports produced by Centacare, at 31 December 2013 the Stay-Keys program
had received 499 referrals, 254 (~51%) of which had been subject to assessment with 137
clients under case management. However, it is unclear from the reporting information made
available precisely how many clients had exited the program. At 31 December 2011, 18
clients had exited the program, which represented approximately 10 per cent of the 174
clients who had graduated the assessment stage of service entry. According to activity
reports provided to the funding agency these clients had exited the program to re-enter
prison or a secure residential facility, or they had moved interstate or absconded, or been
evicted due to breaches of their tenancy agreement.
The most common reason a support period ended in 2011-2012 was that the client no longer
requested assistance (n = 41/~46%). This was also the most common reason for ending a
support period between July 2012 and 31 March 2013. The next most common reason
recorded for ending a support period during this period was the institutionalisation of the
client (n =27/~15%). 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.
Table 3-10: Reason support period ended
2011-2012
Reason Support Period Ended
Client no longer requested assistance
Client institutionalised
Client incarcerated
Client referred to another SHS
Service withdrawn from client no referral made
Client did not turn up
Lost contact with client
Other
Clients immediate needs met/case management goals achieved
Client referred to mainstream agency
Client died
Unknown
Total
*July 2012-March 2013
2012-2013*
Number
Percent
Number
Percent
19
1
1
1
4
0
1
9
2
2
1
0
41
46.3%
2.4%
2.4%
2.4%
9.8%
0.0%
2.4%
22.0%
4.9%
4.9%
2.4%
0.0%
100.0%
9
4
3
2
2
2
2
2
1
0
0
0
27
33.3%
14.8%
11.1%
7.4%
7.4%
7.4%
7.4%
7.4%
3.7%
0.0%
0.0%
0.0%
100.0%
3.1.8 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 41 closed support periods recorded by
Stay-Keys in 2011-2012, 18 (~44%) ended with no case management plan and 7 (~17%)
ended without achieving any of the goals identified in the client’s case management plan.
Between July 2012 and 31 March 2013 there were 27 closed support periods recorded.
Thirteen of these (48%) were recorded with no case management plan and seven (26%)
ended without achieving any planned goals. However, of the 130 support periods on-going
28
at 30 June 2012, 56 (~43%) had achieved up to half of the goals planned and 42 (~32%)
had achieved half or more of the goals planned. Between July 2012 and 31 March 2013 the
number in these two categories had increased. Of the 158 on-going support periods at 31
March 2013, 53 (~34%) had achieve half or more of planned goals and 52 (~33%) had
achieve up to half of planned goals. A small proportion of clients (4%) with an on-going
support period during this period had achieved all goals planned.
Table 3-11: Extent to which case management plan goals achieved
2011-2012
Closed SP
Ongoing SP
18
43.9%
29
22.3%
7
17.1%
3
2.3%
14
34.1%
56
43.1%
1
2.4%
42
32.3%
1
2.4%
0
0.0%
0
0.0%
0
0.0%
41
100%
130
100%
Extent to which case management plan goals achieved
No case management plan
Not at all
Up to half
Half or more
All
Invalid or missing
Total
*July 2012-March 2013
2012-2013*
Closed SP
Ongoing SP
13
48%
36
22.8%
7
26%
10
6.3%
4
15%
52
32.9%
3
11%
53
33.5%
0
0%
7
4%
0
0%
0
0%
27
100%
158
100%
The data available regarding the type of education or training programs in which clients’
were enrolled shows that participation in education or training programs generally remained
stable once clients entered the Stay-Keys program with respect to the level of participation
recorded in the week before entry. For example, during 2011-2012 and between July 2012
and March 2013, slightly more clients were engaged in primary school education than were
attending before entering the service. A small increase was also recorded with regard to
clients enrolled in university and in vocational education and training. However, a significant
proportion of records fell into the ‘unknown’ category during both reporting periods. In
addition, enrolment in an education or training program is counted as ‘not applicable’ for the
majority of clients with an on-going support period at the end of each reporting period (~70.8
in 2011-12 and ~78.5 between July 2012 and 31 March 2013).
Table 3-12: Type of education/training clients enrolled in
Type of education/training clients
enrolled in
Not applicable
Preschool Student
Primary School Student
Secondary School Student
University Student
Vocational education and training
Unknown
Other education or training
Invalid or Missing
Total
2011-2012
2012-2013*
Week before
Closed SP
Ongoing SP
Week before
Closed SP
Ongoing SP
95
18
92
97
12
124
0
3
1
0
0
1
7
4
11
6
2
9
3
0
2
8
0
4
0
0
1
0
0
1
10
0
15
10
0
10
49
16
2
58
12
5
7
0
6
6
1
4
0
0
0
0
0
0
171
41
130
185
27
158
*July 2012-March 2013
29
3.1.9 Indicative Costs of Operating the Service
The funding agreements for Stay-Keys do not specify any expected or indicative service cost
metrics or provide any risk analysis about the expected or indicative service costs the
contracted service providers should experience under normal operating conditions8.
The funding agreements indicate the overall establishment and operational funding provided
to implement the services totalled approximately $7.7M. This figure represents the funding
amounts stated in the funding agreements and does not include the cost of developing the
implementation strategy or identifying the target client group and their needs, developing a
service specification or conducting an evaluation9. The total operational funding component
of this amount, less brokerage funding, is approximately $4.5M (ex. GST).
A variation made to the funding agreement indicates an additional one-off funding amount of
$100, 000 (ex. GST) was applied during 2011. The additional funding was applied to
increase the services offered by Stay to include delivery of a ‘household package’ consisting
of household items such as white goods, furniture, kitchen utensils and linen thought to
assists clients to operate a household at an adequate standard.
Note also the total operational funding (budgeted costs) does not equal the total cost of
operations (actual expenditure costs) and information concerning additional operational
funding inputs beyond the amounts specified in the funding agreement was not considered
here. In this regard it is important to recognise that support services provided to Stay clients
via referral pathways to external agencies such as mental health services also contribute to
the total costs of operations and should not be excluded from consideration on the basis that
these costs involve expenditures by another agency.
One of the benefits of taking account of the costs associated with the external support
services received by Stay clients is it makes estimates of the savings accrued by external
agencies due to the existence of the Stay-Keys service robust. For example, an important
feature of demonstrating the effectiveness of supported housing for high and complex needs
clients involves estimating the cost reduction associated with reducing the number of times
clients of the program engage with emergency and other medical services, crisis mental
health services, police services and crisis accommodation services as a result of
interventions associated with Stay-Keys.
8
The Funding Agreement does include a static funding allocation table.
The client requirement analysis and implementation strategy are described in the NPAH annual report 20102011.
9
30
The minimum average operational cost per client per year can be expressed as the result of
dividing the number of clients accepted into the services by the (annualised) total operational
funding10. However, since the total number of clients accepted into the services during the
funding period is not known precisely we do not provide an estimate of this figure.
A proxy estimate can be calculated based on the following assumptions:

the facilities run at full capacity with one client served per tenancy without
replacement for each year of operation,

rental income and arrears, additional brokerage costs, maintenance and repairs are
excluded11.
These assumptions reduce the complexity of accounting for costs associated with the
number of clients serviced by tying the cost component to rentable units. The resulting figure
for Stay-Keys is approximately $16,030 per dwelling unit per year and represents the total
available dwellings divided into the (annualised12) total operational funding. Since it is known
that a greater number of clients were accommodated than the total number of rooms in the
facilities the actual minimum operational cost per client will be less than this amount. The
figure would be greater were the service to have continually operated at less than full
capacity.
While only one of a number of potential a proxy estimates, this figure compares favourably
with at least one published estimate of the cost involved with supporting a rough sleeper for
one year13.
10
This figure may be offset by including any revenue raised during service delivery.
It is reasonable to exclude rental income, rental arrears and other costs on the assumption they are absorbed
by the service provider and not recouped or paid for by the funding agency.
12
There is more than one way to arrive at this figure. Here we assume the services ran for a total of 34 months
with an operational cost of approx. $132,583 per month.
13
Joffe et al. put this at $28,700.
11
31
3.2 Implementation of Tenancy and Support Service
Question 1: To what extent has the agency been able to implement effective screening
and needs assessment procedures that ensure that people who are at risk of
homelessness are supported?
Since its inception, the Stay service has been successful in implementing effective screening
and needs assessment that ensure that people who are at risk of homelessness are
supported. While understanding the client’s ‘change-readiness’ is a valuable tool in ensuring
the clients enter the program with effective support, it is not used by service providers to
exclude clients who may require additional time to engage with support opportunities. While
most clients were able to readily access the Stay program, some clients experienced delays
in accessing the Stay program.
