PRACTICE EXAMPLE - MOST SIGNIFICANT CHANGE
Evaluating the impact of a Housing First Project in London: Crisis
By Imogen Blood
Imogen Blood & Associates are delighted to be working with the Centre for Housing Policy at the University of York to evaluate the Housing First project being delivered by the homeless charity Crisis in London. Housing First is a system of support for homeless people with high and complex needs, which houses people as quickly as possible in their own homes with the support they need to sustain the tenancy. The personalised, relationship-based support is provided in a way that maximises choice and control by the individual: this is a key success factor. The evaluation began in October 2020 and will run for 3 years.
We are planning to use Most Significant Change (MSC) alongside a range of other traditional evaluation methods in this project.
We want to minimise the use of deficit-based assessment tools and model a participatory evaluation which is fully aligned with the Housing First principles. MSC should allow us to capture a 360 degree view of the project, ensuring that the voices and experiences of those using the service are at the very core of the evaluation.
Previous literature has identified a disconnect between the positive reports which people using Housing First tend to give of the impact which the service has had on their wellbeing, and the more mixed results of evaluations using standard metrics on mental and physical health, and addiction. MSC will allow us to capture non-leading, user-led and personal definitions of what positive change looks like and how the project enables this to happen.
The project aims to stimulate change in homelessness, housing, health and social care systems and practice; yet it is operating across a number of London boroughs and with a range of housing partners. The evaluation does not have sufficient resource to understand in detail the relevant context in each; however, MSC should enable us to identify examples of impact and – crucially – start to unpick and understand what specifically is enabling (and/or preventing) them.
The panel discussions create a good way to engage and influence key decision-makers, internally, locally and nationally, which is one of Crisis’s key objectives, given its campaigning and policy work.
In Year 1, we plan to focus on the implementation of the service and the internal learning from this. We will collect stories of change from the team delivering the service to understand what they see as the most significant changes to their policy and practice; bringing together a diverse group to reflect on learning from this.
In Year 2, we will be focusing on the experiences of and outcomes for those using the service. We hope to work with peer researchers, training them up to collect MSC stories from people using the service.
In Year 3, we will focus on the impact of the service on wider systems and services, and will collect stories of change from health, social care, housing and homelessness professionals who have worked with the project.
In each year, MSC creates an opportunity to bring together people with professional and lived experience, and key decision-makers and influencers to reflect on the learning from the project and its evaluation.
 Watson, D.P. et al. (2017) Housing first and harm reduction: a rapid review and document analysis of the US and Canadian open-access literature. Harm Reduction Journal, 14(1).