Consultations concerning a National Quality Frame work for the Provision of services to People who are Homeless or at Risk

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Appendix E: Workshop Specific Key Themes

E.1 Australian Capital Territory
E.2 New South Wales
E.3 Northern Territory
E.4 Queensland
E.5 South Australia
E.6 Tasmania
E.7 Victoria
E.8 Western Australia

E.1 Australian Capital Territory

Session 1 - What is Quality Service Provision?

Important to measure effectiveness of interventions in terms of short term versus long term outcomes.
Build agendas from the bottom up to retain client-based outcomes.
Use learnings from existing frameworks/accreditations - core qualities may be applicable across all human services.
Incorporate transparency and a definition of 'quality' which is flexible enough to be supported in all contexts.
Adequate documentation of expectations, and training to meet these expectations.
Staff skills and expertise: expert staff to enable continuity of care, after-hours service access; core skills set and with clearer qualifications-based progression.

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Session 2 - Potential components of a NQF

Buy-in from other agencies to be encouraged by using rights-based components shared across services.
Realistic and timely development and implementation to allow time for agencies to respond adequately but without infringing on services delivered to clients in demanding environments.
Clients must be made comfortable with giving critical feedback without fear of negative consequences to them or the services.
There must be an ability to track and measure long term outcomes for clients.
Flexibility to ensure agencies operating in differing contexts can meet expectations for their different client groups.
Government should collate and use information on gaps and trends as collected by individual agencies.
Accompanying action plan and training required which incorporates regular reviews of implementation.
Commitment and support at all levels across agencies and government to ensure consistency and regular review.
Maintain quality in the face of funding issues, including competition for funding and limited resources.

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E.2 New South Wales

Sydney

Session 1 - What is Quality Service Provision?

Mapping similar systems and frameworks important, to take into account overlap, utilise existing knowledge and avoid duplication.
Incorporate feedback for CQI.
Focus on client outcomes, and client involvement at all stages.
Standards and collaborative models need to apply across the board, to services of differing size, speciality, NGOs and government.
Collaborate with other agencies, streamline communications across services, departments and sectors to maximise referrals.
Flexible enough to meet differing client needs, but which recognises the limitations of services and systems.
Adequately funded and resourced.
Transparent and accountable, results-based and driven by proven best practice.
Minimise red tape.

Session 2 - Potential components of a NQF

Suggest a modular approach to standards and accreditation, to provide flexibility and avoid duplication with existing models or standards, and to allow services to incorporate existing accreditations.
Complaints management is important - processes need to be confidential and well known and understood by all, clients and staff.
Charters should keep client needs in focus yet be flexible enough in their definitions to be inclusive.
Need support to resource meeting accreditation, for staff training and development, for data collection and relationship management.
Collaboration, through alliance models, must be improved and measured. This requires commitment across the board.
Components of accreditation must be embedded in performance, and not just paper evidenced. Want to foster CQI, not just compliance.

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Tamworth

Session 1 - What is Quality Service Provision?

Early intervention practices have proven valuable in dealing with the homelessness problem and so they should be included in a quality framework.
Services should be client-focused and see the individual as a human being, not just a problem.
Services should be geared towards long term outcomes - supporting the client to rejoin the community.
Housing support is important - for living skills, clinical support for mental health and drug and alcohol issues, tenancy rights and responsibilities. This requires support from the community as well as funding.
Need networks between services involved in homeless people's lives, to maximise referrals, enable communication across the sector and allow sharing of quality processes and learning.
What are 'trained' staff? Will a training system accompany NQF or will it only specify appropriate qualifications? This will need to be able to recognise informal qualifications and experience.
Clients need after hours services - can there be some coverage in NQF for catching those with need? Quality can require service to have some on-call or back up plan.

Session 2 - Potential components of a NQF

Work for QA, accreditation, standards, CQI requires a lot of time which is taken away from clients. Such processes should not be so burdensome as to impact on service delivery.
Quality Improvement should be built into any standards or accreditation - pure compliance is not valuable.
Compliance regimes already exist with different funders - these should be recognised so as not to duplicate efforts.
Having accurate national data on homelessness collected and made available to services would allow for better allocation of resources and improve quality. Homogenising reporting across all government agencies would reduce reporting burden.
Having an accreditation assessor visit a service is more helpful than completing paperwork, and enables problem solving.