Clients enter the Stay program through five formal referral points and they are then
assessed for eligibility. Service providers considered the efficacy of the assessment process
used to determine client needs as crucial in shaping future outcomes. Assessment was
described by providers as a rigorous, but flexible, process, which involved the use of: a
uniquely designed assessment tool which could cover the diverse client base accessing
Stay; and assessments provided by previous support agencies, including life skills
assessment tools results and cognitive capacity reports, as well as other psychological and
physiological assessment results (SP21, 13/9/2013). The quality of the assessment also
relies on the intense, focused interaction with potential clients. A key issue raised by
providers was the importance of employing staff with specialised skills to undertake any
assessment.
It’s about actually sitting down with the client and having a conversation and hearing
from them around all the different aspects of what they want, and how they want it.
And it is about having the skills to be able to look beyond what the client is saying, to
what they actually mean, and picking up on a range of different cues, which is quite a
specialised skill (SP5 20/08/12).
Service providers also commented on variations in the quality of information provided by
previous support agencies. While most agencies provided high quality and detailed
information, others agencies, such as the Tasmanian Prison Services, only provided partial
accounts of client assessments (SP21, 13/9/2013).
The Stay program works with challenging clients with complex needs, and offers clients
intensive support over two years. In determining eligibility, assessors particularly seek to
32
identify clients who have developed insights into the causes of their homelessness and are
ready to adapt their behaviours in the pursuit of positive change.
I have made sure the workers that do the assessment understand that that is one of
the criteria of the problem that the clients are able to benefit from the 2 years of
support. That means they must have the cognitive capacity to benefit from the 2
years of support and that they need the 2 years of support. So yes, we are taking the
hard ones, but that is what the program was for. . It is only when they have the high
needs paired with our assessment of their motivation is that they get onto the
program, but they are usually at a point in their lives when they finally realise that if
they don’t do something for themselves now, they are not going to be able to do
anything for themselves (SP3 13/08/12).
Service providers expressed differing views on the significance of a client’s motivation in
assessing their needs and appropriate service responses. The notion of being ‘change
ready’ refers to a client’s capacity to acknowledge that past attitudes and behaviours have
contributed to their homelessness and their willingness to alter any counterproductive
attitudes and behaviours. Most service provider participants viewed the recruitment of
‘change-ready’ clients as crucial in ensuring that: the Stay service provision is well-targeted
and efficient; the client is able to take full advantage of the service; and successful client
outcomes are achieved.
[A client] to my mind, has to be change-ready, which means they have to
acknowledge that there is a problem and they have to have made the cognitive leap
that it is them that needs to change, not the world. So I think that concept of being
change-ready is incredibly important. If somebody is self-identifying as changeready, then hello, this is where we put the resources guys and we are actually going
to get some traction (SP4 17/12/12).
Services make limited if any further contribution to improve outcomes. It’s how ready
that client is at that point, that’s what that stuff is about. Having said that, it doesn’t
mean that it is pointless. Because what you are doing, it’s like gardening; you are
planting seeds and eventually they come back (SP5 20/08/12).
However, other participants were critical of the concept of ‘change-ready’, voicing concerns
that it frames as a prerequisite what is actually a desired outcome of service provision for
clients with complex needs (FG2, 21/5/2013). Service providers also observed that there is
flexibility in interpreting change-readiness in practice, with providers able to extend support
to those who may not yet be ready to fully engage with support services.
And I think we do try and see the hope in every client usually that we are doing an
assessment on, so even if maybe they may not seem like it’s the right time for them
we’ve given a number of clients different assessments over different times and we’ve
tried to look at ways how we can support them even if it’s not the right time for them
(FG1, 14/5/2013).
33
that's not necessarily always about mandating behaviours and mandating elements
of change, it's about the change that people want to make and can make and are
empowered to make (FG2, 21/5/2013).
Most participants reported experiencing a relatively seamless transition in their referral to the
Stay program. Their prior use of other services such as mental health, child protection and
emergency accommodation services was an important factor in this process.
I just got a case worker to fill out an application form and I was sort of allocated a
house (C2, 5/2/2013).
It was actually really easy for me, I don’t know why or how but it just fell into place
(C3, 4/2/2013).
Others needed to persist in order to access the Stay program. The response of participant
C6 highlights what one Stay service provider identified as a common problem of service
gaps in early intervention in the homelessness services sector:
It was quite difficult when you don’t know what services were about to support you in
the situation you’re in. Over the last couple of years, to get where I’ve got to, I’ve had
to beg for help sometimes. I kept explaining my situation and to not have that support
and have them listen to me until the last minute was really upsetting. It’s hard enough
for a person to ask for help and then not to be heard (C6 7/2/13).
Approaching Housing Tasmania as a first point of contact had also resulted in frustration for
some clients due to issues of categorisation and low prioritisation (C4 4/2/13; C12 5/4/13).
However, these clients were able to access public housing through the Stay program. This
experience points to problems with a fragmented social housing system, whereby an
individual can be turned away and later enter the system via another, less direct route.
Question 2: To what extent has the agency been able to implement effective allocation
procedures that ensure that people who are at risk of homelessness are supported?
Service providers from both the Stay program and Keys to the Future tenancy program have
been able to implement effective allocation procedures to ensure that people who are at risk
of homelessness have been housed and supported. Service providers reported that while
the program experienced some delays in the allocation of properties to the program,
occupancy rates of allocated Stay-Keys properties were consistently high and close to 100%
throughout the duration of the program (SP21 12/9/2013).
Service providers raised some concerns about the process of allocating properties and
differences in the funding models applied to Stay and Keys. In relation to the allocation of
34
properties, Housing Tasmania identified a target of 100 properties to be transferred to the
Stay-Keys program. These properties, however, were not immediately transferred to
Colony47, instead the Keys property portfolio grew gradually over the two year period.
Service providers also noted that the process of obtaining properties varied across regions,
with some delays experienced in the north. This was a significant concern for Colony47 as
rental income was a substantial component of the Keys funding model. Unanticipated
delays in property allocation created financial risk and potentially impacted on the viability of
the Keys program. In contrast, the Stay support service funding model was set at a
recurrent amount and unaffected by property allocation.
In addition, concerns were expressed about the discrepancy between the funding body’s and
the service provider’s view of the program caseload. While Housing Tasmania viewed the
combined program target as 100 clients receiving support in 100 allocated properties, Stay
service providers identified the caseload as the number of clients who are receiving support
services, some of whom may not necessarily be occupying a property. For example,
referred clients may also turn out to be partners, which results in two clients accessing a
single house. In other instances, clients find more appropriate housing through family
support, which enables them to enter the private rental market, either locally or interstate.
For the poor old tenancy manager, their budget and everything is working on the
aspect of having 100 properties and those 100 income, to be able to run what they
need to run, but they haven’t had that. ….And the fact that we’ve got some clients
that happen to be partners. We’ve got 100 clients, but some of them have been
referred through and they [are] partners. So you’ve got two clients, one house (SP5
20/08/12).
Service providers highlighted that the quality of properties allocated to the program was
variable and there were a number of reasons why a client would reject the property offered
or seek to move once established in their tenancy. For example, the property might be
unsuitable, as when a client has experienced problems in the particular neighbourhood
before, or the house itself may be unsuited to the client’s needs. In some instances, service
providers felt that had they been provided with detailed information from Housing Tasmania
staff about the proposed property earlier in the process then this situation could have been
avoided.
With the housing offers, it’s difficult to work with when you don’t have many say,
three-bedroom houses anyway and in areas that are in the northern suburbs. Most of
our clients don’t want to go back to living in the northern suburbs, because of their
past associates, and they want to start afresh. There’s limited stock out of those
areas (SP18 19/2/13).
35
Because this is a long term housing program and a lot of our clients have had a long
history of itinerancy, a long history of homelessness, a long history of mental health,
quite often the first property that we move them into ends up either not being suitable
for them. Or the tenant themselves, their behaviour might be such that it makes that
property untenable for them to continue with. That’s not necessarily to say the clients
are at fault; it’s just the influence of the culture they came from (SP3 13/08/12).
Question 3: To what extent have providers of the Stay service and Keys to the Future
program been able to implement processes that support residents to sustain their
tenancies?
Since establishment, Stay and Keys to the Future service providers have been successful in
implementing processes that support residents to sustain their tenancies. The model is
based on a formal separation between support services provided by Centacare through the
Stay program and tenancy management services provided by Colony 47 through the Keys to
the Future program. While this model is effective in practice, the program experienced some
initial teething problems as appropriate communication and business systems gradually
became consolidated.
