Chapter 5 A National Standards and Accreditation Framework for Services
5.1
This Chapter considers the rationale for implementing a national
standards and accreditation framework (hereafter referred to as a national
standards framework) for services and the scope of its application. Consideration
is given to the range of legislative and non-legislative strategies that might
be used to support quality improvements in services, and to the possible impact
on services of implementing a national standards framework, including resource
implications.
Rationale for a National Standards Framework
5.2
There is no unified national regulatory framework that applies to
specialist providers of services used by homeless people and people at risk of
homelessness. Previously, service standards for assistance provided under the Supported
Accommodation Assistance Program (SAAP) have been established within each state
jurisdiction. The Road Home suggests that governments have implemented
service standards with ‘varying degrees of success’.[1]
To promote national consistency and encourage best practice in services used by
homeless people, The Road Home foreshadows that:
The Australian Government will enact new legislation to
ensure that people who are homeless receive quality services and adequate
support.[2]
5.3
The Road Home indicates that the establishment of a national
standards framework with a focus on quality improvement will contribute to:
n placing clients at
the centre of the response in both the mainstream and homelessness service settings;
n a greater ability to
attract and retain a highly trained, multi-skilled and well-educated workforce;
n career paths for the
workforce, with skills and expertise that are easily transferable within the
sector;
n continuous service
improvement to ensure that clients receive a service offer focussing on
achieving sustainable housing and employment outcomes;
n stronger connections
between government, business and non-government services.[3]
5.4
To progress the development of a national standards framework The
Road Home explains that:
The Australian Government and state and territory governments
will work with homelessness services and people who are homeless to develop
national homelessness service standards and a system for accrediting services
focused on improving quality.[4]
5.5
The Road Home recognises the diversity of services used by
homeless people and recommends that service standards and accreditation be introduced
for specialist homelessness services only, with a national service charter
produced to guide mainstream services in delivery of support to homeless
people. Thus The Road Home contends:
National service charters for mainstream services and
accreditation for funded specialist homelessness services will lead to a
service system that maintains high-quality service delivery and has
appropriately skilled and qualified staff. It will also help develop
partnerships that encourage consistency and best practice service delivery
across the sector.[5]
5.6
The submission from the Australian Government Department of Families,
Housing, Community Services and Indigenous Affairs (FaHCSIA) summarises the
need for a national regulatory systems as follows:
A strong approach to quality improvement in homelessness
services and mainstream services dealing with vulnerable Australians is needed
to align the efforts of states and territories. Long term efficiencies in
delivery that give consumers and governments assurance of quality are possible.
A quality system will give scope for improved transparency and accountability
to the broader community ensuring funds are being judiciously invested to get
the best outcomes. Legislation that encompasses principles, values, consumer
protections and service standards would create a sound framework.[6]
5.7
Evidence to the inquiry also widely recognises the potential benefits of
introducing a national standards framework for services. It was generally
thought that, if implemented correctly, a unified system could provide services
users with increased confidence about the quality of services they access. It
was also thought that a national standards framework could support improvements
in the quality of services through the adoption and delivery of best practice
and through encouraging capacity building in the workforce.[7]
Key Issues for Consideration
5.8
Despite general support for a national standards framework, many
submissions stressed that careful consideration is required to achieve the
desired outcomes and avoid unintended consequences. A fundamental consideration
relates to how to determine the most effective strategy, or range of strategies,
to achieve consistent service delivery and quality improvement in services. However,
there is some uncertainty about the extent to which legislative or
non-legislative strategies should drive this process.[8]
Also, as homeless people and those at risk of homelessness may seek assistance
from a wide range of services, questions have been raised about the breadth of
services that should be governed by a national standards framework.
5.9
Other issues that need further consideration relate to the process for achieving
consensus on the broad principles and specific standards to be included in a national
standards framework, and the capacity of services to comply with it. The evidence
has emphasised extensive consultation is a prerequisite.
5.10
The following key issues raised in relation to a national standards
framework are examined in more detail below:
n options and
strategies for introducing a national framework;
n the scope of the
framework’s application;
n the process for
development of the framework;
n identifying the
framework’s key components; and
n determining the
process and assessing the potential impact of implementation.
Options for a National Standards Framework
5.11
While evidence to the inquiry generally supports measures to improve the
quality of services used by homeless people, there is considerable diversity
about the best way to achieve this.
Service Standards versus Accreditation
5.12
As noted earlier in the Chapter, The Road Home suggests that
ensuring access to quality services will be achieved by introducing national
homelessness service standards and a system for accrediting specialist services.
