1. PUSHING THE ENVELOPE THROUGH A QUALITY MANAGEMENT FRAMEWORK:CHALLENGING A TRADITIONALIST OUT OF ITS COMFORT ZONE

2. Aims of the paper To underscore the importance of organisations having a way of measuring and managing the quality of their services; To show how The Centre adapted the QMF to suit its own need; To overview The Centre’s QMF; and To identify the challenges encountered during this exercise.

3. About The Centre for Cerebral Palsy It provides a range of services to children and adults with cerebral palsy and their families. Has been in operation for approximately 60 years. Often called a ‘traditionalist’ organisation.

4. The QMF sets out to: Outline the Commission’s expectations of its funded agencies; Establish a better link between individual aspirations, goals and objectives of clients and available services; Shift the focus of assessment/evaluations from process to outcomes; and Increase accountability.

5. The main items of the framework The Commission’s QMF: reinforces the importance of: – clients living and participating in the community; – person-centred planning of services. incorporates 15 broad outcomes areas, 17 outcomes, and 64 performance indicators.

6. The framework The Commission’s QMF: Is an important shift We support the shift

7. Old model versus the new From: process/outputs → outcomes. the ‘how’ → the ‘why’ services are provided. service focus → individuals and families.

8. Reasons for adapting the QMF: A daunting document; Not a holistic document; Potential to encourage silo mentality between programs; and Largely a framework that was not owned by organisations.

9. What the Centre hoped to achieve by adapting framework Simplification Ownership by organisation and staff

10. The principles underpinning the changes Integrity of DSC’s framework; Staff involvement and ownership; Easier to implement; and Amoebic.

11. Two broad strategies for achieving intent of adapting QMF Compression; and Developing systems.

12. Outcome Areas TCCP OUTCOME AREASDSC OUTCOME AREAS  Community Inclusion and Participation  Participation  Social participation  Social connectedness  Welcoming communities  Health and wellbeing  Wellbeing  Independence  Personal Independence  Lifelong learning  Relationships and Social connectedness  Relationships and social connections  Enhanced natural supports  Positive relationships  support networks  Home and lifestyle  Lifestyle  Home  Lifestyle of choice

13. Performance Indicators HOME AND LIFESTYLE PIs - DSCHOME AND LIFESTYLE PIs - TCCP  Individuals make informed choices  Individuals and families are supported to have the lifestyle of their choosing  Individuals are safe from neglect and abuse  Individuals are safe, secure and comfortable, and free from neglect and abuse  Individuals are supported to have the lifestyle that they choose  Individuals and families are satisfied with their chosen lifestyle and services are conducive to their lifestyle and culture  Individuals satisfaction with lifestyle choices  Individuals identify where they live as their home  Individuals have a sense of ownership and dominion  Individuals have their own space  Individuals are safe secure & comfortable  Individuals are able to make informed choices and be themselves  Individuals satisfaction with their homes  Individuals, families & carers are central in decision making about their services and lifestyle  Individuals, families & carers make informed choices  Individuals, families & carers identify that services provided fit their lifestyle and culture  Individuals, families and carers are satisfied with their chosen lifestyle

14. Measures TCCP’s Compressed PIs – home & lifestyleTCCP’s Qualitative and Quantitative Measures – home and lifestyle  Individuals and families are supported to have the lifestyle of their choosing  % of individuals with a plan identifying wishes, goals and choices  % of individuals living in homes that reflect their tastes, preferences and choice  The extent to which individuals/families are satisfied with: - information provided; - choice and decision making; and - sense of ownership of living arrangements.  Individuals are safe, secure and comfortable, and free from neglect and abuse  % staff trained in protective behaviours  % of complaints relating to neglect and abuse  The extent to which the family is happy with: - information provided; and - the manner in which the complaint is handle.  Individuals and families are satisfied with their chosen lifestyle and services are conducive to their lifestyle and culture  The number of respite options available to individuals and families  % of families seeking specific respite options  The extent to which individuals/families are satisfied with: - choice and decision making in home routines; and - services reflecting their culture.

15. Difficulties in implementing an outcomes based framework Difficult to understand; Require different service mindset; Benefits not obvious; Confusion about measurement; Needs involvement of all staff; Easier to focus on lower level indicators; Need systems and processes; and Transparency and accountability challenging.

16. Systems and processes Necessary systems and processes not in place. Need person centred plans, individualised plans.

17. Progress relating to person-centred planning Developing personalised plans in therapy services and accommodation. 30 will be completed by year’s end. Training. Personalised plans → information → outcome based framework.

18. Further boosts for QMF’s implementation Future contracts Role of independent evaluators & evaluations – It is also likely that organisations will be encouraged to develop process and system for implementing the framework once a program area is evaluated under the new model. Good for individuals and families

19. Conclusion The quality management framework pivotal in bringing about positive achievements for clients Currently is too complex Significant change Path to implementation hazardous in the short to medium term But shift to outcome focus must occur