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 Process Change

Feeling safeHaving things to doSeeing peopleAs well as can beLife as want (including where you live)

Listened toHaving a say Respect Responded to Reliability

Improved confidenceImproved skillsImproved mobilityReduced symptoms

Quality of life for cared for person

Quality of life of carer

Coping with caring

Process

Quality of life for cared for person

Health and wellbeingA life of their own

Positive relationship with person

cared for Freedom from financial hardship

Choices in caring including limitsFeeling informed/skilled/equippedSatisfaction in caringPartnership with services

Valued/respectedHaving a say in servicesResponsive to changing needsMeaningful relationship with practitionersAccessible 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’

AGREE OUTCOMES

User’s view Carer’s view

Assessor’s view Agency’s view

NEGOTIATE

RECORD OUTCOMES

‘EXCHANGE MODEL’ OF ASSESSMENT

1

2

3

4

EXCHANGE INFORMATION - Identify desired outcomes

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

outcomesPART 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 emma_miller@talk21.com