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Wagga Wagga

Session 1 - What is Quality Service Provision?

Service is responsive and timely to the needs of the client.
Ongoing professional development of workforce is needed, including specialist training, which in turn can strengthen partnerships between services.
Set achievable goals that are determined by the client, and which respect the client's culture.
Effective complaints systems that are accessible and understandable by clients.
Services are transparent and accountable, and respect the confidentiality rights of clients.
Services share responsibility for delivery to clients through formalised agreements, networks and partnerships, communicate regularly and have clear referral pathways between services.
Collaboration is supported by mutual respect, shared goals, clear roles and responsibility, shared policy and tools.

Session 2 - Potential components of a NQF

Workers need professional development and ongoing training. There is a need for a national qualification system for working with homelessness.
Collecting client feedback, both positive and negative, works well. Quality framework should include ongoing feedback collection and evaluation options.
Important for accountability to have follow up on and report of outcomes, especially with one-off clients.
Keep it client-focused, maintaining the rights and responsibilities of clients.
There's a challenge in engaging all services that link to homelessness. Nominating lead agencies and adopting alliance models, which are signed and promoted at the top level, will encourage services to take responsibility for service delivery.
How do you get everyone into an accreditation system when they have their own core business? Perhaps key outcomes or standards should be included in quality systems of partner services.
Accreditation will need to be well resourced at all levels, with support provided in varied and flexible ways, including online, by phone, in hard copy, and through information sessions.

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E.3 Northern Territory

Alice Springs

Session 1 - What is Quality Service Provision?

Evidence-based service approaches including action research are important. Clients deserve professional approaches based on evidence.
Being client-centred - what do they really need? How do we find this out? Need to emphasise consultation and feedback.
Flexibility of service provision to meet differing client needs.
Collaborative models, which allow for case co-ordination, timely responses and sharing of relevant info.
Utilise cross sector tools to share info, and allow continuity of care and case management - forums, web-based databases, MOUs.

Session 2 - Potential components of a NQF

Standards are more important to have than accreditation - accreditation may be problematic for smaller organisations and emphasis should be on setting goals to improve services rather than requiring pure compliance.
Continuous quality improvement needs to be clear on requirements and based on research.
Workforce development strategies are required to have a strong workforce to move everything forward.
It is important to convey how you operationalise these components, include support mechanisms and the orientation of service objectives, so that roles within the service are clear to staff and clients.
Promotion of clear principles and service objectives, and specific roles of services in clients' lives support collaboration. Must be able to confidently refer on when unable to address client needs.
A web based directory to share info would support the sector, to affect client transfers, keep track of case details, and so clients don't have to start anew with every service.

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Darwin

Session 1 - What is Quality Service Provision?

Focus on client outcomes and involvement, being rights-based, perhaps with consideration of human rights charters and the rights of particular groups, such as children. Services should empower clients.
Flexibility to meet differing client needs in local context, with culturally and regionally relevant service.
Committed to workforce development and skilled and qualified staff, but also able to recognise skills and qualities gained through life experience.
Clear guidelines and protocols for communication across the sector are needed, including shared case management, opportunities to network, and strong referral processes.
Frameworks need a strong legislative base, supported by policy and procedures which govern all services in the sector.
Utilise existing frameworks and knowledge, focusing on strengths-based approaches and building on the existing evidence base.
Privacy and confidentiality should be maintained without inhibiting service delivery, especially across services.

Session 2 - Potential components of a NQF

There are reservations around accreditation - it is time consuming and resource- intensive, and does not necessarily equate to real improvement of services.
Standards which are too prescriptive risk a loss of flexibility within services, but could be useful for benchmarking services across all states.
Appeals and complaints processes are important, and need to be accessible and approachable for clients.
Framework needs to be applicable across all of sector, including NGOs and government agencies, fitting in with existing legislation but developing common understandings and benchmarks.
Quality framework needs to capture what is currently working well within the sector, but co-ordinate more effectively across organisations and departments which greatly differ.

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E.4 Queensland

Brisbane

Session 1 - What is Quality Service Provision?

