1. Results Based Accountability Charlotte Drury WLGA

2. Results Based Accountability Purpose of Workshop: Provide an overview of the RBA framework Show how RBA can help to plan and deliver outcome based services Give some examples of practice in Wales

3. Results Based Accountability RBA increasingly popular in UK and elsewhere... Embeds performance management into planning and delivery Helps turn talk quickly into actions Explains both collaborative and service accountability and how they fit back together A disciplined way of embedding outcome based decision making into planning, delivery and accountability for partnerships and projects. RBA included in CYP Plan and HSCWB Guidance

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5. All these new words are very elitist, and I don’t think there’s a place for it. [By...] using language that a fair proportion of the community won’t understand you’ve already set yourselves apart before you’ve even started.’ Interview transcript - Royal Town Planning Institute research into the language of regeneration, 2001 The Importance of Language

6. The Importance of Language Too many terms. Too few definitions. Too little discipline Benchmark Target Indicator Goal Result Objective Outcome Measure Modifiers Measurable Core Urgent Qualitative Priority Programmatic Targeted Performance Incremental Strategic Systemic Milestone Aim Impact

7. RBA Common Language Tools IDEASPOSSIBLE LABELSCHOICE WORDSMODIFIERS 4 legged mammal – often kept as pet – barks Dog Hound Canine Large Brown Toy Dangerous “Toy dog” What we use to measure the benefits of our service Measure Result Indicator Impact Customer “Customer Result”

8. Two Types of Accountability Performance Accountability – the responsibility of a project, programme or service system for specific results for its “customers” (e.g. drug cessation programme accountable for “customer results”) Population Accountability – collective or collaborative responsibility for the well being of populations (e.g. Local Service Board accountable for all people in L.A. Area)

9. Why This Matters: Responsibility English National Indicator Set: Outcome 4: Healthy & Successful Adults (Population Accountability) NI131: Timeliness of social care assessment (Performance Accountability)

10. Why This Matters: Responsibility CYP Plan Outcome Measures Framework: Priority 3.2: Every child and young person is safe and protected from abuse, victimisation and exploitation (Population Accountability) Outcome Measure: % of initial Social Services assessments carried out within 7 working days (Performance Accountability)

11. Keeping Accountability Straight Population Outcome A condition of well-being for a population (or sub-pop) stated in plain language Population Indicator Measurable information which helps quantify achievement of population outcome Performance Measure Measurable information which helps quantify if a service etc works How much did we do? How well did we do it? Is anyone better off? Population Performance Children in Wales are born healthy People in Wrexham live in a safe community Rate of low birth weight babies in Wales Crime rate in Wrexham

12. Population and Performance Accountability Children in Cardiff WHOLE POPULATION CONDITION OF WELL-BEING A Flying Start for Children in Cardiff POPULATION INDICATORS % low birth weight % breast fed at 6 months % fully immunised % assessed ready for school Parenting Project PERFORMANCE MEASURES % parents attending gaining better coping skills % parents who use techniques learnt after 6 months Contribution Means End Courtesy of David Burnby & Associates

13. Outcome, Indicator or Performance Measure? 1.People in the community are safe 2.Crime Rate 3.Average Police Response Time 4.People living in safe, stable affordable housing 5.First time entrants to Criminal Justice System 6.% of low birthweight babies 7.% of LAC reviews carried out on time 8.Achievement of 5 A*-C grades at GCSE Outcome Indicator P.Measure Indicator P.Measure ? If the question is “How are we doing as a community on education attainment?” If the question is “How good is XYZ school at raising educational attainment?” Indicator P.Measure

14. From Ends to Means in 7 Questions Population Accountability 1.What is the quality of life condition we want for the selected population in our community?

15. Population Outcomes A condition of well being for a population or sub population stated in plain language. A Population (or sub) + A Place + A Condition of Well Being

16. From Ends to Means in 7 Questions Population Accountability 1.What is the quality of life condition we want for the selected population in our community? 2.What would this look like if we could see it? 3.How can we measure these conditions? 4.How are we doing on the most important of these measures? (Baselines and the story behind them)

17. Today 3 years if nothing changes – OK? Baselines Time % Teen pregnancy Target for 3 years from now WHY?

18. From Ends to Means in 7 Questions Population Accountability 5.Who are the partners that have a role to play in doing better? 6.What works to do better, including no cost/low cost ideas and off the wall ideas? 7.What do we propose to do? Action – what, how, who, when, how much!

