Quality Frameworks for Homelessness and Related Services – Literature Review and Environmental Scan

Final Report

September 2009

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TABLE OF CONTENTS

Introduction...... i Purpose of this research ...... i Terms of reference ...... i Methodology...... ii Limitations of this document...... iii The structure of this document...... iii

1 Homelessness: the current context – Australia...... 1 1.1 Introduction...... 1 1.2 Homelessness definitions and demand for services ...... 1 1.3 Conclusions ...... 8

2 Legislative and regulatory context...... 10 2.1 Introduction...... 10 2.2 International law ...... 11 2.3 Australian domestic law...... 12 2.4 Homelessness regulatory context in Australia ...... 13 2.5 Overview of existing state and territory quality frameworks...... 19 2.6 Victoria...... 20 2.7 Queensland ...... 25 2.8 New South Wales ...... 30 2.9 Australian Capital Territory...... 33 2.10 South Australia ...... 34 2.11 Tasmania...... 37 2.12 Western Australia ...... 39 2.13 Northern Territory ...... 43 2.14 Quality frameworks operating overseas...... 44

3 Homelessness service provision – an overview...... 48 3.1 Introduction...... 48 3.2 The national policy framework for service provision ...... 48 3.3 Service provision for homeless people...... 52 3.4 Overview of the homelessness service sector ...... 57 3.5 Service frameworks and providers – state-by-state profiles ...... 61 3.6 Effective service models – a best practice analysis ...... 76 3.7 The vision of the White Paper – towards an integrated service provision model...... 80

4 Quality frameworks: lessons from other sectors ...... 83 4.1 Introduction and approach...... 83 4.2 Lessons for the homelessness sector: benefits and challenges of approaches to accreditation ...... 89 4.3 Conclusions ...... 93

5 Components of a national quality framework ...... 95 5.1 Introduction...... 95 5.2 Aims and objectives of an accreditation system ...... 95 5.3 Potential components of a national quality framework...... 98 5.4 Conclusions and issues for further consideration ...... 104

6 Implementation processes and impacts...... 106

Quality Frameworks for Homelessness and Related Services – Literature Review and Environmental Scan

TABLE OF CONTENTS

6.1 Introduction...... 106 6.2 Potential impacts of implementation – risks and benefits ...... 106 6.3 Strategies for implementation...... 109 6.4 Conclusions and issues for further investigation...... 117

7 References ...... 120

Appendix A Sectoral case studies Appendix B Summary of issues raised through consultations with sectoral stakeholders and service providers FIGURES: Figure 1 – The legislative framework...... 16 Figure 2 – Access to accommodation and support services for the homeless and those at risk ...... 56 Figure 3 – Homelessness services: the funding and delivery framework ...... 82

TABLES: Table 1 – Homeless rates per 10,000 by state and territory – 2001 and 2006 ...... 5 Table 2 – People in different sectors of the homeless population (Australia 2001 and 2006)...... 7 Table 3 – Homeless single person-, couple- and family-households (Australia)...... 7 Table 4 – Age of people experiencing homelessness in 2006 (Australia)...... 8 Table 5 – Comparison of boarding house/lodging accommodation ...... 42 Table 6 – Advantages and disadvantages of boarding house regulation ...... 43 Table 7 – Summary reference guide to existing quality frameworks – Australia and overseas ...... 46 Table 8 – National Partnership funding...... 50 Table 9 – Number of people receiving SAAP assistance (Australia) ...... 57 Table 10 – Increase in SAAP funding and agencies 2005-06 to 2007-08...... 58 Table 11 – SAAP services required by clients across states and territories during 2007-08 ...... 58 Table 12 – NSW Homelessness Action Plan strategic directions ...... 64 Table 13 – Consolidated overview of sectoral case studies ...... 85

Quality Frameworks for Homelessness and Related Services – Literature Review and Environmental Scan

INTRODUCTION

Introduction

Purpose of this research Urbis has been commissioned by the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) to conduct research aimed at facilitating an in-depth understanding of the quality frameworks which currently operate in Australia in relation to the provision of homelessness services. The research has arisen out of the publication last year of the Government’s White Paper on Homelessness – The Road Home: A National Approach to Reducing Homelessness, which sets a target of halving homelessness by 2020 and of offering supported accommodation to all rough sleepers who seek it. The White Paper aims to ‘help services to provide people who become homeless with the full range of support that they need – rather than leaving individuals to try and navigate a complex system looking for help’.1 One of the specific goals of the White Paper is to implement ‘new legislation to ensure people who are homeless or at risk of homelessness receive quality services’. Following the publication of the White Paper, Housing Minister Tanya Plibersek announced an inquiry into homelessness legislation on June 16th 2009. This inquiry will be conducted by the House of Representatives Standing Committee on Family, Community, Housing and Youth. The inquiry will consider one of the key proposals contained in the White Paper on Homelessness: the introduction of new legislation to replace the Supported Accommodation Assistance Act 1994. The new legislation is intended to help deliver ‘consistent national standards, ensuring people who are homeless or at risk of homelessness receive quality services and adequate support to meet their needs’. The Committee will report by December 2009 to allow consideration of outcomes from the Australian Government's National Human Rights Consultation, which is due to report at the end of September 2009.

Terms of reference Through this project, and prior to the deadline for submissions, FaHCSIA has asked Urbis describe current service provision arrangements and accreditation activities for homelessness services across all states and territories. The project will also consider the way in which quality frameworks operate in the aged care, disability services, childcare, community housing, boarding houses and health practitioners sectors, to provide insights into the potential introduction of such systems within the homelessness services sector. The research involves the following key components: A scan of relevant literature to map the current structure of the homelessness service provision sector throughout Australia and to describe existing quality frameworks, including regulatory systems, operating across jurisdictions. An analysis of quality frameworks operating in the homelessness services sector internationally and in other service provision sectors within Australia, including aged care, disability, childcare, community housing, boarding houses and health practitioners. Consultation with sectoral experts and service providers to gain insights into the current operation of the sector and applicable quality frameworks. Their views will be provided to the inquiry, to help inform its work.

1 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p.44

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INTRODUCTION

The objective of the research is to identify what works well, especially in situations where there is shared program delivery between the Commonwealth, states and territories; what weaknesses exist; and how good practice could be adapted to homelessness services. The outcome of the research is a report which provides an evidence base for consultation and for development of a workable legislative framework. The report includes an exploration of the potential components of an overarching national quality framework for the sector, including the development of a set of standards for quality service provision.

Methodology The desk-based literature review and environmental scan comprised the majority of the research. This was followed by interviews with 53 sectoral stakeholders and service providers, which were undertaken in August 2009. The semi-structured telephone interviews conducted with a total of 23 sectoral experts (primarily from peak organisations) were between 30 and 45 minutes in length. Representatives were interviewed from a range of organisations including: National Shelter; Shelter Tasmania; Shelter South Australia; Shelter Northern Territory; WESNET NSW/ACT; Homelessness Australia; the St Vincent de Paul Society; Southern Youth and Family Services; and Anglicare. A complete list of the consulted stakeholders is included in Appendix B. In addition, semi-structured telephone interviews of between 30 and 45 minutes were conducted with 32 representatives from 30 service providers across Australia. Interviews were undertaken with senior team members of services including managers, CEOs, service coordinators, line managers and quality assurance managers. Interviewed providers include services from each state and territory across a range of metropolitan, regional and remote locations to ensure issues and views across a range of geographical locations were captured. The selection of service providers for interview also ensured a range of service types were included. Interviews were conducted with providers targeting single people, men, women, sole parents, families and young people. The sample of services included those provided by: West Coast Crisis Accommodation Referral Service; Bethlehem House; Homeless Men's Assistance Centre; Family Central Hume Support Services; Caroline Chisholm Society; Life Service Association; and Centacare. A full list of those consulted is provided in Appendix B. The interviews focused on a range of issues, including: objectives of the implementation of a national quality framework and associated processes; impacts of accreditation on services/the sector and the benefits of such a system or business impacts; potential components of service quality improvement; views of the role of state/territory and federal governments in facilitating service quality improvement; views of the role of state/territory and federal governments in relation to integrated regulatory process; questions of whether minimum standards should apply to services; and benefits or business impacts of a national quality framework..

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INTRODUCTION

Limitations of this document This research project was undertaken during a period of less than two months, from early July to mid- August, 2009. There are a number limitations stemming from the fact that the primary research was largely a desk-based literature review and environmental scan of available resources, primarily of departmental websites and internet based resources. The document is intended to provide a descriptive overview of the sector at a national and state and territory level, and moves towards identifying potential components of an accreditation system and the impacts of introducing this system in the final chapters.

The structure of this document This document provides a background to the homelessness sector based on a desk-based literature review and environmental scan, along with a series of interviews conducted with sectoral stakeholders and service providers. It includes: an overview of the homeless population within Australia, and an explanation of accepted methods for counting the homeless; an overview of existing quality frameworks, both nationally and throughout individual states and territories; an overview of the structure of the homelessness service provision sector, including the national policy framework for service provision and those operating in individual states and territories; an exploration of the potential components of a national quality framework aimed at furthering the objectives of the White Paper on Homelessness; an exploration of the potential impacts of the implementation of a national quality framework, along with strategies for implementation which will minimise the risks and enhance the benefits; a series of case studies of service provision models and quality frameworks in other sectors, namely: disability services; aged care; community housing; children’s services; boarding houses in Queensland; and health practitioners (Appendix A). These case studies are intended to provide insights into the quality frameworks operating in other sectors, including what aspects are considered to be effective or ineffective, and the impacts of the development of regulatory frameworks on service providers. The insights obtained from these case studies have informed the discussion of the potential components of a regulatory or accreditation system in the homelessness service provision sector; and a summary of the issues raised through interviews conducted with service providers and sectoral stakeholders (Appendix B). The sample of service providers who were interviewed were selected as being broadly representative of a range of geographic areas, sizes, service provision models, and funding streams. These in-depth telephone-based consultations provided information regarding the existing legislative and accreditation activity, and views on quality frameworks among providers.

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HOMELESSNESS: THE CURRENT CONTEXT – AUSTRALIA

1 Homelessness: the current context – Australia

1.1 Introduction As part of the Australian Government’s White Paper - The Road Home: A National Approach to Reducing Homelessness, the Government is planning to develop agreed national accreditation service standards and service charters for organisations delivering services to homeless people.2 It is intended that by developing a national service charter for mainstream and specialist homelessness services, progress towards protecting the rights of homeless people will be achieved by providing them with safer and higher quality services. This environmental scan and literature review aims to contribute to the knowledge base available to inform decisions relating to the development of the new legislation to support the above initiatives. This section sets the context for this work by providing an overview of the current population of Australia which is considered to be homeless on the basis of current agreed definitions. Counting the homeless is an imprecise science due to the difficulties inherent in capturing what is a diverse population living in a diverse range of accommodations. In recognition of this, this section discusses the range of definitions of homelessness currently in use, namely: the Census definition (cultural definition); the Supported Accommodation and Assistance Act 1994 (SAA Act) definition; a definition which has been developed in recognition of the unique cultural issues and living conditions of Aboriginal and Torres Strait Islander people. On the basis of 2001 and 2006 Census data, this section also provides an overview of the profile of the homeless population within Australia in relation to characteristics such as age, sex, and household composition (i.e. families, couples, single people). It also provides an overview of rates of homelessness, both nationally and across individual states and territories, and highlights changes which have occurred to this population during the five years between the two censuses.

1.2 Homelessness definitions and demand for services

1.2.1 The Road Home: approach of the White Paper on Homelessness According to estimates contained in the White Paper on Homelessness, around 105,000 people are homeless across Australia every night. This includes people staying in ‘temporary, unstable or substandard accommodation’ as well as those sleeping rough.3 The White Paper applies the widely accepted cultural definition of homelessness, developed by Chamberlain and MacKenzie and utilised by the Australian Bureau of Statistics (ABS) in Census- counting of the homeless population, discussed in Section 1.2.2 below.4 Estimates of the homeless population contained in the White Paper are based on data provided by the ABS five-yearly Census, as well as data collected from services operating under the Supported Accommodation Assistance Program (SAAP).

2 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p. 43

3 Ibid., p.3

4 Chamberlain, C., and MacKenzie, D., 1992, ‘Understanding contemporary homelessness: Issues of definition and meaning’, Australian Journal of Social Issues, vol. 27, issue 4, p.291 in Chamberlain C., and MacKenzie, D., ‘Counting the Homeless, Australia’, Australian Bureau of Statistics, Census 2006

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The White Paper notes that the profile of the homeless population has changed over the past five years and today includes rising numbers of children, families and older people, along with declining numbers of teenagers.5 This changing profile is discussed further in Section 1.2.3, below. On the basis of this research, the White Paper’s overarching objectives are to: halve overall homelessness by 2020; and offer supported accommodation to all rough sleepers who need it by 2020.

1.2.2 Defining and counting the homeless population The Supported Accommodation Assistance Act 1994 (SAA Act) defines homelessness as: ‘A person is homeless if, and only if, he or she has inadequate access to safe and secure housing’.6 The legislation outlines factors which may contribute to a lack of access to ‘safe and secure housing’.7 These include situations where the only housing to which a person has access: damages, or is likely to damage their health; threatens their safety; marginalises the person though failing to provide adequate access to amenities or to the economic or social supports that a home usually offers; and places the person in a situation which threatens or adversely affects the adequacy, safety, security and affordability of that housing. Whilst this definition identified the target group for service provision under the Supported Accommodation Assistance Program (SAAP), a wider definition is considered to be a ‘culturally accepted’ definition of homelessness developed by researchers Chamberlain and MacKenzie.8 Cultural definition of homelessness In October 2000, the SAAP National Coordination and Development Committee (CAD) commissioned research aimed at providing an estimate of the extent of homelessness in Australia. This involved academics, government and non-government representatives and researchers. This initiative led to support for a definition of homelessness based on the work of Chamberlain and MacKenzie,9 which defined homelessness across three levels: Primary homelessness, which refers to people who are sleeping rough or living in impoverished dwellings. Secondary homelessness, which refers to those who are moving between various forms of temporary shelter such as staying with friends and family and/or accessing specialist services and emergency accommodation. Tertiary homelessness, which includes people who are living in boarding houses or caravan parks with no secure lease and no private facilities.10

5 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p. 2

6 Australian Government, Supported Accommodation Assistance Act 1994, Section 4(1), viewed at www.austlii.edu.au/au/legis/cth/consol_act/saaa1994359/s4.html

7 Ibid., Section 4(2)

8 Chamberlain C., and MacKenzie, D., ‘Counting the homeless, Australia’, Australian Bureau of Statistics, Census 2006

9 Ibid.

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The CAD supported this definition, rephrased as: Sleeping rough – those without shelter (primary homelessness). Stop-gap accommodation – those in crisis but temporarily sheltered (secondary homelessness). Marginal accommodation – those in insecure accommodation (tertiary homelessness). Limitations to the SAA Act 1994 definition have also been pointed out. Thompson11 emphasises limitations in SAAP data collection methods, particularly in relation to calculating ‘unmet demands for accommodation’. These include people needing accommodation who cannot be housed by SAAP agencies. Figures on unmet demands are collected biannually during one week in November/December and one week in May. ‘Unmet demand’ figures exclude three categories of people: Accompanying children (who are not counted as children in their own right). People who do not need accommodation immediately. People who made ‘invalid requests’ (requests for assistance from the wrong agency – i.e. women requesting assistance from a men-only agency, requests accompanied by abusive or intoxicated behaviour, requests at an agency that does not provide free accommodation). According to Thompson, not including these categories of people seriously underestimates the turn- away rate from SAAP. For example, if these categories of people were included in 2003/04 the turn- away rate would have been four times that of the official rate. In this context, Thompson asserts that SAAP fell a long way short of accommodating the needs of Australia’s homeless population. This was not the fault of the SAAP system ‘which on the whole [was] well conceived and well managed, and helps many people in various ways’.12 Instead, Thompson maintains the fault lies with the government allocation of resources and the lack of funding directed at dealing with the problem of homelessness. Thompson concludes that the published figures on homelessness are not an ideal source of information on the exact extent of homelessness in Australia. For most purposes, the Census and SAAP data are not comparable. The Census takes a cross-section of Australian society at one point in time, whereas the SAAP data on the total numbers of people assisted relates to the whole year. The Census also attempts to cover the whole population, whereas the SAAP clientele is unrepresentative and largely self-selected. SAAP figures on unmet demand understate the extent to which SAAP was failing to deal with homelessness; Census figures give a fuller picture, but they too are limited. Homelessness among Aboriginal and Torres Strait Islander people It has been recognised that the definition of homelessness among particular cultural groups, including Aboriginal and Torres Strait Islander people, may need to be widened to include people in ‘grossly overcrowded’ accommodation and people in ‘impoverished dwellings’. In 2005 Urbis Keys Young13 consulted extensively with Aboriginal and Torres Strait Islander people – a project which led to a definition of five types of homelessness among these particular cultural groups:

10 Australian Government Department of Health and Ageing, Homelessness and Mental Health Linkages: Review of National and International Literature, 2005

11 Thompson, D., ‘What do the published figures tell us about homelessness in Australia?’ in the Australian Journal of Social Issues, vol. 32, no.3, 2007, p.358

12 Ibid., p.364

13 Urbis Keys Young, 1998, Homelessness in the Aboriginal and Torres Strait Islander Context and its Implications for the Supported Accommodation Assistance Program (SAAP), prepared for Family Services Branch Commonwealth Department of Health and Family Services; and, Urbis Keys Young, 2005, National Consultations on Aboriginal and Torres Strait Islander Homelessness, prepared for The Department of Family and Community Services

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Spiritual homelessness – which may be defined as: ‘A separation from traditional land, a separation from family and kinship networks, or a crisis of personal identity wherein one’s understanding or knowledge of how one relates to country and Aboriginal identity systems is confused.’14. Overcrowding – a hidden form of homelessness. Relocation and transient homelessness, which results in temporary, intermittent and cyclical patterns of homelessness. Escaping from an unsafe or unstable home. Lack of access to any stable shelter – ‘nowhere to go’. The report emphasises the importance of an approach to these cultural groups which is sensitive to their particular culture and ‘outside the legacy of colonialisation’. ABS Census counting methodology Historically, the Census methodology for counting homeless people has consisted of a ‘Special Enumeration Strategy’ based on the fact that homeless people do not live in houses – the usual basis for collecting Census data. Therefore, special measures are needed to contact those who have no fixed address. The Australian Bureau of Statistics’ (ABS) strategy involves including a category of ‘no usual address’ on the form for visitors to households as well as a shortened version of the form for people who might be intimidated by the longer form, enlisting the help of service providers and using their local knowledge, and recruiting homeless people themselves as Census collectors. According to Thompson,15 the ABS strategy for counting the homeless has a number of limitations, including: The accuracy of the information gained depends on how well the strategy is implemented nationally and coverage has largely been patchy, with sustained efforts made in some states while in others very little extra effort was made. There are difficulties with locating and therefore with counting people of no usual place of residency. The Census does not include those who are at risk of becoming homeless or those who are marginally housed in inadequate accommodation. The Census does not include homeless people who are temporarily located in institutions such as prisons, hospitals and aged care facilities. If the definition of homelessness was broadened to include those permanently housed in caravan parks the total number of homeless people would significantly increase. Chamberlain and MacKenzie16 also indicate that homeless people often move from one form of temporary accommodation to another and the Census does not capture the high level of mobility that is typical of the homeless population.

14 Memmot, P., et al., Categories of Indigenous ‘Homeless’ people and good practice responses to their needs. 2003, Australian Housing and Urban Research Institute, in Clark, J., and D’Onise, K., No Pulgi, Nunkuwarrin Yunti – Urban Indigenous Homelessness and its Effect on Health, Report of the Sixth National Indigenous Homelessness Conference, Australian Government Department of Health and Ageing, accessed at: http://health.gov.au/internet/main/publishing.nsf/Content/natsieh- publicat.htm~natsienh-publicat-ch2.htm~natsienh-publicat-ch2-10.htm

15 Thompson, D., ‘What do the published figures tell us about homelessness in Australia?’ in the Australian Journal of Social Issues, Vol. 32, No.3, 2007

16 Chamberlain C., and MacKenzie, D., ‘Counting the Homeless, Australia’’ Australian Bureau of Statistics, Census 2006

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1.2.3 Profile of the homeless population A comparison of 2001 and 2006 Census data indicates that although the number of homeless people has increased over this five year period – from 99,900 homeless people counted in the 2001 Census to 104,676 in 200617 – the rate of homelessness has remained steady. There was a rate of 53 homeless people per 10,000 of the population at both Census periods (a figure which should be read in recognition of the fact that changes from 2001 to 2006 may not be entirely accurate due to possible differences in counting rules, sampling methods, and collection rates). Rates of homelessness in each state and territory also varied little between 2001 and 2006. In New South Wales, Victoria, and the Australian Capital Territory, there were 42 homeless people per 10,000 in 2006, similar to the 2001 rates. South Australia and Tasmania had a rate of 53 per 10,000 in 2006, again similar to 2001. The rates of homelessness in the other states were higher: in Western Australia and Queensland there were, respectively, 68 and 69 per 10,000 at the time of the 2006 Census. In the Northern Territory there were more than three times as many: 248 homeless people per 10 000 in 2006 and 288 per 10,000 in 2001 (refer to Table 1 below).18 In specific regions within the territory, the rate is even higher. In the Kimberley region, for example, there were an estimated 1,870 homeless people, at a rate of 638 people per 10,000. 19 This significant differential in rates of homelessness found in the Northern Territory, a rate which is more than five times the national average, is considered by Chamberlain to partly reflect issues such as ‘itinerant people on working holidays during the Kimberley dry season’20 and ‘issues of Indigenous transience and inadequate housing, although non-Indigenous Australians also experience higher rates of homelessness in remote locations’. Yet even this high figure is expected by the academics to be based on an undercounting of the Indigenous homeless population within the Northern Territory. Table 1 – Homeless rates per 10,000 by state and territory – 2001 and 2006

NSW VIC QLD WA SA TAS NT ACT Aust. 2001 42 44 70 64 52 52 288 40 53

2006 42 42 69 68 53 53 248 42 53 Source: Chamberlain C., and MacKenzie, D., June 2009, ‘Counting the Homeless, 2006, Northern Territory,’ Australian Institute of Health and Welfare, p.25, viewed at http://www.aihw.gov.au/publications/hou/hou-210- 10761/hou-210-10761-c04.pdf The profile of the nation’s homeless is heterogeneous. Homeless people come from a broad range of ethnic backgrounds and age bands and exhibit a variety of personal circumstances and problems. Today a homeless person is increasingly likely to be younger than at the time of the 2001 Census, i.e. less than 35 years of age. Although there are still higher numbers of homeless males than females, the proportions vary significantly across the various homeless accommodation options. For instance, although more males than females utilise boarding houses across the country (ratio of 72:28) females outnumber males in accessing crisis accommodation (ratio of 53:47). Although homelessness is still

17 Chamberlain C., and MacKenzie, D., June 2009, ‘Counting the Homeless, 2006, NSW’, Australian Institute of Health and Welfare, p.6, Canberra: AIHW, viewed at www.aihw.gov.au/publications/hou/hou-204-10755/hou-204-10755-c00.pdf

18 Ibid., p.27

19 Chamberlain C., and MacKenzie, D., June 2009, ‘Counting the Homeless, 2006, Northern Territory’, Australian Institute of Health and Welfare, p.25, Canberra: AIHW, viewed at http://www.aihw.gov.au/publications/index.cfm/title/10761

20 Thomson, C., 2006 (July 9), Kimberley is Australia’s homeless capital, in WA Today, viewed at http://www.watoday.com.au/wa- news/kimberley-is-australias-homeless-capital-20090708-dd7h.html

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more likely to be experienced by lone individuals, there are increasing numbers of homeless or single parents with children as well as a growing proportion of homeless families.21 The Counting the Homeless report of 2006 provides an estimate of the composition of the homeless population and a comparative compositional analysis with 2001 figures. Of the 104,676 people who were counted as homeless in the 2006 Census, there were: 26, 790 families with children (a 16% increase on 2001 figures for this population sector); 17,891 youth aged 12 – 18 (a reduction of 20.8% on 2001 figures, which is attributed to the success of early intervention measures adopted by welfare agencies22); and 59,995 adults (singles and couples) without children (a 10.4% increase on 2001 figures). In addition: 12,133 (12%) were children under the age of 12; 56% were male; 9.9% were Indigenous; and 7% were aged 65 years or older. Indigenous persons are over-represented amongst the homeless. The 2006 Census indicates that while only 2.4% of the national population was identified as Indigenous, 9.9% of the total homeless population were Aboriginal or Torres Strait Islander persons.23. Indigenous persons comprised approximately 16% of those requiring crisis and emergency housing under SAAP, and approximately 19% of those who were ‘sleeping rough’.24 Previous work by Urbis25 has revealed that Indigenous people experience considerable difficulty in accessing private rental market housing (often due to discrimination) and accordingly are heavily reliant on public housing and crisis accommodation, which itself is in increasingly short supply. Census data on homelessness can be problematic because it does not include people in institutions, such as aged care facilities or prisons. Further, if the criterion for homelessness is expanded to include those permanently housed in caravan parks, the total number of homeless people at the 2001 Census would increase to around 122,770.26 The important message emerging is that the ‘visible homeless’ on the streets and in impermanent locations scattered throughout Australia’s cities represents only part of the problem. A much larger volume of people is also without permanent shelter, yet their plight is not as immediately obvious. For example Chamberlain and MacKenzie added a fourth category to the three traditional categories (primary, secondary and tertiary homelessness) to cover people who live in caravan parks on a long- term basis because it is the only housing they can afford.

21 Council to Homeless Persons, 2007, An Australian Blueprint to Reduce and Eliminate Homelessness, viewed at www.chp.org.au

22 National Youth Commission, 2008, Australia’s Homeless Youth: a report of the national youth commission inquiry into youth homelessness, viewed at www.nyc.net.au

23 Australian Institute of Health and Welfare, 2006, Demand for SAAP assistance by homeless people 2003-04: A report from the SAAP National Data Collection, AIHW cat. no. HOU143, Canberra: AIHW

24 Ibid.

25 Urbis Keys Young, 1998, Homelessness in the Aboriginal and Torres Strait Islander Context and its Implications for the Supported Accommodation Assistance Program (SAAP), prepared for Family Services Branch Commonwealth Department of Health and Family Services; and, Urbis Keys Young (2005) National Consultations on Aboriginal and Torres Strait Islander Homelessness, prepared for The Department of Family and Community Services

26 Australian Institute of Health and Welfare, 2005b, p. 318-325

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Sectors of the homeless population As the table below illustrates, since 2001 the numbers of homeless people living with friends and relatives and in boarding houses have decreased, while the proportion of homeless people living in SAAP accommodation and in improvised dwellings, tents and sleepers-out has increased. In both 2001 and 2006, the highest numbers of homeless people were living with friends and relatives (45%) followed by boarding houses (20%). Table 2 – People in different sectors of the homeless population (Australia 2001 and 2006)27

Difference in no. of homeless 2001 % 2006 % people 2001 - 2006 (%) Improvised 14,158 14 16,375 16 +15.7 dwellings, tents and sleepers-out

Friends and 48 614 49 46, 856 45 -3.6 relatives

SAAP 14,251 14 19,849 19 +39.2 accommodation

Boarding houses 22 877 23 21, 596 20 -5.6

Total 99,900 100 104,676 100 +4.8

Households The following table reveals that there were more homeless households in 2006 compared with 2001 (74,825 and 74,281 respectively). The numbers of persons in each homelessness category did not change significantly between the 2001 and 2006 censuses. In both 2001 and 2006, a little more than three-quarters of the homeless population was single people. Table 3 – Homeless single person-, couple- and family-households (Australia)

Difference 2001 2001 % 2006 % - 2006 (%) Single persons 58,116 78 57,182 76 -1.6

Couple only 9,420 13 10,160 14 +7.9

Family with 6,745 9 7,483 10 +10.9 children

Total 74,281 100 74,825 100 +0.8

Age Data from the 2006 Census shows that 58% of the homeless population was less than 35 years old. Furthermore, the highest proportion of homeless people was in the age bracket 12-18 years old (21%). It is clear that the age profile of the population is now much younger.

27 It should be noted that there is a question about whether ABS comparisons between 2001 and 2006 are reliable, or whether the differences may be an artefact linked to differences in counting rules, sampling differences or to differences in collection rates and other factors

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These issues are illustrated in Table 4, below. Table 4 – Age of people experiencing homelessness in 2006 (Australia)

Age Number % Less than 12 12,133 12

12-18 21,940 21

19-24 10,504 10

25-34 15,804 15

35-44 13,981 13

45-54 12,206 12

55-64 10,708 10

65+ 7,740 7

Total 104,676 100

Sex In 2006, there were more male homeless people (56%) than female homeless people (44%) in Australia. The proportion of males and females in different homelessness sectors translated to: 72% of boarding house residents were male; 60% of people in improvised dwellings were male; 52% of people living with friends and relatives were male; and 53% of people using SAAP services were female. In 2006, there were more males in all homelessness sectors except for in SAAP. The biggest difference between males and females was in the ‘boarding house residents’ category, which was strongly dominated by males. Indigenous and non-Indigenous Indigenous people are more likely to experience homelessness when compared with other Australians. In 2006, 2.4% of the Australian population was identified as Indigenous while 9.9% of the total homeless population was Aboriginal or Torres Strait Islander people. Indigenous people were overrepresented in all homelessness sectors, with SAAP clients being the most significant (17% of SAAP clients were of Aboriginal or Torres Strait Islander origin compared to an Australian population base of 2%).

1.3 Conclusions This section highlights the difficulties inherent in obtaining an accurate estimate of the homeless population of Australia on any given night, due to challenges of counting a population which in many cases may be ‘hidden’ in private sector accommodation or staying with friends and family. Indigenous people in particular are considered to be undercounted in homelessness figures. In addition to challenges in ‘counting the homeless,’ figures which are available through ABS Census data is also qualified in that it is based on a specific definition of homelessness, developed by the work

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of Chamberlain and MacKenzie.28 This definition differs from that utilised by the Supported Accommodation Assistance Act 1994 (SAA Act), which is based on a person’s ‘access to safe and secure housing’ and which does not take into account the high proportion of the homeless who may be temporarily housed with friends or relatives or housed in caravan parks which offer no security of tenure, for example. Aside from those who are ‘sleeping rough’, homeless people reside in a diverse range of accommodation, including staying with other households, the latter of which accounted for 45% of people counted as ‘homeless’ on Census night in 2006. Taking into account these challenges, Census data for 2001 and 2006 paints a useful picture of the current composition of the homeless population and changes therein, along with the varying rates of homelessness across states and territories. The data highlights the diversity of the homeless population with regard to population characteristics such as age, sex and household composition, for example. It also highlights the changing profile of this population, with current trends suggesting rising numbers of homeless children, families and older people and declining numbers of homeless teenagers – the latter trend which is attributed to the success of youth-focused early intervention services. 29 Overall, national rates of homeless have remained relatively steady during the five years between the 2001 and 2006 censuses, both nationally and within individual states and territories.30 The 2006 Census data indicates that Queensland has the second highest number of homeless people after New South Wales. By comparison, the ACT, followed by Tasmania, have the lowest number of homeless people. The Northern Territory stands out as having a far higher rate of homelessness per head of population – more than five times the national average. This figure is explained by a range of factors including itinerant workers migrating to and living within the territory and also the high Indigenous population of this region. Indigenous people are significantly over-represented amongst the homeless. According to 2006 Census figures, whilst just 2.4% of the national population was identified as Indigenous, 9.9% of the total homeless population was Aboriginal or Torres Strait Islander people.31. Indigenous people comprised an estimated 16% of those requiring crisis and emergency housing through SAAP accommodation, and approximately 19% of those who were ‘sleeping rough’.32 The current profile of the homeless population highlights the sectors where attention must be focused in an effort to reduce homelessness rates. It also highlights the need to tailor appropriate approaches to particular population groups, such as families or Indigenous people, to achieve effective outcomes. The potential effectiveness of such tailored approaches is suggested by declining homelessness among teenagers during the five years to 2006. Overall, the relative stability of homelessness rates across Australian states and territories between 2001 and 2006 must not be seen as a source of comfort, but rather an indication that more needs to be done to tackle homelessness with the aim of effecting a significant reduction in the homeless population.

28 Ibid.

29 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p. 2

30 Ibid., p.27

31 Australian Institute of Health and Welfare, 2006, Demand for SAAP assistance by homeless people 2003-04: A report from the SAAP National Data Collection, AIHW cat. no. HOU143, Canberra: AIHW

32 Ibid.

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2 Legislative and regulatory context

2.1 Introduction As part of the Australian Government’s White Paper - The Road Home: A National Approach to Reducing Homelessness, the Government is planning to develop a national quality framework applicable to organisations delivering services to homeless people.33 It is intended that by developing a national service charter for mainstream and specialist homelessness services, progress towards protecting the rights of homeless people will be achieved by providing them with safer and higher quality services. To improve service quality, consistency and to promote best practice, a range of options will be explored, including adopting service charters in legislation and potentially making accreditation a pre- requisite for funding.34 It is also foreshadowed in the Australian Government’s White Paper that the ‘best features of the Supported Accommodation Assistance Act 1994 and the Disability Services Act 1986’ could be amended or incorporated into the new legislation relating to homelessness. 35 Relevant to the development of the new legislation is the Council of Australian Governments’ (COAG) Intergovernmental Agreement (IGA) on Federal Financial Relations, which is an agreement between the Commonwealth and the states and territories to reduce the number of Specific Purpose Payments (SPPs) made by the Commonwealth and to increase the flexibility of the states in implementing the payments. The National Affordable Housing Agreement (NAHA) is one of the new SPPs to emerge from the IGA, which provides $6.2 billion to the states and territories to meet specific outcomes in a range of areas, including homelessness through the National Partnership Agreement on Homelessness.36 As part of this environmental scan, which aims to contribute to the knowledge base available to inform decisions relating to the development of the new legislation to support these initiatives, this section outlines existing quality frameworks relating to specialist homelessness services37 in Australia, including: international law and principles informing the development of legislation in Australia; domestic legislation implemented at national, state and territory levels regulating the provision of specialist homelessness services, as well as other key pieces of legislation which impact on the provision of services to people who are homeless; existing quality frameworks, service standards and measurement tools in Australia for specialist homelessness services; and international examples of best practice quality frameworks and regulation for homelessness services.

33 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p.43.

34 Ibid., p.43.

35 Ibid., p.43.

36 Council of Australian Governments (COAG), Intergovernmental Agreement (IGA) on Federal Financial Relations, http://www.coag.gov.au/intergov_agreements/federal_financial_relations/index.cfm

37 Specialist homelessness services are defined broadly as ‘services that work to assist people who are homeless or at risk of homelessness’ in: Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness

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2.2 International law Over the past few decades the homelessness debate has gradually shifted from one that focused on the ‘needs’ of homeless people to a debate that is increasingly informed by international human rights approaches.38 As Justice Sackville has observed, ‘proponents of reform almost always employ the rhetoric of human rights to advance their argument’ whereas earlier advocates tended to invoke the ‘needs’ of homeless people as the yardstick for evaluating programs or practices and to concentrate on repealing laws or modifying practices that could be properly characterised as discriminatory or unfair to such people’.39 One reason for the shift in the homelessness debate rests with developments in international law. The Universal Declaration of Human Rights, adopted by the General Assembly of the United Nations in 1948, declared in article 25(1) that: ‘... [e]veryone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services...’40

The International Covenant on Economic, Social and Cultural Rights (ICESCR) and the International Covenant on Civil and Political Rights (ICCPR) which came into force in 1976 provided standards by which to measure the performance of participating states in addressing homelessness within their borders. 41 The ICESCR, for example, embodied the right to ‘food, clothing, housing and medical care’ captured in the Universal Declaration of Human Rights and required state parties to ‘take appropriate steps to ensure the realisation’ of these rights.42 To clarify the meaning and scope of the right to housing as protected by the ICESCR, the Committee on Economic, Social, and Cultural Rights (CESCR), the body that monitors the ICESCR, issued its General Comment 4, in 1991.43 Within the definition of adequacy, there are certain aspects of the right that apply in any context. These include:

Legal security of tenure. Notwithstanding the type of tenure, all persons should possess a degree of security of tenure which guarantees legal protection against forced eviction, harassment and other threats. Availability of services, materials, facilities and infrastructure. An adequate house must contain certain facilities essential for health, security, comfort and nutrition. Affordability. Personal or household financial costs associated with housing should be at such a level that the attainment and satisfaction of other basic needs are not threatened or compromised. Habitability. Adequate housing must be habitable, in terms of providing the inhabitants with adequate space and protecting them from cold, damp, heat, rain, wind or other threats to health, structural hazards, and disease vectors. Accessibility. Adequate housing must be accessible to those entitled to it. Disadvantaged groups must be accorded full and sustainable access to adequate housing resources. Location. Adequate housing must be in a location which allows access to employment options, health-care services, schools, child-care centres and other social facilities.

38 The Hon. Justice Sackville, 2004, ‘Homelessness, human rights and the law’, Australian Journal of Human Rights , 2, p.3

39 Ibid., 2, p.3

40 The Universal Declaration of Human Rights 1945, Art 25(1), extracts in His Hon. Justice Ronald Sackville, 2004, ‘Homelessness, human rights and the law’, Australian Journal of Human Rights, 2, p.3

41 The Hon. Justice Sackville, (2004) ‘Homelessness, human rights and the law’, Australian Journal of Human Rights 2, p.3

42 Act 11(1) of the International Covenant on Economic, Social and Cultural Rights

43 Human Rights Education Association, ‘The right to housing’, viewed at www.hrea.org/index.php?base_id=149

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Cultural adequacy. The way housing is constructed, the building materials used and the policies supporting these must appropriately enable the expression of cultural identity and diversity of housing.

2.3 Australian domestic law

2.3.1 Ratification of the ICESCR and the ICCPR Legislative protections for people who are homeless in Australia are few. In ratifying the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the International Covenant on Civil and Political Rights (ICCPR) in 1975 and 1980 respectively, Australia became bound under international law to implement their provisions.44 In Australia however, ratification of an international treaty does not automatically make that treaty enforceable in Australian law, unless domestic legislation is enacted to incorporate its provisions directly into Australian law. While the ICESCR and ICCPR have, to date, had considerable influence on the debate and to some extent on the interpretation of Australian law, neither of these treaties (or other human rights treaties relevant to the experience of homeless people) have been incorporated into Australian Commonwealth legislation. There are some exceptions to this, relating to parts of the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) (through the Sex Discrimination Act 1984) and to the International Convention on the Elimination of All Forms of Racial Discrimination (CERD) (through the Racial Discrimination Act 1975).45

2.3.2 Human rights legislation The Human Rights Act 2004 passed in the ACT and the Victorian Charter of Human Rights and Responsibilities 2006 incorporate most of the civil and political rights embodied in the International Covenant on Civil and Political Rights (ICCPR), however they do not incorporate many of the economic and social rights that are contained in the International Covenant on Economic, Social and Cultural Rights (ICESCR). The right to adequate housing is not included in either the Victorian or ACT human rights legislation.46 There have been some instances, however, where rights included in the Victorian human rights legislation have been used indirectly to protect people from homelessness. For example, in one situation the Victorian Charter was invoked (by reference to the rights to privacy and to the protection of families) to negotiate for a pregnant single mother to avoid eviction from community housing to prevent her family becoming homeless. 47 The Commonwealth Attorney-General’s Department is currently involved in a National Human Rights Consultation, which is potentially the precursor to the introduction of national human rights legislation. The consultation seeks to answer some of these key questions: Which human rights (including corresponding responsibilities) should be protected and promoted? Are these rights currently sufficiently protected and promoted in Australian law?

44 The Hon. Justice Sackville, (2004) ‘Homelessness, human rights and the law’, Australian Journal of Human Rights 2, p.4

45 Innes, G., AM, Human Rights Commissioner, HREOC, 2008 (March) ‘Can rights solve the issue of homelessness?’ Launch of the February 2008 ‘To Make a Difference: Human Rights and Homelessness’ Special Edition of Parity, p.3

46 Ibid., p.4

47 Human Rights Law Resource Centre Bulletin, June 2008. Australian Human Rights Commission, Let’s Talk About Rights, National Human Rights Consultation Toolkit, February 2009, p.3, viewed at: www.hreoc.gov.au/letstalkaboutrights/downloads/HRA_homeless.doc

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How could Australia better protect and promote human rights?48 The outcomes of this consultation process will inform the current Inquiry, particularly if the legislation seeks to protect the right to adequate housing. It is relevant to note the experience of other countries in implementing human rights legislation. As common law countries the United Kingdom and Canada both have a similar legal history to Australia. Both countries have introduced human rights legislation. In relation to the Human Rights Act 1998 in the United Kingdom, there is duty on all courts and tribunals in the United Kingdom to interpret legislation so far as possible in a way compatible with the rights laid down in the European Convention on Human Rights (section 3(1)). In instances where domestic legislation is not compliant with the Human Rights Act, then the higher Courts are able to make a Declaration of Incompatibility. However, the remedies available under the Act are limited. For example, a Declaration of Incompatibility does not make the relevant legislation obsolete, but it can be used to put pressure on the government to resolve the incompatibility. Neither the United Kingdom nor the Canadian human rights legislation directly protects the right to adequate housing. 49 Scotland has introduced more progressive legislation in this area, which is discussed further below at Section 2.14.1. There have been some examples, in the United Kingdom, where the creative use of the legislation has led to some ‘judicial consideration of government actions affecting housing rights’ particularly by invoking the ‘right to life’ and the ‘right to protection of privacy, the home and family life’.50

2.4 Homelessness regulatory context in Australia

2.4.1 Introduction While the right to adequate housing is not currently explicitly incorporated into Australian law, there exists a complex legislative and policy framework relating to homeless services and housing in Australia at the Commonwealth, state and territory, and local government levels. There are a whole range of laws and regulations that impact on homeless people.51 These include laws passed by: the Commonwealth Government, including the Homeless Persons Assistance Act 1974 (now repealed), the Supported Accommodation Assistance Act 1994, the Disability Services Act 1986, Anti-Discrimination Act 1977, the Social Security Act 1991, and the Housing Assistance Act 1996; state and territory governments, including legislation regulating renting, public housing, boarding houses, public space, vagrancy, trespass, public transport and crisis accommodation; local governments, including anti-sleeping, anti-camping and alcohol prohibition zones. People who are homeless are often impacted by a range of laws regulating public space, as there are many essential human activities which are prohibited if they take place in public. Although in many areas laws can impact negatively on homeless people, there has been a growing discussion in Australia

48 National Human Rights Consultation Committee, 2009, About the National Human Rights Consultation, Share your Views, www.humanrightsconsultation.gov.au/

49 Nicholson, D., The Human Right to Housing in Australia, Produced for the Housing is a Human Right Project, Centre on Housing Rights and Evictions, p.6, viewed at www.vcoss.org.au/documents/VCOSS%20docs/Housing/Human%20right%20to%20housing_Eb.pdf

50 Ibid.

51 These issues are summarised on the Gilbert and Tobin Centre for Public Law Website, University of New South Wales, www.gtcentre.unsw.edu.au/Resources/hlr/homelessnessAndTheLaw.asp

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and overseas about the ways in which the law can be used to support homeless people to gain more legitimacy, control and dignity over their lifestyle.52

2.4.2 National Affordable Housing Agreement The National Affordability Housing Agreement (NAHA) and the associated National Partnership Agreement (NPA) on Homelessness now provide the overarching policy framework for Australia’s response to homelessness. State and territory Implementation Plans have now been developed and approved. Currently, there is no additional legislation enacted to support these new policy initiatives. It has been through the granting of SPPs that the Commonwealth has previously regulated housing and accommodation for homeless people. SPPs have, for example, enabled the government to administer the Supported Accommodation Assistance Program (SAAP), established in 1985. This Program has provided funding for states and territories to distribute for the provision of transitional supported accommodation and associated homelessness services. It was administered through two Commonwealth-State agreements – a multilateral agreement at a national level and bilateral agreements between the Commonwealth and the individual states. SAPP V was the most recent recipient of SPP grants.53 In December 2007, COAG agreed to reform the SPPs in response to growing pressure from the states to reduce Commonwealth prescriptions on services and to increase the degree of flexibility allowed to the states to implement the funding. As part of the Intergovernmental Agreement on Federal Financial Relations, 54 COAG agreed to reduce the number of existing SPPs from ninety to five. However, six new SPPs were developed, including NAHA, which incorporates a range of existing programs, including: the Supported Accommodation Assistance Program (SAAP); the Commonwealth-State Housing Agreement (CSHA); and Rent Assistance.55 The diagram at Figure 1 on page 17 sets out the relationship between different types of Commonwealth housing assistance legislation, the programs that have developed to implement the legislation at a Commonwealth level, and the relationship between these agreements and NAHA as part of the current reform. An important feature of NAHA is that under the new framework the policy outcomes and objectives have been separated from funding arrangements to ensure that the policy focus and the implementation are devolved to the states and territories.56 A description of NAHA is included at Section 2.4.2. Essentially it aims to bring together a range of initiatives relating to housing assistance and homelessness. The approach agreed by the Council of Australian Governments (COAG) for NAHA is designed to provide greater flexibility in the way services are delivered, enabling specialist homelessness services to transition some clients more quickly out of crisis services into permanent housing.57 Under the reforms, NAHA contains the objectives, outcomes, outputs and performance indicators for supported accommodation and assistance services. The performance of governments in achieving these mutually agreed outcomes will be assessed by the

52 A comprehensive list of publications is available on the Gilbert and Tobin Centre for Public Law Website, University of New South Wales, http://www.gtcentre.unsw.edu.au/Resources/hlr/homelessnessAndTheLaw.asp

53 Note: SAAP is discussed in detail in Sections 2.4.3 and 2.4.4 below

54 Council of Australian Governments (COAG), http://www.coag.gov.au/intergov_agreements/federal_financial_relations/index.cfm

55 Homelessness Australia, A Discussion Paper on the National Affordable Housing Agreement, viewed at http://www.homelessnessaustralia.org.au/UserFiles/File/NAHA%20Discussion%20Paper.doc

56 Australian Government Budget, 2009 - 2010, Part 6 Accountabilities under the Federal Financial Relations Framework, viewed at www.budget.gov.au/2009-10/content/bp3/html/bp3_accountabilities.htm

57 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p. 41

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COAG Reform Council (CRC). The National Agreements are supplemented by a range of National Partnerships, including the National Partnership Agreement on Homelessness. Funding for NPs is conditional on states and territories meeting agreed milestones and performance benchmarks.58

58 Productivity Commission, Report on Government Services, Vol 2: Health and Community Services, Housing, section 15.11, http://www.pc.gov.au/__data/assets/pdf_file/0004/85360/volume2.pdf

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Figure 1 – The legislative framework

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2.4.3 Supported Accommodation Assistance Act 1994 (Cth) Critical to understanding the current regulatory framework is the Supported Accommodation Assistance Program (SAAP) (which has been incorporated into NAHA) and the Supported Accommodation Assistance Act 1994 (the SAA Act), which is currently in force. The SAA Act is one of the most important pieces of legislation relating to homelessness. The Act underpins the myriad of supported accommodation assistance agreements and programs across Australian states and territories. SAAP, established in 1985, has until recently been Australia’s primary response to homelessness. It brought together a range of homelessness programs funded at the state and territory level under one nationally coordinated program.59 While the SAAP agreements and programs which stem from the SAA Act have been incorporated into the NAHA Agreement the original SAAP legislation remains in force. The SAA Act is the legislative framework for the provision of a whole range of services relating to homelessness and housing. The preamble to the Act frames the rights-based approach of the legislation, stating that: ‘Australia has acted to protect the rights of all of its citizens, including people who are homeless or at risk of homelessness, by recognising international standards for the protection of universal human rights and fundamental freedoms through: (a) the ratification of the International Covenants on Economic, Social and Cultural Rights and on Civil and Political Rights; and (b) the ratification of the Conventions on the Elimination of all Forms of Racial Discrimination, on the Elimination of all Forms of Discrimination against Women and on the Rights of the Child; and (c) the acceptance of the Universal Declaration of Human Rights and of the Declaration on the Elimination of Violence Against Women; and (d) the enactment of legislation such as the Human Rights and Equal Opportunity Commission Act 1986.’ The preamble to the Act also includes a broad commitment to service quality, stating that: ‘The Parliament intends that the Commonwealth Government should work co-operatively with state and territory governments to ensure that people who are homeless or at risk of homelessness are given opportunities to redress their circumstances and that their universal human rights are not prejudiced by the manner in which services are provided to them.’ It is important to note that the commitment to protecting the rights of homeless people is included in the preamble and not in the body of the legislation, which means that it does not make the principles included of the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the International Covenant on Civil and Political Rights (ICCPR) (such as the right to adequate housing) enforceable in Australian law. The aim of the SAA Act is essentially to provide a broad framework for the delivery of transitional, supported accommodation and related support services in order to help people who are homeless to achieve the maximum possible degree of self-reliance and independence (s 5(2)). Within this aim the goals are: to resolve crisis; to re-establish family links, where appropriate; and to re-establish a capacity to live independently of SAAP.

59 National homelessness clearing house, available at: www.homelessnessinfo.net.au/index.php?option=com_content&view=article&id=12&Itemid=14

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The aims of the SAA Act are to be achieved by: providing or arranging for the provision of support services and supported accommodation; and helping people who are homeless to obtain long-term, secure and affordable housing or accommodation and support services (s 3). The SAA Act sets out the responsibilities of service providers who enter into agreements to receive funding from their respective states and territories. One of the key responsibilities is to help people who are homeless to resolve a crisis and to achieve greater independence through the following (s 7(a)): Case management; Assessment and referral; and Early intervention and re-establishment of family links (if appropriate).

Some of the other key responsibilities include assisting homeless people to access disability and rehabilitative services, and to assist them to obtain long-term secure and affordable housing (s 7(b)(iv), s 7(c)).

2.4.4 National principles for SAAP services As part of the implementation of SAAP there were national principles for all SAAP services which were endorsed in 1996 by all state and territory governments across Australia. The Western Australian SAAP Service Standards 2002 document reiterates the agreed national principles: User rights: Each consumer has the same rights and responsibilities as all members of the community. Participation and choice: Each service user has the opportunity for maximum participation in decision making about their own lives and about the service they receive. Complaints and dispute resolution: Each service user has access to fair and equitable procedures for dealing with complaints and with disputes. Safety and security: Each service user has physical safety and security as a result of their contact with a SAAP service. Access to services: Each service users’ access to a service is decided on the basis of relative need within the service's target group. Information and consultation: Each service user is fully informed about the nature and choice of available services and about any rules and conditions that apply, and makes informed choices from the alternatives. Privacy, confidentiality and access to personal information. Each service user has the right to personal privacy, privacy in communications and confidentiality of access to service records and to information pertaining to them. Efficient and effective management. Each service user receives the benefit of well planned, efficient and accountable service management. Coordinated, planned and reliable service delivery: Each service user receives coordinated, reliable and appropriate planned services which meet his or her specific ongoing needs and which are both appropriate and delivered in a culturally responsive manner. Responsiveness to all clients: Children in SAAP services are treated as clients in their own right as well as part of their family unit.

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2.5 Overview of existing state and territory quality frameworks An accreditation system, which represents a specific type of quality framework, is a standards-based recognition system which involves assessment against predetermined standards.60 The accreditation process formally acknowledges achievement against a set of performance measures and introduces minimum standards for services, as well as providing a framework for continuous quality improvement. There are many different types of accreditation systems currently tailored to a range of sectors in Australia, for example, disability services, child care services and the aged care sector. These quality frameworks are explored in the case studies that form part of this document. Quality frameworks in the homelessness sector in Australia and overseas are patchy at best. As discussed above, under the Supported Accommodation Assistance Program V (SAAP V) Agreement, states and territories were assessed against performance indicators which encouraged the services they funded to develop service charters to protect their clients’ rights (see above at Section 2.4.5). This has been one of the factors motivating the development of a range of standards processes around Australia, particularly in Western Australia. As the scan of quality frameworks below reveals, some states, such as Victoria, have introduced non- legislative accreditation schemes that are rights-based and focus on continuous quality improvement as assessed by a third party. Other states, including Queensland and the ACT, have amended their residential tenancy legislation to extend certain rights to occupants of temporary accommodation. Others have introduced tiered systems of accreditation, especially to regulate services providing more than accommodation. Some examples of the different accreditation approaches are: rights-based and involve continuous quality improvement (Victoria, ACT); legislatively based, involving an extension of residential tenancy rights (Queensland and ACT); service charter and guarantee based (ACT); non-legislative, monitored by a third party (Victoria and Tasmania); SAAP-structured (WA). Case management has also been central to assessing homelessness assistance standards ever since it was adopted as a strategy to enhance SAAP. The SAAP Case Management Resource Kit was released in 1997. Some experts have since advocated for the case management framework to become part of the Australian standards for homeless services. The Case Management Society of Australia has been instrumental in developing Australian standards for Case Management, and supports the introduction of these standards into the service charters of homeless services in Australia.61

60 State Government of Victoria, Department of Community Services, viewed at www.housing.vic.gov.au/community-and- housing-partnerships/community-housing/accreditation

61 Cooper, B., 2009, Suggested Standards of Practice for Case Management for Homeless Services, viewed at www.homelessnessinfo.net.au/dmdocuments/standards_of_practice_for_case_management_for_homeless_services_brian_coop er_june_2009.pdf

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2.6 Victoria

2.6.1 Homelessness Assistance Service Standards (HASS) The Victorian Government has allocated $2.1 million over three years to improve the standard of homeless support services. 62 A major aspect of improving these services is through the development of a formal accreditation system for the Office of Housing referred to as the Homelessness Assistance Service Standards (HASS). The development of the HASS accreditation system is intended to ensure a minimum level of service quality for homeless people, to promote best practice and to encourage ongoing improvement of service quality. The White Paper on Homelessness singles out the Victorian model as encouraging specialist homeless services to work collaboratively with agencies and across programs, stating that ‘as a result strong partnerships have been formed with mental health and community care divisions, housing, the Department of Justice and the Office of the Correctional Services Commissioner’.63 The model is reported to be similar to the aged care and childcare accreditation models, both of which involve an external agency visiting service providers and conducting reviews to determine whether services are complying with sector-specific standards, and actively implementing service improvements.64 The Victorian accreditation scheme relates to a wide range of services, including peak organisations. All organisations funded by the Office of Housing for the following programs need to be accredited by December 2009: Homelessness assistance services including crisis and transitional support services. Crisis accommodation services including family violence and youth refuges. Office of Housing-funded integrated Family Violence services. Housing information and referral services. Social housing advocacy and support providers. Peak organisations and other state-wide advocacy programs. Homelessness network services and children’s resource program providers. Other state-wide advocacy services. HASS was developed through an extensive consultation process with service providers, consumers and experts within the sector. The accreditation process is based on a quality improvement model, and is not legislatively based. The accreditation process is run by a third party organisation, Quality Improvement and Community Services Accreditation Inc, chosen through a formal selection process.

Originally, the accreditation model was based on two major components: Client service delivery standards – sections one-to-five of HASS. Organisational management standards – covering business, governance and organisational management.

62 The information in this section has been obtained from the State Government of Victoria, Department of Human Services, Office of Housing website: www.housing.vic.gov.au/community-and-housing-partnerships/community-housing/accreditation

63 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p. 43.

64 Ibid., p.43.

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A formal trial of the standards was conducted in 2005 with four organisations. In response to the findings of the trial, the standards have been revised so that those relating to client service delivery were retained and the sections relating to organisational management standards were removed. There are five sections that make up the current standards: Section 1: Upholding and promoting rights. Section 2: Access to support for people experiencing homelessness. Section 3: Direct service delivery and case management. Section 4: Direct service delivery to specific groups. Section 5: Working with the community. According to a HASS workshop summary developed by the Council to Homeless Persons (CHP) in Victoria, the HASS accreditation process involves: a documented, organisational self-assessment against sections 1-5 of the HASS industry standards, which relate to practice, involving staff, consumers and stakeholder feedback; an internal analysis of gaps in documentation, systems and processes; action planning and improvement work such as identifying staff training requirements at all levels, and policy, procedure, systems and practice improvements; and external assessment against HASS requirements by the end of 2008, (including practice standards and separate – to be determined - business management and governance management standards) by an accreditation body. Further detail is provided about each of the standards, below. The documentation accompanying each section of HASS includes examples illustrating how services are able to achieve the standards. Section 1: Upholding and promoting rights The first section of the HASS standards relate to increasing the focus on rights within the delivery of services to homeless people. The approach is modelled on a consumer rights framework. These are described as the ‘fundamental rights of consumers to respectful, flexible and fair treatment in addressing issues of homelessness, family violence or other housing support issues’.65 The first section of HASS refers to the Supported Accommodation Assistance Act 1994 (SAA Act) as providing a basis for a consumer rights framework which aims to ensure that rights ‘are not prejudiced by the manner in which services are provided’. Section 1 of HASS contains the following standards: Standard 1.1 Rights-based approach. Standard 1.2 Consumer participation. Standard 1.3 Complaints and appeals. Standard 1.4 Privacy and confidentiality. It also notes a number of documents that further support the standards, including: Consumer Charter for community-managed housing and homelessness services (Department of Human Services 2006).

65 HASS, Section 1: Upholding and promoting rights at 1: http://www.housing.vic.gov.au/community-and-housing- partnerships/community-housing/accreditation

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Information Privacy Act 2002 (Victoria). Health Records Act 2001 (Commonwealth). Privacy Act 1988 (Commonwealth). Language services policy (Department of Human Services 2006). Complaints Management Training Package – ‘Taking It Seriously’ (Department of Human Services 2006). Section 2: Access to support for people experiencing homelessness The key aim of this section is to ensure that a person approaching a funded service is provided with assistance of some kind. At minimum, people are to be offered a screening service that provides them with information and/or active referral to appropriate services. The standards require that where people initially approach the most appropriate organisation, a full initial assessment will be conducted. They also require services to consider what other support can be provided by the broader homelessness service system.66 Section 2 of HASS contains the following standards: Standard 2.1 Access to the homelessness service system. Standard 2.2 Initial assessment. Standard 2.3 Effective referrals. The following documents further support these standards: Code of Practice for Specialist Family Violence Services for Women and Children (Domestic Violence Victoria 2006). Common Risk Assessment Framework for Family Violence Services in Victoria (Department of Human Services, under development 2006). Statewide Homelessness Assessment and Referral Framework (Department of Human Services, under development 2006). The Protocol for the Case Management of Unsupported Young People (Commonwealth and States). Section 3: Direct service delivery and case management This section of the standards focuses on engaging and supporting people within a case management or consumer-support framework. The section lists a number of areas where assistance can be provided, including: advocacy, emotional support, parenting assistance, living skill development and family reunification. The standards focus on improving the quality of service delivered to homeless people. For example, one principle is that people should not be disadvantaged in accessing services through discriminatory practices or through poor service design.67 Section 3 of HASS contains the following standards: Standard 3.1 Providing equitable access to support services. Standard 3.2 Engagement, assessment and case planning. Standard 3.3 Responsive support.

66 HASS, Section 2 Access to support for people experiencing homelessness at 1: www.housing.vic.gov.au/community-and- housing-partnerships/community-housing/accreditation

67 Standard 3.1, HASS Section 3: Direct service delivery and case management at 2:www.housing.vic.gov.au/community-and- housing-partnerships/community-housing/accreditation

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Standard 3.4 Exit planning and case closure. Standard 3.5 Documenting case work. Documents that further support these standards include: National Supported Accommodation Assistance Program Case Management Principles (Commonwealth 1996). Quality improvement in case management (Department of Human Services 1998). Working with a multicultural community (Department of Human Services 1998). Duty of care (Department of Human Services 2000). Language services policy (Department of Human Services 2006). Homelessness assistance program guidelines and conditions of funding (Department of Human Services 2006). Code of practice for specialist family violence services for women and children (Domestic Violence Victoria 2006). The protocol for the case management of unsupported young people (Commonwealth and States). Section 4: Direct service delivery to specific groups This section sets out standards that must be complied with when dealing with specific groups, such as children, young people and women experiencing domestic violence, and with people with diverse interests, customs, beliefs, culture and ethnic backgrounds. The section contains the following standards: Standard 4.1 Supporting parents and accompanying children. Standard 4.2 Supporting young people. Standard 4.3 Supporting women, children and others experiencing family/domestic violence. Standard 4.4 Providing culturally competent services. Standard 4.5 Providing advocacy services. The following documents further support these standards: Working with Children Act 2005. Residential Tenancies Act 1997. Children, Youth and Families Act 2005. Duty of care (Department of Human Services 2000). Women’s safety strategy (Office of Women’s Affairs 2002). Language services policy (Department of Human Services 2006). Working with a multicultural community (Department of Human Services 1999). Victorian Indigenous homelessness study (Aboriginal Housing Board of Victoria, 2001). The Victorian Indigenous family violence strategy (Department of Human Services 2001). The protocol for case management of unsupported young people (Commonwealth and States). NTV standards for men’s behavioural change group work – A manual for quality practice (NTV 2006).

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Homelessness assistance program guidelines and conditions for funding (Department of Human Services 2006). Social housing advocacy and support program guidelines (Department of Human Services 2006). Code of practice for specialist family violence services for women and children (Domestic Violence Victoria 2006). Section 5: Working with the community Services are required to demonstrate that they understand and are able to contribute to systemic housing and homelessness issues, through means such as promoting service system advocacy and community education work in relation to housing and homelessness. Section 5 of HASS contains the following standards: Standard 5.1 Building partnerships and integrated networks. Standard 5.2 Advocacy and community education.

2.6.2 Homelessness Assistance Programs Guidelines 2006 – 2009 It is recommended that organisations delivering services to homeless people also use the Homelessness Assistance Programs Guidelines 2006 - 2009, in conjunction with the Homelessness Assistance Service Standards (HASS). The guidelines are part of the Victorian Homelessness Strategy, introduced in 2002, and seek to assist services to deliver and manage business in accordance with program objectives and with funding conditions.68 The guidelines also integrate three different program guidelines that were already in existence so that the compliance process for homeless support services is simplified. All registered community housing agencies are also required to comply with the Registered Agency Performance Standards (RAPS). The performance standards focus on seven aspects of the agency’s business, including: Governance; Management; Probity; Financial viability; Tenancy management; Housing management and maintenance; and Risk management.

68 State Government of Victoria, Office of Housing, viewed at www.housing.vic.gov.au/community-and-housing- partnerships/community-housing/standards-and-guidelines.

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2.6.3 Other standards and guidelines Other standards that are relevant to the delivery of services to people who are homeless are: National Community Housing standards (NCHS), first published in 1983, which guide the operation of community housing providers; Public Housing Infrastructure Program (PHIP) guidelines which provide information for community service organisations about the operation of Social Housing Advocacy Support Program (SHASP) services and about other services funded by PHIP; Public Housing Consumer Services Charter, which explains a person’s rights and responsibilities when looking for or living in public housing.69 Boarding houses in Victoria Victoria was the first state to introduce legislation for the boarding and lodging house sector through the Rooming Houses Act 1990. This Act has subsequently been repealed and the provisions incorporated into the Residential Tenancies Act 1997. The Residential Tenancies Act 1997 (RTA) establishes the Victorian Civil and Administrative Tribunal’s jurisdiction over residential tenancies, rooming/boarding houses and caravan parks. The Act sets out the duties of landlords, tenants, owners and residents; provides for rights of entry by landlords or owners; and sets out the means by which a tenancy agreement or agreement in relation to a residency right may be ended.70 Homelessness Advocacy Service Operating since January 2005, the Homelessness Advocacy Service (HAS) developed as part of the Victorian Government’s Homelessness Strategy. HAS has three broad areas of focus: individual advocacy, secondary consultation, and training - including the Peer Education Support Program. One of its key roles is to provide an independent complaints process for government-funded homelessness support and accommodation services. All complaints made to HAS are recorded using the Department of Housing’s Integrated Complaints Management Processes, which aims to increase transparency and ensure that all complaints are dealt with in a ‘consistent, fair and timely manner’.71 This complaints mechanism is also supported by the Integrated Strengthened Complaints Management Strategy, which offers redress to people who have their rights breached through the complaints process. When a complaint is made to HAS about a Government-funded service, the complaint is measured against the Homelessness Assistance Service Standards (HASS) (the accreditation standards outlined above). These complaints are also measured by the services’ compliance with its own funding and service agreement, and by Commonwealth and state legislation such as the Supported Accommodation Assistance Act 1994 (SAA Act) and the Equal Opportunity Act.

