Transcript Results and Performance Accountabilty, Decision

Keeping Children Safe
- An Outcomes Approach LSCB Development Day
4th
Rob Hutchinson, CBE
& 19th November 2010
Children’s Trusts involve…
Shared Vision
Children &
Young
People
Source: DfES
Outcome Based Accountability
is made up of two parts:
Population Accountability
about the well-being of
WHOLE POPULATIONS
For Communities – Cities – Counties – States - Nations
Performance Accountability
about the well-being of
CUSTOMER POPULATIONS
For Programmes – Agencies – and Service Systems
THE LANGUAGE TRAP
Too many terms. Too few definitions. Too little discipline
Benchmark
Outcome
Result
Modifiers
Indicator
Measurable Core
Urgent
Qualitative
Priority
Programmatic
Targeted
Performance
Incremental Strategic
Systemic
Measure
Goal
Objective
Target
Measurable urgent systemic indicators
Lewis Carroll Center for Language Disorders
Definitions
OUTCOME or RESULT
Population
A condition of well-being for
children, adults, families or communities.
Children born healthy, Children succeeding in school,
Safe communities, Clean Environment, Prosperous Economy
INDICATOR or BENCHMARK
A measure which helps quantify the achievement
of an outcome.
Rate of low-birthweight babies, Percent 16 & 19 yr. olds with 5
A-C GCSE’s, crime rate, air quality index, unemployment rate
Performance
PERFORMANCE MEASURE
A measure of how well a service, agency or service
system is working. 1. How much did we do?
Three types:
2. How well did we do it?
3. Is anyone better off? = Customer Outcome
Is it a Result, Indicator or Performance Measure?
RESULT
1. Safe Community
INDICATOR
2. Crime Rate
PERF. MEASURE
3. Average Police response time
RESULT
4. A community without graffiti
INDICATOR
5. % of surveyed buildings without graffiti
RESULT
6. People have living wage jobs and income
INDICATOR
7. % of people with living wage jobs and income
PERF. MEASURE
8. % of participants in job training who get living
wage jobs
POPULATION
ACCOUNTABILITY
For Whole Populations
in a Geographic Area
Every Child Matters – Children Act
Outcomes for Children and Young People
Being Healthy: enjoying good physical and mental health
and living a healthy lifestyle.
Staying Safe: being protected from harm and neglect and
growing up able to look after themselves.
Enjoying and Achieving: getting the most out of life
and developing broad skills for adulthood.
Making a Positive Contribution: to the community
and to society and not engaging in anti-social or offending
behaviour.
Economic Well-being: overcoming socio-economic
disadvantages to achieve their full potential in life.
Our Health, Our Care, Our Say – White Paper
Outcomes for Adults
1. Health & Emotional Well-being
2. Quality of life
3. Making a positive contribution
4. Exercising choice & control
5. Freedom from discrimination & harassment
6. Economic well being
7. Personal dignity & respect
(8. Effective leadership)
(9. Effective commissioning)
Source: A New Outcomes Framework for Performance Assessment of Adult Social Care 2006 - 07
Outcomes: The Portsmouth 8
Children and Young People should grow up * Having an active say in any development
* Healthy
* Emotionally secure and confident
* Having succeeded as far as they can at school
* Having facilities and opportunities to play safely
* Having stayed out of trouble
* Living in a safe place
* Having the opportunity to succeed in their dreams
Country
New Zealand
Neighbourhood
Kruidenbuurt
Tilburg, Netherlands
Coventry Data Book
Performance Measures Against the Portsmouth 8
Baseline
Indicator
Teenage conceptions
1998
1999
2000
2001
Infant mortality
1998
1999
2000
2001
Breastfeeding rates
2002
2001
2000
1999
1998
Portsmouth
54.3
53.0
39.1
47.7
8.9
5.4
6.8
8.8
at birth
80.9%
70.7
69.7
69.5
66
National/local data
source
England
47.0
45.3
43.8
42.3
Wards in 1999
Charles Dickens 121.7
Fratton 76.6
Paulsgrove 71.2
England and Wales
5.7
5.8
5.6
5.5
For 3 month period
Apr-Jun03, 20%
mothers were
breastfeeding after 2
weeks and 13% when
baby was 6 weeks old
ONS (number/
1000 conceptions in
population
under 18 years)
ONS
(number
per 1000 live
births)
PHT – percent
mums
breastfeeding
their baby
Healthy Eating and Exercise Project in Portsmouth
 Project Driven by LSP and a local Community Board
 Focused on one community
 Many 1%'s …….
