A brief introduction We are Scotlands smallest local authority and partnership area-population under 22k We have interesting geographical and resource challenges There are strong local traditions of partnership working We have to be creative and make our own solutions
The History Orkney started an Udset review pilot in May The pilot became mainstream by October 2007 Some 500 reviews per year are completed using the tool Carers Udset reviews are done by the local Crossroads Carers Centre
Staff/Organisation issues: Undertaking the Udset review takes on average 2-3x longer than our old review tool Staff find writing up the review takes similarly 2-3x as long- but: -Staff appreciate the Udset review process and value having a real social work job to do. -Staff are finding that clients and carers are more likely to discuss issues important to them than before. -Staff feel that the review tool is much more user focussed, rather than the previous more service led tool. -Staff continue to develop their skills to elicit views from client groups who struggle to communicate- or for whom third party views must be sought.
Talking Points with cognitive impairment Emphasis on using social work skills to elicit views and assess the impact of services Talking Points reviews may be an extensive process and involve other staff & carers Staff need to be innovative, developing new tools and skills for communication Staff have to be given the time required to manage the complexities involved
Reporting on Udset Data How to sort the data? Initially, this has been done manually. For CSS reviews- Paris will assist with locating types of response- will still need worker assessment and collation of qualitative material. Some quantitative data can be reported on via Paris- the summaries, for instance Carers reviews from Crossroads are hand written – so as yet, minimal collation of this data.
What has the data revealed? Data from 2007/8 and 2008/9 has been analysed. Service users are very satisfied with outcomes from services. Data confirmed that dissatisfaction with home care services is the most regularly cited issue. Meeting people and getting out and about are consistently problematic- due to our transport infrastructure and its cost. Service user satisfaction improved from 2007/8 to 2008/9
Talking Points ( Udset) summary questions 1.Broadly, is the client supported by their package of care to feel physically and emotionally safe in their own home and environments where community care services are provided? 2. Broadly, is the client satisfied with their involvement in their package of care thinking particularly about whether they have choice, have been supported to make their own decisions and have the information needed to do so? 3. Broadly is the client satisfied with the opportunities available to them to: Engage in leisure and social activities of their choice? 4. Broadly is the client satisfied with the opportunities available to them to: Take part in activities of their choice (including employment and training if appropriate)? 5. Broadly is the client satisfied with the opportunities available to them to: Have social contact with others?
What we do where cognitive impairment affects the client? Use all the available information to come to an assessment of the impact of services for the person Make a professional judgement about the Talking Points summary outcomes. Ensure that we make it clear how the judgement about the summary was arrived at, who contributed and how.
Some graphic results 2008/9- summary responses
And comparisons from year one to year two
Front Line Outcomes Where possible, service user comments are acted upon at once, making immediate improvements and providing positive feedback for everyone involved that the review is making a difference. If changes cant be achieved- Unmet Needs process informs strategic decision makers very quickly.
Strategic Outcomes Outcomes data is available throughout the year- for snapshot or performance reporting Qualitative data is easily retrieved. Quantitative information is gathered and can be provided as required What was anecdotal knowledge about services is now backed up by data.
Transferability of the tool We have recently started looking at the tool to compare the outcomes of varying respite opportunities to help with resource management Outcomes measures will be used in Adult Support and Protection case monitoring An Outcomes focussed single shared assessment is being piloted currently- based on similar client/carer outcomes
The Future Pilot across agencies- most of our health colleagues have yet to use the format- CPNs are already involved Analysis of data- ongoing process and consistency testing required as new teams start to use the tools IT Issues-many are resolved and we have the capacity to resolve others- but need to widen access to Paris ( our information and business IT system) for partners. Monitoring- need to develop a programme for this Utilise information- how to impact on local strategies promptly