2.7 Queensland

2.7.1 Boarding house legislation The provision of boarding houses and hostels is one component of the Queensland Government’s response to homelessness. One aspect of the strategy is to provide greater access to crisis and

69 Ibid.

70 Victorian Civil and Administrative Tribunal Website, www.vcat.vic.gov.au/CA256DBB0022825D/page/Residential+Tenancies- Legislation?OpenDocument&1=70-Residential+Tenancies~&2=35-Legislation~&3=~

71 Homelessness Advocacy Service (HAS) website, www.melbourne.homeless.org.au/has.html

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transitional accommodation and support options, through buying, leasing and redeveloping hostels and boarding houses throughout Queensland.72 Legislation relating to residential services including boarding houses is the primary way that homelessness services are regulated in Queensland. Queensland was the first state in Australia to introduce mandatory accreditation for accommodation providers of residential services. This accreditation-based quality framework protects minimum standards of living conditions, providing residents with rights including protection from arbitrary eviction, and it enables a dispute resolution process.73 A package of reforms was introduced in 2002 by the Queensland Government to the residential services sector to regulate supported accommodation and rental accommodation for the aged. A discussion paper prepared by the Residential Tenancies Authority provides an overview of the 2002 reform package:74 Reforms include: the Residential Services (Accommodation) Act 2002,which requires written residential agreements in order to balance the accommodation rights and responsibilities of residents and service providers. It also provides for a dispute resolution process in relation to these agreements, which is administered by the Residential Tenancies Authority. This has now been incorporated into the Residential Tenancies and Rooming Accommodation Act 2008 (discussed below); the Residential Services (Accreditation) Act 2002, which establishes minimum standards for buildings and services in order to protect the health, safety and basic rights of residents. This includes a registration and accreditation process for operators to encourage continual improvement and fair trading in the sector; the introduction of the Resident Support Program, which is trialling ways to provide assistance to residents in accessing health, well-being and disability support services, and sustaining relationships in the community; an expanded role for Tenant Advice and Advocacy Services (Queensland), to provide assistance for residents in understanding their accommodation rights and responsibilities; an expanded role for the Community Visitor Program in the Office of the Adult Guardian, to provide assistance for residents with impaired capacity at supported accommodation/hostel facilities in dealing with concerns about services or issues affecting their rights and interests; financial assistance and business support for service providers in meeting the new laws to maintain the supply of low cost housing. The accreditation standards established in the Residential Services (Accreditation) Act 2002 (the Accreditation Act), are legislatively based and should be read in conjunction with the Residential Services (Accommodation) Act 2002 (the Accommodation Act). The Accreditation Act applies to private boarding houses, supported accommodation hostels and aged rental accommodation (residential services). It also covers student accommodation which is not a target of the overall residential services regulatory regime apart from where it relates to tenancy issues.75 The accreditation process is run by the now State of Queensland, Department of Employment, Economic Development and Innovation (which includes Fair Trading).

72 Queensland Government’s, Responding to Homelessness Strategy Brochure, www.housing.qld.gov.au/about/pdf/homelessness_brochure.pdf

73 Queensland Fire and Rescue Service, Media Release, 10 May 2002, http://www.fire.qld.gov.au/news/view.asp?id=141

74 This section is extracted from the Residential Tenancies Authority, Review of the Residential Services (Accommodation) Act 2002, Discussion Paper, February 2006, p.1

75 Ibid., p.1.

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Specifically, the Accreditation Act defines a residential service as accommodation where: there are at least four residents in one or more rooms; each resident has a right to occupy one or more room, but not the whole premises; rooms are not self-contained; and residents share facilities (e.g. a bathroom) outside their room.76 The legislation only applies to residential services that are either not regulated by other legislation, or have funding agreements with a government agency or provide only tourist accommodation. The purpose of the Accreditation Act is to: protect the health, safety and basic freedoms of residents; encourage residential services providers to continually improve their services; and support fair trading in the residential services industry.77

Within six months of registering a service, an application for accreditation must be submitted. Queensland has a tiered process for accreditation, which comprises three levels:

Level 1: Accommodation service. Level 2: Food service. Level 3: Personal care service.

All providers must apply for Level 1 accreditation.78 To obtain accreditation, services must show that their residential service meets minimum standards for each accreditation level. The Residential Services (Accreditation) Regulation 2002 outlines these standards.

Level 1 relates to a resident’s right to:79

Privacy and independence. Individual resident agreements. Appropriate record keeping. Protection from abuse and neglect. Grievance mechanisms. Adequate goods and equipment. Access to external professional service providers. Cleanliness and maintenance.

76 Part 1, Section 4 of the Residential Services (Accreditation) Act 2002

77 Queensland Department of Employment, Economic Development and Innovation, Fair Trading within the State of Queensland, viewed at www.fairtrading.qld.gov.au/residential-service-accreditation.htm

78 Ibid.

79 Ibid.

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Appropriate security and emergency measures. Appropriate business and workplace health and safety practices. Human resource management and staff training.

Level 2 relates to a resident’s right to:

Nutritional food. Safe and hygienic delivery, storage, preparation and service of food. Kitchen and dining facilities that meet minimum requirements.

Level 3 relates to a resident’s access to:

External support services. Accountable financial and clerical support. Medication management and health care. Help with clothing and hygiene management. The living environment. Leisure interests. Social networking. Participation in decision-making processes. The accreditation process works initially by services undertaking self-assessment by completing a series of workbooks where they assess their own service against the accreditation. The next stage involves an accreditation officer examining the policies and procedures and conducting a site inspection. Services are accredited for varying periods of time. The maximum period of time for accreditation is three years. If a service does not meet all of the requirements for accreditation, a shorter period may be granted, subject to conditions.80 While the introduction of the accreditation-base quality framework for residential housing is a step towards improved quality of housing for homeless people, it is worth noting the impact that regulation had on this sector in Queensland. As discussed in the case study on boarding houses, completed for this study, there were many boarding house operators who chose not to attempt accreditation. The level of impact is difficult to establish as the number of businesses operating are often under-reported or disputed, however, it is generally acknowledged there has been a significant loss of accommodation across the industry in Queensland recently. A review of the Accommodation Act was undertaken in 2005 by the Queensland Residential Tenancy Authority, to evaluate whether the provisions of the Accommodation Act were achieving their intended objectives. This involved an extensive consultation process across the state. The consultations revealed that all sectors considered there to be room for improvement within the earlier legislation, however there was consensus ‘that the Accommodation Act represented a ”good starting point” in terms of legislation and a framework of rights, providing greater protection and certainty for both sides’.81

80 Ibid.

81 Residential Tenancies Authority, Review of the Residential Services (Accommodation) Act 2002, Policy Review Paper, viewed at www.rta.qld.gov.au/zone_files/Docs/rs_policy_review_paper_web.pdf

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The key aspects identified as needing amendment related to the service provider’s ability to immediately terminate an agreement (where the resident refused to leave after a termination process), and to the service provider’s ability to evict the resident using necessary force (in the presence of a police officer). Other areas that were identified concerned issues of process, clarification and consistency with general tenancy concepts. The major amendment that was proposed involved extending coverage beyond the primary target group of residential services. This is consistent with moves to regulate tenancies on the basis of types of premises (that is, room-only) rather than types of residents.82 The outcome of the review process is the current Residential Tenancies and Rooming Accommodation Act 2008. This Act combines and amends the provisions of both the Residential Tenancies Act 1994 and the Residential Services (Accommodation) Act 2002. Both Acts will be repealed on June 30th 2009 and the Residential Tenancies and Rooming Accommodation Act 2008 will commence on July 1st 2009.83

Some of the key changes are: a prohibition on rent bidding; a restriction on rent increases to only two per year; an increase in notice periods from two weeks to two months for 'without grounds' terminations and rent increases; a creation of additional grounds for entry for lessors; an extension of coverage to most forms of rooming accommodation; and an introduction of new provisions around sale of rental properties.84

2.7.2 Standards for Community Services Also applicable to the operation of some homelessness service providers in Queensland are the Standards for Community Services, which were introduced in 2007 and which apply to all Non- Government Organisations (NGOs) funded by the Department of Communities. Implementation of the standards is a condition of all service agreements between the Queensland Department of Communities and funded organisations. The series of 11 standards sets out minimum expectations of those NGOs providing services and relates to three areas of service delivery: 1. People using services: Standards one to six focus on ‘ensuring that clients receive individually tailored, culturally sensitive services delivered with respect for their individual rights’. 2. People working in services: Standards seven to nine focus on ‘ensuring that client services are provided by staff and volunteers who are appropriately selected, competent, and supported in performing their roles’. 3. Governance: Standards 10 and 11 focus on ‘ensuring that client services are based on a clear vision and set of organisational values, and strong governance arrangements’. 85

82 Ibid.

83 Residential Tenancies Authority, Residential Tenancies Authority Legislation, viewed at www.rta.qld.gov.au/residential_tenancies_legislation.cfm

84 Residential Tenancies Authority (Queensland), www.rta.qld.gov.au/residential_tenancies_rooming_accom_act.cfm

85 Queensland Government, Department of Communities, Standards for Community Services, viewed at http://www.communityservices.qld.gov.au/community/strengthening_ngos/initiatives/standards.html

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The standards have been introduced through a two-phase process. Phase one – 2008 - 2011 - is considered to be a ‘developmental phase, with a focus on self-assessment and quality improvement rather than compliance’. Phase two – to run from 2011 onwards - will be focused on compliances. From this date, all organisations receiving more than $100,000 per annum in triennial funding from the Department (except licensed childcare organisations and organisations recognised under another quality system) will be monitored for compliance with the standards. The introduction of the standards is being implemented through a collaborative approach between the Department of Communities, the Queensland Council of Social Service (QCOSS) and other peak bodies which are working with local networks of NGOs to help them meet the requirements.86

2.8 New South Wales

2.8.1 SAAP Performance monitoring framework In NSW, SAAP agencies had service agreements with the NSW Department of Community Services (DoCS) to provide services in accordance with state and commonwealth laws such as the NSW Anti- Discrimination Act 1977 and the NSW Occupational Health and Safety Act 2000. DoCS has also developed a Performance Monitoring Framework for SAAP services, designed to ensure continuous improvement in service delivery. Services are monitored for: compliance with their Service Agreement; extent to which outcomes/outputs are achieved under the Service Specification/Service Agreement; progress of agencies towards integrating the Good Practice Guidelines for DoCS Funded Services (the Guidelines) into their practice. The Guidelines has been developed as a key resource to support service standards. The good practice guidelines are to be implemented through a cycle of continuous quality improvement, using the DoCS quality self-assessment and quality work-plan support tools. It is suggested that the cycle is completed annually and is aligned with the service’s regular review schedule or reporting requirements. The continuous quality improvement involves four steps: Step 1: Self-assessment. Step 2: Develop quality work-plan. Step 3: Implement quality work-plan. Step 4: Review quality work-plan. A manual has been developed, as well as a quality self-assessment workbook and work-plan to assist services to implement the principles. These tools were developed and piloted with a cross-section of DoCS-funded services, and will assist organisations to align their current practices with those outlined in the Guidelines. 87

86 Ibid.

87 NSW Department of Community Services, The Good Practice Guidelines for DoCS Funded Services, viewed at www.community.nsw.gov.au/for_agencies_that_work_with_us/our_funding_programs/about_our_funding_reform/good_practice_ guidelines.html

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In relation to other types of accommodation in NSW, there are protections for marginal residents of caravan parks under the Residential Tenancies Act 1987 (NSW).88 The Tenants’ Advice and Advocacy Service provides a useful summary of the legislation and its implications.89 Essentially, most residential tenancies in NSW are covered by the Act. The Act and Regulations cover private tenants who have written or oral residential tenancy agreements, including some tenants in caravan parks. The Act provides a range of protections, including the right to: have premises rented to you in a state that is reasonably clean and fit to live in; be given 60 days written notice of a rent increase; have quiet enjoyment and use of the premises; the landlord/agent must not interfere with your possession of the premises; have peace, comfort and privacy; have reasonable locks and security; have reasonable repairs and maintenance done; be given written notice of the landlord wanting to end the agreement; and not to be unlawfully evicted. The Act does not cover: tenants who are covered by the Residential Parks Act 1988 (which grants a similar level of protection to the Residential Tenancies Act 1987); holiday houses, flats and caravans, ordinarily used for holiday purposes; people who rent for holiday purposes for less than two months; ‘protected’ tenants (under the Landlord and Tenant (Amendment) Act 1948 (NSW); and boarders and lodgers.90 The lack of regulation or protections for people in boarding houses is an area that has generated significant controversy in NSW.91 The Residential Tenancies Act 1987 does not cover boarders and lodgers, meaning that they do not have the same rights as tenants. A person is likely to be a tenant under the Act, rather than a boarder or lodger, if they: have exclusive access; do not get meals, linen, or cleaning as part of their agreement; have their own cooking facilities; and

88 Forell, S., McCarron, E., & Schetzer, L., No home, no justice? The legal needs of homeless people in NSW, Law and Justice Foundation of NSW, Sydney, 2005, viewed at http://xml.lawfoundation.net.au/ljf/site/articleIDs/46AFCFE76A8314F8CA25707500815B9F/$file/no_home_no_justice.pdf

89 University of New South Wales, Tenants Rights Fact Sheet: Residential Tenancies Act: http://www.asc.unsw.edu.au/info/RTAact.pdf

90 Note: This list is not exhaustive. Tenants’ Advice and Advocacy Service, Tenants Rights Fact Sheet: Residential Tenancies Act: http://www.asc.unsw.edu.au/info/RTAact.pdf

91 See for example: Forell, S., McCarron, E., & Schetzer, L., No home, no justice? The legal needs of homeless people in NSW, Law and Justice Foundation of NSW, Sydney, 2005

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do not have house rules enforced.92 Boarders and lodgers live in premises where the landlord (or a caretaker living on the premises) keeps control of the premises. The landlord may be the owner or a tenant who has a residential tenancy agreement in their name only. Boarders usually receive meals as part of their agreement, whereas lodgers do not.93 Licensed Boarding Houses were brought within the jurisdiction of the NSW Ombudsman in 2002. Licensed boarding houses are any ‘residential centre for handicapped persons’, licensed or declared as such under the Youth and Community Services Act 1973. There are more than 65 such facilities in NSW, providing accommodation and support to approximately 1,200 people with a disability. These centres generally do not receive any direct funding through the NSW Government, but residents receive a range of community services funded through the government’s Boarding House Reform Strategy.94 The Ombudsman may review the situation of a person, or group of people, with disabilities in care, including residents of licensed boarding houses. In doing so, the Ombudsman will look at the person’s ‘welfare, status, progress and circumstance’. As explained in the Community Services Fact Sheet for licensed boarding houses, the Ombudsman reports to the Minister for Disability Services, the manager of the licensed boarding house, and other appropriate people, on the results of the review and can also make recommendations to improve the welfare and interests of the person, or group of people.95 There are some protections for boarders and lodgers who are not living in licensed boarding houses, under NSW legislation. If the landlord is a business there is some scope to apply under the Consumer Claims Act to the General Division of the Consumer, Trader and Tenancy Tribunal (CTTT) to have the dispute heard. Most rights exist only in common law where the landlord is not a business. In relation to eviction, for example, if rent is paid weekly then the landlord should provide seven days notice before eviction. Similarly, there are very few protections in terms of repairs and maintenance. If premises are unsafe, the landlord could be held responsible under the law of 'negligence' for any personal injuries caused by them not maintaining the premises.96 To bring a claim to enforce a common law right, a court action is required. A review of the needs of homeless people in NSW, published by the Law and Justice Foundation in 2005, identified some of the reasons why these types of dispute resolution mechanisms are not appropriate for homeless people: ‘On a day to day basis, homeless people have many immediate needs: finding accommodation, getting food or money, caring for family. These needs tend to take precedence over their legal issues…Services report that when homeless people finally do contact a legal service (if at all), the issue has usually already reached crisis point: the eviction is imminent; their benefits have been cut off; the court case is tomorrow. In some cases it may be too late to resolve the issue (eg the limitation period may have expired) or the issue has become more complex and difficult to address.’97

92 The Tenants’ Advice and Advocacy Service: Boarders and Lodgers Fact Sheet, viewed at http://intranet.tenants.org.au/print/fs14.htm

93 Ibid.

94 This section has been extracted from the Community Services Fact Sheet No 4: Licensed Boarding Houses, NSW Ombudsman

94 The Tenant’s Advice and Advocacy Service: Boarders and Lodgers Fact Sheet, viewed at http://intranet.tenants.org.au/print/fs14.htm

97 Forell, S., McCarron, E., & Schetzer, L., 2005, No home, no justice? The legal needs of homeless people in NSW, Law and Justice Foundation of NSW, p. xxi viewed at http://xml.lawfoundation.net.au/ljf/site/articleIDs/46AFCFE76A8314F8CA25707500815B9F/$file/no_home_no_justice.pdf

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2.9 Australian Capital Territory The ACT has recently introduced a Homelessness Charter and a Service Guarantee (the Supported Accommodation Assistance Program Guarantee). The Homelessness Charter, which includes a Statement of Rights, sets out the broad principles protecting homeless people. The Service Guarantee explains what people can expect from homelessness service providers, including the types of support and services that are available.98 In addition to these quality frameworks, good practice standards have been developed for community services within the ACT. The Good Practice Standards (2002) aim to establish a continuous quality improvement approach within the sector.

2.9.1 Homelessness Service Charter The Charter was developed by Housing and Community Services ACT, which is part of the Department of Disability, Housing and Community Services, and is responsible for the provision of public housing and community services. The Charter was developed through community consultation with service providers and clients in 2005-06 and acknowledges basic human rights, including the rights to dignity, respect, non-discrimination, safety and freedom. The Charter also recognises the right to ‘services that will provide secure, stable, short and long-term accommodation based on fair policies’.99 It is important to note the preamble to the Charter, which states that ‘the Charter is not a law, and the rights it sets out cannot be directly enforced in a court of law. It is a statement of values subject to the laws of the ACT.’.100 As noted above, the Human Rights Act 2004 introduced in the ACT does not protect the right to adequate housing. The Charter intends to ‘improve the circumstances of homeless people by raising community awareness and promoting a rights-based approach to homelessness service delivery’.

2.9.2 Service Guarantee The Service Guarantee introduced in the ACT is intended to establish a framework to improve service delivery to clients. Services sign up to the Service Guarantee and pledge to display the Charter and Guarantee on the property. Where accommodation is provided by the service, they are required to issue a Supported Accommodation Assistance Program (SAAP) occupancy agreement or tenancy agreement that protects the person’s rights under the Residential Tenancy Act 1997 (ACT). The provision of agreements to boarders, lodgers and other renters is significant in that it has broad application, provides protection for basic, non-prescriptive legislated rights, provides for the creation of standard terms and allows for access to a dispute resolution tribunal. The NSW Tenant’s Union has advocated for the adoption of a similar occupancy agreement in NSW. 101 The Service Guarantee is not intended to override the codes of practice developed by individual agencies. It is designed to provide a minimum level of standard across services and should be read in combination with a manual developed to guide quality improvement for organisations in the ACT, Raising the Standard (2002).102 The ACT continues to be involved in the National SAAP V Coordination and Development Committee (CAD), as the coordination group for the state, territory and Australian Government. The CAD is

98 Stanhope, J., Chief Minister ACT, ‘ACT Homelessness Charter Launched’, Media Release, April 29 2009, viewed at http://www.chiefminister.act.gov.au/media.php?v=6713&m=52&s=5

99 ACT Government, Homelessness Charter, http://www.dhcs.act.gov.au/__data/assets/pdf_file/0005/25376/Charter.pdf

100 Ibid.

101 Tenants’ Union of NSW; http://www.tenants.org.au/artman2/uploads/1/occ_ag_bp.pdf

102 Minister for Disability and Community Services, Breaking the Cycle: The ACT Homelessness Strategy Annual Progress Report July 2006 - June 2007, p. 12

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established by legislation and is a formal sub-committee of the Community and Disability Ministers Conference. The CAD developed the evaluation framework for SAAP V.103

2.9.3 Good Practice Standards 2002 The Good Practice Standards, which have been developed for community services operating in the ACT, were the result of a year-long collaborative project between the ACT Government and the community sector which was funded by the (then) Departments of Education and Community Services, Health and Community Care and Chief Minister’s. The Standards aim to achieve service quality improvement in the sector through setting generic benchmarks for quality which are applicable across a range of community service sectors and enabling capacity building of service providers.104 The Good Practice Standards manual which has been developed (Raising the standard – Good practice standards to guide continuous improvement in community service organisations) offers a practical guide for community service organisations to ‘achieve continuous improvement in the quality of their work with clients and communities and in management.’105 The manual comprises five sections: Section 1 – The Good Practice Standards. This standalone booklet includes background to the development of the standards, principles that underpin good practice and standards relevant to a wide range of community service organisations. Standards are provided in relation to governance and management and work with clients and communities. Section 2: Self-assessment and quality planning guide. The guide is designed to help organisations decide whether they want to use the standards in quality improvement and then to guide them through self-assessment and quality planning processes. Section 3: Tools to support the self-assessment and quality planning. This section provides examples of tools that organisations can use in different aspects of the self-assessment and quality planning process, including gaining client feedback and conducting file audits. Section 4: Self-assessment workbook. The workbook is used to record evidence of current good practice identified through self-assessment, along with areas for improvement against each of the standards. Section 5: Quality improvement plan workbook. This provides a structured format for deciding and mapping out a quality plan for addressing priority issues.

2.10 South Australia

2.10.1 Social Inclusion Board The South Australian Government is working to develop an integrated response to homelessness across government departments. The South Australian Social Inclusion Board, established in 2002, has identified homelessness as a priority focus in addressing the needs of disadvantaged people. In the South Australian Government’s response to the Green Paper on Homelessness, it states that:

103 Ibid., p.25.

104 ACT Government Department of Disability, Housing and Community Services, 2002 ,Raising the Standard – a manual to guide quality improvement in ACT community service organisations, viewed at http://www.dhcs.act.gov.au/__data/assets/word_doc/0012/5007/Intro.doc

105 Ibid.

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‘We believe that a new approach to homelessness should be led at a national level through a multilateral policy framework connected to the NAHA and social inclusion framework. A new approach should facilitate an enhanced role for mainstream services particularly in preventing homelessness, intervening early when there is a risk of homelessness, providing specialist support and sustainable housing to people who are homeless and providing opportunities for social and economic participation. The role of the homelessness service sector should be refocussed to provide a crisis response and the delivery of case managed packages of support facilitated by new investment through the NAHA. To ensure the effectiveness of changes made, sound governance and accountability mechanisms must be applied at the Commonwealth and state level and be supported by a robust evidence base and data systems.’ There is minimal information available publicly about how service accreditation or how standards for homelessness services will form part of the South Australian Government’s response to homelessness.

2.10.2 Boarding house legislation Legislation in South Australia regulating the use of boarding houses is complex and is spread across a number of different Acts, such as the: Residential Tenancies Act (1995). Local Government Act (1934). Public Health and Environmental Health Act (1989). Development Act (1993).106 Shelter SA’s submission to the review of the Residential Tenancies Act 107 outlines some concerns in relation to the lack of protections in place for boarding house residents in South Australia, such as inconsistencies, gaps in coverage, enforcement procedures and effectiveness.108 The situation is broadly similar to that in NSW in that there are protections provided to residential tenants that are not provided to boarders and lodgers. Shelter SA describes the role that boarding houses play in providing accommodation for marginalised groups in the community: ‘The boarding and rooming house sector performs a distinct role in the rental market. It is an important low-cost housing option (often in inner-city areas), and a source of housing for some of the most marginalised people in the community. People with disabilities, mental illnesses or other circumstances which prevent them from successfully negotiating the private rental market often require accommodation options that they can access more quickly than public housing…As many residents are on very low incomes, may have a disability and have few other housing options, the unregulated nature of the boarding house sector can exacerbate exploitation, substandard living conditions and inadequate accommodation.’109 The rights of boarders, lodgers, residents of caravan parks and mobile homes are not well protected under the Residential Tenancies Act (1995). The Residential Tenancies (Rooming Houses) Regulations 1999, which is part of the Residential Tenancies Act (1995), provides some degree of protection to both proprietors and residents. Shelter SA has developed a Guide to Rooming/Boarding House Rights and Responsibilities and plans to conduct an education campaign in conjunction with the Office of Business

106 Shelter SA, Snapshotz, Boarding Houses, www.sheltersa.asn.au/Documents/Snapshotz/Boarding%20Houses.pdf

107 Shelter SA, Submission for the Review of the Residential Tenancy Act (1995), February 2003, p. 4, viewed at http://www.sheltersa.asn.au/Documents/Submission%20for%20Review%20of%20RT%20Act.pdf

108 Shelter SA, Snapshotz, Boarding Houses, http://www.sheltersa.asn.au/Documents/Snapshotz/Boarding%20Houses.pdf

109 Ibid.

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and Consumer Affairs.110 The booklet outlines minimum entitlements, including the responsibility of the landlord to: not interfere with your quiet enjoyment of your room; not restrict or interfere with your access to facilities at the rooming house; allow you to have access to your room at all times; allow you to have reasonable access to toilet and bathroom facilities; maintain your room and any facilities that you share in a reasonable state of repair (unless the rooming house is subject to a housing improvement notice); repair defects, if aware of their existence; and only make house rules that are consistent with the code of conduct, that are reasonable and that help maintain the health and safety of persons in the premises and protect property.111 There is some potential to have disputes in relation to these issues resolved at the South Australian Residential Tenancies Tribunal. In July 2003 a Boarding House Taskforce was established to advise the Minister of Housing in South Australia about recommendations on areas such as: addressing gaps in legislation and governance issues; increasing the supply of boarding house stock, stemming the loss of more boarding houses and improving the amenity of current boarding houses; improving and assisting with management practices; and introducing and monitoring standards of accommodation, amenity and access to support services. A report from the Boarding House Taskforce was sent to the Minster for Housing in February 2004.112 Shelter SA has advocated for the establishment and monitoring of minimum standards for boarding houses, acknowledging that such standards may put further pressure onto owners of boarding houses. To compensate for increasing the pressure on boarding houses Shelter SA has recommended that grants or interest-free loans be made available to assist owners to improve the standards of their boarding houses. Shelter SA has also advocated for changes to be made to the Residential Tenancies Act (or the creation of other specific legislation) to provide greater legislative protection for boarding house residents.113 There are other initiatives underway by Housing SA. For example, Housing SA is working on improving the standard of publicly owned boarding houses, including acquiring additional buildings suitable for use as boarding houses with a high standard of amenity. Through the SA Housing Trust, Housing SA intends to purchase and improve new boarding houses to assist people who currently use boarding houses but who often move in and out of homelessness.114

110 The Guide is available at http://www.ocba.sa.gov.au/assets/files/roominghouse_residents.pdf

111 South Australian Government, Office of Consumer and Business Affairs, A Quick guide for Rooming House Residents, viewed at www.ocba.sa.gov.au/assets/files/roominghouse_residents.pdf

112 Shelter SA, Snapshotz, Boarding Houses, viewed at www.sheltersa.asn.au/Documents/Snapshotz/Boarding%20Houses.pdf

113 Shelter SA, Submission for the Review of the Residential Tenancy Act (1995), February 2003, http://www.sheltersa.asn.au/Documents/Submission%20for%20Review%20of%20RT%20Act.pdf

114 Government of South Australia, Social Inclusion Initiative Briefing Paper, August 2004, viewed at http://www.socialinclusion.sa.gov.au/files/Homelessness_Briefing_Aug2004.pdf

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The Supported Tenancy Scheme (STS) implements lease agreements between Housing SA and Supported Accommodation Assistance Program (SAAP) services. Regular scheduled visits by government staff to evaluate property maintenance and compliance with lease agreements for STS houses, also maintains health and safety standards.

2.11 Tasmania Housing Tasmania will facilitate the alignment of the current housing and homelessness service system with the reform agenda established under the National Affordable Housing Agreement (NAHA) and the National Partnership Agreement on Homelessness. Until the legislation to support these initiatives is reviewed, specialist homelessness services will continue to be guided by the Supported Accommodation Assistance Act 1994 (SAA Act) and will work within the Tasmanian Integrated Continuum of Support service system developed under the SAAP.

2.11.1 Quality Improvement Council Review and Accreditation Program Under the former Supported Accommodation Assistance Program IV (SAAP IV) Bilateral Agreement, the Tasmanian Government initiated a three-year quality development program to develop and implement a culture of continuous quality improvement across the specialist homelessness services sector. The project was delivered by Quality Management Services (QMS), a licensed provider of the Quality Improvement Council (QIC) Review and Accreditation Program.115 The first phase of the project involved mapping the Tasmanian SAAP Service Standards and SAAP principles to the QIC Core Module. This process eventuated in 19 standards, two of which were specific to SAAP services: Section 1: Building quality organisations

− Standard 1.1 Leadership and management

− Standard 1.2 Human resources

− Standard 1.3 Physical resources

− Standard 1.4 Financial management

− Standard 1.5 Knowledge management

− Standard 1.6 Risk assessment and management

− Standard 1.7 Legal and regulatory compliance Section 2: Providing quality services and programs

− Standard 2.1 Identifying and meeting community needs

− Standard 2.2 Focusing on positive outcomes

− Standard 2.3 Ensuring cultural safety and appropriateness

− Standard 2.4 Confirming consumer rights

− Standard 2.5 Empowering consumers

− Standard 2.6 Coordinating services and programs SAAP service delivery standards

115 Quality Improvement Council, viewed at ://www.qic.org.au/about.html

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− Standard 2.1 Case planning occurs for each consumer

− Standard 2.2 Accommodation needs are addressed and assessed Section 3: Sustaining quality external relationships

− Standard 3.1 Service agreements and partnerships

− Standard 3.2 Collaboration and strategic positioning

− Standard 3.3 Incorporation and contribution to good practice

− Standard 3.4 Community and professional capacity building. The second phase of the Tasmanian Government’s three-year quality development program involved services undertaking the QIC Review Cycle which comprised four key stages: an internal review, an external review, feedback stage and taking action stage. The project concluded in June 2009. Overall Housing Tasmania reports that the quality development project has met its key objective in implementing and developing a culture of continuous quality improvement across the sector. Areas for improvement against some of the standards have been noted, and Housing Tasmania intends to introduce a second initiative aimed at providing sector-wide training opportunities and at providing additional support to some services. Specialist homelessness services enter into a funding agreement with the Tasmanian Government that requires them to meet generic agency quality and safety standards (QualityFutures); this is also applicable to all community sector organisations funded by the Department of Health and Human Services. This includes reporting on continuous quality improvement processes and compliance with the generic standards on a six-monthly basis.

2.11.2 Boarding house and caravan park legislation There have been claims that the limited availability of short-term accommodation in Tasmania has meant that caravan parks have been used to house homeless clients increasingly over the past four years. The SAAP brokerage model, introduced in 2002, enabled designated services (such as the Salvation Army, Colony 47, and Anglicare) to use SAAP funds to broker accommodation for clients, in private accommodation such as motels and caravan parks. Similar to many other states and territories, the pattern of homeless people being accommodated in boarding houses and caravan parks has raised a number of concerns about the standards and the protections for private accommodation. There is also confusion about which tenants, if any, are protected under the Residential Tenancy Act 1997, which provides basic protections similar to other residential tenancy legislation in place in other states and territories (discussed in the sections above). Anglicare Tasmania has called for a legislative response to the problem of sub-standard housing, a review of the Residential Tenancy Act - including the incorporation of minimum housing standards -, and a program of inspections and stronger obligations upon landlords to ensure standards. Anglicare has also called for legislative protections to be increased for people living in caravan parks who have very few legal rights and remedies under current legislative arrangements.116 The Tasmanian Government has announced a review of the Residential Tenancy Act in 2010. This review will be managed by the Department of Justice’s Consumer Affairs and Fair Trading and will involve consultation with key stakeholders including the community sector.

116 Anglicare Tasmania, 2007 (October), Housing: Building a Better Tasmania, A Call for Change from the Tasmanian Community Sector, www.anglicare-tas.org.au/index.php?option=com_docman&task=doc_view&gid=133&Itemid=75

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2.12 Western Australia In Western Australia, all Supported Accommodation Assistance Program (SAAP) service agreements between the Western Australian Government and SAAP services require: compliance with all Commonwealth and state laws; services to work towards WA SAAP Service Standards 2002, including health and safety standards; criminal record screening of all employees and volunteers; and respondse to Concerns for the Safety and Wellbeing of Children and Young People Protocols. Services are visited regularly to ensure services are operating within service agreement requirements.

2.12.1 SAAP Service Standards 2002 (WA) The SAAP Service Standards 2002 for Western Australia was designed to regulate the quality of services being delivered by services receiving SAAP funding. Shelter in South Australia, has described the Western Australian standards as going ‘a long way towards identifying and articulating best practice and could be a sound framework for other states’.117 Standards for SAAP services in Western Australia were first introduced in 1996. The Standards were developed in consultation with SAAP providers across Western Australia and provided minimum standards which were ‘agreed, achievable and essential standards of service delivery’. 118 They were used as a guide for services and were not intended to be mandatory or to be prescriptive. Service providers were encouraged to aspire to higher than the minimum standards in the delivery of services. The 2002 Standards are a revised version of the earlier Standards. There are 14 service standards which comprise the Western Australian SAAP Service Standards 2002, which can be grouped in to five categories: 1. Direct service provision: Standards 1 to 4 Standard 1 - Access and eligibility: People have equitable access to services on the basis of need and consistent with the stated aims of the organisation and service agreement. Standard 2 - Planning and providing support: The service works in partnership with each client to identify his or her needs and, where appropriate, to develop a support plan. Standard 3 - Provision of supported accommodation to young people younger than 18 years, who are not with an adult: People younger than 18 years of age who are not with a responsible adult are assessed with regard to their circumstances, their age, their vulnerability and their legal status, and are provided with or assisted to access appropriate services. Standard 4 - Service provision to children accompanying parents/carers: Children accompanying parents/carers have their needs considered, and where possible are provided with or assisted to access appropriate services. 2. Client rights and participation: Standards 5 to 9 Standard 5 - Client responsibilities: Clients are aware of their rights and responsibilities while they are being supported and/or accommodated by the service.

117 Shelter SA, 2008, Response to “Which Way Home”: A New Approach to Homelessness’, p.9, viewed at www.sheltersa.asn.au/Documents/Response%20to%20Green%20Paper.pdf

118 Western Australian Government, Department for Community Development, SAAP Service Standards 2002, p. 3, viewed at www.community.wa.gov.au/NR/rdonlyres/930BD52B-EA09-4F18-A5F1- 1EFBBBD1BB3D/0/DCDPLNSAAPServiceStandardsWA2002.pdf

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Standard 6 - Privacy and confidentiality: The service respects the privacy and confidentiality of clients. Standard 7 - Client participation and decision making: The service encourages clients to take an active role in the decision making processes of the service. Standard 8 - Complaints procedures: The service has a complaints procedure in place for clients, which is clear and widely known. Standard 9 - Understanding and eliminating barriers: The service provider responds in culturally sensitive and appropriate ways to Aboriginal and Torres Strait Islander clients, to clients from culturally and linguistically diverse backgrounds, to clients with disabilities and to clients with diverse sexuality and gender expression. It actively works to identify and to eliminate any barriers clients may face in gaining support from the service. 3. Service networks to support clients: Standard 10 Standard 10 - Referral and support linkages: The service has effective referral and support linkages with relevant service providers, local community groups and government agencies to support clients. 4. Service management: Standards 11 to 13 Standard 11 - Service provider structure and decision making: The service provider has clearly defined decision making structures and processes, which facilitate effective service management and accountability. Standard 12 - Service planning and quality improvement: The service provider has in place processes to plan and review its activities and services, and direct resources to best meet the needs of the target group. Standard 13 - Human resource management: The service provider has effective human resource management systems in place. 5. Health and physical environment: Standard 14 Standard 14 - Health and safety: The service provides a safe and secure environment for clients and staff, where health and safety risks are minimised. These Standards are to be read in combination with the nationally agreed SAAP standards set out at Section 2.4.5. The guide to the Standards also notes that each standard appears in one area only although some standards may be relevant to more than one area. Not all standards apply to all service types. Individual agencies will be able to identify, with their Contract Manager, which standards are relevant to their particular service type. The Standards are also explicit about the need for services to comply with other types of legislation that may be relevant to their service, such as occupational health and safety and disability or local government regulation not included in the Standards. It remains the responsibility of the individual agencies to ensure that they are fulfilling all obligations under the law.119 The implementation guide included in the Standards states that all SAAP services are expected to work towards achieving the Standards. New services and existing services will be required to commit to working towards achieving the Standards during service agreement negotiations. The Standards will be monitored during service reviews by self-assessment and by sampling by Contract Managers. Before the services are reviewed they are sent a copy of the self assessment checklist for completion. The self-assessment is used during the discussion at the review. Each service review focuses on a select number of standards in detail. If a service is having difficulty meeting a standard, they are

119 Western Australian Government, Department for Community Development, SAAP Service Standards 2002, p. 10-12, viewed at www.community.wa.gov.au/NR/rdonlyres/930BD52B-EA09-4F18-A5F1- 1EFBBBD1BB3D/0/DCDPLNSAAPServiceStandardsWA2002.pdf

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required to develop an action plan to achieve the standard. If required, the Contract Manager will provide assistance. The Department for Child Protection, Learning and Development Centre has provided training to help services meet specific service standards. The standards described above relate to services funded by the SAAP program (now operating under the National Affordable Housing Agreement, NAHA, framework). Boarding houses, where they are used as crisis accommodation and are funded by SAAP are required to comply with the SAAP Service Standards for Western Australia outlined above.120 The regulation in place for services, including boarding houses, which do not receive SAAP/NAHA funding, is unclear. Similar to other states and territories, the regulation of boarding houses and other temporary accommodation is complex and controversial. A report published in 2005 by Shelter WA argues that ‘there is a complete absence of any form of consumer protection for boarders and lodgers in Western Australia’. While tenants in private rental and social housing have some protections, boarders and lodgers are not covered by any comprehensive legislation, such as the Residential Tenancies Act 1987 (WA). In Western Australia, there is no legislation that provides a framework for the regulation of boarding houses. The Health Act Local Laws (which was made pursuant to the Health Act 1911) provides conditions relating to the built and health conditions of boarding house premises. Boarding and lodging houses are required to be registered with the local government authorities under their respective health Acts. According to Shelter WA, Western Australia is the only jurisdiction that does not have any specific boarding house legislation (with the exception of NSW which has developed the Boarders and Lodgers Bill 2003, but has not passed the legislation).121

2.12.2 Boarding house legislation – comparison across states and territories A report prepared by Shelter WA provides a useful summary of boarding house legislation across the different states and territories.122 As stated in the report, the first major attempt at promoting a universal approach to boarding house legislation across all Australian states and territories was undertaken in 1996 by the Commonwealth Government’s Department of Housing and Regional Development.123 The approach of the reforms sought to remedy the imbalance between the rights of tenants and the rights of people staying in more temporary accommodation, stating that: ‘In general terms, there is no reason why most provisions of residential tenancies legislation should not have application to boarding houses. The nature of boarding houses is not considered sufficiently different to general private rental tenancies to warrant the lack of application of the basic 124 rights and responsibilities embodied in tenancy law.’ This report recommended that all Australian governments apply minimum legislation standards to their respective boarding house systems. Table 6 (presented over page) has been developed by Shelter WA. It identifies the relevant legislation across the states and territories and highlights key aspects in each of the legislative frameworks. Legislation for Western Australia is absent from the table, presumably because there is no specific legislation regulating the boarding house sector.

120 Shelter WA, prepared by Jim Anthony, 2005 (December), The Boarding House System in Metropolitan Perth, Occasional Paper 2005-2, p.7; viewed at www.shelterwa.org.au/publications/resandproj/OP2005-2.pdf

121 Ibid.

122 Ibid.

123 Town of Vincent: Guidelines for Lodging Houses, www.vincent.wa.gov.au

124 Town of Vincent: Guidelines for Lodging Houses, viewed at www.vincent.wa.gov.au, p. 93

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Table 5 – Comparison of boarding house/lodging accommodation

Boarders Residential Residential Residential Residential Residential and Tenancies Services Tenancies Tenancies Tenancies Lodgers Act 1997 [Accommodati Act 1995 Act 1997 Act Bill 2003 on] Act 2004 [NSW] [Vic] [QLD] [SA] [Tas] [NT]

Act Arrangements Proposed The Rooming Separate from Extended Part 4A of the Part 17 of the separate Act Houses Act Queensland protection for RTA applies to RTA provides RTA 1994 rooming Boarding limited cover housing premises for ‘special tenants in Jan class’ 2000 tenancies and ‘specified class’ of premises

Health covered by yes yes yes Yes Yes no other Act

Crisis Accom. yes yes yes No No yes covered by other Act

Boarders right to yes yes yes no No no reside

Boarders pay rent yes yes yes yes No no

Owners/Boarders yes yes yes yes Yes yes repairs/damage

Owners right of yes yes yes no Yes yes entry

Contract- yes yes yes yes Yes yes standard agreement

Rental bond & yes yes yes yes Yes yes rent advance

Reasons given for yes yes yes yes Yes yes termination & notice periods Source: Shelter WA, prepared by Jim Anthony, 2005 (December), The Boarding House System in Metropolitan Perth, Occasional Paper 2005-2: 8 Shelter WA provides an analysis of the different types of legislation, noting that the degree of protection for tenants’ rights provided by each jurisdiction varies significantly. Some jurisdictions provide basic housing rights for tenants, whereas other states provide boarders with a ‘basic package of explicit legal rights’. Some jurisdictions provide very little at all and some states have legislation that is difficult to interpret. It is significant where states and territories have chosen to protect different rights for boarders than for tenants. The report notes the inherent tension that exists in attempting to regulate the boarding house sector: while regulation may ensure better standards for accommodation, it is also likely to reduce the availability and the viability of boarding house supply.125 The relative advantages and disadvantages identified by Shelter WA are presented in Table 7 over page.

125 Shelter WA, prepared by Jim Anthony: 2005 (December),The Boarding House System in Metropolitan Perth, Occasional Paper 2005-2, p.10; viewed at www.shelterwa.org.au/publications/resandproj/OP2005-2.pdf

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Table 6 – Advantages and disadvantages of boarding house regulation

Advantages Disadvantages

Allows legislative protection and a minimal security of Financial viability: may induce shrinkage of available tenure for boarders and lodgers housing and a reduction of supply - if the regulatory framework is too stringent and costly on boarding house owners

In NSW the Residential Tribunal gives orders and May impact adversely on the flexible and short-term defines procedures which have to be adhered to in stay arrangements, which are popular with licensees regards to termination of agreements and evictions and with some tenants

Provides the boarders with reasonable termination The majority of boarding house residents are on very notice. In non-regulated jurisdictions the notice low incomes, which makes the payment of bonds and normally given by licensees to tenants is two days rents in advance difficult

Allows regular scrutiny and regulation of boarding houses’ physical conditions and their general health standards. In Western Australia this is carried out by local government officers under the Health Act Local Laws Source: Shelter WA, prepared by Jim Anthony, 2005 (December), The Boarding House System in Metropolitan Perth, Occasional Paper 2005-2: 9developed the most suitable best model of regulation?

2.13 Northern Territory Information regarding service standards and the protection of rights for homeless people in the Northern Territory is slim. The Northern Territory was a signatory to the Supported Accommodation Assistance Program V (SAAP V), which required compliance with SAAP standards. These are implemented through the NT SAAP Service Standards 1998. In the Northern Territory, SAAP was delivered by the Department of Health and Families. Housing in the Northern Territory is delivered by Territory Housing. Territory Housing’s stated objective is to deliver ‘safe, secure and affordable housing to all Territorians’.126 Its website also states that: ‘The need for shelter is fundamental to the health and wellbeing of individuals, families and the broader community. Housing underpins economic growth and sustainable development. It is an important channel for population growth and stability. Housing plays a vital role in building and maintaining strong communities across the Northern Territory, including those in regional and remote areas.’ There is minimal other information available about the protections in place for homeless people in the Northern Territory. Territory Housing’s services include private rental housing assistance and priority housing. The Tenancy Unit, within Consumer and Business Affairs, in the Northern Territory is responsible for the day-to-day administration of tenancy legislation. Services provided include advice to landlords and to tenants on their respective rights and responsibilities, and a comprehensive dispute resolution service.127

126 Territory Housing (Northern Territory), viewed at www.territoryhousing.nt.gov.au/

127 Northern Territory Government, Department of Justice, www.rentaustralia.com.au/content/cms/Renting+in+Northern+Territory/374/

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In 2008 there was a shift in Indigenous housing policy, following the Northern Territory Emergency Response triggered by the Wild and Anderson Report, Little Children are Sacred’.128

2.14 Quality frameworks operating overseas

2.14.1 Scotland The homelessness legislation implemented in Scotland since devolution and designed to protect the rights of homeless people has been described by the Scottish Executive as ‘the most progressive homelessness legislation in Europe’.129 The United Nations Committee on Economic, Social and Cultural Rights has singled out the Scottish legislation as ‘best practice’, especially in relation to the right to housing as an enforceable right.130

2.14.2 2001 Housing (Scotland) Act The Scottish Homelessness Taskforce was established in 1999 to investigate the causes and nature of homelessness, which led to the 2001 Housing (Scotland) Act. This Act was significant for two main reasons. Those were: firstly, it placed a duty on authorities to

− carry out homelessness strategies; and

− make advice and information free of charge and available to all. secondly, it increased the rights of homeless people by giving every homeless person the right to:

− temporary accommodation while their case is assessed;

− advice, information and temporary accommodation for a reasonable period (including non- priority applicants).

− the power for everyone to be able to review homeless decisions; and

− the power for ministers to establish minimum rights to people in hostels.131 The 2001 Housing (Scotland) Act led to the development of similar legislation in England and Wales with the establishment of the 2002 Homelessness Act. However, there remained a number of key protections in Scotland that did not exist in England and Wales. According to Homelessness Policy Watch: ‘In Scotland, any homeless person is owed the temporary duty to be accommodated, and any person is owed the temporary duty whilst their case is assessed. In England and Wales, such duties only apply to those who are judged to be in priority need.’ ‘The 2001 Housing (Scotland) Act paves the way for minimum rights for hostel dwellers through secondary legislation. No equivalent was included in the 2002 Homelessness Act in England and Wales.’

128 NT Shelter, 2009 (February), Submission to the Territory 2030 Steering Committee, p 22

129 Homelessness Policy Watch, About Homelessness, Scottish Legislative Framework, viewed at www.crisis.org.uk/policywatch/pages/scottish_legislative_framework.html

130 Bowcott, O., ‘UK should adopt pioneering Scottish homelessness law, says UN’, Wednesday 3 June 2009, viewed at www.guardian.co.uk/society/2009/jun/03/un-scottish-homelessness-law-recommendations-housing

131 Homelessness Policy Watch, About Homelessness, Scottish Legislative Framework, http://www.crisis.org.uk/policywatch/pages/scottish_legislative_framework.html

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The 2001 Housing (Scotland) Act amended the definition of homelessness, such that the ‘threatened with homelessness' definition was extended from one-month to two months.’132 As a result, the legislation is applicable to a person if ‘it is likely that he will become homeless within two months’, on the basis of the definition of ‘homeless’ set out in the section 3, Housing (Scotland) Act 2001.133 A number of other significant developments have occurred in relation to homelessness legislation in Scotland. The Scottish Homelessness Taskforce made 59 recommendations which were endorsed by the Parliament and were incorporated into the 2003 Homelessness etc (Scotland) Act. In particular the Act and the supporting policies aim to phase out the priority need categories by 2012, which had previously underpinned the allocation of housing. This means that by 2012 all people will have a right to housing, not only those in priority need categories, such as women with children. Other significant developments include increasing the duties of authorities to people who are intentionally homeless. When implemented this provision meant that authorities had a duty to provide people who were intentionally homeless, with Short Scottish Secure Tenancy (SSST). The legislation also suspended the local connection provisions that existed in previous legislation. Previously, local authorities were able to refer applicants to other jurisdictions where the applicant had a stronger local connection. The 2003 Homelessness etc. (Scotland) Act suspended this clause in Scotland to ‘avoid local authorities sometimes filtering applications before they are made’.134 Both the 2001 Housing (Scotland) Act and the 2003 Homelessness etc (Scotland) Act allow for amendments to secondary legislation. This includes the power to legislate on ‘the suitability of accommodation’ and on ‘the rights of people in non-tenancy accommodation (primarily hostel dwellers)’. The Unsuitable Accommodation (Scotland) Order 2004 legislates for accommodation for families and pregnant women to meet certain standards, such as the exclusive use of a toilet and sink, and access to cooking facilities. There have also been attempts to legislate to create minimum rights for hostel dwellers and people in temporary accommodation, through the regulations under Section 7 of the 2001 Housing (Scotland) Act, including a right to a minimum notice period. Difficulties in integrating the regulations with other housing legislation have delayed the process of implementing these regulations.135

2.14.3 Summary and conclusions This section has reviewed a range of international and Australian quality frameworks that have a bearing on the homelessness service sector. The key findings of this section have been included in the final chapter of this document, which identifies the potential components of a national quality framework for the homelessness service sector. In summary, there is an increasing focus internationally and in Australia on the need to provide for improved regulation of services to homeless people. In many areas, this move is underpinned by a rights-based legislative framework, which is often a combination of human rights approaches and of consumer rights frameworks and principles. The precise nature of these rights and principles (and the extent to which they are protected in practice) is not always clear and varies considerably by jurisdiction. Some states have moved towards developing standards that are protected in legislation while others have preferred a continuous quality improvement framework for accreditation, which is overseen by a third party. Some of the considerations that emerge from the review of existing quality frameworks include: the type of quality framework that is most appropriate including, for example, whether an accreditation system should be underpinned by legislation and/or linked to funding;

132 Ibid.

133 Govan Law Centre, viewed at http://www.govanlc.com/section24as_amended

134 Ibid.

135 Ibid.

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the nature and extent of the rights that are to be protected under the new framework; whether accreditation processes should be based on a human rights framework and include rights such as the right to temporary accommodation (which is protected by legislation in Scotland); the proposed scope of the national quality framework and the most appropriate way to include services that were not previously funded under SAAP, particularly in regards to the private rental market, to boarding houses and to caravan parks; the most appropriate structures that need to be in place to ensure there is independent review and consumer protection in place, including appeals mechanisms, auditing, and sufficient complaints processes; the need to provide a clear and straightforward process that, for example, does not deter services from applying for accreditation. This will include providing guidance about how to navigate the range of other legislative requirements that services need in order to achieve accreditation – if this is an element of the national quality framework; and the importance of stakeholder engagement, especially with the states and territories in order to achieve collaboration and to overcome limitations in the Australian Constitution. Overall, consideration of the experiences and successes of each of the states and territories in implementing their own quality frameworks within the homelessness service sector is an important component of this research. Considering the ways in which other sectors, including the disability sector, have implemented quality frameworks also offers important lessons for the development of an accreditation system in the homelessness service sector. Table 7 below provides a summary of the key issues covered in this section, including the relevant sections in which they are discussed. Table 7 – Summary reference guide to existing quality frameworks – Australia and overseas136

Legislation/international Policy/quality mechanism Relevant Jurisdiction instrument section International Universal Declaration of Human Section 2.2 Rights 1948z International Covenant on Economic, Social and Cultural Rights (ICESCR) 1976 International Covenant on Civil and Political Rights (ICCPR) 1976

Australian (Cth) Supported Accommodation National Affordability Housing Section 2.3 Assistance Act 1994 Agreement and National Partnership Disability Services Act 1986 Agreement on Homelessness Anti-Discrimination Act 1977 National SAAP Standards (endorsed 1996) Social Security Act 1991 Housing Assistance Act 1996 National Human Rights Consultation leading to potential Cth human rights legislation

136 Note: This list is not exhaustive.

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Legislation/international Policy/quality mechanism Relevant Jurisdiction instrument section Victoria Charter of Human Rights and Homelessness Assistance Service Section 2.6 Responsibilities Act 2006 Standards (HASS) Residential Tenancies Act 1997 Homelessness Advocacy Service (HAS)

Queensland Residential Tenancies and Rooming Standards for Community Services Section 2.7 Accommodation Act 2008 (2007) The Residential Services (Accreditation) Act 2002

New South Residential Tenancies Act 1987 Performance Monitoring Framework Section 2.8 Wales (NSW) for SAAP services NSW SAAP Standards 1998

Australian Human Rights Act 2004 Homelessness Charter (the Section 2.9 Capital Territory Residential Tenancy Act 1997 (ACT). Supported Accommodation Assistance Program Guarantee)

ACT Service Guarantee Good Practice Standards 2002

South Australia Residential Tenancies Act (1995) SAAP Performance Management Section 2.10 Local Government Act (1934) Framework 2005 Public Health and Environmental Health Act (1989) Development Act (1993).

Tasmania Residential Tenancy Act 1997 Tasmanian SAAP Service Section 2.11 Standards 2006 Community Services Core Module Standards

Western Residential Tenancies Act 1987 (WA) WA SAAP Service Standards 2002 Section 2.12 Australia Health Act Local Laws (pursuant to the Health Act 1911)

Northern NT SAAP Service Standards 1998 Section 2.13 Territory

Scotland Housing (Scotland) Act 2001 Section 2.14 Homelessness etc (Scotland) Act 2003

United Kingdom Human Rights Act 1998 Section 2.3.2, Homelessness Act 2002 Section 2.14

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3 Homelessness service provision – an overview

3.1 Introduction In order to set the context for the potential development of a national service charter for mainstream and specialist homelessness services, this section provides a broad overview of the current scope of the homelessness service provision sector within Australia, across the states and territories. This overview encompasses services currently operating within what has until recently been the overarching government service provision and funding framework - the Supported Accommodation Assistance Program (SAAP) - and also outside of this, including charities, private sector services, and non- government organisations not currently funded through SAAP. It encompasses mainstream or non- accommodation-related support services, along with secondary and tertiary accommodation providers, including operators of boarding houses, hostels and caravan parks. The social housing and community housing sectors – comprising a range of government and non- government organisations and private sector businesses – also play important roles in providing accommodation for homeless people who may have progressed through a continuum of service provision to longer-term accommodation, or for those at risk of homelessness who may be assisted through affordable housing provision. The expansion of affordable and community housing provision is a key tenet of the government’s present response to the growing problem of homelessness, since the lack of provision of affordable housing is recognised as a key cause of homelessness. One element of the strategy set out in the White Paper on Homelessness, for example, is the construction of up to 2,700 additional public and community housing dwellings for low-income households.137 However these sectors are not considered in detail within this overview, since they are governed by a legislative and regulatory system and policy framework largely distinct from that applied to the service providers who are the primary focus of this report. The community housing sector is the subject of a separate case study which has been prepared as part of this report.

3.2 The national policy framework for service provision Recent announcements by the Commonwealth Government, coupled with recent economic events, have strengthened the focus on housing and homelessness as a key policy priority. This is evidenced by the suite of new policy developments introduced in the past 18 months. In January 2008, Prime Minister Kevin Rudd announced the government’s intention to make reducing homelessness a national priority and to include it in the government’s long term plans for implementing its social inclusion agenda. Shortly thereafter the government released a Green Paper on Homelessness, Which Way Home?138 This stimulated discussion and debate on homelessness, resulting in more than 600 written submissions, 13 public consultations involving 1,200 people, as well as separate input from state and territory governments, people experiencing homelessness, service providers, peak bodies and academics. The government’s subsequent White Paper on Homelessness, The Road Home, and the National Partnership Agreement on Homelessness are the most significant recent policy developments. These are discussed in greater detail in the section below. Other important initiatives include:

137 Ibid., p.xi 138 Australian Government, May 2008, Homelessness Green Paper: Which Way Home? A New Approach to Homelessness

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The National Affordable Housing Agreement (NAHA): Introduced on January 1st 2009, this includes measures at the Commonwealth, state and local government levels that contribute to housing affordability. The National Partnership Agreement on Social Housing: Commenced January 1st 2009 this entails a commitment by Commonwealth and state and territory governments to a National Partnership (NP) on Social Housing. Under this NP the Commonwealth is providing $400 million over two years for capital investment for social housing. The states will increase the supply of social housing through the new construction of 1,600 to 2,100 additional dwellings by 2009-10. A Place to Call Home: Commenced in July 2008, this provides $150 million over five years to states and territories to create 600 new homes for those who are homeless. The National Rental Affordability Scheme: NRAS aims to stimulate the supply of up to 50,000 new affordable rental dwellings. The Housing Affordability Fund: the HAF will invest up to $512 million over five years to lower the cost of building new homes. In February 2009 the Commonwealth Government announced a $42 billion Nation Building and Jobs Plan designed to respond to the impacts of the global financial crisis. The economic stimulus package has taken steps to prevent an increase in homelessness by supporting employment and economic growth. Initiatives relate to household energy efficiency, school building construction, the creation of new social and defence homes, cash payments, business investment tax breaks, and community infrastructure projects. It is anticipated that stimulus initiatives will provide a boost of around 0.5% of GDP in 2008-09 and around 0.75-1% of GDP in 2009-10.

3.2.1 White Paper on Homelessness: The Road Home The White Paper on Homelessness, The Road Home, was launched in December 2008 and commits the Commonwealth Government to an additional $1.2 billion in funding to address homelessness, over four years. The White Paper outlines a plan for reducing homelessness in Australia by 2020, with specific goals to halve overall homelessness and to provide accommodation to all rough sleepers who seek it. One of the specific goals of the White Paper is ‘implementing new legislation to ensure people who are homeless or at risk of homelessness receive quality services’.139 The proposed response to homelessness will be implemented through three strategies: Turning off the tap (better prevention of homelessness), Improving and expanding services (to assist a greater number of homeless people), and Breaking the cycle of homelessness (by providing long-term housing and support). The key interim targets for 2013 are: Overall homelessness reduced by 20%. Primary homelessness reduced by 25%. The proportion of people seeking specialist homelessness services more than three times in 12 months reduced by 25%. To track progress, the White Paper proposes that a number of interim targets for 2013 be developed with the states and territories, relating to: engaging with employment, education and training; people exiting care and custodial settings into homelessness; families maintaining sustainable housing following domestic violence;

139 Australian Government, 2008, White Paper - The Road Home, A National Approach to Reducing Homelessness, p. 44

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people exiting social housing and private rental accommodation into homelessness; young people having improved housing stability and engagement with family, school and work; children being provided with additional support and being engaged in education; families receiving financial advice, counselling and/or case management; and the provision of legal services.

3.2.2 National Partnership Agreement on Homelessness The National Partnership Agreement on Homelessness outlines how the Commonwealth and the states and territories will work together to reduce homelessness by 2013. The Agreement aims to contribute to the following outcomes: Fewer people will become homeless and fewer of these will sleep rough. Fewer people will become homeless more than once. People at risk of or experiencing homelessness will maintain or improve connections with their families and communities, and maintain or improve their education, training or employment participation. People at risk of or experiencing homelessness will be supported by quality services, with improved access to sustainable housing. The Agreement proposes to improve service provision and coordination, engagement with education, legal services and workforce development and to connect outreach programs with long-term housing and health services. Action plans will focus on assistance in areas identified as having high rates of homelessness. Priorities are given to the demographic cohorts of older people, substance users, those with mental illness, young people, and women and children experiencing domestic violence. The Agreement sets out national performance indicators and benchmarks for 2013, relating to: reducing the overall number of homeless people; reducing the number of Indigenous homeless people; reducing the number of Australians sleeping rough; reducing the number of people released from institutions into homelessness; reducing the number of people moving from social and private rental housing to homelessness; and reducing the number of presentations at emergency services. The Homelessness National Partnership (NP) payment provides recurrent funding of $800 million over four years – $400 million of that being Commonwealth funding which will be matched by the states and territories. A breakdown of funding is outlined in Table 9 below. Table 8 – National Partnership funding

Year Commonwealth contributions State and territory contributions 2009-10 $71.1 million $ 75.0 million

2010-11 $ 102.5 million $ 105.0 million

2011-12 $ 107.5 million $ 110.0 million

2012-13 $ 107.5 million $ 110.0 million

Commonwealth’s own expenditure $11.4 million

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3.2.3 The Supported Accommodation Assistance Program (SAAP) Prior to the introduction of the National Affordable Housing Agreement (NAHA) in January 2009 and the National Partnership Agreement on Homelessness in July 2009, the Supported Accommodation Assistance Program (SAAP) was Australia’s primary policy response to homelessness (established in 1985).140 SAAP aimed to assist people who were homeless or at risk of becoming homeless to achieve the maximum possible degree of self-reliance and independence by providing transitional supported accommodation and a range of related support services. An estimated 1,562 non-government, community and local government organisations were funded nationally under SAAP in 2007-08 to provide support and/or accommodation to people who were homeless or at risk of homelessness.141 SAAP-funded organisations ranged from small standalone agencies with single outlets, to larger bodies with multiple outlets. Each agency has been focused mainly on supporting a particular client group or combination of client groups. SAAP agencies operate through a case management approach to clients, in which either an individual worker or a team provides services and support for an individual client or service user. This approach is defined as follows: ‘Case management within SAAP Services is a collaborative, client-focused approach. It is aimed at empowering and working with clients to effectively meet individual needs. It is a two pronged approach incorporating direct client service, based on sound assessment and support planning, and coordination of access to and delivery of, a range of other appropriate support services. The SAAP Worker operates within an agreed framework of principles, standards and ethics which enhance client choice and responsibility.’142 SAAP was administered under five-year multi-lateral and bi-lateral agreements with the Australian Government, which provided recurrent funding for salaries and operating costs. The agreement which preceded the National Partnership Agreement on Homelessness (NPAH), in operation from 2005 – 2010, was known as SAAP V. Its national priorities for dealing with homelessness were: maintenance and enhancement of involvement in early intervention and prevention strategies; provision of better assistance to people who have a number of support needs; and provision of ongoing assistance to ensure stability for clients after they have experienced a crisis. According to the Australian Institute of Health and Welfare (AIHW), about half of the potential clients of SAAP were not able to be accommodated on any given night.143 Despite innovative models for the delivery of SAAP resources, ‘turn-away rates’ had not declined in recent years.144 On an average day SAAP providers around the country have been turning away up to 350 people seeking immediate accommodation – around a third of them children. In the majority of cases this has been due to a lack of availability. In its 2007 assessment of demand for SAAP services the AIHW reported that ‘SAAP agencies appear to be operating to capacity, with demand for SAAP accommodation unable to be completely met. IT

140 Queensland Department of Housing and Department of Communities, 2008, Review of program management arrangements for the Supported Accommodation Assistance Program and the Crisis Accommodation program: Final Report, p. 2 141 Australian Institute of Health and Welfare, 2009 (April), SAAP National Data Collection Annual Report 2007-08, SAAP NDC report, Series 13, Cat. No. HOU 191, Canberra: AIHW, viewed at http://www.aihw.gov.au/publications/hou/hou-191-10662/hou- 191-10662.pdf 142 Australian Government Department of Families, Housing, Community Services and Indigenous Affairs, 2007, SAAP Case Management – Resource Kit for SAAP Services, Section 1.1, accessed at www.fahcsia.gov.au/sa/housing/pubs/homelessness/saap_er_publications/saap_case_mgmt_resource_kit/section_1/Documents/ SEC01.pdf

143 Australian Institute of Health and Welfare, 2007, Demand for SAAP accommodation by homeless people 2005–06: a report from the SAAP National Data Collection. SAAP NDCA report, Series 11. Cat. no. HOU 169. Canberra: AIHW 144 Ibid.

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also reported that ‘some groups experience more difficulty than others in obtaining SAAP accommodation’145 and that demand for supported accommodation was high, with less than 15% of the total population of homeless people able to be accommodated by SAAP resources on any given night.

3.2.4 The Crisis Accommodation Program (CAP) Also rendered obsolete by the new National Partnership Agreement on Homelessness was the Crisis Accommodation Program (CAP), which was introduced under the Commonwealth State Housing Agreement in 1985.146 It aimed to provide appropriate, affordable and secure housing assistance for those who need it most, for the duration of their need. The program primarily provided capital funding and grants to complement the recurrent funding for salaries and operating costs provided by SAAP (described above). CAP funding was allocated where an organisation had demonstrable capacity to manage additional clients, and funds were primarily directed towards tenancy management.

3.3 Service provision for homeless people The homelessness service provision sector is a complex and dynamic system which caters for the needs of a diverse client group of all ages, nationalities and levels of physical and mental health. Over their lifetime, this clientele may ‘cycle through’ different services – from crisis or transitional accommodation through to boarding houses and other secondary services, and back again. The system rarely operates as a neat continuum of service provision due to the nature of its clientele and of the service provision sector, as is discussed in Section 1 of this report, Homelessness in Australia. As is pointed out in the government’s White Paper on Homelessness: ‘For some people, homelessness is an isolated event – it happens once and for a short time. For others, a small minority, homelessness is part of a chaotic and uncertain life of poverty and disadvantage. These people tend to cycle in and out of homelessness and when they do find housing, it tends to be short term.’ 147 In recognising the complex structure of the accommodation and support services sector for homeless people and for those at risk, it is useful to apply the Australian Bureau of Statistics’ (ABS) cultural definition of homelessness, which establishes a primary, secondary and tertiary classification of homelessness, based on research conducted by Chamberlain and MacKenzie148 These definitions, along with their limitations, are outlined in Section 1 of this report. Taking into account the difficulty of obtaining an accurate picture of the number of homeless people in Australia, it is estimated that on any given night there are approximately 104,700 people who fall into one of the abovementioned homeless classifications. A detailed profile of the homeless population within Australia is also provided in Section 1. Figure 2 on page 57 illustrates the broad range or continuum of accommodation providers and support services relevant to the homelessness sector – from early intervention and crisis accommodation classified as secondary homeless services, through to longer-term forms of accommodation offered within the tertiary sector, through to more secure forms of accommodation offered within the social and community housing sectors.