Several submissions have emphasised the distinction between setting service
standards and introducing a system of accreditation. As explained in the
submission from the Queensland Youth Housing Coalition (QYHC):
In the context of human services, standards establish what is
expected of service providers in relation to the quality and effectiveness of
service provision. Accreditation is the process of evaluating performance and
certifying that standards have been met to the level required.
Accreditation is an active process. While standards can exist
independently of an evaluation system, an accreditation system must have
explicit standards with which to assess performance..[9]
5.13
Evidence included mixed views of the value of accreditation in improving
service quality, with a number of submissions questioning whether mandatory
accreditation should be a component of a national standards framework. As noted
in a joint submission from the Quality Improvement Council (QIC), Quality
Management Services (QMS), and Quality Improvement & Community Services
Accreditation (QICSA):
A case can be made both for and against mandatory
accreditation. If accreditation is mandatory, there is a legal requirement to
comply, with consequences for failure to comply. The argument runs that all
services must meet minimum standards otherwise they are not allowed to operate.
... On the other hand, it is argued that compliance assessment is only as good
as the day the assessment is made, and if sustainable quality performance is
sought then quality improvement systems should be in place. The argument
against mandatory accreditation is that it encourages minimum compliance rather
than quality improvement.[10]
5.14
Similarly YP Space MNC also maintains that:
Accreditation may be a positive avenue, yet it is highly
resource intensive and can at times create a ‘status quo’ platform, through the
setting of minimum standards as opposed to continuous quality improvement.[11]
5.15
Rather than introducing a system of mandatory accreditation, the
submission from QIC, QMS and QICSA suggests:
... legislation that requires services to participate in an
accreditation program, as opposed to meeting a particular accreditation result.
Over time most organisations in accreditation programs develop a motivation to
embrace quality systems even if they do not start this way.[12]
5.16
This suggestion is also consistent with the approach proposed by
FaHCSIA, which recommends:
A staged approach to voluntary accreditation may be the first
step in helping services meet improved quality standards. In recognition of
adjustments needed within the sector, compulsory accreditation could be
introduced as longer term goal.[13]
The Role of Legislation
5.17
The Road Home indicates that new legislation will be enacted to
ensure that people who are homeless receive quality services. As noted in
Chapter 3, the NSW and Tasmanian governments have questioned the role of new
homelessness legislation in setting services standards, particularly as the
National Affordable Housing Agreement (NAHA) indicates that the states are responsible
for the administration and delivery of services for homeless people.[14]
5.18
While also emphasising the complexities associated with a legislative
approach in the context of current federal-state funding and administrative arrangements,
ACOSS observes:
The federal nature of funding agreements raises further
questions about which regulatory and quality-improvement processes are best
conducted nationally, and which at state and territory level. The risk of
complex, inconsistent and overlapping regulatory frameworks must be addressed.
Most importantly, careful consideration must be given to which aspects of
service delivery (and types of service) should best be dealt with in
legislation and which through other means, for example, performance based funding
agreements. Decisions also need to be made about the level of detail which
should be contained in legislation as opposed to standards set out in
legislative instrument and conditions in funding agreements.[15]
5.19
However, others have argued that national consistency and improved
quality services will only be achieved if a national standards framework is
firmly entrenched in new legislation.[16] While some have
suggested that detail of the framework should be included in the parent
legislation, others have suggested it would be preferable for the parent
legislation to include broad principles only and for the details of the
framework to be set out in a disallowable instrument. For example, QIC, QMS and
QICSA caution against legislation that is too prescriptive based on the
following limitations:
Legislation as a vehicle for mandating standards is
problematic because:
n wording is more
likely to be rendered in narrow, legalistic language
n legislation is
primarily concerned with regulation so standards will tend to be written as
inputs or processes rather than desired outcomes
n legislation takes
time to pass (and hence may not keep pace with understandings of better
practice) and once legislation is passed it is very difficult and not timely to
amend.[17]
5.20
Others have suggested that non-legislative measures (e.g. service
charters, non-mandatory accreditation, contracts and funding agreements,
training and support, good practice information dissemination) could be used to
complement legislation or as an alternative.[18]
5.21
The Committee notes the Government’s commitment to new legislation which
establishes nationally consistent standards for services used by homeless
people and those at risk of homelessness. As these standards will need to be relevant
and applicable to diverse range of services, the Committee recommends that
legislation provide overarching principles to underpin service standards. Prescriptive
standards should be set out in complementary non legislative agreements with
the states and territories, and through them with service providers.