19. 1. Condition of Well Being 2. What does this look like? 3. How can we measure these conditions? 4. How are we doing? 5. Which partners? 6. What works to do better? 7. What are we going to do? Baselines & stories DD1 DD2 Children in Powys are safe Safe at home, from crime & bullying etc % young people victims of crime Police, YOTs, schools, families etc Best ideas, new ideas etc Action plan and budget – by when and how?

21. The RBA Commissioning Journey – From Talk to Action DESIRED OUTCOME Choosing the INDICATORS Drawing the BASELINE (and the CURVE TO TURN) The STORY BEHIND THE BASELINE Choosing the PARTNERS Deciding WHAT WORKS The ACTION PLAN REVIEW COMMISSIONING PERFORMANCE MEASURES How Much? How Well? Better Off? (CLIENT OUTCOMES) Contributory Relationship ENDS (POPULATION ACCOUNTABILITY) MEANS (PERFORMANCE ACCOUNTABILITY)

22. Risks Less money – fewer grants – more competitive Everyone likely to be hit - some more than others Less stability = more difficult to retain and develop good people Ultimately the price falls on people who need these services

23. Opportunities Agencies which speak a common language best placed improve services & save money Greater clarity of expectations Being able to demonstrate impact of well- founded programmes Able establish clear link between service results and population well being Opportunity to use flexibility of 3 rd Sector

24. Performance Accountability - for projects/services with a defined customer)

25. Two Types of Accountability Performance Accountability – the responsibility of a project, programme or service system for specific results for its “customers” (e.g. drug cessation programme accountable for “customer results”) Population Accountability – collective or collaborative responsibility for the well being of populations (e.g. Local Service Board accountable for all people in L.A. Area)

26. Keeping Accountability Straight Population Outcome A condition of well-being for a population (or sub-pop) stated in plain language Population Indicator Measurable information which helps quantify achievement of population outcome Performance Measure Measurable information which helps quantify if a service etc works How much did we do? How well did we do it? Is anyone better off? Population Performance Older people in Gwent live independent lives Older people in Flintshire live in a safe community Number of hospital admissions due to falls Crime rate in Flintshire

27. Performance Measures QuantityQuality Effort Effect or How much did we do? # How well did we do it? % Is anyone better off as a result? # %

28. Performance Measures How much did we do?How well did we do it? Is anyone better off as a result? (#) Customers served (#) Activities (%) Common measures (e.g. % staff fully trained) (%) Activity specific (e.g. % on time, % fully completed (%) Skills or Knowledge (e.g. qualification) (%) Attitude or Opinion (e.g. towards school) (%) Behaviour (e.g. attendance) (%) Circumstance (e.g. in work) Types of Performance Measure

29. How much did we do?How well did we do it? Is anyone better off as a result? # young people seen # 1-to-1 sessions % staff with higher qualification % 1 st appointments within 2 weeks of referral % people using service who are off drugs/reduced use at end of 12 week intervention % people using the service who are off drugs/reduced use 6 weeks after end of intervention Substance Misuse Service Performance Measures

30. How much did we do?How well did we do it? Is anyone better off as a result? # of additional learning courses # young people on courses % sessions delivered to schedule % young people completing course % young people on additional learning courses gaining 1 or more GCSEs % young people on additional learning course with improved general attendance Education Performance Measures

31. How much did we do?How well did we do it? Is anyone better off as a result? # outreach bus sessions # contacts % sessions delivered to schedule % young people writing action plan % young people accessing appropriate training as a result of contact with youth outreach % young people reporting increased healthy behaviour Youth Outreach Service Performance Measures

32. Turning Case Management Data into Performance Measures NAMEISSUERESULT John CAnxiety about attending schoolSignificant change Laura DFeels “lonely & friendless”Partial change Carl FInvolved in nuisance activityNo change Anne PUsing alcoholPartial change Mary HUnauthorised absencesNo change Possible service performance measure of “Is Anyone Better Off”? (Lower Right) % service users showing “significant” or “partial” positive change (60%) An aggregate of the difference the service has made to individuals!