145 Australian Institute of Health and Welfare, 2007, Demand for SAAP accommodation by homeless people 2005–06: a report from the SAAP National Data Collection. SAAP NDCA report, Series 11. Cat. no. HOU 169. Canberra: AIHW 146 Queensland Department of Housing and Department of Communities, 2008, Review of program management arrangements for the Supported Accommodation Assistance Program and the Crisis Accommodation program: Final Report, p.3 147 Ibid., p.xi 148 Chamberlain, C., and MacKenzie, D., 1992, ‘Understanding contemporary homelessness: Issues of definition and meaning’, Australian Journal of Social Issues, vol. 27, issue 4, p.291 in Chamberlain, C. and MacKenzie, D., Counting the Homeless 2006: Queensland, AIHW, July 2009, p.7

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These sectors are discussed below, noting that people or ‘clients’ may access one or a number of these services and accommodation sectors over any given time period. Early intervention Government policy recognises the importance of early intervention for those at risk of homelessness, noting that homelessness can often be prevented. The White Paper on Homelessness explicitly states that ‘prevention and early intervention are the most effective and efficient ways to reduce homelessness’.149 Strategies may focus on people in life transition points, such as the period following family breakdown or an exit from statutory care or prison into the community, and on those in housing stress. Providers of early intervention services, such as advice, information, brokerage, advocacy and referrals include state housing authorities and other agencies, such as those responsible for mental health, child protection and criminal justice; peak sector bodies – both national and state/territory-specific; community service organisations; and charities and the private sector, such as landlords and real estate agents. A number of government programs currently operate with a focus on early intervention. For example, under the National Partnership on Homelessness, which operates through a Coalition of Australian Governments (COAG) agreement, state and territory governments are encouraged to prevent evictions from all types and tenures of accommodation through providing tenancy support programs for people in social housing and the private rental market. These support services include forms of financial assistance such as bond and rental payments, along with non-financial assistance such as guidance, support and referrals to appropriate support services.150 Other government early intervention initiatives include: The Job Placement Employment and Training Program (JPETP), which provides assistance to 15- 21-year-olds who are homeless or at risk. An estimated 14,000 are people helped annually by the network of JPETP service providers who are contracted by the Commonwealth Department of Employment and Workplace Relations (DEWR). Reconnect, which supports 12-18-year-olds who are homeless or at risk. Ninety-eight Reconnect services existed in 2002, including 14 Indigenous-specific services. The Household Organisational Management Expenses (HOME) Program, which involves service partnerships between community organisations and government agencies plus local Centrelink offices and social workers, which are funded to provide early intervention for families at risk of homelessness. The initiative is focused on financial stability, family health, wellbeing, and participation in employment and training, and it had assisted an estimated 2,190 families by 2007.151 The Government is currently recommending a ‘no discharge into homelessness’ policy for vulnerable people leaving prison or statutory care, including psychiatric facilities. The proposed model incorporates accommodation and related support services, including education and training, and assistance with finding both employment and housing.152 A number of large, national faith-based charities, including the Salvation Army and the St Vincent de Paul Society, already operate early intervention programs based on this model.

149 Ibid., p.24 150 Ibid., p.25

151 Ibid., p. 28

152 Ibid., p.27

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Specialist homelessness services Services previously funded under SAAP were targeted at ‘the chronically homeless or those who were temporarily homeless as a result of crisis.’153 As is discussed in detail in Section 3.2.3 above, they provide a range of assistance, from early intervention and support strategies that prevent homelessness, through to crisis and emergency support and accommodation, to transitional and post-crisis support. All services are provided using a common case management approach which works with the individual to develop options to resolve crises and to move from support to independence.154 Crisis accommodation A broad range of accommodation may be classified as ‘crisis accommodation’ which is accommodation accessed by people who may be chronically homeless or in a temporary crisis. These include refuges, hostels, motels, caravan parks, boarding houses and the homes of a person’s friends or relatives. A range of providers operate within this sphere, including large, national faith-based charities; small, localised charities; local governments; private sector providers; and non-government organisations. Providers of emergency or transitional accommodation under the previous SAAP system may also be classified as crisis accommodation providers. On the basis of the definition of secondary homelessness provided by Chamberlain and MacKenzie,155 crisis accommodation in relation to boarding houses would include situations where the person is staying for 12 weeks or less. Social and community housing The social and community housing sector includes state housing agencies which provide social or public housing, and a range of non-government and private sector providers of community housing. As is discussed in the community housing sectoral case study, which is provided at Appendix A of this report, the sector is generally highly fragmented: of the 1,069 community housing providers at June 30th 2008,156 three-quarters managed less than 20 dwellings each while 15% of community housing providers managed between 20 and 49 dwellings, and only 11% of providers managed 50 or more dwellings. Community housing providers include a range of organisations. A survey of 613 out of 1,735 community housing providers in Australia in 2006 found that 31% are welfare or not-for-profit organisations, 25% are specific community housing organisations, 21% are community housing cooperatives, 14% are local government organisations, and 7% are church-based organisations.157 There were approximately 35,667 households living in community housing in Australia at June 30th 2008 occupying more than 99% of tenantable community housing stock.158 Of these, 6% were identified

153 Ibid., p41 154 NSW Department of Community Services, 2007 (October), Supported Accommodation Program (SAAP) Program Guidelines, viewed at http://www.community.nsw.gov.au/docswr/_assets/main/documents/saap_guidelines.pdf

155 Chamberlain, C., and MacKenzie, D., 1992, ‘Understanding contemporary homelessness: Issues of definition and meaning’, Australian Journal of Social Issues, vol. 27, issue 4, p.291 156 Community housing for the purpose of this collection includes dwellings where funding (capital and/or recurrent) is provided fully or partly through the CSHA, where the tenancy management functions are undertaken by a community provider or local government and a principle of the community provider is to provide medium- to long-term housing tenure to tenants. The definition also excludes non-CSHA programs and properties owned and managed by community housing providers not funded under the CSHA. It specifically excludes dwellings funded under the Crisis Accommodation Program. AIHW 2009 p 3 157 Community Housing Federation of Australia, May 2007, Community Housing Mapping Project 2005-06 - Report on Findings:, pii 158 Australian Institute of Health and Welfare, 2009, Community Housing 2007-08: Commonwealth State Housing Agreement national data report, p ix

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as Indigenous households, 28% contained households with a disability, and 14% were from a non- English-speaking background. A total of 7% of principal tenants were aged 24 years or younger and 8% of principal tenants were 75 years or older. Private sector Private sector organisations play a significant role in providing accommodation for people who are chronically homeless or in a temporary crisis. These organisations may include operators of boarding houses, hostels, hotels and motels, and caravan parks – all of which may be accessed by homeless people at any given time. On Census night in 2006 an estimated 21,596 people – 20% of the population counted as ‘homeless’ on that night – were residing in boarding houses. This sector accounted for the second highest proportion of the homeless population after those staying with friends and relatives (45%). Private sector providers account for both secondary and tertiary accommodation under the definitions provided by Chamberlain and MacKenzie,159 in that they may house a homeless person for short periods of time (up to and including 12 weeks) or in the medium to long-term (defined as more than 13 weeks). An illustrative summary of homeless people’s pathways into and between various forms of accommodation and related support services is illustrated at Figure 2 on page 58. As has been previously stated, it is important to note that it is not possible to depict a neat continuum of service provision and accommodation/tenure types in the homelessness sector, due to the sector’s complex nature. People at risk of homelessness and those who are in crisis and temporarily homeless or chronically homeless may access one or a number of these accommodation types and services at any given time.

159 Chamberlain, C., and MacKenzie, D., 1992, ‘Understanding contemporary homelessness: Issues of definition and meaning’, Australian Journal of Social Issues, vol. 27, issue 4, p.291

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Figure 2 – Access to accommodation and support services for the homeless and those at risk

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3.4 Overview of the homelessness service sector The following section provides an overview of the current structure of the homelessness service sector. The current legislative and regulatory components of the system are described in detail in Section 2 of this report and an overview of the existing funding and delivery framework for homelessness services is provided at Figure 3 on page 83. It is important to note that this overview does not provide a fully accurate, comprehensive picture of the sector: it is a preliminary overview of the sector’s basic structure and the key providers located across metropolitan and rural or remote areas.160 It should be noted that rates of homelessness are currently higher in rural and remote areas, which accounted for 62% of rough sleepers counted on 2006 Census night.161

3.4.1 Secondary provision – accommodation and mainstream support services An analysis of the Supported Accommodation Assistance Program (SAAP) data162 indicates that access to early intervention and crisis accommodation and support services available for people experiencing homelessness has increased in recent years. Table 10 below outlines the number of people receiving support through the SAAP over a five-year period. The table indicates that the number of people receiving support from SAAP services has steadily increased since 2003, with the most significant increase occurring from 2005-06 to 2006-07.

Table 9 – Number of people receiving SAAP assistance (Australia)

Year Number of people receiving assistance 2007-08 202,500

2006-07 187,900

2005-06 161,200

2004-05 157,200

2003-04 152,900 Source: SAAP National Data Collection 2005-06, 2006-07 and 2007-08, and Thompson, D., 2007163 These figures correlate with 2006 Census data164 which reveals that, since 2001, persons living in accommodation managed by SAAP-funded services have increased most significantly when compared with other types of accommodation. This is illustrated in Table 11 over page.

160 Note: this overview will be further developed following interviews conducted with service providers as part of this research. These interviews will consider existing networks of service provision, funding streams, and current workforce capacity

161 Australian Government, 2008, Homelessness White Paper - The Road Home: A National Approach to Reducing Homelessness, p.41

162 SAAP National Data Collection, Homeless People in SAAP, Annual Report, 2006-07, Australia 163 Thompson, D., ‘What do the published figures tell us about homelessness in Australia?’ in the Australian Journal of Social Issues, Vol. 32, No.3, 2007 164 Chamberlain C., and MacKenzie, D., ‘Counting the Homeless, Australia’, Australian Bureau of Statistics, Census 2006

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Table 10 – Increase in SAAP funding and agencies 2005-06 to 2007-08

Increase Year 2005-06 2006-07 2007-08 (2005-06 to 2007-08) Total funding allocation $348.8m $383.0 m $400.4 m 4.5%

Funding directly to the SAAP $333.4m $367.3 m $383.9 m 4.5% agencies

Number of SAAP agencies 1,300 1,539 1,562 4,401 (total)

In 2007-08 it was estimated that one in every 104 Australians received substantial SAAP support at some time, an increase on2006-07 when it was estimated that one in every 110 Australians received support. In 2005-06, 106,500 clients and 54,700 accompanying children were assisted. In 2006-07, 118,800 clients and 69,100 accompanying children were assisted. In 2007-08, of the total clients receiving assistance, 125,600 were adults or unaccompanied children (clients) and 76,900 were accompanying children. These figures highlight the rise in accompanying children being assisted through the program: the 2007-08 figure equates to one in every 64 children in the general Australian population aged 17 years and under (or 156 children per 10,000).165

The table indicates that the considerable rise in the number of people receiving support from SAAP in recent years is partly related to funding alterations. In 2006-07, the total recurrent allocation to SAAP was $383.0 million. In 2007-08, the total funding allocation to SAAP was $400.4 million, a 14.8% increase from 2005-06. In 2006-07, funding given directly to the SAAP agencies was $367.3 million; in 2007-08 funding given directly to the SAAP agencies was $383.9 million - an increase of 15.1% from 2005-06. Increases in funding have enabled a greater number of agencies to become involved in SAAP – in 2005-06 there were 1,300 SAAP agencies, while in 2007-08 there were 1,562 SAAP agencies, an increase of 262 agencies. Table 12 provides a snapshot of SAAP services required by clients across Australia in 2007-08.

Table 11 – SAAP services required by clients across states and territories during 2007-08

Service type (% of total) Total AUS NSW VIC QLD WA SA TAS ACT NT (total) Housing/accommodation 66.0 45.6 72.2 69.3 71.5 67.9 83.2 78.0 111,100

Financial/employment 31.6 46.1 44.5 33.8 28.4 34.6 53.2 53.7 70,500

Personal support 59.9 47.9 48.3 50.0 70.9 63.4 74.7 64.5 99,100

General support/advocacy 84.0 82.4 69.5 59.3 87.3 74.5 85.9 68.6 143,000

Specialist services 27.8 21.0 25.8 36.9 32.2 15.3 44.2 27.4 47,400

Basic support/other services 59.4 27.5 57.2 69.8 40.7 46.8 62.9 68.6 85,800 Source: SAAP Annual National Performance Report 2007-08, p.59166

165 Australian Institute of Health and Welfare, 2009 (April), SAAP National Data Collection Annual Report 2007-08, SAAP NDC report, Series 13, Cat. No. HOU 191, Canberra: AIHW, viewed at http://www.aihw.gov.au/publications/hou/hou-191-10662/hou- 191-10662.pdf, p.13

166 Ibid., p.59

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Of the total of 111,100 housing/accommodation services provided during 2007-08, 74,500 of these services were specifically providers of SAAP/CAP (Crisis Accommodation Program) accommodation while the remainder were services which provide assistance in obtaining or maintaining accommodation. It is important to note that these accommodation figures exclude the range of organisations which operate outside SAAP networks and are largely independent of government funding. This is particularly important to note in states such as Queensland where SAAP networks account for a lower proportion of the service provision sector. On Census night in 2006, for example, 19% of the homeless across Australia were in SAAP accommodation compared to 12% in Queensland.167 In considering SAAP networks specifically, in 2007-08, National Collection Data shows that SAAP or CAP accommodation was able to be provided directly to clients and their accompanying children in the majority of cases (87% and 85% respectively). When it could not be provided directly, it was referred on in 8% of cases to other organisations and remained unmet in 5% of cases for clients and in 7% of cases for accompanying children. In relation to SAAP services more broadly, data indicates that clients’ needs were able to be met directly by SAAP service providers in 90% of cases; agencies were able to refer clients to other organisations for a further 6% of required services.168 Specialist services (including psychiatric services, drug or alcohol support and physical disability services) were the least likely group of services to be directly provided when required (67%).169 In 2007-08, the most common unmet needs were for specialist services (10%), for housing and accommodation services (7%), and for financial or employment services (6%). When considered as a proportion of all unmet needs (as opposed to as a proportion of all required services) the most common service types for which client’s needs were not met nor referred were housing or accommodation services (accounting for 31% of unmet needs), followed by specialist services (19%), and financial or employment services (15%). The figures for unmet housing and accommodation service needs have remained relatively stable since 2006-07, when this represented the second most common service sector for unmet needs (7%), after specialist services (9%) and on par with financial and employment services (7%). In 2005-06, on par with 2007-08, housing and accommodation services accounted for a total of 31% of all unmet needs, followed by specialist services (20%). Across the jurisdictions, the providers of primary homelessness services – both accommodation and mainstream services and within and without the SAAP system – share a number of basic similarities in their structure and models of service provision. All primary service types are generally available in all jurisdictions, however the geographical spread and local accessibility of these services varies significantly, particularly among more specialised services. One of the most significant groups of service providers in the homelessness sector are large faith- based charities such as the St Vincent de Paul Society, Mission Australia, the Salvation Army, Anglicare, and the Young Women’s Christian Association (YWCA). These charities operate across all jurisdictions, and depending on the jurisdiction, may provide basic support services such as meals, transport, and cleansing, as well as housing and accommodation support services, general support services (including advocacy, living skills, and information), specialist services, such as immigration, medical, and psychological services, and personal services, such as support with emotional issues, family violence, and problem gambling issues.

167 Chamberlain, C. and MacKenzie, D., Counting the Homeless 2006: Queensland, AIHW, July 2009, p.8

168 Australian Institute of Health and Welfare, 2009 (April), SAAP National Data Collection Annual Report 2007-08, SAAP NDC report, Series 13, Cat. No. HOU 191, Canberra: AIHW, viewed at http://www.aihw.gov.au/publications/hou/hou-191-10662/hou- 191-10662.pdf, p.54

169 Ibid.

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The large, often national nature of these faith-based charities enables them to provide integrated services which target sequential points along the homelessness pathway, as well as holistic services which provide for whole-of-life factors that contribute to a person’s experiences of homelessness. They may also provide singular services, such as accommodation support. Examples of these services include Mission Australia in NSW and the YWCA in Darwin. Structured, integrated and holistic services may also be delivered by larger secular organisations, such as Colony 47 in Tasmania and Hanover in Victoria. In a number of larger states and territories, a series of coordinating mechanisms and bodies oversee the development and coordination of service provision and improvements to service delivery. These include: Organisations which act as a central point of contact for persons experiencing homelessness. Examples of these include the Homeless Persons Information Centre (HPIC), which is operated by City of Sydney Council but is active throughout NSW, and the Homeless Persons Information Queensland (HPIQ), which is operated by the Queensland Government. Other jurisdictions also have hotlines which specifically coordinate crisis accommodation, such as the Crisis Accommodation Information Line in Victoria. Organisations which advocate for and seek to coordinate services operating within the sector, including Homelessness SA, a South Australia-based non-government organisation, and the Council to Homeless Persons in Victoria. SAAP provider networks, such as that overseen by the Queensland Council of Social Services (QCOSS), which operates a SAAP provider network in that state, along with other networks operating in specific geographic locations, such as the Central Coast SAAP Network Inc in NSW and ROCKSAAP in Queensland. Programs run by state and territory governments which coordinate services in certain areas or in relation to certain groups, such as the Pathways programs in Victoria; the Queensland government’s ‘hotspot’ planning and implementation approach under the Queensland Responding to Homelessness Strategy; and the Inner City Homelessness Outreach and Support Service (I- CHOSS), which is operated by the NSW Department of Housing as the lead agency. These approaches often include a range of different service delivery organisation types including larger faith-based charities, smaller non-government organisations and other community-based organisations. Across all jurisdictions, a significant number of smaller non-government organisations provide specific services or support for particular groups. These smaller services span the breadth of the sector and may be group-based (providing for women, recent arrivals, refugees, people with legal issues), community-based organisations (local/regional organisations, including local authorities), and culturally- based (providing for Indigenous people, for example). While these services encompass the full diversity of service types the most widespread type of service provider is those targeted at women and families.

3.4.2 Secondary and tertiary provisions – the homeless in the private sector As is discussed in Section 1.3 of this report, the private sector plays a significant role in service provision to homeless people or to those at risk, primarily through the provision of accommodation. This ranges from short-term or crisis accommodation, which may include boarding houses motels, hotels and hostels to medium to longer-term options, including caravan parks. Private sector providers are a highly diverse group, which may include operators of large boarding houses and hostels in a range of locations, to operators of small independent facilities such as caravan parks and hotels specific to a locality. Clientele of these organisations may vary from those in temporary crisis to low income earners who may rent within this sector for long periods of time. This is particularly the case given the current shortage of suitable public and affordable not-for-profit community housing available to low-to- moderate income earners due to a current supply/demand imbalance.

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The important point to note about homeless people or those at risk residing in private sector accommodation is their lack of secure tenancies and lack of protection under current legislation – a key issue to consider in the development of a regulatory or legislative framework which provides support and security to vulnerable people.

3.4.3 Emerging approaches to service provisions While studies are not numerous, the recent evidence base suggests emerging themes for service provision to people at risk of homelessness. These include: Providing people with early initial assistance can promote a move to more stable accommodation. Coordination of accommodation provision and support services can improve client outcomes. Constrained housing supply and lack of accommodation options limits outcomes. Integration across agencies and services supports coordinated service responses. Integration across agencies and services requires ongoing processes around strategic focus, decision-making, implementation and service delivery. Importance of aligned and systematic data collection. The White Paper on Homelessness proposes a continuing drive towards a more integrated, holistic approach to service provision for homeless people, which ‘addresses the causes of homelessness and provides a framework for preventing homelessness from occurring in the first place’.170 This is discussed further in Section 3.6 below.

3.5 Service frameworks and providers – state-by-state profiles The following section provides a state-by-state overview of the service provision sector at present, including the broad policy framework, key service providers, service and organisation types, and needs groups at which these services are targeted. This overview is focused on providers of secondary accommodation and mainstream support services, including early intervention services, supported transitional accommodation and crisis accommodation.

3.5.1 Victoria171 The Victorian Homelessness Strategy (VHS) was launched the Minister for Community Services and Housing in February 2002 as a blueprint for a new government response to homelessness based on an integrated system of assistance. The State Office for Housing currently funds a number of programs to meet the needs of Victoria’s homeless, which provide the framework for the government’s approach to directly and indirectly assisting the homeless, along with providers and support services within the sector. The Office works in conjunction with a number of program partners, including the Department of Justice, Court Services, Disability Services, and the Transitional Housing Management Program (THM) to ensure a comprehensive and holistic network operates in Victoria. The THM program provides medium-term housing linked to support for households in crisis as a result of homelessness or impending homelessness. The program is community managed and houses clients for an average of six months in approximately 3,600 properties across Victoria. Access to the program and associated Supported Accommodation Assistance Program (SAAP) and other support services is achieved through a statewide network of access points.

170 Australian Government, 2008, Homelessness White Paper - The Road Home: A National Approach to Reducing Homelessness, p.iii

171 Policy Review Working Group (PRWG) - Submission to Housing Ministers, 2008, Strategic Assessment of Homelessness Policy, Programs and Approaches – Jurisdiction Responses, pp. 28-34

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Victoria has developed Homelessness Assistance Service Standards in consultation with stakeholders, which are now recognised as relevant industry standards for case-managed housing support services. A self-assessment system was piloted throughout 2007 with an accreditation provider contracted to assess organisation quality and to work with organisations to promote continuous quality improvement.172 Programs funded by the Office for Housing, a number of which are targeted at people who have been involved in the justice and correctional systems, include: Better Pathways: provides linked transitional housing and support services for women in the criminal justice system, primarily those assisted by the Bail Support Program who are homeless, including Indigenous women in rural Victoria. Corrections Housing Pathways: provides a coordinated response to address the needs of people exiting men’s and women’s Victorian prisons who require housing and integrated support. It was extended in 2008 to cover all Victorian prisons, with tailored responses for men through Link Out and for women through the Women’s Integrated Support Program (WISP). Drug Courts Housing Pathways: provides transitional housing and homelessness support to people on drug treatment orders who are at risk of homelessness, referred through the designated Drug Court in Dandenong. Mental Health Housing Pathways: provides pathways out of homelessness for people with a serious mental illness and with complex needs through provision of transitional housing and specialist support packages. This program provides housing support workers to people in residential mental health care to assist with housing support following discharge from institutions. Evaluated in 2006, this initiative was found to improve mental health and housing outcomes, as well as enhancing collaborative responses to the client group. Forensicare Housing Pathways: assists people who are at high risk of homelessness, and specifically targets residents of Thomas Embling Hospital and the Acute Assessment Unit at the Melbourne Assessment Prison. Youth Justice Housing Pathways: provides coordinated transitional housing and support for young people older than 17 who are exiting youth justice facilities and who are at risk of homelessness. Evaluated in 2005, it was found to be successful in achieving the aims of decreasing the number of young people whose parole is delayed due to lack of accommodation and of reducing the chances that young people re-offend. Young People Leaving Care: a VHS initiative to address the social marginalisation experienced by young people leaving care, through the provision of or linkages to stable accommodation and appropriate support to facilitate social participation. The Children, Youth and Families division of the state Department of Human Services provides a range of funding packages for young people including brokerage funds and other types of funding not covered by SAAP, which may be accessed by young people participating in the Young People Leaving Care initiative. The CREDIT/Bail support program: provides people with transitional housing and support while waiting for their hearing. Brokerage is made available to provide a supportive and therapeutic client focused approach, rather than a punitive approach. Refuge Minors Housing Pathways: a joint program with the state Children, Youth and Families’ Child Protection Unit providing transitional housing and support to refugee minors who are at risk of homelessness upon leaving Commonwealth-funded arrival facilities. Disability Housing Pathways: assists people with Acquired Brain Injury who have experienced or are experiencing homelessness to access linked transitional housing and support.

172 Ibid, p. 32

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A number of organisations function within the Pathways framework, including government institutions, non-government organisations, faith-based charities and community organisations. A diverse range of organisations delivers services operating under this program, for example Women’s Housing Ltd, which administers loans under the Housing Establishment Fund, a component of the Corrections Housing Pathway. The Mental Health Housing Pathways program includes providers such as Barron South West, the Mental Illness Fellowship of Victoria and MIND. The Youth Justice Housing Pathways system includes Jesuit Social Services, Mission Australia and the Salvation Army’s East Care. Providers previously funded under SAAP are the major provider of primary accommodation within Victoria and include faith-based charities, community organisations, government run organisations and smaller Non-Government Organisations. Examples of ex-SAAP-funded providers who provide support to a broad range of needs groups include Castlemaine and District Emergency Accommodation and Resource Group, and Hanover South East Crisis and Support Services. There are also a large number of ex-SAAP-funded services which target certain needs groups such as women and families facing domestic violence, single men, children and young people, people with AIDS/HIV, Indigenous people, and people with a disability. These include organisations such as the Elizabeth Hoffman House, which provides short-term crisis accommodation for Aboriginal women and children facing domestic violence, and the Bert Williams Youth Centre, a SAAP-funded service that provides short term accommodation for young Indigenous males aged 15-to-25. Large faith-based organisations such as Anglicare, the Wesley Mission, the Salvation Army and the St Vincent de Paul Society are commonly involved in partnerships with the Victorian Government and often operated without direct SAAP funding, or with SAAP funding as a supplementary funding stream. While these organisations provide a broad range of support services to a wide range of needs groups, they also provide services which focus upon particular needs, for example Salvation Army East Care provides accommodation support for young people experiencing substance abuse issues, and Wesley Homelessness Services assists vulnerable children. There are also a number of non-government organisations which provide accommodation and associated support for people experiencing homelessness. These tend to function outside the Pathways system and focus upon providing services for a particular needs group, such as young people, women facing domestic violence, refugees, and people with mental health and/or substance abuse issues. Frontyard Youth Services and Kids Under Cover are two large Victorian community organisations which provide safe accommodation for young people.

3.5.2 New South Wales173 A Way Home: Reducing Homelessness in NSW, NSW Homelessness Action Plan 2009-14 sets the direction for state-wide reform of the homelessness service system in NSW, to achieve better outcomes for people who are homeless or at risk of homelessness. Through the NSW Homelessness Action Plan, the NSW Government will realign existing effort, increasing the focus of the service system on prevention and long-term accommodation and support. The NSW Homelessness Action Plan will change the way homelessness is understood, its impact on the community, and the way services are designed and delivered to homeless people and people at risk of becoming homeless. The NSW Homelessness Action Plan will also change the way NSW work’s across government, the non-government sector and with the broader community to improve responses to homelessness. The Plan includes actions funded through the National Partnership on Homelessness NSW Implementation Plan. The NSW Homelessness Action Plan includes three strategic directions, which are aligned with the Australian Government’s priority areas on homelessness. These are summarised in Table 13 over page.

173 Ibid, pp. 5-8

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Table 12 – NSW Homelessness Action Plan strategic directions

Strategic Goal Priorities Direction Preventing People never Prevent eviction from all kinds of tenure homelessness become homeless Transition and maintain people exiting statutory care/correctional and health facilities into appropriate long-term accommodation

Provide safe, appropriate long-term accommodation and/or support to people experiencing domestic and family violence, relationship and family breakdown and at key transition points

Responding People who are Improve identification of and responses to homelessness by effectively to homeless receive mainstream and specialist support services homelessness effective responses so that they do not Deliver integrated service responses become entrenched Streamline access to crisis accommodation and specialist homelessness services

Transition people who are homeless to appropriate long-term accommodation and support

Breaking the People who have Provide models of accommodation with support that are suitable cycle been homeless don’t for different target groups become homeless again Increase and upgrade supply of affordable and social housing Promote partnerships between all levels of government, business, consumers and the not-for-profit sector

Improve and better utilise of homelessness data and evidence- based responses to homelessness

Regional homelessness action plans are a key component of the NSW Homelessness Action Plan and will help achieve better coordination and collaboration across the service system and enable services and community organisations to provide input into the implementation of the NSW Homelessness Action Plan on a local level. For each strategic direction, key performance indicators and measures have been developed. Reviewing these indicators and measures will help determine the impact of actions on homelessness in NSW. The following targets have been set in the NSW Homelessness Action Plan and reflect targets in the National Partnership on Homelessness: a reduction of 7% in the overall level of homelessness in NSW by 2013; a reduction of 25% in the number of people sleeping rough in NSW by 2013, and a reduction of one third in the number of Aboriginal people that are homeless in NSW by 2013. Progress against the strategies and actions identified in the Plan will be monitored, with annual reports produced on activities undertaken under the NSW Homelessness Action Plan. The Plan also has a program of evaluation and research to determine the effectiveness of activities and help make decisions about where future efforts need to be placed. SAAP was administered by NSW Community Services and is the key safety net program that responds to homelessness in NSW. SAAP provided a continuum of services comprising 17% prevention/early intervention, 40% crisis response, 25% transitional accommodation, and 16% post-crisis support. In 2008/09, 392 SAAP projects in New South Wales, with total funding of $127.2 million, provided a range of assistance including: crisis and transitional accommodation;

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assistance to access income support and longer term housing options; specialist family, domestic violence and sexual assault counselling and support; drug, alcohol and problem gambling support and intervention; financial and employment counselling; and skills development and living skills and personal development. In 2008/09 over one third of New South Wales’ SAAP resources (35%) were dedicated to young people under 25 years of age and almost 30% to services for women and children affected by domestic violence. Remaining resources targeted single men, single women and families, with approximately 13% dedicated to services that have multiple target groups. More than 25% of SAAP resources were dedicated to rural and remote services, and over 15% to services in regional areas. Remaining resources (almost 60%) are allocated to services in the Sydney Metropolitan area, although over 15% of these resources are used to provide services that support clients across the whole of New South Wales. As a result of SAAP reform and the focus on prevention, early intervention and post-crisis supports, SAAP services had a much wider impact on homeless people than is reflected in the Counting the Homeless 2006 Census report, which only includes people who were accommodated in SAAP services. The Census report indicates that 19% of the estimated 27,500 people who were homeless on census night in New South Wales were in SAAP accommodation. However, in 2006/07 48% of New South Wales SAAP clients were receiving accommodation. This indicates that SAAP services were also assisting other groups of homeless people identified through the Census including the 40% of homeless people staying with friends/relatives, rough sleepers (13%), and people living in boarding houses (28%). The Housing and Accommodation Support Initiative (HASI) is a partnership between NSW Health, Housing NSW and community sector organisations. It assists people with mental illness who need help with accommodation to participate in community life, maintain tenancies and improve their quality of life, and it does so by providing integrated, broad-ranging and individually-tailored services. The Staying Home Leaving Violence Program is a domestic violence intervention program that aims to increase victims’ safety and prevent homelessness by providing tailored strategies to enable women who have experienced domestic violence to remain safely in their own homes with the violent partner excluded. A Bega Staying Home Leaving Violence Pilot, funded by NSW Community Services and auspiced and managed by the Bega Women’s Refuge, commenced in October 2004. A pilot in Eastern Sydney in May 2005. The project receives referrals from Police, Women’s Domestic Violence Court Assistance Schemes and other women’s, children’s and health services. The service includes risk assessment, safety planning, court support and casework, and advocacy to address barriers to staying in the home. An evaluation of the Eastern Sydney pilot project has shown that two thirds of clients accessing the program were able to remain in their own home with the violent perpetrator excluded. A majority of clients accessing the program demonstrated stability in employment and in their children’s schooling and childcare. There was a reduction in breaches of Apprehended Violence Orders during the support period and, where breaches did occur, women were able to use the safety plans developed through the program. The NSW Government has funded the roll out of the Staying Home Leaving Violence program, to be coordinated by the Department of Community Services, to a total of 18 sites. The NSW Government has introduced a variety of innovative homelessness service delivery models which place homeless people directly into longer-term supported housing arrangements, based on the Housing First approach which originated in New York. Since the key principle of the Housing First model is the provision of long term stable housing as a first step to addressing homelessness, access to long term housing is made as simple as possible, with minimal barriers. The following are some NSW Government projects based on the Housing First model: My Place targets homeless people in inner city Sydney who alternate between sleeping in public places, and short stays in temporary accommodation. Through the provision of support services, the initiative assists homeless people to transition from street or crisis accommodation into

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independent living. Housing NSW has allocated 60 units of accommodation to three community housing providers for the program. An evaluation of the program found that 90% of clients have succeeded in sustaining a tenancy. The Homelessness Intervention Project targets chronically homeless people by linking them to housing and support. The project is a partnership between Housing NSW, the Department of Community Services, and NSW Health and comprises two initiatives. The Homelessness Intervention Team in inner Sydney is a six month project aimed at urgently housing and supporting 20 chronically homeless people. The Nepean Youth Homelessness Project is a 12 month project which aims to house and support 10 homeless young people and prevent young people with high needs from rough sleeping and chronic homelessness. The Inner Sydney Chronic Homelessness and Complex Needs Coordination Project is an initiative of the Inner City Homelessness Action Plan Phase 2. The project targets chronically homeless people with complex needs who have used a range of services over a number of years without being able to gain any real change in their circumstances. This is a collaborative project between the City of Sydney and the Department of Community Services. The project has two streams to assist the chronically homeless to exit homelessness. The Housing First component (30 properties); and the Care Coordination stream brings together support agencies in a collaborative approach to assist clients to sustain their tenancies. The Allawah Housing and Support Pilot provides culturally appropriate housing and support for Aboriginal people with co-existing mental health and substance dependency issues (dual diagnosis) in the inner city of Sydney. The project provides secure, affordable long term community housing along with the support services needed to successfully sustain a tenancy. The pilot has been developed and implemented by Housing NSW in partnership with the Sydney South West Area Health Service, including the Aboriginal Mental Health Unit and Drug Health Services, the Inner City Homelessness Outreach and Support Service, St George Community Housing and the Aboriginal Medical Service (AMS) Redfern NSW Community Services and Housing NSW are trialling an innovative project in the Orana Far West region of New South Wales that aims to improve service provision to Aboriginal women and children in isolated communities affected by domestic and family violence. The Orana Far West Safe Houses Project links intensive supports for Aboriginal women and children with access to safe and affordable accommodation. The project has been developed around five existing Women’s Safe Houses operating in the five Orana Far West communities. The project includes the following:

The establishment of child and family linkages worker positions in each of the Safe Houses, and resources to enable each Safe House to implement improvements in organisational governance, service delivery and service integration. New crisis accommodation to support the operations of the Safe Houses with short term housing for clients until they are able to access a safe, long term housing option. The transition of families from the Safe Houses into longer term affordable housing, including social housing where eligible. Five formal operating agreements will be developed under the Housing and Human Services Accord to assist eligible clients to sustain a social housing tenancy when they exit a safe house. The City of Sydney Council (CoS) is a primary provider of referral and brokerage for accommodation and support services for homeless people living in NSW, though particularly in inner Sydney via the Homeless Persons Information Centre (HPIC) and the Homelessness Brokerage Program. The CoS is also a funding and operational partner in the Inner-City Homelessness Outreach Services and Support Service (I-CHOSS).

3.5.3 Queensland The housing and homelessness sector in Queensland has undergone significant change in the past 18 months, with the introduction of a single social housing system – a significant systemic reform that

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seeks to enhance access, streamline assessment and prioritise housing allocation to those in priority and complex need. Until recently, accommodation services were characterised by SAAP-funded services offering crisis accommodation. There were well established SAAP networks in each region, and a state-wide SAAP Network officer based at the Queensland Council of Social Service Inc (QCOSS). Those participating in the networks included larger providers, such as OzCare and Anglicare, which operate across the state, as well as smaller locally focused providers. In June 2005, the Queensland Government introduced the Responding to Homelessness (R2H) Strategy, a whole-of-government program committing $235.5 million in funding over four years. The aim of the initiative was ‘to create an integrated homeless service system and to reduce, over time, the number of people who are completely without shelter by enhancing existing and implementing new initiatives, responding to homelessness and public intoxication’.174 It is a significant cross-government exercise, involving seven state government departments (now reduced to five) including the Department of Communities (including the former Department of Housing); Queensland Health; Queensland Corrective Services; the Department of Justice and Attorney-General; and the Queensland Police Service. In practice, R2H comprises a suite of around 32 initiatives based within the above departments who work in conjunction with community agencies, and is targeted at five ‘hotspot’ locations: Brisbane, the Gold Coast, Townsville, Cairns and Mt Isa. The initiatives are grouped under six themes: Providing more accommodation and support options. Connecting people with services. Responding to homelessness and public space issues. Meeting the health needs of people experiencing homelessness. Meeting the needs of people experiencing homelessness in the legal system. Helping residential services stay open (through accreditation). An evaluation is currently underway to assess the overall strategic impacts and outcomes achieved by R2H,175 the results of which are not yet publicly available. However, an earlier review was undertaken to assess emerging impacts and outcomes.176 The review found that the Strategy had successfully implemented mechanisms and processes to introduce new services, to improve coordination and to increase access and service quality. It also found that the number, range and quality of services available in target locations appeared to have significantly expanded. The following investigates the profile of the homelessness service sector in three locations which represent quite different urban regions: Brisbane, Cairns and Rockhampton, two of which are identified Responding to Homelessness (R2H) ‘hotspots’. Brisbane is the core metropolitan centre in Queensland for homelessness accommodation and other supporting services. There are a wide variety, ranging from neighbourhood centres, through to specialist hub services for people who are homelessness, to crisis and supported accommodation and transitional housing options. Additional new services funded under R2H include Roma House Crisis Accommodation, the Homeless Persons Information Queensland (HPIQ), and the Information and Referral Service Hubs – HART 4000 and the Brisbane Homelessness Service Centre (BHSC). Service

174 Seelig, T. Phillips, R. and Thompson, A., 2007, Mid-term review of the Queensland Government’s Response to Homelessness: Final Report, University of Queensland Social Research Centre, Brisbane, p. 5

175 The Strategic Impact Evaluation of the Queensland Government’s Responding to Homelessness Strategy is being undertaken by Urbis. A Draft Final Evaluation Report is currently being reviewed for public release.

176 Seelig, T. Phillips, R. and Thompson, A., 2007, Mid-term review of the Queensland Government’s Response to Homelessness: Final Report, University of Queensland Social Research Centre, Brisbane, p. 5

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system relationships and networks are still emerging: the Inner City Housing and Affordability Network (ICCHN), for example, meets regularly, but stakeholders report the sector is highly fragmented and there is limited sharing of information across services. Cairns is a regional base for an extensive network of homelessness and accommodation services, in part due to funding under the R2H Strategy. This network comprises a combination of government, non-government, major charity and privately owned organisations, which offer support and services to people experiencing homelessness or at risk of homelessness. There is a strong focus on accommodation and support for Indigenous people and for transitional populations in the region. In general, services are aimed at the following client groups: youth (12 to 20 years of age); single women and men; single women with children; single men with children; families and Aboriginal and Torres Strait Islander people. The regional service network is particularly concerned with ensuring that service models are locally planned and relevant, rather than adopting a ‘one-size-fits-all’ approach from other locations. A range of homelessness service providers, including Anglicare, OzCare and the smaller Quigley Street Night Shelter, receive funding through SAAP and Crisis Accommodation Program (CAP) programs administered by the Queensland Department of Communities. Services targeted specifically at youth are funded through the Department of Child Safety. A specialist service centre (or Hub) for people who are homeless was recently established in Cairns, designed as a one-stop-shop offering advice, information, and access to a range of housing and support services. Rockhampton is a regional community that has experienced significant economic growth for the last several years due to the mining and resources boom. Housing costs are high and while income levels have been high, the effects of the economic downturn have hit the community hard, resulting in a significant rise in unemployment and housing hardship. A range of services in the region provides: general housing assistance; long-term community housing; supported housing; transitional housing; youth housing; housing support for people with a disability to live independently; crisis accommodation for women and children; boarding houses; and supported accommodation for families. Some of these organisations provide a combination of services, such as accommodation and integrated support. In the current financial context, there are concerns that Rockhampton is witnessing a changing profile of people in accommodation need (particularly regarding older people, clients with complex needs, and those seeking assistance due to lack of affordable housing), growing accommodation needs, and a requirement for integrated support. Rockhampton has not received specific funding under R2H. Existing service networks include regular inter-agency meetings - ROCKSAAP Network Meetings and Housing Area Network Meetings. Networking arrangements in Rockhampton include government agencies as well as the non- government sector.

3.5.4 Western Australia177 A range of homelessness programs operate within Western Australia, providing both accommodation and mainstream services: The private Rental Support and Advocacy Program works with people having difficulty maintaining tenancies and provides assistance structured around the needs of each person or family. Success is defined as maintaining or moving to sustainable accommodation and avoiding eviction. The Supported Housing Assistance Program (SHAP), managed by the state Department of Housing and Works, provides support to public tenants at risk of being evicted as a result of rent arrears or anti-social behaviour. Success is defined as sustaining a tenancy or avoiding eviction.

177 Policy Review Working Group (PRWG) - Submission to Housing Ministers, 2008, Strategic Assessment of Homelessness Policy, Programs and Approaches – Jurisdiction Responses., pp.24-28

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The Strong Families Program works across government and non-government service providers to provide a coordinated response to families with complex needs. Success is measured by outcomes including increased access to services, family and agency participation, improved stability in clients’ lives, achieving stable housing, and improved school attendance. Home Connect assists families and individuals who need accommodation to access private housing, and success is measured by the number of clients and how long it takes for them to acquire a tenancy. The Government of Western Australia implemented a State Homelessness Strategy in May 2002. This was evaluated in 2006 and was found to have significant benefits for service users, who praised the ongoing interagency collaboration and the relationship between government and non-government partners. A total of 72% of clients surveyed said that their needs had been well met, and requests for housing and accommodation were significantly reduced in the period following the implementation of the Strategy’s initiatives, from 15,000 in 2001-02, to 13,000 in 2003-04. 178 All of the services funded through the State Homelessness Strategy have now been incorporated into mainstream Department for Child Protection funding programs, the majority into the Supported Accommodation Assistance Program (SAAP). According to the Western Australian Department for Child Protection (WA DCP), 136 services currently provide support and/or temporary (transitional) accommodation funded under the SAAP, relatively evenly spread between metropolitan and country areas (a ratio of 50:46). These include: crisis, temporary accommodation for young people and support and counselling for young people at risk; refuges and outreach support services for women who are single or have children and who are victims of domestic violence; and crisis and temporary accommodation and support for homeless single adults and families. The largest proportion of services provides for women and children who are victims of domestic violence, and this includes a significant number of Indigenous corporations. Faith-based charities Anglicare and the Salvation Army operate 13 services between them, which cater for young people, adults and families. The most common service is emergency accommodation, followed by transitional accommodation, and most also provide support for homeless people or those at risk to obtain and maintain accommodation. In terms of specific client groups, there are 32 services classified as meeting the needs of young people, around a third of which are located in rural and remote areas. All of these services were SAAP- funded, with one exception which was funded by corporate sponsorship. The majority are provided by non-government or community organisations and faith-based charities, including Anglicare, the Salvation Army and Mercy, while local authorities operate a small number. The majority of service providers offer transitional accommodation (59%), and 47% offer emergency short-term accommodation, along with support to obtain and maintain accommodation. Other services provide meals as well as medium to long-term accommodation. A total of 39 services operating in WA are described as catering for women, many of which also provide for children. Approximately 80% of these cater exclusively for women and children escaping domestic violence.179 A number of services (approximately 10%) also offer services specifically for Indigenous people, and a small number of services provide specifically for families, single women and people from diverse cultural and linguistic backgrounds. In addition all WA homelessness services are required to be accessible to ATSI and CALD client groups. Almost all of these services were SAAP-funded (now incorporated into the National Affordable Housing Agreement, NAHA), and around half of them are co- funded under the State Homelessness Strategy (support for children). Almost all services provide

178 Victorian Department of Community Development, 2006, Evaluation of the Impact and Effectiveness of the Western Australian State Homelessness Strategy

179 Note: General services are however likely to accept persons from sub-groups.

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emergency short-term accommodation, while just under a third provide assistance with food/meals and two or three services offer additional support including long-term accommodation and/or ‘sobering-up shelters’. A scan of these services indicates that around 20% are operated by faith-based charities including, Anglicare and the Salvation Army, a further 20-25% are operated by Indigenous organisations, and around 10% are operated by local councils. The largest group of 17 providers (44%) appears to be non- government or community organisations.180 There are 25 services operating in WA which provide ‘general homelessness services’, 88% of which were SAAP-funded. All cater for families and more than half also cater specifically for young people. Around a quarter describe providing services for people from diverse cultural and linguistic backgrounds and three cater specifically for Indigenous people. The majority of these services are provided by non- government or community organisations (41%) such as Swan Emergency Accommodation Inc, and 31% by faith-based charities, including the Salvation Army and Anglicare. The majority of services provide emergency short-term accommodation and support to obtain and maintain accommodation, while some provide transitional accommodation, assistance with food/meals and long-term accommodation.

3.5.5 South Australia The Government of South Australia has implemented a number of initiatives aimed at improving service homelessness provision during the last decade. In 2003 it funded a 14-point action plan response to the Social Inclusion Board’s (SIB) recommendations contained in the report, Everyone’s Responsibility: Reducing Homelessness in South Australia. The Action Plan involves 22 government departments and community organisations working collaboratively to improve homelessness service provision. 181 In addition, the government has introduced a number of key elements endorsed by the SIB,182 including providing stable housing, recognising the importance of social inclusion when assisting the most vulnerable, creating targeted responses across the service system, developing an integrated, multi- dimensional, multi-agency approach, and developing evidence-based and outcome-focused initiatives. Following the implementation of this plan in 2004, the government commissioned Rosanne Haggerty, founder of the Common Ground Community not-for-profit housing provider in New York City,183 to explore further solutions to homelessness within the state.184 It subsequently introduced the Common Ground model, which differs from traditional approaches to homelessness service provision in that it is based on the premise that access to stable high quality housing is ‘a vital first step towards a satisfying and balanced life’.185 It focused on capacity-building among previously homeless people to enable them to become independent productive members of society, and to this end it provides permanent homes rather than temporary shelter, has a mix of diverse tenants, and includes on-site support services. In partnership with the government and local business leaders, three Common Ground sites have subsequently being established since 2008, backed by $5 million in start-up government funding coupled with additional funding from corporate donations.

180 Note: These categorisations are inferred based on the names of the services only

181 Policy Review Working Group (PRWG) - Submission to Housing Ministers, 2008, Strategic Assessment of Homelessness Policy, Programs and Approaches – Jurisdiction Responses., pp. 15-19

182 Naidoo, S., SA Department of the Premier and Cabinet, 2003, ‘Social Inclusion at Work: The South Australian Social Inclusion approach to ending homelessness’, Parity, Council to Homeless Persons

183 www.thinkers.sa.gov.au/rhaggerty

184 Haggerty, R., 2004, Smart Moves: Spending to Save, Streets to Home

185 Ibid.

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In addition, the state government has implemented the SA Foyer Plus project, based on a supportive housing model developed in England which is designed to break the cycle of homelessness by intervening early with young people aged 16 to 21 and encouraging them to become engaged in education, training and life coaching. The Federal Government will contribute $5.5 million to the initiative, in addition to $4 million in state funding to provide an initial 40 apartments with associated support services and contributions from the AFL Players Association and AFL Foundation in the form of funding for players to work with the project team. Another key program operating within Adelaide is the Street to Home program, which targets rough sleepers residing in the inner city, through an assertive outreach approach. Established in 2005 as a joint initiative of the Department of Health, Department for Families and Communities and Social Inclusion Unit, by 2006-07 the program had assisted 112 rough sleepers into short-term and transitional accommodation with a further 71 assisted into long-term housing. During 2007 the program expanded to metropolitan areas known to be rough sleeper haunts. In addition to these initiatives the Supported Accommodation Assistance Program (SAAP) which has operated in South Australia since 2006 is administered through the Department for Families and Communities’ Homelessness Strategy Division. There are 85 programs currently operating – 52 in the metropolitan area and 33 in rural and remote areas, based on SAAP V priorities which are: increased involvement in early intervention and prevention strategies; providing better assistance to people who have a number of support needs; and providing ongoing assistance to ensure stability for clients post- crisis. There has been some substantial reform to the SAAP model in South Australia, involving three main elements: The development of a model for a single gateway into SAAP services. The application of a model that separates the tenancy management function from the support function. The development of a new service model that better integrates services at the regional level. Key charities such as Anglicare, the Wesley Mission, the Salvation Army and the St Vincent de Paul Society are the primary providers of services to the homeless within South Australia. Most of these major organisations provide assistance to the general homeless population – including transitional and short-term accommodation along with other support and meals services – along with services for specific client groups, including women with families, single men and Indigenous people. A number of non-government organisations also provide both material assistance – accommodation and basic support – and referral advice to the general homelessness population, including Homelessness SA, Shelter SA, Housing SA, the Community Housing Council of SA Inc, and Centacare. The number of organisations that provide services for specific groups of homeless people is significantly smaller; they function in a similar manner and provide similar services. Issue- or client-specific providers include the Services to Youth Council (SYC), which has developed Trace-A-Place (TAP) program to direct youths towards appropriate services such as the Foyer Foundation and the Unity Housing Company. Also, the Kahlyn Day Centre provides drug and alcohol counselling for homeless people.

3.5.6 Tasmania In March 2008, the Tasmanian Government committed to halving the number of people sleeping rough by 2010. It has also committed to developing a whole-of-government social inclusion strategy with a strong initial focus on addressing homelessness through a social inclusion unit established within the Department of Premier and Cabinet.186

186 Tasmanian Government submission to the Senate Select Committee Inquiry into Housing Affordability in Australia, April 2008, p.6

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Tasmania has also established a Housing Innovations Unit (HIU) within the Department of Health and Human Services (DHHS). The HIU was tasked with developing initiatives that particularly focus on opportunities for increasing investment into the affordable housing sector. Future work of the HIU involves the implementation of new affordable housing and homeless initiatives under the National Affordable Homeless Agreement (NAHA) and associated National Partnership Agreements. Significant reform is also taking place on the way in which government services are delivered to children, young people and families. An extensive review undertaken by KPMG in 2007-08 found that Tasmanian Child Protection, Family Services, Out-of-Home Care, and Disability Services needed restructuring. This involved the specification and tender of an Integrated Family Support Service (IFSS) within each region of the state, with access via a separate front-end Gateway service. These gateways provide a single access point and referral pathway for children, young people, families, and people with a disability, and will provide information, identify needs, and refer families to appropriate services. Community sector organisations in Tasmania are valued highly for their expertise and capacity to provide services to people in need. In 2008 the Department established an Office for the Community Sector responsible for providing strategic leadership in the development of the non-government community sector as well as the development of policy, systems and processes to enhance the delivery of community sector services. Community sector organisations involved in the provision of housing and homelessness support services are a diverse group ranging from small, singular organisations to large organisations. The Tasmanian Specialist Homelessness Services ((SHS) system is based on the Integrated Continuum of Support (ICOS) model and is delivered by around 20 organisations. The homelessness service system comprises: an integrated service system within each of the three regions of the state; a clearly defined set of service types detailing service specifications and functions; an equitable funding rationale based on input unit-costs; and proportional regional funding based on regional populations. The integration of services within each region has been crucial in providing increased flexibility and better services to clients. Rather than each service trying to provide the full range of services itself, the modular nature of the service system requires services to work collaboratively in providing joint support for clients. Different agencies focus on different aspects of the client’s needs. For example, accommodation needs are handled differently from a client’s support needs, and involve different agencies. This means that the support is independent of where the accommodation is provided and hence the support can follow the client wherever they are located. In practice this means that the same worker who initially assessed the client can continue to support them until they are eventually established in independent accommodation. In order to achieve this seamless support, each region has a range of services that focus on the provision of Immediate Emergency Accommodation for specific target groups. Each region also has front-end services that provide case planning and support functions that assess clients and then maintain the support until those clients are established in independent accommodation. To best meet clients’ needs the transitional support services provide support to clients who present directly to the shelters and therefore may have bypassed the front-end case planning and support services. The service system is supported by the provision of brokerage funds to provide flexible assistance to clients. Brokerage support is extremely important in preventing homelessness by assisting people to maintain their existing accommodation, to purchase emergency accommodation, and to assist people to move into independent accommodation. Anglicare Tasmania manages three supported residential facilities that play a pivotal role as an early intervention and prevention mechanism in reducing the likelihood of homelessness, particularly for people with low to moderate support needs. The prominent advantage of the supported residential

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facilities model is the capacity to provide affordable housing linked to support which is provided onsite by staff or through referral to other providers. Supported residential facilities generally accommodate around 30 residents (singles or couples). Residents enter into a tenancy and receive a furnished bedroom (some with en-suites), three meals daily in the communal dining room, and a weekly linen service. Board is based on income (85% excluding Commonwealth Rent Assistance) and includes all meals, rent and electricity costs. Tasmania also funds two complementary state-wide programs to assist low income earners in the private rental market, in part as a homelessness prevention strategy. They are: The Private Rental Support Scheme, administered by Colony 47, which provides bond, rent and removal assistance payments and non-financial assistance including budgeting, referral, information and advocacy. The Private Rental Tenancy Support Scheme (PRTSS), administered by Centacare Tasmania, which provides non-financial support to people usually with tenure-related support needs. This includes support for clients in maintaining tenancies, assistance to resolve tenancy-related problems, and development of clients’ knowledge and skills in tenancy and budgetary matters. The Tasmanian Government has also invested significantly in affordable housing in order to increase exit points from the homelessness sector. This includes the establishment of an affordable housing organisation – Tasmanian Affordable Housing Limited (TAHL) -, an allocation of $60 million to the Housing Innovation Unit and expansion of community managed housing, particularly for older people in rural areas. Other primary homelessness services in Tasmania are offered by a range of funded organisations including non-government organisations, national faith-based charities, along with local church-based, independent not-for-profit, and private organisations. Along with Colony 47, the primary providers are Anglicare, City Mission and the Salvation Army. These organisations provide generic forms of assistance including emergency accommodation, referral facilities and basic support for all client groups. A number of programs also offer assistance in addressing underlying causes of homelessness, such as substance abuse, mental illness and relationship breakdown. City Mission provides a range of support services including age- and gender-specific services and accommodation facilities such as Star House for young people aged 12 to 17, and Mountain View for men older than 55. Both of these services offer longer term accommodation and Star House offers extensive supervision and support through full-time, trained ‘house parents.’ The charity also runs a Crisis Unit and Sobering-Up Facility, which provides 24-hour crisis accommodation for homeless men and sobering-up beds for men and women. Counselling is provided through case management along with other support services. A number of programs, services and accommodation facilities operating in Tasmania are targeted at young people experiencing homelessness, including Karinya Womyn’s Service for women; Reconnect,; the Corner Health Service; Youth Futures Inc Accommodation Service (YFIA); PASS; and the Community Connections Inc LINX Youth Transitional Support Service.

3.5.7 Australian Capital Territory Since 2004 the ACT has sought to create an integrated service system spanning crisis support to safe and secure long-term accommodation. The final evaluation of the ACT homelessness strategy, Breaking the Cycle – the ACT Homelessness Strategy 2004-2008, undertaken by KPMG in late 2007 found that ‘stakeholders report that this has been achieved and that SAAP [Supported Accommodation Assistance Program] providers and DHCS [Department of Disability, Housing and Community Services], including Housing ACT now view themselves as part of a whole system that is responsible for providing different but integrated programs of support to clients to achieve common objectives’. Other key achievements in establishing a service system include: development of Pathways groups;

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development of the ‘any door is the right door’ policy through the Joint Pathways group; additional outreach services; additional families and men’s services; establishment of the multi-disciplinary priority panel within Housing ACT and the involvement of a range of stakeholders on the panel; and development of protocols between the Office for Children Youth and Family Support (OCYFS) and the youth SAAP sector and between Mental Health ACT and the SAAP sector. New services established under Breaking the Cycle included a shift from congregate living responses to accommodate individuals and families within their own dwellings, and an expansion of flexible outreach support services. Models were also introduced to facilitate property transfers to clients allowing them to be housed in place, whilst ensuring ongoing support is provided as required. In 2008-09 a total of 46 homelessness programs were funded in the ACT from funding provided by the Australian and ACT governments. These services include 13 congregate accommodation refuges; 14 services where clients live in individual dwellings; and 19 support services and one sector capacity building service. There are 95 supported accommodation places available per night for young people in the ACT and 60 places specifically for single people. Since early 2008, the ACT has had the capacity to provide a total of 300 supported accommodation places per night to young people, singles and families which equated to an average of 486 individuals accommodated concurrently. General homelessness support services in the ACT are provided by a combination of government, non- government, church-based, major charity and private organisations. Primary providers include Anglicare, the St Vincent de Paul Society, and the Salvation Army. As in other states and territories, these organisations offer a range of forms of assistance including emergency accommodation, referral facilities and basic needs assistance for men, women and children. While primarily funded under homelessness programs, some organisations also receive funding under other programs such as mental health or drug and alcohol and are able to add to the range of supports to offer holistic forms of assistance, including addressing the underlying causes of homelessness. A number of services also target specific clientele, for example the St Vincent de Paul Society’s Samaritan House is a shelter for men older than 18 and also operates as a central services hub for single homeless men in the ACT. Other services include: Inanna Inc. which provides: crisis accommodation for women with or without children who are homeless and have special and/or complex needs; outreach workers who work with women experiencing mental health issues; a transitional housing service for families; an Indigenous Boarding House Program and an Indigenous Supported Accommodation Service for Aboriginal and Torres Strait Islander individuals and families; and headleasing for specific individuals and families with complex needs. Families Experiencing Accommodation Transitions in Tuggeranong (FEATT) and the Family Housing Outreach Service (FHOS), which are operated by the Canberra YWCA and provide low- cost supported accommodation in individual homes and outreach support for homeless families. Toora Women Inc. which operates services for women not accompanied by children throughout the ACT including outreach services and short-term and transitional accommodation; and Marzenna – a drug and alcohol halfway house for women and women with children, which offers medium-term accommodation. Barnardos ACT, which has been operating for nearly 50 years and provides family support, foster care and supported accommodation services to disadvantaged children, adolescents and their families. The Parenting Outreach Program is specifically focused on addressing the needs of young people experiencing both parenthood and homelessness, while the Youth Stairwell supports young people in their transition to independent living. Karinya House, a service for pregnant women and women and their babies.

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Canberra Fathers and Children Service Inc. (CANFaCS), which provides crisis accommodation and outreach support services, including skills training, to at-risk or homeless fathers with children. The Transitional Housing Program, which utilises housing stock that is for sale, redevelopment or hard to let, making these properties available to homelessness services for homeless clients not requiring crisis support, but awaiting a longer-term housing option. Homeless asylum seekers in the ACT can access services and accommodation through the Refugee Transitional Housing Program (RTHP), which is a government initiative offering six-month temporary housing in properties scheduled for redevelopment. The RTHP also includes an initiative which involves the preparation of exit plans which assist in clients making the transition into more permanent accommodation. There are a number of free or low-cost food providers located in the ACT, many of which are affiliated with church groups and other charity organisations such as Hare Krishna, Stasia’s Soup Kitchen, and the Salvation Army. Other mainstream responses to supporting people who are at risk of homelessness include services which adopt a community development approach to sustainable tenancies, supporting people who are at risk of eviction for rental arrears and or for disruptive or anti-social behaviours. The ACT Government also provides a range of financial support and emergency relief services which can assist tenants to manage their finances, particularly when they are at risk of eviction, and which can alleviate the impact and burden of poverty. Significant reforms to the provision of public housing assistance have assisted in the creation of an integrated service system by refocusing the role of Housing ACT as a post-crisis service. These reforms have been critical in driving and implementing systemic change, and Housing ACT has been instrumental in achieving an integrated service response.

3.5.8 Northern Territory187 The overarching policy framework for the provision of homelessness services in the NT was, until recently, the Supported Accommodation Assistance Program (SAAP), which was administered by the Northern Territory (NT) Department of Health and Families. There are 41 previously SAAP-funded homelessness services operating throughout the Territory. Outside that network, there are at least two services providing emergency accommodation and referral services for women and children. The majority of former SAAP services are located in the main population centres of Darwin/Palmerston (20 services), the Katherine region (six) and Alice Springs (five), and the remainder are located in remote and very remote areas. Most services are targeted at youth (10), followed by women and children (nine) and families (eight); four are dedicated to single men and two to single women. The majority of services provide accommodation (75%) with 53% providing emergency accommodation and 22% providing medium term accommodation. Services which do not provide accommodation provide services such as counselling, information and referral, day support and/or outreach. A large number of services provide multiple, often integrated services: 47% provide information and referral, 39% provide counselling, 36% outreach, 33% advocacy, and 31% support to obtain or maintain accommodation. Other ancillary services which are provided by a smaller number of services include day support; education and recreational activities, and assistance with food/meals. Most services offer two or more services and around half offer a wider range of associated services. Services in the sector are predominantly operated by faith-based charities. The YWCA is the primary provider (six services), followed by the Salvation Army (five services), Anglicare (four services), and the St Vincent de Paul Society (three services).

187 Ibid, pp. 8-10

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There is one identified Indigenous organisation operating a service, however there is likely to be some level of Indigenous involvement or management in a number of services, particularly in remote locations. A notable program operated by the YWCA in Darwin and Palmerston includes a three-stage program of crisis accommodation, medium-term accommodation and transition to independent living. Anglicare also runs an integrated program providing services from crisis situations to transitional solutions and beyond. Anglicare also offers a service for persons from remote areas who are receiving medical treatment. Stuart Lodge in Alice Springs is supported and managed for short to medium-term clients who are visiting from remote communities seeking access to health and other services in Alice Springs. The facility is managed by Territory Housing and provides 35 rentable rooms and up to 70 beds. The Larrakia Nation Information and Referrals Office provides services to Indigenous people living in or visiting Darwin from remote and interstate areas. It provides assistance with ‘proof of identification’ documentation, and a user pays return-to-country service for clients and/or referral to accommodation.

3.6 Effective service models – a best practice analysis

3.6.1 Characteristics of effective service provision There are a number of common features of effective programs and services: Services need to be ‘wrapped’ around individuals and case management should allow regular review of progress. Good programs are underpinned by a commitment to ‘joined-up’ service delivery at all levels, involving diverse areas of government and the service delivery sector jointly addressing the needs of common clients.188 Early intervention and prevention of homelessness gets better results. These terms need to be clearly defined and distinguished from one another. Addressing and preventing homelessness requires flexibility and creativity among the service sector as well as a clear focus on client outcomes. Homelessness is a collective responsibility and good services find a role for the entire community in addressing and preventing homelessness. In particular, diverse partnerships can help bring different skills together to tackle homelessness. Integration across agencies/services is needed to support coordinated responses A recently-completed review of the program management arrangements of SAAP and the Crisis Accommodation Program (CAP) in Queensland189 focused on broader management and administrative aspects of homeless services. The strengths of the current program management arrangements were identified as: The Queensland Department of Housing and Department of Communities (now all part of Department of Communities) each has considerable and clearly distinct expertise in its core business.