Recommendation 11
|
5.22
|
That new homelessness legislation provide overarching
principles to underpin a national standards and accreditation framework for
services used by homeless people and those at increased risk of homelessness.
Prescriptive standards should be expressed in complementary non legislative
agreements with state and territory governments and, through them, with service
providers.
|
The Importance of Adequate Resourcing
5.23
Importantly, evidence has also cautioned against placing too much
emphasis on a purely legislative approach to achieving consistent service
quality and driving quality improvements. Many submissions note that it is
crucial for services to be adequately resourced in order to meet service
standards and obligations. As stated by Catholic Social Services Australia:
Legislation certainly has a role in improving the quality of
services for people who are homeless or at risk of homelessness but it will
also be necessary to ensure that goals and objectives are appropriately and
adequately funded, resourced and monitored.[19]
5.24
Also to achieve consistently high service standards submissions have
emphasised the importance of being in a position to recruit and retain well
trained staff.[20] As observed by Southern Youth
Family Services (SYFS):
A focus on a regulatory model will not achieve the intent
which is quality services for homeless people. It must be done as part of a
progressive program to support and develop services including addressing issues
in the community workforce (training and development, pay and conditions,
portability of long service leave, ability to attract and maintain quality
staff etc).[21]
5.25
Similarly, the submission from the Byron Emergency Accommodation Project
called for:
... legislation that ensures a commitment to resourcing the
sector with sufficient finances to attract and retain a skilled work base of
qualified and quality workers. Please keep the legislation goals in line with
the reality of how the sector is financed and resourced to achieve these goals.[22]
5.26
Clearly adequate resourcing is essential for services to achieve and
adhere to new quality service standards. In this regard the Committee notes
that the Commonwealth and state governments together have committed $1.1 billion
over the next four years from 2009–10 to reducing homelessness under the National
Partnership Agreement on Homelessness. In accordance with the federal-state
financial arrangements administration of these funds, including allocation of
resources to specialist homelessness services, is the responsibility of the
state governments.
Scope of Application
5.27
Another important aspect to be taken into account when considering the national
standards framework is the scope of its application. As noted earlier in the
report, the service standards under SAAP were contained in service agreements which
applied specifically to providers of specialist homelessness services funded
under the program. However The Road Home implies that a national
standards framework should include provisions that apply to a broad range of
specialist and mainstream services used by homeless people. Recognising the
difficulty of applying a single quality framework to the diverse range of
services used by homeless people The Road Home recommends a national
service charter to guide mainstream services in delivery of support to homeless
people.[23]
5.28
However, many submissions have argued that to be effective any national
standards framework must apply equally to government and non-government
services, and extend beyond specialist homeless services to include mainstream
services.[24] As stated by Christo
Youth Services:
The legislation needs to ensure that ALL systems and
institutions – including Government, non-government, community and Corporate –
are regulated with the same legislation, accountability and transparency.[25]
5.29
Similarly, Homelessness NSW suggests that:
... legislation can address the issue of quality services
only if it ensures that both government and non-government services are bound
to the Act. Mechanisms must be built into the legislation that stipulate the
minimum level of service that state and territory governments must deliver for
people who are homeless and those at risk of homelessness.[26]
5.30
The difficulty of having a framework which applies to all providers of
services to homeless people and those at risk of homelessness, is that the
standards will need to be broad but meaningful at the same time. SYFS
highlights the challenge as follows:
The new Legislation should be supported by national standards
for both Government and community providers of services to homeless people and
those at risk of homelessness. However, the challenge in this will be that the
standards are broad enough to apply across Government and community, are
realistic and useful, and that community agencies, as mentioned above, are
funded adequately to be able to meet the standards.[27]
5.31
As also observed by Mission Australia:
... a key challenge in creating the new legislation will be
to influence the activities and administrative processes of other sectors and
institutions which sit outside the circle of direct service provision, but
nevertheless have a bearing on and a role to play in reducing homelessness.[28]
5.32
If standards are prescriptive rather than broad, a significant risk is
that mainstream service providers will be required to apply standards that are
relevant only to a minority of their clients. In this regard the NSW Government
observes:
If the intention is to regulate all services accessed by
homeless people or people at risk of homelessness, there is a risk that the
legislation would end up applying to a very wide range of services - many of
which provide services to a broader range of clients than those experiencing or
at risk of homelessness.[29]
5.33
Furthermore the NSW Government also notes that many mainstream services
already have service standards and accreditation systems in place. Therefore
the NSW Government argues:
The need for the homelessness legislation to further regulate
these broader services would need to be established in light of the existing
mechanisms in place for ensuring quality service delivery in these sectors.[30]
The Case for a Staged Approach
5.34
The Committee acknowledges the widespread support in evidence to the
inquiry for the introduction of a national standards framework to increase national
consistency and promote quality improvements in services. However, it also
recognises that there are differing views about the relative merits of
legislative versus non-legislative measures for driving quality improvement, the
extent to which standards should be prescribed in legislation and the range of
services that should be governed by any framework. This highlights some of the
complexities still to be addressed.
