Developing a National Outcomes Framework Cathryn Thomas SSIA Programme & Improvement Lead

An Outcomes Framework? - Policy and political context - Understanding and measuring an outcome? - Impact on practice

Sustainable Social Services for Wales: A Framework for Action (SSS:FFA) “We want to see social work and the relationship with the social worker as a means of enabling people to make changes in their lives” “We know that social workers are not simply the deliverers of pre-determined care, but co-creators of the support that people need”.

The Social Services & Well-being (Wales) Act 2014 Sets out the key priority of Welsh Government’s intentions to promote independence and provide service users with greater control Strong emphasis on empowering, recognising and supporting the resources and autonomy of service users and staff alike.

Part 2 General functions Section 5. Well-being duty A person exercising functions under this Act must seek to promote the well- being of:- –People who need care and support, and –Carers who need support. Section 8. Duty to issue a statement of the outcomes to be achieved The Welsh Ministers must issue a statement relating to the well-being of:- a) People in Wales who need care and support, and b) Carers who need support. The statement must be issued within 3 years beginning with the date on which the Act received Royal Ascent.

What well-being meansWhat people expect Well-being Also for children: “welfare” as that word is interpreted for the purposes of the Children Act 1989 I know and understand what care, support and opportunities are available to me I get the help I need, when I need it, in the way I want it Physical and mental health and emotional well- being Also for children: Physical, intellectual, emotional, social and behavioural development I am healthy I am happy Protection from abuse and neglectI am safe and protected from abuse and neglect Education, training and recreation I can learn and develop to my full potential I can do the things that matter to me Domestic, family and personal relationships I belong I have safe and healthy relationships Contribution made to societyI can engage and participate I feel valued in society

What well-being meansWhat people expect Securing rights and entitlements Also for adults: Control over day-to-day life My rights are respected I have voice and control I am involved in making decisions that affect my life My individual circumstances are considered I can speak for myself or have someone who can do it for me I get care through the Welsh language if I need it Social and economic well-being Also for adults: Participation in work I am supported to work I have a social life and can be with the people that I choose I do not live in poverty I get the help I need to grow up and be independent Suitability of living accommodationI have suitable living accommodation that meets my needs

A National Performance Measurement Framework The Social Services Performance Management Framework Technical Group considered the purpose of a performance measurement framework to:- provide national, consistent and robust evidence in relation to the provision of well-being outcomes that will evidence responsibility and accountability for local delivery to the Welsh Ministers. be outcomes focussed and drive the shift in service provision to focus on well- being outcomes for people.

and……. support local authority social services to secure well-being outcomes for people, and use this evidence to drive service improvement and learn and improve, including ensuring commissioned services are right to meet the needs of the population. underpin and inform the regulation and inspection regime.

Pilot Project to explore reporting on aggregated personal outcomes Aim; to arrive at a small number of national measures which report on the extent to which outcomes are being achieved for individuals Challenge; to find a way to record and measure the extent to which interventions deliver the changes needed for each individual and to aggregate these up to provide a national picture against the national outcomes Further consideration; how this looks for the authority, service, team, and client group. Coordinated and supported by SSIA, with technical support coming from Data Unit Wales

The Working Group Wrexham, Flintshire, Neath Port Talbot, Denbighshire, Caerphilly, Monmouthshire, Blaenau Gwent, Bridgend Welsh Government (policy, statistics and inspection), NHS Informatics, SSIA and Data Unit Wales Membership:-

MilestonesTimescales Establish pilot sites & service cohortsAug 14 – October 14 Working Group agree structure and process for recording Sept 14 - Dec 14 Workforce trainingJan - March 15 Coaching and mentoring supportMarch - July 15 Authorities record outcomesApril - Sept 15 Working grp evaluate pilot and agree recommendations Oct - Nov 15 Report to WG technical groupChristmas 15 Life of the Project

Likely key issues Degree of complexity we are able to create in terms of reporting within project timescales Understanding and skills base of front-line staff and managers Supportive ICT systems Service cohort complexities Departmental understanding and support

A Personal Outcome? Outcomes are defined as what matters to people using services, as well as the end result or impact of activities, and can be used to both plan and evaluate activity. Personal outcomes are distinct from outcomes for services, organisations or indeed nations. So, by personal outcomes we mean the impact of support on a person’s life, and not the outputs of services. Performance measures have historically focused on activity indicators, on inputs, outputs and processes, rather than outcomes for people.

For example “Imagine making a birthday cake for a child. The inputs are the ingredients eggs, flour, sugar and fruit, the process is the mixing and baking, the output is the cake. The desired outcome is a happy child”. “However, there has to be discussion with the child to see if the outcome has been successful. The child may have wanted a chocolate cake while you have made a fruit cake and the impact make’s the child unhappy, not a successful outcome! Source: Talking Points, (Cook and Miller, 2012).

Imagine wanting to learning to cook a meal. The inputs are the having the ingredients, and the process is preparing the meal. The desired outcome is the impact on the individual of being able to successfully prepare a meal. Was the outcome successful? – discussion with client.

Developing skills and supporting the move towards outcomes focused practice Collaborative Communication Skills: Rhoda Emlyn-Jones Achieving Sustainable Change

A 3 day course which:- equips workers with the skills and strategies for collaborative communication helps lower barriers and engage service users demonstrates clear direction and purpose in workers’ conversations with service users helps service users be more self motivated and build on their own strengths and resources (clearly key to citizen centred engagement)

But It’s not enough on it’s own, It’s not a stand alone solution because………..

…..successful embedding of this approach will need service managers and wider the organisation to understand what is being asked of front-line staff and the impact this may have on service delivery and recording ….and ongoing mentoring/support is essential!!

Talking Points Early messages preparing the ground Recording Reporting Anaylsis Cultural shift

Group work and feedback

Please consider 1.In terms of personal practice, score yourself between 1 and 5 as to how ready you are to practice within an outcomes focussed model 2.In terms of your team/service score yourself between 1 and 5 as to how able your team is to practice within an outcomes focussed model 3.What key messages would you like to feedback to ADSSC and WG

Cathryn Thomas SSIA Programme & Improvement Lead