188 Lake, P., 2005, ‘Responding to Homelessness: A Joined-up Government Approach’, paper presented to Building for Diversity: National Housing Conference

189 Queensland Department of Housing and Department of Communities, 2008, Review of program management arrangements for the Supported accommodation Assistance program and the Crisis Accommodation Program: final report (evaluation carried out by KPMG)

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The current matching of support for people who are homeless with infrastructure, in the form of housing and maintenance, is important. There are effective working relationships between service providers and the Departments in a number of regions in Queensland. SAAP and CAP services were seen to be delivering positive outcomes to clients. Links with specialist areas such as disability and domestic violence services are important to support clients who have multiple or complex needs. Reporting through the National Data Collection Agency provides a single source of data collection and reporting which contributes towards accountability. The review also raised issues and challenges190 with the current arrangements, including: the need for improved coordination of programs, in recognition of the importance of the alignment and integration of the two programs at all levels of operation; the need for policies and procedures, funding and contracting arrangements, performance management, and data collection and reporting which could contribute to streamlined and integrated processes; and the use of mechanisms such as consultation and information sharing, regional networks, regional advisory groups and ‘feedback loops’ to lead to improved communication and feedback. In the Victorian experience, Lake concludes that the success of joined up initiatives depends on the capacity of government- and community-managed agencies to effectively participate and work holistically with individuals across the housing, support, health, justice, education and employment sectors, and to identify service as a continuum of tailored assistance. This view challenges policymakers to rethink service models, platforms and tools to build in greater integration, and challenges service providers to develop strengthened relationships that better link service provision for people requiring assistance. Integration across agencies and services requires ongoing processes around strategic focus, decision-making, implementation and service delivery In reviewing literature relevant to the integration of services within the social housing sector in Australia, Jones, Phillips and Milligan191 identified three main sets of challenges: Integration challenges internal to social housing, i.e. relations among the three core sectors of public housing, community housing and Indigenous housing. The challenges of effectively linking social housing with human services, including support services and homelessness services. The challengers of effectively linking social housing with the wider set of policies, programs and services concerned with housing assistance and housing affordability. Each of these sets of challenges involves integration at both the policy and the service delivery level. Integration projects are inherently difficult to implement, to sustain, and to replicate. They are also are typically seen to involve some degree of loss of autonomy, so require countervailing incentives or advantages to ensure active engagement. Achieving a more integrated service delivery arrangement is

190 ibid, pp.12-16

191 Jones, A. Phillips, R. and Milligan, V., 2007, Integration and social housing in Australia: challenges and options, Research paper. Queensland AHURI p 11

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not an end in itself, and human services participants should question the evidence of likely improvements in outcomes for consumers – evidence that is often not available.192

3.6.2 Examples of effective service provision models The Queensland Health Homeless Initiative This Queensland Health Homeless Initiative is based on the principle that providing people with early initial assistance may promote a move to more stable accommodation. The initiative seeks to enhance the delivery of mental health, drug and alcohol and other health services to people already homeless or at some risk of homelessness. Two innovative service models were pioneered: Health Homeless Outreach Teams (HHOT), which uses an assertive outreach service model, and the Transitional Housing program, which has brought together housing providers, case managers and support workers to assist people to exit acute hospital- based mental health care into community-based transitional accommodation. The Initiative was evaluated for Queensland Health by the Housing Policy Research Program within the University of Queensland Social Research Centre. Key findings of this evaluation193 include: The HHOT and Transitional Housing programs have successfully operationalised innovative models of service delivery, secured a net increase in access to services and support, and expanded the range of assistance for people experiencing homelessness, or those at risk of homelessness. The Initiative had successfully targeted highly marginalised people with varying experiences of mental health services. The service models applied, i.e. assertive outreach assistance in the case of HHOT and coordinated housing and health services in the case of Transitional Housing, have facilitated more streamlined access to services. The assertive outreach approach in particular was seen as having overcome barriers people have continually faced in accessing mainstream mental health services. There are clear indications of improvements in the longer-term housing options for clients. People moving through Transitional Housing are achieving improved housing stability, and homeless clients of the outreach services have acted to improve their housing situation. The assertive outreach model appears to be a positive step in reaching Indigenous people who may be less likely to come into services for assistance. HHOT intervention often occurs prior to the point of crisis, significantly reducing the onset of an acute episode, or preventing presentation and/or hospitalisation. Housing First Housing First is an approach to addressing long-term homelessness that encompasses a range of sustainable responses. The key principle of the Housing First model is the provision of long term stable housing as a first step to addressing homelessness. As part of this model, homeless clients are moved directly from the streets into stable, long term accommodation and provided with structured multi- agency support to promote their capacity to live independently. The Housing First approach is different to other homelessness responses that utilise a ‘pathways’ approach, starting with a crisis response through to transitional responses and then long-term housing. With a Housing First approach, access to long-term housing is made as simple as possible, with minimal barriers. While the upfront costs of providing access to permanent housing may be greater, the

192 Ibid p 34

193 Seelig, T., Thompson, A., Foster, M., Phillips, R. and Ramsden, D. 2008. Evaluation of the Queensland Health Homeless Evaluation: Final Report. University of Queensland, Brisbane, pp. 4 - 6

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Housing First approach has been shown to reduce the personal and financial costs associated with long term homelessness and repeat episodes of homelessness. This model is most appropriate for people who have been homeless for a long time; it is generally not be suitable for people who have recently become homeless. Therefore, while it is very different from early intervention or prevention approaches but just as crucial to ending homelessness. A central principle of the Housing First approach is that social services to enhance individual and family wellbeing can be more effective when people are in their own home. Services should also be effectively coordinated and access to housing should not be dependent on the person’s state of being - for example, drug free. Until recently, the Housing First approach had not been implemented in Australia. Typically, a ‘pathways’ approach is taken which responds to a crisis situation and then follows this through to transitional accommodation and then to longer term accommodation. The NSW Government, however, has introduced a number of initiatives based on the Housing First model, which are discussed in Section 3.5.2. My Place, for example, targets homeless people in inner city Sydney who alternate between sleeping in public places, and short stays in temporary accommodation. Housing NSW has allocated 60 units of accommodation to three community housing providers for the program. Through the provision of support services, the initiative assists homeless people to transition from street or crisis accommodation into independent living. An evaluation of the program found that 90% of clients have succeeded in sustaining a tenancy. Supportive housing model Supportive housing is a form of service delivery that provides stable and affordable housing along with access to flexible and individualised support services. There are a number of different supportive housing models and these vary according to the client group and location. Some supportive housing models may be dependent on acceptance of support service providers or on certain conditions such as drug- and alcohol-free housing or psychiatric disability housing. Supports may be provided through on- site services, outreach to support housing, or traditional support service models. This model is well developed and tested in the United States, and has proven to be a good option for responding to those who have experienced long term homelessness. Common Ground In New York State, there are approximately 34,000 units of supportive housing and of these, Common Ground operates nearly 1,700 units of supportive housing in seven different sites across New York. Common Ground began in 1990 following a plight to save a derelict building in Times Square, and the model today provides tenancy and building management services, partnering with non-government and community organisations to provide social support services. Common Ground’s vision is to provide clean, safe, well-designed housing and services to help people rebuild their lives and become self-sufficient.194 The principles are intended to reflect the characteristics of a healthy community: a diverse mix of residents, high quality property management services, high quality supportive services, good design, connections to the wider community, and committed staff with shared values. This model has inspired many governments and service providers in Australia. In 2005, the Government of South Australia invited the founder, Roseanne Haggerty to be a ‘thinker-in-residence’ and this lead to an introduction of the housing first policy in South Australia. The model also now operates in Victoria through a partnership between the Victorian Government; Grocon, a large Melbourne-based development company; Yarra Bay Community Housing; and HomeGround, a service provider. The partnership is building a housing facility for homeless people on the edge of the CBD at cost price through the groundbreaking initiative, which has leveraged $15 million in corporate funding.

194 Black, C., 2008, ‘Supportive Housing: Case Studies’, Parity – Models of Supportive Housing, Vol. 21, Issue 2

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What has been acknowledged as particularly significant about Common Ground’s approach, beyond being a leader in supported accommodation, is the well-designed and attractive nature of the buildings. Residents take pride in their accommodation and feel empowered because of where they live. Mission Australia Centre, Sydney The Mission Australia Centre has reduced its number of accommodation places from 100 to 40 in order to provide a more high quality and supported service. Now, there are approximately 32 different professional, training and education services delivered on-site, as well as health services that provide a range of medical, dentistry, optometry and chiropractic services. This is an intensive case management approach where the accommodation comes with clear service coordination, review and transition processes for the clients. Rooming Housing Plus, Melbourne Rooming House Plus in Melbourne was opened in 2006 and is a rooming house offering 64 units of long-term accommodation as well as on-site services. It was established in a renovated motor inn located in the inner city with good access to transport and other supports. Many of the units have also been adapted for accessibility by disabled people. The scheme provides 24-hour on-site support services and tenants are provided with meals, laundry and room cleaning. Tenants are also given practical assistance such as behaviour management, counselling, help with medications and connection with the local community.

3.7 The vision of the White Paper – towards an integrated service provision model The Government’s 2008 White Paper on Homelessness, The Road Home, represents a concerted effort to improve service delivery for homelessness people and for those at risk. The key tenet of the White Paper is the provision of an holistic, joined-up service provision model operating throughout the states and territories. This model places service users squarely at the centre of the system and recognises that these clients ‘typically interact with multiple service systems at any one time and over time’.195 The White Paper’s vision for integrated service provision incorporates both accommodation and mainstream services and encompasses a wide range of providers in sectors including mental health; drug and alcohol abuse support; domestic violence assistance; juvenile justice and the wider criminal justice system; along with supported accommodation and other housing providers operating outside the Supported Accommodation Assistance Program (SAAP) system. The vision has arisen out of a recognition that ‘people who are homeless often experience considerable frustration with the broader social service system’, describing it as ‘having wasted their time because of misinformation’ or ‘getting the run-around’.196 This is an ambitious vision, in the context of the diverse nature of the homelessness service provision sector. As is illustrated in this section, accommodation service providers are spread across a range of sectors and include government and non-government organisations, national and localised or specialist charities, and private sector organisations. These are additional to the range of mainstream support services which operate throughout these sectors. An integrated service provision model may be defined as one which encompasses all providers of services to homeless people or those at risk. It is a model which requires all services providers within the system to recognise their roles and responsibilities in providing for vulnerable people and ensuring they are adequately supported and held within the system.

195 Australian Government, 2008, Homelessness White Paper - The Road Home: A National Approach to Reducing Homelessness, p.38

196 Ibid., p.38

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Ideally, the model will operate to support people to transition from crisis into secure forms of long-term accommodation, providing them with the necessary support in the form of mainstream services along the way, which will concurrently enable them to move into employment and training or other forms of community participation. The SAAP model has to date provided a framework for service provision which recognised the importance of integrating mainstream support services with accommodation provision. Yes this model has been recognised as inadequate, and as failing some service users who have been unable to gain sufficient access to SAAP services. The vision of the White Paper is effectively an extension and expansion of this model, to encompass all service providers and to achieve the stated goal: ‘Services should operate so that there are ‘no wrong doors’ for people who are homeless and seeking help’.197 Achieving this vision will require the coordination of a number of interrelated policy initiatives, including: improving the capacity of the service provision sector, including workforce training and up-skilling; the development of an accreditation or regulatory system to underpin quality improvements to service provision; and improving the degree of integration between accommodation and mainstream service providers. Ultimately, realising the government’s vision will require all organisations within the sector to reach for a quality improvement goal which is focused on the needs of the vulnerable clients within the sector. As the White Paper states: ‘All services that work with people who are homeless should focus on getting people into stable long-term housing, employment and training, or other community participation’.198 Achieving this will require the full support of state and territory governments, who are central to the operation of homelessness services across Australia. To this end, The Road Home will require a strongly collaborative approach between the Commonwealth and states and territories, again with the vulnerable people to which this system applies always borne in mind. The development of a regulatory or accreditation system for the sector is a key component of this vision. It also offers a potential mechanism through which this collaborative approach may be developed and through which service improvement enacted. The system will need to be developed through a collaborative approach which is cognisant of and sensitive to the diverse, complex and multi- faceted nature of this service provision sector.

197 Ibid.,p.38

198 Ibid., p.38

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Figure 3 – Homelessness services: the funding and delivery framework

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4 Quality frameworks: lessons from other sectors

4.1 Introduction and approach One of the priorities set out in the Australian Government’s White Paper on homelessness was the implementation of a national quality framework for homelessness service providers, which is intended to assist in the drive to improve the quality of service provision to homeless people. This framework will potentially establish minimum standards for services, to ensure consistent quality of delivery across the range of services operating throughout Australia. Chapter Five of this research paper provides a discussion of the potential components of a national quality framework for the sector. This has been informed by a desktop literature review and environmental scan of the homelessness sector, along with interviews conducted with sectoral stakeholders and service providers. An important component of the above-mentioned research is also an analysis – through sectoral case studies - of quality frameworks and processes which have already been introduced into six other service sectors, namely: community housing; children’s services; aged care services; disability services; boarding houses operating within Queensland; and health services – general practices. These sectoral case studies were selected on the basis of the particular insights or the lessons which they might offer the homelessness sector. The community housing sector was selected since it has recently seen the introduction of an accreditation system for providers based on a set of minimum standards, which is implemented by state and territory governments. This case study is also of interest in relation to the tiered standards which have been introduced to reflect organisations’ size and structure – an approach which recognises the diversity and fragmentation of the sector. The children’s services sector is considered to offer some potentially useful insights since the regulatory regime operating within this sector is currently under review, with a move from a state-based to a national quality framework for service providers being considered. This would involve the introduction of a single set of national standards administered by a national regulatory body, replacing fragmented state-based licensing and quality assurance processes. The aged care services sector has been selected for research with particular regard to the audit function and the complaints mechanisms which operate in this sector. The system is based on a set of national standards designed to protect the quality of life of vulnerable residents, which are established through a national accreditation framework implemented by independent audit agency. Within the disability services sector, a number of legislative instruments apply to service providers, each requiring compliance with a set of service standards. The National Disability Agreement, which replaced the Commonwealth State Disability Agreement in January 2009, is of particular interest to the homelessness sector. This provides an overarching policy framework for the delivery of specialist disability services in Australia, implemented by state and territory governments.

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A further case study which was considered was the introduction by the Queensland Government of a regulatory system for boarding houses operating within the state. This case study is of potential interest because the requirement for residential service providers to meet minimum standards has been enshrined in legislation through the Residential Services (Accreditation) Act 2002. This incorporates a system of accreditation that requires service providers to meet 38 minimum standards relating to quality of accommodation, food, and personal care services. Finally, within the health services sector, the regulation of general practices was considered to potentially hold lessons for the homelessness sector since the accreditation system within the general practices sector operates on a voluntary basis. The model involves peer-review accreditation, administered by a not-for-profit arm’s-length accreditation body which also provides professional development services to the profession. This chapter provides a concise summary of the insights which have been gained from these case studies in relation to the benefits and opportunities of particular approaches to accreditation and to the potential risks and challenges therein. A consolidated overview of the case studies, summarising the regulatory or quality frameworks and the key lessons from the sectors is provided at Table 14 over page. The case studies are provided in full at Appendix A to this report.

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Table 13 – Consolidated overview of sectoral case studies

Legislation/ Sector Service charter Accreditation system Standards Funding drivers Key lessons/comments regulations Disability National JAS-ANZ System – Disability Services 12 National Disability Federal minister has The disability sector offers services Disability industry based, third-party Act 1986 Service Standards, oversight; states and a highly structured Agreement – agency: Regularly checks which provide territories administer; framework for accreditation, human rights compliance of Disability guidance to the Commonwealth and enshrined in legislation, based Employment Network states/territories. states/territories can defined by standards, members and Vocational withhold funding if regulated by a specifically Rehabilitation Services. service is de- constituted third party for Can issue ‘non- certified. employment services that conformance’ rating for are the responsibility services leading to de- Commonwealth. certification if matter Given the proliferation of unresolved. standards and review processes, it may be worth considering how to rationalise these for the homelessness service sector. Involving service providers and recipients is crucial to accreditation processes working most efficienctly. Using independent accreditation mechanisms helps ensure objectivity and consistency. Training is necessary for service providers to help them implement standards effectively.

Children’s Principles All jurisdictions have Coordinated, Coordinated approach All FDC, OSHC and The proposed National services based; COAG agreed need to move to streamlined to minimum standards LDC must currently Quality Agenda has has proposed new National Quality regulatory is proposed be registered with developed partly due to National Quality Agenda and consultation to environment Currently has three NCAC to receive recognition of the need to Framework for this end is occurring proposed separate sets of Child Care Benefits streamline multiple Early Childhood Currently, accreditation is Currently has A accreditation NCAC is largely requirements and systems. Education and operated by National New Tax System standards, one for Commonwealth- Children’s services offers a

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Legislation/ Sector Service charter Accreditation system Standards Funding drivers Key lessons/comments regulations Care and Childcare Accreditation (Family each service type – funded with some relevant comparison to National Quality Council (NCAC) Assistance) Family Day Care, income from homelessness given the Agenda It deems that: Administration Act Long Day Care and registration process mix of large providers with services self-assess 1999 (FAAA), and Out of School Hours smaller and more performance; each State and Care. Standards cover fragmented services, a Territory has relationships, focus on building workforce validators review service plethora of leadership, health and capacity, and a proposed providers; Regulations for safety and educational tiered model linked to moderators assess operation of child programming. quality improvement systemic performance; care centres;, Strong push for new supports and responses. rating of ‘satisfactory’ or OH&S, etc national standards The process of seeking higher required on all Some implementation offers some quality areas states/territories lessons for the currently reviewing homelessness sector.

Community National Federal commitment made National National commitment States/territories The sector is governed by Housing Affordable through the Council of Regulatory to core national administer and national standards and Housing Australian Governments Framework performance register services; if oversight, with Agreement - COAG, processes proposed, with standards; currently service not implementation at state and principles based operationalised at National differing levels of registered, funding territory levels. state/territory level, Regulatory Code progress by can be withdrawn The community housing including third-party Some states/territories sector reflects a similar mix accreditors (NSW, ACT); states/territories toward national of large and small providers Departmental Accreditation currently reviewing consistency as the homelessness Councils (Qld, SA, WA); sector. and Registrar (Vic) A tiered model of registration is used, linking scale and scope of service to requirements; this supports service diversity and mix. Competency standards are linked to curricula for accredited training programs, to build workforce training and capacity.

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Legislation/ Sector Service charter Accreditation system Standards Funding drivers Key lessons/comments regulations Aged care Principles based Aged Care Standards and Aged Care Act Four Accreditation All residential aged Accreditation processes Services Quality of Care Accreditation Agency 1997 standards and 44 care homes must be create a key regulatory link Principles, Focus on accountability of outcome areas accredited to receive between Commonwealth 1997, with approved providers; Commonwealth funding and quality of care. consumer rights provides for application of funding There are a range of component sanctions relating to Government limits ‘nested’ accreditation, audit (User Rights physical facilities and care access to residential and compliance and quality Principles) Supported by Office of care subsidies to assurance mechanisms, at An Aged Care and approved providers national and state and Accountability Compliance, managing the territory levels. Principles Complaints Investigation This accreditation system component also Scheme, Community requires the critical link exists Visitors Scheme, and the between funding and National Aged Care operation to drive Advocacy Program outcomes. An Office of the Commission of Complaints reports findings to the Department of Heath and Ageing A Senate Community Affairs Reference Committee reviews standards and accreditation processes

Boarding Standards in Office of Fair Trading (Qld) Some states have Thirty-eight standards Implications of accreditation houses legislation, most Registration and legislation, e.g. in Act, covering in a context where financial (Queensland) re-building and accreditation under the Act Residential accommodation, food, viability and service accommodation required in order to operate Services personal care services capacity may be an issue Focus on physical Accommodation that needs to be standards and recognition Act 2002 (Qld) considered. In the boarding of residents’ rights and house industry, it is suitability of staff who suggested that provide personal care accreditation resulted in a services significant loss of providers. The level of financial assistance provided to meet requirements is

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Legislation/ Sector Service charter Accreditation system Standards Funding drivers Key lessons/comments regulations critical, supported by officers who can visit and assist services locally. The initial phases of accreditation have focused on assistance to services to meet maintenance and physical building requirements. Peaks point to the importance of linking accreditation to tenants’ rights frameworks.

Health: Royal Australian Currently provided by either State and territory State and territory Australian Health The model for accrediting Medical College of Australian General Practice legislation for legislation identifies Ministers Conference practices in the health area practitioners General Accreditation Limited registration minimum standards of Commonwealth is a voluntary model, which and general Practitioners (AGPAL) or Quality (licensing) as a entry to medical Practice Incentive requires a highly structured, practices (RACGP) Practice Accreditation medical profession Payment provides professionalised sector with RACGP Limited (GPA) practitioner (e.g. Standards for GP financial incentive to the capacity to establish Standards for Currently accreditation of Medical Practice practices developed be accredited appropriate supporting General general practices is Act 1992 (NSW)) by RACGP in mechanisms. The Practices (3rd voluntary consultation with the homelessness sector is not edition) Australian Commission on medical profession sufficiently developed nor Safety and Quality in resourced to support this Health Care tasked with model. developing national quality The health sector also has and safety framework for a system to license health services individuals to practice. This would not apply in the homelessness accommodation sector.

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4.2 Lessons for the homelessness sector: benefits and challenges of approaches to accreditation The quality frameworks which are applied in other sectors hold a range of potentially useful lessons for the homelessness sector. Many of these lessons relate to the implementation of the elements of the framework on a day-to-day basis and its effectiveness in contributing to service quality improvement. These are outlined below.

4.2.1 Applying a single quality framework to a diverse sector There is an underlying concern across sectors that the implementation of quality frameworks and associated processes impose additional pressures on services already experiencing financial and service delivery pressures. Developing a national framework which may be applied across a range of services without overburdening smaller services is a critical issue. The community housing sector provides useful insights into the application of a single quality framework within a sector which is diverse and fragmented and comprises a number of small services. In the case of this sector, a tiered system of accreditation has been introduced, with the level of requirements for each performance area being proportionate to the scope and scale of individual operations. Each operator is deemed to belong to a particular registration class These classes range from ‘growth provider’ to ‘small housing manager’. Insights on this issue may also be gained through considering the introduction of a quality framework in the boarding houses sector in Queensland - a sector in which businesses face significant economic viability issues. A large number of small providers operate within this sector and the reported impact of regulations here was that many smaller services which considered the regulatory system to be too onerous exited the sector altogether. It has in fact been reported that the introduction of the regulatory framework led to half the services that previously operated Level 3 boarding houses chose to reopen as accommodation not requiring accreditation (e.g. student accommodation or backpacker hostels), or sold the property and left the industry. While the level of impact of the new regulatory framework is difficult to establish, it is generally acknowledged there has been a significant loss of accommodation across the industry recently. This demonstrates the risks of loss of service provision capacity which may result from the implementation of a national regulatory system in a previously largely unregulated sector.

4.2.2 Managing the regulatory burden This leads to a consideration of the importance of managing the burden on services, to ensure the implementation of a quality framework does not adversely impact on service provision. This issue has been highlighted as a critical consideration in all of the sectoral case studies. The implementation of a national quality framework in the children’s services sector provides an interesting example of how this issue has been approached and handled. In the consultation process concerning the National Quality Framework for Early Childhood Education and Care, service providers sought a reduction in the cost of compliance - especially the administrative burden of meeting compliance - and a reduction in the overlap between Commonwealth and state/territory licensing requirements. An Inquiry conducted by the Independent Pricing and Regulatory Tribunal (IPART) in 2006 recommended ways of reducing the regulatory burden on children’s services providers at that time. The Inquiry indicated that regulations were difficult to understand and comply with, and IPART recommended changes to make the regulations more user-friendly. The cost of applying standards in relation to groups of children was also recognised and the Tribunal recommended a more flexible, outcomes-based approach in this regard. The Tribunal also recommended that the government support the Council of Australian Governments’ (COAG) review to

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identify areas of duplication that could be addressed and to identify options to enhance efficiency, including a single national regulatory model and a single national regulator. In the community housing sector, a tiered structure of accreditation has been applied to registration processes (as is discussed above) to facilitate a less complex process for smaller organisations. The structure permits agencies to choose the right level of registration according to their risk profile in order to match compliance requirements with their level of risk. Within the aged care sector, where are number of small providers operate, the time and effort that must be expended in liaising with numerous national and state oversight bodies provides significant challenges and it is not clear that there are comparable benefits. The accreditation system operating in this sector, in which aged care homes must demonstrate compliance with 44 separate outcomes, is widely considered to be overly burdensome. The case studies indicate that while a national quality framework may be introduced with the laudable goal of improving service standards, care must be taken to avoid overburdening the sector at the risk of losing providers who are unable or unwilling to meet new requirements. In addition, care must be taken to avoid diverting significant resources from service provision on the ground to paperwork processes associated with compliance.

4.2.3 Monitoring the effectiveness of complaints and accreditation mechanisms Quality frameworks introduced into some of the researched sectors incorporated independent complaints mechanisms. In the case of the aged care sector, complaints may be made against a service by any individual. This mechanism was considered to be particularly important in this sector, where users of residential aged care facilities are recognised as being highly vulnerable and in need of strong protective mechanisms – characteristics which are applicable to many homeless people. From the point of view of services however, there is some concern about the effectiveness of complaints procedures and the impact on services. Questions about the effectiveness of the operation of accreditation systems have also been raised in the aged care sector. While the government generally reports that virtually all facilities and services meet accreditation requirements, indicating a successful system, the Aged Care Crisis Team, for example, found otherwise.199 Using data published online by the Aged Care Standards and Accreditation Agency and the Department of Health and Ageing, the Crisis Team found that about 7% of aged care homes were not in full compliance with accreditation standards. The Crisis Team noted that this may be a red flag pointing to a pervasive change in ethos and to a consequent malaise in the sector as indicated at ground level by the number of nurse whistle blowers, falling staff levels, rising community concern and the succession of scandals since 2000. If these findings are replicated in a more thorough study then this would be a serious indictment of the accreditation policies and practices embarked upon in 1997. This issue highlights the need for the ongoing critical appraisal and review of accreditation systems and arrangements within a sector, to ensure complacency does not set in, particularly in relation to ongoing improvements to the quality of service provision and to the effective operation of the quality improvement regime.

4.2.4 National versus state-based regulation The sectoral case studies have also provided useful insights in relation to the issue of the introduction of a national regulatory quality framework within sectors which have previously been regulated by individual states and territories. The proliferation of different regulatory regimes in different jurisdictions can be problematic when striving for a consistent quality of service provision for all service users if services in one state may not

199 Aged Care Crisis Team, Aged Care Report Card, 2007-2008, viewed at www.agedcarecrisis.com/aged-care-report-card

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be required to meet the standards that must be met by services in another state. This is a particular issue for the homelessness sector, as is highlighted in the White Paper. The White Paper in fact identifies the approach taken through the disability services legislation as potentially relevant to the development of legislation in the homelessness sector. The Disability Services Act 1986 is human rights-based and guides services to be innovative and be focused on achieving positive outcomes for people with disabilities.200 Within the disability services sector, however, there is an identified need to rationalise the quality framework and associated processes . The proliferation of standards, outcomes, performance indicators and compliance mechanisms across jurisdictions within the sector has resulted in service providers having to undergo multiple accreditation and review processes, which is time consuming and unproductive. In response to this situation there are at least two initiatives underway to rationalise standards across the sector (one in Queensland and one supported by the Department of Families, Housing, Community Services and Indigenous Affairs ,FaHCSIA). This should not be difficult given the commonality among the different sets of principles, guidelines, outcomes and indicators. For example, both service sectors would be interested in ensuring access to services, in meeting individual needs, in client involvement in decision making, in ensuring privacy and confidentiality, and in treating all clients with respect. Within the community housing sector, where regulation was primarily state-based, the implementation of a national regulatory system was undertaken through early engagement of state-based service sector representatives, who were recognised as important to its success. Implementation involved a national process, funded by the Commonwealth but delivered through a sector peak body (the National Community Housing Forum), to incorporate the developments across states and to engage all jurisdictions in the development of standards. In addition, the publication of national standards was complemented by the development of state-based implementation plans that responded to the different levels of service sector development in each jurisdiction. This is a model which could potentially be applied in the homelessness sector. In the children’s services sector, while there currently exists a well-developed framework for accreditation and quality assurance for child care services (under the National Childcare Accreditation Council, NCAC), the current processes seeking to bring together ‘education’ and ‘care’ and to coordinate separate and fragmented jurisdictions into one coordinated process is not unlike the changes sought in homelessness legislation. The desire for one national framework and, among some, for one regulator in children’s services is long standing. There is a strong desire within the sector to implement a national framework which will facilitate shared agreement across jurisdictions and will provide a commitment to national coordination of the National Quality Agenda both during implementation and for the longer term. These case studies indicate the potential benefits of a national quality framework which is intended to protect the rights of individuals who are accessing services to a consistent level of service quality. This is considered preferable, in many cases, to a proliferation of different legislative and regulatory systems across states and territories. The case studies do, however, indicate the benefits of state and territory implementation of the national framework and the importance of ensuring regulations are sufficiently flexible to take into account issues which vary across states and territories.

4.2.5 Continuous service quality improvement A supportive, cooperative approach to accreditation and service quality improvement was found to be a beneficial model in the sectors researched. Within the community housing sector, for example, the constant quality improvement model allowed for agencies to assess and to respond to shortcomings. As part of this process, projects are funded by state jurisdictions to enhance the capacity of sector agencies – often provided by sector peak agencies.

200 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p.68

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In addition, small grants are made available for service development, and specific training modules for community housing providers are offered in the social housing sector. The system is considered to represent a cooperative approach by regulators and service providers, around attaining and maintaining registration – a model which would undoubtedly benefit the homelessness sector. In the disability services sector, since the development of an initial set of standards in 1991 a great deal of work has gone into designing frameworks with outcomes and performance indicators that can be used to underpin continuous improvement, evaluation, monitoring and accreditation. Workforce capacity building is a key tenet of the Quality Strategy, which incorporates a quality assurance system based on international standards of best practice. Within the children’s services sector, it is envisaged that workforce capacity building and service quality improvement initiatives will be integral components of a National Quality Agenda, which will incrementally incorporate all service types. The proposed areas for attention in the Agenda include leadership and management, and the qualifications and training of staff. Within the health services sector, continuous professional development is a core aspect of the continuing accreditation of general practices. A number of the accreditation standards for GPs which have been developed by the Royal Australian College of General Practitioners (RACGP) relate to practice management and capacity building with a professional development focus. However this system may have limited applicability in the homelessness sector where the workforce is less professionalised. The case studies illustrate the recognition which exists across service provision sectors that continuous quality improvement is an important objective of an accreditation or regulatory system and that services must be formally supported in their service quality improvement objectives.

4.2.6 Funding and resourcing for accreditation Related to the issue of workforce capacity building is the level of funding or resourcing which may be available to organisations in seeking to meet the requirements of the quality framework. This is an issue in a number of the researched sectors, where some mechanisms have been put in place to enable organisations to seek, for example, financial support in the form of grants and free education and training materials to support accreditation processes. In the boarding houses sector in Queensland, education and financial assistance to prepare for, apply for and to achieve accreditation is important to assist small services and providers meet requirements. However there is concern that there is insufficient financial assistance provided to operators for building improvements, and that further capital and ongoing grants should be available. It is suggested the introduction of this particular approach to service quality improvement has resulted in significant loss of providers in the industry, highlighting the risks of imposing additional demands on those who may not be able (or choose not) to respond. In the children’s services sector, the cost of accreditation has been raised as a significant issue particularly in relation to staff training and backfilling positions to allow this to occur. Again, this is an issue which is expected to be particularly significant in the homelessness services sector. Within the community housing sector, some of the risks associated with the resource burden of accreditation on providers – particularly on smaller providers – have been mitigated by the introduction of a tiered accreditation system. In this way, it is intended that the regulatory burden is appropriately tailored to the scope and the complexity of the organisation. The provision of adequate funding and resources to enable service providers to meet new requirements and to undertake the required training and workforce capacity building is a significant challenge. This is particularly evident in the case of small services, which find it difficult to fund the backfilling of positions to enable employees to attend training, for example, or to fulfil the administration requirements associated with accreditation. A recognition of the cost of implementation, and the need for financial

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assistance to support the service sector, is considered to be potentially critical to the success of the process.

4.2.7 Involvement of services in the development of quality frameworks A key issue which was common across all of the sectoral case studies was the importance of the involvement of service provider organisations and of peak sectoral bodies in the development of quality frameworks. In the community housing sector, the high level of stakeholder acceptance of the regulatory regime is attributed to the involvement of service providers and their peak organisations in the development from the beginning of quality improvement processes and regulatory standards. The level of support for regulation is largely driven by the awareness that increased management standards are inextricably linked to expansion and growth in the sector. The process of implementation of an accreditation system within the boarding houses sector in Queensland has been strengthened by early engagement and relationship building across sectors. Officers who can build those relationships through networks and with individual operators on site are valued as part of the process. Within the health services sector, following the decision made in 1991 by the Royal Australian College of General Practitioners (RACGP) with support of the Australian Medical Association (AMA) and the Commonwealth Government to develop national standards for general practice, negotiation to develop the accreditation model took seven years 201 A key issue in negotiations was the issue of who would set standards and monitor those standards. Across all sectors, the involvement of the service sector and indeed all of those organisations which might be affected by the implementation of a national accreditation system is considered to be critical to obtain buy-in and support for the initiative. Whilst this may involve additional time and resources, it is considered fundamental to the establishment of an effective system.

4.3 Conclusions This chapter has provided an overview of the issues which have been faced across six other service sectors into which a unified quality framework has been introduced in recent years. The general practices of these sectors, namely community housing; children’s services; aged care services; disability services; boarding houses operating within Queensland; and health have been researched through case studies, which are provided in Appendix A to this document. A range of common themes have emerged through these case studies which may be applied to the implementation of a national quality framework within the homelessness services sector. These are: The importance of a national quality framework being sufficiently responsive and flexible to apply to the range of service provider organisation types which may operate within a single sector. The importance of managing the regulatory burden to avoid diverting resources away from service provision and to avoid overburdening smaller organisations with the risk of losing providers from the sector. The importance of the incorporation of complaints mechanisms within the system, to provide for independent review and assessment of services, and of the effective functioning of the system itself.

201 Royal Australian College of General Practitioners, History of Accreditation , viewed 7 July 2009 at: www.racgp.org.au/Content/NavigationMenu/PracticeSupport/StandardsforGeneralPractices/AccreditationagainsttheRACGPStand ards/Appendix_B_History_of_Accreditation.pdf

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The benefits of a national framework which is implemented by states and territories. This model is considered to be the most appropriate to take into account different circumstances across the jurisdictions whilst facilitating a consistent level of quality of service provision to service users. The benefits of a continuous quality improvement model, whereby organisations are required and supported to raise standards through an ongoing, rolling process of self-assessment, audit and review. The importance of providing adequate funding and resourcing to assist service providers in meeting standards, particularly, for example, in the case of sectors which may be chronically underresourced or where a number of small providers proliferate. The importance of involving state and territory agencies, service providers and peak sectoral bodies in the development of the framework, to help gain buy-in and to provide insights into the potential applicability of the system.

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5 Components of a national quality framework

5.1 Introduction This section draws together the key aspects of research carried out to date and moves towards identifying the potential components of a national quality framework for Australia’s homelessness service sector. The material presented in this section is based on: desktop research, including a literature review and an environmental scan of existing quality frameworks operating in the homelessness service sector across Australian states and territories and overseas; key lessons drawn from the case studies (summarised in Chapter 4, with further detail provided in Appendix A); and a series of consultations, which involved semi-structured interviews with 23 sectoral experts and 32 service providers from 30 organisations across the homelessness sector. The findings of the consultations are described throughout the analysis in the next two sections of the report. A more complete summary of the consultations is provided in Appendix A and a list of the stakeholders consulted is also included in Appendix A. This chapter covers the following areas: The aims and objectives of a potential national quality framework, including a brief discussion about the different tensions which need to be balanced in the development of a single national system. The key components of a national framework , including some preliminary analysis of the benefits and disadvantages of the different mechanisms which may be available to support this. Conclusions and issues for further consideration.

5.2 Aims and objectives of an accreditation system Consultations with representatives from sectoral peak bodies and from service provider organisations provided a range of views about the objectives, appropriateness and components of a potential national quality framework for the homelessness service sector (refer to Appendix B for a more complete summary of the topics discussed and the different views of stakeholders). The interviews highlighted the concerns and frustrations of those currently working within the sector, particularly with regard to funding and workforce capacity issues, the lack of integration between services and between services and government, which is considered to be an obstacle for service quality improvement. There was a high level of consistency in the views expressed across the different stakeholder groups. Overall, most stakeholders were supportive of the development of a national quality framework, including an accreditation system for homelessness services that would ensure professional services are provided to homeless people in a range of settings. There were significant concerns expressed by both service providers and peak organisations about the resource burden that the implementation of such a system may have on smaller services (discussed further below). In some cases, stakeholders were particularly concerned about how, for example, new accreditation processes at a national level would interact with existing standards and regulatory processes currently in place at a state and territory level. Stakeholders also identified a number of strategies to assist in the implementation of a quality framework which may alleviate the burden associated with introducing accreditation procedures and standards. These ideas are considered throughout this section and in Section 6: Implementation processes and impacts.

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As the homelessness service system is vast, there are many competing considerations which will impact on the success of a new national quality framework. The aims and objectives of the system will need to be clear and comprehensible to a range of different stakeholders, each with a varying capacity to navigate a complex regulatory environment. A number of considerations will need to be addressed in implementing a new framework, including: The appropriate scope of the elements of the quality improvement system. The range of services that fall within the homeless service sector span accommodation services (temporary/crisis through to medium and long-term accommodation), through to referral and counselling services, mental health services, financial services and peak/advocacy organisations. The same type of accreditation system, for example, will not necessarily be appropriate for all of these services; indeed some services such as advocacy and peaks may have a role in delivering and or developing the processes. An accreditation system – if indeed this is an agreed component of the national quality framework – will need a clear framework to encompass the varying needs of services along this spectrum and will likely need to be implemented progressively to different types of services in different stages. The rights and the standard of service to be guaranteed by the new arrangements. There is considerable variation in the degree of protection provided to homeless people currently in the different jurisdictions across Australia and overseas. While some countries aim to maintain very high standards and guarantees of housing and accommodation for homeless people, Australian jurisdictions, in some instances, provide very minimal protections and standards. The nature and extent of the rights to be guaranteed will need to be carefully considered and appropriately resourced, and accompanied by training and service capacity infrastructure to support the level of service guarantee that becomes reflected in the accreditation processes. This is considered further, below. Balancing regulation with the need to maintain supply. The Australian Government’s vision (as expressed in the White Paper) is to halve the overall number of homeless people in Australia by 2020 and to offer supported accommodation to all ‘rough sleepers’ by 2020.202 The introduction of higher standards and increased regulation for some current providers of homelessness services (particularly accommodation in boarding houses, caravan parks etc) will potentially have an impact on the availability and supply of affordable accommodation. The major challenge for the development of a quality framework is to balance competing demands of service quality with availability. This can be achieved by making standards which are applied attainable through providing appropriate levels of support to services and by providing incentives for compliance so that the White Paper’s vision can be realised. The stakeholders and service providers who were consulted identified a number of objectives that a national quality framework should set out to achieve. They included: Professionalisation of the sector: Many homelessness services are dependent on a volunteer or low wage-earning workforce, which places limitations on the level of service and experience that can be expected from staff. Stakeholders noted the importance of improving the quality of staff training, guidance and support, of retention strategies and of standards for professional behaviour. (Note: Stakeholders noted that in Queensland the Industrial Relations Commission recently ruled that there should be a pay increase of between 8% - 30% for the non-government and community services sector. The changes will be partially funded by the Queensland Government.)203 Minimal overlap of accreditation processes: If an accreditation model is to comprise an element of the quality framework, then the keys to its success and uptake will be that it is user-friendly and does not place an unnecessary burden on services. A key theme among interviewed stakeholders

202 Ibid., p.viii

203 Details of the decision can be found at: http://www.ja.com.au/CSIR_home/article.aspx?id=13673. The Qld Government has committed to funded part of the increase: http://www.communityservices.qld.gov.au/about/budget/2009-10/documents/bh-new- funds-fact-sheet.pdf

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was the importance of developing a system that does not result in senior service staff or coordinators ‘sitting at a computer’ for extended periods of time completing accreditation documents when they could be on the ‘frontline’ assisting people. The importance of developing an accreditation system that is compatible with other accreditation schemes, so that services are not required to undertake multiple and overlapping accreditation processes, was highlighted in a number of interviews. There were particular concerns expressed by some stakeholders about how national accreditation would ‘fit’ with other accreditation or processes that are already in place to regulate homelessness services, as well as with community, welfare and housing services more generally. This is a particular concern when regulation has only recently been introduced at a state level and it has required considerable time and resources to be committed by services to adjust to the new system (for example in Tasmania and Victoria). One stakeholder noted that it would be important to allow services to adjust to new state-level measures first before introducing another layer of national regulation, especially if it isn’t clear how the different regulatory regimes interacted. Stakeholders were also interested in continuity between any national regulation regarding accreditation and standards for public and community housing, and regulation of the homelessness sector. A system that regulates more than the ‘SAAP services’: Some stakeholders noted that it is important that any new quality framework regulates a whole range of environments in which homeless people receive services, not only the services previously funded by the Supported Accommodation Assistance Program (SAAP). For example, they argued that dormitory or boarding house style accommodation is in need of some level of regulation. A framework that is flexible and encompasses the diversity of the community and services available: Stakeholders were particularly concerned that if, for example, the ‘bar was set too high’ for accreditation this would lead to a withdrawal of services from smaller organisations valued at less than $500,000 or $1 million. One representative stated that the ‘risk is that welfare organisations will walk away’. Stakeholders emphasised the need for flexibility in the system so that small or remote services have to complete less onerous accreditation processes, or are supported in some way to ‘get over the line’. Moving people out of crisis accommodation quickly: Sector-wide issues were identified by some stakeholders that could potentially be addressed by a national quality framework. In particular, the need to move people as quickly as possible from crisis and temporary accommodation into stable accommodation was highlighted as an important intervention to reduce the risk of long-term homelessness. The insecurity of temporary living was described as exacerbating other factors such as mental health, confidence, daily living skills and employment, and as entrenching long-term homelessness. Standards supporting a continuum of care: Another sector-wide issue identified by stakeholders is the need for the introduction of standards which will promote a continuum of care whereby people who have had experiences with homelessness are still supported in some way after they exit homelessness. Nationally consistent regulation: All but one stakeholder perceived it to be important that a national quality framework be developed rather than state-based frameworks. Some of the reasons given for why a national system is preferable included making it easier for larger services to deliver services across jurisdictions, and improving both the consistency for clients and the simplicity of expectations.

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5.3 Potential components of a national quality framework

5.3.1 Human rights-based legislative framework There are many different ways to encourage service improvement in the homelessness service sector. The type of framework deemed most appropriate for Australia will depend on the extent to which the government wishes to implement a service guarantee or an underpinning framework of human rights legislation.204 Where international human rights conventions have been introduced into domestic law, as in the disability sector, this has acted as a powerful driver of national consistency in standards and practice. The Australian Government is currently investigating which rights and responsibilities matter to us as a society, whether these rights and responsibilities are adequately protected and promoted in contemporary Australia and how they might be better protected and promoted. The National Human Rights Consultation Committee, chaired by Father Frank Brennan, will report to government by September 30th 2009. Potential legislative recommendations from this review could substantially remake the landscape around developing service standards and add a judicial motivation to aligning practice with human rights obligations. Many of the leading practice approaches to homelessness service provision are underpinned by a legislative framework (e.g. Scotland: see Section 2.14.1 of the Legislative and regulatory context section of this document). A legislative framework can guarantee minimum rights in law, such as entry into the service pathway via assessment and the provision of temporary accommodation until a longer term response can be developed. This approach is consistent with the human rights approach embodied in the Universal Declaration of Human rights and the International Covenant on Civil and Political Rights (ICCPR) and the International Covenant on Economic, Social and Cultural Rights (ICESCR). One of the reasons why a legislative framework is perceived to be one of the strongest social policy responses to homelessness is that it provides a process for recourse in the law to enforce the rights embodied in legislation. While the types of remedies available will vary depending on the specific legislation developed, there are advocacy groups and homeless legal centres that can leverage the rights contained in the legislation to access accommodation for homeless people by bringing an action in the courts. This may be by way of administrative review and/or other legal actions. A key component of many legislative frameworks is the establishment of an independent body to oversee complaints and grievances, to reduce the burden on the court system and to streamline the process of enforcing the intention of the legislation, particularly for disadvantaged and marginalised groups. Some of the different types of independent review/complaints mechanisms are discussed further below. One advantage of developing a legislative system is that it provides a clear incentive for services to comply, as the alternative is to operate illegally. As experience from the other areas of regulatory reform has shown (such as the introduction of the Goods and Services Tax through the Goods and Services Tax Act 1999), the need to support services in the process of becoming accredited (financially and through education) is critical to ensuring the success of such a system. There are limitations in the Australian Constitution which restrict the capacity of the Australian Government to legislate directly in relation to homelessness services (as they relate to housing). These limitations are discussed elsewhere in this document at Section 2. The key issue for the Australian Government is to achieve the cooperation of the states and territories, either in committing to national standards and legislation or in developing their own state-based legislation based on nationally agreed principles. The role of stakeholder engagement is discussed further below.

204 National Human Rights Consultation Committee, 2009, About the National Human Rights Consultation, Share your Views, www.humanrightsconsultation.gov.au/

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Features of a legislative framework There are a number of different features to be considered in developing a legislative framework: Enshrining minimum standards, duties and/or a service charter that is adopted into national legislation or is incorporated into state and territory legislation. This may include the development of nationally agreed standards that services commit to delivering as part of their service charter. This type of approach is based on placing duties on services and government agencies to provide a minimum response to all people who approach their service. The protection of rights in legislation. This approach could enshrine certain rights for all people and provides a standard by which the Australian government could be held to account. Legislating to enforce the right to be assessed and provided with temporary housing would require a system to be put in place so that homeless people are directed to an appropriate coordinating service and not turned away when they approach a service which is at capacity. Extent of existing or potential future regulation of related sectors particularly housing and health. The capacity of service standards or legislative requirements for homelessness may or may not be enforceable in key related areas such as public/social and community housing and key health services required to support homeless people. For example, there is variable regulation of the boarding house sector across Australia at present, despite this sector forming a major role in the low-cost private rental market utilised by people at risk of homelessness. This raises questions of the applicability to and staging of accreditation processes from crisis accommodation to other forms of housing support. Impact on and relationship with other legislation. Similar to above, the legislative framework would need to be developed so that it interacts with other legislation in a sensible and clear fashion and does not place multiple, overlapping (and especially directly competing) demands on services or government agencies. Many services have multiple funding sources and may be subject to a variety of requirements. A number of consulted stakeholders and service providers indicated their support for a ‘rights-based’ legislative framework for service delivery. Some expressed their support for the Supported Accommodation Assistance Program (SAAP) legislation in that it represents an human rights-based approach, the basic principle of SAAP being that if you are homeless you are deserving of shelter. The Bill of Rights enacted in Victoria was considered by some to be a good model for a national legislative framework. ‘There are practical and symbolic implications to enacting homelessness legislation. Having legislation brings a valuing and appreciation and structural importance to the task of responding to homelessness. And in addition to the legislation, you need a mechanism to activate it and not let it be a dusty relic.’ (Sectoral stakeholder) One challenge raised by stakeholders of enacting legislation was the difficulty of defining ‘homelessness services’ and identifying which organisations would fall within the legislative system. ‘How will we define homeless services? Currently this would be the specialist services – potentially residualising the homelessness response to the large crisis model. We need to keep a broad and encompassing definition to allow innovation and inclusion of new forms of response.’ (Sectoral stakeholder) A number of stakeholders suggested that a national quality framework would best be implemented by way of a national legislative framework administered by the states and territories. This framework would enable the tailoring of service standards in recognition of the issues which are unique to particular geographies. The need for the framework to be sufficiently flexible and responsive to different localities was seen as crucial. ‘Government has responsibilities in terms of setting the expectations and then embedding that in a legislative framework and then the states and territories will work in partnership with providers to administer the framework and establish improvement plans.’ (Service Provider)

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5.3.2 Continuous quality improvement framework Regardless of the type of national quality framework developed (whether it is mandated through legislation, voluntary or linked to funding), most leading practice regulatory models will involve some type of continuous quality improvement framework. Victoria, Tasmania and Queensland have developed a system based on continuous quality improvement, although neither the Tasmanian nor the Victorian model is legislatively based. Legislation is often an appropriate way to ensure minimum standards and protections are in place. A separate accreditation scheme linked to funding and based on a continuous quality improvement framework may be an appropriate way to establish incentives to aspire to improved service practices. Continuous quality improvement aims to provide more than simply basic protections; it puts in place a process for review and for improvement. Both the Victorian model and the Tasmanian models involve self-assessment according to predetermined standards and then review by an external third party monitor in order to gain full accreditation. The Victorian model provides valuable insights in relation to how a national quality framework may cover a wide range of issues, including consumer rights, access to services, assessment, referral, exit planning, data recording and building partnerships across different sectors. An important feature of effective quality framework is the ease with which it may be understood and implemented by the organisations which will need to comply.. Rationalising the number of standards with which services will need to comply may assist this process. For example, the accreditation process could aim to guide services through the process of complying with other key pieces of legislation, such as anti-discrimination legislation, disability legislation, and health service legislation. Alternatively, it could provide advice and direction about where to go to find out about additional standards required under the law, even if they do not fall within the homelessness service accreditation process. An auditing and evaluation function is a potential component of a continuous quality improvement framework. Auditing is performed to assess the reliability and performance of organisations in terms of their internal control. It is usually carried out on a statistical sample of services and provides an incentive for compliance. All stakeholders in homelessness policy and services have a part to play in the process, and roles need to be clearly and explicitly defined. The roles inherent in funding, legislative frameworks, standards development, audit and compliance, grievance and disputes, and service improvement need to be linked in a transparent and comprehensive framework. Roles are sustainable on an ongoing basis when they are appropriately tasked, with adequate funding and with authority to exercise their responsibilities. A number of consulted stakeholders supported a continuous rolling program of service quality improvement, backed by supportive mechanisms including incentives. This approach was considered to be an effective means of driving organisational change from within, with a focus on improving processes and workforce capacity. Some stakeholders also commented on the importance of client feedback as an integral element of the continuous service quality improvement model. ‘I support a quality improvement cycle: reviewing and evaluating in a fair, frank and fearless way from a consumer’s perspective and then addressing whatever issues arise out of consultation.’ (Service provider) ‘The value to us [a service operating under the Victorian framework] is that we put in place a management cycle to look at what we are doing and how we can improve. We prefer this quality improvement framework rather than the quality assurance audit approach. This process also has an audit component but it’s not just tick a box.’ (Service provider)

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5.3.3 Minimum standards and a tiered framework of standards Some accreditation schemes implemented as part of a quality framework have sought to respond to varying levels of resources available to different services, recognising that smaller operators may have different objectives to larger services working towards holistic service delivery and towards best practice. This may be achieved through tiered frameworks of standards and through offering provisional licences. In Queensland for example, the maximum time period for accreditation of supported residential accommodation is three years. If a service does not meet all of the requirements then a further, shorter period may be granted subject to certain conditions. In the community housing sector, the tiered design of registration standards supports the diversity of providers in the sector nationally and could apply well to the diversity of types and sizes of agencies providing homeless services. The tiered approach in community housing is multi-factorial – where an organisation’s registration status identifies the scope of operations (A, B, C) and the level of attainment against the standards (1, 2, 3). So a registration status, e.g. B2 or C1 etc., communicates detailed information about an organisation’s capacity and is sensitive to progress with quality improvement strategies. Similarly in the child care service sector, there have been moves towards developing a regulatory framework based on a three-tiered system of accreditation. Services are accredited according to whether they are ‘provisional,’ ‘operating effectively’ or a ‘centre of excellence’. A ‘provisional’ service would receive active assistance and support to address aspects of its operations that required improvement. While there was reluctance among stakeholders to introduce such a system into the child care sector (because of the anxiety it may cause parents who place their children in provisional centres), these concerns may not have the same level of application in the homeless service sector.205 If registration is to apply beyond funded services, extension to micro services and to private sector providers will require high levels of voluntary compliance by these stakeholders. This would be maximised by: early engagement in consultations around appropriate standards, and involvement of key stakeholders in the sectors as sponsors of the processes; support for quality improvement actions through personal relationships, training and reputation enhancing processes for those involved; clear and well articulated links to established regulatory frameworks (e.g. the Building Code of Australia); and commercial incentives, in the case of private sector providers. The majority of consulted stakeholders supported the introduction of minimum standards. Aspects of service provision including accommodation quality, staffing training, qualification and level of supervision were singled out to be addressed by the standards. Linkages between services and processes for referring people to appropriate services were also prioritised by the consultations. Stakeholders identified a need for minimum standards to include an assessment process. One stakeholder was concerned about the need to build into the standards an assessment process for all people who come into contact with homelessness services, so that appropriate decisions could be

205 Australian Government Department of Education, Employment and Workplace Relations, A National Quality Framework for Early Childhood Education and Care, First wave of public consultations on reform proposals, August and September 2008 – Summary of outcomes, viewed at www.deewr.gov.au/EarlyChildhood/OfficeOfEarlyChildhood/EarlyChildhoodEducation/Documents/Summary%20of%20consultatio n%20outcomes%20(revised).rtf

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made about the level of client need. As this stakeholder argued, ‘not all people who become homeless have high and complex needs’ and there is a risk of pathologising everyone who is homeless. A number of stakeholders pointed out the importance of ensuring the system is not administered on the basis of the ‘lowest common denominator’ but rather that standards are inspirational and encourage organisations to strive for service quality improvement. The provision of incentives for the attainment of high standards was seen to be integral to this approach. ‘People want to know what ‘really good’ looks like as well as what ‘getting over the line’ looks like. ’ (Sectoral stakeholder) ‘Instead of looking for lowest common denominator we need to look for the highest. It is not good enough that we look at criteria for quality assurance and consider how we can just do the minimum to meet that. We should aim for the highest or the best. And there needs to be some sort of encouragement for the attainment of higher status. Incentives might be funding, or they might be recognition, for example awards with a small monetary incentive or conference attendance for staff attached. It is about providing a reward to the service and the people in the service.’ (Sectoral stakeholder) A number of stakeholders commented on the benefits of introducing minimum standards within the sector as a means of improving perceptions of the sector’s workforce and of service provision models and confidence in the sector from external parties, including government. ‘Introducing some objective standard whereby organisations can measure themselves can give the sector greater confidence and a greater ability to attract corporate and philanthropic funding, for example. It also enables the sector to attract higher calibre people, both as employees and board members. So for organisations to be able to say ‘we are doing well by some objective standard’ is a good thing.’ (Sectoral stakeholder)

5.3.4 Registration processes At minimum, the accreditation process can provide a register of homelessness support services, their location and the types of support offered by each. The register would be a potential source of data collection for research and for service planning. As such, it would require regular maintenance to ensure accuracy and validity of information. The development of a national framework for accreditation and data collection was supported by a number of stakeholders, in that centralised data collection would allow for comparisons to be made across regions and across client groups. The limitations of the data collection mechanisms implemented through the Supported Accommodation Assistance Program (SAAP) framework were highlighted: ‘SAAP achieved some consistency through the national data collection framework. But data collection [under SAAP] was limited to the service types that were on the ground. So there was a whole lot of invisible stuff going on that was not recorded or reported.’ (Service provider)

5.3.5 Charters of rights The White Paper on homelessness proposes the introduction of national service charters for mainstream services, and accreditation for funded specialist homelessness services, to improve service provision within the sector by maintaining high quality service delivery and by encouraging consistency and best practice service delivery. The ability for services to recruit and retain a ‘highly trained, multi- skilled and well educated workforce’ is one of the key tenets of this approach.206 Some stakeholders thought that it may be appropriate to include a homelessness charter of rights either in the legislation or in national principles in order to inform the development of specific state and

206 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p. 43

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territory frameworks. A charter has been developed in the ACT, which is a statement of principles and rights that services and government agencies seek to uphold. The charter developed in the ACT is not enforceable in law; it is a statement of principles. It is accompanied by a service guarantee which communicates the practical effects of standards to stakeholders - what they can expect from each service and the dispute resolution processes available to them.

5.3.6 Review and complaints mechanisms A national quality framework would include of a process for service quality review and for receiving of complaints and grievances. In terms of compliance with standards, this issue was raised by a number of stakeholders in relation to the question of what is driving compliance. The importance of providing drivers other than funding was highlighted in terms of the effectiveness of service quality improvement. A voluntary compliance system was considered to have significant benefits and to potentially be more appropriate than a system of compulsory compliance. The drivers put in place in the sector to encourage compliance would include marketing and fundraising benefits. Making resources available to support smaller organisations in seeking compliance was highlighted as important in the application of such a system. There are many ways in which a compliance function can be implemented. Some of the options are: Internal review, which involves a process for complaints to be dealt with internally by the service itself at first instance. Self-assessment processes, by which organisations are encouraged to continuously improve their own standards. This may be complemented by an audit and inspection regime whereby organisations are infrequently inspected by an external body, without warning. A number of stakeholders commented on the potential benefits of self-assessment regimes as an integral component of audit processes in that they may contribute to workforce capacity development within organisations. ‘In terms of self-assessment, it is good to encourage organisations to become their own harshest critics, so when it comes to an external assessment they are well and truly ready. But admittedly this is difficult in a sector that feels criticised, as they do in community housing and in the homelessness service sector.’ (Sectoral stakeholder) Peer review processes, which may form part of a continuous quality improvement model and through which professionals working within organisations would be trained to review other organisations. The peer review processes which have been implemented in Victoria as part of the Quality Improvement Council (QIC) standards and the accreditation processes were seen to be a helpful approach by some stakeholders. They were particularly praised as offering a supportive model of quality improvement and one in which experts were assessed by peer experts, rather than by a bureaucrat who may be perceived as unaware of the realities of service provision on the ground. ‘[Another] big advantage of QIC is peer review, so they train peers to review you. So professionals working in the area are the people who conduct the review. This model, which is applied in Victoria, could be applied nationally.’ (Service provider) ‘The peer review framework in Victoria acknowledges that a lot of bureaucrats have never run a service, so the people who actually work in services are assessing the services. This is a more realistic approach: best practice within constraints.’ (Service provider) Establishment of an independent organisation, such as the Homelessness Advocacy Service (HAS) in Victoria or the Complaints Resolution and Referral Service for the disability sector, to handle complaints that can not be resolved internally. These organisations may investigate complaints and also engage in advocacy to improve access to and quality of services for homeless people. It could

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be led by a government/Non-Government Organisation (NGO), peak/advocacy or accreditation specialist. Some stakeholders commented on the benefits of an accreditation system being administered by an arm’s-length accreditation body, rather than by government directly. Such a system has been implemented in the sector in Victoria, and it was considered to facilitate a more open and honest approach from service providers. The cost implication, however, of utilising a private sector arm’s- length accreditation organisation was raised as a concern among stakeholders, particularly if service providers are required to bear the cost of accreditation. Ombudsman review. It is possible that the Ombudsman could review complaints relating to homelessness services. Processes for informing people about their rights. As part of the accreditation and review process, structures to support homeless people and those at risk of homelessness to understand their rights, need to be in place. Case workers, advocates or counsellors may be the most appropriate people to handle these aspects of the process as people approaching homelessness services are often unable and unaware of the ways they can access assistance. If a process for independent review and complaints is established then it will need to address a number of potential issues. While some of the issues will relate to the standards of certain services and to the appropriateness of the way they work with clients, issues about access to services will also arise.

5.4 Conclusions and issues for further consideration This section has set out some of the potential components of a national quality framework within the homelessness services sector, including: a broad rights-based legislative framework to replace the SAA Act (which incorporates some aspects of the SAAP framework); a continuous quality improvement framework; the establishment of minimum standards for services, including the potential for a tiered framework of standards; a registration system for services; a charter of rights for homeless people, which may or may not be enshrined in legislation; and review and complaints mechanisms. The discussion of the potential components of a national system has considered the issues raised by sectoral stakeholders and service providers who were consulted as part of this research, and is reflective of their views. The risks and benefits of the various regulatory and accreditation models are considered in the context of the current structure of the homelessness service provision sector and the challenges of developing a framework which is appropriate to the range of organisations operating within it. The consultation revealed broad agreement among stakeholders on the most appropriate components of a system. The establishment of a regulatory rights-based framework was supported by many as a basis for the introduction of a national system which would support the objectives contained in the White Paper on homelessness for ensuring a client-centred approach to service quality improvement. Stakeholders’ experiences of existing accreditation systems which are currently operating in some states, particularly Victoria, have provided some useful insights into what aspects have worked well and what components might be suited to a national framework. The implementation of a continuous service quality improvement model, similar to the system which has been implemented in Victoria, was supported by a number of stakeholders. Particular aspects of this model, including self-assessment and peer review processes, were highlighted by organisations as beneficial for service quality improvement

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and workforce capacity development. Such a system was considered preferable to what was perceived as a ‘tick-a-box’ approach represented by a quality rating system. The majority of consulted stakeholders considered the implementation of minimum standards for services to be an essential aspect of a national framework, however a number also stressed the importance of standards being inspirational rather than based on the ‘lowest common denominator’. Other potential components of a national quality framework, including a charter of principles and rights, were supported by some stakeholders, although views varied in relation to whether these principles should be enshrined in legislation. Audit and review processes were considered by stakeholders to be important components of a system, however views on the form this should take were varied, with many supporting self-assessment and peer review processes alongside external audit mechanisms. The challenges of implementing a national framework are explored in the following section, particularly with regard to the processes of implementation – including timing and resourcing – and the importance of risk-mitigation strategies to deal with issues which might arise during this process.

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6 Implementation processes and impacts

6.1 Introduction This section explores the potential processes involved in implementing a national regulatory and accreditation system for the homelessness services sector. It considers issues such as: support mechanisms for implementation, including funding and resourcing for services; training and workforce capacity development associated with the implementation of a national service quality improvement system; the potential for a collaborative approach to implementation between government and the community services sector, along with other sectors which may be impacted, such as the community housing and mainstream services sectors; the relative merits of a national or state-based implementation framework; the potential challenges or obstacles to effective implementation and how these might be addressed; and the timing and phasing of implementation. The information contained in this chapter has been informed by a desktop literature review and environmental scan as well as by consultation undertaken with representatives from 53 organisations within the sector, including 30 service providers and 23 sectoral peaks.

6.2 Potential impacts of implementation – risks and benefits The implementation of a national system of accreditation and regulation for the homelessness services sector will potentially have a range of beneficial impacts, particularly in relation to: improved service provision for homeless people and those at risk; improved integration between various services – both accommodation and mainstream services – working with the sector; improved collaboration between government and the service sector; increased professionalisation of the sector through workforce capacity building programs which may be implemented alongside accreditation and regulatory mechanisms; and increased recognition of the services provided by the sector as a result of its increased professionalisation, which may have benefits in terms of funding being directed to the sector and the attraction and retention of a more highly skilled and qualified workforce. At the same time, as has been demonstrated by the implementation of national regulatory frameworks in other sectors (refer to Section 4), there are many challenges associated within implementation which, if not handled effectively, may result in unintended consequences for the sector. These challenges relate to the following issues: The need for a national system to be sufficiently flexible and responsive to the range of sizes and structures of service provider organisations, particularly in service sectors which are diverse and fragmented. The challenge of developing a single framework which is sufficiently flexible to respond to varied conditions for service providers working across states and territories and across metropolitan and rural and remote areas.

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The challenge of encouraging compliance with a national set of standards in a sector in which there is no associated Commonwealth funding driver. The importance of recognition from government of the particular challenges to smaller organisations of the introduction of regulation in a previously unregulated sector, in order to avoid the loss of service providers from the sector who cannot – or may choose not to – undertake compliance processes. The challenge of seeking support and compliance for a new regulatory system from a sector which is currently considered to be stretched to capacity in meeting demand for services. Associated with this is the risk of a loss of service provision resources within organisations which may be diverted into compliance processes. The need for the costs associated with implementation to be sufficiently acknowledged and handled, through mechanisms such as grants for smaller providers to meet the administrative costs of compliance; free training and education initiatives for the workforce; or a tiered system of accreditation which tailors regulatory requirements to the size and structure of organisations. The need for states and territories along with the service sector and other affected sectors to be sufficiently consulted and included in the development of accreditation systems and their implementation, to avoid unnecessary conflict or concern and to encourage buy-in and facilitate knowledge-sharing. The need for workforce capacity building systems to be enacted as an integral component of regulatory requirements to provide support for service quality improvement in a sector which has wide variation in the level of skills and qualifications of the workforce and has a strong voluntary component. These risk and benefits associated with the implementation of a national accreditation system are discussed below.

6.2.1 Improving service quality and avoiding loss of services Improving the consistency of service quality on the basis of a more ‘client centred’ approach to service delivery was seen as a potential benefit of a new national accreditation system by a number of stakeholders. This issue was expressed in relation to the geographic location of services – particularly for people in rural and remote areas – and also in relation to the various access points into the system; for example people accessing drug and alcohol treatment centres or mental health services. ‘You would definitely get more uniformity of service delivery. Now the experience for a client, especially adults and families, is that there is no uniformity, not even of assessment criteria. So what you get depends on where you go. Organisations have a mentality of ‘our clients’ – it is not client focused. So I hope this swings the focus back to the client.’ (Service provider) ‘It shouldn’t matter where you live or what service you present at, you should be able to expect the same quality regardless of where you are.’ (Sectoral stakeholder) ‘An accreditation system will have benefits for clients: they will know what are realistic expectations of that service when they enter it, for example advocacy, counselling, case management. For some organisations they would appreciate being recognised as meeting standards as a reflection of the good work they do.’ (Sectoral stakeholder) The challenge, however, of developing a single system that was relevant across all of the sectors through which homelessness services are delivered and also across all geographies was not underestimated. ‘Having consistent national standards is a worthy aim – the challenge is that the response to homelessness has significant diversity and different levels of investment in the response across the jurisdictions.’ (Sectoral stakeholder)

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In relation to improving service quality, the cost associated with implementation was raised as a significant issue by service providers and by sectoral stakeholders. If services are not supported in accreditation processes – in terms of resourcing and other forms of assistance – then there is a risk that some services will exit the sector. The workforce of the homelessness services sector was seen to be currently overstretched in its ability to meet demand, and having little resources in terms of staff and time to devote to implementing a system. For this reason, a number of stakeholders commented on the importance of accreditation requirements being appropriate to the sector’s resource levels and not overly onerous. ‘Until they fix the funding level for services I don’t think they should have to meet the standards. You can’t impose standards on services that aren’t receiving adequate funding. There are services providing a 24-hour service and without adequate funding they cannot comply with the raft of standards that are imposed on them.’ (Service provider)

6.2.2 Training and workforce professionalisation The implementation of accreditation processes is usually accompanied by a funded research project to identify appropriate skills for practitioners. This work leads to the development of accredited training programs for workers, which operate to raise standards and to increase worker mobility. This could build on existing training packages and add recognised qualifications for homelessness practitioners, while formally recognising workers with advanced skills. Access to professional development could be encouraged by instigating a scholarship system for relevant study, as operates in the health sector, and through the introduction of enhanced pay scales for qualified practitioners. Incentives could also be included in funding agreements, for services to maintain high levels of skills and qualifications. Until now, the homelessness services sector has not been highly professionalised. Professional development is now largely a role for the individual worker and workplace, sector peak organisations and education providers. Partnership with an existing professional body or the development of a new professional body could further support professional development and quality improvement in the sector. A homelessness sector peak may take on the task of developing such a body and of sponsoring the development of the accreditation processes. There is a challenge in identifying a natural group to provide this professionalised leadership for the sector. The existing professional organisations, such as the Australasian Housing Institute (AHI) (covering social housing workers) and the Australian Association of Social Workers (AASW) (covering some community service workers) do not identify a field of interest that would include the diversity of people providing homelessness services. Likewise, the sectoral peaks’ role has not traditionally encompassed that of a professional body. The potential for the implementation of an accreditation system to contribute to workforce capacity building in the homelessness service sector is discussed further in Section 6.3.2 below.