Service providers identified the key strengths of the Stay-Keys program in terms of its
capacity to support clients with medium to high needs to sustain tenancies. These included:
the quality of the support available; the length of support available; and the flexibility of
tenancy managers in responding to client housing needs.
I think it’s the only viable model for addressing these sorts of clients. You need at
least two years of support to achieve any lasting and significant outcomes for clients
with such high and compounded needs (SP21, 13/9/2013).
Support service providers observed that, Colony47 was in many instances more flexible than
Housing Tasmania in its approach to housing clients. When problems arose with a particular
tenancy, Colony47 were willing to transfer clients to a more suitable property within their
portfolio. However, service providers also noted that Colony47 had a fairly limited portfolio
of properties and that this limited choice.
If we had another client that was having issues with their particular house that would
be alleviated by us transferring them to another property, that was quite easily done
within the Colony 47 Portfolio and we could basically move them to the empty
property fairly quickly with the least amount of fuss (SP21, 13/9/2013).
A further issue raised by clients was the scope of the Keys and Stay programs to enable
clients to maintain their housing during temporary periods of absence was recognised as a
key strength. The comments of the two participants quoted below illustrate the value of
36
providing continuity in the provision of housing, and of a home-based sense of identity, for
clients who might need to return temporarily to institutional life. This may occur because of a
need for intensive therapeutic care, or because of repeat offending. Having a home to return
to, or knowing that valued possessions would be stored safely for them, was a powerful
source of hope for the future and motivation to build on the improvements they had already
made in their lives with the support of the Stay program.
I’ve got a bit of a problem, a suspended jail sentence …I have to go to jail for two and
a half months. And through this, through the Stay program, [my case worker]
organised everything. I’ll only pay five dollars a week rent while I’m in jail. But if I get
any longer than say three months, then I’ll lose my house. But [Stay case worker]
told me not to worry about it. They’ll pack my unit up and put it in a container, and
then the month before I have to go to jail they’ll find me another house and another
placement. So when I get out of jail, I will still have somewhere to go to. Whichever
way it goes, I know they’re going to be there (C14 5/4/13).
What she [Stay case worker] has done for me has been brilliant. I’ve recently gone to
detox and rehab and still kept my place. They’ve been very, very supportive of my
recovery. They’ve seen me grow a lot and they’re just so proud of me. And they tell
me so (C15 10/4/13).
In contrast, service providers provided insight into some initial teething problems with the
program, which had the potential to place tenancies at risk. These included: delays in
allocating properties to the program; and inadequate processes in place to respond quickly
and effectively to rental arrears and property damage. As previously noted, the Keys
property portfolio grew gradually over the two year period, with most of the delays in property
allocation occurring in the north. Service providers observed that despite considerable
consultation with the regional offices, support for the program, including timely allocation of
properties, remained a problem (SP21, 13/9/2013). They also noted that the program was
implemented in haste and accordingly critical communication and business processes were
underdeveloped between the agencies and Housing Tasmania’s regional offices (SP20,
12/9/2013). Moreover, problems with internal communication systems within Colony47,
between their finance department who was collecting the rent and the actual tenancy
managers, in some instances, resulted in a delayed support and tenancy response to rental
arrears. Such problems would have been more easily addressed had these issues come to
the tenancy and support workers attention more quickly (SP21, 13/9/2013). Inadequate
resourcing for tenancy management in the north of the state was also highlighted as an
issue that hindered initial responsiveness to tenancy problems.
A collaborative relationship between the tenancy manager and the support worker is
recognised by staff as the key to support residents to sustain their tenancies. Good
37
communication between the tenancy manager and support worker is critical to preventing
the escalation of minor tenancy issues into a major issue. In the most part, communication
between the services was good, but fell down when there were issues of financial risk to the
Keys program (SP20, 12/9/2013). While rental income formed a substantial component of
the Keys program, the Stay service carried no financial risk should a tenancy not work out.
As the support service provider’s primary role is to support a client to sustain a tenancy and
avoid eviction, there is effectively an incentive to under-report issues that may place that
tenancy at risk such as property damage. Service providers noted that although this was a
minor issue in practice, it was a limitation of the model (SP20, 12/9/2013).
In relation to supporting people to sustain their tenancies, service providers also raised the
issue of the location of poor quality housing stock in areas of concentrated disadvantage.
Many of the properties allocated to the Keys to the Future program were located in
disadvantaged areas, which can exacerbate the very problems that Stay providers are trying
to work with the client to address.
Finally, in relation to sustaining tenancies, further monitoring is required to see how clients
manage following their transition out of the Stay program and the transferral of their tenancy
management from Colony 47 back to Housing Tasmania. While some participants
expressed apprehension about the changeover to Housing Tasmania, the knowledge that
they would not have to move house was reassuring. The Stay program has the flexibility to
continue to provide support to clients who still need services after the formal two-year period
has expired, but for most, it represents the point of transition to independence.
I think the failure rate for a lot of these clients will increase over the next six months
to 12 months. ...The relationships that have with workers is key (FG2, 21/5/2013).
Those properties are coming back right here right now at a rate of knots.....my
concern would be once all these people do come back into Housing Tasmania they
won't have that person who is driving them and they'll lose all their links to their other
services, 'cause it's so easy to happen (FG2, 21/5/2013).
The time limited nature of the service (FG2, 21/5/2013).
38
Question 4: To what extent has the Stay service provided opportunities for residents
to: reunite with and increase connection with family; improve independent living
skills; access a range of health and support services; and pursue education, training
and employment options?
Since establishment, the Stay service providers have been successful in providing clients
with opportunities for residents to: reunite with and increase connection with family; improve
independent living skills; access a range of health and support services; and pursue
education, training and employment options. Critically, the Stay service providers have
provided clients with empathic assistance and support that is valued by clients. Service
workers have been successful in establishing trust and rapport with clients.
Service providers and clients identified a range of factors that were critical in helping clients
to achieve an enhanced quality of life through the Stay program. These included: empathic,
empowering and comprehensive service delivery; a high level of trust between Stay worker
and client; and a stable housing situation.
They pushed and pushed for a counsellor even though you don’t want to see one,
they still keep consistently pushing that you do ....That’s why I like the Stay program,
my worker, ‘cause I talk to her about absolutely everything. At the end of the day
when they’re around, half of them are just like us. My one that I have at the moment,
she’s just the same as me kind of thing. Well, not really, but kind of. We’ll just talk
about girl’s stuff and then like we’d slowly get into a conversation about my past and
stuff like that, so it wouldn’t be just straight-up kind of thing. It’s not so awkward and
it’s not straight to the point. It’s about other things as well (C13 8/4/13).
He [Stay case worker] said he’d come to court with me and sat there with me, ‘cause
I’ve had no-one to go with me, no-one to talk to . He helps me organise my shopping,
helps me with my budget, helps me with my house, like makes suggestions. … He
doesn’t tell me what to do; he makes suggestions and then he leaves it for me to
work it out for myself around! (C15 10/4/13).
I think that you feel overloaded from the stress of being homeless and with everyday
life and, struggling with your relationship and addictions and all those sorts of things,
and so you just spend a lot of time on the phone, you go for a hell of a lot of
appointments, but they’re all necessary in the end … By the time you get there and
actually push yourself to go to them, you’re pleased that you have. The [Stay]
workers that we had picked up on that. They would say, I think you’re being
bombarded a bit; we’ll pull back a little bit. They were spot on. We’ve been extremely
lucky (C9 1/2/13).
39
While service providers recognised positive movement in client outcomes, they also
emphasised that the client group supported by Stay-Keys had high and complex needs.
Outcomes such as participation and training need to be assessed with regard to the
significant barriers faced by a client group in which drug and alcohol dependence and mental
health conditions were pervasive. Equally, family re-unification was not appropriate for all
clients, particularly those who had experienced domestic violence and abuse.
Service providers observed that in-home support was critical in assisting clients to take firststeps towards engaging with more intense and specialised support services.
You don’t want to create dependence but then because of the crises ... the lives that
our clients have had sometimes they just do need a little bit of help and someone
doing something for them and it’s, yeah, I guess a balancing act of doing that without
creating a dependence there (FG1, 14/5/2013).
There's a lot of preparation that these people in the home can actually do to prepare
people to actually .....a different level of service provision to do with childhood trauma
or chronic anxiety (FG2, 21/5/2013).
