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Planning for Outcomes Nicola Gitsham and Jo Harvey. A reminder: the case for change. The current system is not working for families and children: Too many children with SEN have their needs picked up late ;
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Planning for Outcomes Nicola Gitsham and Jo Harvey
A reminder: the case for change The current system is not working for families and children: • Too many children with SEN have their needs picked up late; • Young people with SEN do less well than their peers at school and college and are more likely to be out of education, training and employment at 18; • Schools and colleges can focus too much on the SEN label rather than meeting the child’s needs, and the current Statements/ Learning Difficulty Assessments do not focus on life outcomes; • Too many families have to battle to find out what support is available and in getting the help they need from education, health and social care services; and • When a young person leaves school for further education, they enter a very different system which does not carry forward the rights and protections that exist in the SEN system in schools.
Vision of SEN reforms • Children’s SEN are picked up early and support is routinely put in place quickly; • Staff have the knowledge, understanding and skills to provide the right support for children and young people who have SEN or are disabled; • Parents know what they can reasonably expect their local school, college, LA & local services to provide, without having to fight for it; • Aspirations for children and young people are raised through an increased focus on life outcomes, including employment; • For more complex needs, an integrated assessment and a single Education, Health and Care Plan are in place from birth to 25; and • There is greater control for parents and young people over the services they and their family use.
Involvement of children, young people and parents in decision making
Improved identification of children and young people’s needs
Collaboration between education, health and social care to provide support
High quality provision to meet the needs of children and young people with SEN
Greater choice and control for young people and their parents over their support
Raise aspirations for children and young people through an increase focus on life chances including employment and independent living
So what does this mean for outcomes • Person centred - description • Focus on improving life chances – life span approach • Raising aspiration and sharing expectations • Multi agency - overarching but clear who does what • Will change over time and develop • Workforce will need to know how to write outcomes and deliver evidence based practice • Young people and families – MCA and supported decision making
“It isn’t what you pump in its what (young people) are getting out of it “ SQW evaluation key working and workforce development report (part 1) Dec 13 What is an outcome ?
Outcome Benefit or difference made as a result of intervention
A Person Centred Outcome….. • Is personal, not expressed from a service perspective • Is something you have influence/control over • Is measurable and specific • Is something that is a benefit or difference to the individual All these make the outcome well formed
What’s difference between the following ? • Aspiration • Long term outcome • Long term/ short term outcome (1 year) • Targets
Compliance with national standards: CQC, Ofsted, Quality assessment frameworks • Activity data: Numbers of people with plans, time taken to carry out assessments, numbers of interventions • Cost information, average cost of support, hourly rates • Customer experience: satisfaction surveys, parents opinions
But not so good at measuring whether peoples lives are improving
“Achieving a better focus on outcomes for people using support requires that they and their families are central to the design and implementation of ways to measure results.” Putting People first: Changing lives together: Using person centred outcomes to measure results in social care, (2010)
One of the main difficulties we have when developing outcomes is our tendency to embed the solution into the outcome.
A Solution ……. • Is the resource you need to achieve your outcome • It can be an item or an activity • It can have a cost associated with it, or be free
The other one is that we are not specific enough with our outcomes, which makes it hard to measure them.
Does it keep something that is working? • Change something that isn’t working? • Does it move towards a future you want?
A Person Centred Outcome….. • Is personal, not expressed from a service perspective • Is something you have influence/control over • Is measurable and specific All these make the outcome well formed
When writing your outcome you may find it helpful to do the following….. Top tips • Write your outcome as though it has already been achieved-it makes it more compelling • Write it as positively moving towards something you want to achieve rather than away from something you want to avoid
There are two tools we have found useful when developing outcomes Firstly:
Questions to test if something is an outcome or a solution If you got your outcome…what would it….. • Give you? • Do for you? • Make possible for you? • Where, when and with whom do you want it? You can repeat these questions if you need to until you get to the outcome. This helps us find the true outcome rather than the solution that we may have embedded in the outcome
What would that:- • Give you? • Time with a speech therapist • Do for you? • Help me be more easily understood by my friends • Make possible for you? • Friendship • Social activities • Feel confident around other people 5 hours of speech and language therapy
So what is the real outcome?…. • I am understood by my friends and I can play with them at the after school club everyday.