6.2.3 Improving service integration A number of stakeholders expressed their support for the improved service integration objectives proposed in the White Paper and also for those which have been implemented through the new National Partnership on Homelessness. The inclusion of mainstream and other services within the parameters of new policies was considered to be an improvement on the approach effected through the Supported Accommodation Assistance Program (SAAP), which was seen as a ‘siloed approach’. ‘I would agree with a more integrated approach. Previous legislation was very specific to the SAAP funding program. Therein it had the effect of siloing homelessness within this program. So I agree with looking at a system that stretches across all portfolio areas. We have to have something that acknowledges the responsibilities of all of those working within the system to people who are homeless or at risk. The new system has more of a focus on the individual.’ (Sectoral stakeholder)

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Some stakeholders suggested that the accreditation system which is introduced should be applied to government agencies, along with the service sector, as a means of improving relationships between the two along with improving service quality. ‘Integration remains one of our greatest challenges and unless we embed the instruments in every part of the system we won’t see the level of integration we are looking for. Need to build performance plans for executives within government departments. Protocols need to be embedded throughout the system internal and external to government.’ (Sectoral stakeholder) A lack of integration and cooperation among services working within the sector was in fact seen as a potential barrier to the effective implementation of a national, unified system. As one stakeholder commented: ‘Services have not developed in unison: they don’t share expertise and information. The whole idea of having more communication between services, this is the biggest stumbling blocks, because in the family homelessness sector there is fear not giving away too much. Providers are mostly large church-based charities and they have views of keeping things in-house. These organisations will be a challenge. They are very protective. This is a barrier. So when talking about accreditation and standards, will be very difficult to implement that.’ (Service provider)

6.3 Strategies for implementation

6.3.1 Funding and resourcing mechanisms Whether legislatively based or otherwise, developing standards and implementing service improvements is going to involve investment of resources. Additional costs will be incurred in developing the standards, in running an accreditation process, in implementing service improvements and in providing avenues for grievance and dispute resolution. Continuous improvement requires investment in service review, training and network development. Robust, inclusive networks are important in developing integrated responses, as venues for the necessary communication, sharing of resources and for joint planning. Costs will fall most heavily on the state and territory jurisdictions and on the service delivery sector, but will require investment by all stakeholders. This can be either in the form of new money or come from existing resources, although the latter option will divert resources from other objectives and could be a serious barrier to involvement of smaller organisations and private sector providers. All stakeholders will bring their own contributions to the process and the challenge will be in balancing the imposts of regulation. There will be a need for different mitigation measures across the different scales and types of operations, in order to maintain and promote the diversity of providers in the sector and openness to new players. ‘The goal of accreditation has to be to deliver better quality services to clients. If it requires diverting significant resources away from clients, forget it.’ (Service provider) New resources/grants Several mechanisms are available to make an investment in the development of the sector, depending on the model of accreditation selected. Jurisdictions can directly employ sector development officers or units, or can contract the provision of support services to sector peaks or to others, either nationally or through the state and territory jurisdictions. The extent of this required investment will vary, depending on the different levels of individual jurisdictions’ progress to date. Victoria, for instance, has already made considerable progress in implementing standards across the homelessness service sector and may be in a position to provide national leadership. Incentives, possibly by way of resource materials, peer support and small grants, will be needed to support the engagement of smaller agencies and private sector providers.

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6.3.2 Workforce capacity building A supportive structure of workforce capacity development and training is considered to be an essential ingredient for the success of a new national accreditation system within the homelessness sector. The implementation of a workforce capacity building program in parallel with the implementation of a national accreditation system was seen as a potentially effective approach by a number of consulted stakeholders and service providers. Increasing workforce capacity is one of the key objectives of the White Paper on homelessness. As is stated in the document: ‘To increase the capacity and diversity of the service response, creative ways of developing a high quality workforce, retaining and attracting staff and improving and enhancing career paths in the current employment market must be identified.’ 207 The White Paper points out a series of issues to be addressed in this sphere, including: low wages; a lack of career progression; high staff turnover; low skilled staff; an ageing workforce; casualisation of the workforce; and workload stress.208 Addressing these issues is considered to be particularly important in the area of homelessness service provision, for a number of reasons. Firstly, the sector is one in which a high proportion of clients have highly complex needs and service requirements in relation to issues such as physical and mental health, domestic violence, and drug and alcohol use. Secondly, the sectoral workforce has traditionally included a high number of volunteers, which in some cases may not be adequately equipped to meet the needs of high-needs clients. As the White Paper points out, the low wages offered through the sector represent a significant barrier to services attracting and retaining the best recruits. As one stakeholder commented: ‘I know that volunteers have a place, but in using volunteers at more critical levels you are devaluing the task. Especially, for example, in family and child protection services. These clients should be in the hands of qualified paid staff who are accountable. I don’t think volunteers should be working at that critical level. Although in some services a lot would not be done without volunteers.’ (Service provider) These issues are adversely impacting on the quality of service delivery to clients along with the potential for the sector to effectively implement a national service quality improvement framework. For this reason, the implementation of a workforce development strategy as an integral component of a national accreditation or regulatory framework for the sector is considered to be potentially highly beneficial, if not essential. Skills development and training The need for a workforce development plan to be implemented through a medium- to long-term framework was raised by a number of the stakeholders interviewed. This was considered particularly important, not only in light of the current poor levels of training in some areas of the sector, but in order

207 Australian Government, 2008, White Paper - The Road Home: A National Approach to Reducing Homelessness, p. 42

208 Ibid., p. 42

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to support the culture shift that would be necessary to achieve objectives for service quality improvement. ‘Some homeless services really need organisational support to strengthen their internal management and governance and human resource management in order to embrace and implement minimum standards. For example Indigenous services really struggle to have a skilled executive and management committee and well informed governance structure and model. Organisational development, governance and management development need to happen alongside any implementation of minimum standards. Some organisations are very small and volunteer-based so it is very difficult to impose high level of reporting and accountability and standards onto an organisation that doesn’t have the human resources.’ (Sectoral stakeholder) A number of consulted service providers thought accreditation could include minimum skills levels for workers in the sector, which would lead to higher standards of service. This would then need to be recognised in adequate levels of salaries and in funding. Services would also need to be given adequate funding and timeframes to up-skill their workforces. Some of those interviewed suggested that care needed to be taken to retain older workers who may not have formal qualifications but do have significant experience. This was particularly important in services working with family violence, where it was suggested that skills were learnt over time, and could not be provided simply with formal training. Services in more remote areas also suggested that experience was at times at least as important as formal training, especially where workers had close connections with the local community. In relation to training mechanisms, some services which have undergone accreditation suggested that a dedicated, funded worker employed on a regional basis to assist organisations with accreditation could be considered. Many stakeholders commented on the importance of funding for accreditation-related training, to take into account the cost of backfilling positions. This was especially critical for small organisations which may not operate in the absence of a worker. This should also cover costs of travel and accommodation for those in regional or remote areas who needed to travel to metropolitan or regional centres and to stay overnight. A suggestion was made by one remote service that a DVD or some form of online training be compiled and made available to all services nationally. Improved career path structures One of the approaches to enhancing workforce capacity suggested in the White Paper is the inclusion of an ‘advanced practitioner’ level within the existing state-based Social and Community Services awards structures which operate in the sector. In addition, the government has initiated a partnership drive aimed at improving working relationships between government and the not-for-profit sector. The Australian Council of Social Services (ACOSS) has been commissioned to consult on this initiative.209 Other workforce improvement issues which have been identified within the sector and which it is hoped this approach will achieve are the establishment of clearer career paths within the sector and of continuous service improvement processes. Improved integration of working practices and service provisions among services and between services and state/territory and federal government is a further desired outcome for the sector.210 The role of management committees The ability of management committees to play more of a role in quality-improvement systems varied greatly across the sector. Most services reported that management committees had a role in the development of strategic direction and in overseeing budgets and overall operations. In some committees skill levels in management and commitment to quality improvement was high, while some

209 Ibid., pp.42-43

210 Ibid., p.43

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services had difficulty filling positions on the management committee, and were currently operating with positions not filled. Since management committees were voluntary in many organisations, managers of some services reported difficulty in making demands on the committee. It was reported that training for management committee members was not currently funded. A number of service providers commented that consideration should be given to funding training for management committees, in areas of management and strategic development, including quality improvement. Services reported more positive staff perceptions of accreditation when service quality improvement was linked to professional development. Mentoring and networking Any potential ways to foster mentoring and networking between services during implementation was encouraged by stakeholders. One stakeholder described how it would be effective to offer ‘Excellence Awards’ and extra funding to services that are surpassing expectations in relation to accreditation. Some stakeholders suggested that opportunities for these services to go out into the community and consult with other services about how to improve their operation and governance structures so they can deliver more effective services, would be welcomed by the sector. As one stakeholder stated: ‘With so many current accreditation models, everyone gets assessed, but there is no chance to network and learn from each other about what others did differently, or more efficiently. We need to hear about other peoples achievements.’ (Service provider) Accordingly, the potential for networking and sharing of ideas/best practice between homelessness services was considered to be a potentially positive aspect of regulation. Grants and other support from government Support in the form of small grants and/or supervision and advice from government were identified as important ways that services could be assisted to achieve accreditation. Small grants that services can apply for were thought to be important, especially where a service needed to make operational changes or deliver training to staff as part of the accreditation process. Funding for peak organisations to deliver training and mentoring to services was also identified as an important way that services can be supported during the accreditation process. As one stakeholder stated, ‘Peaks are the graphite or the lubricant between the services and government’. The implementation strategies supporting the Victorian Homelessness Service Assistance Standards (HASS) were noted by one stakeholder as being effective. As part of the implementation strategy, workers were made available to mentor and to assist services to understand the process. Services needed to identify two of their own contact people to work with Quality Improvement and Community Services Accreditation (QICSA, run by the Australian Institute for Primary Care at La Trobe University), throughout the process. The staff also needed to undertake a one day training course with QICSA.

6.3.3 Improved sectoral collaboration Consultation to develop and implement standards and accreditation could be led by a number of agencies in government or from the non-government sector, as long as the process is seen to be inclusive, transparent and timely. State agencies with a track record of progress in developing standards for the homelessness sector, Victoria for instance, are well placed to provide national leadership, as are national non-government peak organisations that have the confidence of government stakeholders. The White Paper on homelessness advocates a single responsible agency with an inclusive consultation process to advance the development of nationally consistent standards. The process should have clear linkages back to Council of Australian Governments (COAG), through the Prime Minister’s Council on Homelessness and the COAG Reform Council. The shape of the resulting structure may be informed by consultations with stakeholders. Case studies have demonstrated a variety of mechanisms, including Standards Councils, appointed Commissioners

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reporting to the relevant Minister, specifically constituted accreditation and standards agencies, and third party audit and compliance reviews via professional and industry bodies. The relevance of these approaches for the homelessness accommodation sector could be tested more specifically with stakeholders. Publication of national standards and devolution of the implementation to state/territory and sector authorities has resulted in high levels of satisfaction in the related fields of the Supported Accommodation Assistance Program (SAAP) and community housing. National standards and state- based implementation has allowed for flexible implementation that responds to the service sector development in each jurisdiction. This model can also promote the partnership between mainstream agencies and specialist homelessness services in delivering on the National Partnership objectives. Involving service providers and recipients Both service providers and recipients should be involved from the beginning of developing standards and accreditation procedures, to maximise buy-in from stakeholders and to maximise the experience and knowledge base informing the developmental process. The development of service charters in the ACT and Victoria have engaged with homeless people and the experience of these jurisdictions will provide valuable insights into factors for success in engaging homeless people. There are strong peak organisations in the homelessness sector, which can assist with communication and consultation with service providers and which currently play an important role in sector education and capacity building. A ‘bottom-up’ versus ‘top-down’ approach Improved collaboration between government and the service sector was seen among stakeholders and service providers as essential to the successful implementation of a national accreditation system. The development of an accreditation system and associated workforce development plan through a collaborative ‘bottom-up’ versus ‘top-down’ approach was seen as a potentially effective means of improving working relationships between both parties, as well as a means of improving the quality of service delivery and workforce morale within the sector. ‘One of obstacles is getting around suspicion in the sector that accreditation will be imposed on them by government and it will involve purely government-driven processes. If it can be promoted and put forward as a partnership with the sector it stands a much better chance of being accepted. Involving services in the development of the system might reduce the level of suspicion and improve the processes.’ (Service provider) ‘Our members would be opposed to having no involvement in developing standards as this may mean that standards are developed without a true recognition of the service environment.’ (Sectoral stakeholder) Understanding stakeholder interests and motivations The objectives contained in the National Affordable Housing Agreement provide a focus on improving services. All stakeholder groups may bring their own motivation to the task of lifting service standards. For instance: Consumers may seek to preserve and to strengthen their rights to access to effective services; to improve their personal circumstances; and to have effective redress where their reasonable expectations are not met. Service providers may seek to improve their effectiveness in pursuit of social justice aims; to publicly demonstrate their commitment to constant quality improvement; to satisfy legal and contractual obligations from several sources; and to support fund-raising/partnership activities. Peak organisations may seek to enhance the professionalism and capacity of their constituent members; to publicly demonstrate their commitment to constant quality improvement; and to satisfy legal and contractual obligations from several sources.

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Advocacy groups may seek to promote the human rights and dignity of disadvantaged communities; and to entrench best practice and international human rights obligations in domestic law and practice. Philanthropic groups may seek assurance of the quality of partner organisations and their capacity to achieve benevolent objectives; to publicly demonstrate their commitment to constant quality improvement; and to satisfy legal obligations from several sources. Local government may seek effective local networks of services to respond to local need; to publicly demonstrate their commitment to constant quality improvement; and to satisfy legal obligations from several sources. State governments may seek assurance of the quality of partner organisations and their capacity to achieve funded project objectives; to publicly demonstrate their commitment to constant quality improvement; to satisfy legal and National Partnership obligations from several sources; and to provide a framework for grievances and complaints. Federal government may seek assurance of the quality of partner organisations - their capacity to achieve funded project and social inclusion objectives and their commitment to constant quality improvement; to satisfy legal and National Partnership obligations from several sources; to provide a framework for national consistency in service standards; and to ensure ongoing review, introduction of best practice innovations and public accountability. Small/voluntary services may seek to enhance their service provision; to access best practice supports; to achieve benevolent objectives; to publicly demonstrate their commitment to constant quality improvement; to satisfy legal obligations from several sources; and to support fundraising/partnership activities. For-profit providers may seek to demonstrate their commitment to constant quality improvement; to access government programs and small grants/loans; and to enhance their market ‘brand’ and business viability. Taxpayers may seek to address entrenched social disadvantage; to invest public funds in the most effective responses; and to ensure public accountability for policy and outcomes.

6.3.4 A supportive model of accreditation Many stakeholders have stressed the need for the introduction of a national accreditation system to be based on a model of support and encouragement and on a strong leadership from government. The low morale of the workforce in many parts of the service provision sector was highlighted and this was in part attributed to a lack of recognition within government of the high quality service that many within the workforce already provide. Praise and recognition for existing achievements was set out as a potential starting point for the introduction of a new system. ‘It’s a cultural shift – it’s about people self-evaluating and having supportive discussions in a supportive environment. If organisations are not achieving [the standards] you can discuss how they can try to achieve them and what they need to do so.’ (Service provider) ‘To date, there has been an oppositional relationship between the government and the community housing and homelessness sectors. We need to see much more respectful relationships between all parts of the system. People need to see things from a number of perspectives: sit around the table and have a sensible, respectful conversation.’ (Sectoral stakeholder) Avoiding onerous reporting requirements A number of stakeholders voiced their fears that the introduction of an overly onerous accreditation system within the sector would lead to a loss of services and a loss of qualified, experienced staff within services – all of whom may choose to exit the sector rather than deal with the issues associated with meeting an overly onerous regime. Stakeholders stressed that ‘form filling’ requirements need to be cognisant of the resourcing issues within the sector, and should also be appropriate to the likely outcomes which would result from the

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reports. A number of stakeholders and service providers commented on reporting regimes in other sectors being ‘too unwieldy’, particularly for smaller services with stretched resources. ‘People in our organisation want to work with young people but the job becomes onerously administrative and this reduces morale and it’s the wrong way around.’ (Service provider) ‘I think some of the cons about accreditation would be that the level of bureaucratic and administrative burden on organisations that are already fairly overloaded with direct service delivery without adding a layer of bureaucracy and paperwork.’ (Sectoral stakeholder) A broad-based system which avoids micro management A number of stakeholders commented on the need for the implementation of standards through an accreditation system to be broad-brushed and to avoid a micro management approach which may be overly time consuming and ineffective and not easily applied to the wide range of services that operate within the sector. The clear message from stakeholders was: ‘simplify rather than diversify’. The most effective standards would be those that could be applied across a range of community service sectors. ‘Standards nee to be broad and realistic: broad enough to capture range of [service provision] models. It could involve simple self-evaluation – show and tell. It is essential that the system is flexible.’ (Sectoral stakeholder) ‘The question is do you go broad and shallow or narrow and deep. I think it is better to go narrow and deep. But you need to be very wise in your choice of performance areas.’ (Sectoral stakeholder)

6.3.5 Moves toward a national system of accreditation Recognition of accreditation gained in other sectors There is currently a proliferation of standards, performance indicators and compliance mechanisms for homelessness services, and a large number of different agencies and organisations involved in monitoring, review and accreditation processes. A number of stakeholders commented on the importance of a system being introduced which allowed for mutual recognition of organisations’ accreditation under other systems. The problems of current arrangements, whereby multi-function centres were required to be accredited under a number of separate regimes, were highlighted. ‘Governments regulate lots of different things and many homeless service providers also provide other services through different funding streams. Services might undertake two, three, four, regulatory mechanisms – all similar but different. There is lots of overlap but it is different enough that you can’t just have the one core response to all of them.’ (Sectoral stakeholder) ‘Homelessness may be just one activity of a service, and having multiple layers of accreditation requirements is counterproductive.’ (Service provider) ‘There needs to be coordinated credit. We have to avoid duplicating standards and increasing compliance too much – particularly for multi-function centres.’ (Sectoral stakeholder) There are currently at least two initiatives underway to move toward a national approach to standards and service accreditation across the disability sector (one in Queensland and one supported by the Department of Families, Housing, Community Services and Indigenous Affairs, FaHCSIA). In children’s services, case study research identified a long-standing desire for one national system, and some stakeholders advocate for one national regulator (i.e. a national standards or accreditation agency). Similar to White Paper objectives for homelessness, current processes for child care services seek to coordinate separate and fragmented jurisdictions into one coordinated process. These processes face considerable challenges in areas where the Commonwealth has limited jurisdiction and the states and territories have traditionally exercised responsibility for delivery and regulating services. National standards need to integrate with other existing standards, rather than duplicate the compliance effort. This is increasingly difficult with the range of agencies that might be covered, from mainstream government agencies, to large and small not-for-profit agencies and some private providers. Some

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stakeholders suggested mutual recognition of standards under diverse funding streams, with a few additional accreditation requirements for specialist services, as a potential response to this issue. Implementing existing state-based regulatory systems on a national basis The accreditation framework which has been implemented in Victoria was seen by many stakeholders as a well considered and effective approach and one which has the potential to be rolled-out on a national basis. A number of the elements of that system were particularly praised, including the peer-review framework and the facilitation of mutual recognition of accreditation processes to avoid duplication of accreditation processes. The continuous quality improvement model which operates through this system was also praised. A number of stakeholders supported the nationalisation of this model through a phased implementation program. ‘The worst case scenario would be for the Commonwealth to go a separate way to Victoria and roll out a new system nationally, because Victoria is so far ahead. I would say beware of throwing the baby out with the bathwater because an enormous amount of work has gone into the Victorian system so if you diverted too much away from the Quality Improvement Council (QIC) [continuous quality improvement] standards, beware. It would be very expensive and onerous to implement a new system in this state.’ (Service provider)

6.3.6 Timeframes and phasing The timing and phasing of the implementation of a new system was raised by stakeholders as a critical issue and one which is strongly linked with the need for a workforce development strategy within the sector. A number of stakeholders made reference to the importance of the two strategies being implemented simultaneously, since they are mutually supportive. Workforce capacity building was seen to be a medium- to long-term goal and not something that could be achieved in a short timeframe. ‘It may be best to have a five to ten year capacity building plan rather than trying to do it overnight.’ (Service provider) Timing was considered to be a particularly important issue in relation to smaller services which may not have the capacity to release staff for training at a time when services are considered to be overstretched. ‘It has to be a phased approach: you cannot just jump in and expect people to meet minimum requirements immediately. So you could require, for example, a 30% compliance rate, then 40%, then 60%, then 80%. You don’t go from zero to 100 in no time or you will overburden the sector. It has to be a pragmatic approach which acknowledges that 100% compliance will take time. In terms of resources, this will be a significant change process in quite an unregulated sector, so applying all of that wonderful change management theory will be a good thing.’ (Sectoral stakeholder) Some stakeholders were interested in a staged implementation process, whereby larger services would be required to gain accreditation first so that the smaller services could learn from the process and potentially benefit from information sharing between services. The appropriate process for networking and information sharing would need to be explored through consultation. Another reason noted for why a staged process would be desirable is that there would be many hundreds of services that will need to gain accreditation, and it may place a large burden on the relevant government department responsible for the implementation. There was some concern that if there were not enough resources available for services, that there would be widespread disruption to the sector if all services were required to become accredited at once.

6.3.7 Limitations impacting on processes There are different levels of development within the homelessness services sector across the country. A key challenge will be in getting alignment between the different jurisdictions and national priorities. This has been a critical issue in both the children's services and disability services areas. There will be

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a role, both for responsive developmental strategies in each jurisdiction, and for national oversight of consistency of standards. Recent changes to the operation of the intergovernmental agreements, through the Council of Australian Governments (COAG), means that where the Commonwealth is not a direct funder of services there is very limited leverage for the national government to dictate processes. While one model that addresses this issue is a national regulatory framework with standards embedded in legislation, the centralism of this model may be seen as inconsistent with the principles of COAG. A sustainable system of accreditation is going to need the voluntary support of stakeholders across all jurisdictions.

6.4 Conclusions and issues for further investigation This discussion has been informed by a preliminary overview of key issues for an accreditation framework, based on desktop research and case study analysis, along with interviews with more than 50 sectoral experts and service providers across state and territory jurisdictions. The research has highlighted a range of potential opportunities for improving the quality of service delivery within the sector, along with the challenges of developing and of implementing a national system which will be sufficiently flexible to capture the range of services operating within the sector. Some of the potential ingredients of an accreditation system and the potential processes for implementation are summarised below, along with the particular issues which are deemed to require further consideration in the development of a national system.

6.4.1 Ingredients that support implementation The following are considered to be essential elements in supporting the implementation of a national accreditation framework for the sector: An established consensus about appropriate guiding principles and practice standards. Potential for accreditation to apply across state boundaries and to support more national operations by large providers. A tiered structure which allows agencies to choose the right level of registration according to their risk profile and scope of services, and which allows small providers to stay within the system in their own right. Availability of small grants for service development and for participation in the accreditation process. Availability of specific training modules in and recognition of, sector-specific specialist skills, based on research and evidence about the skills required. A cooperative approach by regulators and service providers around attaining and maintaining accreditation. Engagement of all stakeholders in regular reviews of the standards. Enhancement of capacity for the sector to control both the standards’ development and the monitoring and review of practices against the standards. Establishment or development of an existing organisation to take the role of a professional practitioner organisation, with a professional development focus.

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6.4.2 Successful steps in the process of establishing a national system The following are considered to be essential steps or processes for the successful establishment of a national accreditation system; Early engagement of sector – amongst peaks, advocacy groups and the range of service providers. Development of principles which underpin service provision and agreement regarding links with/and inclusion in legislation, human rights, and the use of a service charter. Research to establish appropriate skills for the service sector. Agreement of complaints processes – specifically concerning the mechanisms and roles of referral bodies. Establishment of a national process, led by the Commonwealth and delivered through a partner agency (sector, peak/academic, body/state, agency/other), to incorporate progress across states and to engage all jurisdictions in the development of standards and their implementation process. Implementation of a staged process which allows parts of the homelessness service sector to establish processes which can then be adopted more broadly. Clarity around timing established as part of the implementation processes. Publication of national standards and development of state-based implementation plans that respond to the different levels of service sector development in each jurisdiction. Establishment of a continuous quality improvement framework that allows agencies to assess issues and to respond flexibly to identifying them. Funding of processes to enhance the capacity of sector agencies, including training and capacity to participate in accreditation processes. Extensive communications and opportunities for stakeholder input into the process – ensuring it is subject to regular evaluation and review. Facilitation of opportunities for further development, responding to input from stakeholders and continuously reviewing its implementation.

6.4.3 Issues for further consideration Negotiating the process Case studies have highlighted the importance of a process of negotiation with key policy, administrative and service delivery organisations. An accreditation system necessarily considers complex policy and legislative frameworks, diverse perspectives, and stakeholder interests. The homelessness sector is no exception. It is still evolving, displays different characteristics and stages of development across state and territory jurisdictions, and is informed by local planning and funding frameworks. It is therefore important that the development of a future accreditation system considers and reflects these factors. The Australian government has committed to a process of discussion and of negotiation with key stakeholders. Discussions should consider the options of an incremental pilot process, selecting particular jurisdictions to pilot a potential approach, to leverage strengths, to assess impacts and to suggest future directions for broader application. Victoria and Queensland may both offer potential benefits as pilot jurisdictions – Victoria due to supporting frameworks already in place, and Queensland due to the regional and sectoral diversity it offers to understand positive outcomes for broader national application. Strategic engagement All other approaches for accreditation highlight the importance of a strategic engagement approach. Accreditation frameworks involve government, non-government, industry and professional bodies, private sector and service delivery agencies taking critical roles. Some have employed a centralist

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approach, others have employed third parties in audit and compliance roles, while others have adopted a model where an external and specially constituted role has assumed an oversight and monitoring function. The Commonwealth and state and territory jurisdictions should consider who is best placed to support development of the preferred model, potential lead agencies, and existing resources to deliver the desired outcomes. Managing the process Given the complexity and diversity of sectoral and jurisdictional arrangements, consideration could be given to managing the process to develop an accreditation system is managed through a national lead agency and supported by state and territory implementation and funding mechanisms (engaging all sector level stakeholders). The Prime Minister’s proposed Council on Homelessness may offer a framework for ongoing review and assessment. Managing the risks of unintended consequences The introduction of new accreditation requirements and compliance frameworks brings clear risks to small and private sector accommodation providers, who may not be equipped to respond. Ongoing review and monitoring mechanisms to consider unintended consequences and impacts resulting from the introduction of accreditation may support the process of implementation. As suggested above, this may involve the Prime Minister’s proposed Council on Homelessness. Implementation processes and addressing existing frameworks Given the diversity of the homelessness system and of existing sectoral and workforce capacity issues, the introduction of a new accreditation framework poses a developmental challenge. It is suggested that a capacity-building approach is adopted, allowing for a progressive implementation to support action learning, progress review, options for remedial actions, and investment in future directions. It is further suggested that the implementation of accreditation leverage the existing frameworks and strengths. As previously noted, Victoria may offer an opportunity to build on existing systems and pilot the approach. Discussions with state and territory stakeholders may consider the options further.

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REFERENCES

7 References Act 11(1) of the International Covenant on Economic, Social and Cultural Rights ACT Government Department of Disability, Housing and Community Services, 2002 ,Raising the Standard – a manual to guide quality improvement in ACT community service organisations, viewed at http://www.dhcs.act.gov.au/__data/assets/word_doc/0012/5007/Intro.doc ACT Government, Homelessness Charter, http://www.dhcs.act.gov.au/__data/assets/pdf_file/0005/25376/Charter.pdf Aged Care Crisis Team, Aged Care Report Card, 2007-2008, viewed at www.agedcarecrisis.com/aged- care-report-card Aged Care Standards and Accreditation Agency, http://www.accreditation.org.au/accreditation/accreditationoverview/ Aged Care Standards and Accreditation Agency (1998) Accreditation Guide for Residential Aged Care Services. The Aged Care Standards and Accreditation Agency, Parramatta Anglicare Tasmania, 2007 (October), Housing: Building a Better Tasmania, A Call for Change from the Tasmanian Community Sector, www.anglicare- tas.org.au/index.php?option=com_docman&task=doc_view&gid=133&Itemid=75 Australian Government Budget, 2009-2010, Part 6 Accountabilities under the Federal Financial Relations Framework, viewed at www.budget.gov.au/2009- 10/content/bp3/html/bp3_accountabilities.htm Australian Government Department of Education, Employment and Workplace Relations, A National Quality Framework for Early Childhood Education and Care, First wave of public consultations on reform proposals, August and September 2008 – Summary of outcomes, viewed at www.deewr.gov.au/EarlyChildhood/OfficeOfEarlyChildhood/EarlyChildhoodEducation/Documents/Sum mary%20of%20consultation%20outcomes%20(revised).rtf Australian Government Department of Families, Housing, Community Services and Indigenous Affairs, May 2008, Homelessness Green Paper: Which Way Home? A New Approach to Homelessness Australian Government Department of Families, Housing, Community Services and Indigenous Affairs, 2007, SAAP Case Management – Resource Kit for SAAP Services, Section 1.1, accessed at www.fahcsia.gov.au/sa/housing/pubs/homelessness/saap_er_publications/saap_case_mgmt_resource _kit/section_1/Documents/SEC01.pdf Australian Government Department of Families, Housing, Community Services, Indigenous Affairs and the Arts, National Disability Agreement, http://www.fahcsia.gov.au/sa/disability/progserv/govtint/Pages/policy-disability_agreement.aspx Australian Government Department of Health and Ageing, Homelessness and Mental Health Linkages: Review of National and International Literature, 2005 Australian Human Rights Commission, http://www.hreoc.gov.au/disability_rights/ Australian Institute of Health and Welfare, 2009 (April), SAAP National Data Collection Annual Report 2007-08, SAAP NDC report, Series 13, Cat. No. HOU 191, Canberra: AIHW, viewed at http://www.aihw.gov.au/publications/hou/hou-191-10662/hou-191-10662.pdf Australian Institute of Health and Welfare, 2006, Demand for SAAP assistance by homeless people 2003-04: A report from the SAAP National Data Collection, AIHW cat. no. HOU143, Canberra: AIHW Australian Government, Supported Accommodation Assistance Act 1994, Section 4(1), viewed at www.austlii.edu.au/au/legis/cth/consol_act/saaa1994359/s4.html

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Australian Institute of Health and Welfare, 2009, Community Housing 2007-08: Commonwealth State Housing Agreement national data report, p ix Black, C., 2008, ‘Supportive Housing: Case Studies’, Parity – Models of Supportive Housing, vol. 21, issue 2 Bowcott, O., ‘UK should adopt pioneering Scottish homelessness law, says UN,’ Wednesday 3 June 2009, viewed at www.guardian.co.uk/society/2009/jun/03/un-scottish-homelessness-law- recommendations-housing Chamberlain, C., and MacKenzie, D., 1992, ‘Understanding contemporary homelessness: Issues of definition and meaning,’ Australian Journal of Social Issues, vol. 27, issue 4, p.291 in Chamberlain, C. and MacKenzie, D., Counting the Homeless 2006: Queensland, AIHW, July 2009, Chamberlain, C. and MacKenzie, D., Counting the Homeless 2006: Queensland, AIHW, July 2009 Chamberlain C. and MacKenzie, D., June 2009, ‘Counting the Homeless, 2006, NSW,’ Australian Institute of Health and Welfare, p.6, Canberra: AIHW, viewed at www.aihw.gov.au/publications/hou/hou- 204-10755/hou-204-10755-c00.pdf Community Housing Federation of Australia, May 2007, Community Housing Mapping Project 2005-06 - Report on Findings Cooper, B., 2009, Suggested Standards of Practice for Case Management for Homeless Services, viewed at www.homelessnessinfo.net.au/dmdocuments/standards_of_practice_for_case_management_for_home less_services_brian_cooper_june_2009.pdf Council of Australian Governments (COAG), Intergovernmental Agreement (IGA) on Federal Financial Relations, http://www.coag.gov.au/intergov_agreements/federal_financial_relations/index.cfm Council to Homeless Persons, 2007, An Australian Blueprint to Reduce and Eliminate Homelessness, viewed at. www.chp.org.au/ Forell, S., McCarron, E., & Schetzer, L., No home, no justice? The legal needs of homeless people in NSW, Law and Justice Foundation of NSW, Sydney, 2005, viewed at http://xml.lawfoundation.net.au/ljf/site/articleIDs/46AFCFE76A8314F8CA25707500815B9F/$file/no_ho me_no_justice.pdf Gilbert and Tobin Centre for Public Law Website, University of New South Wales, www.gtcentre.unsw.edu.au/Resources/hlr/homelessnessAndTheLaw.asp Haggerty, R., 2004, Smart Moves: Spending to Save, Streets to Home and www.thinkers.sa.gov.au/rhaggerty HASS, Section 1: Upholding and promoting rights at 1: http://www.housing.vic.gov.au/community-and- housing-partnerships/community-housing/accreditation HASS, Section 2 Access to support for people experiencing homelessness at 1: www.housing.vic.gov.au/community-and-housing-partnerships/community-housing/accreditation HASS Section 3: Direct service delivery and case management at 2, Standard 3.1, www.housing.vic.gov.au/community-and-housing-partnerships/community-housing/accreditation Homelessness Advocacy Service (HAS) website, www.melbourne.homeless.org.au/has.html Homelessness Australia, A Discussion Paper on the National Affordable Housing Agreement, viewed at http://www.homelessnessaustralia.org.au/UserFiles/File/NAHA%20Discussion%20Paper.doc Homelessness Policy Watch, About Homelessness, Scottish Legislative Framework, viewed at www.crisis.org.uk/policywatch/pages/scottish_legislative_framework.html

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Housing NSW, Policy: Classes of Registration under the Regulatory Code for Community Housing Providers viewed at http://www.housing.nsw.gov.au/NR/rdonlyres/F9640DCD-EA9D-4FA5-8E41- FCD423AC891B/0/HousingNSWPolicyClassesofRegistration.pdf Human Rights Education Association, ‘The right to housing,’ viewed at www.hrea.org/index.php?base_id=149 Human Rights Law Resource Centre Bulletin, June 2008. Australian Human Rights Commission, Let’s Talk About Rights, National Human Rights Consultation Toolkit, February 2009, p.3, viewed at: www.hreoc.gov.au/letstalkaboutrights/downloads/HRA_homeless.doc Innes, G., AM, Human Rights Commissioner, HREOC, 2008 (March) ‘Can rights solve the issue of homelessness?’ Launch of the February 2008 ‘To Make a Difference: Human Rights and Homelessness’ Special Edition of Parity, p.3. Intergovernmental Agreement on Federal Financial Relations – National Affordable Housing Agreement 2009, clause 14(b), p6 Jones, A. Phillips, R. and Milligan, V., 2007, Integration and social housing in Australia: challenges and options, Research paper. Queensland AHURI p 11 Lake, P., 2005, ‘Responding to Homelessness: A Joined-up Government Approach’, paper presented to Building for Diversity: National Housing Conference McIntosh G., and Phillips, J., 2001 (November), The Commonwealth-State Housing Agreement, E-Brief, viewed at http://www.aph.gov.au/library/intguide/sp/statehouseagree.htm Memmot, P., et al., Categories of Indigenous ‘Homeless’ people and good practice responses to their needs. 2003, Australian Housing and Urban Research Institute, in Clark, J., and D’Onise, K., No Pulgi, Nunkuwarrin Yunti – Urban Indigenous Homelessness and its Effect on Health, Report of the Sixth National Indigenous Homelessness Conference, Australian Government Department of Health and Ageing, accessed at: http://health.gov.au/internet/main/publishing.nsf/Content/natsieh- publicat.htm~natsienh-publicat-ch2.htm~natsienh-publicat-ch2-10.htm Minister for Disability and Community Services, Breaking the Cycle: The ACT Homelessness Strategy Annual Progress Report July 2006 - June 2007, p. 12 National Human Rights Consultation Committee, 2009, About the National Human Rights Consultation, Share your Views, www.humanrightsconsultation.gov.au National homelessness clearing house, available at: www.homelessnessinfo.net.au/index.php?option=com_content&view=article&id=12&Itemid=14 National Human Rights Consultation Committee, 2009, About the National Human Rights Consultation, Share your Views, www.humanrightsconsultation.gov.au/ National Youth Commission, 2008, Australia’s Homeless Youth: a report of the national youth commission inquiry into youth homelessness, viewed at www.nyc.net.au Nicholson, D., The Human Right to Housing in Australia, Produced for the Housing is a Human Right Project, Centre on Housing Rights and Evictions, p.6, viewed at www.vcoss.org.au/documents/VCOSS%20docs/Housing/Human%20right%20to%20housing_Eb.pdf Northern Territory Government, Department of Justice, www.rentaustralia.com.au/content/cms/Renting+in+Northern+Territory/374/ Northern Territory Shelter, 2009 (February), Submission to the Territory 2030 Steering Committee, p 22 NSW Department of Community Services, The Good Practice Guidelines for DoCS Funded Services, viewed at www.community.nsw.gov.au/for_agencies_that_work_with_us/our_funding_programs/about_our_fundin g_reform/good_practice_guidelines.html

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NSW Department of Community Services, 2007 (October), Supported Accommodation Program (SAAP) Program Guidelines, viewed at http://www.community.nsw.gov.au/docswr/_assets/main/documents/saap_guidelines.pdf NSW Department of Housing and Commonwealth Department of Family and Community Services, 2003 (May), National Community Housing Standards Manual: Second edition Policy Review Working Group (PRWG) - Submission to Housing Ministers, 2008, Strategic Assessment of Homelessness Policy, Programs and Approaches – Jurisdiction Responses, pp. 28-34 Productivity Commission, Report on Government Services, Vol 2: Health and Community Services, Housing, section 15.11, http://www.pc.gov.au/__data/assets/pdf_file/0004/85360/volume2.pdf Quality Improvement Council, viewed at ://www.qic.org.au/about.html Queensland Government, Department of Communities, Standards for Community Services, viewed at http://www.communityservices.qld.gov.au/community/strengthening_ngos/initiatives/standards.html Queensland Government, Department of Housing and Department of Communities, 2008,’Review of program management arrangements for the Supported Accommodation Assistance Program and the Crisis Accommodation program,’ Final Report (evaluation carried out by KPMG), p. 2 Queensland Department of Employment, Economic Development and Innovation, Fair Trading within the State of Queensland, viewed at www.fairtrading.qld.gov.au/residential-service-accreditation.htm Queensland Government’s, Responding to Homelessness Strategy Brochure, www.housing.qld.gov.au/about/pdf/homelessness_brochure.pdf Queensland Fire and Rescue Service, Media Release, 10 May 2002, http://www.fire.qld.gov.au/news/view.asp?id=141 Residential Tenancies Authority (Queensland), Review of the Residential Services (Accommodation) Act 2002, Discussion Paper, February 2006, p.1 Residential Tenancies Authority (Queensland), Review of the Residential Services (Accommodation) Act 2002, Policy Review Paper, viewed at www.rta.qld.gov.au/zone_files/Docs/rs_policy_review_paper_web.pdf Residential Tenancies Authority (Queensland), Residential Tenancies Authority Legislation, viewed at www.rta.qld.gov.au/residential_tenancies_legislation.cfm Royal Australian College of General Practitioners, History of Accreditation, viewed 7 July 2009 at: www.racgp.org.au/Content/NavigationMenu/PracticeSupport/StandardsforGeneralPractices/Accreditatio nagainsttheRACGPStandards/Appendix_B_History_of_Accreditation.pdf SAAP National Data Collection, Homeless People in SAAP, Annual Report, 2006-07, Australia SAAP V Multilateral Agreement, Schedule 1, Accountability Framework Seelig, T. Phillips, R. and Thompson, A., 2007, Mid-term review of the Queensland Government’s Response to Homelessness: Final Report, University of Queensland Social Research Centre, Brisbane, p. 5 Seelig, T., Thompson, A., Foster, M., Phillips, R. and Ramsden, D. 2008. Evaluation of the Queensland Health Homeless Evaluation: Final Report. University of Queensland, Brisbane, pp. 4 - 6 Shelter SA, Snapshotz, Boarding Houses, www.sheltersa.asn.au/Documents/Snapshotz/Boarding%20Houses.pdf Shelter SA, Submission for the Review of the Residential Tenancy Act (1995), February 2003, p. 4, viewed at http://www.sheltersa.asn.au/Documents/Submission%20for%20Review%20of%20RT%20Act.pdf

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Shelter Tasmania, 2006 (May), Response to the Caravan Parks Issues Paper by Consumer Affairs and Fair Trading, viewed at www.sheltertas.org.au/newsissues/papers/sheltercarvanpark_sub_may05.pdf Shelter SA, 2008, Response to “Which Way Home”: A New Approach to Homelessness,’ p.9, viewed at www.sheltersa.asn.au/Documents/Response%20to%20Green%20Paper.pdf Shelter WA, prepared by Jim Anthony, 2005 (December), The Boarding House System in Metropolitan Perth, Occasional Paper 2005-2, p.7; viewed at www.shelterwa.org.au/publications/resandproj/OP2005- 2.pdf South Australian Government, Office of Consumer and Business Affairs, A Quick guide for Rooming House Residents, viewed at www.ocba.sa.gov.au/assets/files/roominghouse_residents.pdf South Australian Government, Social Inclusion Initiative Briefing Paper, August 2004, viewed at http://www.socialinclusion.sa.gov.au/files/Homelessness_Briefing_Aug2004.pdf Stanhope, J., Chief Minister ACT, ‘ACT Homelessness Charter Launched,’ Media Release, April 29 2009, viewed at http://www.chiefminister.act.gov.au/media.php?v=6713&m=52&s=5 State Government of Victoria, Department of Community Services, viewed at www.housing.vic.gov.au/community-and-housing-partnerships/community-housing/accreditation South Australian Government Department of the Premier and Cabinet, written by Naidoo, S., 2003, ‘Social Inclusion at Work: The South Australian Social Inclusion approach to ending homelessness,’ Parity, Council to Homeless Persons Swinburne University of Technology, 2009 (July), Homeless vary across Australia, viewed http://www.sciencealert.com.au/news/20091307-19416-2.html Tasmanian Government submission to the Senate Select Committee Inquiry into Housing Affordability in Australia, April 2008, p.6 Tasmanian Department of Premier and Cabinet, 2007, State of our Community Report 2007: Starting the Conversation Tenants’ Advice and Advocacy Service: Boarders and Lodgers Fact Sheet, viewed at http://intranet.tenants.org.au/print/fs14.htm Tenants’ Union of NSW; http://www.tenants.org.au/artman2/uploads/1/occ_ag_bp.pdf Territory Housing (Northern Territory), viewed at www.territoryhousing.nt.gov.au/ The Hon. Justice Sackville, 2004, ‘Homelessness, human rights and the law,’ Australian Journal of Human Rights , 2, p.3 The Universal Declaration of Human Rights 1945, Art 25(1), extracts in His Hon. Justice Ronald Sackville, 2004, ‘Homelessness, human rights and the law,’ Australian Journal of Human Rights, 2, p.3 Thompson, D., ‘What do the published figures tell us about homelessness in Australia?’ in the Australian Journal of Social Issues, Vol. 32, No.3, 2007 Thomson, C., 2006 (July 9), ‘Kimberley is Australia’s homeless capital,’ in WA Today, viewed at http://www.watoday.com.au/wa-news/kimberley-is-australias-homeless-capital-20090708-dd7h.html University of New South Wales, Tenants Rights Fact Sheet: Residential Tenancies Act: http://www.asc.unsw.edu.au/info/RTAact.pdf Urbis Keys Young, 1998, Homelessness in the Aboriginal and Torres Strait Islander Context and its Implications for the Supported Accommodation Assistance Program (SAAP), prepared for Family Services Branch Commonwealth Department of Health and Family Services; and, Urbis Keys Young, 2005, National Consultations on Aboriginal and Torres Strait Islander Homelessness, prepared for The Department of Family and Community Services

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Victorian Department of Community Development, Evaluation of the Impact and Effectiveness of the Western Australian State Homelessness Strategy, 2006, Perth Victorian Civil and Administrative Tribunal Website, www.vcat.vic.gov.au/CA256DBB0022825D/page/Residential+Tenancies- Legislation?OpenDocument&1=70-Residential+Tenancies~&2=35-Legislation~&3=~ Western Australian Government, Department for Community Development, SAAP Service Standards 2002, p. 3, viewed at www.community.wa.gov.au/NR/rdonlyres/930BD52B-EA09-4F18-A5F1- 1EFBBBD1BB3D/0/DCDPLNSAAPServiceStandardsWA2002.pdf

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APPENDICES

Appendix A Sectoral case studies

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Introduction...... i

1 Sectoral case study: Community housing...... 1 1.1 Scope of the sector...... 1 1.2 History of the service improvement process ...... 1 1.2.1 Early days...... 1 1.2.2 COAG reforms...... 2 1.3 Current quality frameworks...... 4 1.4 Processes to support quality ...... 8 1.5 Relationship to the regulations ...... 8 1.6 Mechanisms for monitoring and review...... 9 1.7 Effectiveness and appropriateness ...... 9 1.7.1 Regulatory burden...... 9 1.7.2 Challenges...... 10 1.7.3 Stakeholder acceptance...... 10 1.8 Implications for homelessness services...... 10 1.9 References ...... 11

2 Sectoral case study: Children’s services ...... 13 2.1 COAG reforms...... 13 2.1.1 National Quality Framework: Discussion Paper...... 13 2.1.2 Expert Advisory Panel ...... 14 2.1.3 Outcomes of the first wave of consultations...... 15 2.1.4 Regulation Impact Statement ...... 15 2.1.5 Proposed governance arrangements...... 19 2.1.6 Economic analysis of proposed ECEC National Quality Agenda ...... 19 2.1.7 Facilitation of the process...... 19 2.2 Historic scope of the sector ...... 20 2.3 History of the service improvement process ...... 21 2.3.1 Early days...... 21 2.4 Historic accreditation arrangements...... 21 2.5 Current processes to support quality...... 22 2.6 Historic legislation and relationship to regulations ...... 23 2.7 Current mechanisms for monitoring and review...... 24 2.8 Effectiveness and appropriateness ...... 25 2.8.1 Regulatory burden...... 25 2.8.2 Challenges...... 25 2.8.3 Stakeholder acceptance...... 26 2.9 Summary of accreditation elements and processes ...... 26 2.10 Implications for homelessness services...... 26 2.11 References ...... 27

3 Sectoral case study: Aged care services...... 28 3.1 Scope of the sector...... 28 3.1.1 Community care ...... 28 3.1.2 Residential aged care...... 29 3.2 Current accreditation arrangements...... 31 3.3 Accreditation standards...... 32 3.4 Processes to support quality ...... 32

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3.5 Quality assurance mechanisms ...... 34 3.6 Relationship to the regulations ...... 35 3.7 Mechanisms for monitoring and review...... 35 3.8 Effectiveness and appropriateness ...... 35 3.9 Stakeholder acceptance...... 36 3.10 Implications for homelessness services...... 36 3.10.1 Rationalisation of oversight mechanisms...... 36 3.10.2 Complaints mechanisms ...... 36 3.11 References ...... 36

4 Sectoral case study: Disability services...... 38 4.1 Introduction...... 38 4.2 Background and scope of the sector...... 38 4.4 History of service improvement processes...... 40 4.2.1 Applicable legislative instruments and agreements ...... 40 4.2.2 International developments ...... 40 4.2.3 Domestic developments ...... 41 4.4 Accreditation arrangements ...... 45 4.3 Processes to support quality ...... 47 4.4 Relationship of funding to standards and regulations ...... 48 4.5 Mechanisms for monitoring and review...... 48 4.6 Evidence of effectiveness...... 49 4.7 Stakeholder acceptance...... 49 4.8 Implications for homelessness services...... 49 4.8.1 Rationalising standards and accreditation procedures ...... 50 4.8.2 Involving service providers and service recipients ...... 50 4.8.3 Independent reviewers ...... 50 4.8.4 Training for service providers ...... 50 4.9 References ...... 50

5 Sectoral case study: Boarding houses (Queensland) ...... 52 5.1 Scope of the sector...... 52 5.2 History of service improvement processes...... 52 5.3 Current accreditation arrangements...... 53 5.4 Processes to support quality ...... 53 5.5 Mechanisms for monitoring and review...... 54 5.6 Evidence of effectiveness...... 54 5.6.1 Acceptance by key stakeholders...... 54 5.7 Implications for homelessness services...... 55 5.8 References ...... 55

6 Sectoral case study: Health – medical practitioners and general practices ...... 56 6.1 Scope of the sector...... 56 6.2 History of service improvement processes...... 56 6.3 Current accreditation arrangements...... 57 6.4 Processes to support quality ...... 57 6.5 Relationship of funding to standards and regulations ...... 58 6.6 Mechanisms for monitoring and review...... 58 6.7 Evidence of effectiveness...... 58 6.8 Implications for homelessness services...... 58

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6.9 References ...... 58

7 Summary: Consolidated overview of sectoral case studies ...... 60

FIGURES: Figure 1 – Accreditation process under National Childcare Accreditation Council quality assurance systems (adapted from Report on Government Services 2009) ...... 22 Figure 2 – Disability services certification process ...... 47

TABLES: Table 1 – Proposed national quality standard options for long day care and preschool ...... 17 Table 2 – Proposed national quality standard options for family day care...... 18 Table 3 – Proportion of state and territory licensed and/or registered children’s services by management type 2007-08 (%)...... 20 Table 4 – Disability Service Standards ...... 43 Table 5 – Consolidated overview of sectoral case studies ...... 60

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Introduction This document presents a series of case studies of service provision models and regulatory and accreditation frameworks in other sectors, namely: disability services; aged care; community housing; children’s services; boarding houses in Queensland and health practitioners. These case studies are intended to provide insights into the accreditation and legislative models operating in other sectors, including what aspects are considered to be effective or ineffective, and the impacts of the development of regulatory frameworks on service providers. The insights obtained from these case studies have informed the discussion of the potential components of a regulatory or accreditation system in the homelessness service provision sector.

Limitations of this research document This research project was undertaken during a period of less than two months, from early July to mid- August, 2009. There are a number limitations stemming from the fact that the primary research was largely a desk-based literature review and environmental scan of available resources, primarily of departmental websites and internet based resources.

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1 Sectoral case study: Community housing Accreditation in the community housing sector occurs under National Community Housing Standards, established in 1998.

1.1 Scope of the sector There were approximately 35,667 households living in community housing in Australia at 30 June 2008 occupying over 99% of tenantable community housing stock.1 Of these, 6% were identified as Indigenous households, 28% contained households with a disability, and 14% were from a non-English- speaking background. Seven per cent of principal tenants were aged 24 years or under and 8% of principal tenants were 75 years or over. Of the 1,069 community housing providers at 30 June 2008,2 three-quarters managed less than 20 dwellings each; 15% of community housing providers managed between 20 and 49 dwellings; only 11% of providers managed 50 or more dwellings. Nationally, over two-thirds (67%) of community housing dwellings were located in ‘major cities,’ 20% were located in ‘inner regional’ Australia, 10% in ‘outer regional’ areas, and 3% were located in ‘remote and very remote’ areas. A separate survey of 613 out of 1,735 community housing providers in Australia in 2006 found: 31% are welfare or not-for-profit organisations; 25% are specific community housing organisations; 21% are community housing cooperatives; 14% are local government organisations; and 7% are church-based organisations.3

1.2 History of the service improvement process

1.2.1 Early days The National Community Housing Forum4 (NCHF) developed the National Standards (first published 1998), based on work by the NSW Office of Community Housing, and in consultation with every state and territory, with funding from the Australian Government.5 NCHF’s project also piloted evaluating services using the standards, and identified options for accrediting services on the basis of the evaluations.6

1 Australian Institute of Health and Welfare, 2009, Community housing 2007-08: Commonwealth State Housing Agreement national data report, p ix

2 Community housing for the purpose of this collection includes dwellings where funding (capital and/or recurrent) is provided fully or partly through the CSHA, where the tenancy management functions are undertaken by a community provider or local government and a principle of the community provider is to provide medium- to long-term housing tenure to tenants.

The definition also excludes non-CSHA programs and properties owned and managed by community housing providers not funded under the CSHA. It specifically excludes dwellings funded under the Crisis Accommodation Program. AIHW 2009 p 3

3 Community Housing Federation of Australia, 2007 (May), Community Housing Mapping Project 2005-06 – Report on Findings, pii

4 The Forum operated as a non-profit association from July 1996 to October 2006 and had members drawn from community housing peaks, resourcing bodies, relevant State and Federal Government departments, the Australian Local Government & Shires Association, ATSIS, advisory bodies and other national housing organisations. The National Community Housing Forum is now succeeded by the Community Housing Federation of Australia.

5 Commonwealth Department of Family and Community Services

6 www.nchf.org.au

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Publication of the National Community Housing Standards Manual in 1999 established an overall framework for accreditation at the national level, which is then administered by individual states and territories. This involves three main elements: the establishment of a state-based system for reviewing services using the tools developed by the project, leading to quality improvement strategies; the accreditation and/or registration of services by states, and the national oversight of these processes to ensure consistency in standards of accredited services and the national collection of data for future quality improvement, and or financing strategies.7 Accreditation units were established in New South Wales and Queensland in 1999, to conduct accreditation evaluations using the National Standards. National oversight was provided by the Interim National Community Housing Accreditation Council, which had representatives from the jurisdictions currently or potentially involved in implementing national service standards and accreditation. The Council commenced in 2000, was auspiced by the National Community Housing Forum and wound up with the closure of the Forum in 2006. In 2002, the National Community Housing Standards were reviewed under the auspice of the National Community Housing Forum – leading to publication of a second edition of the standards. This manual adapted the first edition after extensive sector consultation and included Good Practice Standards in: tenancy and asset management; tenant rights and participation; working with the community; governance and organisational management; management systems, and human resource management.8

1.2.2 COAG reforms The 2003-2008 Commonwealth State Housing Agreement provided continuing impetus to the development of national standards. Principle Six committed to promote innovative approaches to leverage additional resources into social housing, through community, private sector and other partnerships and Principle 11 committed to promote a national, strategic, integrated and long term vision for affordable housing in Australia through a comprehensive approach by all levels of government. In 2005, state, territory and Australian Government Ministers for Housing, Local Government and Planning agreed to adopt a Framework for National Action on Affordable Housing.9 The Framework commits to a National Sector Development Plan for ‘not-for-profit growth providers’ and a National Regulatory Framework that sets out the requirements and leading practices for ‘NFP Growth organisations’ – focusing on: core national performance standards and principles of good regulation, and

7 National Community Housing Forum, 2006 (December), National Standards and Accreditation: A Brief History, viewed at www.nchf.org.au

8 NSW Department of Housing & Commonwealth Department of Family and Community Services, 2003 (May), National Community Housing Standards Manual: Second edition

9 Local Government and Planning Ministers Council: Communiqué, 4 August 2005, Melbourne, viewed at: www.alga.asn.au/newsroom/communiques/08.lgpmc/20050804.php

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specifications for instruments for delivering regulation and different approaches to implementation (including monitoring and reporting against core standards). A proposal for a National Regulatory Framework for not-for-profit housing providers undertaking large scale affordable housing projects was approved for public release by Commonwealth, state and territory housing ministers on 5 September 2008. The proposal identifies mechanisms to achieve a nationally consistent approach to regulation. The Regulatory Framework will only apply to organisations with the capability to operate at scale in partnership with government and the private sector – that is, to manage large property portfolios and to contribute to construction projects. The basis of the Framework is a National Regulatory Code setting out outcomes not-for-profit housing providers must meet for registration as a Growth Provider. Each state and territory that participates in the proposed National Regulatory Framework would commit to: Operate a multi-tiered registration system within their jurisdiction which, as a minimum, included a specific category of registration for NFP Growth providers. Adopt the National Regulatory Code as the basis for defining and measuring the outcomes that registered NFP Growth providers are expected to meet. Appoint a Registrar (or assign the function to an officer) who has responsibility for making registration decisions and initiating actions allowed under the registration system. Maintain a Register that lists the organisations operating within the jurisdiction that the Registrar has recognised as meeting the National Regulatory Code. Require that registered NFP Growth providers are companies registered under the Corporations Act, are registered charities, and have a constitution that includes an appropriate social housing object and requires that, if wound up, its surplus assets must be distributed to another registered provider approved by the Registrar. Advise other jurisdictions of all NFP Growth registration decisions made by the Registrar and any changes in performance or risks associated with a particular registered NFP Growth provider that could impact on their registration status. Mutual recognition of inter-jurisdictional registration decisions. Work cooperatively across jurisdictions to develop the tools and guidelines to support nationally- consistent registration systems. Where appropriate, negotiate bilateral arrangements with other jurisdictions to share existing registration infrastructure (eg established registration assessment systems) in order to reduce the costs for smaller jurisdictions in duplicating infrastructure.10 The Council of Australian Governments’ National Affordable Housing Agreement (NAHA) commenced on 1 January 2009, and commits Federal, state, territory and local governments to identify and have best practices11 and ongoing reforms including enhancing the capacity and growth of the not-for-profit housing sector, supported by a nationally consistent provider and regulatory framework.12

10 ARTD Consultants, 2007 (July), Proposal for a National Regulatory Framework for Affordable Housing – Final Report, p6

11 Intergovernmental Agreement on Federal Financial Relations – National Affordable Housing Agreement 2009, clause 14(b), p6

12 NAHA clause 20(i), p7

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1.3 Current quality frameworks Service providers within the community housing sector are currently monitored in relation to the quality of service provision through registration under a regulatory framework as well as accreditation against minimum standards. National standards are operationalised by each state and territory jurisdiction, with different levels of progress towards national consistency. New South Wales administers its legislatively-based registration process through a Registrar of Community Housing. The Registrar operates as a business unit of Housing NSW, but is independent and reports directly to the minister for housing. The Registrar: assesses the suitability of organisations to be registered and maintains a register of suitable community housing providers; investigates complaints and other matters involving registered community housing providers; provides advice to the minister in relation to community housing, any regulation and on the matters to be included in a regulatory code for registered community housing providers, and where necessary, can intervene in the operations of a registered provider to safeguard ongoing operations.13 As Housing NSW consolidated its role as the ‘regulator’ of community housing, it has tendered out its accreditation services. In 2008, Global-Mark Pty Ltd14 became the only recognised provider of accreditation services to community housing providers in NSW. Although relying on some initial Housing NSW funding, the tendered services aim for a self-financing model, through charging agencies for the accreditation services.15 Housing NSW will recognise decisions of Global-Mark’s Accreditation Committee. The Accreditation process includes:16 A document review of the systems, policies and procedures of the organisation (typically completed off site). An on-site assessment (certification review) to test the consistent implementation of the systems in compliance with the requirements of the Standards (this will include review of records, discussions and interviews with management, board members, tenants and other stakeholders as needed). Reporting (a comprehensive report and findings are presented at the end of the process). Follow up activities (typically within three months) to ensure that findings are addressed. A review team, which includes a Global-Mark Client Manager(s), and a peer evaluator(s) who have current Housing experience. Review of the review team’s recommendations for or against Accreditation, by the Global-Mark Reviews Council, which includes housing providers, tenant representatives, and accreditation experts. Accreditation is reviewed every three years, or every 12 months for partial accreditation. The level of requirements for each performance area is proportionate to the scope and scale of operation

13 Registrar of Community Housing website: www.rch.nsw.gov.au/About+Us/Legislation.htm

14 Global-Mark is a certification company, accredited by the Joint Accreditation System of Australia and New Zealand

15 Housing NSW, 2009 (May), CHD eNews No.1

16 Global-Mark website at www.global-mark.com.au/Housingprovider/

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associated with the registration class of an organisation. Importantly, not all classes of registration involve organisations meeting every requirement. Four registration classes reflect the scale and type of activities that providers engage in. They are:17 Growth provider Organisations managing a large portfolio of properties (400 or more) and undertaking housing development projects with private sector funds and investment. Housing provider Organisations managing a large portfolio of properties (200 or more) and undertaking small scale projects to develop community housing. Housing manager Organisations managing a small to medium sized portfolio of properties (30 or more) focused on property and tenancy management. Small housing manager Organisations managing a small portfolio of properties (one or more) focused on tenancy management.

The NSW Aboriginal Housing Office and the NSW Aboriginal housing sector have developed governance and management standards specifically designed for the Aboriginal housing sector of NSW. The standards establish the type and qualities of services expected, and are designed to be used in the Service Improvement System and one outcome of this system is accreditation.18 Queensland manages its legislatively-based accreditation through the Queensland Department of Housing, with accreditation decisions made by the Queensland Community Housing Standards and Accreditation Council. Council members are appointed by the Queensland Government and include government and non-government members and experts in quality/accreditation systems. Accreditation based on the National Standards starts with a self evaluation process using tools and guides developed by the Community Housing Standards and Accreditation Unit. Self evaluation can either lead to development of a Quality Improvement Plan or directly to an application for accreditation. External evaluation is conducted over one or two days by an evaluation team with at least two evaluators: an experienced evaluator who will coordinate the evaluation and a Peer Evaluator who has practical knowledge of the community housing sector19. The process involves: meetings with staff and committee members; discussions with tenants and other organisations; review of tenant files and property records; site inspection; document inspection, and evaluation briefing to give immediate feedback. Based on the contents of a draft Accreditation Evaluation Report, the Accreditation Assessment Panel considers the percentage of standards met, the overall scores recommended by the evaluation team, any correspondence from the community housing provider in response to the draft Accreditation Evaluation Report, and any other information made available to it, in order to determine an organisation's accreditation status. The Panel consists of three members from the Queensland

17 Housing NSW Policy: Classes of Registration under the Regulatory Code for Community Housing Providers viewed at http://www.housing.nsw.gov.au/NR/rdonlyres/F9640DCD-EA9D-4FA5-8E41- FCD423AC891B/0/HousingNSWPolicyClassesofRegistration.pdf

18 www.aho.nsw.gov.au/

19 www.chsau.qld.gov.au/system/evaluation.htm

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Community Housing Standards and Accreditation Council. One of these members is independent of both government and community housing providers. Successful accreditation can be either for one or three years. In 2006, around 25 organisations, approximately 5% of the sector in Queensland, were accredited. There were 44 organisations in the system in total – 19 moving towards accreditation. The Queensland Accreditation Unit currently (2009) lists six organisations as having completed accreditation under the second edition of the National Standards. Within the ACT, a regulatory framework came into effect for not-for-profit housing providers as a result of the passing of the Housing Assistance Amendment Act 2008 (the Act) on 19 August 2008. The Act commenced on 2 March 2009 with the registration of housing providers proposed to commence in late 2009. Providers in receipt of government assistance are contractually required to register: others may seek registration. Consultation with key stakeholders to develop the four Disallowable Instruments (DIs) that will form the basis of the framework is complete. Under the amended Act the Commissioner for Social Housing (the Housing Commissioner) is empowered to register, monitor, and de-register or intervene in the conduct of housing providers who breach conditions of their registration and to determine guidelines for the exercise of each of these powers, as well as standards. The ACT regulatory framework has two tiers applicable to an ‘affordable housing provider’ and community housing provider.’ The tiers are subject to regulation proportional to the level of risk each tier’s activities will involve. A Registrar has been appointed by the Commissioner for Social Housing to implement and oversee the assessment and registration of both affordable and community housing providers under the legislation. Community Housing providers in the ACT are also required to become accredited against the National Community Housing Standards. This is a distinct and separate process to registration under the Regulatory Framework. One ACT provider has been accredited under the NSW system. Victoria has legislatively-based registration, administered through a Registrar of Housing Agencies. The Housing Registrar is an operational unit within the Department of Human Services and has two main functions: registration of rental housing agencies, and compliance and performance monitoring of registered agencies. 20 The registration process for Housing Associations and Providers involves a comprehensive assessment for compliance with the Performance Standards. The Office of the Registrar of Housing Agencies has developed a range of assessment methodologies and tools for conducting registration assessments, including a major emphasis on financial viability.21 In June 2009, there were eight registered housing associations and 25 registered housing providers in Victoria. There were a further 11 applications for registration.22 South Australia’s existing quality assurance system is legislatively-based and has been modified to bring it in line with the National Standards. A sector-driven Interim Accreditation Council has been established and both the sector and government are looking at ways to promote the National Standards and consider options for introducing accreditation in SA.

