Talking Points: personal outcomes approach

advertisement
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
–
•
Time limited change
–
•
e.g. Achieving and maintaining acceptable levels
of safety, social contact
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 of carer
Quality of life Health and
for cared for wellbeing
person
A life of their
own
Positive
relationship
with person
Coping with
caring
Choices in
caring including
limits
Feeling
informed/skilled
/equipped
Satisfaction in
caring
cared for
Freedom from Partnership with
services
financial
hardship
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
1
User’s view
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, coproduction 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/talkingpoints-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]
Download