If working with Personal Outcomes and Talking Points is so easy why does it not feel simple? June Findlater Fieldwork Manager, South Lanarkshire Council Bac

Like letters through a stick of Rock! Purpose Process Talking points This should run through the whole organisation no matter where you slice it!

A social workers story Change since 1975 Implications of community care act East Renfrewshire CHCP experience Implications of policy ? Qulifuies since 1975, working in generic (aminly Childcare) until 1993. Previous responsibility to design a “better” assessment tool Policy add ons not always supports?

Background Easterhouse example Implementation of Community Care act is Scotland Opportunities to reframe and redefine? 1975 , context for social work ,power; control; authority; balanced with community development approaches Well intentioned but ambiguous Community Care Act 1993.? New relationship, new customers Transparency - Sharing resources fairness based on assessment of need Partnership – citizen and other sectors

Carers 1995 (recognition) Act JPIAF SSA Guidance 2001 Community Care Act 1993 Carers 1995 (recognition) Act JPIAF SSA Guidance 2001 Community Health and Care Act 2002 IoRN (Indicator of Relative Need) Updated Care Management Guidance 2004 Training Relaunch 2006 NMIS SSA,Review,carers ,care plan Joint Future Agenda Energy alignment - working back to front Loss of confidence in skills (Needs Services Charges - what is an assessment?) A series of good intentions, values and principles coupled with missed opportunities Bureaucratised - needs led/unmet need/charging policies Missing the point? Developing assessment tools? Are we really sure about that?

Relationship between service user and frontline staff? Purpose? [Next slide]

The Turnaround Use Defined Service Evaluation Tool This is what people want CHCP development Why we were Early Implementers East Renfrewshire Council & CHCP Focus on outcomes for the customer Provide simplified, cost effective services Promote equality and sustainability Be accountable Be open to change Service redesign NHS Better Lives Better Care Long term condition management Services closer to person Community based Involving person Reduced hospital admission Effective discharge

Working to an outcome/goal It’s what we all understand Operationally the outcomes agenda is an integral part of a wider programme of work locally related to developing a tiered and targeted model within rehabilitation and enablement services. Also related to business process review and up-grading our core information system. Critically in relation to UDSET we have designed and delivered an assessment and care management and carers assessment training programme across all staff which places the UDSET and National Outcomes themes centre stage. Specifically the UDSET carers tool has been piloted locally. Digital stories emerging from this have fed into national as well as local learning. We have revised core documentation to ensure the integration of UDSET themes and to embed the approach in practice. Turning to evidence of impact. [Next slide]

Seeing friends & family What makes a good life? Having people to rely on Choice Seeing friends & family Treated with Dignity and respect Involved in community Feeling valued Having things to do Being in control Feeling safe In Community care this conversation resonates with all staff particularly helpful in terms of collaboration and working together, it makes sense and confirms purpose of engagement. Supports problem solving practise and uses assets of person as someone able to develop solutions It moves away from service led approach Fulfilling ambitions Keeping well

And for SW Changing Lives Personalisation agenda moving: From - managing access to service To - helping people seek solutions From - passive recipients To - active partners But who is leading on this? Are councils and partnerships pulled in competing directions?

Challenges How do we maintain and increase independence and reduce costs against background of our demographic change? Citizenship means influence – that means transforming the way we interact and engage Unpicking current service design? And changing habits that for many social workers are organisational habits not theirs And have been embedded in their careers Role of Government?

Opportunities from an outcomes approach A shift in power and where decisions are made Staff become more effective making best use of skills An integrated approach New Mission and Purpose – what matters most to you? It is not the public who ask for services it is the staff (We as citizens are the experts, we need expertise to guide us) This was the message we shared with staff in east Renfrewshire A shift in power and where decisions are made Staff become more effective making best use of skills An integrated approach New Mission and Purpose – what matters most to you? It is not the public who ask for services it is the staff We as citizens are the experts, we need expertise to guide us

What is cultural change? Redefine purpose – a new mission Change culture and transform Citizenship means influence and responsibility: this can be harnessed - organisational capacity building Same tools, same resources put to best use through real partnership at all levels Role of leadership? Should expertise be recognised at frontline starting form person and how can current structures even with best intentions really embrace this challenge?

It felt right We acknowledged need to change culture - new post, training language commitment to embedding approach at practice level - back to core values An outcomes focussed organisation – SOA-like words through stick of rock Congruent - best use of energy We can influence further change Public consultation supported the approach

Carers Pilot in East Renfrewshire Reframing the process Outcomes driven Effective training delivered to staff by carers A significant improvement in performance Digital stories , shared with staff , BUT it needs drip drip drip

Performance culture? Talking Points and personal Outcomes-what matters most to people, not a wish list Harvard research-reorientation not redesign Is there a disconnect with policy AWI AS&P etc? Improve not prove? Battleship story Challenged in large organisations –that TP and personal outcomes is a special interest as opposed to core business and of value in AWI Adult Support and Protection If 14 years or research was undertaken who asked for it and what was the purpose-for information or to influence change? Challenge of managing services , easy to revert to previous dialogue Change impact underestimated and perhaps avoided? How do we learn from measurements? Battleship story-example of care at home provison, if everyone needs their breakfast at breakfast time , why is that seen a saprobelsm and not our strating point? Who represents councils and partnerships in implementing and leading the dialogues ARCG &JIT experience

Has it been embedded? Does everything from your pubic information to your internal processes at every level assume citizen as partner , and that staff are clear about role? Does implementation of policy support or weaken staff and lead to default position? Who in your organisation owns personal outcomes agenda?