20 Housing Registrar Annual Report 2007-08, Victorian Government Department of Human Services, 2009, p5

21 Proposal for a National Regulatory Framework for Affordable Housing – Final Report, ARTD, 2007, p18

22 Note: as of September 2009 there are 35 registered agencies, nine housing associations and 26 housing providers.

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An analysis of growth capacity: resulted in a comprehensive set of indicators which can characterise a high quality NFP Growth Housing Provider, and provided a gap analysis to participating organisations. This work highlighted areas of each organisation’s structure and function which will require development should they wish to further pursue becoming a potential NFP Growth Provider.23 A Preferred Growth Provider program was launched by Housing SA: Office for Community Housing, in early March 2009, to work with a small group of high performing housing providers who can demonstrate significant growth capacity and high level governance capability. It is expected that this group will include some traditional community housing providers, and some organisations which are new to the sector. The selected Preferred Growth Providers will be the organisations to receive allocations through the Stimulus Plan, the National Rental Affordability Scheme and any future allocations from the Affordable Housing Innovations Fund and other programs as they arise.24 The Office of Community Housing Regulation team is responsible for the regulation of Housing Co- operatives and Associations, and the new Preferred Growth Providers. SA is developing capacity consistent with the National Standards and is contributing to development of national regulation, but does not yet have an accreditation process. Western Australia has a diverse community housing sector, with 241 agencies managing nearly 5,000 units.25 Community Housing organisations have been accredited under the Community Housing Coalition of WA Code of Practice, which was based on the National Community Housing Standards. Registration is now under the Department of Housing and Works, Community Housing Regulation - Registration Policy 2007 Registration is managed administratively by the Department of Housing and Works, through a Registrar of Community Housing Providers, being the Manager of the Registration and Compliance Unit (RCU) in the Community Housing Branch of the Department. Registration is under one of three, tiered registration categories: Growth providers are organisations that meet the WA Community Housing Growth Provider Regulatory Code and have a strong strategy toward growth and the development of social housing. In Western Australia it is expected that only a small number of Growth Providers will be registered initially. Preferred providers typically house people from a specific target group or geographical location and have a housing portfolio of approximately 100 units or more. Registered providers will typically be smaller organisations with housing portfolios of below 100 units with limited capacity or demand for further growth and development of social housing. The WA Community Housing Growth Provider Regulatory Code is aimed at higher level outcomes for social housing including property development and project, contract, investment, and commercial risk management. Registration is assessed by a combination of self assessments, evidence, review by RCU and site visits. There is an administrative review process for decisions of the RCU. In Tasmania there are approximately 50 community-based housing providers, managing just under 500 properties. Organisations range in size from a Housing Association managing over 100 homes to small

23 South Australian Housing Trust Annual Report 2007-2008, Department for Families and Communities, 2008, p27

24 Community Partnerships (Office for Community Housing) eBulletin – April 2009

25 Pike, L., Community Housing – Regulation for the Future, Department of Housing and Works

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community based housing providers managing only a handful of properties. There are seven cooperatives within the sector, managing around 100 properties.26 The Standards have been made broadly available in Tasmania. The Department has expressed interest in exploring accreditation options. The Standards have been made available in the Northern Territory and sector development activities are underway.

1.4 Processes to support quality A project (concurrent to the initial development of community housing standards) by the Australasian Urban and Housing Research Institute developed national competency standards describing the skills needed to perform the work of community housing provision. The competency standards are used to assess individual skill levels, and were used to develop curricula for accredited training programs. Certificate IV and Diploma in Social Housing qualifications are now accredited through VETAB and available from several sources nationally, including through industry bodies. All jurisdictions maintain or link to web-based resources designed to support organisational capacity building and compliance with the national standards. The standards and extensive resources to assist organisations are available on the web. Both national and state-based non-government peak agencies are engaged in projects to raise capacity and compliance with the standards. The standards are based on a constant quality improvement model and most accreditation systems allow for a period of quality improvement after self-assessment.

1.5 Relationship to the regulations As a part of, or in addition to the COAG reform process, several states are undergoing regulatory review processes, described as follows:

New South Wales In New South Wales, amendments to the Housing Act (2001) in 2007 and the Housing Regulation 2009, which commenced on 1 May, establish the regulatory code and Registrar, and require housing providers be accredited and registered with the Registrar in order to receive assistance from Housing NSW.

Queensland Achieving and maintaining accreditation by 31 January 2010 is a requirement under the Housing Regulation 2003 for registered organisations funded under the Community-managed Housing – Studio Units program, Affordable Housing program and the Community Rent Scheme, and for long-term community housing providers managing more than 100 tenancies. New providers must become accredited within 18 months of becoming registered under the Housing Act 2003.27

Victoria Amendments to the Housing Act 1983, in January 2005, created a regulatory framework for rental housing agencies providing affordable housing. This legislation also created the Registrar of Housing Agencies, with functions and powers to register and regulate rental housing agencies.

26 http://www.sheltertas.org.au/communityhousing/communityhousinginfo.html

27 Community Housing information bulletin - March 2009

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South Australia South Australia has a legislatively-based registration system covering Housing Cooperatives and Housing Associations (SA Co-operative and Community Housing Act 1991.) The Registration of Housing Associations is dealt with in Schedule 1 of the Act. The current registration process is essentially administrative, although once registered, providers are required to comply with the prescribed requirements in the legislation. In the broader NGO sector there is an increasing emphasis on accredited, ‘quality’ systems that can provide assurance to funders and consumers about business and customer processes. In SA the Service Excellence Framework (SEF) is increasingly being used by non-government agencies – especially in the disability sector. A number of CHOs are about to undertake the SEF and this will provide a useful example of how SEF could be more widely used across the community housing program. It is very likely that over time accreditation processes will become the norm for NGOs and that government regulators and funders will stipulate some minimum accreditation as a pre-condition of funding.28

Western Australia Under the Department of Housing and Works, Community Housing Regulation - Registration Policy 2007, community housing organisations must be applying for, or hold, registration in order to receive government funding. Growth Providers will be eligible for funding under the State Community Housing Investment Program (SCHIP). Preferred Providers must comply with the National Community Housing Standards 2003 and will be eligible for future funding under the Crisis Accommodation Program (CAP), Community Housing Program (CHP), Joint Venture Housing Program (JV), Community Disability Housing Program. Registered Providers will not be eligible for SCHIP funding but may be considered for further funding under the CAP, CHP, JV programs.

1.6 Mechanisms for monitoring and review An initial review of the standards was completed after five years operation, in 2003. An extensive process of national consultation was undertaken by consultants, under the auspice of the National Community Housing Forum. The standards are currently under review again, since March 2008. The Queensland Department of Housing is leading the review of the Manual with the non-government sector and all states, territories and the Australian Government participating.

1.7 Effectiveness and appropriateness While there has been no specific evaluation of the impact of registration, sector stakeholders credit the registration and quality improvement processes for raising standards of service, governance and probity.

1.7.1 Regulatory burden The community housing sector has a wide range of organisations delivering services, from very small groups managing just one or two houses, to large specialist housing managers with extensive portfolios. While all services take on an extra regulatory burden, it is felt that this is most challenging for the small agencies and may threaten their ongoing viability.

28 A New Vision For Community Housing in South Australia – Discussion Paper, South Australian Community Housing Authority, January 2006 p 5

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Within some states, the need to manage the risks associated with placing an unnecessary regulatory burden on smaller agencies with fewer resources to leverage has been recognised. In New South Wales, for example, where agencies are classified through a tiered registration system, the level of requirements for each performance area is proportionate to the scope and scale of operation associated with the registration class. In Western Australia too, the regulatory framework has regard for the range of organisations operating in the sector, with registration processes being appropriately tailored to one of three tiered categories. While a risk-based approach is inherent in existing systems within some – but not all –states, there further opportunities remain to reduce the risks to smaller service providers through the introduction of a tailored system across the board.

1.7.2 Challenges Some jurisdictions are more advanced in the development of the housing association sector and their regulatory regime. Increasingly, the large housing associations are developing projects and operating across state borders, which can introduce multiple registration requirements and burdens. There is a challenge in attaining national consistency in the requirements for registration.

1.7.3 Stakeholder acceptance There is a very high level of stakeholder acceptance of the regulatory regime. Service providers and their peak organisations have been closely involved in the development of quality improvement processes and regulatory standards from the beginning. The level of support for regulation is largely driven by the awareness that increased management standards are inextricably linked to expansion and growth in the sector. Standards and quality improvement processes support the sector’s ambitions to hold title to the properties they manage and to be able to leverage extra resources into the task of developing more affordable housing stock and stronger, more viable housing associations.

1.8 Implications for homelessness services In Victoria, Homelessness Assistance Service Standards recognise achievement against other organisational management standards, such as housing registration. The tiered design of the registration standards supports the diversity of providers in the housing sector and could apply well to the diversity of types and size of agencies providing homeless services. National standards and state-based implementation has allowed for flexible implementation that responds to the level of service sector development in each jurisdiction. Successful steps in the process of establishing a national system included: Early engagement of service sector representatives. A national process, funded by the Commonwealth but delivered through a sector peak body (the National Community Housing Forum), to incorporate the developments across states and engage all jurisdictions in the development of standards. Publication of national standards and development of state-based implementation plans that responded to the different levels of service sector development in each jurisdiction. The constant quality improvement model allowed for agencies to assess and respond to shortcomings. Projects funded by state jurisdictions to enhance the capacity of sector agencies - often provided by sector peak agencies.

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Ingredients of the system that support acceptance include: The potential for registration to apply across state boundaries and support more national operations by large housing providers. The tiered structure of registration, which allows agencies to choose the right level of registration according to their risk profile. The tiered structure of registration, which matches compliance requirements with level of risk and allows small providers to stay within the system in their own right. Availability of small grants for service development. Availability of specific training modules in social housing and recognition of sector-specific specialist skills. A cooperative approach by regulators and service providers, around attaining and maintaining registration. A clear link between registration and further funding. Engagement of all stakeholders in regular (each five years) reviews of the standards. The first of these reviews was led by a non-government agency and the current review is led by the Queensland Department of Housing.

1.9 References Australian Institute of Health and Welfare, 2009, Community housing 2007–08: Commonwealth State Housing Agreement National Data Report Community Housing Federation of Australia, 2007 (May), 2005-06 Community Housing Mapping Project - Report on Findings National Community Housing Forum (website), December 2006, National Standards and Accreditation: a Brief History NSW Department of Housing and Commonwealth Department of Family and Community Services, May 2003 (May), National Community Housing Standards Manual: Second edition Local Government and Planning Ministers Council: Communiqué, 4 August 2005, Melbourne, viewed at: http://www.alga.asn.au/newsroom/communiques/08.lgpmc/20050804.php ARTD Consultants, 2007 (July), Proposal for a National Regulatory Framework for Affordable Housing – Final Report Intergovernmental Agreement on Federal Financial Relations – National Affordable Housing Agreement 2009 Housing NSW, Registrar of Community Housing: CHD eNews No.1 May 2009 Housing NSW Policy: Classes of Registration under the Regulatory Code for Community Housing Providers ACT Government, 2008, Affordable Housing Action Plan Progress Report, Victorian Government Department of Human Services, 2009, Housing Registrar Annual Report 2007-08 Department for Families and Communities, 2008, South Australian Housing Trust Annual Report 2007- 2008 Community Partnerships (Office for Community Housing) eBulletin – April 2009 Pike, L., Community Housing – Regulation for the Future, Department of Housing and Works

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Queensland Community Housing information bulletin – March 2009 South Australian Community Housing Authority, 2006 (January), A New Vision for Community Housing in South Australia – Discussion Paper Community Housing Federation of Australia, 2009 (June), Achieving a viable and sustainable community housing sector: an Industry perspective

Internet references www.rch.nsw.gov.au/About+Us/Legislation.htm www.sheltertas.org.au/communityhousing/communityhousinginfo.html www.global-mark.com.au/Housingprovider/ www.aho.nsw.gov.au/ www.chsau.qld.gov.au/system/evaluation.htmhttp://www.nchf.org.au

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2 Sectoral case study: Children’s services

2.1 COAG reforms All Australian Governments have committed to national reform in the area of child care. Through the Council of Australian Governments (COAG), every state and territory government and the Commonwealth Government have endorsed partnership agreements relating to Indigenous Early Childhood Development (part of Closing the Gap targets for Indigenous Children) and a National Partnership Agreement on Early Childhood Education which provides $970m in Australian Government funding to ensure that by 2013 every child has access to quality early childhood education. Some $955m of this funding goes to state and territory governments through bilateral agreements to support implementation of the Universal Access commitment – it is intended that there will be ongoing funding of $450m per annum once Universal Access has been achieved by 2013. These major funding agreements are part of a broader reform agenda which includes actions to: address early childhood workforce issues; establish a national Early Years Learning Framework; create a national approach to quality and regulation of early childhood education and child care; improve data and performance information in early childhood; and develop a national early childhood development strategy.

2.1.1 National Quality Framework: Discussion Paper In December 2007, the Council of Australian Governments (COAG) sought a series of reforms to be conducted through the Productivity Agenda Working Group (PAWG) within a new national quality framework for early childhood education and care, including: strong national quality standards; a quality rating system to drive continuous improvement and clear consumer information, and streamlining or integrating licensing and accreditation arrangements. Throughout 2008, a Discussion Paper was issued, public consultations were held and an Expert Advisory Panel on Quality Early Childhood Education and Care appointed. The Discussion Paper recognised that a significant proportion of children will spend some time in formal or informal care from birth, and that the quality of that care has positive and long-term effects on children’s development. It identified that the early childhood education and care sectors in Australia have been largely planned, funded and delivered separately; that the distinction between ‘education’ and ‘care’ is artificial and that traditional child care settings need to refocus on learning and development.29 The paper also commented on current fragmented regulatory arrangements, with the Commonwealth having responsibility around Child Care Benefits, Child Care Tax Rebate, funding of the NCAC, funding of organisations to provide training and provision of some operational and capital funding to service providers. The states and territories, meanwhile, have varying roles and responsibilities which may include preschools; licensing, monitoring and setting standards for children’s services; providing funding to non- government service providers; providing information and support; providing curriculum advice and

29 Productivity Agenda Working Group: A national quality framework for early childhood education and care: A discussion paper, August 2008. pp.7,8

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training; providing parental advice, providing dispute resolution mechanisms; and undertaking some direct service provision. The paper indicated that this approach was unsatisfactory because of the shared responsibility of the Commonwealth and state/territory governments for early childhood education and care regulation and because of different regulatory arrangements for different services. It indicated a series of shared goals and a quality and standards system focusing on the following: leadership and management (service governance, continuous improvement, planning and evaluation and business management); relationships between staff and children; family and community partnerships; an Early Years Learning Framework and a differentiated play-based curriculum and evaluation of programs; and physical environment aspects. The discussion paper sought feedback on whether the key drivers of quality were considered to be those described above; how these should be reflected in standards; in which settings they should be applied; aspects for consideration (eg health and safety, physical environment, staffing standards in different setting and the integration of preschool and child care); potential impacts of new standards on workforce, financial viability and service provision and issues around staff qualifications and staff-child ratios and group size; as well as on transition arrangements. Advice on service rating (an A-E service rating was proposed), workforce improvement and improving the overall regulatory approach was also sought. Findings from the consultations indicate support for national quality standards across the areas described in the discussion paper. Parents were keen to ensure a focus on the health, safety and security of their children. Staff qualifications, staff to child ratios and group size were also considered important, although parents of children (especially those under two years) placed more emphasis on a carer’s nurturing capacity than formal qualifications. There was a mixed response to the proposed ratings system, which parents suggested would not provide useful information in its current form – the three tiered system of ‘provisional,’ ‘operating effectively’ and ‘centre of excellence’ was considered preferable, as were licensing and accreditation arrangements that give parents consistency and certainty around the quality of care being delivered. There was not strong understanding of the concept of an Early Years Learning Framework. Low wages, high turnover and staff attraction and retention were seen as key workforce issues. Cost implications around supporting ongoing staff development were recognised alongside the perceived need to raise the perceived status of early childhood education and care. Indigenous families, Culturally and Linguistically Diverse families and families of children with disabilities also provided specific views on aspects of childhood education and care that could be improved to be more appropriate to their children’s needs.

2.1.2 Expert Advisory Panel The Expert Advisory Panel (EAP) Report details differences in licensing requirements, standards and programming across states and territories.30 It also identified differences in some states (NSW, Western Australia and Queensland) in required early childhood qualifications.31 The EAP indicated that the following aspects of quality requiring attention in a national system (borrowed from the OECD) should include:

30 Expert Advisory Panel on Quality Early Childhood Education and Care: Towards a national quality framework for early childhood education and care, January 2009, pp 7-9

31 Ibid, Appendix C

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Orientation quality: Government engagement through national legislation, regulation and policy initiatives. Structural quality: the overarching structures needed to ensure quality in early childhood programs. Educational concept and practice: the curriculum framework, underpinning knowledge of staff and the application of these in practice. Interaction or process quality: the day-to-day experience of children. Operational quality: the management and leadership – including policy and process – that guide the way a service operates. Child-outcome quality or performance standards: the environment and interactions that improve the present and future well-being of children. Standards pertaining to parent/community outreach and involvement: outreach to parents groups, efforts to improve the home learning environment responsiveness to local cultural values and norm and participation in integrated programming. The EAP Report also detailed ‘quality enablers’ for children’s services. These aspects have relevance to accreditation and service improvement for homelessness services.

2.1.3 Outcomes of the first wave of consultations The outcomes from the first wave of consultations were made available to the PAWG. The Group considered this information as well as advice from the EAP, during the development of more detailed draft documents, including: a set of draft national quality standards; draft models for quality rating systems; a draft Early Years Learning Framework; and proposals for enhanced regulatory arrangements. A series of focussed discussions with selected early childhood education and care providers and sector representatives has also been held.

2.1.4 Regulation Impact Statement On 2 July 2009, COAG agreed to commence a formal process of consultation on quality reforms in early childhood and child care. A series of options are set out in the Consultation Regulation Impact Statement. These will eventually cover the full range of early childhood education and care, including: long day care; family day care; outside school-hours care; preschool; in-home care (eg children with a disability who cannot be cared for outside the home); occasional care; and non-mainstream services (flexible services; mobile services; Indigenous services; crèches, neighbourhood models of occasional care).

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It is envisaged that the National Quality Agenda will incrementally incorporate service types, starting with the largest (in terms of numbers of children) and the most regulated – including, in this instance, LDC, FDC, OSHC and preschools. The proposed areas for attention in the National Quality Agenda broadly relate to those identified by the EAP, above, and include: The quality of interactions and relationships between children and ECEC staff. The programs or curricula that support children’s learning and development. Connections with family and community. Leadership and management. The qualifications and training of staff and staff-to-child ratios. The physical environment. Health and safety requirements. The first three of these are regarded as ’process’ components, while the final four are ‘structural’ components of quality. As part of the consultation process, four national quality standard options are proposed for long day care and preschool. These are set out in Table 1 over page.

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Table 1 – Proposed national quality standard options for long day care and preschool

Option Staff-to-child ratio Qualifications LDC and No COAG Policy change No COAG Policy change Preschool Option 1 - Under this option states and territories will Under this option states and Baseline be free to choose whether or not to make territories will be free to choose their own changes to ratios, and may whether or not to make their own include some growth changes to qualifications, and may include some growth A broad range of standards for ratios between jurisdictions will remain A broad range of standards for qualifications will remain

LDC and For children from birth to 24 months the All staff working with children would Preschool staff-to-child ratio to be 1:4 no later than be required to have a minimum Option 2 the end of 2015 Certificate III level qualification (or be enrolled in study) no later than For children aged 25 to 35 months the the end of 2013. staff-to-child ratio to be 1:5 no later than the end of 2015 Fifty per cent of all staff working with children are to have a qualification For children 36 months to school aged the (or be enrolled in study) of Diploma staff-to-child ratio to be 1:11 no later than or above by no later than the end of the end of 2016 2013. Services that have 25-59 children LDC and For children from birth to 24 months the on any day, are required to employ Preschool staff-to-child ratio to be 1:4 no later than 1 full-time university qualified early Option 3 the end of 2011 childhood teacher by 2013. For children aged 25 to 35 months the Services that have 60-80 children staff-to-child ratio to be 1:5 no later than on any day, are required to the end of 2014 employ0.5 of an additional For children 36 months to school age the university qualified professional by staff-to-child ratio to be 1:11 no later than 2015, and a full additional university the end of 2015 qualified professional for services with over 80 children on any day (with exact requirements for LDC and For children from birth to 24 months the additional professionals to be Preschool staff-to-child ratio to be 1:4 no later than determined). Option 4 the end of 2010 and 1:3 no later than the end of 2020 Services with less than 25 children would be expected to have access For children aged 25 to 35 months the to a proportion of an early childhood staff-to-child ratio to be 1:5 no later than qualified teacher for educational the end of 2015 leadership by 2013. For children aged 36 months and over the Where the service provision only staff-to-child ratio to be 1:10 no later than includes children birth to 3 years or the end of 2013 where there is already a qualified teacher on site an appropriate alternative qualification may fulfil this requirements (with the need for and exact requirements for additional professionals to be determined).

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Two national quality standard options are proposed for family day care.

Table 2 – Proposed national quality standard options for family day care

Option Staff-to-child ratio Qualifications FDC No COAG Policy change No COAG Policy change Option 1 - Under this option states and territories will be Under this option states and Baseline free to choose whether or not to make their territories will be free to choose own changes to ratios whether or not to make their own Many jurisdictions will operate at a ratio of changes to qualification requirements 1:7 with variable restrictions on the age A broad range of standards for composition of children receiving care. qualifications will exist between jurisdictions.

FDC Mixed age groups of children would have a All carers would be required to have a Option 2 staff-to-child ratio of 1:7 no later than the end minimum Certificate III level of 2011 with a maximum of four children qualification (or be enrolled in study) under school age and all coordinators would be required to have a Diploma qualification no later than the end of 2013

Two options are proposed to enhance regulatory arrangements. These are: Option one: No policy change – effectively the National Childcare Accreditation Council (NCAC) or similar would remain responsible for administering the Commonwealth Government quality assurance system and states and territories would regulate child care through their own regulatory or licensing systems, including building and safety requirements; staff-to-child ratios and staff qualifications. Option two: An integrated national system for administering the National Quality Standard and Ratings Framework and a new national body assuring national consistency. This proposed system would have the following features:

− a unified national system to replace current fragmented licensing and quality assurance processes

− A single set of national standards encompassing and integrating education and care; stronger standards initially applying to LDC, FDC, preschool and OSHC

− Joint governance taking into account perspectives of all jurisdictions

− No duplication of regulation across governments or sectors

− Mutual agreement across jurisdictions about level of standards and how these may be raised in future. Similarly, two options are proposed for a quality rating system. These include: Option one: No policy change to current NCAC certification Option two: A new rating system based on a new National Quality Standard with 5 ratings. These are:

− Unsatisfactory (service does not meet National Quality Standard or, prior to legislation, does not meet relevant state/territory licensing requirement)

− Operating Requirements (for new services prior to formal assessment)

− National Quality Standard (service meets standard)

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− High Quality( service meets standard plus additional elements)

− Excellent (service demonstrates excellence by fostering innovation). The Commonwealth Government and state and territory governments will be required to implement legislative changes relating to new requirements for ChildCare Benefit approval and to allow the above options as outlined.

2.1.5 Proposed governance arrangements Assuming that there is a transition to a National Quality Agenda, the proposed joint governance arrangements will help to overcome previous fragmented licensing and regulatory arrangements. It should also help to speed discussion and agreement about issues within the system. A new National Quality Agenda commenced on an incremental basis from July 2009, with implementation of the Early Years Learning Framework being the first step. New ratio, qualification and regulatory arrangements will be implemented progressively to allow adjustment time for the sector. Implementation issues will be addressed as respective governments agree on a final position. A detailed transition plan for all jurisdictions and service types will be available once a final decision is made on the National Quality Agenda. Governments will continue to engage with the sector for all stakeholders to fully understand the transition requirements, and there will be ongoing work to address those services not considered in the framework at this time. Jurisdictions will also be collectively and individually developing strategies to improve recruitment and retention and increase training as part of the process of meeting workforce demands.

2.1.6 Economic analysis of proposed ECEC National Quality Agenda An economic analysis of the proposed ECEC National Quality Agenda undertaken by Access Economics concluded that the benefits resulting from introduction of the National Quality Standard would be children receiving incrementally higher care; costs would accrue in terms of the additional staff required to meet new staff to child ratios, through higher staff wages for newly qualified staff and the costs of increasing the qualified workforce. Benefits resulting from enhanced regulatory arrangements would be more efficient administration of industry regulation and reduced regulatory burden on industry; costs would be the costs of transitioning to the new framework and the costs of information sharing where regulatory effort was previously duplicated. The benefits of a quality rating system were assessed as better informed decision-making by parents and potential augmentation of quality improvements over time; costs were assessed as administrative costs, collection and collation of data and the dissemination of service rating information. The Access Economics report also concluded that the reforms proposed under the National Quality Agenda have the potential to markedly increase the quality of ECEC in Australia, in a consistent fashion and within an efficient regulatory environment. It noted, however, that determining the net benefits of the National Quality Standards is not currently possible.

2.1.7 Facilitation of the process The process of introducing the proposed National Quality Agenda, while not prolonged, has been comprehensive and focussed. It included the following elements: Appointment of an Expert Panel. Preparation of background documentation and feedback as the bases for consultation. Identification of relevant stakeholders and a targeted engagement process. Staged consultation to respond to key issues, including factsheets, a Q&A process, online survey, capital city and regional forums and opportunities for written and faxed submissions.

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A further factor facilitating the process is undoubtedly the information that the jurisdictions will have shared responsibility for ongoing coordination of the roll-out of the National Quality Agenda.

2.2 Historic scope of the sector Accreditation in the child care sector currently occurs nationwide, and comes under the umbrella of an incorporated body, the National Childcare Accreditation Council (NCAC), established in 1993. The NCAC notes that it works ‘in partnership with families, services, government and other key stakeholders to facilitate and support continuous improvement to the quality of child care provided for children in Australia’32. It is funded (87% of total budget in 2007/08)33 by the Department of Education, Employment and Workplace Relations to administer child care quality assurance systems. The balance of funds is received through registration fees; sale of publications and interest. The NCAC has as its mission statement: Child Care Quality Assurance – Making a difference for children. The NCAC covers the following service areas: family day care; outside school hours care; and long day care services. As at 25 February 2009, over 90% of all child care services in Australia are accredited. These include: family day care schemes, not-for-profit; community child care and corporate child care providers. There is, however, considerable variation across jurisdictions, as indicated by the following table: Table 3 – Proportion of state and territory licensed and/or registered children’s services by management type 2007-08 (%)

NSW Vic Qld WA SA Tas ACT NT

Child care

Community 27.8 34.6 37 20.9 35.1 50.7 81.6 71.3 managed 69.5 53.5 59.9 75.2 40.6 32.4 18.4 28.8 Private Government 2.7 11.8 3.1 3.9 24.3 16.8 – na managed 100 100 100 100 100 100 100 100 Total Preschool

Community 80.6 74.2 92.9 na 4.9 na 8.7 – managed 8.6 8.2 na na na 26.7 – 3.6 Private Government 10.8 17.6 7.1 100 95.1 73.3 91.3 96.4 managed 100 100 100 100 100 100 100 100 Total

32 National Childcare Accreditation Council Inc: NCAC Response to the Report of the Expert Advisory Panel on Quality Early Childhood Education and Care

33 National Childcare Accreditation Council Inc: NCAC Annual Report 2007/08, p 15

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2.3 History of the service improvement process

2.3.1 Early days It is understood that the impetus for accreditation began with the States and ultimately became a national system. We suggest that, in order to understand the drivers behind this process, it will be critical to address a series of questions to the key advisors. These questions are noted, below. Family Day Care Quality Assurance was introduced by the Commonwealth Minister for Families and Community Services in 2001 and the National Child Care Accreditation Council charged with implementing the Quality Improvement and Accreditation System (QIAS). The first accreditation decisions were made by the NCAC in 2003. A standard period of accreditation was introduced by the NCAC for all accredited services in 2002. This provided services with two and a half years in which to renew accreditation. Outside school hours care Quality Assurance commenced in 2003, with the first accreditation decisions being made in 2005. Standards were reclassified by the NCAC for family day care in 2005, and long day care in 2006, effectively raising the benchmark required by services to become accredited. There was also a transition at this time from peer validators to staff validators. The former Community Services Ministers’ Advisory Council developed a framework of performance indicators for children’s services, against which data was to be provided for the Report on Government Services. However, some of the data for the indicators is incomplete, yet to be developed or is subject to caveats by individual jurisdictions, depending upon how those services are provided locally. It is clear that the COAG reforms have now overtaken this process. The NCAC held public discussion forums throughout 2007 on Draft Standards for an Integrated Child Care Accreditation System, which would reflect new practice and address the boundaries between centre based care and childhood education. With the election of the Labor Government in November 2007 and changes in portfolio responsibilities and policy directions, further development of the Draft Standards was suspended, and existing Child Care Quality Assurance systems have continued to operate.

2.4 Historic accreditation arrangements Family day care schemes, outside school hours care and long day care centres eligible for Child Care Benefit funding must currently register with the NCAC to be part of Child Care Quality Assurance. They are issued with a Certificate of Registration and receive a Registration Kit to assist the quality assurance process. Services undergoing Quality Assurance are required to undertake, at their own cost, self assessment and must submit a Self-Study Report and to provide a Continuing Improvement Plan. These steps must involve consultation with staff and families of children in the service. Each service receives an unscheduled annual visit during a specific time period from a Quality Assurance Validator, who assesses a service’s progress toward continuous improvement. Services can comment on any indicators regarded as ‘not occurring’ and they are also encouraged to provided feedback on the visit to the NCAC. NCAC Moderators, who identify patterns of quality care from the Self Study Reports and various Validation Reports provide each service with a Continuing Improvement Guide with their accreditation decision, guidance points and recommended resources. Spot checks can also be conducted. Each service that has been accredited receives a Certificate of Accreditation which must be displayed prominently. Any service which is not accredited by NCAC must submit another Self-Study Report

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within a timeframe determined by NCAC. Each centre must pay an annual registration fee to the NCAC for their accreditation to remain current. This process is described in the Productivity Commission’s Report on Government Services, as is illustrated in Figure 1 below.

Figure 1 – Accreditation process under National Childcare Accreditation Council quality assurance systems (adapted from Report on Government Services 2009)

Families are generally encouraged to discuss quality of care with their service, and can determine the status of a service’s accreditation via the NCAC website. Where families may be concerned about quality of care, they are encouraged to discuss matters directly with their service. They can also telephone the NCAC for a confidential discussion with Child Care Advisers. However, in the matter of complaints, the NCAC notes it can only act on written complaints. The NCAC notes in its 2007/08 Annual Report, that there has been a significant increase in the number of enquiries and complaints from families, staff and members of the public about child care services.34

2.5 Current processes to support quality Services are currently provided with a range of materials to assist in the implementation of standards and quality improvement, directly and via NCAC and government websites. These include the issue of factsheet, guides and other publications necessary for participation in the quality assurance system, as

34 National Childcare Accreditation Council Inc: NCAC Annual Report 2007/08, p. 14

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well as national and international literature on early childhood development and quality assurance in service provision and customer service analysis. The NCAC trains Endorsed Quality Assurance Trainers in all three Child Care Quality Assurance systems. The Commonwealth Government currently funds Professional Support Coordinators in each state and territory who provide independent training and support to services to children’s services staff. The NCAC further provides information and support to services via the telephone, through a link with Child Care Advisers. A quarterly newsletter, Putting Children First, is issued by NCAC as a source of information for children’s services providers, Moderators, Validators and child care professionals. It includes information on new practice in early childhood development; new developments in service approaches; partnership and community development and personal development advice.

2.6 Historic legislation and relationship to regulations Current regulatory arrangements are generally regarded as confusing (in terms of jurisdictional arrangements) and resulting in the potential for gaps, overlaps and inconsistencies, especially between centre-based care and education services. As a part of, or in addition to the COAG reform process, several states are undergoing regulatory review processes. These are described as follows: Victoria was the first jurisdiction in Australia to introduce legislative protections for children with severe, life threatening allergies. This focus is apparent in the outcomes of State’s Children’s Services Regulation Review, which commenced in March 2007. Other aspects of children’s safety are also highlighted. The Victorian Government aims to integrate the provision of early childhood education and care services and to raise the quality of services for children. It has amended legislation and provided minimum standards across al childhood settings. These changes will: bring family day care services and outside school hours care services into the regulatory framework; alter the licensing process for children’s services; enhance the enforcement powers of the regulator, and improve the clarity and efficiency of the Act. The Early Years Program Unit in the Department of Education and Early Childhood Development has responsibility for the implementation of initiatives, performance measures and service specifications and targets. New Regulations came into effect on 25 May 2009. Services licensed since this date are required to meet improved staff to child ratios of 1:4 and qualified staff to child ratios of 1:12 for children up to the age of 3. For previously licensed services, transitional arrangements apply. Queensland’s Review of the Child Care Act 2002 commenced in 2007-08 with the aims of: improving safeguards for children in child care; reducing regulatory burden on services; improving requirements for enrolment, completion and monitoring of child care studies and to broaden the areas of study for school age care staff. The Office for Early Childhood Education and Care Regulation Services Unit administers the legislation. Western Australia has completed its Review of State Child Care legislation, including extensive consultation, and has completed new regulations. The government hopes that 28 resulting recommendations, together with the regulations and amendments to the Child Care Act 2007 will streamline and strengthen the regulatory framework. The Child Care Licensing and Standards Unit in the Department for Communities administers the legislation. It has commenced a program of annual visits and additional unannounced visits and a new rural/remote child care model is in the process of being developed.

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South Australia has completed a strategic assessment of the children’s services industry, which surveys the current situation nationally, and comments there is no national map of children’s services. South Australia and notes that it is continuing its reform of education and early childhood legislation. The Department of Education and Children’s Services undertakes licensing of centres. The current regulations are due to sunset in 2009 and these will be postponed from expiry for 12 months so that the new regulations will align with national reforms. Tasmania has signalled its intent to focus on implementing the Commonwealth Government’s initiatives in 2008-09. The strategic goals of the Child Care Unit in the Department of Education (which has responsibility for licensing) are as follows: Complete the review of the CBC1 Licensing Standards and commence implementation. Complete the review of the CBC1 Licensing Standards and commence implementation. Complete Stage 3 OSHC Licensing Standards and commence implementation. In conjunction with MCCAC and the Tasmanian Polytechnic, provide support to the Recognition Project. Trial and then review the GSAT (Glazing Self Assessment Tool) for OSHC with four year olds. Trial and then review new processes for OSHC services which have/wish to have approval for four year olds. Respond as required to COAG initiatives particularly those related to quality, workforce and data. New South Wales is currently undertaking a Review of the Children’s Services Regulation 2004, through the Children’s Services Directorate, having conducted an initial round of consultations. Two previous Review processes resulted in only small, incremental changes to the Regulations, mainly focusing on standards and without much consideration of regulatory efficiency or compliance. This Review is considering centre-based, mobile, home-based and now school-based care, but not Outside School hours care. Changes in the regulatory environment in NSW: from 2004-08 indicate an 18% increase in child care places and a change in the role of commercial childcare providers. There are indications that, as a result of this changing environment, regulators are taking a more legalistic approach. A Survey conducted for Stage One of the Review indicates that parents’ main priorities were: caring staff; physical environment; equipment and support for 1:4 staff:child ratios. The Survey Providers’ Survey has indicated strong support for regulation applying to services where parents were not on the premises; strong support for the 1:4 ratio (with some wanting flexibility for the size of groups aged under three to under six, and others opposing this); changes to staff qualifications sought were around child protection and first aid; they also suggested censures/breaches should deal with unsafe facilities/equipment, poor hygiene/food and inadequate staffing. The Review is scheduled to conclude toward the end of the year with a new regulation expected to commence in 2010. The ACT Government’s Children’s Policy and Regulation Unit has responsibility for the monitoring and licensing of children’s services. The Children and Young People Act 2008 was passed in August of that year. On October 27 2008 provisions commenced relating to the care and protection of children and young people including parental responsibility, out of home care, the Official Visitor, family group conferences, enforcement, appeals and review and information sharing. The Child Care Chapter of the Act was due to start in February 2009. The Northern Territory’s Children’s Services Unit in the Department of Education and Training is responsible for licensing child care services under the Community Welfare Act 1983 and the Community Welfare (Child Care) Regulations, 1987.

2.7 Current mechanisms for monitoring and review Currently, a service can apply to the Accreditation Decisions Review Committee (ADRC) for a review of its Accreditation Decision. The ADRC is appointed by the Commonwealth Government Minister responsible for children’s services and is independent of the NCAC. In the 2007/08 year, the ADRC

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provided NCAC with a total of 84 recommendations in response to requests for review – the ADRC recommended changes in 46 instances and no changes in 37 instances.35 Services have the opportunity to rate Validator visits across a range of performance measures including professionalism; knowledge; personability and conduct. Quality assurance progress statistics reported by services across each of the three service areas (family day care, outside school hours care and long day care) are updated monthly. In addition, bi-annual Quality Trend Reports identify specific areas of quality service provision, relating to childhood development; relationships with carers; communications with families, etc. Trends in areas requiring quality improvement are also monitored in these reports. As the Accreditation Body, the NCAC is governed by a Board comprising a chairperson and directors appointed by the responsible Commonwealth Government Minister. The Board meets seven times a year. The NCAC also provides analysis of the range of visitors to and usage of its website.

2.8 Effectiveness and appropriateness While the NCAC reporting processes, mechanism and data bases indicate a level of satisfaction with current processes for children’s services, it is widely acknowledged (including by NCAC) that there is a need for a more effective and appropriate process to address both early childhood education and care, and to deal with the fragmentation of the regulatory environment across jurisdictions.

2.8.1 Regulatory burden In the consultation process around the National Quality Framework for Early Childhood Education and Care, service providers sought a reduction in the cost of compliance especially the administrative burden of meeting compliance and a reduction in the overlap between Commonwealth and state/territory licensing requirements. An Inquiry conducted by the Independent Pricing and Regulatory Tribunal (IPART), in 2006, recommended ways of reducing the regulatory burden on children’s services providers at that time. It indicated that regulations were difficult to understand and comply with, and recommended changes to make the regulations more user-friendly, including for carers from Cultural and Linguistically Diverse backgrounds, including: provision of regularly updated guides in electronic forms (and hard copy provision for those without access); including answers to FAQs; mapping sections of the Building Code of Australia, ANZ Standards and legislation that must be complied with; and the importance of the provision of consistent advice from the responsible Department. Better consultation at the regulation design stage was also recommended. The cost of applying standards in relation to groups of children was recognised and the Tribunal recommended a more flexible, outcomes-based approach in this regard. The Tribunal also recommended that the Government support the COAG review to identify areas of duplication that could be addressed and to identify options to enhance efficiency, including a single national regulatory model and a single national regulator.

2.8.2 Challenges Some jurisdictions have seen value in conducting their regulatory reviews broadly in line with COAG objectives, however, it is unclear whether others are lagging, being unwilling to change or simply lacking the resources to move forward on reforms. This has led to unhelpful processes of ‘parallel’ consultative processes about regulatory processes which has not exhibited much in the way of a cooperative approach and has left the sector confused. A key challenge does appear to be around generating a sufficient moral imperative for respective jurisdictions to act collaboratively. In the current environment, if this is not able to be generated around improved client outcomes, it may be around demonstrated efficiencies through cutting down on duplication and administrative overburden.

35 National Childcare Accreditation Council Inc: NCAC Annual Report 2007/08, p. 8

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Another key challenge in raising accreditation standards is related to the costs inevitably borne by service providers (and then passed on to consumers) of staff training and back-filling positions to allow this to occur. This cost of staff investment should be properly assessed against the cost of staff turnover and therefore the need to constant recruitment. Parents apparently have a vastly different interpretation of what a rating system should look like, which poses a challenge for program administrators – however, this is a challenge which should be heeded, if the system is to be legible for all stakeholders.

2.8.3 Stakeholder acceptance The stakeholder consultation outcomes reported at the national level (in relation to the National Quality Agenda for Early Childhood Education and Care) and in New South Wales (in relation to the current Regulatory Review process) indicate a strong general acceptance of the need for accreditation and quality assurance and a willingness to proffer views about the detail of changes to those ends. There are varying degrees of acceptance indicated among different types of providers, although all seek a reduction in administrative burden. There have been views expressed in the consultation process for the National Quality Agenda for Early Childhood Education and Care that consideration of the issues appears to be rushed.

2.9 Summary of accreditation elements and processes Elements of the child care accreditation process include: Partnership with families, services, government and other stakeholders to support continuous improvement. Establishment of standards (addressing staffing ratios; OH &S matters; physical aspects of the facility; service elements). Rating system (recommended as part of new national framework). Performance Indicators for services. Transitional arrangements for new services. Self-assessment by service (registration paid by service). Continuous Improvement Plan developed by service. Validators appointed by Accreditation Council. Moderators to identify patterns of care and provide service guidance (funded by Government). Certification. Appeal process for review of certification decisions. Complaints process with regards to services. Integration/streamlining of respective jurisdictions’ Regulatory processes.

2.10 Implications for homelessness services While there currently exists a well-developed framework for accreditation and quality assurance for child care services (NCAC), the current processes seeking to bring together ‘education’ and ‘care’ and to coordinate separate and fragmented jurisdictions into one coordinated process is not unlike the changes sought in homelessness legislation. The desire for one national system, and, among some, for one regulator in children’s services is of long- standing. There is a sense that this current opportunity presents ‘one brief, shining moment’ for political and administrative change. The power of siloed government departments who have jealously guarded

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their responsibility and their way of regulating services for decades has been addressed by seeking shared agreement across jurisdictions and providing a commitment to national coordination of the National Quality Agenda during implementation and for the longer term. There have been views expressed in the consultation process for the National Quality Agenda for Early Childhood Education and Care that consideration of the issues appears to be rushed. In other reform processes (such as the Queensland Government’s Responding to Homelessness Initiative), it has been observed that changes, even those that have been long sought, require an investment of time and resources to allow for reforms to be introduced, owned and understood, as well as being implemented. It is noted that, while the period for consultation is focused, in this instance, the facilitation process for the National Quality Agenda has been comprehensive, including the appointment of the Expert Advisory Panel; stakeholder identification and staged engagement; commissioning of detailed background and research reports; and, provision of extensive opportunities for consultation and response to issues. Acknowledgement in the RIS of the commitment of respective jurisdictions to investment in both the implementation process and in workforce development is also noted.

2.11 References Access Economics Pty Ltd: An economic analysis of the proposed ECEC National Quality Agenda, (2009) July Children’s Services Sub-Committee of Community and Disabilities Advisory Council, Government of South Australia, 2009, A Strategic Assessment of the Children’s Services Industry Department of Education and Early Childhood Development, Victoria, 2007 (March), The Children’s Services Regulation Review: A discussion paper Department of Education and Early Childhood Development, Victoria, Children’s Services Legislation Fact Sheet No 1 Department of Education, Employment and Workplace Relations (DEEWR), 2009 (January), A National Quality Framework for Early Childhood and Care: First wave of public consultations on reform proposals, August and September – Summary of outcomes Early Childhood Development Steering Committee: Regulation Impact Statement for Early Childhood Education and Care Quality Reforms: COAG Consultation RIS, July 2009 Expert Advisory Panel on Quality Early Childhood Education and Care, 2009 (January), Towards a national quality framework for early childhood education and care Independent Pricing and Regulatory Tribunal, 2006 (October), Investigation into the burden of regulation in NSW and improving regulatory efficiency, National Childcare Accreditation Council Inc, NCAC Annual Report 2007/08 National Childcare Accreditation Council Inc, Response to the Report of the Expert Advisory Panel on Early Childhood Education and Care Office of Early Education and Child Care, National Quality Agenda for Early Childhood Education and Care Productivity Agenda Working Group, 2008 (August), A national quality framework for early childhood education and care: A discussion paper, August, 2008 Productivity Commission, 2009 (January) Report on Government Services

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3 Sectoral case study: Aged care services

3.1 Scope of the sector Individuals enter the aged care system at different points, requiring varying levels of care and combinations of services in a range of settings. Three important points of diversity that drive much of the variation in demand for aged care services are differences in older people’s need for care; their income and wealth, and accommodation arrangements.36 Need for care: approximately 30% of people over the age of 65 need some assistance with personal activities,37 a further 15% need assistance with other everyday activities,38 while more than 53% require no assistance at all. By age 85 years plus, more than 90% require significant care. Income: In 2007, 75% of Australians who were eligible took up the aged pension and other means- tested income support from Veterans’ Affairs. Accommodation: Almost 90% of Australians over 65 years of age live in a private dwelling with another 4.5% in accommodation for the retired or aged. While residential aged care receives the most attention in terms of regulation, community-based care serves a much larger population. Older people have a spectrum of care needs and will often experience increasing support needs, either gradually or following acute care episodes. Various bundles of services are available to cater for these needs, ranging from in-home support with some everyday and personal activities, through to full-time personal and nursing care provided in a residential care facility.

3.1.1 Community care39 Backed by government policy, a range of services are available to assist older people to live independently in the community, from personal care through nursing, medical and palliative care. Informal carers including family and friends typically supply such services, often in conjunction with more formal community care providers through a range of government-subsidised programs. The Home and Community Care (HACC) program serves as the mainstay of community care by providing basic maintenance and support services to older people (and some younger people) wishing to live independently at home. Two programs administered by the Department of Veterans’ Affairs (DVA) also offer a range of services similar to those delivered through the HACC program. The Veteran’s Home Care (VHC) program provided services to around 72,100 veterans aged 70-plus in 2006-07 while the DVA Community nursing program assisted 33,365 veterans of all ages. The Australian Government also funds three programs designed for older people eligible for residential care but who have expressed a preference to remain in the community: Community Aged Care Packages (CACPs) provide a bundle of services averaging seven hours a week as an alternative to low level residential care. Extended Aged Care at Home (EACH) programs target older people eligible for high level residential care by providing an average 23 hours of packaged care a week. EACH Dementia (EACHD) is designed to provide the highest level of community care for those with complex cognitive, emotional or behavioural needs.

36 Productivity Commission (2008), Trends in Aged Care Services: some implications, Commission Research Paper, pp 9-11.

37 Personal activities include self-case, mobility, communication, cognitive or emotional tasks and health care.

38 Other everyday activities include paperwork, transport, housework, meals and property maintenance.

39 The statistics in this section all come from: Productivity Commission 2008. Trends in Aged Care Services: some implications. Commission Research Paper, pp.12-14

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As at 30 June 2007, there were 36,555 older people receiving packaged care through these programs, the majority receiving CACPs (32,983) with the balance (3,572) receiving EACH and EACHD packages. There are also a number of programs for informal carers to help with the financially, physically, socially and emotionally demanding work of caring.

3.1.2 Residential aged care40 While only a small proportion of older persons reside in aged care homes at any given time, the lifetime probability of a person requiring residential aged care is high. A woman at age 65 has a 46% chance of eventually using an aged care home for permanent care, compared to 28% for a man. In 2005 there were over 200,000 older Australians living in residential aged care and there are almost 3,000 aged care homes, operated by approximately 1600 approved providers in receipt of funding from the Australian Government. The majority are charitable, not-for-profit organisations. Private organisations provide approximately 24% of residential care beds and state and local governments provide a minority of homes. The sector is characterised by many small operators with a few entities owning a large number of residential aged care homes. While many of the religious and charitable groups own large numbers of aged care homes on a national basis, they tend to operate them on a state or local basis. Occupancy rates are high, characteristically above 95%.

History of the service improvement process Australia’s aged care sector is subject to extensive regulation, with linkages to funding and consumer mechanisms; the following list of key aged care legislation relating to accreditation is by no means exhaustive. The Commonwealth initiated accreditation standards and principles and later supported the inclusion of consumers and independent advocacy services in each state/territory. There is little doubt that the Commonwealth was the key driver in introducing standards, however service providers were also keen to have a clear set of requirements against which to assess their own quality and performance. The Commonwealth uses a combination of funding incentives and disincentives to promote compliance. While there are standards in the community care sector through the Home and Community Care Program, this case study focuses on residential aged care, since this is the primary concern given the vulnerability of this sector’s service users. The Aged Care Act 1997.41 This is the principal regulatory instrument of the Australian Government relating to aged care. Section 2-1 of the Act nominates the government’s objectives in this area, including: to provide funding that takes account of the quality, type and level of care; to promote a high quality of care and accommodation and protect the health and wellbeing of residents; to ensure that care is accessible and affordable for all residents; to plan effectively for the delivery of aged care services and ensure that aged care services and funding are targeted towards people and areas with the greatest needs; to provide respite for families and others who care for older people; to encourage services that are diverse, flexible and responsive to individual needs;

40 The statistics in this section all are sourced from: Productivity Commission, 2008. Trends in Aged Care Services: some implications, Commission Research Paper, p14

41 Aged Care Act 1977, accessed at www.comlaw.gov.au/ComLaw/Legislation/ActCompilation1.nsf/current/bytitle/8094A5D14064FE5BCA25740E008260CF?OpenDo cument&mostrecent=1

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to help residents enjoy the same rights as all other people in Australia, and to promote ‘ageing in place’ through the linking of care and support services to the places where older people prefer to live. During early stages of implementation, the Commonwealth recognised the need for additional standards and assessment mechanisms, and there have been a series of updates regarding principles in the areas of accountability; accreditation grants; certification; information; investigation; quality of care; records; sanctions and user rights. Aged Care Standards and Accreditation Agency, 1997-98. The Agency was established to ensure that residential aged care facilities achieve and maintain high standards of care and accommodation. By 2001, all residential aged care facilities were accredited and certified. National Aged Care Accreditation and Compliance Forum, 2000. The Forum was established to allow members and consumers in the industry to discuss accreditation and compliance issues and strategies to further improve the quality of care provided in residential aged care services. Aged Care Advocacy Program, 2002. This program has been a vital element in supporting residents’ rights, offering consumer protection in the aged care environment of accreditation and continuous improvement. Improving workforce skills, 2003. Approximately 200 aged care nursing scholarships were offered to train personal care staff to increase the skills and knowledge of personal care staff. State, territory and local government regulation. Government regulation impacts on the provision of aged care services through provisions covering building planning and design; occupation health and safety; fire; food and drug preparation/storage, and consumer protection. Beyond these measures, Commonwealth, state and territory governments do not actively regulate the operation of their aged care sectors, except within the Northern Territory, where the government still licences aged care facilities which receive Commonwealth subsidies and controls their conduct through annual inspections and powers over licence renewals. According to an evaluation commissioned by the Department of Health and Ageing, the accreditation requirement is only one element in improving and sustaining quality. The Act together with the User Rights Principles provides authority for the following, which have lead to quality improvement in residential aged care.42 a Charter of Residents’ Rights and Responsibilities;43 independent advocacy services, which operate in each state and territory funded by the Commonwealth,44 and the Department’s Aged Care Complaints Resolution Scheme.45

42Department of Health and Ageing, Evaluation of the impact of accreditation on the delivery of quality of care and quality of life to residents in Australian Government subsidised residential aged care homes - Final Report, accessed at http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-iar-final-report.htm~ageing-iar-final-report-3.htm

43 Section 23.14 of the User Rights Principles provides that information about the care recipient's rights and obligations in relation to the service under the Charter must be provided to a care recipient upon entering a service

44 Part 5.5 of the Act provides for Advocacy Grants. Through the National Aged Care Advocacy Program, the Department funds Advocacy Services in each state and territory to provide independent advocacy services to residents, potential residents and their families Part 5.5 of the Act provides for Advocacy Grants. Through the National Aged Care Advocacy Program, the Department funds Advocacy Services in each state and territory to provide independent advocacy services to residents, potential residents and their families

45 Section 10.38(2) of the Committee Principles provides that '… the affected care recipient or their representative, or anyone else (the complainant) may make a complaint to the Secretary about anything that (a) may be a breach of the relevant approved provider's responsibilities under the Act or the Aged Care Principles and (b) the complainant thinks is unfair or makes the affected care recipient dissatisfied with the service.'

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The Aged Care Complaints Resolution Scheme is operated by the Department to provide a free, accessible independent system for the resolution of complaints about Commonwealth-funded aged care services, including residential services, aged care homes, hostels and community aged care packages. The Office of the Commissioner for Complaints was established in September 2000 by the Australian Government (under the Committee Principles 1997) to oversee the Complaints Resolution Scheme. The Complaints Resolution Scheme is available to anyone who wishes to make a complaint (if required, confidentially and anonymously) about an aged care home. In 2006–07 further changes were introduced which included: a more robust aged care complaints investigation process; compulsory reporting of incidents of sexual and serious physical assault in residential aged care with protections for those who report; more frequent unannounced inspections of aged care homes by the Aged Care Standards and Accreditation Agency to ensure they comply with the care and safety standards for residents, and the requirement for police background checks for aged care workers and certain volunteers in Commonwealth subsidised aged care services. Qualitative research commissioned by the Department of Health and Ageing46 has indicated that a range of other influences have supported quality improvement in the residential aged care sector. These factors include the consumer participation movement, changing community expectations and industry leadership, which has driven internal changes including consolidation of services; changes in the size of services; improved management and quality systems and improved approaches to professional development.

3.2 Current accreditation arrangements Accreditation is the arrangement established by the Commonwealth Government to verify that residential aged care homes provide quality care and services for residents. All residential aged care homes must be accredited in order to receive Commonwealth funding. It is the formal recognition provided to a home by the Aged Care Standards and Accreditation Agency (the Agency) that the home measures up to the standards for quality of care set out in detail in the Quality of Care Principles 1997. The Aged Care Act 1997 and subordinate instruments are designed to protect and foster residents’ quality of life by: focusing on the accountability of approved providers rather than on approval of premises as applied under the previous scheme regulated through the National Health Act 1953; limiting access to residential care subsidies to approved providers, and ensuring that only people assessed as suitable to provide aged care are approved as providers; specifying in the Act and in the associated Quality of Care Principles 1997 (the Quality of Care Principles), the User Rights Principles and the Accountability Principles many of the legitimate rights and expectations of residents and the responsibilities of providers; providing for the application of sanctions if approved providers fail to comply with their responsibilities; providing for a process of certification of physical facilities, with financial incentives available for certified homes, and providing for a process of accreditation of residential aged care homes, with the availability of residential care subsidies contingent on a home meeting its accreditation requirement.

46 Department of Health and Ageing, Evaluation of the impact of accreditation on the delivery of quality of care and quality of life to residents in Australian Government subsidised residential aged care homes - Final Report

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The accreditation requirement established by the Act created a key regulatory link between funding and quality of care. The most significant change introduced in the Aged Care Act has been described as ‘a move from passive monitoring of standards to an active audited regime of continuous improvement.’47 The Aged Care Standards and Accreditation Agency is a company limited by guarantee whose sole member is the Minister for Ageing. It has a board of directors appointed by the Minister and receives revenue from accreditation fees paid by aged care homes when they apply for accreditation, the accreditation grant and interest and income from educational activities.48

3.3 Accreditation standards Homes are assessed against the four Accreditation Standards: Standard 1: Management systems, staffing and organisational development Standard 2: Health and personal care Standard 3: Resident lifestyle Standard 4: Physical environment and safe systems For each standard, there are a number of outcomes – 44 in total, on which agencies are assessed as compliant or non-compliant.

3.4 Processes to support quality The independent Aged Care Standards and Accreditation Agency assesses agencies against the four standards outlined above. As part of this process, residents and relatives are interviewed about their experiences of care and services in the home. Existing aged care homes may be awarded up to three years accreditation; homes demonstrating exceptional standards may be awarded up to four years accreditation, and accreditation is not awarded to poorly performing homes. New (‘commencing’) aged care homes are awarded a maximum of one year accreditation.49 It is the responsibility of the approved provider to demonstrate the residential aged care home complies with the Accreditation Standards. The Agency’s Guide outlines the accreditation process in eight main stages as follows: 50 1. The approved provider and service conducts a self-assessment. 2. The approved provider submits an application, including the self-assessment report. 3. A team of at least two registered aged care quality assessors conducts a desk audit examining the application. 4. The same team conducts a two to three-day site audit which includes interviews with residents, their families, staff and management. Following a May 2009 Budget announcement, all funded aged care homes now receive at least one unannounced support visit annually, with a target of an average of 1.75 visits per home per year.51

47 Productivity Commissioner. Regulation and its Review 1999–2000. Example regulation impact statements. Accessed on 8 December 2006 at www.pc.gov.au/research/annrpt/reglnrev9900/ris/.

48 In the 2004 Federal Budget the Australian Government provided a further $36.3 million over four years to enable the Agency to enhance its education, accreditation and monitoring roles¨Press release, the Federal Minister for Ageing, Julie Bishop, 20 October 2004

49 The process of accreditation is outlined in the Accreditation Grant Principles 1999. Other information such as rights and responsibilities of approved providers is outlined in the Aged Care Act 1997

50 The Aged Care Standards and Accreditation Agency, www.accreditation.org.au/accreditation/accreditationoverview/

51 www.accreditation.org.au/upload/documents/August%202006%20issue%20THE%20STANDARDv41_115888945 361114.pdf

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5. The Agency considers the assessment team’s findings, any submission from the approved provider and any other relevant information, including input from the Department. It decides whether or not to accredit the service, and if granted, the period of accreditation as well as the form and frequency of support contacts and whether the service must make improvements. 6. The Agency informs the provider of the decision. 7. The Agency publishes the team’s report and the Agency’s decision on the Agency’s website.52 8. The approved provider manages compliance with the Accreditation Standards and the Act and ongoing continuous improvement to the service throughout the period of accreditation. At the same time, the Agency conducts support contacts to monitor compliance with the Accreditation Standards and the Act and, to assist the service to undertake continuous improvement.53 If the accreditation body believes, on reasonable grounds, that an accredited aged care home may not be complying with the Accreditation Standards or its other responsibilities under the Act, it may arrange for a review audit.54 Following a review audit, the accreditation body may decide to revoke the accreditation of the home, to vary the period of accreditation or to make no change.55 If the accreditation body finds non-compliance with one or more ‘expected outcomes’ and decides that non-compliance has placed, or may place the safety, health or wellbeing of persons receiving care through the home at serious risk, it must report immediately to the Department and make a recommendation on whether sanctions under the Act should be imposed on the provider.56 There is provision for reconsideration by the accreditation body of a decision concerning the period of accreditation or a decision not to accredit a home.57 There also is provision for review of certain decisions by the Administrative Appeals Tribunal, including the decision of the accreditation body to refuse an application on reconsideration58 and a reconsidered decision itself. If, following a review audit, the accreditation body maintains its finding of non-compliance; it may vary or revoke the period of accreditation and put in place a timetable for improvement.59 The timetable for improvement gives the provider a defined period within which to take corrective action. The accreditation body schedules a series of support visits to assess progress made by the service in making improvements. The Department is notified and, if upon completion of the defined period, the provider remains non-compliant or there is evidence of ‘a serious risk to the health, safety or wellbeing of a person receiving care,’ the provider is referred to the Department for action.60 The Act provides for sanctions to be placed on the operation of aged care homes by the Department under certain conditions. Part 4 of the Accreditation Grant Principles establishes the framework for enforcement of compliance with the Accreditation Standards. If a desk audit, site audit or review audit reveals evidence of serious risk to residents, or the accreditation body identifies a failure to comply with

52 The Aged Care Standards and Accreditation Agency, 2004, About Accreditation

53 The Aged Care Standards and Accreditation Agency, 1998, Accreditation Guide for Residential Aged Care Services. The Aged Care Standards and Accreditation Agency, Parramatta, p. 7

54 20 Section 3.21(1) of the Accreditation Grant Principles

55 In the event of a further review audit occurring, the powers conferred on the Agency by section 3.24 of the Principles are enlivened and may again be exercised.

56 Section 4.6 of the Accreditation Grant Principles 1999

57 Subdivision 5 of Part 2

58 Part 7 of the Accreditation Grant Principles 1999

59 Section 4.6 of the Accreditation Grant Principles 1999

60 See generally Division 3 of Part 3 and Part 4 of the Accreditation Grant Principles. For a good discussion of when ‘there is an immediate and severe risk to the safety, health or well-being of care recipients’, see the judgment of the Administrative Appeals Tribunal in (Riverside Nursing Care Pty Ltd and Secretary, Department of Health and Aged Care, 2003).

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Accreditation Standards which has placed, or may place, the safety, health or wellbeing of residents at serious risk, or the accreditation body identifies evidence of non-compliance with the Act, it must advise the Secretary and, amongst other things, recommend whether or not sanctions should be applied. The Secretary has a range of sanctions at his or her disposal up to and including revoking or suspending the 61 approved provider’s approval under Part 2.1 of the Act. 19

3.5 Quality assurance mechanisms The Aged Care Standards and Accreditation Agency’s role extends beyond assessing services for the purposes of making a decision about accreditation. It includes other responsibilities which are defined in the Accreditation Grant Principles, and are described by the Agency as: promoting high quality care and assisting industry to improve service quality by identifying best practice, and providing information, education and training; assessing and strategically managing services working towards accreditation, and liaising with the Department about services that do not comply with the relevant standards.62 To support its function of promoting high quality care, the Agency conducts educational activities and has processes in place for identifying examples of better practice.63 21 The accreditation quality assurance program is a program of activities and processes designed to maintain conformance with set processes and to find better ways of performing accreditation activities. It sits within the broader quality assurance program and ensures information on how residential aged care homes provide care and services to residents is accurate. The quality assurance program is underpinned by: Policy: the quality assurance program relating to accreditation activities begins with a strong foundation of policy. Underneath these policies sits a framework of procedures and associated documentation such as templates for sending correspondence, and assessment tools. Adherence to requirements as set out in policies and other Agency documentation ensures a consistent approach. Education: the quality assurance program is underpinned by initial and ongoing education and training of Agency staff and contractors. This ensures all personnel are familiar with requirements as set out in accreditation policies and procedures. There are educational activities for service providers (eg, evidence-based practice, continuous improvement seminars) and for assessors in the form of seminars, workshops, Internet-based materials and tool boxes. Research projects are also conducted on a regular basis. Recent examples include the impact of legislative change; best practice models; outcomes of other quality assurance activities; outcomes of case management activities, and identification of issues relating to Agency processes and outcomes. Research has also been undertaken into particular areas of activity to seek improvement or new approaches. The Office of Aged Care Quality and Compliance (the Office) is located within the Australian Government Department of Health and Ageing. It is responsible for ensuring the quality and accountability of Commonwealth-subsidised aged care services.

61 Section 66-1

62 The Aged Care Standards and Accreditation Agency Ltd. About the Agency, accessed at www.accreditation.org.au/AboutTheAgency

63 According to a recent submission made by the Agency (2004c), those processes include identification by Agency staff, self- nomination by providers who consider they are providing outstanding 'better practice' and by people wishing to speak at the Agency Better Practice events as well as the higher awards arrangements

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The Office manages national programs that seek to: ensure the safety and security of people in aged care services; promote good practice in delivery of aged care; enhance the skills and availability of the aged care workforce, and ensure the financial security of aged care residents. The Office's key responsibilities include managing the Aged Care Complaints Investigation Scheme, the Community Visitors Scheme and the National Aged Care Advocacy Program; promoting the aged care sector's awareness of the importance of providing high quality of care and the prudential regulation of approved providers charging accommodation bonds. The Office currently has a number of high priority projects reflecting the government's priorities in aged care including: extending the requirements for police checks for people working in aged care; enhancing the accreditation framework for residential aged care and the quality assurance arrangements for community based aged care; and increasing the number of nurses working in aged care.

3.6 Relationship to the regulations Aged care standards and regulations started with a principles-based focus, although consumer rights were always part of the process. Consumer rights have become more important as acknowledged by the creation of the Office of the Commission of Complaints. Consumer complaints may be brought to the Office and the Commissioner reports findings directly to the Department of Health and Ageing. Aged care facilities can be de-certified and, therefore, lose Commonwealth funding. This only occurs after a rigorous assessment process against the standards and principles enunciated in the legislation.

3.7 Mechanisms for monitoring and review The Senate Community Affairs Reference Committee is the primary national driver for monitoring and review of standards and accreditation processes. It has recommended the development of a ‘benchmark of care,’ a review of the Accreditation Standards, and a review of the documentation required in applying for accreditation.64 One of the most important changes regarding mechanisms for monitoring and review over the years is the increased involvement of consumers and other stakeholders. It is now a given that they will be included in any reviews at the Commonwealth level. States and territories also monitor their accreditation processes under the watchful eye of advocacy organisations, which work continuously to drive implementation of processes to protect and vulnerable and improve quality of care and quality of life.

3.8 Effectiveness and appropriateness While the government generally reports that virtually all facilities and services meet accreditation requirements, indicating a successful system, the Aged Care Crisis Team found otherwise.65 Using data

64 Discussion Paper: ‘Review of Accreditation Process for Residential Aged Care Homes,’ viewed at www.health.gov.au/internet/main/publishing.nsf/Content/ageing-quality-accreditation-review.htm~ageing-quality-accreditation- review-4.htm

65 Aged Care Crisis Team, Aged Care Report Card, 2007-2008, viewed at www.agedcarecrisis.com/aged-care-report-card

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published online by the Aged Care Standards and Accreditation Agency and the Department of Health and Ageing, the Crisis Team found that about 7% of aged care homes were not in full compliance with accreditation standards. The Crisis Team noted that this may be a red flag pointing to a pervasive change in ethos and a consequent malaise in the sector; a malaise, pointed to by the number of nurse whistle blowers, falling staff levels, rising community concern and the succession of scandals since 2000. If these findings are replicated in a more thorough study then this would be a serious indictment of the accreditation policies and practices embarked on in 1997.

3.9 Stakeholder acceptance There has certainly been acceptance of standards and accreditation by individuals and consumer groups. For decades, people have been calling for increased efforts to improve quality and expanded mechanisms for monitoring and review. There is a strong feeling that users of residential aged care facilities, in particular, are highly vulnerable and need strong protective mechanisms in place. Having a workable complaints mechanism has been particularly important, although there is scepticism about how well it works in practice. As with most accreditation systems, there is some concern among providers that the paperwork burden associated with accreditation takes time away from direct service delivery. This may be more of a problem for small operators than large for-profit and not-for-profit operators.

3.10 Implications for homelessness services

3.10.1 Rationalisation of oversight mechanisms There are a number of different agencies with involvement in monitoring, review and accreditation processes in aged care. While there is no explicit evidence to support that this proliferation of overseers might be inefficient, it is an issue worth investigating further. While some service providers in the aged care sector are quite large, there are also a number of small providers. The time and effort that must be expended in liaising with numerous national and state oversight bodies provides significant challenges and it is not clear that there are comparable benefits.