5.35
Although not published at the time of writing, the Committee is aware
that FaHCSIA has commissioned research to investigate the development and
implementation of a national standards framework for homelessness and related services.[31]
The Committee understands that the report produced by Urbis Pty Ltd will
contribute to the Government’s considerations of the most appropriate strategy
or mix of strategies for supporting the aim of ensuring that people who are
homeless receive quality services. Without intending to pre-empt outcomes of
the Urbis Pty Ltd report, the Committee believes that at a minimum, additional work
and consultation will be needed. Notwithstanding the impending Urbis Pty Ltd
report the Committee wishes to make its own observations.
5.36
While acknowledging the calls for a national standards framework to
apply to all services equally (that is to government and non-government, to specialist
and mainstream), the Committee believes that achieving, developing and applying
a single framework would be an ambitious undertaking. Therefore the Committee
supports the proposal in The Road Home for the national standards
framework to apply to specialist homelessness services only and for a national
charter of service standards for homeless people and those at risk to be
developed as a guide to mainstream services. This initial approach should be followed
by a gradual process to extend a national standards framework to a broader
range of services over time.
5.37
In addition, the Committee believes a staged approach to the implementation
of a national standards framework for specialist homelessness services would be
appropriate. Staged implementation should include sufficient flexibility to
accommodate the many different models and structures of service delivery that
exist even within the specialist homelessness sector. Importantly, implementation
should recognise that different services within the sector will have different
levels of preparedness and capacities to meet quality standards. Requirements
to comply with minimum standards and an accreditation system should be
introduced over a reasonable period of time to allow services to continue to
meet the needs of their clients, while at the same time improving service quality.
Recommendation 12
|
5.38
|
That the Minister for Housing, through the Housing
Ministers’ Conference, support the introduction of a national standards and
accreditation framework which:
n provides
a broad national service charter to guide mainstream services in their
delivery of services to people experiencing homelessness or at risk of
homelessness; and
n sets
specific minimum quality standards for specialist homelessness services,
leading progressively to accreditation.
|
5.39
With regard to applying a national standards framework to services more
broadly, including mainstream services, the Committee notes evidence that the
Victorian Department of Human Services is considering moving away from program
specific standards to a set of core standards for community services. Where required, core standards can then be
supported by good practice guidelines that are sector specific.[32]
The Committee encourages support for this approach as it believes that it
provides an option to strike a balance between the uniformity of minimum
standards and flexibility.
Recommendation 13
|
5.40
|
That the Australian Government consult with state and
territory governments, and other key stakeholders to develop a national
regulatory system based on core service standards to be broadly applied to
community services, including homelessness services.
|
Process for Developing a National Standards Framework
5.41
While The Road Home suggests that the development of service
standards might be informed to some extent by those developed for disability
services or by models of accreditation similar to those used in aged care or
childcare[33], evidence to the inquiry
has emphasised the need first and foremost for extensive consultation.
Consultation
5.42
A large number of submissions have maintained that a national standards
framework for services used by homeless people and those at risk of
homelessness will need to be developed in consultation with key stakeholders.[34]
As explained in the submission from YP Space MNC:
Any new development of new service standards – that will
govern all levels of service systems responsible for responding to homelessness
– will need to be developed in full and comprehensive consultation with
community and non-government service systems. These services have the knowledge
and experience in the homelessness sector – they know what has worked and what
hasn’t, the barriers, the constraints and the opportunities and strengths of
this work.[35]
5.43
Homelessness Australia also suggests that involving a broad range of
service providers and peak bodies in the process of developing standards and
regulation would encourage greater ‘buy in’ and commitment to the outcomes, stating:
[Consultation] would engender a feeling of ‘shared ownership’
of the standards and ensure that they are both realistic and reflective of the
different environments in which services catering to particular client groups
operate.[36]
5.44
Evidence has also highlighted the importance of involving homeless
people themselves in the process of setting service standards.[37]
As the submission from ACOSS states:
Importantly, service providers and people who are homeless or
have been homeless should be closely involved in the development of service
standards.[38]
5.45
National Shelter observed that greater consumer participation is in
accordance with the Government’s Social Inclusion Principles, noting the third
principle ‘A greater voice, combined with greater responsibility’ which states:
Individuals and service users must have a say in shaping
their own futures and the benefits and services that are offered to them.