Alliance models, including MOUs, are positive ways for services to work together, but better partnerships are needed to develop joint case management, referral pathways and greater awareness of other services that are available and how they can be accessed. Services in allied sectors should be engaged to develop common visions and processes.
Services need adequate funding, including for the training and recruitment of staff to support quality improvement.
Complaints and feedback systems must be positive processes of shared practices. The client must always be involved.
Standards must allow for review to remain relevant to services, and may benefit from external auditing. If they are to universal they must also be flexible.
Accreditation should be about continuous quality improvement, to support service provision, not just accreditation for accreditation's sake.
Consumer and service charters are important to maintain a balance of power between services and clients. They must be communicable to all levels of service provision.

Session 2 - Potential components of a NQF

Service models need to reflect a client outcomes focus but services need an effective outcomes-based measure of performance.
Quality service delivery needs to address long term outcomes to manage homelessness.
Support is needed for workforce development across the sector, to train and retain staff. The quality framework could be supported by a national accredited training framework for staff.
NGOs and government need to be supported to collaborate through streamlined processes and shared standards.
Feedback processes must be transparent for all stakeholders; a separate body or ombudsman to handle complaints will maintain transparency.
Collaborative service development should be supported by data, to be able to adjust service to meet local needs and client needs. This will encourage networks that will help address the gaps within the system.

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Townsville

Session 1 - What is Quality Service Provision?

A human rights, social justice oriented framework must underlie all components and needs to be ethical, equitable and fair for all and based on respect for the client.
Must retain a client-outcomes focus, especially in a sector that has such a diverse client group.
Cross-service collaboration can be supported by systems and joint case management processes, to build ongoing relationships between services.
Service delivery must be prioritised and red tape associated with a national quality framework must be minimised. We must be able to ensure small services will not be crippled by requirements.
The framework could include evidence based action planning, to recognise and utilise the good work already being done in the sector. Ensure services share this information to reduce duplication of effort and allow for effective referrals.
Adequate resourcing is required to meet quality requirements - where will the money come from to improve services?
Cultural competency is important, not just for Indigenous clients, but a greater sensitivity towards all cultural backgrounds.
Services need to be able to have the flexibility to act outside their funding agreements to secure client outcomes and have this work recognised.

Session 2 - Potential components of a NQF

Accreditation should be more meaningful than a pass/fail system, requires adequate funding support, and must not cause a lack of service provision.
Alliance models need to incorporate partnerships and engage stakeholders at all levels.
Complaints management processes need to consider client accessibility, possibly incorporate an external body and be outcome focussed to improve services.
Services should be able to share common review and evaluation tools and have access to peer evaluation of their performance.
Continuous quality improvement is a shared value across the sector, but is challenged by funding limitations.

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E.5 South Australia

Adelaide

Session 1 - What is Quality Service Provision?

A client centred approach, which is needs-based, focused on long term goals and respectful of their rights and responsibilities.
Co-ordinate and collaborate with other services well, NGO and government, including case management. Communicate effectively, including through forums, roundtables and formalised agreements between organisations.
Have the flexibility to deliver outcomes, based on developing an understanding of complex client needs. This includes cultural competency.
Collect and utilise consumer feedback effectively to improve quality - evaluation, consumer participation, worker feedback.
Evidence based planning and development, with quality improvement based on best practice standards and benchmarks.
Supportive of staff and offers professional pathways and development.
Service is accessible - outreach is important.
Effects referrals based on shared understanding of service capabilities.
Streamlines the client experience, through shared case management, smooth referrals, support to exit homelessness and reduce risk of return.

Session 2 - Potential components of a NQF

Collaboration should be supported by alliance models and by legislation, especially in regards to information exchange. NFQ needs to use common language so that meanings are understood by all across the sector; nominating lead agencies may make services more responsible for relationship building.
Client involvement in processes is key - feedback collection and evaluation should be incorporated.
Education and training of staff needs to recognise both diversity of client needs and professional pathways, on the ground skills.
Focus of any accreditation processes should be continuous quality improvement, not pure auditing or compliance.
Identify and evaluate existing quality frameworks and recognise services that have achieved compliance.