3.10.2 Complaints mechanisms An effective and efficient complaints mechanism which that has some teeth is an important element in sustaining quality services. While the aged care sector has such a mechanism with a Commissioner who reports directly to the Department of Health and Ageing, it is not clear whether this either protects individual rights adequately or improves service delivery more broadly. There appears to be agreement among all stakeholders that a complaints process should be part and parcel of the aged care services sector; however, a best practice system has yet to emerge.

3.11 References Aged Care Crisis Team, Aged Care Report Card, 2007-2008 Aged Care Standards and Accreditation Agency Ltd (undated), Aged care quality assessor registration requirements Aged Care Standards and Accreditation Agency Ltd (undated), Application for Accreditation, Self Assessment Prompts Aged Care Standards and Accreditation Agency Ltd, 2008, Annual Report 2007/2008, Aged Care Standards and Accreditation Agency Ltd, Parramatta

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Australian Government, 2007, Australian Government Response to the Senate Community Affairs References Committee’s Report of the Inquiry into Aged Care - Quality and equity in aged care, Commonwealth of Australia Australian National Audit Office, 2003, Managing Residential Aged Care Accreditation. The Aged Care Standards and Accreditation Agency Ltd, Audit Report No. 42 2002-03 Performance Audit, Canberra Department of Health and Ageing, 2007, Evaluation of the impact of accreditation on the delivery of quality of care and quality of life to residents in Australian Government subsidised residential aged care homes. Final Report, prepared by Campbell Research and Consulting for the Commonwealth Department of Health and Ageing, Canberra Department of Health and Ageing, 2003, Standards Setting and Accreditation Literature Review and Report prepared by Matthews Pegg Consulting Pty Ltd for the Safety and Quality Council, Commonwealth Department of Health and Ageing, Canberra Discussion Paper: ‘Review of Accreditation Process for Residential Aged Care Homes,’ viewed at www.health.gov.au/internet/main/publishing.nsf/Content/ageing-quality-accreditation- review.htm~ageing-quality-accreditation-review-4.htm Productivity Commission, 2008, ‘Trends in Aged Care Services: some implications:’ Commission Research Paper Senate Community Affairs References Committee, 2005, Quality and equity in aged care, (Senator McLucas chairperson), Senate Community Affairs Committee The Aged Care Standards and Accreditation Agency, www.accreditation.org.au/accreditation/accreditationoverview/ The Aged Care Standards and Accreditation Agency, 1998, Accreditation Guide for Residential Aged Care Services. The Aged Care Standards and Accreditation Agency The Aged Care Standards and Accreditation Agency, www.accreditation.org.au/accreditation/accreditationoverview/

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4 Sectoral case study: Disability services

4.1 Introduction The Australian Government’s White Paper on Homelessness, The Road Home: A National Approach to Reducing Homelessness, identifies the current disability services legislation as relevant to the development of legislation in the homelessness service sector. The White Paper foreshadows that the legislation and service standards which will be developed to ensure people who are homeless or at risk of homelessness receive quality services and adequate support may be based on those in the current Disability Services Act 1986, which guides services to be innovative and focused on achieving positive outcomes for people with disabilities.66 This section provides a case study on the disability services sector and identifies those aspects of the disability legislation that may have application in the homelessness service sector.

4.2 Background and scope of the sector In 2003, the ABS estimated that one in five people in Australia (3,958 300 or 20%) had a reported disability, defined as a core activity limitation, a schooling or employment restriction or an impairment. Of the population aged 5–64 years in 2003, an estimated 13% per cent had a core activity limitation or specific restriction. Of these, 4% had a profound or severe core activity limitation; 6.6% had a mild to moderate core activity limitation and 2.4% had a schooling or employment restriction only.67 Indigenous people have significantly higher rates of profound or severe core activity limitation than non- Indigenous people – an estimated 2.4 times that of non-Indigenous people aged over 18 years according to 2002 Australian Institute of Health and Welfare estimates.68 People with disabilities receive care and assistance from a range of sources including: unpaid care from family and friends; income support; disability support services, and generic services. Disability support services are primarily delivered under the Commonwealth State Disability Agreement (CSDA), (now the National Disability Agreement) as well as through programs such as Home and Community Care (HACC) and the Commonwealth Rehabilitation Services (CRS).69 The White Paper on Homelessness identifies the current disability services legislation as relevant to the development of legislation in the homelessness service sector. The White Paper foreshadows that the legislation and service standards which will be developed to ensure people who are homeless or at risk of homelessness receive quality services and adequate support may be based on those in the current Disability Services Act 1986, which guides services to be innovative and focused on achieving positive outcomes for people with disabilities.70 To support the Agreement, the Commonwealth Government has allocated approximately $5.3 billion over five years to the states and territories. Outside the Agreement, the Australian Government will continue to provide $9.88 billion for the Disability Support Pension, $3.2 billion for Carer Payment and

66 Australian Government, 2008, White Paper: The Road Home: A National Approach to Reducing Homelessness, p.68

67 Australian Bureau of Statistics, 2004, http://www.abs.gov.au/AUSSTATS/[email protected]/ProductsbyTopic/768EE722E31F6315CA256E8B007F3055?OpenDocument; Australian Institute of Health and Welfare, http://www.aihw.gov.au/disability/natpic/index.cfm

68 Australian Institute of Health and Welfare, 2006 (February), Welfare Working Paper No. 50: Disability rates among Aboriginal and Torres Strait Islander People. This estimate is based on data from the ABS’s General Social Survey (GSS) and National Aboriginal and Torres Strait Islander Social Survey (NATSISS) and takes into account differences in the: age structure of the Indigenous and non-Indigenous populations; and the method that was applied in remote areas for the two surveys.

69 Australian Government, Productivity Commission, Report on Government Services 2009, at 14.2, www.pc.gov.au/__data/assets/pdf_file/0020/85421/60-chapter14-only.pdf

70 Australian Government, 2008, White Paper: The Road Home: A National Approach to Reducing Homelessness, p.68

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Carer Allowance, and more than $600 million for services for people with disability, including employment services.71

4.3 National Disability Agreement The National Disability Agreement now provides the overarching policy framework for the delivery of specialist disability services in Australia. It aims to assist people with disability to live as independently as possible, by helping them to establish stable and sustainable living arrangements, increasing their choices, and improving their health and wellbeing. At the same time, the Agreement provides support for families and carers in their caring roles.72 The National Disability Agreement clarifies the jurisdictional responsibilities of the Commonwealth and the states and territories. All jurisdictions share the following responsibilities: Development of national policy, reform, funding and pursuing research that provides and evidence base for national policy reform and direction. They also share the responsibility of implementing reforms to improve outcomes for Indigenous people with a disability and gathering data for the national minimum data set. The Commonwealth is responsible for: Provision of employment services for people with disability. Provision of income support targeted to the needs of people with disability, their families and carers. Provision of funds to states and territories to contribute to the achievement of the objectives and outcomes of the Agreement, and where appropriate investing in initiatives to support nationally agreed policy priorities in consultation with the states and territories. Ensuring that Commonwealth legislation is aligned with the national priority, reform directions and the UN Convention on the Rights of People with Disabilities 2006. The states and territories are responsible for: Provision of specialist disability services (except employment services), for example, accommodation support services, community support services, community access services, respite services to families and carers of people with disability. Ensuring that state and territory legislation is aligned with national policy and reform directions, and where appropriate investing in initiatives to support nationally agreed policy priorities, in consultation with the Commonwealth Government. 73 The National Disability Agreement paves the way for broader reform to the disability service sector that will begin in 2009. As part of this reform, the Australian governments have committed to working in the first half of 2009 on proposals in community care relating to mental health, disability and aged care services. The goals of the reform are to improve the integration and responsiveness of services for individuals and families, to clarify accountabilities between governments and to improve performance of service systems. Specific proposals in relation to community mental health, disability services and aged care will be considered in the first half of 2009 as part of the reform process, including future arrangements under the Home and Community Care Program (HACC).74

71 Council of Australian Governments’ Meeting, 29 November 2008, http://www.coag.gov.au/coag_meeting_outcomes/2008-11- 29/index.cfm#disability

72 Australian Government Department of Families, Housing, Community Services, Indigenous Affairs and the Arts, National Disability Agreement, http://www.fahcsia.gov.au/sa/disability/progserv/govtint/Pages/policy-disability_agreement.aspx

73 Council of Australian Governments, National Disability Agreement, at 4

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4.4 History of service improvement processes

4.2.1 Applicable legislative instruments and agreements There are a number of different legislative instruments and agreements relevant to the disability sector including: International human rights covenants. Disability Services Act 1986 (and related Disability Services Standards and accreditation processes under JAS-ANZ). This legislation provides a legislative and funding framework for a range of disability services in the states and territories, most significantly employment services. Disability Discrimination Act 1992 (and related standards for education, public transport, access to premises, employment, accessibility of web pages, guidelines for insurance and superannuation). This legislation is the main Commonwealth legislation protecting the rights of people with a disability, and is supported by the Human Rights and Equal Opportunity Commission (HREOC), which is charged with protecting the rights of disabled people and advocating on their behalf. Commonwealth State Disability Agreements which have been superseded by the National Disability Agreement (and related National Disability Services Standards developed in 1992, which appear to incorporate the first eight standards of the Disability Services Standards developed under the Disability Services Act 1986).

4.2.2 International developments International law has been particularly influential in the development of Commonwealth disability legislation and a national framework for the delivery of services for disabled people in Australia. There are numerous international instruments that relate to the rights of people with disability, including: International Covenant on Civil and Political Rights 1976 International Covenant on Economic, Social and Cultural Rights 1976 Declaration on the Rights of Disabled Persons 1975 Declaration on the Rights of Mentally Retarded Persons 1971. UN Convention on the Rights of Persons with Disabilities 2006 (and Optional Protocol). The principle of universality and the guarantee of non-discrimination enshrined in all human rights instruments requires governments to ensure the full and effective enjoyment of human rights to all persons on an equal basis, regardless of condition or status. The International Year of Disabled Persons in 1981 drew attention to the experience of people with disability around the world and stimulated a range of initiatives that had implications for the provision of support and services for people with disabilities in Australia. The most important of these was a shift away from institutional services to a more community-orientated model of service provision and the development of the Disability Services Act 1986, discussed below.75

74 Australian Government Department of Families, Housing, Community Services, Indigenous Affairs and the Arts, National Disability Agreement, http://www.fahcsia.gov.au/sa/disability/progserv/govtint/Pages/policy-disability_agreement.aspx

75 Australian Human Rights Commission, Disability discrimination legislation in Australia from an international human rights perspective: History, achievements and prospects, at 5 http://www.hreoc.gov.au/disability_rights/speeches/2002/history02.htm

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4.2.3 Domestic developments Similar to the homelessness sector, the Commonwealth Government does not have original jurisdiction to legislate in relation to human rights, disability and discrimination (see the discussion at Section # of this document). In the 1980s, as NGOs and the Human Rights and Equal Opportunity Commission (HREOC) identified disability issues as a national priority, the pressure on the Commonwealth Government to provide a national response grew. However, the limitations in the Australian Constitution presented a barrier to developing national legislation. To overcome this barrier, HEROC and other interest groups successfully argued that national disability legislation could be introduced by using the external affairs power in the Constitution. The external affairs power in s 51(xxix) of the Constitution enables the Commonwealth to legislate with respect to ‘external affairs’ which includes international treaties to which Australia is a party and matters of international concern. Laws validly enacted under this head of power will take precedence over state laws, pursuant to s109 of the constitution. Drawing on the international covenants to which Australia is a party and other evidence of international concern about human rights and disability, the Australian Parliament used the external affairs power to introduce the Disability Services Act 1986 and other broad ranging legislation on disability discrimination. The power to enact legislation with respect to external affairs is the principal source of most Commonwealth legislation such as the Human Rights and Equal Opportunity Commission Act 1986. The use of the external affairs power to enact the disability legislation is relevant to the legislative review currently underway as part of the Australian Government’s response to homelessness. 76 Disability Services Act 1986 The Disability Services Act 1986 provided a comprehensive framework for the funding and provision of support services for people with disability77 The Act provided a coordinated approach to assisting people with a disability to work towards full participation as members of the community, and to achieve positive outcomes such as increased independence, employment opportunities, and integration into the community. A key objective of the Act was to de-institutionalise segregated services and increase the range and flexibility of services for people with disability. The legislative funding framework set up by the Disability Services Act applied to a range of services, in particularly employment services. The Disability Services Act also provided for a set of standards to be developed under the Act to guide the quality and delivery of services, which are known as the National Disability Service Standards. Split responsibilities It is important to note that in the early 1990s, the first Commonwealth/State Disability Agreement was signed and it split responsibility for services between the Commonwealth and the states/territories. The Commonwealth regained responsibility for disability employment services while the states assumed responsibility for all other disability services. Responsibility for advocacy services was to be shared. It was agreed that the National Disability Service Standards would serve as a guide, but each jurisdiction would be responsible for interpreting how their services met the requirements. National Disability Service Standards National Disability Service Standards set the basic benchmark for federal and state disability employment services, but federal and state/territory governments have adopted these standards differently. It is not compulsory for state/territory governments to meet the Standards, KPIs or meet the requirements of independent accreditation as set out in the Disability Services Act. Table 4 over page summaries the standards for the federal government and each state/territories.

76 Australian Human Rights Commission, Disability discrimination legislation in Australia from an international human rights perspective: History, achievements and prospects, at 5 http://www.hreoc.gov.au/disability_rights/speeches/2002/history02.htm 77 Lindsay, Mary (1996). Commonwealth Disability Policy 1983-1995, Background Paper 2. Parliamentary Library Publications.

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The 12 Disability Service Standards are included below: Standard 1: Service access: Each person with a disability who is seeking a service has access to a service on the basis of relative need and available resources. Standard 2: Individual needs: Each person with a disability receives a service that is designed to meet, in the least restrictive way, his or her individual needs and personal goals. Standard 3: Decision making and choice: Each person with a disability has the opportunity to participate as fully as possible in making decisions about the events and activities of his or her daily life in relation to the service he or she receives. Standard 4: Privacy, dignity and confidentiality: Each service recipient’s right to privacy, dignity and confidentiality in all aspects of his or her life is recognised and respected. Standard 5: Participation and integration: Each person with a disability is supported and encouraged to participate and be involved in the community. Standard 6: Valued status: Each person with a disability has the opportunity to develop and maintain skills and to participate in activities that enable him or her to achieve valued roles in the community. Standard 7: Complaints and disputes: Each service recipient is encouraged to raise, and have resolved without fear of retribution, any complaints or disputes he or she may have regarding the service provider or the service. Standard 8: Service management: Each service provider adopts quality management systems and practices that optimise outcomes for service recipients. Standard 9: Employment conditions: Each person with a disability enjoys working conditions comparable to those of the general workforce. Standard 10: Service recipient training and support: The employment opportunities of each person with a disability are optimised by effective and relevant training and support. Standard 11: Staff recruitment, employment and training: Each person employed to deliver services to a person with a disability has relevant skills and competencies. Standard 12: Protection of human rights and freedom from abuse: The service provider acts to prevent abuse and neglect and to uphold the legal and human rights of service recipients.78

The approach in the legislation and the standards is human rights based, but with strong components of individual rights and basic principles for how services will work with people with disabilities to achieve the end results. While there are many statements in the legislation and standards that confirm the human rights approach of the Act, such as re-iterating the right of people with disability to the same quality of life and dignity as all people, the legislation is not ‘entitlement based.’ Instead the legislation and standards are based on ‘relative need’. As a submission to the Inquiry into the Funding and operation of the Commonwealth State/Territory Disability Agreement states:

In legislation and in the CSTDA there is definition of ‘people with disabilities’. By definition, the population of people eligible to receive services is limited. The Federal Disability Services Act 1986 (DSA 1986) is not entitlement legislation, and neither is the complementary State/Territory legislation. The National Standards set down that access to services is based on ‘relative need.’

Section 3A(2) of the DSA 1986 explicitly addresses limited resources for disability services and relative need: In construing the objects and in administering this Act, due regard must

78 Disability Services Standards (FaCSIA) 2007, available on Comlaw, www.comlaw.gov.au/comlaw/comlaw.nsf/sh/homepage

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be had to (a) the limited resources available to provide services and programs under this Act; and (b) the need to consider equity and merit in accessing those resources. 79

Independent quality accreditation In the late 1990s, the Commonwealth started investigating the possibility of using independent accreditation bodies for employment services (open employment, supported employment and vocational rehabilitation services). JAS-ANZ would oversee the system of accreditation auditing disability employment services against disability services standards based on the National Standards but with additional standards relating to staff training and human rights and freedom from abuse. Procedure 18 provides guidance to certification bodies. All disability employment services were required to meet the standards by January 2005.Funding for disability employment services is tied to the maintenance of a certificate of compliance against the DEEWR/FaHCSIA Disability Standards. As mentioned above, states and territories operate different quality standards and have their own legislative frameworks. No state uses Procedure 18, but Queensland has adopted JAS-ANZ and the federal system of QA.

Table 4 – Disability Service Standards

Commonwealth NSW VIC QLD WA NT Standard service Standard Service access Service access Standard Service access access service access service access

Individual needs Individual needs Individual needs Individual needs Individual needs Individual needs

Decision making Decision making Decision making Decision making Decision making Decision and choice and choice and choice and choice and choice making and choice

Privacy, dignity Privacy, dignity Privacy, dignity Privacy, dignity Privacy, dignity Privacy, dignity and and and and and and confidentiality confidentiality confidentiality confidentiality confidentiality confidentiality

Participation and Participation Participation Participation Participation Respect for integration and integration and integration and integration and integration Right

Valued status Valued status Valued status Valued status Valued status Promote cultural and family relationships

Complaints and Complaints and Complaints and Complaints and Complaints and Support and disputes disputes disputes disputes disputes training for support workers and volunteers

Service Service Service Service Service Consumer management management management management management focused service management

79 Senate Community Affairs References Committee, Inquiry into the Funding and operation of the Commonwealth State/Territory Disability Agreement, Rules of Engagement, Submission by Margaret Ryan, 2 August 2006, www.aph.gov.au/senate/committee/clac_ctte/completed_inquiries/2004-07/cstda/submissions/sub29.pdf

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Commonwealth NSW VIC QLD WA NT Employment Family Freedom from Protection of Protection of conditions relationships abuse and legal and Human Rights neglect human rights and and freedom Freedom from from abuse and Abuse and neglect Neglect

Service recipient Rights and Staff training and freedom from recruitment, support abuse employment and development

Staff recruitment, employment and training

Protection of human rights and freedom from abuse

Disability Discrimination Act 1992 The Disability Discrimination Act 1992 is the main Commonwealth legislation protecting the rights of people with a disability, and is supported by the Human Rights and Equal Opportunity Commission (HREOC), which is charged with protecting the rights of disabled people and advocating on their behalf. The Disability Discrimination Act provides for the Commonwealth Attorney-General to determine disability standards to specify rights and responsibilities about equal access and opportunity for people with a disability. Standards to protect the rights of people with disability can be made in the areas of employment, education, public transport services, access to premises, accommodation and the administration of Commonwealth laws and programs.80

The following standards have been developed (or are in the process of being developed):

Disability Standards for Education 2005 Disability Standards for Accessible Public Transport 2002 Draft Disability (Access to Premises-Buildings) Standards 2009 Draft Disability Standards for Employment (not currently proceeding through Parliament) Web Content Accessibility Guidelines 2.0

Guidelines for Providers of Insurance and Superannuation (Revised 2005). The Commonwealth State Territory Disability Agreements (now the National Disability Agreement) encompassed the principles and objectives outlined in the Disability Services Act 1986, the Disability Discrimination Act 1992 and the complementary state and territory legislation. The rights of people with disabilities under the United Nations Declaration of Rights of Persons with Disabilities are also reaffirmed in the Agreements. The Commonwealth State Territory Disability Agreement focused primarily on funding and did not have a significant focus on quality improvement. However, the National Disability Agreement is focused on

80 Australian Human Rights and Equal Opportunity Commission, www.hreoc.gov.au/disability_rights/Standards/standards.html

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service quality improvements including establishing stable and sustainable living arrangements; expanding service options; improving the health and wellbeing of disabled people, and supporting families and carers. It requires Commonwealth and state/territory governments to work together to introduce single access points for services; uniform assessment processes; a national quality assurance system; more consistent access to disability aids and equipment and better ways to measure unmet demand for disability services. In addition to these national initiatives, states and territories have implemented their own service principles and standards81 It is important to view the disability standards in the context of both international agreements or statements and relevant Australian legislation such as laws relating to discrimination, guardianship provisions, Equal Employment Opportunity, Occupational Health and Safety, and Freedom of Information.

4.4 Accreditation arrangements In the late 90s, the lack of formal accreditation system to support the Disability Services Standards (made under the Disability Services Act 1986) was recognised as resulting in poor measures of quality, little incentive for improvement and an ad hoc complaints and referral system. In response, the then Minister for Family Services approved the following objectives for a new quality assurance/accreditation system in 1997: Provide people with disabilities with an improved level of confidence in the quality of service delivery. Treat all service providers equally (in both the government and non-government sectors). Make assessment of quality more objective and measurable. Link quality assurance to funding through an accreditation process which would provide the purchaser with confidence in the quality of service delivery and outcomes for individuals. Reduce government intervention in the day to day operation of services. Three options were canvassed: 1. Status-quo: the then Commonwealth Department of Family and Community Services conducted audits of employment services against 11 Disability Services Standards every five years. In addition, the service provider was required to assess their service against the standards annually and to lodge this assessment with FaCS for scrutiny. In addition, each service was required to provide internal complaints mechanism for consumers. 2. JAS-ANZ system of accreditation: this system is based on a system of accreditation/certification that is well established in the Australian industry, based on international standards of best practice tailored to the requirements of people with disabilities. It involves the use of skilled audit teams whose competence and impartiality will be monitored by an independent, internationally recognised accreditation agency, the Joint Accreditation System of Australia and New Zealand (JAS-ANZ). Audit teams include a person with a disability, either as a lead auditor or a technical expert. The role requires technical expertise and a detailed understanding of the Disability Services Standards, industry practices and strong communication skills to engage and draw feedback. 3. Disability specific system of accreditation: the disability-specific option would involve the establishment of a disability specific accreditation authority with powers under Commonwealth legislation to accredit service providers for funding purposes similar to arrangements that apply to aged care facilities.

81 Uniting Care Australia, http://unitingcare.org.au/news/national-news/462-national-disability-agreement-begins.html

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Through the consultation process, the JAS-ANZ system received ‘strong support from service providers and consumers,’ and the system was adopted on 1 July 2002 to cover Commonwealth employment services. JAS-ANZ has developed the external assessment component of the Disability Sector Quality System, known as Procedure 28, which outlines how service providers and on what basis. On 15 September 2008, version 2.1 of Procedure 28 was released for the sector. It included new elements such as: details of the two-stage audit process; key timeframes for maintenance audits and recertification; and timeframes to close out major nonconformities dealing with a notifiable issue. Independent third party auditors regularly check the compliance of Disability Employment Network members and Vocational Rehabilitation Services and may issue a ‘non-conformance’ rating for services which provide inadequate evidence of compliance. Non-conformities that remain unresolved result in serious consequences for service providers such as de-certification and finally withdrawal of government funding. Figure 2 over page illustrates the certification process.82

82 Department of Families, Community Services and Indigenous Affairs, 2008, Quality Strategy Toolkit, Australian Government Department of Families, Community Services and Indigenous Affairs, Canberra, viewed at www.fahcsia.gov.au/sa/disability/pubs/employers/Documents/quality_strategy_toolkit/default.htm

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Figure 2 – Disability services certification process

4.3 Processes to support quality The Quality Strategy in disability services includes a quality assurance system that passed into law in 2002. It requires services funded under the Disability Services Act 1986 to be independently assessed for compliance with the Disability Services Standards. All disability employment services are audited by independent third party certification bodies, which are accredited by the Joint Accreditation System of Australia and New Zealand (JAS-ANZ). Services must meet the requirements of the independent quality assurance system to receive Commonwealth Government funding.

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The Quality Strategy has three components: 1. Quality assurance: the quality assurance system of accredited certification is based on international standards of best practice. Service providers are required to be certified against the 12 Disability Services Standards with 26 related key performance indicators (KPIs). 2. Continuous improvement: this involves services constantly reviewing their performance against the Disability Services Standards and planning ongoing improvements with the aim of increasing capacity to fulfil and exceed the Standards requirements. 3. Complaints and referrals: service recipients who are not satisfied with their service provider's internal complaints and disputes mechanisms can contact the Complaints Resolution and Referral Service (CRRS). The CRRS operates a free-call hotline, which is run in conjunction with the National Disability Abuse and Neglect Hotline as a single contact point for anyone to report claims of abuse and neglect of people with disability using government funded services. There are other strategies in place to support ongoing quality. For example, the Australian Human Rights Commission83 undertakes a wide range of activities to assist individuals and organisations to understand their rights and meet their legal responsibilities. The Commission conducts public inquiries, negotiates disability guidelines and standards and supports organisations to develop Disability Action Plans and runs community education programs. People with a Disability Inc (a national peak body) and other disability organisations produce a variety of training materials to help service providers offer appropriate programs for people with disabilities.

4.4 Relationship of funding to standards and regulations While the Commonwealth and states/territories can withhold funding from organisations that have been de-certified, it does not appear that this ‘stick’ is a primary driver in promoting adherence to quality standards. The exception may be in competitive funding processes when a jurisdiction identifies specific practice principles as criteria for funding decisions. For example, Victoria has developed a policy and funding plan for disability services that includes a set of principles that providers must meet in competitive tendering processes.84 South Australia uses a ‘qualification’ process, which allows services to join provider panels; then they may apply for tenders or respond to invitation to quote.85

4.5 Mechanisms for monitoring and review Consumer groups are keen watchdogs and make frequent submissions to government regarding the need for additional standards or new mechanisms for ensuring compliance. This has resulted in action on the part of states and territories to review standards and accreditation processes and make changes as appropriate. The Commonwealth/State Disability Agreements required regular review of standards and accreditation processes. As the new National Disability Agreement (replacing the Commonwealth/State Disability Agreement) comes into play this year with its emphasis on improving quality, there is likely to be widespread consultation with consumers and service providers.

83 Australian Human Rights Commission, http://www.hreoc.gov.au/disability_rights/

84 Disability Services Department of Human Services, Victoria. Policy and Funding Plan 2008-09.

85 Department for Families and Communities, Government of South Australia, Disability Service Agreements (webpage), from www.dfc.sa.gov.au/Pub/Default.aspx?TabId=360

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4.6 Evidence of effectiveness There does not appear to be any comprehensive, objective evaluation of the effectiveness of standards and accreditation processes on quality and effectiveness of disability services. Some advocacy groups claim that the quality control system is still too frail, but it is not clear what impact this has on services. This would be an important area to canvas during the interview phase of this project. The two independent reviews of the Disability Employment Network and Vocational Rehabilitation Services revealed that there is a current lack of provision for effective open employment pathways for jobseekers with intellectual disability from school to work. Assessment and eligibility processes are unnecessarily complex and jobseekers are not referred to appropriate services, as these services are not tailored to meet the specific needs of the jobseeker86

4.7 Stakeholder acceptance In 2000, there was a national round of public information sessions on the proposed quality assurance system for disability employment services and consumers. A further round of consultations with the sector was conducted in April 2001 on the findings of the evaluation and future directions. These sessions included 50 consumer focus groups organised and run by expert facilitators. There were two main areas where consensus between all stakeholders was not reached. The outstanding issues involve the performance indicators for two of the Disability Service Standards (under the Disability Services Act 1986), both related to service delivery outcomes. Standard 5 is about developing opportunities for job seekers and workers to participate in their community. For those actively job seeking it may be, for example, encouraging participation in society through volunteer work or participation in community centre programs, while waiting to find a job. This standard seeks to extend the goals of employment beyond simply getting a job (‘any job’) by finding opportunities for a person to make the most of their skills and to grow as members of society. Standard 9 is about integration into the wider community and the achievement of social outcomes that increase the likelihood of job seekers or workers finding and maintaining sustainable employment. Some stakeholders apparently felt that the supporting indicators were not robust enough. Stakeholders also wanted regular, ongoing reviews involving consultation with the disability sector.87

4.8 Implications for homelessness services From the development of an initial set of standards in 1991, a great deal of work has gone into designing frameworks with outcomes and performance indicators that can be used to underpin continuous improvement, evaluation, monitoring and accreditation. It would make good sense to take advantage of this work in the evolution of homelessness services. It may also be possible to use the external affairs power in the Australian Constitution to enact national homelessness legislation in a similar way to the Disability Services Act 1986.

86 Department of Education, Employment and Workplace Relations, September 2008, Review of Disability Employment Services Disability Employment Network and Vocational Rehabilitation Services DISCUSSION PAPER, from http://www.workplace.gov.au/workplace/Publications/PolicyReviews/DisabilityEmploymentServicesReview/ReviewofDisabilityEmp loymentServicesDiscussionPapers.htm

National Council on Intellectual Disability, October, 2008, The Commonwealth Review of the Disability Employment Network and Vocational Rehabilitation Services, from http://www.ncid.org.au/submissions/submissions/0809/DEN%20Review.pdf

87 The Parliament of The Commonwealth of Australia, 2002, Disability Services Amendment (Improved Quality Assurance) Bill 2002 Explanatory Memorandum, viewed on 2 July 2009 viewed at http://austlii.law.uts.edu.au/au/legis/cth/bill_em/dsaqab2002587/memo1.html

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In terms of the components of an ideal accreditation system, the following seem very important, perhaps even essential.

4.8.1 Rationalising standards and accreditation procedures However, the proliferation of standards, outcomes, performance indicators and compliance mechanisms across jurisdictions has resulted in service providers having to undergo multiple accreditation and review processes to meet the requirements of different funders. This is time consuming and unproductive. In response to this situation, there are at least two initiatives underway to rationalise standards across the disability sector (one in Queensland and one supported by FaHCSIA). This should not be difficult given the commonality among the different sets of principles, guidelines, outcomes and indicators. For example, both service sectors would be interested in ensuring access to services, meeting individual needs, client involvement in decision making, ensuring privacy and confidentiality and treating all clients with respect.

4.8.2 Involving service providers and service recipients Both service providers, who will have to implement standards and undergo accreditation, monitoring and review processes, and recipients, who will experience the service journey should be involved from the very beginning in developing standards, outcomes, indicators and accreditation, monitoring and review procedures. In this way, it is more likely that there will be buy-in from providers and that service users’ knowledge and experience will inform the developmental process so that positive outcomes will result.

4.8.3 Independent reviewers Accreditation is generally performed by an independent body, which can provide an honest, unbiased assessment. This should also be true of the people involved in reviewing services, particularly if the results of the reviews might affect funding, be independent from the organisations under review.

4.8.4 Training for service providers To support continuous improvement, it is essential to have training available to service providers, preferably in the form of face-to-face workshops and written materials. This is particularly important if the policies and standards governing service delivery are complex as they are in respite care, for example.

4.9 References Australian Bureau of Statistics (2004), viewed at www.abs.gov.au/AUSSTATS/[email protected]/ProductsbyTopic/768EE722E31F6315CA256E8B007F3055?O penDocument Australian Institute of Health and Welfare, http://www.aihw.gov.au/disability/natpic/index.cfm Australian Institute of Health and Welfare (February 2006), Welfare Working Paper No. 50: Disability rates among Aboriginal and Torres Strait Islander People. Australian Institute of Health and Welfare (February 2006), Welfare Working Paper No. 50: Disability rates among Aboriginal and Torres Strait Islander People, Canberra: AIHW Department of Families, Community Services and Indigenous Affairs, 2008, Quality Strategy Toolkit, Australian Government Department of Families, Community Services and Indigenous Affairs, Canberra, from http://www.fahcsia.gov.au/sa/disability/pubs/employers/Documents/quality_strategy_toolkit/default.htm

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Department of Families, Community Services and Indigenous Affairs, 2003, Quality Assurance Handbook version 2 for disability employment services, viewed at www.facsia.gov.au/disability/qa_handbook2/index.htm Disability Services Department of Human Services, Victoria. Policy and Funding Plan 2008-09 The Parliament of the Commonwealth of Australia, 2002, Disability Services Amendment (Improved Quality Assurance) Bill 2002 Explanatory Memorandum Lindsay, Mary (1996). Commonwealth Disability Policy 1983-1995, Background Paper 2. Parliamentary Library Publications Uniting Care Australia, http://unitingcare.org.au/news/national-news/462-national-disability-agreement- begins.html Department of Families, Community Services and Indigenous Affairs, 2003, Quality Assurance Handbook version 2 for disability employment services, viewed at www.facsia.gov.au/disability/qa_handbook2/index.htm Disability Services Australia, http://www.dsa.org.au/Page.aspx?element=67&category=1 Quality Strategy Toolkit, Department of Families, Housing, Community Services and Indigenous Affairs Australian Human Rights Commission, viewed at www.hreoc.gov.au/disability_rights/ Disability Services Department of Human Services, Victoria. Policy and Funding Plan 2008-09 Department for Families and Communities, Government of South Australia, Disability Service Agreements (webpage), from www.dfc.sa.gov.au/Pub/Default.aspx?TabId=360 The Parliament of The Commonwealth of Australia, 2002, Disability Services Amendment (Improved Quality Assurance) Bill 2002 Explanatory Memorandum, viewed on 2 July 2009 from http://austlii.law.uts.edu.au/au/legis/cth/bill_em/dsaqab2002587/memo1.html

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5 Sectoral case study: Boarding houses (Queensland)

5.1 Scope of the sector Boarding houses are non-private dwellings that may offer short-term, long term or emergency accommodation. They are sometimes also called private hotels. The Australian Bureau of Statistics employs a number of basic rules for defining a non-private dwelling as a ‘boarding house’ or a ‘private hotel.’88 Specifically, a dwelling is classed as a boarding house (rather than a private hotel) if: 20% or more of residents are living there permanently, and 75% or more of residents are either unemployed or outside of the labour force, with incomes of less than $600 per week. The 2006 Census statistics 89 revealed 20% of homeless people in Queensland were residing in a boarding house (as defined above) on the night of the Census (down from 22% in 2001). This compares with 28% in NSW, 22% in Victoria, 17% in South Australia, 12% in WA, 10% in TAS and 8% in ACT). In recent years, there has been a general pattern of boarding house closures and an overall loss of traditional boarding house stock due to gentrification and increasing property values. In Queensland in particular, ageing stock and high profile fires in Childers and parts of Brisbane led to concerns regarding potential further losses in the early 2000s. At the same time, government policies relating to de- institutionalisation and high profile media reports covering service quality and tenants rights issues contributed to a growing concerns regarding supported accommodation generally.

5.2 History of service improvement processes In 1998, the Queensland Government commissioned a series of reports into the viability of the sector through the Hostel Industry Development Unit (HIDU). The following year, HIDU issued a ‘Five Year Plan for the Supported Accommodation and Boarding House Industry.’ The Plan identified three key components for the future of the sector, including industry improvement, resident supports, and coordination across government and between government and other sectors. A series of reforms to the residential services sector was introduced by the Queensland Government in 2002, including the Residential Services (Accommodation) Act 2002 (The Act). The Act was introduced to require registration and accreditation as a condition of operation. The Act applies to private boarding houses, supported accommodation hostels or aged rental accommodation. It does not apply to some student accommodation, staff accommodation, motels, backpacker hostels or services regulated under other legislative frameworks, including: Aged care services regulated under the Aged Care Act 1997 (Commonwealth). An authorised mental health service operating under the Mental Health Act 2000. A private hospital under the Private Health Facilities Act 1999. Retirement villages registered under the Retirement Villages Act 1992. Licensed premises under the Liquor Act 1992.

88 Chamberlain C., and McKenzie, D., Counting the Homeless Australia, Australian Bureau of Statistics, Census, 2006

89 Chamberlain and MacKenzie note in their analysis of Census statistics there are a variety of methodological issues in counting the homeless; this may mean that statistics under-represent the issue.

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It also does not apply to services that have a funding agreement with government agencies, including those: under funding or in premises owned by Aboriginal Hostels Limited; conducted by Department of Housing, or funded under the Housing Act 2003, and conducted by Department of Disability Services, or funded under the Disability Services Act 1992.

5.3 Current accreditation arrangements In Queensland the Residential Services (Accreditation) Act 2002 (‘the Act’) governs the regulation of residential services through a system of accreditation that requires the service provider to meet minimum standards as outlined in the Act. The Act introduced 38 new standards, to be phased in over three years – 22 standards related to accommodation, six related to food, and ten related to personal care services. There are three levels of accreditation under the Act and the level or levels of accreditation required depend on the services provided in the course of the residential service. The criteria of standards across the three levels include: The extent to which the service provider recognises and observes the rights of each resident. The standard of the registered premises and facilities in the registered premises. The way the service is managed and otherwise conducted by staff of the service. The quantity, quality, variety and nutritional value of the food provided. The preparation, delivery, service and storage of the food. The extent to which the service provider provides the personal care service in a way that meets the individual needs of the residents to whom the service is provided, protects their interests and maintains and enhances their quality of life generally. The suitability of the staff members providing the personal care service. In addition, the service is required to provide a Building Compliance Notice (BCN) that has been issued by local government within the previous 12 months, and a Fire Safety Management Plan (FSMP). Additionally, applicants are required to complete a work book outlining a self-assessment assessing their performance against relevant accreditation standards identifying any areas for improvement. The self assessment must be conducted prior to the lodging of the application for accreditation and be included with the application. Accreditation is valid for a period of three years. Application fees are determined according to the number of residents ($24.50 per resident). Operating a service without accreditation may result in a maximum penalty of $20,000 or cancellation of registration. The maximum penalty for corporations is $20,000.

5.4 Processes to support quality The Office of Fair Trading (Department of Employment, Economic Development and Innovation) established the Residential Services Accreditation Unit (RSAU) to manage the registration and accreditation process. This includes: Regulating conduct of services via the registration and accreditation process. Encouraging services to adopt a continuous improvement approach. Promoting the standards and accreditation system more broadly. Monitoring the effects of regulation on the industry and residents.

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Building and improving the industry to provide highest quality services. Monitoring for compliance with the Act. Investigating complaints relating to alleged breaches of the Act. The underpinning policy rationale was to work with service providers to keep services open and transition to the new regime of standards and accreditation requirements. The RSAU offers assistance to service providers to prepare for accreditation (including financial assistance to upgrade or address physical building requirements), provides advice on standards and requirements and administrative support to complete the application process and undertake self assessment. Assistance has also included education courses for service providers, and interagency networking and relationship building where possible.

5.5 Mechanisms for monitoring and review The Accreditation Standards Implementation Review Program was recently introduced by the RSAU to address a gap in the legislation, as the unit previously had no power to revisit services to assess continuing compliance. Ongoing review is now assisted by a checklist of requirements considered with the operator informally during a site visit. The review is treated as a voluntary, confidential self assessment. The RSAU note the issues for informal assessment at re-registration. An additional mechanism is the Community Visitor Program, which aims to assist adults who have an impaired capacity or a mental or intellectual impairment and who reside in a hostel registered under the Act as Level 3 supported accommodation (high care). Community Visitors may refer complaints to the RSAU. Complaints may also be referred anonymously.

5.6 Evidence of effectiveness For those who have achieved accreditation, the assistance of the RSAU to prepare for the process and negotiate requirements is positive. This approach is perceived to have significant benefits in improving collaborative working and relationships. However, there is concern that there is insufficient financial assistance provided to operators for building improvements, and that further capital and ongoing grants should be available. There is an underlying concern that accreditation processes impose additional pressures on services already experiencing financial and service delivery pressures. This is particularly relevant in the boarding house industry, where businesses are already facing significant economic viability issues. It has been reported that the introduction of accreditation led to half the services previously operating Level 3 boarding houses choosing to re-open as accommodation not requiring accreditation (eg student accommodation or backpacker hostels), or selling the property and leaving the industry altogether. The level of impact is difficult to establish as the number of businesses operating are often under-reported or disputed, however, it is generally acknowledged there has been a significant loss of accommodation across the industry recently.

5.6.1 Acceptance by key stakeholders There are a number of peak bodies and advocacy groups who are active in the boarding house industry, including the Supported Accommodation Providers Association (SAPA), the Boarding House Action Group (Queensland Shelter), the Boarding House Managers and Owners Association (BHOMA). The Queensland Council of Social Service Inc (QCOSS), these organisations’ perspectives on accreditation processes and outcomes will be important to inform further considerations.

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5.7 Implications for homelessness services The process of implementation is strengthened by early engagement and relationship building across sectors. Officers who can build those relationships through networks and with individual operators on site, are valued as part of the process. Education and assistance to prepare for, apply and achieve accreditation, is important to assist small services and providers meet requirements. The financial costs associated with accreditation need to be considered – both in terms of initial physical upgrades and ongoing maintenance requirements. The potential impacts of introducing accreditation into a context where financial viability and service capacity may be an issue, need to be considered. In the boarding house industry, it is suggested the introduction of accreditation resulted in significant loss of providers in the industry. Accreditation needs to consider the danger of imposing additional demands on those who may not be able (or choose not) to respond.

5.8 References Queensland Shelter, 2008, Boarding House Action Group: Green Paper Submission June 2008 Chamberlain C., and MacKenzie, D., 2006, Counting the Homeless Australia, Australian Bureau of Statistics, Census 2006 Residential Services (Accreditation) Act 2002, Section 47, Form 2 Notes July 2009, Department of Employment, Economic development and Innovation (DEEDI) Guidance Notes for Local Government – Assessment of Residential Service premises for compliance with the Residential Services (Accreditation) Act 2002 Residential Services (Accreditation) Act 2002

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SECTORAL CASE STUDY – HEALTH: MEDICAL PRACTITIONERS, GENERAL PRACTICES

6 Sectoral case study: Health – medical practitioners and general practices

6.1 Scope of the sector Health services are provided by individual health professionals in a variety of settings and by hospitals and other institutional services in the public, private and not-for-profit sectors. There is a diverse range of licensing, registration and accreditation standards which apply to individual professionals, to hospitals, day surgeries and other services.

6.2 History of service improvement processes Registration (licensing) of individual medical practitioners and accreditation of the private practices of general medical practitioners provide examples of two different standards processes which can apply to one profession. Registration is the traditional legislative system for protecting the public by ensuring minimum standards of entry to the profession. Each state and territory has legislation which prevents a person from practising medicine and/or from calling themselves a doctor, unless they are registered. The registration system also provides, to varying degrees, a framework for professional standards and scope of practice. For example, specialist medical practitioners are required to undertake training and assessment by specialist colleges, and to maintain college standards. Some jurisdictions require private hospitals to be licensed. Both public and private hospitals maintain credentialing systems for medical practitioners who practice in the hospital, and general practices may be accredited. Of this range of standards systems, the system of accreditation of general practices is potentially the most relevant to the homelessness sector. In 1991 the Royal Australian College of General Practitioners (RACGP), with support of the Australian Medical Association (AMA) and the Commonwealth Government, resolved to develop national standards for general practices with the aim of engaging the medical profession in continuous quality improvement. 90 Negotiation of a model for general practice accreditation took approximately seven years. A key issue in negotiations was the issue of who would set standards and monitor those standards. By the late 1990s agreement had been reached on a model for voluntary, peer-review accreditation, administered by a non-for-profit body providing professional development of general practices through accreditation and controlled by the profession. Australian General Practice Accreditation Limited (AGPAL) was established in 1997. It is a not-for-profit company whose members include the RACGP, AMA, Australian Association of General Practitioners, Australian Divisions of General Practice, the Consumers’ Health Forum, the Australian College of Rural And Remote Medicine, the National Association of Medical Deputising Services, the Rural Doctors Association of Australia, and the Australian Association of Practice Managers. Another provider, Quality Practice Accreditation Limited (GPA) was formed in 1999 to provide accreditation services. 91

90 Royal Australian College of General Practitioners, History of Accreditation , viewed 7 July 2009 at: www.racgp.org.au/Content/NavigationMenu/PracticeSupport/StandardsforGeneralPractices/AccreditationagainsttheRACGPStand ards/Appendix_B_History_of_Accreditation.pdf

91 Ibid.

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6.3 Current accreditation arrangements

The RACGP develops standards in consultation with the profession. The standards encompass consumer rights, practice management and quality and safety and include the following:

Access to care; opening hours; care outside normal hours. Information about the practice, including informed patient decisions, interpreter services and costs. Health promotion and prevention of disease. Diagnosis and management of specific health problems; evidence-based practice and clinical autonomy. Continuity of care; continuity of therapeutic relationship; follow-up of tests and results. Coordination of care; engaging with other services; referral documents. Content of patient health records; health summaries; consultation notes. Collaborating with patients; culturally appropriate care; patient feedback. Safety and quality; quality improvement activities; risk management system. Education and training, including general practitioners and clinical and non-clinical staff. Practice systems; human resources and occupational health and safety. Management of health information; confidentiality and information security. Practice facilities; physical access; conditions conducive to confidentiality and privacy. Practice equipment for comprehensive care; doctor’s bag. Clinical support processes, including infection control, vaccine potency, perishables and Schedule 8 medicines. AGPAL also provides accreditation services for optometry and physiotherapy practices against standards developed by national professional bodies, the Optometrists Association of Australia and the Australian Physiotherapy Association. The Australian Health Ministers Conference tasked the Australian Commission on Safety and Quality in Health Care (the Commission) with developing a national quality and safety framework for health services. A draft framework is scheduled for consideration by Health Ministers in July 2009, and the Commission is currently consulting on possible strategies to achieve the directions in the draft framework.92

6.4 Processes to support quality General practices pay a fee for accreditation services provided by either AGPAL or GPA. Fees for accreditation vary depending on the size of the GP practice; the preferred survey team (eg two GPs or one GP and one practice nurse or practice manager); the number of three-year accreditation cycles

92 Australian Commission on Safety and Quality in Healthcare, 2009, Safe and high quality healthcare for Australia, Discussion paper on achieving the directions established in the proposed National Safety and Quality Framework, viewed at www.qualityhealthcareconversation.org.au/uploads/36707/ufiles/downloads/discussion-paper-on-safety-and-quality- framework.PDF

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already undertaken, and the use of electronic or paper based self-assessment. Practices have access to online materials, support and training from the provider.

6.5 Relationship of funding to standards and regulations Accreditation of general practices is voluntary. The standards and accreditation system imposes a cost on those general practices which elect to participate. The Commonwealth Practice Incentive Payment provides a financial incentive to become accredited. Detail of the relationship of funding to the standards is proposed to be explored in interviews with sectoral experts.

6.6 Mechanisms for monitoring and review The mechanism for accreditation occurs over a three year cycle. It consists of an online practice self- assessment, a visit by peer surveyors and review by an Accreditation Review Committee. Both AGPAL and GPA provide support to practices throughout the accreditation process. Both accreditation providers train surveyors who visit general practices to assess the practice against standards. A survey team always includes a general practitioner.

6.7 Evidence of effectiveness A preliminary scan has not identified data about the effectiveness of voluntary general practice accreditation. One current international study has been identified. An evaluation of the Effects and Costs of a National Continuous Improvement Programme on Cardiovascular Diseases in Primary Care has commenced in The Netherlands. Completion is expected in 2011. The framework for standards in Australian health care is still in development. As noted above, Health Ministers are soon to consider a national quality and safety framework developed by the Australian Commission on Safety and Quality in Health Care, and consultations are underway on strategies to achieve the directions in the draft framework.

6.8 Implications for homelessness services Of the range of standards approaches in the health sector, general practice accreditation appears to be of most relevance to homelessness services however, it appears to have limited applicability. The accreditation system for general medical practice relies on characteristics which are not common in homelessness services: uniform initial professional education of participants in accreditation; a high degree of professionalisation; an established consensus about appropriate practice standards; a professional practitioner organisation (RACGP) with a professional development focus, and capacity for profession control of both standards development and the monitoring and review of practices against standards.

6.9 References Australian Commission on Safety and Quality in Healthcare, 2009, ‘Safe and high quality healthcare for Australia,’ Discussion paper on achieving the directions established in the proposed National Safety and Quality Framework, viewed at www.qualityhealthcareconversation.org.au/uploads/36707/ufiles/downloads/discussion-paper-on-safety- and-quality-framework.PDF

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Australian Health Workforce Ministerial Council, Communique, May 2009 (May), ‘Design of new national registration and accreditation scheme,’ accessed at: www.ahmac.gov.au/cms_documents/2009- May%208%20Australian%20Health%20Workforce%20Ministerial%20Council%20Communique.doc Effects and Costs of a National Continuous Improvement Programme on Cardiovascular Diseases in Primary Care, overview Radboud University, 2008, US National Institute of Health, accessed at: http://clinicaltrials.gov/ct2/show/NCT00791362 Health Practitioners (Professional Standards) Act 2001 (QLD) accessed at: www.legislation.qld.gov.au Medical Practitioners Registration Act 2001 (QLD), accessed at: www.legislation.qld.gov.au

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SUMMARY: CONSOLIDATED OVERVIEW OF SECTORAL CASE STUDIES

7 Summary: Consolidated overview of sectoral case studies

Table 5 – Consolidated overview of sectoral case studies

Legislation/ Sector Service charter Accreditation system Standards Funding drivers Key lessons/comments regulations Disability National JAS-ANZ System – Disability Services 12 National Disability Federal minister has The disability sector offers services Disability industry based, third-party Act 1986 Service Standards, oversight; states and a highly structured Agreement – agency: Regularly checks which provide territories administer; framework for accreditation, human rights compliance of Disability guidance to the Commonwealth and enshrined in legislation, based Employment Network states/territories. states/territories can defined by standards, members and Vocational withhold funding if regulated by a specifically Rehabilitation Services. service is de- constituted third party for Can issue ‘non- certified. employment services that conformance’ rating for are the responsibility services leading to de- Commonwealth. certification if matter Given the proliferation of unresolved. standards and review processes, it may be worth considering how to rationalise these for the homelessness service sector. Involving service providers and recipients is crucial to accreditation processes working most efficiently. Using independent accreditation mechanisms helps ensure objectivity and consistency. Training is necessary for service providers to help them implement standards effectively.

Quality Frameworks for Homelessness and Related Services – Literature Review and Environmental Scan Page 60

SUMMARY: CONSOLIDATED OVERVIEW OF SECTORAL CASE STUDIES

Legislation/ Sector Service charter Accreditation system Standards Funding drivers Key lessons/comments regulations Framework for this end is occurring proposed separate standards Child Care Benefits streamline multiple Early Childhood Currently, accreditation is Currently has A across staffing ratios, NCAC is largely requirements and systems. Education and operated by National New Tax System OH&S matters, Commonwealth- Children’s services offers a Care and Childcare Accreditation (Family physical aspects of funded with some relevant comparison to National Quality Council (NCAC) Assistance) service, and service income from homelessness given the Agenda It deems that: Administration Act provision for Family registration process mix of large providers with 1999 (FAAA), and Day Care; OSHC; and smaller and more services self-assess Long Day Care performance; each State and fragmented services, a Territory has Strong push for focus on building workforce validators review service plethora of national new national capacity, and a proposed providers; Regulations for standards tiered model linked to moderators assess operation of child quality improvement systemic performance; care centres;, supports and responses. rating of ‘satisfactory’ or OH&S, etc The process of seeking higher required on all Some implementation offers some quality areas states/territories lessons for the currently reviewing homelessness sector.

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SUMMARY: CONSOLIDATED OVERVIEW OF SECTORAL CASE STUDIES

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APPENDICES

Appendix B Summary of issues raised through consultations with sectoral stakeholders and service providers

Quality Frameworks for Homelessness and Related Services – Literature Review and Environmental Scan

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

Introduction...... i

1 Introduction...... 2 1.1 Approach and methodology ...... 2

2 Issues raised through stakeholder interviews...... 4 2.1 Overview...... 4 2.2 Objectives and challenges of an accreditation system ...... 4 2.3 Potential components of a system ...... 6 2.4 Implementation approach and processes ...... 14 2.5 Impact of an accreditation system...... 20

3 Issues raised through service provider interviews ...... 24 3.1 Current structure and function of the service provision sector...... 24 3.2 Current approaches to improving service quality and delivery...... 26 3.3 Benefits and risks of introducing an accreditation system ...... 31 3.4 Workforce capacity impacts of the introduction of a national accreditation system...... 33 3.5 The potential components of an accreditation of regulatory system...... 34

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

1 Introduction This document provides a summary of the issues raised through consultation with a total of 53 organisations, including 32 representatives from 30 service providers and 23 stakeholders, primarily representatives from peak sectoral bodies. These interviews were conducted during August 2009.

1.1 Approach and methodology

Stakeholder interviews The semi-structured telephone interviews conducted with stakeholders were between 30 and 45 minutes in length. The interviews addressed a series of issues, including the following: Stakeholder experience relevant to accreditation/homelessness services The objectives of an accreditation process. The impacts of accreditation/standards on the sector, as well as the business impacts or benefits of such a system. The essential elements of service quality improvement systems. Stakeholder views of the role of state/territory and federal government in facilitating service quality improvement. Stakeholder views of the role of state/territory and federal government in relation to integrated regulatory process. Whether it is desirable to have a coordinated national regulatory response to homelessness services rather than state and territory based regulation. The most appropriate ways to develop a nationally coordinated regulatory response so that services and accreditation systems are integrated across Australia? Possible issues being addressed/or could be addressed by a service quality improvement system Minimum standards that could potentially apply to services. Different approaches to improving service quality. The potential challenges to service delivery/the sector of an accreditation system. The potential impacts on the sector workforce of an accreditation system. What transition arrangements, if any, should be put in place. Case study examples or lessons learned which might be relevant to this study.

Service provider interviews Semi-structured telephone interviews of between 30 and 45 minutes were conducted with 32 representatives from 30 service providers across Australia. Interviews were undertaken with senior team members of services including managers, CEOs, service coordinators, line managers and quality assurance managers. Providers interviewed include services from each state and territory across a range of metropolitan, regional and remote locations to ensure issues and views across a range of geographical locations were captured. The selection of service providers for interview also ensured a range of service types were included. Interviews were conducted with providers targeting single people, men, women, sole parents, families and young people.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

Issues addressed in the service provider interviews included the following: Different approaches to improving service quality. Potential challenges to service delivery. Views of the role of state/territory and Federal Government in facilitating service quality improvement. The impact that accreditation/standards has on services and the business impacts or benefits of such a system. The workforce capacity of services, including:

− capacity building

− the role of management committee and staff

− training

− budgets

− key performance indicators, and

− views associated with service improvement processes and accreditation. .

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

2 Issues raised through stakeholder interviews

2.1 Overview Senior representatives from sectoral peak bodies and service provider organisations provided a range of views about the function and appropriateness of existing accreditation and regulatory processes across the states and territories. The interviews highlighted the concerns and frustrations of those currently working within the sector, particularly with regard to funding and workforce capacity issues, and the lack of integration between services, and between services and government, which is considered to be an obstacle for service quality improvement. Overall, most stakeholders were supportive of developing service standards and/or an accreditation system for homelessness services that would ensure professional services are provided to homeless people in a range of settings. There were concerns expressed about the resource burden that an accreditation scheme may have on smaller services (discussed further below), and in some cases, stakeholders were concerned about how new accreditation processes at a national level would interact with existing standards and regulation processes already in place at a state and territory level. Stakeholders also identified a number of strategies to assist in the implementation of standards and accreditation which may alleviate some of the burdens caused by introducing accreditation procedures and standards. This summary covers stakeholders’ views on: The objectives and challenges of an accreditation system. Sectoral consultation. The content of service standards and accreditation. Implementation strategies.

2.2 Objectives and challenges of an accreditation system The stakeholders identified a number of objectives that a potential accreditation scheme should set out achieve, including: Professionalisation of the sector: Many homelessness services are dependent on a volunteer or low wage earning workforce, which places limitations on the level of service and experience that can be expected from staff. Stakeholders noted the importance of improving the quality of staff training, guidance and support, retention strategies and standards for professional behaviour. This is challenging considering it is difficult to attract skilled staff and homelessness services often have modest resources available. (Note: one stakeholder noted that in Qld the Industrial Relations Commission has recently ruled that there should be a pay increase of between 8-30% for the NGO and community services sector. The changes will be partially funded by the Queensland Government.)1 Minimal overlap of accreditation processes: The need for an accreditation model that is user- friendly and does not place unnecessary burden on services is key to its success and uptake. A key theme among the stakeholders was the importance of developing a system that did not result in senior service staff or coordinators ‘sitting at a computer’ for large periods of time completing the accreditation documents when they could be on the ‘frontline’ assisting people. The importance of developing an accreditation system that is compatible with other accreditation schemes, so that services are not required to undertake multiple and overlapping accreditation processes was highlighted in a number of interviews.

1 Details of the decision can be found at: http://www.ja.com.au/CSIR_home/article.aspx?id=13673. The Qld Government has committed to funded part of the increase: http://www.communityservices.qld.gov.au/about/budget/2009-10/documents/bh-new- funds-fact-sheet.pdf

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

There were particular concerns expressed by some stakeholders about how national accreditation would ‘fit’ with other accreditation or processes that are already in place to regulate homelessness services, as well as community, welfare and housing services more generally. This is particularly a concern when regulation has only recently been introduced at a state level, and has required considerable time and resources to be committed by services to adjust to the new system.

In Tasmania, for example, all services funded by the Department of Health and Human Services have signed new funding agreements which introduce significant quality assurance measures.2 One stakeholder noted that it would be important to allow the sector to adjust to the new measures first before introducing another layer of national regulation, especially if it wasn’t clear how the different regulatory regimes interacted. These issues were raised in a number of contexts and are discussed further below.

Stakeholders were also interested in continuity between any national regulation regarding accreditation and standards for public and community housing, and regulation of the homelessness sector. A system that regulates more than the ‘SAAP services’: Some stakeholders noted that it is important that any new accreditation scheme or standards regulate a whole range of environments in which homeless people receive services, not only the services previously funded by SAAP. For example, they argued that dormitory or boarding house style accommodation is in need of some level of regulation. Other stakeholders argued that expanding regulation beyond SAAP services to boarding houses would be challenging because boarding houses are typically part of the private rental market. A system that is flexible and encompasses the diversity of the community and services available: Stakeholders were particularly concerned that if the ‘bar was set too high’ for accreditation then there would be a withdrawal of services from smaller organisations valued under $500,000 or $1 million. One representative stated that the ‘risk is that welfare organisations will walk away’.

Stakeholders also emphasised the need for flexibility in the accreditation system so that small or remote services have to complete less onerous accreditation processes, or are supported in some way to ‘get over the line’. The accreditation system needs to avoid creating barriers for services that are trying to deliver quality services, as ‘too many regulations will kill responsiveness’. Moving people out of crisis accommodation quickly: Sector wide issues were identified by some stakeholders that could potentially be addressed by an accreditation scheme or set of standards. In particular, the need to move people as quickly as possible from crisis and temporary accommodation into stable accommodation was highlighted as an important intervention to reduce the risk of long-term homelessness. The insecurity of temporary living was described as exacerbating other factors such as mental health, confidence, daily living skills and employment and entrenching long-term homelessness. According to one stakeholder, contact with crisis accommodation should last no longer than a week because the impact of this experience on mental health is so significant, stating that, ‘you can’t engage the world if your sense of your self is that you are homeless.’ A view was taken that the SAAP supported emergency accommodation, which is typically 13 weeks, is too long. Acknowledging that it is a difficult task to find permanent accommodation, the aim should be to focus resources on early intervention, prevention and providing stable long-term accommodation rather than crisis accommodation. Some of the reasons given for why temporary SAAP accommodation has often become semi- permanent were: a lack of supply of housing, the private rental market being unaffordable, that many of the available housing options had premises that were not secure and that the skill of workers in homeless services are often not sufficient to assist people to move on. Standards supporting a continuum of care: Another sector wide issue identified by stakeholders is the need for standards to promote a continuum of care whereby people who have had

2 The contract can be viewed at: http://www.communityexpress.dhhs.tas.gov.au/Upload/files1208/EXPOSURExposure%20DRAFT%20Funding%20Agreement% 2028thApril%20(2).pdf

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

experiences with homelessness are still supported in some way when they exit homelessness. For example, on-going assistance for people at risk of slipping in and out of homelessness may prevent a repeat experience, such as support with daily living skills, tenancy and legal negotiations, health, financial and employment needs. Nationally consistent regulation: Most stakeholders perceived it to be important that a national system be developed rather than state-based accreditation and service standards. Some of the reasons given for why a national system is preferable included: making it easier for larger services to deliver services across jurisdictions and improving consistency for clients and simplicity of expectations.

A strong view was taken by some stakeholders that developing an accreditation model should not be devolved to the states as this would be too complex, particularly in relation to data recording and reporting. Stakeholders generally thought that the SAAP system was a valuable model with attributes that could be adopted by the new system (discussed further below).

2.3 Potential components of a system

2.3.1 Continuous service quality improvement A number of stakeholders supported a continuous rolling program of service quality improvement. The importance of providing a framework which facilitates service quality improvements through providing mechanisms for support and encouragement, including incentives, was highlighted. Organisations should be looking at a culture of self-improvement in all aspects of the business. The introduction of standards can increase the drive in the sector to service the client well. Many people will say ‘I’m too busy doing my job to think about that,’ so it requires a change in focus.

Sectors need structural support for growing and maturing. We have to make organisations do it, then equip them to do it. You can’t make people do it then just leave them scrabbling around in the dark.

Some stakeholders also commented on the importance of client feedback as an integral element of the continuous service quality improvement model. Developing new and meaningful processes for consulting clients and their inclusion in planning will be a challenge.

The advantage of a continuous quality improvement process was seen to be its focus on improving processes and workforce capacity within organisation on a continuous rolling basis. This approach was considered to be preferable to a ‘tick box’ audit-based approach. The value to us [a service operating under the Victorian framework] is that we put in place a management cycle to look at what we are doing and how we can improve. We prefer this quality improvement framework rather than the quality assurance audit approach. This process also has an audit component but it’s not just tick a box.

I support a quality improvement cycle: reviewing and evaluating in a fair, frank and fearless way from a consumer’s perspective and then addressing whatever issues arise out of consultation. And it is a cycle, so you consult, evaluate, then plan to make changes, then you implement the changes, scoping the likely consequences and the unintended consequences and the resource issues around implementing changes. Implement and review. It is an ongoing circular process. It needs to be informed by the consumer, from the consumer’s perspective. What worked for the consumer and what they experienced as a barrier or obstacle to them getting the most benefit out of the service and their internal and external factors that can address those barriers.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

2.3.2 Minimum standards The majority of stakeholders supported the introduction of minimum standards. However a number pointed out the importance of ensuring the system is not administered on the basis of the ‘lowest common denominator’ but rather than standards are aspirational and encourage organisations to strive for service quality improvement. The provision of incentives for the attainment of high standards was seen to be integral to this approach. People want to know what ‘really good’ looks like as well as what ‘getting over the line’ looks like.’

Instead of looking for lowest common denominator we need to look for the highest. It is not good enough that we look at criteria for quality assurance and consider how we can just do the minimum to meet that. We should aim for the highest or the best. And there needs to be some sort of encouragement for the attainment of higher status. For example: you attain this level and this is what the reward will be, or you attain that level and that is what the reward will be. So there is an incentive to get to upper levels. Incentives might be funding, or they might be recognition, for example awards with a small monetary incentive or conference attendance for staff attached. It is about providing a reward to the service and the people in the service.

We need to be careful: standards need to be higher than the minimum or they can be counter productive. This can only come from national regulation.

Some stakeholders commented on the irrelevance of minimum standards to many service provider organisations which are already required under legislation to meet minimum standards in order to receive government funding. Services don’t receive funding unless they are an incorporated legal entity, so they already have to meet standards of accountability of the board and to clients. So that already exists. The main issue is where we think the bar should be set around clients’ rights. You could articulate this through peer-reviewed standards.

Other stakeholders commented on the benefits of introducing minimum standards within the sector as a means of improving perceptions of the sector’s workforce and service provision models and confidence in the sector from external parties, including government. Introducing some objective standard whereby organisations can measure themselves can give the sector greater confidence and a greater ability to attract corporate and philanthropic funding, for example. It also enables the sector to attract higher calibre people, both as employees and board members. So for organisations to be able to say ‘we are doing well by some objective standard;’ is a good thing.

Overall, the majority of stakeholders considered the introduction of minimum standards to have potentially positive benefits. Standards need to cover the service delivery aspects. Not any old person can work with this client group and workers need special experience and expertise.

Minimum standards for accommodation quality, staffing training, qualification and level of supervision were singled out to be addressed by the standards. Linkages between services and processes for referring people to appropriate services were also prioritised by the consultations. One stakeholder was concerned about the need to build into the standards an assessment process for all people who come into contact homelessness services, so that appropriate decisions can be made about the level of client need. One stakeholder argued that, ‘not all people who become homeless have high and complex needs’ and there is a risk of pathologising everyone who is homeless. There is a need to distinguish between services for people with relatively straightforward needs for accommodation and services for people with high and complex needs, such as addiction or mental health.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

Cultural appropriateness The need for standards to improve the cultural appropriateness of services for Indigenous Australians and people who have migrated to Australia from overseas was a strong theme in the consultations. In the Northern Territory, in particular, it was reported that many Indigenous people would never approach the mainstream homelessness services because they tend to be culturally alienating.