Detailed feedback from users and community members and genuine and inclusive
consultation are important sources of information to improve policy settings
and service delivery … Organisations – both government and non-government –
also have responsibilities to listen and respond, and to make sure their policies,
programs and services help to build social inclusion.[39]
5.46
Similarly the Australian Human Rights Commission (AHRC) highlights the importance
of client involvement and its links to other Government policy objectives,
stating:
Enabling the participation of people in decision-making that
will affect them is a key feature of a human rights-based approach. The
Australian Government’s Social Inclusion Principles and the White Paper
acknowledge that the participation of people in decisions which affect them is
an important part of achieving social inclusion.[40]
Lessons from Other Legislative and Regulatory Models
5.47
As noted above there are several references in The Road Home to
other legislative and regulatory models that might inform development of a
national standards framework for homelessness services. Specifically The
Road Home states:
In addition, service standards encouraging best practice and
achievement of outcomes would be set out in the legislation, ensuring national
consistency and quality of the services offered to people experiencing
homelessness. The best features of the Supported Accommodation Assistance
Act 1994 and the Disability Services Act 1986 would be
incorporated into new legislation on homelessness.[41]
5.48
Accordingly the inquiry’s terms of reference specifically invited consideration
of the applicability of existing legislative and regulatory models. Submissions
contained reference to a large number of models that currently apply in the
community services system, drawing attention to their strengths, weaknesses and
their applicability or otherwise to services used by homeless people. These regulatory
models referred to include:
n Disability
Services Act 1986;
n Disability
Services (Eligibility – Targeted Support Services) Standards 2008;
n Aged Care Act
1997;
n principles
(regulations) made under the Aged Care Act 1997;
n Home and Community
Care Act 1985;
n Home and Community
Care National Service Standards 1995;
n National Service
Standards for Mental Health Services 1997;
n state legislation for
disability services and associated service standards;
n state legislation for
children's services and protection and associated service standards; and
n state legislation for
housing and associated housing standards.
5.49
A number of submissions identified aspects of existing regulatory models
which might be used to support enhanced quality services for homeless people.[42]
For example, while of the view that no single model is transferable in its
entirety, the Homeless Persons’ Legal Clinic (HPLC) highlights the following
aspects of existing regulatory models that might be incorporated into a
national standards framework for services for homeless people:
n a Charter of user
rights and responsibilities, to help protect rights and ensure quality services
(refer to the Aged Care Act 1997 (Cth))
n an appropriate
dispute resolution process (refer to the Aged Care Act 1997 (Cth));
n use of regular
independent audits to assess compliance of services or something similar to the
‘community visitors’ program found in the Disability Act 2006 (Vic);
n a general principle
that services operate in manner which ensures the safety, health and wellbeing
of the client and that the wider needs of the client in addressing homelessness
are met (refer to Children’s Services Act 1997 (Vic));
n the critical
requirement to produce individualised support plans (Disability Services Act
1996 (Cth)) – a support plan may tie in directly with guiding principles or
minimum standards; and
n guiding principles
and minimum standards.[43]
5.50
Cairns Community Legal Service proposes that the Disability Services
(Eligibility – Targeted Support Services) Standards 2008 framework
could be adapted and applied to all support services under the Government’s
social inclusion agenda.[44] Specifically the
submission suggests service standards might be based on the following:
n service access - each
recipient has access to a service on the basis of relative need and available resources;
...
n individual needs -
each recipient receives a service that is designed to meet his or her
individual needs and personal goals consistent with the purpose of the service;
...
n independence and
resilience maximised - service delivery is aimed at maximising the recipient’s
capacity for independence and resilience; ...
n decision making and
choice - each service recipient has the opportunity to participate as fully as
possible in making decisions in relation to the service he or she receives; ...
n 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;
...
n 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; ...
n service management -
each service provider adopts quality management systems and practices that
optimise outcomes for service recipients; ...
