A LOCAL RESPONSE

1
A LOCAL RESPONSE

• SSRG Implications for the Assessment of Adult
  Social Care 09/11/2007
• Dave Burnham
• Head of Information
• Lancashire County Council

2
CSCI Outcome Driven Performance Assessment
Framework

• Atmosphere of new framework
• Councils to report impact of services outcomes
• Judgements made on basis of outcomes demonstrated
• Quantitative PIs to be reduced (more or less
  important?)
• Burden to be reduced
• Inspection/Assessment/Regulation resource to be
  reduced.

3
Moving away from.

• Focus on 30 PAF PIs
• Councils got good at counting reporting numbers
• Debate about relevance robustness of PIs
  relative quality of data became sophisticated
  intense
• Annual PAF book a triumph of clarity comparison
• Councils distaste for PIs comparison turned
  into secret enthusiasm glee overhauling a local
  rival D55 score.

4
Moving towards

• Outcome Domains Descriptors more focussed but
  only partial precision
• BRMs more insistent in asking for evidence
• SAS re-ordered along 7 outcome domains so,
• Service user group silos collapsed together
• Have to think in seven outcome terms
• Numbering Byzantine
• But in the main the requirement to demonstrate
  achievements are clearer (Outcome 4 1a 1b)

5
Gaps Questions

• Local inertia?
• There are clear connections between descriptors
  some PIs . But 90 of descriptors do not relate
  to PIs
• So how is a Council to
• Maintain emphasis on key PIs?
• Provide evidence against descriptors?
• Convince local managers that everythings changed
  when the cycle, the process PIs look
  deceptively familiar?

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Principles used in Lancashire

• So what to do?
• Need Quantitative Qualitative evidence
• Need to talk about evidence not PIs
• Need to both convince senior operational
  managers of new direction .
• . and engage front line staff in process .
• . and relate evidence collection use, much
  more to planning cycle. If weve got evidence we
  must use it.

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The Response

• asked performance management groups (one for each
  SU group) to identify standards for all
  descriptors
• established project group to identify what
  evidence is required against these standards
• identified a simple model of evidence on which to
  hang relevant evidence methodologies.

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Evidence Model

• Aim to
• provide link between Quantitative Qualitative
• provide potential evidence coverage for all
  descriptor activities
• to ensure everyone can understand it
• to humanize local notions of performance
  engaging front line staff

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Evidence Model

• 5 layers of evidence from Quantitative
• to Qualitative
• Numbers
• Numbers to a standard (PIs)
• Objective Outcomes
• Subjective Outcomes (Peoples Perceptions)
• Individual Stories

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Examples

• Assessment (4 1a 1b)
• Numbers
• D55
• Proportion receiving care package (E50)
• Proportion of people sampled
• asked questions about their experience
  relating to treatment
• 5. Individual stories. Who do those social
  workers, think they are or she made me feel so
  safe,

• Direct Payments (4.7)
• Numbers
• C51
• Evidence from care plans on database of planned
  outcomes outcomes achieved
• Proportion of people sampled and asked about
  independence quality of life
• 5. I can go shopping again! or Im so
  worried about having to be an employer.

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Head Scratching

• OK, but wouldnt this be a lot of work?
• We cant get that sort of outcome data out of our
  database
• How many surveys are we going to have to do?
• Wont we be tempted to just get positive stories?
  And dont people lie?
• Real difficulty in capturing outcomes on SU
  databases no national standard, CAF moving at
  snails pace

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The model shifts your thinking

• There is considerable overlap between descriptors
  and activities so its not as big an ask as
  it seems
• Puts quantitative data into context
• Ensures that you think creatively about asking
  people what they think
• Offers the CSCI (and AC) triangulation
  opportunities
• Ideas are simple no problem explaining to staff
  or partners.
• Offers commissioners something concrete
• Potentially contributes to JSNA in providing more
  evidence of what people think its like to live
  here
• Engages a broader group of staff in performance
  

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Our local response

• Identifying evidence for each activity SU Group
• Seven evidence sections
• 1. access 1st contact
• 2. assessment
• 3. service
• 4. carers
• 5. safety
• 6. economic activity
• 7. other processes
• Standard Menu of Questions . Menu (40 questions)
• All surveys Registered so no intelligence is
  lost

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Our local response

• Range of approaches to asking people
• Readers Groups
• User forums
• Contract Monitoring
• Review
• Cold Survey
• Direct service staff face to face
• Proportionate asking
• Story Collection Model Story board
• Operationally led
• Front line staff fully engagedwell some of them
  are

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We aint done nothin yet

• But .
• 5 layer model really gets people thinking
• SMQ is being used as basis for all feedback
  initiatives
• Reclaiming Stories has grabbed peoples
  imagination
• Feedback intelligence is growing

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BRIGHTON GROUP WORKSTREAMS

• Making the NIS measures work/adding qualitative
  element?
• Managing Domains Descriptors
• Evidence methodologies
• Rational Information Reporting set