While service providers emphasised that each client presented with a unique suite of issues,
they were also able to identify challenges associated with particular client groups. Some
providers noted that the duration of the program, two years, was not suitable for all clients, in
particular, some young people and some ex-offenders.
With youth, I think that a lot of 16 year olds, especially 16 year old males, I think it is
unrealistic for us to think that they would be staying in the house after the 2 years.
Many of them, it would be realistic for them to stay in the house for 2 years. So I think
shorter term transitional options, particularly for 16 year old males would be a better
option for them.... Transitional support might be a good stepping stone for those
clients - purpose built youth accommodation facilities (SP3 13/08/12).
However, the length of the program was seen as a significant advantage for: people with
mental health issues; young people engaging in education; single mothers; and some exoffenders, such as sex offenders who may experience anxiety and prejudice when being
relocated.
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4 Evaluation of Service Participant Outcomes
In Chapter 4 we present the evaluation of service participant outcomes. Service participant
outcomes are evaluated in terms of: increased stability of tenure and reductions in
homelessness; increases in family reunification and connection with family among residents;
increased participation in education, training and employment among residents; increased
independent living skills among residents; and improvements in the health and wellbeing of
residents. The evaluation also identifies the key factors that have facilitated and hindered
positive client outcomes.
Question 1: To what extent has the Stay service in association with Keys to the Future
program achieved stability of tenure for clients?
Since establishment, Stay and Keys to the Future service providers have been successful in
supporting residents to sustain their tenancies. In their review of the implementation of the
NPAH in Tasmania, the Tasmanian Audit Office (TAO 2013: 34) notes that over 70 per cent
of housed Stay clients had maintained their tenancies for at least 18 months.
The Stay program provides clients with access to stable, long-term housing. In relation to
housing, clients were very positive about: the support they received with finding a home; the
support they received when establishing themselves in their new home; and the ongoing
access to support to enable them to sustain their tenancy.
Very helpful. I’ve never encountered support of that nature before in my life. It’s just
incredible. I’m really on my feet. They got me a place. They placed me in housing
which is the most important thing. A range of essential stuff was here. There’s a huge
financial barrier for people who are going from scratch, from employment or pension
to a functional household, so they basically jumpstarted the organising electricity
bills, direct debit stuff, just practical things. Helped me sort out getting a car licence
and having foundational appliances and furniture here, like a bed, a chair and things
like that. I’m so ecstatic at how things have come out, because my life has been a
disaster for years. I’ve had a pretty hard time and I think the outcome speaks for itself
with me (C1 5/2/13).
Having somewhere permanent to live (C1, 5/2/2013).
Ending up with a good, stable accommodation residence (C2, 5/2/2013).
The best thing was just to get stable long-term accommodation (C3, 4/2/2013).
My main area was my budgeting and keeping on track with bills to keep my housing
(C6, 7/2/2013).
I’d say putting a roof over my children’s heads (C7, 4/2/2013).
41
It was good to finally have my own house and not be couch surfing and sleeping on
the streets and that. But I’m still sort of dealing with depression at the moment so I’m
still struggling a little bit...it’s a lot better having my own house. It’s a lot easier and it’s
nice knowing I’ve got a roof over my head (C10, 5/4/2013).
In relation to sustaining tenancies, service providers observed that there were distinct
challenges associated with particular groups of clients. Some client groups were also more
likely than others to have problems sustaining tenancies. For young people, such problems
were linked to negative peer influences and anti-social behaviour.
Certainly with younger people, we definitely do have issues with disturbance, loud
noise and parties and that causes a problem because neighbouring residents
complain heavily quite a lot of times. Effectively if people put in complaints about
disturbances after hours, then we go back and we get the feedback, we go back to
the tenant, we go back to the Stay program and we talk to them about what needs to
change. And the person will get multiple chances and usually they get better over
time. Some don’t and some do get asked to leave after a while, after multiple
breaches of their lease (SP19 22/3/13).
Clients who had experienced chronic homelessness also faced challenges in sustaining their
tenancies. These were largely due to practices that persisted from their previous homeless
lifestyles, such as house sharing. As one service provider explains:
People that are used to sleeping out on the domain, they’re often part of a community
of chronically homeless people., What we find is that those tenants don’t visualise
that property as their own. They open that up to their community of other homeless
people. We’ve found that they’ll give out keys and then come back to us: Oh I’ve lost
my keys. Can you get some cut for me? You do that, then two weeks later, I’ve lost
my keys, can you get some cut for me? You’ve probably got 10 other people that can
frequent the house as much as they want, but they keep it on the quiet, because
that’s part of their survival. That concept of, this is mine. None of them own the
properties, but that sense of ownership over their own space. It’s a broad concept of
‘my space’. You know they’re going to allow their community into it (SP19 22/3/13).
In relation to sustaining tenancies, further monitoring is required to see how clients manage
following their transition out of the Stay program and the transferral of their tenancy
management from Colony 47 back to Housing Tasmania. While some participants
expressed apprehension about the changeover to Housing Tasmania, the knowledge that
they would not have to move house was reassuring. The Stay program has the flexibility to
continue to provide support to clients who still need services after the formal two-year period
has expired, but for most, it represents the point of transition to independence.
Without the Stay program, we wouldn’t be where we are today, so I’m going to be
sorry to see them [go]. That finishes [soon] and we get transferred through to the
42
Housing Department. I think it’s time. It’s been two years and we’re doing well and it’s
time to move on (C9 1/2/13).
The house gets handed back to Housing. That’s okay, as long as I’ve still got me
home and nobody else can take it off me, so to speak (C11 5/4/13).
One client expressed a sense of impending loss, as she had developed a valued personal
relationship with her tenancy manager.
Well in three months I won’t stay with the Stay Program and my house is getting
handed over to Housing. That’s been really hard because the lady who does the
inspections and then if anything’s wrong with the place or if the locks or anything play
up, from Colony 47, she’s been awesome and she knows me very, very [well]. I've
told her all about me and she knows how I like to keep my place and she knows that
I’m a good tenant. I’ve got a bond with her now. I just know what she expects. It’s just
going to be very, very different and I won’t be able to have her as a worker. They’re
going to be big changes. It’s all slam bam kind of thing. I just don’t function like that. I
knew it was going to happen, but three months is going to go, just like that (C15
1/4/13).
Question 2: To what extent has the Stay service been able to improve client outcomes
relating to: family and community connection; independent living skills; health and
wellbeing; training, education and employment?
Since establishment, the Stay service providers have been successful in improving client
outcomes relating to: reunite with and increase connection with family; improve independent
living skills; access a range of health and support services; and pursue education, training
and employment options. Critically, the Stay service providers have provided clients with
empathic assistance and support that is valued by clients. Service workers have been
successful in establishing trust and rapport with clients.
In their review of the implementation of NPAH in Tasmania, the Tasmanian Audit Office
reports that the majority of Stay clients have improved across all measured life skills and
attributes (TAO 2103: 35). However, these findings are qualified by the observation that such
improvements are from a low base and that the measurement is subjective (TAO 2103: 35).
In relation to client outcomes, the audit also reports on the proportion of Stay clients entering
into education and employment. It provides information that 50 of the 130 clients (38% of
clients) had entered into education or employment. This includes 27 clients (21%) entering
into training and 23 clients (18%) entering into employment (TAO 2013: 36). Further data
analysis presented in section 3.1.8 of this evaluation indicates that only modest gains were
achieved in relation to education and training enrolments in 2011-2012 and 2012-2013.
43
Service user participants greatly appreciated the support they had received through the Stay
program, and associated services, and reported a range of positive outcomes. In the
assessment of many clients, the program had completely transformed their lives.
Very helpful. I’ve never encountered support of that nature before in my life. It’s just
incredible. I’m really on my feet. They got me a place. They placed me in housing
which is the most important thing. A range of essential stuff was here. There’s a huge
financial barrier for people who are going from scratch, from employment or pension
to a functional household, so they basically jumpstarted the organising electricity
bills, direct debit stuff, just practical things. Helped me sort out getting a car licence
and having foundational appliances and furniture here, like a bed, a chair and things
like that. I’m so ecstatic at how things have come out, because my life has been a
disaster for years. I’ve had a pretty hard time and I think the outcome speaks for itself
with me (C1 5/2/13).
It was perfect. Anything I really needed help with, my social worker jumped straight in
and helped me. She was always there if I needed anybody to talk to. Not only was
she a social worker, but she was my friend at the same time (C8 5/2/13).
I’ve received superb help (C9 1/2/13).
We just have a talk and make sure I’m up to date with my bills and all that sort of
thing (C11, 12/3/2013).
