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Housing First: balancing the Principles in practice

Alex Smith, Housing First England’s practice project manager, reflects on how Housing First services across England are implementing the key principles in practice.

Fidelity is such a strange word isn’t it? It isn’t something we are very familiar with here in England when talking about housing models. For most of us the word is more synonymous with relationships, which is ironic considering how important professional relationships are for Housing First (as described in our recent blog).

For the purposes of the Housing First model, we use the following standard definition of fidelity:

‘The degree of exactness with which something is copied or reproduced.’

In this specific context, fidelity is the degree of exactness with which a service follows the Principles for England, which we know are the cornerstone of achieving positive outcomes. The Principles, published by Homeless Link in November 2016, are based on evidence initially gathered by Pathways to Housing in the USA, and are aligned with the core principles in the FEANTSA Housing First Guide Europe

Our Principles summarise the seven key aspects of delivering the model, which range from matters of infrastructure – such as the availability of suitable housing and ensuring housing and support are separate –  through to the skills of the Housing First team to offer a person-centred, harm reduction approach to the residents they support. 

For some, The Principles are ‘gospel’ and are regularly referred to in daily practice, and for others, they seem really good but in practice are still treated as a little idealistic. For a further small number of practitioners, The Principles do not form a significant part of their Housing First work, which means that the effectiveness of the service is compromised.

The reality is, there is a degree of variation across Housing First services, and this is understandable because the model has been developed at different rates, in vastly different local contexts and with varying funding structures.  

Much like psychologically informed environments (PIE), high fidelity to Housing First is not an on/off switch, but an ongoing process of reflection, adjustment and decision-making. It is important that we are talking and reflecting on the Principles as individuals, teams, organisations and across national platforms like Housing First England.

To support this process, and ultimately to achieve high fidelity to all seven of the Principles, thereby attaining the best possible outcomes for Housing First residents, we have developed new guidance: ‘The Principles in Practice.’ For each Principle the guidance details what high and low fidelity looks like in order to help and encourage teams to reflect on their practices, how they may be deviating from the Principles, and, most importantly, discuss what changes might be needed for their project’s successful delivery.

The Principles in practice is all about balance:

  • Finding a balance of active engagement over an individual’s choice not to access support sometimes
  • Finding a balance between the right to have a tenancy and engagement in criminal activity
  • Finding a balance between the choice of not engaging with mental health services and the need to reduce harm from drinking as self-medication

Balance is essential; providing services to people experiencing multiple disadvantage is tough, with significant operational pressures around risk management, safeguarding and managing cross-sector relationships. I joined the Housing First England team after working with Fulfilling Lives Newcastle Gateshead where I was the operational lead. Having spent five years supporting a frontline delivery team, I understand just how important reflection and support are to ensure practice remains on track.

I would encourage all Housing First teams to use this fidelity guidance in team meetings, reflective practice sessions, 1-2-1s, and even senior management meetings, because the most important thing we can do is get the model right for the people we support, enabling Housing First to effectively play its role in ending homelessness in England.

Channel website: http://www.homelesslink.org.uk

Original article link: https://www.homeless.org.uk/connect/blogs/2020/jan/13/housing-first-balancing-principles-in-practice

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