• Secondary School
• Primary Schools
• Surestart
• Faith Community
• Playgroups and Child Minders
• Dieticians
• "Trained" parents
• Children’s Video
• Schools Meal Service
• Co-op
• University
• Portsmouth Football Club
• Health Visitors
• Public Health Consultant
• PCT Chief Executive ……….etc
Performance
Accountability
For Services, Agencies
and Service Systems
Effect
Effort
Programme Performance Measures
Quantity
Quality
How much
did we do?
How well
did we do it?
Is anyone
better off?
#
%
Quadrant
How much did we do?
How many nurses appointed
since 1997?
How well did we do it?
Reduction in Waiting Times
Is anyone better off?
Percentage of patients saying
their health has improved as
a result of the hospital
intervention
Number of fatalities within 2
months of operation
Proposed National Indicator Set
How much did we do?
How well did we do it?
% of initial assessments carried out within 10 working days
% of core assessments completed within 35 working days
% of child protection plans lasting 2 years or more
% of child protection cases which were reviewed within
required timescale
% of referrals to children’s social care going on to initial
assessment
% of applications for care proceedings which have been
assessed as incomplete
Children’s social worker vacancy rate
Children’s social worker turnover rate
Did it make a difference?
Did it make a difference?
Population:
% increase of children and young people who have
suffered unintentional/deliberate injuries or
preventable deaths
% children who report they feel safer
Performance:
% children becoming the subject of child protection
plan for a second or subsequent time
Possible local additions to the NIS
How much did we do?
Number of children with protection plans
Did it make a difference?
Numbers of children who report that they
feel safer
Numbers of parents who report that their
parenting has improved as a result of
intervention
How well did we do it?
% of initial assessments within 10 working days
% of core assessments for children’s social care carried
out within 35 working days of commencement
% of child protection plans lasting 2 years or more
% of child protection plans reviewed within time scales
% of applications for care proceedings deemed as
incomplete by the courts service
% social worker vacancy rate
%social worker turnover rate
% complaints
% surveyed families saying service was delivered in a
respectful and timely manner
Did it make a difference?
Population:
% reduction in children referred for physical, emotional
and sexual abuse and neglect
% increase of children who have suffered
unintentional/deliberate injuries or preventable deaths
Performance:
% of children subject to CP Plan for a second or
subsequent time
% of children’s plans whose recommendations have
been successfully implemented
% reduction of children with CP Plans
% of children whose risks are reduced as a result of
intervention and are removed from protection plans
within 6 months
Swale Kids Performance Measures
How much did we do? (Quantity)
How well did we do it? (Quality)
Types of activity:
Number of Children seen by Team
- parenting groups
- one to one with children
- group work with parents
% staff turnover
% of children per staff member
% of staff trained
% of children completing activity
% of parent/carer completing
activity
Is anyone better off?
No. of pupils with improved results
No. of permanent exclusions
Number of fixed term exclusions
No. teachers who say the
intervention a difference
No. parents/carers who say the
intervention made a difference
No. children who say the
intervention made a difference
% of pupils with improved
attainment
% of permanent exclusions
% of fixed term exclusions
% teachers who say the
intervention made a difference
% parents/carers who say the
intervention made a difference
% children who say the intervention
made a difference
Mentoring Scheme
#
No. attended
No. mentors recruited
Training for mentors
No. of referrals made
No. of
1:1s
%
Distribution of referral by agency
Mentors staying 1 year or more
YP staying 1 year or more
YP / mentors treated well *
Referrals accepted
Partner agencies who attend meeting
about CYP
Recruited who serve for more than 1
year*
Unit cost per mentor
YP matched within 30 days
Rate of attendance at 1:1s
#
YP reporting programme has helped
improved relationships with parents /
carers
%
YP say prog help in probs at exit, 3, 6
months*
YP say improved relationships
YP showing improved attendance *
YP showing reduced exclusions
(days)
Average length of exclusions
Attainment levels (mentor exceed set
targets)
LSCB effectiveness
How much did we do?
