The NAP residential service for homeless people in Bergamo, Italy has experimented with both bottom-up and top-down approaches to quality assurance. Initially, NAP used a bottom-up approach where users and staff worked together in groups to develop quality regulations and organizational changes. While this fostered empowerment and shared commitments, it risked becoming too self-referential. Later, NAP shifted toward a top-down approach aligned with regional legislation, which secured long-term funding but imposed standards not tailored to the target group and increased bureaucracy. Both approaches provided benefits and disadvantages for quality assurance at NAP.

1. Workshop 1
Developing quality systems
in the homeless sector:
bottom-up or top-down approaches?

2. The experience of the
Nuovo Albergo Popolare (NAP)
Bergamo (Italy)
Residential service for male homeless
people
Stefano Galliani

3. Some information on NAP (2011)
• 70 users
• 38 people employed
• Annual budget 1.500.000 €
• Not for profit association
• Mission: from street to housing

4. Territory context
• Rich city of 120.000 inhabitants in Lombardy
Region
• Province with 244 municipalities and 1 million of
population
• Low unemployed rates
• (large) Network of services on homelessness in
the city (outreach team, night shelters, canteens,
advice and guidance, supported housing)

5. NAP “biography”
• 1957 – 1982 traditional night shelter
• 1982 – 1992 shelter + social support
• 1992 – 1996 night and day centre + social
support
• 1996 – ongoing residential care centre +
many other external
activities (inside the
“mission”)

6. What about quality: the process
• 1982 – 1992: attempt to fill some self-quality criteria
• Small team of social workers and social educators (4
people) + 9 other workers (mainly keepers)
• Massive voluntary intervention
• Link to health services (mental health, drug addiction)
and municipality social service
• Social support for a small group of users
• 110 bed available for extremely short or long
(permanent) period

7. What about quality: the process
After an organizational and financial crisis because
massive arrive of migrants people from Africa in
Bergamo (1989 – 1992)
• new small staff drives a change from the past
- Data collection on the users profile
- New mission
- Change in the organizational model
- Users participation in design model

8. Bottom up approach on quality
• Number of (general) assembly with the users
• On specific issues working groups were set up
with users, employers and volunteers:
- “public and private spaces”
- “Cultural”
- Employment
- Relation with the external city services
- “wake up group”

9. Bottom up approach on quality
• Large debate in the board of association
• Large debate in the city network of
homeless services
• Alliance with the city social services
• Conflict with other stakeholder (hospital,
health services, other local municipalities)

10. Organizational change
• Mission: from assistance towards promotion
• Method:
- Transitional service with medium – long term pathway
- From night service towards day service
- from “working first” approach to relationship
- From control and strict regulations to “warm and friendly”
environment
• Internal spaces: from shelter to “small” communities
(from 110 to 70 beds from 1993 to 1996)
• Staff: from keepers to social educators
• Identity of clients: users became “guests” and resources

11. Advantage of bottom up approach
• Shared (quality) regulations = more wellbeing
• Strong motivation from both employers and
guests in the pathway to housing
• More capacity building and active citizenships
(“empowerment”)
• Shared commitments and responsibilities with
other (local) stakeholders on the basis of
outcomes
• More appropriate organizational model to the
target group (low threshold, open communities,
etc.)

12. Disadvantage of bottom up
approach:
• Self reference (risk in evaluation of work)
• Professional tools used on uncontrolled
basis
• Negotiation in every new engagement with
other stakeholders
• ????

13. Top down approach to quality
• Small communities adapted to Regional
legislation on social-health services
- At the beginning high standard requested but
few economic resources
- Every “coin” was devoted to enlarge the staff
with social educators and replacement of
keepers
- Money was saved because of strong
commitment of guests for managing the change
(rebuilding internal spaces, furniture, cleaning,
etc.) as part of individual pathway
- Money arrived because the Region decided to
support the new organization as an “innovative
experiment on homelessness”

14. What’s different?
• 5 small communities (from 10 to 15 homeless
people)
- 2 communities are “certificated” and under
contract with the Region (alcohol and multi
dependency, drug addiction)
- 3 are authorized with economic support by the
local authorities but without contract with the
Region (first aid, mental health, “generic”
disadvantage)

15. Top down approach on quality
Regional standard obliged to:
- Professional staff
- Medical control
- Rethink and adapt the internal spaces
- Transparent and precise model of
communication to the guest about aim,
activities, tools and limits of this service
(so called “Service card”)

16. Advantage of top down approach:
• Long term contract between Regional
administration and NAP (secure and more
economical resources)
• Support service development (number of people
employed with 18 social educator + 19 other
employers)
• More clear negotiation with health sector
• Insertion in a Regional database
• Support for skill training
• Membership of formal WG and Commission
• NAP workers participate as skill trainer in
courses for public/health practitioners

17. Disadvantage of top down
approach:
• Standard not tailored on target group
• Ongoing negotiation between Nap and
Region on how fill the criteria
• (minor) change in standard without any
consultation with the ONG sector
• More bureaucracy, (risk of) less time
devoted to homeless people
• No control on outcomes!

18. Thank for your attention!
For more information
Stefano Galliani
albpop@tin.it
www.nap.bg.it
(only in Italian, sorry)