n staff recruitment,
employment and training - each person employed to deliver services to
recipients has relevant skills and competencies; ...and
n 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. [45]
5.51
Also noting the potential for principles and standards from the aged
care and disability sectors to serve as useful points of reference, Homelessness
Australia proposes canvassing standards which cover the following broad areas:
n Ensuring that the
dignity, privacy and rights of clients are protected at all times and that
clients are placed at the centre of service delivery considerations.
n Ensuring clients have
some agency about the types of services they receive and are afforded
opportunities to provide feedback to providers.
n Service responses are
flexible and meet the needs of particular clients.
n Services are
accessible and accommodating.
n Services adopt sound
management practices that maximise positive outcomes for clients.
n Clients have the
right to have complaints heard and services should develop mechanisms for the
resolution of disputes.
n Clients are supported
and encouraged to participate and be involved in their communities.
n Professional
development opportunities are available to staff.
n Accommodation
provided is appropriate, comfortable, safe and secure.[46]
5.52
While the potential for other legislative or regulatory frameworks to
inform the development of national standards homelessness services was widely
recognised, evidence also indicated that specific standards and accreditation
models for the sector would need to be developed. As stated by SYFS:
It has been mooted by a few in Government that it would be
simple just to borrow existing standards such as from disability areas or from
other States/Territories. In our experience this will not work. This is a
specialist area and one that should be independently developed and consulted
on.[47]
5.53
Expanding these concerns the HPLC explained:
... given the multifaceted and complex contributors to
homelessness, it is not appropriate to simply adopt one of the existing
community service frameworks and apply it to homelessness.
These frameworks are all designed to meet a particular type
of need or regulate providers of a particular type of service. This means,
generally speaking, each of the existing frameworks is too specific to the need
they are addressing to be a direct fit for the homelessness sector.[48]
5.54
Also, in considering the applicability of accreditation models from aged
care and child care service sectors, any accreditation model for homelessness
services will need to take account of the federal nature of service delivery.
As observed by FaHCSIA:
Both the aged care and child care frameworks lie exclusively
in the province of the Commonwealth, although states and territories have
responsibility for licensing operators. In contrast, the homelessness sector operates
under a Commonwealth-state funding partnership with service-level funding
agreements between states and services.[49]
Where to Next?
5.55
There is already a plethora of legislative and regulatory frameworks that
apply to community service systems. The Committee acknowledges that up to a
point a review of existing frameworks may assist with the development and
implementation of a national standards framework for specialist homelessness
services. However, the Committee agrees that there is no existing framework
that can be transferred directly from one sector and applied to services used
by homeless people.
5.56
Given the diversity of the services within the homelessness sector, the
Committee appreciates that developing a national standards framework will be
challenging. At a minimum the Committee anticipates the need to consult state
and territory governments, not for profit and for profit service providers, peak
bodies and people with experience of homelessness. The Committee expects that
the report produced by Urbis Pty Ltd will provide guidance on the key issues to
be resolved.
Recommendation 14
|
5.57
|
That the Minister for Housing consult with the Housing
Ministers’ Conference and key sectoral stakeholders about the essential
components of a national standards and accreditation framework to determine
the broad principles and minimum standards to apply to specialist
homelessness services.
|
Components of a National Standards Framework
5.58
Although recognising the need for further consultation to establish the
essential components of a national standards framework, the following key
elements emerged in evidence to the inquiry:
n the need for a clear
definition of ‘quality’;
n the need to identify
agreed broad principles and minimum standards;
n a commitment to continuous
quality improvement ; and
n appropriate
mechanisms for accountability and complaints handling.
Defining Quality
5.59
A number of submissions emphasised the importance of providing a clear definition
of service quality in a national standards framework.[50]
As noted by Homelessness Australia:
There is support within the sector for the inclusion in
legislation of what is meant by ‘quality’. Workers have expressed the view to
Homelessness Australia that they believe the term ‘quality’ is subjective and
open to interpretation. With a clear definition of quality to work with, they
are not opposed to undertaking measures at a service level that commit to
continuously improving the quality of their service provision.[51]
5.60
Similarly the Council to Homeless Persons also advocates for a
meaningful definition of what constitutes quality, recommending:
A useful definition of quality ... measures service
appropriateness, equity, accessibility, effectiveness, acceptability and
efficiency.[52]
Broad Principles and Minimum Standards
5.61
Evidence clearly indicates that the inclusion of broad guiding
principles and minimum standards are an integral component of a national
standards framework. While there is some variation in the detail, there was
considerable uniformity in the evidence with regard to the broad principles
that were proposed to guide delivery of quality services for homeless people
and those at risk of homelessness. A large number of submissions proposed using
principles and standards founded on the protection of human rights (e.g. rights
to dignity, respect, safety, non-discrimination, inclusion etc) and the
realisation of social inclusion.[53]
5.62
However as noted earlier there was less agreement on the extent to which
broad principles and prescribed service standards should be entrenched in
legislation. To address concerns about legislated prescriptive standards, ACOSS
suggests that broad principles only should be included in legislation, with
more detailed service standards set out in subordinate legislation.[54]
Similarly the HPLC suggests that:
The HPLC is also of the view that the new Homelessness Act
should create overarching minimum service standards, which must be adhered to
by service providers that are based on human rights principles. In addition to
these principles and standards, the new legislation could provide a Charter of
Rights and Responsibilities for Consumers that clearly sets out their rights,
responsibilities and mechanisms for redress when their rights have been violated.
