A Framework for Adopting an Outcome
Focused Approach to Self Directed Support
South West Region JIP
Presentations, Guidance and Good Practice
Lucianne Sawyer and Michael Heap
Community Care Research and Consultancy
1) Scene Setting – Policy Context and Personalisation
‘Outcomes’ refer to the impacts, or end results of services, on a person’s
life’. (SCIE 2007)
Its not what services do that matters, its what’s achieved for people, and
with people, as a result of what they do.
What are outcomes?
It’s a completely different way of looking at the effectiveness of services –
measuring outcomes is often more difficult than measuring service provision.
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Are you sure of the difference between outcomes and outputs?
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Focusing on outcomes is positive and can be aspirational – people start
thinking about what they want to do and perhaps could do (but needs are
still important)
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Outcomes may be at different levels:
– Population outcomes
– Community outcomes
– Outcomes for specific interest groups, users or organisations
– Individual outcomes
You can’t achieve change if you just go on doing the same old things
in the same old way
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Service providers must have autonomy (not always the case in health
care where there may be well tested protocols)
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The relationship between commissioners and providers needs to change
(investors rather than purchasers)
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Should not be service driven – achievement of the desired outcome may
not depend on a service
Personalisation provides a stage for focusing on outcomes
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The business of assessment should be based on getting people to think
about the outcomes they want – about what would really make a
difference to their quality of life
Freedom to choose how support will be provided gives real opportunity to
innovate, to think of different ways of using the budget, different ways of
achieving outcomes
It gives prominence to individual outcomes
Outcome-based services give people choice and control – they are a
good option for those who don’t want to go down the personal budget
route
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Presentations:
Basic Concepts and Principles – Personalisation
Changes in Thinking in Community Care -Coventry experience of
personalisation and outcomes
References and tools:
Outcomes and Personalisation - Colin Slasberg (2009)
2) Outcomes – an overview of outcome focused approaches
This chapter provides examples and experiences of people and
organisations who have started on the journey of delivering outcomes
throughout the self directed supported process from assessment, support
planning, commissioning and delivery.
‘We went on a journey. It wasn’t always easy – there was fighting and tears
but it won’t happen unless the whole organisation understands it and wants
it.’
The Thurrock experience – see below.
Presentations:
An introduction to working with outcomes
The Thurrock Journey
Outcome Based Approach – A Provider Perspective
References and tools:
Outcomes Working and Strategic Commissioning and Contracting - Colin
Slasberg (2009)
The Thurrock Experience - Colin Slasberg
Outcomes Based Commissioning and Contracting Research in Practice for
Adults (2009)
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3) Assessment
This chapter explores how service users should be placed at the centre of
the assessment through person centred planning and how they should
experience the assessment process. It gives examples of how outcomes
can be built into the assessment process.
Presentations:
Further slides on assessment
References:
Outcomes, Eligibility, Resource Allocation and Personalisation - Colin
Slasberg
Outcomes Star briefing
Additional information about the Outcomes Star
Additional Information about the Outcomes Star, including new versions
developed to help measure outcomes for different user groups
COAT: The Carers Outcome Agreement Tool: A new approach to working
with family carers. - E. Hanson, J. Nolan, L.Magnusson, E. Sennemark, L.
Johnson, Mike Nolan (2006) Getting Research into Practice (GRiP) Report
No 1, University of Sheffield.
Minibook on Person-Centred Thinking with Older People - Helen Sanderson
and Gill Bailey.
Person Centred Thinking Cards - Helen Sanderson Associates
4) Support Planning and brokerage
Support planning is a person centred and directed process that explores
what is important to a person, explores the possibilities within their life and
how support can be organised and created to enable them to live their
chosen lifestyle. The support plan identifies how they will use available
resources including a personal budget and family and community resources
to meet their needs and achieve their agreed outcomes. This chapter looks
at aspects of this process including risk, outcome focused support planning,
and outcome focused reviews.
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Presentations:
Managing Risk in Support Planning
Outcome Based Support Planning
Assessment, Review and the Personalisation Agenda
References:
Approaches to Support Planning – an interview with Avril Watson from
Barnsley CSIP Self-directed Support Network, DH
Support brokerage Research in practice for adults (2009)
The ‘Senses Framework’: A guide for care home and inspection staff. Draft
– Mike Nolan, Mark Faulkner, Dawn Brooker. Produced for the Care
Commission
Transforming the market for social care - set of 7 papers from Institute for
Public Care at Oxford Brookes:
1. The background to market facilitation - describing the evolution of social
care markets
2. A model for market facilitation - defines market intelligence, market
structure and market intervention
3. Perspective on Market Facilitation – commissioner/provider views giving the views of commissioners and providers on current policy issues
4. Changing the Currency of Commissioning from Outputs to Outcomes How an outcomes-based approach can be implemented and integrated
with the personalisation agenda
5. The purchase process: contracting for services by the local authority practical advice on contracting and tendering, offering wording for
contract terms and conditions, and service specifications
6. The purchase process: contracting for services by individuals - setting
out the policy and legal context, and considering key issues for
individuals setting up care arrangements
7. Annotated Bibliography - Referencing key texts that may assist in
influencing and shaping viable local markets in the context of health and
social care commissioning
Contracting for personalised Outcomes: learning from emerging practice –
account of progress towards personalisation made by 6 local authorities Sam Bennett (2009)
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5) Outcome focused commissioning
This chapter looks at the requirement to commission and contract in a
different way to ensure that services at personalised and outcomes are met.
It also explores how to ensure that outcomes are met and monitored.
Presentations:
Problems for the market
References:
Outcomes Working and Strategic Commissioning and Contracting - Colin
Slasberg (2009)
Contracting for personalised Outcomes: learning from emerging practice account of progress towards personalisation made by 6 local
authorities Sam Bennett (2009)
The Personalisation Agenda: threats and opportunities for domiciliary care
providers (2008) Lucianne Sawyer Jnl. of Care Services Management
Vol.3, No.1, pp.41-63
The ‘Senses Framework’: A guide for care home and inspection staff. Draft
– Mike Nolan, Mark Faulkner, Dawn Brooker. Produced for the Care
Commission
Transforming the market for social care – see IPC papers in section 4
6) Barriers/Challenges/Opportunities
This final chapter summarises some of the key challenges and barriers and
gives some practical examples of how these can be worked through.
Presentations:
Some of the challenges presented by personalisation and by outcomes
focused care
Personalisation, outcomes and cultural change: ‘Money can’t buy me love’?
References:
A number of helpful papers from Swansea/SSIA’s ‘All Together Now’ project:
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‘All Together Now’ project Highlight Report (2009)
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Mumbles Pilot Action Plan (2009)
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Initial Project Evaluation Report (2009)
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Project Evaluation Tool – based on the LEAP model
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A Beginners Guide to the Swansea/SSIA ‘All Together Now’ project
(Swansea)
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