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two outcomes paradigms 11 th July 2012 . Dr. Emma Miller, Glasgow School of Social Work . Overview . Story of outcomes research followed by national outcomes into practice project in Scotland (mainly Adult Care)
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two outcomes paradigms11th July 2012 Dr. Emma Miller, Glasgow School of Social Work
Overview • Story of outcomes research followed by national outcomes into practice project in Scotland (mainly Adult Care) • Outcomes of health and social care partnership – Glasgow University – worked with 3 service user research organisations (2004-6) • 2 researchers worked with the Joint Improvement Team of the Scottish Government since 2006: Talking Points • Refocusing Adult care on what matters to people who use the services (personal outcomes) = implemented across Scotland • Challenging in a system rooted in 1990 Health and Social Care Act – care management, deficit and service led, managerialism, performance culture focused on inputs, throughput etc
Types of Outcome (Qureshi 2001) Glasgow University research started by reviewing existing work by York University – Social Policy Research Unit (SPRU) 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
Outcomes defined by people using services (Petch et al 2007)(separate framework for carers)
Principles/Defining Outcome Focused Approach Understand outcomes as the impact or end result of support and/or services on a person’s life: However, crucially start by defining expectations and outcomes with the person Focus on strengths and capacities more than deficits Include consideration of the person’s role as well as supports and services Consider mainstream opportunities not just formal services Ensure that there is review of whether the plan is achieving the intended outcomes.....
Inputs output process outcome
Exchange Model of Assessment (Smaleand Tuson 1993) EXCHANGE INFORMATION - Identify desired outcomes
Talking Points (Cook and Miller 2012) Engagement, recording and use of information
Making the shift FROM TO Q and A Conversation Needs Led Identifying Potential Coordinator Use of Self Tick Boxes Analytical Service Led Outcomes Led Clienthood Citizenship
Progress and challenges • TP activity in all 32 local authority areas in Scotland – also many third sector provider agencies • TP featuring strongly in policy in Scotland (4 government strategies in 2010) and Reshaping Care for Older People, associated with community capacity building (JIT) • Surrounding culture has a way to go, particularly with regard to performance management (Miller 2012) • Need to ensure better outcomes for staff too = Senses (Nolan et al 2006)
Outcomes Focused Support/Supervision (Stirling Council Social Services 2011
Resources Lots of resources on JIT website http://www.jitscotland.org.uk/action-areas/talking-points-user-and-carer-involvement/ Miller (2012) Individual outcomes: Getting back to what matters, Edinburgh: Dunedin Contact: e.miller@strath.ac.uk