This approach would provide a national framework of rights and minimum
standards while at the same time not being so prescriptive as to be only
applicable to a small set of services. This framework would also allow the
States and Territories to legislate to address their own specific needs while
ensuring any legislation enacted by a State meets or exceeds the minimum
standards specified in the national framework.[55]
Continuous Quality Improvement
5.63
Evidence included widespread support for enhanced service quality to be
achieved through continuous quality improvement (CQI).[56]
CQI describes a process through which organisations systematically assess and
improve their performance along a range of criteria. Christo Youth Services has
suggested that a focus on CQI may actually achieve better outcomes than setting
‘minimum’ standards and accreditation, observing:
Accreditation may be a positive avenue, yet it is highly
resource intensive and can at times create a ‘status quo’ platform, through the
setting of minimum standards as opposed to continuous quality improvement.[57]
5.64
In providing its support for a CQI approach, the Council to Homeless
Persons outlines the following key elements:
n the establishment of
agreed minimum standards to ensure consistency of service delivery;
n action to support and
enhance individual worker and organisational capacity to meet standards
requirements and improve or enhance service delivery;
n service assessment,
monitoring, auditing and reporting requirements against standards and progress
towards improvement;
n ongoing assessment of
outcomes of the process for consumers, workers and organisations; and
n ongoing reflection
and improvement of standards and associated monitoring / reporting processes.[58]
Accountability and Complaints Handling
5.65
Increased accountability for services and the inclusion of appropriate
complaints handling process have also been identified as critical components of
a national standards framework.[59] Issues associated with monitoring
service compliance with a national standards framework particularly in relation
to accreditation were raised in a number of submissions. Evidence has
emphasised the importance of independent monitoring of services, possibly with
compliance linked to funding. However, the need for the administrative burden
of compliance monitoring to be minimised and for a monitoring system that
supports CQI has also been emphasised.[60] As noted by FaHCSIA:
Consideration also needs to be given to the optimal way in
which quality standards could be assessed. Options include self-assessment,
peer review and audit by an independent third-party.[61]
5.66
Evidence also indicated that increased accountability of services must
be supported by appropriate internal and external mechanisms for handling complaints.[62]
With regard to the current situation the HPLC commented:
... accountability mechanisms to ensure existing service
standards are enforced are inadequate. In many cases, service standards are
enforced only by internal grievance procedure, or to an external community
based services, with no right to appeal to an independent administrative or
judicial body, and no external monitoring of the effectiveness of these
internal procedures or compliance with service standards.[63]
5.67
In relation to external mechanisms for handling complaints, several
submissions proposed a defined role within the office of an Ombudsman. For
example the submission from the Regional Youth Development Officers’ Network (RYDON)
suggests:
If there is an introduction of standards and accreditation
within the new legislation then there need to be a grievance process possibly
with a defined role for an Ombudsman that protects and promotes a voice for the
homeless.[64]
5.68
Homelessness Australia also supports the notion but suggests that the
extent to which this role is already fulfilled by state and territory Community
Services Ombudsmen must be considered.[65] Other suggestions
include the establishment of a Homelessness Commissioner instead of, or to
supplement, an Ombudsman’s role. According to Australian Lawyers for Human
Rights:
The Commissioner should have the power to:
n develop grievance and
appeals procedures in respect of public housing matters and general social
support services;
n refer grievances to
the Housing Ombudsman for further investigation;
n develop a Charter of
rights and responsibilities that service providers must adhere to in order to
access Government funding;
n develop, review and
monitor national standards for the provision of adequate housing;
n report on an annual
basis to the Federal Government on the progressive realisation of the right to
adequate housing; and
n any other powers as
are necessary and convenient for the Commissioner to perform his or her
function of promoting and protecting people’s right to adequate housing.[66]
5.69
In the Committee’s view a commitment to CQI and the requirement for appropriate
internal grievance processes and options for external complaints handling would
be essential core elements of a national standards framework.
