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Domiciliary Care Workshop

Domiciliary Care Workshop. Waterfront Place, Chelmsford 11 October 2007. Monitoring and evaluating home care. Gill Herbert September 2007. What do we really need to know?. What the people we serve want us to achieve (politicians, community, individuals) What we are trying to achieve

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Domiciliary Care Workshop

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  1. Domiciliary Care Workshop Waterfront Place, Chelmsford 11 October 2007 Gill Herbert, Consultancy & Development Ltd

  2. Monitoring and evaluating home care Gill Herbert September 2007

  3. What do we really need to know? • What the people we serve want us to achieve (politicians, community, individuals) • What we are trying to achieve • What we currently do • What we currently do not do that may be important • What we need to do differently • Whether the changes we make improve success over time or not HOW MANY MORE PEOPLE ARE WE MANAGING TO SUPPORT IN THEIR OWN HOMES OR AT A LOWER TARIFF OF CARE? Gill Herbert, Consultancy & Development Ltd

  4. Thinking about Home Care • Personal and group outcomes are important • Key “link” services and other groups - interfaces are as important as service delivery • Multi-disciplinary and multi-agency working essential • single assessment, joint provision, joint outcomes • Performance management and milestones for changes defined Gill Herbert, Consultancy & Development Ltd

  5. The Key Questions for Evaluation • How many people do we serve and where? • How do we improve or support their health, safety, quality of life and well-being? • Does each service effectively meet its defined objectives? • Can the service respond to the requirements of individual budget holders? • How does each user of an benefit from the service (or not)? • How do services link with and support each other and mainstream services? • What happens to people who use the services and their carers over time? Gill Herbert, Consultancy & Development Ltd

  6. Management Information or Evaluative Research? • Both required - can inform each other • Different levels needed for different purposes: • National • Regional • Local - county wide • Local – communities or groups (natural or defined?) • Service specific • Individual user specific • Consistent data set for all services could be linked to single assessment framework • Process for constant review, re-evaluation and planning needed Gill Herbert, Consultancy & Development Ltd

  7. Methods & Approaches (1) • Macro Level • Using current MI and analysing in new ways - identifying what questions to ask • Mapping of services, resources, skills and supporting facilities • Partnership arrangements at strategic and operational level • Supporting processes and infrastructure • Audit and benchmarking • Developing IT that works across boundaries • Project management to collate and analyse new data Gill Herbert, Consultancy & Development Ltd

  8. Methods & Approaches (2) • Locality Level • Baselines - how home care links to and impacts on other services • Collating and comparing / benchmarking between services/approaches • Usage - numbers, hours per week, length of package • ADLs and other measures of enablement • Achieving professional and personal goals and multi-disciplinary working and outcomes • Populations - conditions, age and ethnicity • Pathway tracking for small cohorts • Identifying and monitoring unmet need Gill Herbert, Consultancy & Development Ltd

  9. Methods & Approaches (3) • Service & Individual Level • Clearly defined aims and objectives for the service and for individuals • Ensuring users and carers have active and useful input • Outcomes as basis for evaluation • Measurable success criteria which are quantifiable if possible • Qualitative investigation of experience and outcomes • Review processes - for individuals and service • Developing research and self evaluation skills What can be done by practitioners and what needs to be independent? Gill Herbert, Consultancy & Development Ltd

  10. Taking an individual / user-perspective view • Qualitative information important • Changes for the individual over time • Quality of life, social inclusion and choice as well as other outcomes and costs • Compare what is expected (pathways, protocols, standards) and what is experienced (perceptions and outcomes) • Compare with other approaches – e.g. befriending or day care • Sustainability of achievements/improvements important • Small cohorts can inform bigger picture Gill Herbert, Consultancy & Development Ltd

  11. Making it doable • Use what information is already available • Keep it simple • Acknowledge the variables and influencers - keep the focus on what we really need to know • Win the ownership of the data providers and those that use the information - make it useful to them • Address other needs if possible - inform other interest groups, reduce duplication, produce user information • Learn how to make evaluation an achievement acknowledgment which motivates towards improvement Gill Herbert, Consultancy & Development Ltd

  12. Key Decision Points • Initial contact • Overview Assessment • Allocation of “service” or other action • Review or further assessment (in-depth or comprehensive) • Transfer to alternative location • Discharge • Follow up Gill Herbert, Consultancy & Development Ltd

  13. Types of information • Personal data • Background and situational data including history • Reports of • diagnosis, need or wishes • action to be taken - treatment, service or other inputs • activity or events • decisions • intentions or goals • outcomes • Other??? Gill Herbert, Consultancy & Development Ltd

  14. Making sense of information • Use case studies to explain what is important and why • Use numbers wherever possible to justify investment and change • Constantly review the usefulness of the information and how it relates to the experience of the people dependent on the service Gill Herbert, Consultancy & Development Ltd

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