2.3.3 Standards enshrined in legislation Stakeholders offered mixed views on a move to enshrine standards in legislation. Some commented that this was a potentially inflexible route to service quality improvement due to the difficulties inherent in amending legislation over time. Many, however, commented on the benefits of a rights-based approach to legislation, in that enshrining clients’ rights in legislation would support the drive to a more client-centred approach to service delivery. The Bill of Rights enacted in Victoria was considered by some to be a good model. We advocate that, at a minimum, the effect of the SAAP Act should be retained. It would be great to have legislation on the rights to adequate housing, ideally legislation that activates UN covenants. But that may be too high a political bar. I am not confident that is what we will end up with.

There are practical and symbolic implications to enacting homelessness legislation. Having legislation brings a valuing and appreciation and structural importance to the task of responding to homelessness. And in addition to the legislation, you need a mechanism to activate it and not let it be a dusty relic.

One stakeholder commented on the consensus reached among attendees from SAAP services at a recent forum held to discuss the potential replacement of the SAAP Act. They commented: The forum identified an Act in three parts:

1. Set the principles based on rights – connected to international covenants, similar to the preamble to the SAAP Act. Set the principles by drawing on a broader set of rights, dignity of individuals etc like the current Act and then link to housing covenants. If principles were broad and wide, need to define who is bound to the Act – federal, state and territory governments and specialist services. Current Act has links to other stakeholders – local government and private sector, don’t see it as easy to bind ‘other groups’

2. Requirements about government should work cooperatively and opportunity for the community to have input into developing a response (in SAAP Act preamble). Also include the UK model of state governments having to have a strategy and consistent with the principles of the Act and this rights-based approach will bind mainstream and specialist services

3. Provisions for specialist services which take into account the unique aspects of those services.

One of the issues raised at the forum was the challenge of defining homelessness services under the Act, and of agreeing a sufficiently flexible definition. How will we define homeless services? Currently this would be the specialist services – potentially residualising the homelessness response to the large crisis model. We need to keep a broad and encompassing definition to allow innovation and inclusion of new forms of response.

Overall, legislation was considered by many stakeholders to be the essential framework within which an accreditation system could be effected. Stakeholder views on the SAAP framework and its role in the future The SAAP framework was perceived as a valuable starting point for developing the NAHA initiative. Some of the positive aspects of the SAAP framework identified included:

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The legislative base of the SAAP framework. The provision of a national framework for SAAP services which supported consistency across the states and territories. The ‘practice focus’ of the SAAP standards because they are ‘not esoteric’ and they provide clear guidance to services about best practice. The SAAP data collection and reporting framework. One of the limitations of SAAP, as identified by stakeholders, is that it had few mechanisms to enforce standards – other than through contract and performance management. There has been no national independent complaints body or ‘watch dog’ to oversee the implementation of standards. Some stakeholders noted that NAHA was a positive development because it brings homelessness into the government response to housing. Without this alignment, the SAAP framework was limited in its capacity to focus on prevention. However, one or two stakeholders expressed the view that NAHA is a very broad framework with very general performance indicators. Fears were expressed by some stakeholders that without more specific guidelines and performance indicators incorporated into NAHA, (like the SAAP reporting framework), that the funding will not be used to support homelessness services directly in the states and territories. These stakeholders suggested that clear performance indicators would assist the funding to be used effectively to support the sector. As one stakeholder stated: We are anxious that losing the national agreement [SAAP] and having less detail – runs the risk of that homeless dollars will be gobbled up in mainstream service delivery.

2.3.4 Audit and inspection regimes The issue of compliance with standards was raised by a number of stakeholders in relation to the question of what is driving compliance. The importance of having drivers other than funding was highlighted in terms of the effectiveness of service quality improvement. A voluntary compliance system was considered to have significant benefits and potentially be more appropriate than a system of compulsory compliance. The drivers in place in the sector to encourage compliance would include marketing and fundraising benefits. Making resources available to support smaller organisations in seeking compliance was highlighted as important in the application of such a system. Self-assessment processes A number of stakeholders commented on the potential benefits of self-assessment regimes as an integral component of audit processes in that they may contribute to workforce capacity development within organisations. In terms of self-assessment, it is good to encourage organisations to become their own harshest critics, so when it comes to an external assessment they are well and truly ready. But admittedly this is difficult in a sector that feels criticized, as they do in community housing and in the homelessness service sector.

Peer review The peer review processes which have been implemented in Victoria as part of the Quality Improvement Council (QIC) standards and accreditation processes were seen to be a helpful approach by some stakeholders. They were particularly praised as offering a supportive model of quality improvement and one in which experts were assessed by peer experts, rather than by a bureaucrat who may be perceived as unaware of the realities of service provision on the ground. Other big advantage of QIC is peer review, so they train peers to review you. So professionals working in the area are the people who conduct the review. This model, which is applied in Victoria, could be applied nationally.

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The peer review framework in Victoria acknowledges that a lot of bureaucrats have never run a service, so the people who actually work in services are assessing the services. This is a more realistic approach: best practice within constraints.

Implementation and accreditation organisations Some stakeholders commented on the potential for the accreditation system to be administered by an arm’s length accreditation body, rather than by government directly. Such a system has been implemented in the sector in Victoria, and it was considered to facilitate a more open and honest approach from service providers. One of advantages of homelessness service standards accreditation organisations in Victoria is that they are at arm’s length from government – the government has engaged an external review body. So organisations can be a bit more honest about where they are at without fear of retribution in relation to funding. This has merit.

The cost implication of utilizing private sector arm’s length accreditation organisation was raised as a concern among stakeholders, particularly if service providers are required to bear the cost of accreditation. People doing the accreditation are often private sector organisations required to make a profit. We can’t afford to pay some of the accreditation organisations, because they cost money which we have to take out of the funding for service provision.

2.3.5 Quality rating system A number of stakeholders commented on the disadvantages of a quality rating system. It was seen as an undesirable ‘tick a box’ approach. The importance of implementing a system which supported service quality improvement was highlighted. I think should services should either be accredited or not, and organisations that aren’t are supported to become accredited. It should be about service quality improvement not about taking organisations out of business.

A quality rating system would have to be attached to incentives.

Some stakeholders commented that the links between achieving standards and actual service quality on the ground needed to be drawn carefully, since the achievement of standards was not always an accurate indication of the latter. I am more cynical about the link [between standards and] better service quality. Service standards can be a check-list and a range of processes do this now – but it is not about practice. Practice is about interpersonal skills and other issues.

Another issue raised by some stakeholders was the importance of ensuring that ratings or standards were not overly prescriptive. The problem with [the Victorian model] is that it sets out series of thoughts of what a good homeless service is. You have to be careful not to be too prescriptive.

2.3.6 National system v state/territory system A number of stakeholders suggested that a system would be best implemented through a national framework which was administered by the states and territories. This framework would enable the tailoring of service standards in recognition of the issues which are unique to particular geographies. The need for the framework to be sufficiently flexible and responsive to different localities was seen as crucial. Government has responsibilities in terms of setting the expectations and then embedding that in a legislative framework and then the states and territories will work in partnership with providers to administer the framework and establish improvement plans.

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I’d like to see broad, consistent and national standards, with state and territory implementation to allow for local responsiveness.

I would go with a national framework, maybe following the community housing model – with states and territories implementing a system consistent with a national Act providing the framework.

We need national leadership with local implementation. The federal government develops up the system in cooperation with stakeholders and this can be nuanced at the local level – because a system developed for people in inner Melbourne cannot be applied to a remote Indigenous territory. But the broader framework and legislation should be developed at the national level.

I recognise there is a tension with being able to provide local and responsive and connected services to the community to which the services are operating in and the need for a consistent approach across the states and at commonwealth level. So I feel there should be clear principles which are easily translated into action in service models. But I would caution that they shouldn’t lose the ability for a service or agency to respond to what they are experiencing on the ground. I don’t think lots of bits of Western Australia and the Northern Territory cannot be seen as equivalent to what is happening across New South Wales or Victoria, things happen differently in different places. And they need to be able to happen differently. Having underlying principles supports the ability to deliver quality but they have to be responsive to the place; they need to be place-based. This a particular issue for rural and remote communities.

A number of stakeholders commented on the fact that through the replacement of SAAP agreements with the National Partnership framework there has been a move to facilitate a more state-based approach to service provision, with less Commonwealth control over service delivery and outcomes. The development of a national system was therefore seen to fly in the face of this recent change, presenting a significant challenge. Every state will do its own thing based on the implementation plans [currently being agreed between the Commonwealth and state/territory governments for the implementation of the National Partnership Agreement]. All of them are being launched now and they are all different. No national system exists.’

One of issues of a Commonwealth-level process is how are you going to implement it? Under new COAG arrangements there is no longer a national program or targets for homelessness services. SAAP had some consistency governed by legislation. How would you do it and implement it and get consistency nationally.

In principle I support a national regulatory response but I want to know what leverage the Commonwealth has. The time for this has passed because there is now no national program on homelessness. As a national organisation, it would be better if COAG committed to a framework such as the Quality Improvement Council (QIC) framework because we could then roll it out across all of our programs. I am not sure though what role the Commonwealth has in this space.

The Commonwealth could set its own regime for Commonwealth-funded programs such as Reconnect. But that would be a disaster because then there would be two regimes to deal with on the ground. If the Commonwealth can’t work within the state is should defer to the state.

In spite of the challenges, the need for a national framework for accreditation and data collection was supported by a number of stakeholders. I support a national consistent and coordinated framework based on sound principles. I support data collection and reporting that enable comparisons across regions and client groups. The only way to achieve that is to have a national framework and consistent coordination. SAAP achieved some consistency to some extent – national data collection

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framework allowed some of that. But national data collection [under SAAP] was limited to the service types that were on the ground. So there was a whole lot of invisible stuff going on that was not recorded or reported.

Implementing existing state-based regulatory systems on a national basis The accreditation framework which has been implemented in Victoria was seen by many stakeholders as a well considered and effective approach and one which has the potential to be rolled-out on a national basis. A number of the elements of that system were particularly praised, including the peer-review framework and the facilitation of mutual recognition of accreditation processes in other sectors, so if an organisation is accredited through one funding stream, this will be recognised and acknowledged, to avoid the duplication of accreditation processes. The continuous quality improvement model which operates through this system was also praised. A number of stakeholders supported the nationalization of this model. The worst case scenario would be for the Commonwealth to go a separate way to Victoria and roll out a new system nationally, because Victoria is so far ahead. I would say beware of throwing the baby out with the bathwater because an enormous amount of work has gone into the Victorian system so if you diverted too much away from the Quality Improvement Council (QIC) [continuous quality improvement] standards, beware. It would be very expensive and onerous to implement a new system in this state.

2.3.7 Challenges or obstacles to the introduction of a national system Resistance from the sector A number of stakeholders commented on the low morale within the sector and the fact that the workforce in many areas feels undervalued and fatigued. A number of stakeholders expressed resentment at the level of reporting requirements imposed on the service sector from government, and the lack of recognition of the impacts of the paperwork requirements on the workforce, which was already overstretched. A number also revealed concerns that experienced staff would resign if the organisation was required to undertake onerous reporting requirements – some reported that they had experienced this in the past. There is a huge commitment of undiagnosed underlying burnout and stress in that workforce, that is a time bomb. I don’t think data around stress leave and sick leave are analysed, but that would be an indicator of how well that workforce is. They are stressed and overloaded and frustrated, usually because of lack of access to complementary or supplementary services and resources that would allow them to be more effective.

We are overwhelmed would get resignations from key people if this was introduced.

Some stakeholders commented that there was a degree of mutual suspicion and cynicism between the government and non-government sectors, and that this could only be overcome if services were fully involved in the formulation of an accreditation system, from the beginning. This is discussed further in Section 2.4.5 below. Many stakeholders commented on the need for the process to be undertaken in a supportive and encouraging manner, one which encouraged organisations to strive for continuous improvement through self-evaluation processes. One particular comment which was put forward by a number of stakeholders was that the question of the objective or purpose of the introduction of an accreditation system needed to be fully answered before any steps were taken. We need to step back and say, ‘what is the intent of what we are trying to do?’ Accreditation may not be the answer. But a set of good practice principles might be a good first step.

Rather than imposing an accreditation system, you need to decide ‘why are we thinking about doing this?’ The question is: ‘Who has thought of this and why?’

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There has to be an element of standing back and considering, what is the purpose of this. If it is about good quality services, it might not need to be about standards.

There are questions around who has the power and authority to make this happen. The homelessness sector does a good line in not listening. It can be belligerent. So this is a very sophisticated task for FaHCSIA in building genuine and meaningful alliances.

A lack of integration and cooperation among services working within the sector was seen as another potential barrier to the effective implementation of a national, unified system. As one stakeholder commented: Services have not developed in unison: they don’t share expertise and information. The whole idea of having more communication between services, this is the biggest stumbling blocks, because in the family homelessness sector there is fear not giving away too much. Providers are mostly large church-based charities and they have views of keeping things in-house. These organisations will be a challenge. They are very protective. This is a barrier. So when talking about accreditation and standards, will be very difficult to implement that.

This was what was implanted when outsourcing staff, considered to keep prices down. But it means you have sectors with underpaid staff and frightened of working together.

Government has worked through a silo approach to date, and bringing all of these services and agencies into one frame will be onerous.

Inadequate funding and resourcing The issue of the funding and resourcing necessary for services to implement an accreditation system was raised by the majority of stakeholders consulted. The pressures on services of meeting increased demand with little additional funding was considered to be a significant barrier to their potential to implement a national accreditation system. In addition, the low level of qualifications among many staff was considered to be a barrier to the effective implementation of new governance arrangements associated with the implementation of an accreditation system. This is discussed further in Section 2.4.2 below. You get what you pay for. If you really want to lift service delivery it is about a workforce strategy: paying more, training better. An accreditation system won’t do that. It’s about salary, conditions and training.

One of the problems in this country is the madness around accreditation and quality improvement for sector agencies. Resources don’t have capacity and they impose onerous systems that don’t reflect the level of skills in the sector.

Capacity building processes in the homelessness sector have been woeful to date. In terms of the government’s SAAP training unit, it has done a bit of consulting with the sector to decide what the sector needs, but people perceive themselves to receive little training apart from ‘stirring the soup pot.’

There is a question over who is doing the management? Our impression is that the role is usually a stepping stone to leaving the sector – often to government. This leaves a transient and low skilled management. Succession plans often do not really work because of high turnover. If the sector was better funded, organisations could bring in operations managers etc and have the governance covered.

I think any regulatory system being implemented needs to come with training, skills support for capacity-building. It can’t be done on the cheap. That is a really tricky thing to do. The Western Australian community skills, training body and the SAAP training body here really struggled because the agencies often didn’t have the capacity to release staff to do the training. Not being able to backfill or buy in coverage makes it very difficult when the services are already operating to capacity with high numbers of turn away and more complex high needs clients. Any case worker worth their salt prioritises their clients: that’s

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what they are there for. So often they can’t make time to do the reflection and training and the skills-building and professional development to allow them to work better. Once you’re on that treadmill you have to keep running as hard as we can. That’s what we see in most homeless services.

2.4 Implementation approach and processes

2.4.1 Support and encouragement – carrots and sticks Many stakeholders stressed the need for the introduction of a national accreditation system to be based on a model of support and encouragement and a strong leadership from government. The low morale of the workforce in many parts of the service provision sector was highlighted and this was in part attributed to a lack of recognition within government of the high quality service that many within the workforce already provide. Praise and recognition for existing achievements was set out as a potential starting point for the introduction of a new system. Working in services is a thankless job without a great deal of job satisfaction.

It’s a cultural shift – it’s about people self-evaluating and having supportive discussions in a supportive environment. If organisations are not achieving [the standards] you can discuss how they can try to achieve them and what they need to do so.

Morale is fragile: leaders often leave and morale goes down. You have to address fears and what people are worrying about. You have to reassure people through good leadership.

To date, there has been an oppositional relationship between the government and the community housing and homelessness sectors. We need to see much more respectful relationships between all parts of the system. People need to see things from a number of perspectives: sit around the table and have a sensible, respectful conversation.

Avoiding onerous reporting requirements A number of stakeholders voiced their fears that the introduction of an overly onerous accreditation system within the sector would lead to a loss of services and a loss of qualified, experienced staff within services – all of whom may choose to exit the sector rather than deal with the issues associated with meeting an overly onerous regime. Stakeholders stressed that ‘form filling’ requirements need to be cognizant of the resourcing issues within the sector, and should also be appropriate to the likely outcomes which would result from the reports, to avoid service providers becoming fatigued and disillusioned. The SAAP system had extensive form filling and reporting requirements and not a lot has translated into improved service delivery. A lot of the data collection across the SAAP sector has identified gaps in services in terms of the provision of types of services on a regional basis and gaps in connecting and complementary services. But SAAP services report and report and report and not a lot has been responded to through additional resourcing or streamlining or responses.

[Reporting arrangements] can be unwieldy and too strenuous. We run some aged care services and there are 44 standards in the aged care industry, for example. Also, anyone can complain about you to an agency and they will make a surprise visit, sometimes at midnight, unannounced. There is no apology for the fact that there are 44 standards. You are going to have some providers who are going to say: ‘We are going to step out of the business.’ We run one an aged care home, for example, and we are thinking of stepping out of the business because accreditation takes too much time and effort. It puts us into a corner. It’s simply not viable for organisations to run just one aged care home, for example, because of the accreditation processes: you would have to run at least 10 to make it viable. We are thinking of handing over our home to one of the large providers because we are starting to get cold feet. I don’t want to see the homelessness service

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sector get to this stage. In aged care in 10 years there will be hardly any small providers around, you need so much expertise.

People in our organisation want to work with young people but the job becomes onerously administrative and this reduces morale and it’s the wrong way around.

I think some of the cons about accreditation would be that the level of bureaucratic and administrative burden on organisations that are already fairly overloaded with direct service delivery without adding a layer of bureaucracy and paperwork.

The need for the system which is introduced to be appropriate to the level of skills and qualifications in the sector’s workforce was highlighted as an important consideration. Where staff are professionally qualified, it is about honing those skills to the purpose. Where staff are not professionally qualified, it is about performance management and monitoring and having work plans around performance management and training agenda.

A broad-based system which avoids micro management A number of stakeholders commented on the need for the implementation of standards through an accreditation system to be broad-brush and to avoid a micro management approach, which may be overly time consuming and ineffective and not easily applied to the wide range of services that operate within the sector. The clear message from stakeholders was: ‘simplify rather than diversify.’ The most effective standards would be those that could be applied across a range of community service sectors. Standards nee to be broad and realistic: broad enough to capture range of [service provision] models. It could involve simple self-evaluation – show and tell. It is essential that the system is flexible.

The question is do you go broad and shallow or narrow and deep. For example, do you assess performance on the basis of six key areas and go deep or 60 areas and go shallow. I think it is better to go narrow and deep. But you need to be very wise in your choice of performance areas. Some can act as a proxy for other performance areas, for example how a community housing organisation undertakes its asset management processes gives you enormous clues about their ability to manage their finances and they customer care.

We don’t want to go overboard in the introduction of accreditation so much that it restricts your operating.

Mutual recognition of accreditation under other funding streams/sectoral accreditation A number of stakeholders commented on the importance of a system being introduced which allowed for mutual recognition of organisations’ accreditation under other systems. The problems of current arrangements, whereby multi-function centres were required to be accredited under a number of separate regimes, were highlighted by a number of stakeholders. We have had to go through three different accreditation systems already. QMS – quality mark, plus the Office of the Children’s Guardian and we are currently going through regulations to delivery housing services. It is not right and it is not fair. The processes reduce morale and they take time away from the client. It can cause a great deal of stress. I had one excellent manager who left because she couldn’t face going through the accreditation system. It is madness.

Homelessness may be just one activity of a service, and having multiple layers of accreditation requirements is counterproductive.

There needs to be coordinated credit, for example for child safety standards because you meet SAAP standards and others. We have to avoid duplicating standards and increasing compliance too much – particularly for multi-function centres.

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2.4.2 Funding and resourcing The issue of funding and resourcing within the services sector was raised as one of the most significant potential obstacles to the successful introduction of a national accreditation system by the majority of stakeholders consulted. The need for government to better resource the sector through increased funding and other forms of support was considered an essential element of the implementation of any new system. The workforce of the homelessness services sector was seen to be currently overstretched in its ability to meet demand, and having little resources in terms of staff and time, to devote to implementing a system. For this reason, a number of stakeholders commented on the importance of accreditation requirements being appropriate to the sector’s resource levels and not overly onerous. The goal of accreditation has to be to deliver better quality services to clients. If it requires diverting significant resources away from clients, forget it.

You could open up a Pandora’s box in introducing an accreditation system, because it is very costly. Small providers could be knocked out of the market.

I don’t have extra staffing and I don’t have capacity to pull people offline in the office to work on the onerous documentation required for accreditation.

Cost is an issue, especially for small non-government organisations which run on a very tight budget. It takes time to review policies and plans; it is time consuming. And you can only do this if you have someone backfilling for day to day management.

In terms of business impacts, there will be a cost impact. The question is how that is acknowledged and how there is some sort of offset or resources that can be applied – a way to ensure that services and systems don’t have to absorb this at a time of already burgeoning demand. The processes around accreditation can’t be so cumbersome or intensive that practitioners are then taken to a paper-based exercise rather than working with clients. Practitioners are concerned about the administration workload that takes them away from client work.

Until they fix the funding level for services I don’t think they should have to meet the standards. You can’t impose standards on services that aren’t receiving adequate funding. There are services providing a 24-hour service and without adequate funding they cannot comply with the raft of standards that are imposed on them. Organisations need to be funded to meet the standards.

[The Victorian model of accreditation] is going ok, although for a lot of services, it is very resource intensive. Big services have generally been able to employ expertise, for medium services, they have worked together in a network and helped each other. Small organisations have struggled most – they don’t feel they have the capacity. This has been particularly evident in the family violence and youth housing sectors.

Grants and other support from government Support in the form of small grants and/or supervision and advice from government were identified as important ways that services could be assisted to achieve accreditation. Small grants that services can apply for were thought to be important, especially where a service needed to make operational changes or deliver training to staff as part of the accreditation process. Funding for peak organisations to deliver training and mentoring to services was also identified as an important way that services can be supported during the accreditation process. As one stakeholder stated, ‘Peaks are the graphite or the lubricant between the services and government.’ The implementation strategies supporting the Victorian Homelessness Service Assistance Standards (HASS) were noted by one stakeholder as being effective. As part of the implementation strategy, workers were made available to mentor and assist services to understand the process. Services needed to identify two of their own contact people to work with QICSA (Quality Improvement and Community Services Accreditation run by the Australian Institute for Primary Care at La Trobe

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University), throughout the process. The staff also needed to undertake a one day training course with QICSA.

2.4.3 Timeframes and phasing The timing and phasing of the implementation of a new system was raised by stakeholders as a critical issue and one which is strongly linked with the need for a workforce development strategy within the sector. A number of stakeholders made reference to the importance of the two strategies being implemented simultaneously, since they are mutually supportive. Timing was considered to be a particularly important issue in relation to smaller services who may not have the capacity to release staff for training at a time when services are considered to be overstretched. It has to be a phased approach: you cannot just jump in and expect people to meet minimum requirements immediately. So you could require, for example, a 30% compliance rate, then 40%, then 60%, then 80%. You don’t go from zero to 100 in no time or you will overburden the sector. It has to be a pragmatic approach which acknowledges that 100% compliance will take time. In terms of resources, this will be a significant change process in quite an unregulated sector, so applying all of that wonderful change management theory will be a good thing.

Timing was also raised as an issue in relation to the development of a workforce capacity building plan in support of the government’s service quality improvement objectives. This was seen to be a medium to long term goal and not something that could be achieved in a short timeframe. It may be best to have a five to ten year capacity building plan rather than trying to do it overnight.

Some stakeholders suggested a staggered approach to implementation whereby workforce development and training systems were rolled out to enable professionals within the sector to work with organisations to assist them with compliance and implementation. Staged implementation and a network for information sharing Some stakeholders were interested in a staged implementation process, where possibly the larger services were required to gain accreditation first so that the smaller services could learn from the process and potentially benefit from information sharing between services. The appropriate process for networking and information sharing would need to be explored through consultation. Another reason noted for why a staged process would be desirable is that there will be many hundreds of services that will need to gain accreditation, and it may place a large burden on the relevant government department responsible for the implementation. There was some concern that if there were not enough resources available for services, that there would be widespread disruption to the sector if all services were required to become accredited at once. Peak bodies were also concerned that they would have difficulty supporting all of the services to gain accreditation if all services were required to undertake the process a the same time. One stakeholder referred to the 400 SAAP services in NSW that would need assistance alone, not including non-SAAP services which may also be required to comply under the new system.

2.4.4 Training and workforce capacity building The issue of training and workforce development was raised as a very significant issue within the sector, and one which is having a range of detrimental impacts on service quality. Whilst the level of volunteerism in the sector was seen as having a positive contribution, it was also acknowledged that the complex needs of many of the clients within the homelessness sector demanded the attention of a skilled and qualified workforce. The sector relies of volunteers – about half of workforce in some services. A workforce strategy would have to recognize their role. Many would benefit from increased funding for training.

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A number of stakeholders did point out that the proportion of volunteers in the sector’s workforce was reducing, and this was yet to be recognised by government. However, one stakeholder pointed out that there is in fact very little knowledge about the structure of the workforce in the sector and little reliable data on the level of volunteerism. There was a perceived need to improve data collection on this issue. It is hard to say because of how little we know about the workforce. The Victorian Office of Housing initiated a workforce survey to get basic information about who is in the workforce. The Department did not release full document, but sent out a summary. They found that most of the workforce was university educated. This exercise should be replicated Australia-wide.

In addition, a number of stakeholders commented on the problematic issue of a proportion of the workforce which is servicing clients with complex needs, including mental health and drug and alcohol issues, as being underqualified or undertrained for the level of complexity of the work involved. It was considered that this issue needed to be addressed if service quality improvement goals are to be met. In terms of skills, lots of people in the sector are trained as welfare workers, but they are often servicing very high needs clients. If they are servicing people with complex mental illness they may need much higher level training. People can do this without a social work degree, but they have to be able to do all of the things a qualified social worker or mental health professional can do.

I know that volunteers have a place, but in using volunteers at more critical levels you are devaluing the task. Especially, for example, in family and child protection services. These clients should be in the hands of qualified paid staff who are accountable. I don’t think volunteers should be working at that critical level. Although in some services a lot would not be done without volunteers.

The current situation was seen to be impacting negatively, not only on the quality of service delivery, but also on external perceptions – particularly amongst government – of the value and professionalism of the workforce within the sector. This issue was in turn considered to be impacting heavily on the morale of the sector workforce. A lot of people who work in this sector do not feel acknowledged. There is a lot of workforce capacity development that needs to happen to develop a healthy, vibrant, energetic workforce, so it could be problematic if you go too heavy on regulation. It can’t be all stick – we have to see opportunities for increasing skills and general conditions for people who work in the sector to build capacity for them to enhance their service provision abilities.

Training at the moment seen as unimportant. But the whole thing about the implementation [of an accreditation system] has been brought about awareness by all services that maybe we do need to improve. There is external pressure saying, ‘how well do we do this?’ May organisations are doing lots of self-evaluation they may not have done with the enthusiasm they have done. It has stepped up.

The need for a workforce development strategy to be implemented as an integral element of improving standards within the sector was highlighted by a number of stakeholders. If you want to have a client-centred approach you have to be very clear what capacity you are looking for in people working for these organisations.

In terms of skills, lots of people in the sector are trained as welfare workers, but they are often servicing very high needs clients. If they are servicing people with complex mental illness they may need much higher level training. People can do this without a social work degree, but they have to be able to do all of the things a qualified social worker or mental health professional can do.

The need for a workforce development plan to be implemented through a medium to long term framework was also raised by some of the stakeholders interviewed. This was considered particularly

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

important in light of the current poor levels of training in some areas of the sector, and the need for a culture shift to enable the government’s objectives for the workforce and for service provision to be achieved. A supportive structure of workforce capacity development and training was seen as an essential ingredient for the success of a new national accreditation system. Some homeless services really need organisational support to strengthen their internal management and governance and human resource management in order to embrace and implement minimum standards. For example Indigenous services really struggle to have a skilled executive and management committee and well informed governance structure and model. Organisational development, governance and management development need to happen alongside any implementation of minimum standards. Some organisations are very small and volunteer based so it is very difficult to impose high level of reporting and accountability and standards onto an organisation that doesn’t have the human resources.

Mentoring and networking Any potential ways to foster mentoring and networking between services during implementation was encouraged by stakeholders. One stakeholder described how it would be effective to offer ‘Excellence Awards’ and extra funding to services that are surpassing expectations in relation to accreditation. Some stakeholders suggested that opportunities for these services to go out into the community and consult with other services about how to improve their operation and governance structures so they can deliver more effective services, would be welcomed by the sector. As one stakeholder stated: ‘With so many current accreditation models, everyone gets assessed, but there is no chance to network and learn from each other about what others did differently, or more efficiently. We need to hear about other peoples achievements.’

Accordingly, the potential for networking and sharing of ideas/best practice between homelessness services was considered to be a positive aspect of potential regulation. One stakeholder described the process in Queensland where all welfare services are required to ‘work in partnership with their funder in the performance and review process.’ The assessment takes place by interview, which was described as being ‘more personable and manageable’ with less focus on paper work and more opportunity for other members of staff to get involved

2.4.5 A ‘bottom-up’ versus ‘top-down’ approach A number of stakeholders commented on a perceived lack of cooperation and sense of mutual distrust between government and the service sector at present. Government representatives were seen by some as not respecting the level of professionalism of the community services workforce, and as not understanding the realities of working within the sector on a day-to-day level. Improved collaboration between government and the service sector was therefore seen as essential to the successful implementation of a national accreditation system. The development of an accreditation system and associated workforce development plan through a collaborative ‘bottom up’ versus ‘top down’ approach was seen as a potentially effective means of improving working relationships between both parties, as well as a means of improving service the quality of service delivery and workforce morale within the sector. One of obstacles is getting around suspicion in the sector that accreditation will be imposed on them by government and it will involve purely government-driven processes. If it can be promoted and put forward as a partnership with the sector it stands a much better chance of being accepted. A lot of services want to be recognized as providing a quality service – if accreditation could be put to them as a process that recognizes the strengths of their services rather than a system for punishing those who don’t meet the standards, this would be a better approach. Involving services in the development of the system might reduce the level of suspicion and improve the processes.

I think it is best to bring together all of the parties in a taskforce to develop a workforce plan, rather than FaHCSIA decreeing one from on high. You need to get people to feel they are party to the plan. Make it as comprehensive as possible.

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We need to make a connection to listening to the experiences of people who have experienced homelessness and incorporating this into standards and charters.

The leaders of the sector need to be brought into the room with government. They should be trusted, listened to and called upon to give advice. They should be party to all of the information: often, people outside government are only party to 25% of the information. It’s about ‘what is a genuine and meaningful partnership and who should these partnerships be with.’’

I would be shocked and angry if the government thought imposing this process will improve service delivery. Unless services are able to help and support and help write the standard then the standards will be hopeless anyway.

Our members would be opposed to having no involvement in developing standards as this may mean that standards are developed without a true recognition of the service environment.

Accreditation can be done well if services are involved. Some are positive about this and some have voluntarily entered in accreditation in South Australia and Victoria – they have gone to government and said: ‘We want to meet standards and we want to be recognized.’

Sectoral consultation There was a strong view taken by stakeholders that an extensive consultation process should be carried out to develop the content of the standards, with input from service providers. The opportunity to comment on multiple drafts of standards was valued highly, so that the standards are meaningful and ‘practice focused’, similar to the SAAP framework. One stakeholder gave an example of an effective consultation process that has occurred recently in Queensland to develop a Compact (or partnership/agreement) between the Queensland Government and community services. The purpose of the Compact is to encourage collaboration and to ensure that the Community Services Strategy is an effective document which is meaningful to the sector and can affect practice.3 The stakeholder commenting on the Compact, emphasised that the process was successful because it was iterative and well-timed, allowing representatives on the consultation panel to go back to different parts of the sector and gather feedback at each stage. According to this stakeholder, the impacts of an accreditation scheme would be welcomed if they were well researched. This view is also supported by the following quote: ‘The SAAP standards came from the field. We all want them. They are fantastic for us.’

2.5 Impact of an accreditation system

2.5.1 Improving service integration and quality A number of stakeholders expressed their support for the improved service integration objectives proposed in the White Paper and also those which have been implemented through the new National Partnership on Homelessness. The inclusion of mainstream and other services within the parameters of new policies was considered to be an improvement on the approach effected through SAAP, which was seen as a ‘siloed approach.’ I would agree with a more integrated approach. Previous legislation was very specific to the SAAP funding program. Therein it had the effect of siloing homelessness within this program. So I agree with looking at a system that stretches across all portfolio areas. We have to have something that acknowledges the responsibilities of all of those working within the system to people who are homeless or at risk. The new system has more of a focus on the individual.

3 More detail about the compact can be found at http://www.qcoss.org.au/Article.aspx?type=sector&id=4716

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

We strongly support service integration. It will take a whole-of-government approach to bring the different departments together. There are examples where services work well and closely with mainstream agencies. But it will also take local service area responses, and staff making personal connections.

The introduction of a new national approach to homelessness service delivery and accreditation which captured mainstream services along with others that were outside of the SAAP system was seen as one of the biggest advantages of the system in terms of improving service delivery for clients. However the challenge of developing a single system that was relevant across all of the sectors through which homelessness services are delivered and also across all geographies was not underestimated. Having consistent national standards is a worthy aim – the challenge is that the response to homelessness has significant diversity and different levels of investment in the response across the jurisdictions. In Victoria, for example, there has been lots of investment in homelessness services and the response remains a continuing problem.

Improving the consistency of service quality on the basis of a more ‘client centred’ approach to service delivery was also seen as a potential benefit of a new national accreditation system by a number of stakeholders. This issue was expressed in relation to the geographic location of services – particularly for people in rural and remote areas – and also in relation to the various access points into the system, for example people accessing drug and alcohol treatment centres or mental health services. You would definitely get more uniformity of service delivery. Now the experience for a client, especially adults and families, is that there is no uniformity, not even of assessment criteria. So what you get depends on where you go. Organisations have a mentality of ‘our clients’ – it is not client focused. So I hope this swings the focus back to the client.

It shouldn’t matter where you live or what service you present at, you should be able to expect the same quality regardless of where you are.

An accreditation system will have benefits for clients: they will know what are realistic expectations of that service when they enter it, for example advocacy, counseling, case management. For some organisations they would appreciate being recognized as meeting standards as a reflection of the good work they do.

We need to have uniform approach and this needs to start looking at a uniform Federal system that does everything it can to protect the clients, then we build underneath it.

We have gone way past states being isolated entities, with technology it is all much more integrated and people move around much more freely. We have to move with the times.

There has been loads of discussion about this, for example in terms of homeless families, it depends who they contact what level of service they get. It is the same with domestic violence – the response from state to state is very different. Getting protocols established is very difficult and it’s happening very slowly. It comes back to needing consistency and uniformity and we need to set high standards, not the lowest standard. This should be uniform throughout Australia regardless of geography. It is hard and a complete change to [the system the government] has set up.

This issue was raised by some stakeholders in relation to the need to address the ‘exclusionary’ and ‘territorial’ practices which arose through the operation of the SAAP system. As one stakeholder commented: There needs to be some level of accountability. We need to respond holistically to people’s needs rather than using a criteria of exclusion and we get territorial about who fits within our system or not – the SAAP system has in some cases been about trying to exclude people by virtue of need. I am not sure this [integration] can be achieved through accreditation process but there needs to be something that supports accountability in the sector. The ‘no exit into homeless’ idea where parts of services sector create demand in other parts is good. It’s more integrated and accountable.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

Some stakeholders suggested that the accreditation system which is introduced should be applied to government agencies, along with the service sector, as a means of improving relationships between the two along with service quality. If you just impose standards on community services and not on the relevant government departments there will be a very bad reaction from peaks and services because this is inequitable.

Government does not even have this imposed on itself, so they could never meet the standards we meet. Until those issues are fixed why would we want to go down this path that would be a great impost on people. It’s about how it gets implemented.

Integration remains one of our greatest challenges and unless we embed the instruments in every part of the system we won’t see the level of integration we are looking for. Need to build performance plans for executives within government departments. Protocols need to be embedded throughout the system internal and external to government.

2.5.2 Workforce capacity building and professionalisation The issue of the perception of the service sector’s workforce among government and external organisations as lacking professionalism and quality was seen to be one of the potential issues which might be resolved or at least improved through the introduction of a national cross-sectoral accreditation system. This change was considered to have a range of benefits for organisations, including improving confidence in their own achievements; improving external perceptions of the organisation, and consequently improving access to funding opportunities and opportunities to recruit and retain skilled staff. Overall, it was considered to lead to a ‘greater valuing of services by stakeholders and the community at large.’ The introduction of standards and accreditation in the community housing sector has had nothing but a positive impact. One of the key benefits of accreditation is the growing confidence within organisations and growing confidence in those organisations from external parties.

Accreditation can be a way of demonstrating quality – linked to public perception and marketing and better articulation and documenting of service practice.

One of big advantages [of the introduction of an accreditation system] would be perception from other mainstream services of the ability and quality of service. Government departments in particular have a diminished respect for the work done in services partly because they are not sure of the level of qualifications and standards. This is the same within organisations, especially where non-practitioners are in charge. Any push for equity and pay will not happen until this situation changes. When there is respect for the [workforce’s] professionalism they will employ properly trained and qualified people and see the value of expanding on that training.

If we don’t take responsibility as a sector for workplace skills and training improvement, who is going to? There is room for us to ask the universities to implement specialisations in social work [which would be relevant to the homelessness services sector]. But there has to be assistance and support for existing staff. You would have to make that a condition of funding: that people with base grade qualifications are supported and encouraged to step up.

Giving good quality service requires adequate resourcing and skills training and support to enable the workers in those sectors to do the best they can. The quality and qualifications of the homeless service workforce hasn’t really been acknowledged through salary and conditions and through organisations that employ them, nor through relationship between state/Commonwealth government and non-government service providers.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

The general perspective from public agencies that non-government organisations are somehow less professional or less skilled or knowledgeable, that they are a bit stupid and good hearted and charitable, and this is undervalued and devalued. So the non- government sector’s delivery perspective and feedback to funding departments isn’t acknowledged with the same weight and importance as feedback and input from public service agencies. I would hope that could change.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

3 Issues raised through service provider interviews

3.1 Current structure and function of the service provision sector Service providers interviewed vary widely in size and type and include the larger charitable organisations, incorporated bodies both large and small, and smaller independent or community run services. The majority of providers interviewed indicated that they had management committees or boards who were in the main comprised of volunteers and who generally had the role of overseeing operations and financial management as well as the development of longer term strategy. Management committees generally meet with service managers on a regular basis and managers report regularly to these committees. However, the skill levels and commitment of management committees vary greatly from one service to the next. In one metropolitan area service the entire committee is made up of professional people with a range of tertiary qualifications including management and financial management. This was seen by the service as an invaluable asset in the development of strategic direction and financial management. However, a service in a remote area reported that for two years there had been difficulties which they had only recently overcome in finding suitable people to serve on the committee. We are lucky with the committee at the moment as we have some long term local people on the committee who oversee, provide checks, have different skills and provide advice. They track finances and offer direction.

A manager of a medium sized service in a Queensland metropolitan area reported that: The management committee is made up of volunteers. I would like more input from them regarding the future of where the agency is going, but at the moment have to do all that myself. The state standards require professional development for the management committee members, but we haven’t got funding for that. Committee members need professional development, I have offered it to them, but they have been slow to take it up. It is difficult to get them to do it. They have to achieve a level of expertise in governance, but they haven’t.

A number of services have different funding streams for various services, with provision of homelessness services as one aspect of their operations, while some smaller agencies have only homelessness services operated with SAAP funding. One service was a referral and mentoring service operating with only two staff. One example of a large provider is an incorporated charitable organisation in a regional area of Victoria which works with health and mental health services to ensure that people who are discharged from institutions are not discharged into homelessness. They are a registered housing provider and also provide advocacy and support services to those on public housing waiting lists and those who are in danger of losing tenancy in public housing. Another service in South Australia works with the criminal justice system providing accommodation and support services for those exiting prison. This service works with mental health and drug and alcohol services in the provision of support services. An example of a small provider is one with funding for 0.5 of a worker for homelessness services, but who also has one full time worker for family support. The service reports that 0.5 of a worker is inadequate. Once in accommodation, the family support worker can provide support services and can also cover the role of the SAAP-funded worker if needed. A service in a remote region of Tasmania operates as a sole practitioner. Challenges in this type of operation are isolation, inability to debrief and difficulties taking time out for training or other purposes, as this means the service is unable to operate. The recent employment of a community services worker in the same area has assisted in overcoming some of these challenges, in that both sole practitioners have familiarised themselves with each others roles and can step in if needed.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

Memoranda of Understanding (MoU) with other services and working with council support services and family support has helped overcome some barriers, and there are moves towards more integrated services through a community service team. A challenge reported by one provider was that of different expectations around different funding arrangements. One provider managing some community housing and also providing crisis accommodation for people affected by family violence reported different requirements from each. With the family violence service no one is to be turned away, regardless of whether they can pay for accommodation but community housing expects rent to be paid. Service providers generally worked closely with housing providers such as community housing organisations and public housing bodies. However, many service providers interviewed across a range of geographical areas including metropolitan, regional and remote in New South Wales, South Australia, Northern Territory and Western Australia identified lack of housing stock as a major challenge. While this is a general issue, it is particularly acute in the Northern Territory and in Western Australia. Lack of housing in Western Australia pushed vulnerable people to the edges of cities and towns, where support services and networks were less likely to be available. A Northern Territory agency spokesperson commented: Transitional housing is time limited, towards independence, but the problem is there are no exit points. The budget hostel is supposed to be for three months, but we have had people there six years because there is nowhere to go. There are no options. For homeless the affordable housing (buy into) scheme is not an option. Where would they get a $30,000 deposit for a $300,000 house? There needs to be more low cost rental properties. They can’t afford ownership.

A small community-run service in a regional area of Western Australia which has three staff to run 24 hour crisis accommodation reported that: We run short term three day (two weeks for emergency) accommodation. There are no houses. At the end of three days we usually send people back to where they came from – overcrowded situations, 15 to 20 people in a house, sleeping on couches, with friends or families.

Services have reported an increasing demand due to economic factors and many have reported that this exceeds their ability to meet demand. One service in a metropolitan area reported that while they have worked hard to ensure better collaboration with mainstream services such as Centrelink, mental health and drug and alcohol services, all of whom visit their men’s shelter on a regular basis, this does not always happen across the sector. One regional provider suggested that mainstream services often had long waiting lists, were underresourced and could not always provide services in a timely manner. One example was housing which had been found for an older person but required an occupational therapy assessment. There was a month’s waiting list for this service, which meant the house could not be occupied for that period of time. One barrier to the homelessness sector engaging with mainstream services such as mental health and drug and alcohol services identified in interviews is the difficulties in getting the entrenched homeless to engage with mainstream services. ‘They don’t always jump through the right hoops.’ Suggestions were that more outreach services were needed for this as well as services operating outside normal business hours, such as night time services. The three months allocated under SAAP funding arrangements was regarded by many agencies as an inadequate timeframe to find accommodation and establish support services to assist people to stay in accommodation. Many clients came from a long history of homelessness or failed tenancies and need long term support, including financial counseling and were in danger of repeated failed tenancy if support was not available.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

A barrier to service delivery identified by a Queensland provider was seen as rigorous requirements for homeless people to get onto waiting list for housing, including 20 page application forms and requirements for photo identification which homeless people often could not meet. Many services saw prevention and early intervention programs as essential in breaking the cycle of homelessness. It was suggested these programs be targeted at younger age groups through schools. Some services, especially in regional areas, reported seeing the children of previous clients now seeking their services.

3.2 Current approaches to improving service quality and delivery This section outlines current approaches to improving service quality and delivery across the sector. In cases where services currently engage in accreditation processes, their views on the challenges and benefits they have experienced as a result of the process are outlined in this section. Interviews indicated that services in Victoria and South Australia were more likely than those in other states to be involved in formal accreditation as a means of improving service quality. All those interviewed in Victoria, larger and smaller, and from metropolitan or regional services had either recently been through accreditation or were currently working towards accreditation. Some agencies with multiple services and funding streams suggested they were using Quality Improvemetn Council Standards and Accreditation (QICSA) as means of combining and streamlining accreditation to avoid multiple separate procedures for each service. Providers in Victoria generally thought the benefits of accreditation outweighed the challenges associated with it. Potential challenges to service delivery associated with accreditation were seen as: Agencies with multiple services may go through multiple accreditation procedures. For example, an agency involved in SAAP accreditation had previously gone through 10 separate accreditation procedures. The level of work involved in accreditation is a particular burden on smaller services. Homelessness service accreditation has as many policies for a 0.5 EFT service as a six EFT service. There is a significant cost involved in delivering accreditation systems and smaller organisations particularly are not resourced for this. Large services could employ someone full time (for accreditation), a smaller service with a budget of $2.5 million could perhaps employ someone for a period, but for a small service of $500,000 it would be difficult if not impossible. It could be the final nail in the coffin of small agencies – they could not sustain long term the intensity required for accreditation. For smaller services with few workers time for accreditation will come from client time and take services away from families with complex needs. It may speed up the trend towards centralisation of services, leading to loss of community identity and informal networks built up over a period of time which allow clients seamless shifts between services. Benefits of accreditation were viewed as: Services are often crisis driven and responsive. An external overview provides a more objective view of the service. Consolidated strategic plans incorporating action plans are developed to address shortcomings. Assists in getting documentation up to date, which is often put on the backburner. Continuous improvement is linked to professional development. Provides some consistency in standards across the sector

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

Clients benefit because of improved quality across the sector; regular review leads to higher standards of service. All workers in a service have access to the same knowledge. Confusion about the roles of different services provided by a single agency are clarified. Business benefits: once accredited it becomes a selling point for attracting additional funding, either government or private. It gives the service a high level of credibility. It leads to pride, a sense of achievement in the workforce. In some cases accreditation has encouraged providers in a region to meet and exchange information and learning. Some views on the roles of governments in facilitating service quality improvement were: Listen to those in the field. Local government knowledge in terms of planning and demographics should be respected. Federal government should set broad policy directions. Federal government should consider legislating tax concessions for the provision of affordable housing. Federal government should not be directly involved; review should be through the state governments. Geographical differences and state differences means a national system would be difficult – needs to take into account regional differences. Some in metropolitan areas thought a broad-based generic national system would be beneficial. Governments should provide the money for accreditation but not be directly involved themselves, as they know little about service operation. Service providers in Victoria were generally more accepting of the state governments rather than the federal government being involved in review of services. One view held by several providers in Victoria was that a national system may hold back those states such as Victoria which have already made significant advancement in terms of accreditation. All services interviewed in South Australia had been involved in some form of formal accreditation procedures or had been working towards accreditation, although interviewees reported that many providers in South Australia had not yet begun working towards accreditation as it was perceived by many to be overwhelming. Services were generally supportive of some form of accreditation. For one provider which had been a small independent service up until recently, they achieved accreditation by coming under the umbrella of a large non-government provider which already had accreditation. We were independent until July 1, but have now become part of Centacare Family Service. We are a small service with four workers. Costs are rising but funding is shrinking. We knew that in another four or five years we would have been in trouble. Government reforms in the sector indicate they don’t want small agencies. Centacare was already accredited, so now as part of them we are. Previously we were in the process of working towards accreditation.

Potential challenges to service delivery associated with accreditation were seen as: Uncertainty at whether achieving a level below the highest will affect future funding and tendering prospects.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

When we asked the assessor whether we should strive for the next level up we were told that achieving the next level would make no difference to a service of our sise, would make no difference to the service we provide, but we need to tender and are not sure how this will affect it. The process is time consuming. The process is costly. It is daunting for smaller providers. In organisations that do not have a dedicated position to drive accreditation, managers take on the role even though they often don’t have capacity to do this. Benefits of accreditation were viewed as: It formalises existing procedures. It gives staff a sense of achievement. Highlights areas that need procedures put in place. Provides minimum standards. Provides transparency for clients. Provides a framework to inform organisations where they are heading; assists in long term planning. Allows organisations to generate extra income by attracting donations and other funding. Gives credibility to organisations. Some views on the roles of governments in facilitating service quality improvement were: A suggestion was made that a peak body rather than any level of government may be better placed to be the driver. Funding should come from government through the peak body. Funding should come from the federal government and be managed by state governments who have better knowledge of services. Services in Western Australia had a range of approaches to service quality improvements and delivery though services interviewed were not engaged in formal accreditation systems. Smaller regional areas tended to see service quality improvement in terms of obtaining funds for physical improvements to premises. This was done through management committees which allocated a budget and additional funds were sought if additional improvements were required. Services in remote areas suggested that their approach to quality improvement was fairly ad hoc. Services in Western Australia adhered to service agreement reporting requirements, and services in metropolitan areas were more likely to undertake more formal reviews of policies and procedures. One interview suggested that Western Australia was well accredited and that this had been driven by a peak body rather than government. In metropolitan areas providers are likely to have gone through compliance audits and registration processes, for example, community housing compliance and have reviewed policies and procedures. They are more likely to be somewhat accepting of formal accreditation as long as adequate funding and resources are provided by government. Two small services reported that they had little to do with government other than adhering to the budget. One has three staff for a 24-hour service with a minimal budget. The main potential improvement to service in their view would be associated with physical improvement of buildings. One service in a remote area reported that while an accreditation system may be possible in larger metropolitan areas such as Sydney or Melbourne, it would be unlikely work in remote areas. Even if funding was available for additional staff, it was already virtually impossible to attract staff to the area.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

The federal government has already spent significant money on researching ways to improve services in the area, but they are still waiting for results. One metropolitan service suggested shared databases across a region would be a good way to improve service quality, especially around case management of clients. Several suggested that abolishing the disparity in salaries between the not for profit and government sector was essential to attract retain quality staff which is a key element to service quality improvement. Some views on the roles of governments in facilitating service quality improvement were: Federal government and state governments need to facilitate more land release and reduce timeframes for building of houses. The COAG model of the federal government providing objectives and funding and state governments managing these is a good model. Governments need to factor in regional differences. Services work well responding at a state level: there a people at a state level available to discuss funding and to negotiate with. Governments would need to adequately fund any accreditation system, otherwise the money would end up coming out of service delivery. All services interviewed in New South Wales thought they provide services to the best of their ability with limited resources. Most saw the key to improving service quality and delivery as the provision of extra resources. Service monitoring generally revolves around reporting obligations to state funding agencies as well as registration and compliance around community housing. One provider in a metropolitan area suggested that consistency across the sector would be desirable, but adequate funding would be required for this. Another regional service indicated that they had just participated in the first review in 10 years. The review identified areas for improvement and developed a two year ‘improvement plan.’ Other services in regional and remote areas thought that current compliance requirements were adequate and in some cases challenging and they were either tentative towards or opposed to further accreditation requirements. Two services in regional areas reported that the Department of Community Services had made errors four years ago in calculating services to be provided for funding suggesting services were under providing. However, reviewed this year their services were found to be providing services in excess of funding expectations. One provider in a regional area stated: We are a small non-government organisation (NGO). We have a government property through Housing NSW. We have had the government property for many years, but now must register and report to DoCS and Housing. For a small refuge, this takes time and money from people who need it most. It creates jobs for public servants. The powers should work out what is reasonably required from all people in the SAAP system. We service between 45 and 50 clients. Four years ago we were told we needed to service 57 clients. Estimates were redone this year, and we were told there had been a problem with the maths and we needed to service eight clients. Government departments ought to know, but have no idea, can’t even work out volumes for NGO’s. NGO’s do a good job despite government.

Suggestions were made that accreditation may have benefits for the larger providers, but it was beyond the capacity of small NGOs. An issue around accreditation was that larger providers with the capacity to do so were taking up accreditation. This put small agencies who are not accredited at a disadvantage in tendering putting them at risk of losing existing funding streams. Two services in Queensland reported having undergone accreditation. Another provider indicated that as services for homelessness was not their core business, but a peripheral aspect of their service, they could not comment on quality improvement procedures.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

A remote service which had undergone accreditation reported that there were significant difficulties involved in accreditation. They indicated that there was too much paperwork involved and was highly stressful on staff. They had lost a couple of senior staff due to difficult demands around accreditation. A metropolitan service which has undergone accreditation reported major benefits with no major challenges. It reported that accreditation played an important part in developing a Reconciliation Plan with the Aboriginal community and improved access for Aboriginal and Torres Strait Islands (ATSI) clients. The service has developed links with Aboriginal elders as a result and an elder now sits on the management committee. Lack of access to ATSI clients had previously been an issue. A person who was working with the service in a volunteer capacity, but was passionate about improving links with the Aboriginal community was instrumental in this work. This is one of the few service providers interviewed who reported having volunteers work directly on programs with clients. The service now has a MoU with an Aboriginal agency and is developing others. It is implementing more professional development with the help of Aboriginal agencies. Benefits of accreditation for services involved were seen as: Clients benefit as the service can identify areas for improvement. New staff will be able to have policies and procedures in place to allow them to start in the right manner. It helps ensure policies are suited to the program. Has ensured information such as housing register is up to date and online. Gives the organisation direction. May improve access for ATSI clients. Challenges were identified as: Accreditation is costly as staff needed to be taken off line to be involved in accreditation. Funding is not available to backfill positions for staff involved in accreditation. It involves high levels of stress for staff. If several services are under one umbrella and one service gets a C rating, the whole provider gets a fail rating. Two service providers in Tasmania, one in a metropolitan area and one in a remote area indicated they had recently undergone Quality Management Systems (QMS) review for SAAP services. Other quality improvement processes include six monthly reporting on service delivery including quality framework. Both were positive about the review process, indicating in one case it led to the development of a three year plan regarding policies and procedures and MoUs with other agencies. The service in the remote area was working towards accreditation. Service providers in Tasmania generally thought benefits outweighed the challenges. Benefits of an accreditation scheme were seen as: Consistent standards of service across the sector. Provision of safe environment for clients and staff. Updated food dispensing procedures across services. The reputation of the service is enhanced as a professional service. Formal policies and procedures are in place for new workers coming to the service.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

Potential challenges were seen as: If never having done it before, not knowing where to start. For a small service, the time taken to work on accreditation issues. The role of government was seen as: Having a common set of standards across all levels of government. funding services at appropriate levels. Coordination of services should be led by government, especially state government. Services interviewed reported that they had their own standards which they had to report against. One service had managers of each program who reported to the line manager and annual reviews were undertaken. A service in a remote location suggested that accreditation may be good in ensuring a level of skills among staff as long as it was funded and the service allowed adequate time to comply. Services tended to think of the role of government in terms of providing adequate funds rather than in a regulatory sense. The service provider interviewed in the Australian Capital Territory indicated that the service reported against standards set out in service agreements. There was agreement that accreditation could assist in setting benchmarks if this was done in a constructive way. The services suggested that a collaborative approach between the ACT government and services could be an example for other states.

3.3 Benefits and risks of introducing an accreditation system

3.3.1 National versus state-based system There is a reasonably widespread view among service providers from various locations, particularly those already participating in accreditation processes, that national guidelines would be beneficial and that the federal government should have a role in setting objectives and providing adequate funding and resources to implement accreditation systems, but that these could be administered and managed by state governments. State governments were viewed as having channels of communication already established with providers and knowledge of service provision. There was a view across the sector that if an accreditation system or regulatory system was to be introduced adequate resources had to be provided to implement it. It would also need to be flexible enough to take into account regional differences, differences in types of services provided and sise of services. ‘Services need to reflect diversity in the community.’ A suggestion was made that standard policies and procedures could be made available which could be adapted and modified for particular services, so that services didn’t need to start from scratch. One view was that accreditation could be driven and administered by peak bodies rather than government.

3.3.2 Benefits of accreditation Accreditation was thought to bring a higher level of professionalism to services, as well ensuring more consistent and higher standards of service to clients across the sector. Accreditation could provide a more objective view of where services were heading, and assist in long term planning as well as the development of action plans to address specific issues. Benefits to business included providing services with credibility which could help services attract additional funding.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

3.3.3 Risks associated with introducing a national system Risks associated with accreditation were seen as placing an extra burden on smaller services in particular, who were often already under-resourced. Larger agencies we perceived to have an advantage in accreditation processes, which may limit the ability of smaller services to compete in tendering processes. This was viewed as part of a trend towards larger providers at the expense of smaller providers. There was a general view that care should be taken to preserve a role for smaller independent and community-based services, as these had the ability to be flexible and were thought to be more closely aligned with needs of communities in some cases. Management committees of these were likely to be local community members, whereas large organisations may not have local boards. However, one view was expressed that in economy of scale, uneconomical services should not continue to be supported. In Victoria where a statewide accreditation is already in place, some providers did not see a place for a national system. There was a view that as Victoria was well advanced in service quality improvement systems, a national system may hinder gains already made here. Services in remote areas saw difficulties in implementing a national accreditation system due to significant regional differences affecting the operation of services. Remote services were also less likely to have resources available to implement quality improvement systems. Several services in NSW regional areas tended to see a national accreditation system as yet another layer of bureaucracy, and expressed a view that they found complying with state government reporting requirements difficult enough. Services that did not participate in accreditation, particularly those in remote areas, tended not to have definite views on what it may involve. Several thought its main function may be to lift skill levels of staff and establish minimum qualifications for staff in the industry.

3.3.4 The application of minimum standards There was a view by several of those interviewed that standards and accreditation were closely linked, with accreditation the process by which standards could be achieved. Standards were regarded as benchmarks for services. There was a suggestion that standards need to be clear and easy to use. Benefits of standards were seen as being important for accountability and guidelines for service delivery. They increased professionalism of services. Agencies that were previously at risk have been strengthened by addressing issues such as Operational Health and Safety (OH&S), client rights and risk management. Services reported a sense of pride and achievement for staff in exceeding standards. Another benefit was identified as ‘all coming from the same page – they give workers the opportunity to come from the same base knowledge.’ Standards provide specific policies and procedures for homelessness services as opposed to general agency policies. One service reported that they ‘provide a template on how to structure what we do, we work with standards in mind, but base it on what is needed in the community, driven by what we see.’ Data collection and reporting around standards was reported to be a challenge for smaller services with limited staff. The amount of data collection and reporting could be a problem for agencies with multiple funding streams. One agency reported that due to 14 separate funding streams, they had to undertake 14 sets data collection and reports. One potential issue identified was that in standards being all things to all people, they could become nothing to everyone, and become ineffective. Potential competition between agencies due to some agencies meeting standards with less funding was seen as a threat to cooperation between services.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

3.4 Workforce capacity impacts of the introduction of a national accreditation system Current workforce skills levels Staff numbers and levels of qualifications vary greatly across the sector, from services with 80 EFTs all of whom have tertiary qualifications to small services with 0.5. In some services, few or no staff have relevant tertiary qualifications. These are likely to be in more remote areas. Staff recruitment and retention A widespread issue in staffing was identified as difficulties recruiting and retaining qualified staff due to poor salaries and conditions such as maternity leave compared to the government sector. Social workers in particular sometimes join a service straight from university to get a broad range of experience in the sector then move on to the health sector, where salaries and conditions are better. Services in rural and remote areas reported that it was difficult to recruit anyone, with or without qualifications. In one remote area rents were between $500 and $700, which meant workers in the sector could not afford accommodation. Government sectors such as education and health have the ability to subsidise rents for their workforce, which put SAAP-funded services at a disadvantage in attracting and retaining staff. Funding and resources Interviews indicated that larger organisations were more likely to be able to find extra resources for accreditation and quality improvement processes. Some of these larger services have a dedicated position for policy development and quality improvement. Small to medium organisations had at times been able to employ someone for a period, but this had meant using funding from other sources. Small organisations, however, indicated that they needed extra resources for quality improvement processes. Suggestions were made that funding bodies need to recognise that organisations needed funding for service delivery, and separate funding for service support. Smaller services suggested that they required a minimum 0.5 EFT to be able to undertake quality improvement systems such as accreditation. One medium sised service in a remote region indicated they would require a 25% increase in resources to undertake accreditation. A suggestion was made that services would need policy and procedure manuals, and training and support over a year. Skills and training A number of services thought accreditation could include minimum skills levels for workers in the sector, which would lead to higher standards of service. This would then need to be recognised in adequate levels of salaries and funding for this. Services would also need to be given adequate funding and timeframe to up-skill their workforce. Some of those interviewed suggested that care needed to be taken to retain older workers who may not have formal qualifications, but significant experience. This was particularly important in services working with family violence, where it was suggested that skills were learnt over time, and could not be provided simply with formal training. Services in more remote areas also suggested that experience was at times at least as important as formal training, especially where workers had close connections with the local community. Some services which have undergone accreditation suggested that a dedicated funded worker employed on a regional basis to assist organisations with accreditation could be considered. Some service providers suggested that current training for the sector needed to be updated more regularly to capture changes in the landscape, for example, to include training around accreditation issues. It was also suggested that SAAP training was generally at a basic level, so workers who had been in the industry for several years sometimes found it difficult to access new, relevant training. A suggestion was also made for government to play a role in ensuring that TAFE and university courses were relevant to the sector. One service interviewed suggested: ‘a principled approach is needed to training, how to insert training into our model, how does it fit with our work, rather than a hotch potch.’

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

Funding for training around accreditation needed to take into account the cost of backfilling positions. This was especially critical for small organisations which may not operate in the absence of a worker. It should also cover costs of travel and accommodation for those in regional or remote areas who needed to travel to metropolitan or regional centres and stay overnight. A suggestion was made by one remote service that a DVD or some form of online training be compiled and made available to all services nationally. Role of management committees The ability of management committees to play more of a role in quality improvement systems varied greatly across the sector. Most services reported that management committees had a role in the development of strategic direction and overseeing budgets and overall operation. In some committees skill levels in management and commitment to quality improvement was high, while some services had difficulty filling positions on the management committee, and were currently operating with positions not filled. Since management committees were voluntary in many organisations, managers of some services reported difficulty in making demands on the committee. It was reported that training for management committee members was not currently funded. Consideration should be given to funding training for management committees around management and strategic development, including quality improvement. Services reported more positive staff perceptions around accreditation when service quality improvement was linked to professional development. Volunteerism Many services reported that volunteers were not used for client services face-to-face due to confidentiality and safety issues. Some did not use volunteers at all, while other used them for tasks such as painting of premises and packing and moving furniture. Only a couple of services reported using volunteers directly in program delivery. One such service reported that a volunteer was as the critical extra resource in an accreditation process.

3.5 The potential components of an accreditation of regulatory system National versus state-based system Varying views were held as to whether there should be an overarching national quality improvement system or state-based systems. In areas where accreditation was more entrenched such as Victoria, the tendency was to view a state- based system as the most desirable. Those services who viewed a national system as beneficial tended to see the role of the federal government in terms of setting broad objectives and provided funding, and for the states to manage review processes. There was a view that government bodies should set standards, but that it was up to services to work out how to meet standards. ‘Government’s role is compliance. Government needs to fund services to deliver at an appropriate level, to agreed standards, but not tell us how to.’ Organisations that had services funded directly by the Commonwealth as well as state-funded services and had Commonwealth and state compliance requirements, suggested collaboration between states and the federal government to streamline requirements would be desirable. Flexible, responsive systems There was a widespread view that accreditation systems needed to be flexible enough to take into account differing operational contexts and methods of delivery as well as different performance standards and different expectations across states. Suggestions for elements of quality improvement systems included: Quality improvement systems need to be incorporated into the daily operation of services to be relevant to staff and clients.

APPENDIX B – SUMMARY OF ISSUES RAISED THROUGH CONSULTATION

Quality improvement systems need to be client-focused: ‘How will this benefit the client?’ Few rules, but clear, for example everyone is entitled to a safe, clean environment. Could contain standards regarding accommodation offered, for example clean, lockable. Diversity, allow locally flexible models according to different demographics – not one sise fits all. Continual review to see how to improve service and understand landscape changes. Responsive to client; safe for worker. Plan for three years, articulate what needs to be improved and test this during the second review. A homelessness charter could be included. An aligned standard set of reporting requirements, to avoid separate accreditation for various services, for example for crisis accommodation, housing, drug and alcohol services. Principles to underpin service, policies in keeping with operation from strength perspective – enable clients to make decisions. Could incorporate minimum qualifications/training around report writing, case management, office administration. Accreditation systems require consultation and cooperation between the different levels of government and service providers. More collaboration between state governments and the federal government is required. Implementation timeframes Timeframes for introducing quality improvement were suggested as five or six years. Transitional arrangements could involve stepped procedures. The first review could be easier, with the second and third more rigorous. Issues which could be addressed by accreditation include more consistent and higher standards for service delivery; more consistency regarding skill levels of staff; more definition around roles of various staff such as managers, case managers, support workers; guidelines on rent operation for landlords. Quality rating systems There were mixed views on whether ratings systems were applicable. There was a tendency among those who have been involved in accreditation to oppose a ratings system. Views opposing a ratings system suggested the question that needed to be asked is: ‘What is in it for the client.’ One service suggested: It is rubbish. With the homeless rate in the Northern Territory, just getting a bed is an issue, it is an achievement. Forget the five star rating for accommodation. Ratings would be ridiculous.

One view suggested there should be either met on unmet criteria. If unmet there should be the opportunity to address this and be reviewed again next time round. ‘It is not about competition, but how services feel internally about how they could do better.’ One issue raised around ratings was the possibility of a service receiving an unsatisfactory rating in just one area. This should not result in the service being rated as unsatisfactory overall, but there should be consultation and the opportunity to bring the unmet area up to a high standard. Those who supported a ratings system thought there was a need for accreditation to be able to objectively measure the quality of service.

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