Delivering Person Centred Outcomes Through on-the-job Learning and Involvement Rosemary Hurtley MSc, Dip COT, FRSA Managing Director 360 Forward The 360 Standard Framework Using measurable outcome standards to exemplify excellence

The Learning Conundrum Am I and my team compliant and how can we move beyond compliance? Do we meet the new personalisation agenda? Do we meet the ‘Dignity in care’ criteria? Are we outcomes focussed? How can we demonstrate excellence? Where do we focus limited resources in hard times? What does quality look like from a resident’s perspective?

What is the 360 Standard Framework? A diagnostic assessment framework that shows care organisations how to establish and maintain person-centred cultures from the perspective of the cared for person, their families and carers An outcomes based practice development framework for achieving continuous improvement

How the 360 Standard Framework helps the organisation Promotes self-management of QI Facilitates analysis of training needs Is a blueprint for education and training for self audit, practice development and change management Helps care providers to meet CQC registration requirements Makes good care homes visible for older people and their relatives

Assessment Framework – Residents' Measures 1.Receiving person-centred care 2.Opportunities for social/occupational activity 3.Influencing meals and 4.Meeting spiritual needs 5.Resolving concerns and complaints

Example : Resident Standard 3:1 The resident has a choice of culturally acceptable food and drink that meet his/her dietary requirements StructureProcessOutcome

Staff and Relative’s Measures Staff measures 4. Feeling valued as a staff member 3. Equipped to do the job 2. Having time to deliver good care 1. Finding the work fulfilling Relative measures 2. Communicating with staff and managers 1. Welcoming ambience of the home 4. Seeking to resolve concerns and complaints 3. Being fully informed 5. Contributing to the care of the family member and the community of the home

Managers making it happen Facilitative management style, clear channels of communication, positive relationship building, collaboration with other professionals and agencies Pivotal leadership role in change management (operations, practice development, quality improvement, business management) –Operational management –Practice development –Quality improvement –Business planning

2 - Preparing and Planning 1 - Client Decision 4 - Data Analysis 5 - Feedback 3 - Data Collection 8. Internal Evaluation Foundation Commitment Award Foundation Outstanding Progress Award 6. Action Plan 7. Internal Implement Action Plans. Routes: The 10 step cycle Identifying learning needs

Key learning needs for staff Understanding ageism in society Understanding chronic conditions and their effects on the person –identity, significance, continuity, purposefulness, belonging and being understood Building positive relationships –the triangle Understanding transition, loss and adapting Understanding and preventing institutionalisation Wanting to understand more about how to measure person centred outcomes Wanting advice and help on how to achieve and sustain improvements

Organisational requirements of success Organisational structures promoting, supporting QI as a primary function of the organisation e.g.-QI working groups, communication network, lines of accountability, job descriptions, business plans, organisation of training QI priorities integral to business planning –all levels QI implementation strategies (blended learning and doing on the job, adult learning model) Designated responsibilities for QI Models of care organisation that deliver outcomes of consistency, continuity, involvement and empowerment of residents (and relatives)

Managers QI competencies for implementing the 360 Standard Framework Skills in providing learning support (action learning, coaching, supervising, communicating) Knowledge and skilled use of the 360 SF Facilitation styles: facilitation and group dynamics, listening, valuing Setting outcome standards for projects including process and resource elements QI action planning and project management Open, facilitative pivotal leadership roles for operations, QI initiatives, and staff training

The Adult Learning Model Starts where new people are at Introduces the new as a modification of the old Introduces the new as a series of individual, reasonable demands that build to the total behaviour desired. Involves a steering committee of people from all levels Launches the programme with an upbeat information session Keeps up the momentum with feedback and support Schedules further information sessions

Characteristics of the 360 Standard Framework Delivers continuous quality improvement and demonstrates measurable change A Standard of excellence in relationship activated care for person-centred outcomes Involves the cared-for person, relatives and staff Incorporates evidence from research and empirical studies Underpins all other service and practice standards Diagnostic with measurable outcomes

In summary Culture Structure Processes Outcomes Benefits Payback Staff organisation Staff organisation Staff develop- ment Staff develop- ment Management systems Management systems Attitudes Behaviours Management style Management style How to: Work with residents Work with residents Involve relatives Involve relatives Work together Work together Well-being Staff satisfaction Staff satisfaction Relatives’ reassurance Relatives’ reassurance Good feedback Good feedback Staff loyalty, performance Staff loyalty, performance ‘Word of Mouth’ ‘Word of Mouth’ Higher VFM, fees Higher VFM, fees Lower staff costs Lower staff costs Increased occupancy Increased occupancy Excellence performance driver components, within the 360 Standard Framework

‘We must not loose our faculty to dare, particularly in dark days’ Winston Churchill Thank you Rosemary Hurtley

Domiciliary Care: Clients Main themes for clients: Control over decisions Receives consistent care and support Care and support is delivered in acceptable ways to acceptable standards Positive relationships Empathetic and effective communications Able to resolve concerns and complaints without fear of retribution

Domiciliary Care: Staff and Family Carers Main themes for staff: Finding the work fulfilling Support to do the job Equipped with the knowledge and skills to do the job Feeling valued as a staff member Main themes for family carers: Involvement in decisions about the client’s care and support Consistency and continuity of support to the family carer Standards of personal care and support to the client Relations and communications Concerns and complaints