Two key priorities for current social care and health policy in Scotland are that service users and carers should be better included in decisions around their care and support, and that services should focus not just on the nature and extent of support they deliver, but ensure that the support provided delivers good outcomes for service users and carers.
Over the last two years, the Joint Improvement Team (JIT) has been working with two researchers, Emma Miller and Ailsa Cook, to develop a way of both improving outcomes for, and with, users of community care services and their unpaid carers, and of gathering information about user and carer outcomes to feed into service developments. More recently, this work has linked with the development of the National Outcomes Framework for Community Care, a joint performance framework.
Working with partnerships in Scotland, the researchers have developed tools, guidance and support materials – the User Defined Service Evaluation Toolkit (UDSET) – based on the outcomes important to users and carers of community care services. The toolkit builds on previous work funded by the Department of Health conducted at Glasgow University along with three service user research organisations.
More recent work has focused on building outcomes based tools into community care practice, identifying the training and support materials required in the process. The focus now is on collating the data gathered from users and carers to inform service improvements. Building on early work in Orkney, some pilot sites are using an outcomes approach to review service users while others are building outcomes into their assessment processes. Current piloting work with six early implementers of the National Outcomes Framework for Community Care (as well as Orkney and Glasgow) should be completed in June 2008.
The biggest investment required to use the UDSET is time spent with users and/or carers, as well as training and guidance for staff on using an outcomes approach. Initial feedback has shown that adopting outcomes based approaches to capturing service user views are making positive differences. Practitioners are working with people to identify their priorities which can help to ensure both that interventions are relevant, and that they focus on aspirations, not just problems. The opportunity to be listened to and talk about experiences in a holistic way has in itself proven beneficial to some users and carers. Practitioners have identified that the approach has allowed them to use core skills and exercise innovative practice, increasing professional satisfaction.
The results of the piloting work will be reported on the JIT website later this year. The UDSET is now available on the website, along with support materials and tools from pilot sites. The researchers are also working with a lottery funded digital stories project. Two short stories relating to an UDSET pilot with carers in East Renfrew – Part of the Job? and Black andWhite – are also available: http://www.jitscotland.org.uk/actionareas/themes/involvement.html