Housing First Accreditation: Key considerations
In Wales, we recently officially accredited our first Housing First project, running across the two counties Conwy and Denbighshire.
The full report is available online [LINK: https://www.cymorthcymru.org.uk/index.php/download_file/view/2365/2503/] and I have already written a blog post covering some of my thoughts and experiences carrying out this accreditation [LINK: https://www.cymorthcymru.org.uk/en/news-blog/news/delivering-housing-first-wales-accreditation]. It’s worth noting that Housing First in Wales uses a specific set of principles [LINK: https://www.cymorthcymru.org.uk/index.php/download_file/view/2363/2503/], developed by Wales’ Housing First Network.
What I’d like to do here is talk about some of the key issues we thought through while planning the accreditation. Some of these ideas came up briefly during the presentation I delivered [LINK to webinar presentation] as we awarded the Conwy and Denbighshire project with the accreditation; here, I’ll explore the ideas further, to help provide some insight for other countries, organisations, or individuals looking at establishing some kind of accreditation.
Fidelity or quality?
Originally, during early conversations with the Housing First Network in Wales [link: https://www.cymorthcymru.org.uk/en/policy/housing-first/], and discussions with Welsh Government, we would refer to a ‘Housing First Quality Mark’. After my role was created, and I took on the position of Housing First Policy and Practice Co-ordinator, we started to develop the process.
It became apparent that the term ‘Quality Mark’ wasn’t right. The accreditation process was being set up, in part, to ensure that Housing First referred to a specific model of support in Wales. As such, evaluating the quality of a project was down to funders and commissioners. (There might, of course, be overlap in terms of the evidence used in both processes.)
Instead, by determining fidelity to the HF principles, we were not saying that a project was delivering good or poor support. The stance of the Network is as follows: if a project delivers Housing First in accordance with the principles, then its support is likely to be effective, because Housing First is proven to be effective. That said, the accreditation doesn’t go beyond a judgement about fidelity.
The decision we made also means that if a project goes through the process and is not accredited, and not considered Housing First, we are not suggesting that the work it is doing is low quality. By being clear about this, we can be sure we are testing the model, and protecting the model against erosion, not assessing the quality of support.
We also that thought that assessing fidelity over quality was the right choice to determine whether a Housing First project was strong in a systemic way, which would also give us an accurate picture of the strength of the model in Wales.
For example, let’s say a project had employed a couple of fantastic, dedicated support workers – it might score very highly on quality and effectiveness. Individual members of staff, however, might move on at any time. By scrutinising and challenging the policies and guidelines that a project is built on, with a focus on how they demonstrate the principles, we would ensure that the Housing First approach was established strongly at a systemic level; as opposed to being dependent on isolated good practice. That said, we do of course speak to staff and value their input to the process highly. (And trust me, all the projects I’ve spoken to as part of the accreditation process employ fantastic support workers!)
Another way in which we try and gauge how well-founded a project is in the systemic sense, is the way we ‘score’ the evidence gathered during the accreditation. If evidence for a principle comes from different types of source (for example, a client interview as well as an internal and external policy document), the strength of that evidence is seen as higher. This ensures that working in alignment with the principles is properly embedded, both written into the policies, and reflected in day-to-day experiences.
Who is the accreditation for?
Another decision made early on was that accreditation would apply to a specific project or Housing First service, rather than to an organisation. To properly evaluate and challenge practice in Wales, we wouldn’t want accreditation for a project in South Wales to automatically apply to one in the very different environment in North or West Wales, simply because the same organisation ran them. The organisation would be working with different health boards, local authorities and landlords, so the partnerships and commissioning environment could be vary greatly.
Additionally, by accrediting at project level, we can be clear that all stakeholders involved in delivering a specific project share in that accreditation. Mental health teams and probation officers, for example, work hard to support Housing First tenants and are part of the reason an accreditation would be awarded. Recognising that Housing First depends on a wide range of sectors is a vital part of delivering Housing First properly; we wanted to make sure our accreditation reflected that. As such, the accreditation is awarded to a specific project (and all those who collaborate within it), not to an organisation. In theory, an organisation could be part of delivering several Housing First projects which were all accredited at different times. We hope to see this happen in Wales over time.
Another thing we had to think about very carefully was Cymorth Cymru’s relationship with its members. Cymorth Cymru must represent and advocate for its members. What if a project involving one of our members failed to be accredited? That could strain relationships and make it look like Cymorth Cymru were policing practice, rather than being on the side of the members. While Cymorth often plays a leadership role and provides constructive challenge to its members, we needed to consider how best to deliver the accreditation.
Clearly, we had to keep the accreditation work I do separate from Cymorth Cymru’s member work. As such, we’ve carefully devised rules for the panel that meets to make the final decision on accreditation (remember, you can read more about the process in this presentation [LINK to webinar presentation] or the final report for the first accreditation we awarded [LINK: https://www.cymorthcymru.org.uk/en/events-and-training/events/housing-first-accreditation-and-introduction] or the final report for the first accreditation we awarded [Link https://www.cymorthcymru.org.uk/index.php/download_file/view/2365/2503/]) that ensures the roles of participants are clear. Similarly, while all evidence is stored and documented properly, access to it is limited to specific people. Cymorth Cymru will always stand up for its members, and ensure the voices of those members are heard – whether or not those members are delivering Housing First.
Ultimately, evaluating a project’s adherence to the Housing First principles should be a concerted, in-depth progress that is challenging for all involved. I think we have developed a process that works, but I accept that we will be learning as we go forward with it in Wales; we have learned throughout the process already. The accreditation work I am doing now feels very different compared with my previous accreditation work, which demonstrates how different projects will involve a unique process, shaped by the nature of the evidence they provide.
For anyone planning any kind of accreditation, thinking about the aspects I have mentioned above, as well as being willing to learn and adapt throughout the process, are likely to be valuable – and I recommend them highly.