Delivering Person Centred Outcomes Through on-the-job Learning and Involvement

Rosemary Hurtley MSc, Dip COT, FRSAManaging Director 360 Forward

The 360 Standard Framework Using measurable outcome standards to exemplify excellence

The Learning Conundrum

Am I and my team

compliant and how can we

move beyond compliance?

Am I and my team

compliant and how can we

move beyond compliance?

Do we meet the new

personalisation agenda?

Do we meet the new

personalisation agenda?

Do we meet the ‘Dignity

in care’ criteria?

Do we meet the ‘Dignity

in care’ criteria?

Are we outcome

s focussed

?

Are we outcome

s focussed

?

How can we demonstrat

e excellence?

How can we demonstrat

e excellence?

Where do we focus limited

resources in hard times?

Where do we focus limited

resources in hard times?

What does quality look like from a resident’s perspectiv

e?

What does quality look like from a resident’s perspectiv

e?

What is the 360 Standard Framework?

A diagnostic assessment framework that shows care organisations how to establish and maintain person-centred cultures from the perspective of the cared for person, their families and carers

An outcomes based practice development framework for achieving continuous improvement

How the 360 Standard Framework helps the

organisationPromotes self-management of QIFacilitates analysis of training needsIs a blueprint for education and training for self audit, practice development and change managementHelps care providers to meet CQC registration requirementsMakes good care homes visible for older people and their relatives

Assessment Framework – Residents' Measures

1. Receiving person-centred care 2. Opportunities for social/occupational activity3. Influencing meals and 4. Meeting spiritual needs5. Resolving concerns and complaints

Example : Resident Standard 3:1

The resident has a choice of culturally acceptable food and drink that meet his/her dietary requirements

Structure Process Outcome

Staff and Relative’s Measures

Staff measures

4. Feeling valued as a staff member

3. Equipped to do the job

2. Having time to deliver good care

1. Finding the work fulfilling

Relative measures

2. Communicating with staff and managers

1. Welcoming ambience of the home

4. Seeking to resolve concerns and complaints

3. Being fully informed

5. Contributing to the care of the family member and the community of the home

Managers making it happen

Facilitative management style, clear channels of communication, positive relationship building, collaboration with other professionals and agenciesPivotal leadership role in change management (operations, practice development, quality improvement, business management)

– Operational management

– Practice development

– Quality improvement

– Business planning

  

  

  

    

2 - Preparin

g and Planning

2 - Preparin

g and Planning

1 - Client

Decision

1 - Client

Decision

4 - Data Analysis

4 - Data Analysis

5 - Feedbac

k

5 - Feedbac

k

3 - Data Collectio

n

3 - Data Collectio

n

 Routes: The 10 step cycleIdentifying learning needs

Key learning needs for staffUnderstanding ageism in society Understanding chronic conditions and their effects on the person –identity, significance, continuity, purposefulness, belonging and being understoodBuilding positive relationships –the triangleUnderstanding transition, loss and adaptingUnderstanding and preventing institutionalisationWanting to understand more about how to measure person centred outcomes Wanting advice and help on how to achieve and sustain improvements

Organisational requirements of success

Organisational structures promoting, supporting QI as a primary function of the organisation e.g.-QI working groups, communication network, lines of accountability, job descriptions, business plans, organisation of trainingQI priorities integral to business planning –all levelsQI implementation strategies (blended learning and doing on the job, adult learning model)Designated responsibilities for QIModels of care organisation that deliver outcomes of consistency, continuity, involvement and empowerment of residents (and relatives)

Managers QI competencies for implementing the 360 Standard

FrameworkSkills in providing learning support (action learning, coaching,

supervising, communicating)

Knowledge and skilled use of the 360 SF

Facilitation styles: facilitation and group dynamics, listening, valuing

Setting outcome standards for projects including process and resource elements

QI action planning and project management

Open, facilitative pivotal leadership roles for operations, QI initiatives, and staff training

The Adult Learning Model

Starts where new people are atIntroduces the new as a modification of the oldIntroduces the new as a series of individual, reasonable demands that build to the total behaviour desired.Involves a steering committee of people from all levelsLaunches the programme with an upbeat information sessionKeeps up the momentum with feedback and supportSchedules further information sessions

Characteristics of the 360 Standard Framework Delivers continuous quality improvement and

demonstrates measurable change

A Standard of excellence in relationship activated care for person-centred outcomes

Involves the cared-for person, relatives and staff

Incorporates evidence from research and empirical studies

Underpins all other service and practice standards

Diagnostic with measurable outcomes

In summary

CultureCulture Structure Structure ProcessesProcesses Outcomes Outcomes BenefitsBenefits PaybackPayback

Staff organisation

Staff organisation

Staff develop-

ment

Staff develop-

ment

Management systems

Management systems

AttitudesAttitudes

Behaviours Behaviours

Managementstyle

Managementstyle

How to:

Work with residents

Work with residents

Involve relativesInvolve relatives

Work together

Work together

Well-beingWell-being

Staff satisfaction

Staff satisfaction

Relatives’ reassuranceRelatives’

reassurance

Goodfeedback

Goodfeedback

Staff loyalty,performanceStaff loyalty,performance

‘Word ofMouth’

‘Word ofMouth’

Higher VFM,fees

Higher VFM,fees

Lower staffcosts

Lower staffcosts

IncreasedoccupancyIncreasedoccupancy

Excellence performance driver components, within the 360 Standard Framework

‘We must not loose our faculty to dare, particularly in dark days’

Winston Churchill

Thank you

Rosemary Hurtleytransform@360fwd.com

Domiciliary Care: Clients

Main themes for clients:Control over decisionsReceives consistent care and supportCare and support is delivered in acceptable ways to acceptable standardsPositive relationshipsEmpathetic and effective communicationsAble to resolve concerns and complaints without fear of retribution 

Domiciliary Care: Staff and Family Carers

Main themes for staff:•Finding the work fulfilling•Support to do the job•Equipped with the knowledge and

skills to do the job•Feeling valued as a staff member

Main themes for family carers:•Involvement in decisions about the client’s care and support•Consistency and continuity of support to the family carer•Standards of personal care and support to the client•Relations and communications•Concerns and complaints