I didn’t have a house at the time, I didn’t have my daughter home with me. I was in
trouble with the police and had a drug habit and now I’m clear of all them things and
have two kids home with me full-time and have for the last year and a half (C13
8/4/13).
There are a number of ways that the Stay support workers have facilitated resident
connection with family. Residents reflected on the importance of a stable base in order to
enable their family to keep in touch and visit. For some people, improvements in their health
and wellbeing had provided a good foundation for reconnecting with family and maintaining
contact. While the Stay program has assisted with family reunification and connection
among clients, not all clients desire family reunification.
While the Stay support workers have been successful in increasing client participation in
education and training, not all clients are able to or interested in pursuing further education
and training. The support worker can assist clients with managing anxiety, depression and
other health conditions that might hinder training and workforce participation. The support
worker can also facilitate the process of identifying individual educational, training and
employment goals and pathways. A stable home provided through the program is also
critical in enabling clients to take steps towards participation in training, education and
44
employment. The highest rates of participation in education and training are experienced
among young people in the program.
Yeah. In the last five years since I’m mentally well, I’ve started work, some casual
work in a health food shop and that, yeah, and all that. That’s only because I’ve got
my own place and I’ve got myself stable and my mental whatever, eating and all
that’s changed. Like I’m on top of things and I’m on top of my life (C14, 5/4/2013).
Client health and wellbeing can vary enormously and fluctuate significantly. Client health
and wellbeing is also dependent on a complex set of factors that interact with the benefits of
Stay and Keys to the Future. While it is not possible to confirm the impact of the program on
client health, clearly the Stay service has improved client wellbeing. Clients reported that
they: generally feel better about life; they have a more positive outlook; life has become
easier to manager; and they have less anxiety and stress. The support workers have played
a critical role in providing clients with access to someone whom they trust to talk through
their concerns with. The Stay service has also been successful in improving clients’ access
health services and their capacity to manage their health and wellbeing.
They got me a caseworker and Karen helps me get to my hospital appointments and
comes around and sometimes takes me out like if I’m unwell to go anywhere...when
I’m unwell, she’ll come around and help me take … like do my shopping and she just
helps me rectify things (C11, 12/3/2013).
She’s helped me out a lot, when I first moved in it was a new area and I didn’t have
my licence at the time so she helped me with the bus services, she’s also helped me
get my Labrador in ... staying with me and he’s been staying with me for the last two
years and it’s been ... oh, I can’t even tell you how good it is to have him around, he’s
been really good for my health (C15, 10/4/2013).
They don’t push anything on me or she’ll take me out for coffee and we’ll talk about
things, like what’s been going on in my life and how my health is and where she can
help me, ‘cause not everything she can help me with. Like she’s not a doctor or she’s
... what she’s done for me has been brilliant, like I’ve recently gone to detox and
rehab and still kept my place, they’ve been very, very supportive of my recovery,
they’ve seen me grow a lot and they’re just so proud of me (C15, 10/4/2013).
Someone very understanding, not judging them, not giving ... show ... she’s never
given up on me, there’s a lot of ... I’ve had other workers that have given up on me
and I test workers now, it’s just this thing in my head ‘cause I’ve been let down and
rejected a bit in my life and she stuck by me. ... at the beginning, I didn’t tell her
anything about myself or I just had my wall up I guess....And over time I got a trust
with her over time (C15, 10/4/2013).
I’ve been able to talk to them about stuff, if you know what I mean, I’ve been able to
sit down and talk about all sorts of things (C1, 5/2/2013).
45
Formally structured, issue-targeted counselling was not as well received by client
participants as the kind of spontaneous psychological support delivered within the broader,
more natural settings provided by Stay case workers.
They push counsellors and stuff, just keep pushing the subject even if you say you
don’t want to they can still like every visit they bring it up. ...Just trying to be helpful
[but]....I don’t know. I’ve never agreed with counsellors, I’ve never liked them so I’m
just against them altogether kind of thing. ...You know they just question you pretty
much and want to know absolutely everything down to the last detail and stuff and
sometimes you just don’t want to talk about it....that’s why I like the STAY program,
my worker ‘cause I talk to her about absolutely everything. ...Well, when you sit and
having a conversation we’ll be on the same thing like she’ll turn around and talk
about fishing and all with my ex-partner at the time and we’ll just talk about girl’s stuff
and then like we’d slowly get into a conversation about my past and stuff like that, so
it wouldn’t be just straight-up kind of thing, she would start a conversation first....Like
it’s not so awkward or anything like that and it’s not straight to the point, it’s about
other things as well (C13, 8/4/2013).
The support available through the Stay program seeks to develop interpersonal skills that
enable residents to relate well to others, as well as the development of independent living
skills that enable residents to manage their budget, mange their health and undertake
domestic tasks. Residents enter the Stay program with differing levels of interpersonal and
independent living skills and these skills fluctuate over time with residents experiencing
improvement and regression. In terms of sustaining independent living skills, service
providers sought to provide clients with a sense of agency and ownership over decision
making and outcomes. They also sought to establish a sense of trust and empathy, which
became the foundation for working positively and collaboratively with a client towards
achieving their goals. This approach was valued by clients.
Organisational skills...I just didn’t have the skills to organise the household or
whatever....I’m so ecstatic at how things have come out because my life has just sort
of started up again (C1, 5/2/2013).
Oh, yes and no, I did have someone coming to see me weekly to start with and then
it went to fortnightly and then monthly or whatever but it was good to have that … a
few things put in place where they help you out with a budget or you need to sort of
be accountable for things but it’s mainly your own person, like you need to be
accountable for yourself, but I mean they were helpful and they were really good and
showing me different thing, but if you don’t do it yourself, it’s not worth it (C3,
4/2/2013).
He’s helped me for three months when I moved in here and he’s backed off from me,
lets me make my own decisions. I just make a decision I’m going to do something or
buy something and then I’ll sit down and talk to him about it and then he’ll look at …
he helps me just … he doesn’t tell me what to do, but he sort of puts it out there, well
46
this is what can happen if it goes wrong, or that or it’s a good idea but … but in the
end he’ll show me, you know, like a scenario of what could happen or what, you
know? (C14, 5/4/2013).
In relation to client outcomes, further monitoring is required to see how clients manage
following their transition out of the Stay program and the transferral of their tenancy
management from Colony 47 back to Housing Tasmania. As noted above, the Stay program
has the flexibility to continue to provide support to clients who still need services after the
formal two-year period has expired, but for most, it represents the point of transition to
independence.
Question 3: What are the key factors that have facilitated positive client outcomes?
The key factors that have facilitated positive client outcomes as identified by both service
providers and clients include: access to stable, long-term housing; duration of the program,
which provides sufficient to establish high levels of trust between support worker and client;
access to trusted case workers who can provide clients with practical and emotional support;
flexibility in service delivery, which enables service workers to be responsive to client need;
and collaboration among agencies working in homelessness support services.
Service providers identified major strengths of the Stay service as: the intensity of support,
the duration of support, and the stability of tenancy over two years. These factors were
considered crucial, because they allowed sufficient time for clients with high and complex
need to respond to and benefit from homelessness service provision.
I think the length of time that caseworkers can work with individual clients is one of
the greatest strengths ..... specialist workers typically are brief interventionists, six
weeks, short, sharp, but the relationship that’s built and built upon in this role yeah, I
think it’s one of the kind of star qualities of STAY (FG1, 14/5/2013).
Service providers noted that the intensity and duration of the program is important in
providing an enabling environment for clients with mental illness to manage their symptoms
from a place of security and safety.
Basically a lot of clients have got a previous diagnosed mental health condition. ...
We have been able to help those people immensely in the program. The 2 years is a
good period of time, because it allows them to get used to their house; it allows them
to become accustomed to having their periods of wellness and unwellness (SP3
13/08/12).
47
Flexibility in service response, rather than simply an abundance of services, was considered
necessary to address the complex range of client needs. While the Stay program offers
some flexibility in support service, this could be further enhanced.
The main challenge is not necessarily to provide a plethora of support programs, but
just to provide flexible support programs. You don’t need a lot of them, you just need
ones that are able to be flexible in the type of support they are giving, the length of
support they are giving. So, as it works in mental health where you have packages
of support, I think that could be a way of doing it in the homelessness sector, where
you have packages of short term support, packages of medium term support and
packages of intensive long term support for the high and complex needs (SP3
13/8/12).
The [Stay] program needs to be flexible. Two years was always an arbitrary number.
