Avoiding the Mediocre ASENZ, 26 August 2013

Different Views on “Quality” Standardisation- Personalisation Predictable – Variable Compliance to standards – Subjective Clear procedures – Good practice Consistent outputs – Real outcomes Set – Evolving Meeting specific criteria – aspiring to be excellent

Key Thought The ‘version of quality’ we subscribe to is consistent with the values, principles and aspirations of the sector.

Enabling Good Lives 1. building knowledge and skills of disabled people - more choice and control over their supports 2. investment in families 3. changes in communities: e.g. businesses and workplaces are accessible, welcoming and recognise the contribution that disabled people can make 4. changes to service provision e.g. align monitoring and evaluation with the vision and principles of the transformed system 5. changes to government systems and processes: to support the system redesign e.g. individualised funding, flexible outcomes-focussed contracting, funding pooled from across Votes

EGL Principles Self-determination: disabled people are in control of their lives. Beginning early: invest early in families and whānau to support them to be aspirational for their disabled child, to build community and natural supports and to support disabled children to become independent, rather than waiting for a crisis before support is available. Person-centred: disabled people have supports that are tailored to their individual needs and goals, and that take a whole life approach rather than being split across programmes. Ordinary life outcomes: disabled people are supported to live an everyday life in everyday places; and are regarded as citizens with opportunities for learning, employment, having a home and family, and social participation - like others at similar stages of life.

EGL Principles c/o Mainstream first: disabled people are supported to access mainstream services before specialist disability services. Mana enhancing: the abilities and contribution of disabled people and their families are recognised and respected. Easy to use: disabled people have supports that are simple to use and flexible. Relationship building: supports build and strengthen relationships between disabled people, their whānau and community.

A SAMS View on “Quality” Quality is: to do with people, partnerships and processes (not paper) to do with developing a culture that is about supports / networks / services being responsive, flexible and creative. about building brilliance and innovation about identifying what is not working - so that we can “try another way”.

Unfortunate “quality” strategies When some systems / supports / services are confronted with practices that do not work (i.e. a dead horse) their approach to ‘quality’ lead them to do the strangest things e.g. Hire outside contractors to see if they can ride the dead horse Conduct research to study the dead horse Rewrite the performance requirements for all horses Reclassify the dead horse as being living impaired Provide additional $ or training to see if that improves the horses performance

Two concepts central to quality - Excellence and Effectiveness Clues to effectiveness: engagement, authenticity, credibility, plan driven not event driven and constantly reviewing and adapting according to actual results Clues to excellence are more elusive e.g. Attitude – “whether you think you can or think you can’t you are right” Henry Ford Innovation – “Some of the worlds greatest feats were accomplished by people not smart enough to know they were impossible”

Some steps to create and maintain “quality” 1. Practical Partnership – Find out what people want and work with them in building this. 2. Make sure all perspectives are “heard”. 3. Seek strength and integrity through unity (mana kotahitanga). 4. Have a clear direction – where we are going (aspirational base). 5. Identify pathways – how we will get there. 6. Clear and constructive communication 7. Inclusive decision making 8. Monitor perceived risk (ask open questions in safe environments) 9. Be specific about expectation – who will do what

SAMS believes that an approach that creates “quality” will: be proactive, i.e. it will constructively address emerging issues before they mature into significant challenges provide leadership opportunities, i.e. people with a lived experience of disability will gather the insights, skills, experiences and evidence to enhance their involvement enable the gathering of information to form a solid evidence base for further innovation identify particular approaches/strategies that appear to ‘work well’ for individuals and families, i.e. collating real time success stories to inform others ensure there is an effective on-going review of the results and impact of service approaches and government policies, i.e. information on the results/outcomes experienced by individuals

An “quality” approach must have certain approaches that maximise: Trust, e.g., that information will be treated in a respectful manner or that differences will not be judged or exploited. Safety, e.g. that contributors will not lose a service by complaining. Confidence, e.g. the process is designed to ensure an equitable and accurate representation of participants' perspectives.

A Effective Approach to “Quality” Can Cover: Attitudes Aspirations Potential Priorities Processes Practices

Some things to consider A multi-perspective approach Controversy is OK Organic or mechanistic? Outcomes /results of the process – increased insight and enthusiasm or an intrusive distraction? Nothing beats creating multiple safe environments, open questions and a constructive focus