Implementation
5.70
A key consideration in adopting and implementing a national standards
framework would be its potential impact on the homelessness services sector. The
main concern expressed in the evidence is that achieving, monitoring and
reporting on compliance will increase the administrative burden on already
stretched services.[67] This in turn could
result in loss of services, with smaller community based services and services
catering to clients with complex needs perhaps being more vulnerable.[68]
Some service providers, including smaller agencies and those that receive
funding from multiple sources, already find existing reporting requirements overly
burdensome. As noted by QMS:
For organisations with more than one source of funding they
are increasingly burdened with multiple accreditation and compliance
requirements that are onerous and duplicitous.[69]
5.71
This administrative burden of demonstrating compliance with multiple
regulatory systems is well illustrated by the experience of SYFS:
SYFS which is not a large charity and is regionally based is
already accredited through the Office of the Children’s Guardian in NSW,
through the Quality Management System (QMS), and currently being assessed under
the Housing Registration System by the Office of the Registrar in NSW. It is
also monitored under the Performance Management Scheme for SAAP Services in
NSW. SYFS has had to pay for some of the systems, it is wearing staff out, and
has concerning levels of duplication.[70]
5.72
In summarising the potential impacts of introducing a new standards and
accreditation framework for services, SYFS suggests:
The [standards/accreditation] model adopted must be user
friendly, flexible to accommodate all the different models of service delivery,
proportionate to the service delivery size, easy to participate in, economical
and practical. It is essential that any service delivered is not costly, not
prescriptive, not inflexible, time consuming, not proportionate to the services
delivered and unfairly applied to community agencies. Rigid Key performance
Indicators (KPI’s) to support national standards could prevent services from
providing individualised services to meet the assessed needs of clients.
Compliance costs and external auditing in existing systems are expensive and
funding would need to be increased to cover the costs of these processes.[71]
5.73
Several submissions have also recommended taking measures to reduce the
administrative burden on services by avoiding duplication. Specifically,
evidence has included recommendations for reciprocal recognition of existing
quality and regulatory frameworks. As explained by Catholic Social Services
Australia:
The core objective of a quality framework should be to ensure
certain standards of service for people who are homeless or at risk of homelessness
but it should not be overly onerous so as to detract from the capacity of
community service organisations (especially smaller ones) to deliver quality
services. It should enhance the quality of service provision not add red tape.
This can only occur if new accountability frameworks replace current. If no
rationalisation and harmonisation of existing frameworks takes place, new
initiatives will only be adding to the existing burden of compliance and
administration.[72]
5.74
Similarly the NSW Government suggests:
If the need for a national service quality system was
established, it is suggested that reciprocal recognition of States' and
Territories' existing service quality frameworks should be considered as an
option. This would also be an effective mechanism for removing any regulatory
burdens arising if there are any inter-state providers of homelessness specific
services facing conflicting or duplicative requirements in different States and
Territories.[73]
5.75
Support for reciprocal recognition was also provided in the submission
from FaHCSIA:
It will be important to ensure that any new accreditation and
quality standards system recognises other accreditation and licensing
achievements of a service provider and provide for reciprocal recognition where
possible, to reduce compliance burden.[74]
Managing the Impact of Implementation
5.76
The Committee believes that it is important for the potential impact of
implementing a national standards framework on the homelessness services sector
be recognised. The Committee’s earlier recommendation for a staged approach to
implementation which recognises the diversity of services within the homelessness
sector and different levels of preparedness should mitigate some of the risks
by allowing sufficient time for services to adjust. However there are already a
large number of regulatory frameworks specific to community services, including
specialist homelessness services. Many services, particularly those with
funding from multiple sources, find the administrative burden associated with
compliance onerous.
5.77
While recognising the potential benefits of a national standards
framework for homelessness services, the Committee is anxious that its
implementation should not add further to the administrative burden. Therefore
the Committee recommends that a national standards framework include provision
for reciprocal recognition of compliance with other service quality frameworks.
Recommendation 15
|
5.78
|
That the Minister for Housing ensure provision for
reciprocal recognition of existing quality service frameworks is incorporated
into a national standards and accreditation system for homelessness services.
|
Annette
Ellis MP
Chair