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E.6 Tasmania

Hobart

Session 1 - What is Quality Service Provision?

Client-focused, outcome-centred, with client actively involved in process.
Services share common goals and work in partnership, with common protocols streamlining collaborative work.
Evidence based - and able to effectively incorporate feedback.
Resourced - to meet needs, to meet CQI goals, to be sustainable.
Engaging consumers, building rapport and focussing on their needs rather than red tape requirements.
Focus on integration between services, which allows services to retain their flexibility when working in partnership.

Session 2 - Potential components of a NQF

Resources are required to meet the need for quality improvements, which could be difficult in particular for small organisations.
Focus on quality improvement with client at the centre.
Complaints management may give too negative an impression - need to capture and utilise good and bad feedback.
What is working well should be acknowledged and incorporated into standards and accreditation.
Consumer charters need to be accessible and understandable by clients.
Quality improvement processes need to enable information about service performance to travel both way between services and government.
There needs to be a capacity to recognise compliance achieved by services with existing accreditations.

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Launceston

Session 1 - What is Quality Service Provision?

Cohesion and consistency - within services and across the sector, supported by the culture within a service.
Accessibility to both clients and other services, making others aware of what you do.
Skilled and trained workforce - with professional development, equitable wages, and recognition of experience.
Client focused, and focused on outcomes, with the flexibility to meet differing client needs.
Strong partnerships between services, across Government and NGO, with clear protocols/guidelines to govern interactions.
Timeliness - able to respond to crisis but also support client throughout journey.
Accreditation systems should recognise what has been achieved, and not make anyone start from zero. Needs to be supported and funded.
Monitor performance through feedback mechanisms.

Session 2 - Potential components of a NQF

Alliance models, MOUs and networking are important to enhance collaboration between agencies, through formalised partnerships.
Core components should be adopted by all agencies, however there needs to be room for flexibility and specialisation by services.
Accreditation and standards should be a meaningful improvement process, not just pure compliance.
QA is resource intensive to establish, and staff need to be supported with resources and training.
Commitment is required by services within the sector and with allied sectors such as mental health and disability.
Need to map existing systems to avoid duplication.
Feedback processes need to capture more than just complaints, and assure client of neutrality, perhaps by the use of an ombudsman.

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E.7 Victoria

Bendigo

Session 1 - Potential components of a NQF

Alliance models and collaboration works well, including existing networks and peak bodies; practice forums.
CQI enhances accountability; ensures reflection; tracking outcomes; supports best practice.
Multiplicity of standards does not work well; require a single set that apply to all services.
Streamlining - both reporting to multiple bodies and cross-services (using same forms, etc.)
Implementation of quality frameworks requires adequate resourcing.
Need an outcome focus to be client focused - measuring 'improvements' as opposed to activity, valuing change in client's lives, not just meeting numbers.
Accreditation body needs to understand the sector and conduct regular review.

Session 2 - Mainstream and allied services

Mainstream and allied services have a lack of understanding about homelessness issues; this could be resolved by educating services and community to understand issues of homelessness and appropriate responses.
Need to develop strong relationships between services, with common charters and goals.
Sharing referral practices and having a common language.
A lack of shared understanding of homelessness and the issues accompanying homelessness across mainstream and allied services is a barrier to collaboration. Each agency has a differing approach to homelessness.
Resourcing issues, including lack of staff time/funding to develop collaborative skills and develop relationships.
Collaboration would be supported by having resources available for staff training and supporting collaborative skills, relationship building.
Also need common standards or frameworks which outline common aims.

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Geelong

Session 1 - Potential components of a NQF

Workforce development - commitment to training and remunerating staff, to retain and improve service delivery. Ensuring equity of pay across sector.
Financial support to meet requirements, especially for smaller services.
Supporting culture change within the service to ensure a philosophy of quality improvement underlies the work.
Cross-sector work is challenged by competition for resources, a lack of case co- ordination, and differing approaches.

Session 2 - Mainstream and allied services

A lack of understanding exists between services - they operate on 'myths' about what each other does.
Standards for responses to homelessness could be included in mainstream and allied services.
Educate services about each other.
Effective collaboration is hindered by varying referral processes and eligibility criteria, language and terminology between services; a lack of understanding of what services are available and what they offer.
Collaboration can be supported by MOUs and other formalised agreements between services, and funding to support collaboration and cross sector training.