Number of meetings
Numbers of agencies attending LSCB
meetings
Frequency of meetings
Progress on business plan
Financial management
Numbers of member annual appraisals
carried out
Did it make a difference?
How well did we do it?
% of Members attending regularly
% of Members presenting items
% of Members stating their satisfaction with
meetings
% serious case reviews considered
% recommendations in training plan implemented
% recommendations in Reports agreed
Identifiable progress achieved on business plan
% agreed recommendations reviewed on a regular
basis
Did it make a difference?
Population:
% of children who report that they feel safer
% reduction in children referred for physical, emotional and
sexual abuse and neglect
% hospital admissions caused by unintentional or deliberate
injuries
Performance:
% of children whose risks have been reduced and whose
protection plans are ended within 6 month
% reduction of children with child protection plans
% protection plans which have been successfully
implemented
% of parents who report that services have improved the
parenting of their children
% children becoming the subject of Child Protection Plans
for second or subsequent time
LR
UR
Strengthening Families Framework
How much did we do?
# of children subject to S47
# of consultations carried out using SFF
# of consultations which don’t lead to
CP intervention
# of children subject to SFF
ICPCs/RCPC
# of children with PPs
Did it make a difference?
How well did we do it?
% of consultations leading to ICPCs
% reduction in time subject to PP
% ICPCs held in 15wdays
% professionals who feel meetings are run
well/timely
% profs who deliver actions in timescales
% parents/CYP who report feeling listened to
% parents/CYP who understand/agree with the
aim of the plan at the end of the meeting
Did it make a difference?
Population
Children are safer…
Performance
% Children subject to SFF less likely to exp repeat
PP
% reduction in time subject to PP per category/need
% reduction in children experiencing further episodes
of harm (S47s?)
% increase in # of children who stayed at home
safely
% children who report they feel safer
% parents who report that intervention helped them to
make children safer
% agencies who report that intervention made
children safer
Success Measures for Children’s Trusts
How much did we do?
Establishment of Joint Commissioning
Strategy and Plan
No.of attendees at Trust meetings
No.of items considered
No. of agencies represented
No. of children and young people
attending
No. of events/learning opportunities
undertaken
No. of staff whose awareness is realised
on CT priorities
How well did we do it?
% Joint Commissioning Strat. which identifies both
population and performance priorities
% Joint Commissioning Strat/ plan implemented within
defined timescales
% Joint Commissioning Strat. Delivered within budget
% of trust members attending meetings
% of reports with agreed implementation plans
% of items actioned from meeting
% of priorities reviewed on regular basis
% of plans consulted on/approved by children & yng people
% of children, y. people & families who say services are
delivered in timely and respectful manner
% of staff and public who understand CT priorities
Did it make a difference?
POPULATION:
%of children, young people & families who say services
made difference to 1 or more of 5 outcomes
(Tell Us survey)
PERFORMANCE:
% of professionals who say CT priorities contributed to an
improvement of 5 outcomes for children, young people &
families
BOTH:
Depending on priorities, there’s evidence that the curve had
turned on Top 2 priorities at both populations and
performance level,
eg teenage pregnancy & obesity for population levels
eg A to Cs in school x for performance level
Safeguarding young people at risk of self harm or suicide
How much did we do?
Number of young people offered services
through CAHMS
Number of mental health assessments
carried out
Number of universal services being used
by young people feeling excluded
Amount of attachment support for young
people and their families
Numbers of follow up ‘missing’ interviews
Did it make a difference?
How well did we do it?
% mental health assessments which led to signposting to other
agencies
% 10 – 16 year olds and their families receiving
attachment intervention
% of families that are responded to as per the Rapid
Response Protocol
% children’s workforce trained in brief interventions
% young person satisfaction with post return home
services
% placements receiving additional support for young
people
% increase in school attendance
% increase in targeted CAMHS provision for young
people with emerging mental health difficulties
Did it make a difference?
Population
% reduction in young people that self harm or attempt
suicide
% reduction in the number of attendance at A&E due to
drug or alcohol misuse
% young people that report feeling safe
Performance
% reduction in young people that repeatedly self harm
% reduction in young people committing suicide
% reduction of young people experiencing long term
rejection
% reduction in placement breakdowns
% reduction in repeat missing persons
% increase in children returning home in a planned way
% in repeat attendances in A&E
% of young people that say they have been properly
consulted on their plans and the development of services
people