33. 1. Customer Population 2. Is anyone better off? LR 3. Are we delivering services well? UR 4. How are we doing? 5. Which partners? 6. What works to do better? 7. What are we going to do? Baselines & stories DD1 DD2 Young people on ed. support programme % Key Stage passes % sessions delivered on scheduled date Schools, families, peers etc Mentoring, alternative curriculum Action plan and budget Population Outcome Contributed to – “High Achievement for Young People”

34. Fitting Population Accountability and Performance Accountability Together

35. Contributory Relationship Alignment of measures Appropriate responsibility POPULATION ACCOUNTABILITY Outcome = Healthy children Indicator = % low birth weight How much? # sessions # service users How well? % sessions to schedule % satisfied # service users stopping while pregnant PERFORMANCE ACCOUNTABILITY Ante-Natal Smoking Project Is anyone better off? % service users stopping while pregnant Fitting it all Together Customer Result

36. Presenting Your Contribution Outcome(s) to which you most directly contribute Indicators Story behind the curves to turn Partners with a role to play Actions – what its going to take to turn the curve Your role – as part of the larger strategy Population Accountability Story behind the curves to turn Partners with a role to play Actions – what its going to take to turn the curve Your programme & what it delivers Performance measures Performance Accountability

37. How it all fits together Community StrategyOutcome = Prosperous City Indicator = % unemployed CYP PlanOutcome = Children Live Free From Poverty Indicator = % children living in workless households Project = Maintained Childcare % parents helped to access work, education or training Economic Strategy Flying Start Outcomes & contributions align – indicators/measures make sense – appropriate accountability – what matters is outcomes not plans and process

39. HOW ARE WE DOING? Population Scorecard POPULATION Children aged 0-3yrs 11 months with an eligible post code, resident in one of the eight Cardiff Flying Start catchment areas. OUTCOME Flying Start Children are Healthy & Thriving Headline Indicators (Bellwethers) % FS Children assessed, scoring >2 deviations below their chronological age on the ‘Schedule of Growing Skills Assessment at 2yrs (21-29 mths) & at 3yrs (33-41 mths) % FS Children fully immunised to schedule at 47 mths % FS Families who respond to questionnaire, reporting that FS has helped THEIR CHILD ‘a lot or more’ DATA DEVELOPMENT AGENDA % FS Children completing primary immunisations % FS Children with a BMI below the 91 st percentile and above the 2 nd percentile at 36 months % FS Children scoring >2 deviations below their chronological age on the ‘hearing & language skills SOGS Assessment ‘ when aged (a) between 21-29 mths & (b) 33-41 mths

40. HOW ARE WE DOING (Con’t)? STORY BEHIND THE BASELINE Children who had their 1 st SOGS II assessment at 3 yrs were born in 2006/7, prior to the initiation of the FS Programme. These are children that would have had very limited exposure to FS interventions. In comparison the children who had their 1 st SOGS at 2yrs were born in 2007/8 & would have had greater exposure to FS interventions. The trend line indicates that children having greater exposure to FS are more likely to be developing normally. Initial analysis needs to be treated with caution, as we need to be certain that SOGS assessment are being applied consistently SOGS scores shows marked developmental variations across catchments, with some children in particular catchments scoring lower than average on particular skills sets. Schools are telling us that FS children are entering nursery classes with good language & communication skills, are settling quickly and are more independent that their non FS peers. The introduction of mandatory training for all FS practitioners on supporting and developing childrens language & communication is possibly having an impact on practice. Childcare settings are also being encouraged to take up and apply the ‘Learning Language & Loving It’ training and we think that this is starting to improve practice. Parents are reporting that FS is helping their children to be more confident and sociable and that they are learning more, but more could be done to support parents in developing their childrens language skills; relationships and managing behavioural issues. Immunisation data suggests that parents are good at taking their children for Primary Course & Booster immunisations but that it drops below 50% for the final MMR & HIB catch up immunisations. PARTNERS WHO CAN HELP US FS Service Managers & Teams; FS Catchment Schools; Early Years Forum; Childcare Settings; Childcare Workforce Development Team; Parents; GP Practices WHAT ARE WE DOING & WHAT IS OUR RESOURCE Develop a referral pathway for children with additional needs Explore development of ANCo role for FS childcare settings Interrogate SOGS & Parental questionnaire data to establish trend lines & what might help parents more Develop a standardised induction process for all FS staff, which includes compulsory training on language development and behaviour management strategies.