The service provider was always able to come back to us after a 12 or 18 month
period and say, ‘we think this client has tipped over and they are fine now and can
sustain independence and we have in fact been pulling back our contact hours’, or
whatever they have been doing for a period of time (SP4 17/12/12).
Whatever the program, it needs to be able to have the flexibility not to have a one
brush approach. You have to be able to use a range of different methods of
supporting, but having the framework of unconditional positive regard, maintaining
consistency, maintaining boundaries, sometimes about being able to build rapport, all
of those things, and having a framework to head towards (SP5 20/08/12).
While service providers identified problems with communication, coordination and
collaboration across the homelessness support sector, they recognised that professional
relationships based on trust and goodwill were critical in responding creatively and
effectively to structural deficits. Participants observed that often collaboration between
homelessness services is informal, spontaneous and aimed at addressing gaps in the
system with available resources.
Early on in the program, we realised that a lot of clients needed quite extensive
socialisation skill building and so we were referring them to the mentors program. ...
It became very clear early on that [this] program was completely snowed under with
referrals, and realistically, that wasn’t going to happen... We were able to get
another program called Stay Plus up and running. [It’s] basically the Mates program,
but just for Stay clients and so it is only a small program. It is only for the South at the
moment, but it is something that we can build on (SP3 13.8.12).
We all have limited resources at our fingertips and sometimes it’s really good to just
sit with other people or with other organisations and say, well, we can't really do what
we want to do on our own, because we have limited resources or limited funding and
in order to achieve it, we need to collaborate a little bit more. It helps a lot to build
those types of networks and the coordinators and the caseworkers do a lot of that on
the ground, in the coalface relationship-building with their counterparts (SP19
26.3.13).
48
I think we’re good at it [communicating with other service providers] when the needs
are high. When there are crises, I think we’re good at contacting services and
coordinating, so that we can help resolve those crises. For example, an employment
service provider might link a client with a job and give them some money to buy
some clothing and equipment for their employment, but then we may assist the client
to get out of bed in the morning and get to their appointments. And when family and
other stresses arise we can work through those, so we’re basically working with other
providers to make those referrals work. ... It’s basically case coordination, but done
holistically and more thoroughly (SP14 19.2.13).
From the client’s point of view, trusted case workers embody the service experience.
Very helpful, I’ve never encountered support of that nature before in my life, not any,
not from parents or … it’s just incredible. I’m really on my feet (C1, 5/2/2013).
that’s why I like the STAY program, my worker ‘cause I talk to her about absolutely
everything (C13, 8/4/2013).
Question 4: What are the key factors that have hindered positive client outcomes?
The key factors that have hindered positive client outcomes within the Stay-Keys program
include: delays in property allocation; the quality of available housing stock; and, more
broadly, structural fragmentation within the social housing sector.
As noted in Chapter four, service providers raised some concerns about the process of
allocating properties and differences in the funding models applied to KEYS and Stay. In
relation to the allocation of properties, Housing Tasmania identified a target of 100 properties
to be transferred to the Stay-Keys program. These properties, however, were not
immediately transferred to Colony47, instead the KEYS property portfolio grew gradually
over the two year period. This was a significant concern for Colony47 as rental income was
a substantial component of the KEYS funding model. It also meant that clients consistently
had to wait considerable periods of time before being allocated appropriate housing,
particularly in the North of the state. Service providers noted that this varied across regional
Housing Tasmania offices.
In addition, the location of poor quality housing stock in areas of concentrated disadvantage
was identified as a problem in relation to trying to support people to sustain their tenancies.
There was concern about the lack of coherence between the nature of client needs and the
nature of available housing stock. The issue of inappropriate housing is recognised by
service providers as key factor contributing to past housing stability across all referral
groups.
49
More broadly, service providers expressed concern about the fragmentation of the social
housing system, which entails the allocation of public housing stock to the Stay-Keys
program for a two year period. Such fragmentation is recognised by service providers as a
problem in that it: directs costs towards administration of the system away from service
delivery; it creates barriers to clients trying to access support services; and it can hinder
collaboration between agencies.
unless you actually give people complete control over a property, just having a
middle person there to manage things just creates work on ... like creates work out
that way to support and you know land owner, you know having the person spinning
your wheels in the middle (FG2, 21/5/2013).
The model of a component part of an integrated service was definitely there, but on
delivery and on roll out it... became a service bubble that has created more problems
for operational staff I think, and it's contributed to exacerbated communication issues
across the services (FG2, 21/5/2013).
Several participants suggested that further fragmentation of the social housing and support
system generates risks and unintended consequences, such as increasing bureaucracy and
administrative costs, which in turn redirects resources away from clients into administration
and management.
There are 35 services. Each one of them looks after a range of support services. One
of the big challenges that I see is decoupling all the duplication. You don’t need a
tenancy officer looking after 10 properties when another service has got 10
properties, and another tenancy officer and all those administrative tasks. The big
challenge is to make sure that the dollars that are available get to the client, not to
the service administration (SP9 17/12/12).
As soon as you set up a new support service and separate out functions and do all of
that kind of thing, you are actually creating work for the individuals that are managing
it. You are creating management structures that need to be looked after (SP12
20/01/13).
You have your youth services. You have your women’s services. It’s broken up like
that and that’s good, because there are specialised needs in each area. But you’ve
also got the generic services like the COS service that is doing all those things
anyway. There is room to consolidate in my view (SP16 22/3/13).
Service providers also expressed misgivings that structural fragmentation was encouraging
competition between service providers for limited funds, at the expense of cross-service
collaboration and integration. Others noted the potential for duplication of services, with a
need to re-learn lessons with each new service.
You have a number of NGOs who are, in some respects, competitors. The
organisations are encouraged to patch protect by the funding arrangement. They are
50
not inclined to share clients or have shared wait lists or to integrate their front ends.
So there is a perverse incentive in the system and we keep perpetuating it (SP4
17/12/12).
[Stay staff were] open to sharing and developing policies specific to the Stay
program, but were also guarded about their investment in their own intellectual
property that had brought them through various learnings in working in the
homelessness space (SP11 17/12/12).
I just think that we still have problems in terms of people having ownership of their
own patch, seeing themselves as part of a big plan that actually has a common goal
(SP12 20/01/13).
Some felt that structural fragmentation was making it unnecessarily complex and difficult for
clients to navigate the system. Such observations accord with the intent of broader
structural reforms taking place within the housing sector, namely the introduction of Housing
Connect in 2013, which aims to improve client access to appropriate services through the
establishment of a single ‘front door’ or ‘gateway’ to housing and associated support
services (SP4 17/12/12; SP12 20/1/13).
51
5 Discussion of Service Implementation and Outcome Information
The Stay-Keys program has successfully transitioned people who are homeless or at risk of
homelessness into secure housing. The Stay-Keys program fits well with the policy response
to homelessness articulated in the Homelessness National Partnership Implementation
Plan for Tasmania (DHHS, 2009) in that it provides those who are homeless or at risk of
homeless with immediate access to permanent housing and ongoing access to social
support. The comprehensive support service has been critical in enabling people to sustain
tenancies and to take steps towards improving their independent living skills and achieving
greater social and economic inclusion.
A key strength of the Stay program is the empathic, non-judgemental support clients have
received from Stay support workers. As noted in the previous chapter, formally structured,
issue-targeted counselling was not as well received by client participants as the kind of
spontaneous psychological support delivered within the broader, more natural settings
provided by Stay case workers. This entails the support worker simultaneously: assisting the
client with practical everyday tasks; listening to the client talk about his/her concerns; and
supporting clients to identify and achieve personal goals in the longer term. This finding
suggests that taking time to build relationships with clients through integrated informal
counselling and practical support contributes substantially to client wellbeing and housing
stability. Service providers further noted that the Stay service plays an important role in
delivering informal support that can then prepare clients to undertake more intensive and
specialised therapeutic interventions. This integrated, client-driven approach to identifying
and engaging with support services contrasts with an alternative approach that entails
assessing client need and then directly referring the client to discrete or formal counselling
services.
In relation to the support service, further strengths of the program include: the flexible
duration of the service, which enabled clients to access support for up to two years and to
remain in contact with support workers following transition out of Stay should this need be
identified; and the fact that support could be tailored towards client-specific needs.
