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Developing Outcomes-focused services for older people: Progress and possibilities

Developing Outcomes-focused services for older people: Progress and possibilities. research in practice for adults Manchester, 10th April 2008 Professor Caroline Glendinning Social Policy Research Unit University of York. Outline of presentation. SPRU/SCIE Knowledge Review

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Developing Outcomes-focused services for older people: Progress and possibilities

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  1. Developing Outcomes-focused services for older people: Progress and possibilities research in practice for adults Manchester, 10th April 2008 Professor Caroline Glendinning Social Policy Research Unit University of York

  2. Outline of presentation • SPRU/SCIE Knowledge Review • Progress in developing outcomes-focused services for older people • Defining outcomes • Evidence on barriers/opportunities • Local authority developments – national survey and case studies • Challenges – the language of outcomes • New opportunities for outcomes-focused approaches?

  3. Outcomes, research and policy • SPRU research on outcomes since 1996 • Context – concern over community care implementation • Outcomes now widely reflected in policy: • Green Paper Independence, Well-Being and Choice • DWP Opportunity Age • Outcomes-focused performance assessment frameworks for adult social care

  4. SPRU/SCIE Knowledge Review Aimed to identify: • Outcomes valued by older people • Systems and processes that deliver desired outcomes • Examples of good practice Involved: • Research review • Practice survey: • Postal survey England • 6 site case studies • User advisory group

  5. Research review 1: outcomes valued by older people Change outcomes: • Improvements in symptoms, physical functioning, morale Maintenance/prevention outcomes: • Meeting physical needs, personal safety, clean home, keeping alert and active, having social contacts, having control over daily routines Service delivery/process outcomes: • Feeling respected, treated as an individual, having a say, value for money, compatibility with other sources of help, respect for religious/cultural preferences

  6. Research review 2: factors helping/hindering outcomes-focused approaches • Assessment and review • Care management purchase of care ‘packages’ • Provider-level barriers • Commissioning and contracting for services Throughout…. the importance of communication and trust

  7. Local authority developments:1National survey – England/Wales 2005 • Targeted at practitioners known to be interested in outcomes-focused approaches • Partnerships common – NHS; private providers; voluntary sector • Few long-established outcomes-focused initiatives • Most outcomes-focused developments for: • Older people living at home • Hospital discharge • Day care • Most frequent activities: • Assessment, care planning, review • Achievements - for services as well as users

  8. Local authority developments:2Case studies 6 sites, longer-established initiatives Key outcomes-focused developments: • Adapting SAP to outcomes focus • Outcomes-focused review • Commissioning for change outcomes – intermediate care/re-ablement services • Commissioning for maintenance outcomes: • new models of home care commissioning • low level preventive services – voluntary sector partnerships

  9. Local authority developments:3 What helps and hinders? • Helps: • National policy environment • Local vision, leadership, change management • Partnerships and ‘whole systems’ approaches • Hinders: • National policies and performance indicators • Resource constraints • Staff culture/attitudes • User/carer attitudes

  10. Challenges • Are ‘social care outcomes’ too narrow? • Outcomes-focused social care or ‘whole system’ approaches? • The importance of partnerships • The language of ‘outcomes’: • Different (professional/service) meanings • Short-term change (eg reablement) vs long-term maintenance • ‘Responsive’ or ‘personalised’ services instead?

  11. New developments, new opportunities • Home care reablement services – addressing change outcomes • Outcomes-focused approaches to commissioning home care services • Partnerships for Older People Pilots (POPPs) • Direct payments • Personal budgets

  12. Adults Services Knowledge Review 13:  Outcomes-focused services for older people Available from: www.scie.org.uk/publications

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