41. Cardiff Flying Start Parents Plus Service : Performance Evaluation Report 2009-10 Service Description: The Parents Plus service is part of the Parenting core strand of the National Flying Start Programme. The Parents Plus Service consists of one Senior Educational Psychologist; three Senior Home Liaison Officers; four Home Liaison Officers; and two p/t Administration Officers. In addition, there is one f/t Specialist Home Liaison Officer (Homeless) and two Home Liaison Officers (former Sure Start) It has a budget of £312,972 and aims to offer time-limited, targeted, home-based parenting interventions in each of the 8 Cardiff Flying Start catchments reaching approximately 110 families annually. Purpose of Service Assessment of child’s functioning within family and community context Agreement with parents on appropriate changes to implement within the home Evaluate improvements in early play skills; in family interactions and relationships; and in the child’s behaviour Headline Performance Measures 1.Perceived improvements by parents in play/devt; relationships; and/or behaviour 2.Perceived improvements by HLO in play/devt; relationships; and/or behaviour 3.Use of behaviour techniques by staff with EY children 6 months after PP+ Behaviour Training course Data Development Agenda DD1 - % Families referred (needing the intervention) who take it up DD2 - % Families receive Initial Assessment Visit within five weeks of referral How Are We Doing?

42. Story Behind (last 3 years) Performance Parents Plus has been through a period of transition: from earlier Sure Start processes to greater Flying Start standards and requirements. It has been an exciting and challenging period. Forming a coherent induction period and regular supervision has ensured new HLOs have become established within the team. The additional supervision and monitoring by Senior HLO have contributed to the successful and relatively smooth move to Flying Start functioning. Unfortunately, significant personnel changes and alterations in working practices by other partners, has had knock-on effects to our referrals and integrated working. Over time, this has been improving. Staff illness and absenteeism has also interfered with our capacity to engage with some families. The developments within the EYFT(Homeless) has ensured an innovative multiagency team approach to working across city hostels, including within Flying Start areas. Research by Cardiff University followed up families which had received Parents Plus interventions up to six years ago. Parental interviews confirmed the effectiveness of our behavioural techniques; and their long lasting influence. This was in part due to empowering the parents to take ownership of the changes. There was evidence that the families referred to Parents Plus have had more entrenched difficulties and dysfunctional patterns of family life. This has meant they tend to be more difficult to engage and to intervene with to implement change. Nevertheless, evaluations of changes following Parents Plus interventions [ Before v After ] continue to show better play/developmental progress, benefits for family relationships and improvements in behaviour management. Parents Plus contributes to improving the wellbeing and progress of Flying Start children through high quality training to EY staff working with young children. What We Propose To Do To Improve Performance In The Next Year Low Cost/No Cost Idea: -Provide “telephone clinic” weekly when Senior HLO will be available at base -Print a leaflet for parents attending all settings on “Building Better Behaviour Together” -Publish article on Parents Plus approach -Re-establish termly visits to all Nursery settings [school-links] -Posters for childcare settings about 1. referral to Parents Plus and 2. self referral by families to Parents Plus Off the Wall Idea: -Develop a training manual for childcare staff with introductory, intermediate and -advanced modules on Understanding and Managing Behaviour in Early Years Settings -& identify funding source to publish and disseminate -put together video examples of “before and after” -Team approach with gypsy-traveller families through childcare session Partners Who Can Help Us Do Better Referral criteria explicit and awareness raising:- Childcare staff Health Visitors Children’s services Nursery staff Play team Home Start CAMHS/PSS

44. How Can RBA Help Us? 1.Planning & performance management framework to deliver on collaborative duties 2.Planning & performance management framework for funded projects (e.g. Cymorth) 3.Organise and explain how population and performance levels fit together e.g. CYP Plan and Cymorth projects 4.Make sense of multitude of partnerships and plans – what matters is results not processes! 5.The future – less money, less small specific grants, more emphasis on outcomes and collaboration

45. Implementing Results Based Accountability Leadership at a senior level Championship by a senior project manager and from champions at different organisational levels Ownership of a commitment to recognising success as better outcomes, not outputs Partnership and multi-agency working. RBA is hard to implement where partnerships are not invested in

47. Resources Mark Friedman Trying Hard Is Not Good Enough (Trafford Publishing, 2005) www.raguide.org – website including implementation guide and examples www.resultsaccountability.com – website including papers on Results Accountability and links to other resources

48. Results Based Accountability Charlotte Drury Questions?