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Melbourne

Session 1 - Potential components of a NQF

Agencies need support to implement - funding, staff training, and professional development of workforce.
Make it a client-centred process - implementation must not impact negatively on client time - incorporate consumer input into framework and implementation, through flexible and meaningful feedback processes.
Accessibility and usability of services must be ensured - service must be able to cater to a variety of client needs, including language, literacy, culture.
Must avoid duplication of frameworks and standards, and allow for recognition of existing compliance.
A focus on integration - with existing frameworks, standards, processes and systems.
Framework should be focused on CQI, not just compliance, and needs to be evidence based and encourage further research/info collection.
Commitments are required from all levels of services to collaborate and network more effectively.

Session 2 - Mainstream and allied services

Build understanding between organisations of what other organisations do, how they can help, how their systems operate.
Create more opportunities to network and share resources, goals; dedicated staff, and programs, to share information and resources across sector.
Organisations need to share language, definitions, understandings.
Build a more 'collegial' way of operating that allows organisations to break down 'silo operating', through a focus on client needs.
Make more resources available/reduce competition to encourage organisations to work together; collaborating and building networks takes time, money, and other resources that services can't spare.
Train and develop staff to respond to diverse client needs and make effective referrals.
Train staff in more general services in the skills/knowledge needed to help homeless and at risk clients.
Implement agreements and policy at the top and the effect will flow down.

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E.8 Western Australia

Bunbury

Session 1 - What is Quality Service Provision?

Resourcing services to meet requirements, both for clients and to be able to train staff, without impacting on service delivery.
Clear and transparent referral services and communication standards across agencies;
working well in collaboration.
Centralised resource/database to facilitate collaboration of agencies - with government involvement.
Follow-up processes for referrals and in general to track clients and their outcomes.
Valuing the work of small services and appreciating the diverse work done within the sector.
Services are flexible in being able to meet client needs and appropriate to their region and client group.

Session 2 - Potential components of a NQF

Complaints management system is important, but is this best managed in-house or externally? Internal management can colour the service received by a client.
Collaboration may be enhanced by using a 'hub' approach, with a common body to collect and collate info, with funding, to make available to every service provider.
Ensure standards are not duplicated or conflicting, or too prescriptive, while allowing for the flexibility to meet differing client needs.
The need for clear review processes, which take into account the unique operating system of the service, with some allowance for qualitative data incorporation.
How will alliance models ensure effective collaboration - does this belong in NQF, or are MOUs more appropriate? NQF would require all bodies working collaboratively to sign off on it to ensure understanding between agencies.
Appropriate understanding of rights and responsibilities for all stakeholders - this can be enabled by charters.
Appropriate funding to meet NQF requirements.

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Perth

Session 1 - What is Quality Service Provision?

Develop trust, between service and client, between organisations. Clients require respect, non-judgemental treatment and access, and to feel safe.
Maximise agency collaboration strategies to ensure timely response.
Monitor outcomes, and develop outcomes in consultation with clients. Not necessarily measure outcomes via compliance with stringent standards, or based on clients' economic status.
Organisations are resourced to meet requirements.
Flexibility around service models to meet different needs, and to be responsive to real needs.
Ensure appropriate access for clients, including effective referral processes, appropriate language and user friendly materials.
Well equipped workforce, with right competency, training and skills base. Professional development opportunities, organisational support for staff (health and wellbeing, counselling). Competencies must be able to recognise different pathways into the sector.
Transparency of policy and procedures - internally and externally. Feedback mechanisms which include clients.
Inter-agency collaboration should not mean more footwork for clients - have one primary management agency so they are not continuously telling their story.
Collaborative case management requires a co-ordinator to be allocated. Who has primary responsibility for client?

Session 2 - Potential components of a NQF

Framework must not be as onerous as to impact service delivery negatively but must be meaningful - not just a box-ticking exercise.
Evaluation of compliance - is it undertaken by those who understand the unique operating context of the organisation?
Consideration of an external complaints process, to ensure clients feel comfortable giving feedback.
How will compliance with the NQF be resourced?

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