May 15, 2019
Dr Jenny Wood
While we found many nuanced barriers and facilitators for each type of intervention, five crucial factors emerged that applied across all interventions:
Housing offers a stable environment from which individuals can address other issues in their lives and move on. A lack of move-on accommodation from many temporary accommodation projects limits the potential success of interventions.
Staff capacity and ability to meet service users where they currently are (physically and psychologically) is vital. Where resourcing is inconsistent across the timeframe of a programme, or policymakers/commissioners remove or ration entitlements to subsidies, programmes tend to become less effective.
When partnerships are effective, better outcomes tend to follow. When they are poor, or break down, both effectiveness and efficiency drop off. Partnership working can offer multiple challenges, but there are key factors that promote it:
Services deliver better outcomes for people when they deliver personalised support and offer choices around both participation in the intervention, and in the services received throughout the programme.
No matter the intervention, people on the receiving end need to feel valued by staff and implementing agencies and feel their views matter. So the quality of the service is paramount. This human rights-centred approach underlies the interventions we increasingly know to be successful, such as Housing First. It is also the case that, to date, relatively little focus has been put on the rigorous evaluation of the quality of most homelessness interventions.
A quality service requires staff with the ability, training and capacity to deliver person-centred care, working in organisations with the right culture. As such, staff caseloads need to fit the aims of an intervention. The broader service culture and environment also matters. Without these things in place it won’t be possible to deliver effective care and ensure low staff turnover and high staff wellbeing.
We hope that through the new implementation issues section of the Intervention Tool we can emphasise that these five elements should underpin service design approaches and understood by all people involved in policy making, commissioning and implementing interventions to help improve the welfare of people experiencing homelessness or at risk.
<Check out the updated Intervention Tool>