Demonstrating outcomes – an exploration of models

1. Demonstrating outcomes – an exploration of models CYPEDA (Chidren and young people experiencing domestic violence) Talking Points Better Futures

2. Scottish Women’s Aid Janet Sanders Children’s Service Development Worker ‘Improving Outcomes for Children and Young People Experiencing Domestic Abuse’

3. Background Scottish Government Children’s Service Women’s Aid Fund: • 42 Women’s Aid groups in Scotland receive funding • Original Framework and Toolkit developed in 2006 • SG working group – short timeframe, large amount of information sought

4. Original Framework: • Development of outcome evaluation extremely valuable • Useful information generated Areas for Improvement: • Large number of outcomes • Lack of clarity about some outcomes • Measurement and achievability • Repetitive

5. Revision of Outcomes Aim of revisions: • Clear framework of outcomes and indicators based on SMART principles • Information gathered is more robust

6. Revision of Outcomes: • Approval from Scottish Government • Consultation with Women’s Aid groups • Partnership Working

7. Consulting Women’s Aid Groups The ‘JARS’ Model: Model developed by researcher in USA for domestic abuse services: • Justice • Autonomy • Restoration • Safety

8. Consulting Women’s Aid Groups Ideas storm – What changes do workers expect to see in CYP Group changes together under ‘JARS’ headings Distil changes into 1 or 2 clear outcomes

9. Revised Outcomes • CYP’s diverse needs are being met better • CYP’s social and leisure activity needs are met better • CYP have more involvement in decisions about this lives • CYP have increased understanding of how to maintain and develop healthier relationships

10. Revised Outcomes • CYP have better understanding of their feelings and how to deal with them • CYP have increased understanding of domestic abuse and how its affects themselves and others • CYP feel safer

11. Measuring Outcomes • New toolkit was developed to support outcome measurement • Specific tools to measure each outcome were developed or adapted

12. Toolkit was developed using: • Research tools (Australian ‘Attitudes to Domestic Violence Survey) • Service delivery tools (North Ayrshire Women’s Aid ‘Healthy Relationships Pack) • Small trial with Children at Women’s Aid group

13. Impact of Revisions: Informal feedback • Less time involved • Clearer outcomes – better fit for service • Use of 2 indicators increases robust nature of information • Improved service for CYP • Supports service development • Toolkit helpful (observation tools)

14. Janet Sanders Children’s Service Development Worker Janet.sanders@scottishwomensaid.org.uk 0131-2400-313

15. Talking Points: personal outcomes approach Emma Miller

16. Defining outcomes Understand outcomes as the impact or end result of support and/or services on a person’s life: • Involve the person in identifying the goals they want to work towards • Outcomes can be measured both for the individual and for the service as a whole • Important to focus on what the person/carer/natural supports can do as well as services • Can measure outcomes for the individual and across the service

17. Where does talking points come from Started with research at York University and Glasgow University – the outcomes important to people using services Researchers worked with JIT since 2006 Started with a focus on evaluation Can use outcomes for separate evaluations or events But the focus is broader now

18. Types of Outcome Maintaining quality of life e.g. Achieving and maintaining acceptable levels of safety, social contact Time limited change e.g. Improving confidence and regaining skills Process outcomes - impact of service process e.g. Service users feeling valued and respected, listened to

19. Service user defined outcomes

20. Carer defined outcomes

21. Inputs output process outcome

22. What does this mean for staff • The DATA response is common • So is concern about raising expectations • But the emphasis is different with outcomes • Start with the outcome and work backwards • Record clear plans including different views • ‘Engaging with people not processing them’ • Shift from focusing on deficits to capacities • Not about creating wish lists but a negotiation • It does take time to involve people but it is investing time to save time – avoid failure demand and get it right

23. Exchange Model of Assessment EXCHANGE INFORMATION - Identify desired outcomes

24. What does it mean for organisations • Requires systems to re-orientate around outcomes • Buy-in from senior mgmt important – staff need ‘permission’ to do things in a different way • Biggest cost is staff development • Fits with emphasis on reablement, recovery, co-production and mutuality = “doing with” • Collect info once and use it for multiple purposes • Fits with SCSWIS requirements – care standards • Personalisation in the broad sense • Shared language across agency boundaries – importance of trust

25. Some developments and resources • Provider forum – early implementers – Getting Started Paper (available) Outcomes focused conversation and recording (2011) • New provider forum – first event 8/2 Edinburgh • Scottish Care and IRISS – package of materials with a focus on audio visual 2011 • Community of Practice • Talking Points website http://www.jitscotland.org.uk/action-areas/talking-points-user-and-carer-involvement/ Emma_miller@talk21.com

26. ‘Changing Lives: 21ST Century Social Work Review’ Chapter 5: Building capacity to deliver personalised services: "We expect services to make a positive difference to our lives. We are people first. The outcomes we want include having power and control, being able to take risks and contribute to society. This means that there needs to be a shift in power away from people who commission and provide services to service users and carers." (Users and Carers Panel)

27. General Context Increasing movement towards more person-centred approaches: Personalisation Agenda Self-Directed Support In-Control ‘Changing Lives’/ ‘Talking Points’: Increased emphasis on empowerment & personalised Outcomes/Results – rather than inputs/processes and tasks with passive service receivers Financial Imperatives: Best Value Current funding crisis Evidence-based approaches/proof investment worth it. Outcomes-Based Contracts.

28. Background to ‘Better Futures’ The ‘Housing Support Outcomes Framework’ piloted in 2008 by DTZ Pieda & evaluated by Craigforth; involved 21 services across Scotland and 7 local authorities. Currently in final phase of development as a web-based tool

29. Why ‘Better Futures’? Suggests positivity/instils hope/ explicit expectation there should be growth in individuals confidence & abilities; Inclines person’s perspective towards looking forward to new possibilities - rather than preoccupation with the past; Helps tilt support worker positively in same direction; Also applicable in maintaining confidence & abilities at current levels: a sense that person worse-off in absence of the service.

30. Key Features of Better Futures Tool Encourages person to be in the driving seat. Starts with the ends in mind! Establishes baselines – then measures ‘distance travelled’ Can produce reports showing individual and wide range of aggregate levels of change; Produces numerical & graphical representations of distance travelled;

31. Structured around 5 Themes:  • Accommodation • Health • Safety and Security • Social and economic wellbeing • Employment & meaningful activity ----------------------------------------------- 21 elements under those themes.

32. Scoring Individuals decide on areas to focus on: They score the level of support they require from 0 – 4: 0 = needing little or no support; 4 = being in crisis.

33. The Matrix

36. Charting Progress 0 1 2 3 4

37. 0 1 2 3 4 4

38. Percentage of individuals who are repeat applicants (received support before, left & have come back again) compared to a previous period (investigation of the revolving door syndrome). 0 – 2 hours

39. Aspire Developmental Support Assessment and Review

40. Timescales & Costs Better Futures can be used on a trial basis from January up to December 2011 No charge to use the system up to December 2011 except for training costs Charges after December 2011 still to be established

41. To find out more ….. Better Futures Framework and news updates: www.ccpscotland.org/hseu/information/better-futures Better Futures Report Testing - GETTING STARTED:  The website address is: https://outcomes.capitasupport.co.uk