Assuring Service Quality and Controlling Systems Performance

Angela Taylor, Oxford Policy Management

Topic 1

2

Gate keeping/service quality procedures and mechanisms

1. Clear identification of vulnerable children and their needs for services;

2. Identifying specific national and local services for children;

3. Developing children centred standards for service delivery;

4. Developing service specifications: type of service and service activities;

5. Stimulating development of different kinds of service providers (private, NGOs);

3

Service quality and controlling mechanisms

6. Case management – mandates and methodologies;7. Effective licensing and contracting of all public and private

service providers (service agreements); 8. Changing behaviour:

– proper accreditation of professionals and continuous development and training, and follow up support;

– professional supervision and support to service providers;

– Codes of conduct; and– Motivation of staff.

9. Monitoring and IT information systems (standards compliance);

10. Ensuring effective appeals and complaints systems; and11. Inspection (licensing and contract requirements).

4

Question

How can we move from a position of having standards that focus on

institutional infrastructure and formal education requirements for staff, to

standards which are centred on service outcomes for service users

5

Developing children centered standards for service delivery

• Currently most standards/normatives are focused on institutional infrastructure and formal education.

• Children centred a new way of looking at standards. Standards related to the design and content requirement of services—buildings, staffing levels and issues impacting running costs (structural standards) and standards related to minimum requirements for professional activities (functional standards).

• When developing standards we need to listen to children/parent/carers and understand better what children need. Quality4children: S6 – “the out of home care process is guided by an individual care plan”, S9 – “the caregiver’s relationship with the child is based on understanding and respect”, S18 (leaving care process) “follow-up, continuous support and opportunity for contact are ensured”.

• Finance and standards need to be aligned.

6

Effective licensing and Contracting of all public and private providers

Licence – an official certification that the service can be provided by a provider (a legal entity) who has demonstrated an ability to meet minimum standards and other agreed licensing criteria.

contracts—the legal agreement between contractor (at ministry, regional, municipality levels) and the provider to provide a service on behalf of the commissioner.

7

Changing Behaviour

• ownership - improved communication and information sharing – stakeholders, levels, professionals;

• overcoming resistance to new working practices, institutional closures etc;

• proper accreditation of professionals and continuous development and training, and follow up support;

• external professional supervision and support to service providers;

• internal professional supervision; • ensuring professionals are motivated; and• Codes of professional conduct.

8

Effective monitoring and IT systems standards compliance

• Reliable data bases;• Adequate interlinked IT systems; • Monitoring activity by the provider an expectation and

specified within the contract or the license. • Monitoring information from the provider supports the

management requirements of both licensing and contracting; and

• Monitoring identifies actual performance usually assessed as a percentage (performance indicator), expressions of actual performance against required performance. Measures the extent to which a standards is met or not.

9

Ensuring effective appeals and complaints systems

• Children need to be informed about their rights and how to complain and appeal decisions;

• Children and people who come into contact with children (doctors, teacher etc) need to know how to report infringements of children's rights;

• Complaints systems need to be made accessible – national telephone line, E-mail etc; and

• The system needs to be able to respond.

10

Inspection (licensing and contract requirements)

Who improves services?• Purpose of inspection is to improve the

quality of services provided to children;

• Inspect against minimum standards – provides the criteria for appraisal of service effectiveness; and

• Provides on site confirmation of monitoring data.

11

Periodically reviewing standards

• There need to be a continuous loop of quality systems and assessment of gate keeping mechanisms that leads back to a reassessment of standard

12

Piloting of new approaches

• Focus - critical mass not scatter gun; • Ensure effective monitoring and evaluation systems to

test whether outcomes are being achieved; • Dedicate resources to extracting lessons learnt, most

resources go into administering the pilot/test; • focus on establishing the true costs of the

service/system being piloted; • build in sustainability arrangements; and• know when to stop testing/piloting and to scale up the

systems/services piloted/tested.