A central feature of the Stay-Keys model is the separation of tenancy management and
support. Service providers noted that this separation has benefits for both service workers
and clients. For workers, separation of the roles in practice recognises that both tenancy
and support roles are complex and require a particular skill set. For clients, the separation is
important in reducing confusion and ensuring that the client directs their individual support
52
and tenancy issues towards the most appropriate person. In relation to Stay-Keys, this
desire for a clear separation of tenancy management and support was built into the design of
the program. While the strengths of separate tenancy and support are well-established, the
experience highlights that there are some areas of risk with this model. Service providers
observed that in retrospect the tendering process for the Stay-Keys program was
problematic. The process was a two stage process, with the first tender being awarded to
the organisation delivering the Stay support service and the second tender focused on
tenancy management. At this stage, organisations were not able to consult with the Stay
provider, nor were they provided with a detailed understanding of the support service being
delivered. This lack of communication and the lack of information about the regularity and
intensity of support available through the program made it difficult for organisations to
accurately assess the financial risks associated with managing such tenancies.
Service providers suggested that a partnership approach during the tendering process would
have been highly beneficial in improving inter-organisation communication and in developing
a fair and equitable service model. It would also have enabled agencies to select a
collaborator with congruent organisational values to their own. Instead, service providers
noted that there were inequities in the design of the program, with the tenancy management
provider, Colony47, taking on a significantly higher proportion of risk than the support
organisations, Centacare and Red Cross. A substantial proportion of Colony47’s funding
was based on rental income. This meant that problems that arose during the program, such
as delays in accessing properties from Housing Tasmania, property damage, evictions, and
clients disengaging from the support service, all represented financial risks for the tenancy
management provider. Further problems related to establishment of potentially competing
KPIs between agencies, rather than consistent KPIs across the program and partnership.
For example, as the support service provider’s primary role is to support a client to sustain a
tenancy and avoid eviction, there is effectively an incentive to under-report issues that may
place that tenancy at risk such as property damage. While this was a minor issue in
practice, it was a limitation of the model.
Service providers identified an additional discrepancy in the design of the service model.
They noted that the model assumes that clients would be consistently engaging with support
delivered through the Stay program while being accommodated in housing allocated through
Keys. However, legally this cannot be enforced under the Residential Tenancy Act as the
landlord is unable to evict someone from a property for not engaging with support. In
practice, some clients chose to disengage from Stay and instead work with other services.
This created additional financial risk for the property management provider in terms of
53
potential property damage or inability to sustain the tenancy without appropriate support in
place. This flaw in the service model highlights the potential for tension between the role
required of a residential landlord and the social objectives that inform supportive housing
services. While this issue was also present in other services established under the NPAH, it
was more visible with Stay-Keys because the service was delivered across existing housing
stock, rather than being identified with a distinct residential facility.
While the Stay-Keys program provided a valuable service and entry point to permanent
housing for people who had previously experienced difficulties in sustaining their tenancies,
service providers provided insight into some initial teething problems with the program.
These included: delays in allocating properties to the program; and inadequate processes in
place to respond quickly and effectively to rental arrears and property damage. In relation to
property allocation, the program’s property portfolio grew gradually over the two year period.
Unanticipated delays in property allocation created financial risk and potentially impacted on
the viability of the Keys program. Service providers observed that despite considerable
consultation with the regional offices, support for the program, including timely allocation of
properties, remained a problem, particularly in the northern region. They also noted that the
program was implemented in haste and accordingly critical communication and business
processes were underdeveloped between the agencies and Housing Tasmania’s regional
offices. In relation to implementing adequate processes, problems with internal
communication systems within Colony47, between their finance department who was
collecting the rent and the actual tenancy managers, in some instances, resulted in a
delayed support and tenancy response to rental arrears. Such problems would have been
more easily addressed had these issues come to the tenancy and support workers attention
more quickly. Inadequate resourcing for tenancy management in the north of the state was
also highlighted as an issue that hindered initial responsiveness to tenancy problems.
In relation to supporting people to sustain their tenancies, service providers also raised the
issue of the quality and location of allocated properties. Many of these were located in
disadvantaged areas, which can exacerbate the very problems that Stay providers are trying
to work with the client to address. Service providers were concerned that there was some
inconsistency in the program logic in that the nature of available housing stock did not
facilitate the objectives of assisting clients to sustain their tenancies and to achieve greater
social and economic inclusion. We suggest this lack of appropriate housing is a wider,
structural problem that is not specific to the Stay-Keys program.
The service objectives of the Stay-Keys program detailed in the funding agreement broadly
reflect the national policy commitment to not simply house people who are homeless or at
54
risk of homeless, but to enable people to sustain their housing and obtain social and
economic inclusion. While these objectives translate well to some client groups, particularly
young people, they were not uniformly viewed as desirable by all client groups. For
example, some clients were fearful that workforce participation may trigger or exacerbate
existing anxiety. In addition, the objective of family reunification was not relevant to all
clients. Consultation with clients indicated that the specified service objectives are not
sufficiently nuanced to capture the full range of positive client outcomes for all client groups,
in particular, the critical role Stay workers played in supporting clients to engage with more
intense and specialised support services. There may be scope for reshaping the objectives
of the program to better reflect the priorities of clients as identified in their case management
plans. This has the potential to enhance the value and utility of monitoring processes and
ensure that the evidence-base is used to inform practice.
Our analysis highlights the problems associated with prescribing standardised client
outcomes in policy documentation and in service specifications as has occurred in the
operationalization of the NPAH objectives. Instead, we suggest that assisting people with
high and complex needs to attain greater levels of social integration is better defined in
practice and through negotiations between the client and their service provider. This is
particularly so for programs such as Stay-Keys, which service diverse client groups. There
may be scope for reshaping the objectives of the program to better reflect the priorities of
clients as identified in their case management plans. This has the potential to enhance the
value and utility of monitoring processes and ensure that the evidence-base is used to
inform practice.
While service providers observed that all clients groups were able to achieve positive
outcomes, young people were particularly well-placed to achieve economic and social
inclusion. However, service providers noted that the program in its present form was not
sufficiently targeted towards youth. They observed that the program assumes that young
people are looking for long-term housing security, when often many young people are
seeking stable medium-term housing solutions. In addition, some young people entered the
program with limited or no previous experience in managing a tenancy and with limited life
skills. These clients required intensive support and intervention to enable them to sustain
their tenancy.
In relation to data capture and performance reporting, the evaluation highlighted that there is
scope for improving performance monitoring of the Stay-Keys program, including attention to
the financial dimension of program performance. Such performance monitoring could then
form the basis of program innovation. In Chapter 3 it was noted that current reporting
55
requirements are not well-matched to the characteristics of the services specified or to the
broader characteristics of the actual service systems experienced by many in the target
population, especially those exiting health or custodial facilities. One consequence of this
divergence is that it hinders an evidence-based approach to service delivery. Gaps in the
key performance indicators and a lack of integrated datasets increase the challenge of
maintaining a close or converging relationship between the services delivered to, and
required by, clients and of demonstrating the efficacy of the service model.
We suggest the Stay-Keys funding agreements should provide a reasonable indication of the
expected size of the eligible population for the program and an indication of the time-toservice characteristics that describe how much time people spend or are expected to spend
at various points in the service system, especially in light of the fact it is known that reducing
the risk of homelessness for the specified target population requires the timely delivery of
services.
As a first step towards improving the performance measurement of program outputs we
suggest that Housing Tasmania update the current output performance specification for the
Stay-Keys program. We also suggest that Housing Tasmania investigate the possibility of
retaining the role of specifying an output performance regime (in conjunction with the funded
service provider where relevant) rather than outsourcing this role to third parties not directly
responsible for achieving the aim of the services commissioned. Action in this area is crucial
to attaining desired service objectives and enhancing service performance. This would
facilitate the development of a systematic data-driven approach to resource allocation and
program monitoring and innovation.
Finally, service providers expressed broad concerns about the fragmentation of the social
housing system. Such fragmentation is recognised by service providers as a problem in that
it: directs costs towards administration of the system away from service delivery; it creates
barriers to clients trying to access support services; and it can hinder collaboration between
agencies.
56
6 Recommendations to Stakeholders
It is clear that the Stay-Keys program provided a high quality support and tenancy service
that was critical in assisting clients to sustain their tenancies, improve their general health
and wellbeing and reduce their social isolation. However, we also suggest some
improvements that this model of service delivery could sustain in order to better address the
needs of current and future clients. These include:
1. Revising the separate tendering process in a way that supports a collaborative,
partnership approach to the delivery of tenancy and support programs. While the
separate procurement process was meant to ensure the two functions of property
management and tenancy support were clearly separated, it also meant that
agencies could not partner and could not select a collaborator with congruent
organisational values to their own. A partnership approach would entail making
explicit the requirement for agencies to establish appropriate communication and
business systems to support inter-agency collaboration. It would also entail clarifying
KPIs across the program and ensuring that KPIs established for complementary
services are not in conflict with one another.
