1. Answering the ‘so what’ question
Nigel Henderson, Chief Executive,
Penumbra

2. About Penumbra Started in 1985
Significant provider of community mental health services across Scotland
400+ staff
1600+ people using our services each week
Innovative
Recovery focused
Person centred

3. Transformations
Services Service Care Worker Coach/Mentor Patient Active Citizen Outputs Outcomes Maintenance Recovery

4. Focus on wellbeing
+ve
Wellbeing
-ve
+ve
Mental Health
-ve

5. Recovery Recovery isn’t waiting for the storm to pass…
Connectedness
Hope
Identity
Meaning
Empowerment
The CHIME framework for personal recovery (Leamy et al, 2011)
Recovery isn’t waiting for the storm to pass…
It’s learning to dance in the rain!

6. Our journey Created a framework
Explored how we might measure personal recovery
Tested and retested various prototypes with people we support
Set up a KTP with Abertay University
Gradually refined, researched and developed I.ROC between
Began our digital journey in 2015

7. Framework for Wellbeing
HOPE Framework = 4 areas of HOPE – all relevant to wellbeing and recovery.

8. I.ROC 4 Areas of HOPE 6 Point Scale 12 Wellbeing Indicators Recovery
I.ROC is a personal recovery tool. It is used within support as a facilitated self-assessment. People therefore complete I.ROC as part of a conversation with their support worker. Using I.ROC in this way enables the person to take ownership of their I.ROC, and subsequently their own recovery journey. It helps staff to focus the support that they provide on what is important to the person, and it facilitates conversation about what the person want to achieve – what their personal recovery outcomes look like.
12 Wellbeing Indicators
Recovery

9. Testing and validation process
Method
Relevant
Literature Review.
Comprehensive
Literature Review and Focus Groups.
Valid
Study by Abertay University and published peer reviewed results.
Reliable
We have been assessing the reliability and validity of I.ROC over the past 4 ½ years to make sure that you can be confident in why you are using it and what it is telling you.

10. Recovery Assessment Scale
Initial Validation
Questionnaire
Cronbach's Alpha
N of Items
I.ROC
.862 12
Recovery Assessment Scale
.963 41
BASIS-32
.946 32
r = 0.7
p < 0.001
I.ROC has good internal consistency and concurrent validity with measures of recovery and clinical outcomes
(Monger et al, 2013)
The next step was to determine whether I.ROC is a valid and reliable measure of recovery outcomes. In order to do this we entered into a knowledge transfer partnership with the University of Abertay. This KTP was part funded by the technology strategy board and made the validation of I.ROC possible both in financial terms and also in terms of bringing the knowledge and expertise into the organisation. Bridey was employed by the University (not by Penumbra at this point I would emphasise!) and Bridey conducted a range of literature reviews and psychometric tests to determine whether we were in fact measuring recovery. I.ROC correlated positively against other validated measures of recovery and overall we are pleased to say that the results were very positive and proved that I.ROC is indeed valid and reliable. These results have been published and if anyone would like more information about this please ask Bridey or myself, or papers are available on our website.
People who use our services have been involved in the design and revision of I.ROC from the very outset and as part of this process we also ran another series of focus groups throughout the organisation which resulted in key revisions and improvements but overall evidenced that both staff and people who use our services found it relevant, comprehensive and easy to use.
Having said all that however it has been said that:
“What counts can’t always be counted; what can be counted doesn’t always count.”
This phrase is attributed to Einstein, although some doubt exists as to whether that is accurate or not. What is not in doubt is the accuracy of the statement, and the relevance of this to delivering an effective social care service, whether through self directed support, or by any other means, We were, and still are, very conscious of this throughout the whole project.
What does count in this process is that we are improving the wellbeing of people who use our services, that the interaction between practitioner and person is purposeful and is meaningful, that it is based on the outcomes as described and defined by the person and it is those that are used to frame and plan the way forward toward recovery.
r = -0.55
p < 0.001

11. Questionnaire Preference
We also asked people which questionnaire they preferred. Because, if I.ROC correlates well with other measures that have already been through rigorous testing, why use I.ROC rather than these other tools? Luckily for us, people significantly preferred completing I.ROC to either BASIS-32 or RAS. When asked why, they said that it was shorter, easier, made more sense and was more relevant to their concept of recovery.
I.ROC

12. Review Frequency Change in scores over time * * p <0.05
So when we looked, we saw that the first time point at which there was a significant change in people’s scores was 3 months. This was a good finding for us of course, as this is the time that you are asked to review I.ROC. It does not mean that for each individual this will be appropriate, and we are aware that for some services this may not be the optimum, but for Penumbra as a whole, 3 months is the best time at which to repeat I.ROC.

13. I.ROC

14. I.ROC Reports

15. Measuring Impact

16. Variables

17. Demonstrating Impact

18. I.ROC in Penumbra Now in use across relevant Penumbra services
Over 12,000 people have used I.ROC in Penumbra since 2012
Offers a dynamic personal outcomes focused process for staff and the people we support
Data gathered enables us to focus on particular areas for service development

19. Benefits of using I.ROC For the person who wants to:
√ Identify factors that impact own wellbeing
√ Define personal outcomes
√ Shape and manage own recovery
√ Develop strategies of self-management
For the Practitioner who wants to have
√ Clarity of purpose
√ Support tools and resources
√ Confidence of approach
√ Ability to measure “distance travelled” of person

20. Who’s using I.ROCwellbeing
People in: UK USA Australia Netherlands Belgium Spain Chile

21. And….
Work/research underway with new partners in: Finland Australia Netherlands Czech Republic China

22. Settings where I.ROC is in use
Hospital wards
Forensic unit
Rehabilitation units
Specialist trauma services
Step down services
ARBD services
Ex-offender services
Community services
Recovery Colleges
Supported Housing

23. Website – Home Page

24. I.ROC digital – Log in

25. Clients

26. New I.ROC questionnaire

27. View I.ROC overview

28. Client report

29. Service report

30. The benefits of using I.ROCwellbeing.com are:
A secure and reliable system to store detailed personal, demographic and recovery data for each client in one place.
Access the system securely anywhere, on almost any device, PC, tablet and smartphone.
Easy for practitioners to update client records and upload further documents to the account.
Complete I•ROCs online or
via mobile APP (online or offline).

31. benefits cont/
Access HOPE Toolkit and recovery resources online.
Generate comprehensive client, service and organisation outcome reports quickly and easily.
Access comprehensive eLearning modules about I•ROC wellbeing and recovery approach.
Create unlimited accounts per service - with unlimited storage.

32. Individual Recovery Outcomes Counter (I.ROC)
#morethanameasure
Supports culture change
Self-management
Personalisation of service
Can support ROM collection

33. Contact Details Nigel Henderson www.irocwellbeing.com
Nigel Henderson