Speech and language therapy • Help in the classroom including my friends • Social activities outside of school • Differentiated curriculum • My friends learn my signs So what possible solutions might there be
What would that:- • Give you? • Fresh air, company and exercise • Do for you? • Increase my physical level of fitness • Make me steadier on my feet • Make possible for you? • Friendship • To be out for longer, do more things Go outdoor walking activity once a week
So what is the real outcome?…. • I am fit and strong and can walk every day outside for longer. I can go to the shops and social events several times a week
Improving my communication skills To be understood To be included in social conversations at school To have my views listened to To not get so frustrated because people can’t understand me and don’t listen to me. For people to understand what I am saying, listen to my views and include me in conversations at school, so I don’t get frustrated because I don’t feel listened to.
How I receive my additional oxygen is not working for me as it is stopping me going out of the house To be able to spend time with my friends each week when I am well To maintain my oxygen saturation at above 96% When I am well to go out and spend time with my friends twice a week and maintain my oxygen saturation at above 96% when I am out.
So what is the real outcome?…. • I am fit and strong and can walk every day outside for longer. I can go to the shops and social events several times a week
The second tool is using the person centred thinking tool important to and important for, to ensure that the outcome is specific to the person as possible
Improving my communication skills To be understood To be included in social conversations at school To have my views listened to To not get so frustrated because people can’t understand me and don’t listen to me. For people to understand what I am saying, listen to my views and include me in conversations at school, so I don’t get frustrated because I don’t feel listened to.
How I receive my additional oxygen is not working for me as it is stopping me going out of the house To be able to spend time with my friends each week when I am well To maintain my oxygen saturation at above 96% When I am well to go out and spend time with my friends twice a week and maintain my oxygen saturation at above 96% when I am out.
Finding the right solution to meet an outcome Once we have established the outcome we can look at finding the right solution. Ask; • What is stopping you? • The obstacle stopping you reaching your outcome • What could you do instead? • What else could you do? You can repeat these questions until you find a solution which will work
Speech and language therapy • Help in the classroom including my friends • Social activities outside of school • Differentiated curriculum • My friends learn my signs So what possible solutions might there be
Long term outcome • When I leave education I want a job • short term outcomes • To know what types of jobs I am interested in and what skills and attributes I bring to the world of work • To be able to travel independently around my community • To have experience of working in a real workplace • Short term targets • To have recruited a job coach • To have undertaken a vocational profile • To learn to travel from home to college • To have a plan work experience
Long term outcome • To live in my own place near my parents • Short term outcome • To understand the key threats to personal safety and how to stay safe in the community • To understand different types of housing options and express a view of which one I would prefer • To learn what is it like to be a tenant – what I must to • Short term targets • For the family and young person to have understand the different type of housing options and where to go for help • To find out what I would be entitled to re housing and support • To use my personal budget to develop informal networks in my community
Long term outcome • I would like to be friends with more people and in the future I would like a special friend or partner • Short term outcome • To have learnt how to manage my anger when I disagree with people • To have a circle of friends who support me to go out at weekends • To know what promotes positive adult relationships and how to practice safe sex • Short term targets • To recruit a male supporter • Identify friends that I want to spend time with – pool my personal budget with others • To contact circles of support for a circles facilitator
Monitoring and reviewing outcomes Does the EHC plan capture ? • What will we do • Who will do it and who will pay for it • How often • How will we know we have succeeded • How well did we succeed
Monitoring and reviewing outcomes Annual reviews Are they person centred ? Do they review life chance outcomes ? Are the right people there ? Do they review and set new outcomes Approaches in FE Destination led planning – Orchard Hill RARPA