2. Addressing inequities in the distribution of financial risk partner organisations
responsible for the delivery of the program. While a partnership approach would
facilitate this, financial risks were also exacerbated by delays in the allocation of
appropriate properties and problems with transferring properties back from the
program to Housing Tasmania. Further understanding of why these delays occurred
and strategies to address this are required should this model be pursued in the
future. This entails monitoring and responding to differences in Housing Tasmania’s
regional office response to delivering and supporting new programs.
3. Ensuring that the agency responsible for tenancy management is adequately
resourced and that it has effective internal communication systems in place to deliver
a responsive tenancy service from the commencement of the program.
4. Examining how the existing Stay-Keys program might be more effectively tailored to
address the specific housing and support needs of young people. In relation to this
issue, service providers raised important concerns, such as the need for intensive
support early-on in the tenancy to support young people with limited experience and
life-skills; and the appropriateness of a long-term housing program for young people,
who may prefer secure, medium-term housing options.
57
5. Updating the current output performance specification for the Stay-Keys program in
order to improve the capacity to undertake quality performance monitoring, including
attention to the financial dimension of the program performance. This entails
identification of the characteristics of the services specified and the broader
characteristics of the actual service systems experienced by many in the target
population. Performance monitoring would be further supported by specifying in the
funding agreement: the expected size of the eligible population for the program; and
the time-to-service characteristics that describe how much time people spend or are
expected to spend at various points in the service system.
6. Examining the potential to revise performance specifications to enable clients and
service providers to have greater input into defining client goals and performance
measures, rather than applying prescriptive, standardised client outcomes. This may
entail reshaping service objectives to better reflect the priorities of clients as identified
in their case management plans, with the benefit of enabling the process of reporting
against objectives to be a valuable one that has the potential to improve practice.
7. Investigating the possibility of Housing Tasmania retaining the role of specifying an
output performance regime (in conjunction with the funded service provider where
relevant), rather than outsourcing this role to third parties not directly responsible for
achieving the aim of the services commissioned.
58
References
Australian Government (2008) The road home: a national approach to reducing
homelessness, White Paper, Department of Families, Housing, Community Services and
Indigenous Affairs, Canberra.
DHHS (2009) Homelessness National Partnership implementation plan for Tasmania,
Department of Health and Human Services, Hobart.
DHHS (2010) Coming in from the cold: Tasmanian homelessness plan 2010-2013,
Department of Health and Human Services, Hobart.
DHHS (2012a) National Partnership on Homelessness Tasmanian Homelessness
Implementation Plan – Updated Version, Department of Health and Human Services,
Hobart.
DHHS (2012b), Coming in from the cold: mid-term report April 2012, Department of Health
and Human Services, Hobart.
Eardley, R, Thomposon, D., Cass, P., and Dadish, A. (2008) Measuring the impact of SAAPfunded homelessness services on client self-reliance, Report for the SAAP Coordination and
Development Committee, research commissioned through the Department of Families,
Housing, Community Services and Indigenous Affairs.
Flateau, P., Zaretzky,K., Brady, M., Haigh, Y. And Martin, R. (2008) The cost-effectiveness
of homelessness programs: a First assessment, Volume 1 – main report, Australian Housing
and Urban Research Institute.
Joffe, G., Chow, J., Heligman, T., Wilhelm, K., Collins, L., Giles, E., Lee, S., Goodwin, C.,
and Cox, M. (2012) ‘The economic costs of sleeping rough: An estimation of the average
economic costs of homelessness as measured by utilisation of services over a 12 month
period’, Parity, Vol.25, No.6, September.
Johnson, G., Parkinson, S., and Parsell, C. (2012) Policy shift or program drift?
Implementing Housing First in Australia Final Report No.184, Australian Housing and Urban
Research Institute: Melbourne.
Mackenzie, D. and Chamberlain, C. (2003) Homeless Careers: Pathways In and Out of
Homelessness, report from the Counting the Homeless 2001 Project, Swinburne and RMIT
Universities.
TAO (Tasmanian Audit Office) (2013) Report of the Auditor-General No. 8 of 2012-13
National Partnership Agreement on Homelessness, March, Hobart.
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APPENDIX A
Schedule of indicative questions service providers
1. Do you believe the Keys to the Future in collaboration with the Stay service was a
successful program that delivered positive outcomes for clients?
2. To what extent has this the Keys to the Future service been successful or
unsuccessful in supporting people who are homeless or at risk of homeless to find
stable accommodation?
3. What have been the key factors that have facilitated positive client outcomes?
4. What have been the key factors that have hindered positive client outcomes?
5. Can you please comment on the appropriateness of the key performance indicators
detailed in the Stay-Keys Funding Agreement. Did these fit with what you believed to
be the major objectives of the program?
6. We would like to understand the benefits and problems associated with a separate
tenancy and support service model from the perspective of those delivering the
service.
Can you identify and describe any problems arose in the delivery of the
Stay-Keys service? What do you think were the strengths of having separate
providers?
7. How do you think the Keys to the Future-Stay program can be improved? What
improvements do you think this model of service delivery could sustain to better
address the needs of current and future clients?
8. Is there an optimal level or type of service, or tipping point, for clients of
homelessness services, whereby additional services make limited if any further
contribution to improved outcomes?
9. Are there specific tipping points for different types of client (for example ex-prisoners
who may have shorter but more intense support needs following release)?
10. What are the best methods for assessing the ‘needs’ of those who have experienced
homelessness and for identifying the optimal level of service provision to address
these needs?
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11. What challenges arise in seeking to provide a plethora of support programs for
clients of homelessness services?
12. To what extent do ‘intense’ forms of support appeal to clients?
13. What services are provided and how might the effectiveness of these services be
improved and duplication or unnecessary service provision be avoided?
14. How do individuals experiencing homelessness view the support services they
receive? What can policy makers learn from their insights?
15. Is there anything else that you would like to add?
Thank you for participating – your time and input are appreciated.
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APPENDIX B
Schedule of indicative questions service users

Can you tell me about the services you have received to help you with housing?
o
What help did you get?
o
Who provided these services?

How did you come to be using the Stay service?

How many people do you see from the Stay service?
o
What kind of help do they give?
o
Are they all equally helpful?

How does it feel to use the Stay service? (Pace, choice, respect, control)

What has been the best thing about using this service? How satisfied are you with t
this service?

We know that housing is connected with other important things, such as health.
While you have been using housing services, have you also used other services?

Have you ever been annoyed by anything about the services you have used? Can
you think of anything that could have made the situation better?

Overall, do you think you have received enough support from services, not enough or
too much?

If you could change anything you wanted about the services you have received,
whether housing or other kinds of support, what might that be?

Is there anything else that you would like to add?
Thank you for participating – your time and input are appreciated.
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APPENDIX C
Table 1: Service Activity Specification
Service Establishment
To establish an intensive intervention service to assist people to
sustain rental accommodation and the funding and tenancy
agreements to support the objectives of the STAY service
Administrative Documentation
Undertake pre- and post-measurement of health and wellbeing
outcomes relevant to each client’s circumstances
Provide client and performance data to relevant stakeholders
Collaborate with Housing Tasmania to develop an information
management and reporting system
Monitor and report on services delivered to individual clients for
participation in an independent evaluation of service provision
Property Management and Client
Support
Provide general facility and tenancy management functions for up
to 100 residential dwellings received from Housing Tasmania
including:
Making rental agreements with clients
Supporting clients to maintain dwelling condition and pay rent.
Deliver client support services including:
Manage pre-discharge planning and participate in handover
processes with referring organisation
Conduct psycho-social assessments of clients to determine
eligibility to access STAY, priority of need, identify suitable
property, identify referral networks and pathways
Develop a comprehensive case management plan
Take actions to implement the case management plan including
regular contact with client, initiating therapeutic and specialist
interventions, service coordination, providing client with practical
life skills
For a maximum of 100 clients deliver a part-household package to
assist clients to establish a stable household and sense of
belonging
Conduct exit planning from STAY for clients transitioning to social
housing.
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APPENDIX D
Table 2: Program Performance Measures
Safe Environment
Is fire compliant
Is food safety compliant
Safe medications management
Adheres to health and safety requirement
Consumer Focus
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
Workforce
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
Incident Feedback
Possess robust compliments and complaints management processes
Adherence to incident monitoring systems policy
Consumer Information
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
Governance
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
Service Specialist Standards
Obligations
Case planning occurs for each consumer
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