Emma Miller

“The definition of outcomes is the impact or end results of services on a person's life. Outcomes-focused services and support therefore aim to achieve the aspirations, goals and priorities identified by service users – in contrast to services whose content and/or forms of delivery are standardised or are determined solely by those who deliver them (Glendinning et al 2006).”

 Started with research at York Uni (from 1996) Then Glasgow University (2004-6) – the outcomes important to people using services provided in partnership, including OP, MH, LD  Researchers Ailsa and Emma worked with JIT since 2006  What is the JIT?  Initially UDSET  Worked with partnerships and providers on what has proven to be an intricate puzzle!

• • • 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

Quality of life Feeling safe Having things to do Seeing people As well as can be Life as want (including where you live) Process Listened to Having a say Respect Responded to Reliability Change Improved confidence Improved skills Improved mobility Reduced symptoms

Quality of life for cared for person

Quality of life for cared for person

Quality of life of carer

Health and wellbeing A life of their own Positive relationship with person cared for Freedom from financial hardship

Coping with caring

Choices in caring including limits Feeling informed/skilled /equipped Satisfaction in caring Partnership with services

Process

Valued/respected Having a say in services Responsive to changing needs Meaningful relationship with practitioners Accessible and available and free at the point of need

 The DATA response  Concern about raising expectations  But the emphasis is different with outcomes  Start with the outcome and work backwards  Record clear plans including different views  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  ‘Engaging with people not processing them’

Exchange Model of Assessment

User’s view 1 EXCHANGE INFORMATION - Identify desired outcomes 2 Carer’s view NEGOTIATE 3 AGREE OUTCOMES Assessor’s view 4 RECORD OUTCOMES Agency’s view ‘EXCHANGE MODEL’ OF ASSESSMENT

PART ONE Revisiting core communication skills  Listening, and not talking, is very hard to do!  Active listening, paraphrasing, prompting  Supporting the person to define their outcomes PART TWO Communication support needs  Advantage of qualitative conversational approach – flexible, tailored to the person  Other tools and approaches e.g. Talking Mats, Viewpoint

   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

 Talking Points website http://www.jitscotland.org.uk/action-areas/talking points-user-and-carer-involvement/  Current developments include Outcomes focused conversation and recording (2011) Outcomes based commissioning (2011) Care home pilot  Provider forum  Scottish Care and IRISS – package of materials with a focus on audio visual June 2011  Community of Practice [email protected]