Embed Size (px)
Citation preview
Outcomes focused objectives
East Midlands Learning Cluster
July 15th 2014
Outcomes: strategic level
Partners must also involve children, young people and their families in this process, they are central to the process of reviewing provision and developing shared outcomes. These outcomes should form the basis of reviewing strategic commissioning decisions and should contain measures for monitoring and evaluating progress.
This process of assessing need, provision and identifying outcomes should be linked to the existing Joint Strategic Needs Assessment (JSNA) carried out by the Health and Wellbeing Board and make full use of the available local data. Examples of shared joint commissioning outcomes include:• Improved educational progress and outcomes for children and young people with SEN and disability• Increasing the proportion of children with SEN and disability whose needs are identified in the early years• A reduction in avoidable unplanned episodes of care in acute hospital services• Improved family (or patient) experience feedback.
SEND Code of Practice 2014
Outcomes: individual EHCP level• Education Health and Care (EHC) Plans are legal documents that set
out the education, health and social care support a child or young person with SEN requires when their needs cannot be met by resources available to mainstream early years providers, schools and post-16 institutions.
(What about outcomes for children with SEND but no EHCP?)• They are focused on the outcomes the child or young
person wants to achieve and set out how services will work together to support these outcomes. They will also set out the details of any personal budget that has been identified to deliver some or all of the provision set out in the EHC Plan.
SEND Code of Practice 201
Outcomes- challenges and opportunities
Challenges• What is an outcome?• How is an outcome
different from an objective or a target?
• Specificity?• What level of challenge?• How realistic should an
outcome be?• How many outcomes for
one child or young person?
Opportunities• New way of thinking• Raising aspirations of
children and young people and their families
• Longer-term view• Facilitates effective
planning across services• Greater involvement of
children, young people and their families
The Status Quo
• What do we do now?• How effective are targets/objectives in
statements, IEPs, health care plans or care plans?
• Do current targets/objectives drive progress?• How accountable are they?• Do they involve children and young people?• How are parent carers involved?
Objectives? Outcomes?1. To be able to reach her potential in a supportive and specialist
environment that can meet all of her special educational needs.
2. To achieve better communication skills.3. To continue to develop his sensory skills. 4. To work towards being fully toilet trained.5. To be educated in a setting that can provide a waking-day
curriculum.6. To have improved self-esteem, confidence and emotional
health and to have better developed social interaction skills.
Language used?…..involvement of children, young people and their families?
Code of Practice
Joint Commissioning• Working together across education, health
and care for joint outcomes • developing joint arrangements for
commissioning services to improve outcomes for 0-25 year old children and young people with special educational needs (SEN) or disabilities, including those with Education Health and Care (EHC) plans.
Code of Practice
Outcomes in EHC Plans• An EHC plan starts by focusing on outcomes
that are important to the individual. Any education, health or care provision required to meet a child/young person’s needs related to SEN must be included in the plan
Code of Practice
Deciding on shared outcomes • Local partners should identify the outcomes that matter to
children and young people with SEN or disabilities • Outcomes refer to the benefit or difference made to an
individual as a result of an intervention at three levels:
– Individual outcomes such as might be set out in an EHC plan: for example, Martha can communicate independently with her friends at playtime.
– Service level outcomes: for example, paternal mental health has improved in 10 families
– Strategic outcomes: for example, there has been a 10% increase in young people supported into employment and independent living
Code of Practice
Individual outcomes such as might be set out in an EHC plan: for example, Martha can communicate independently with her friends at playtime.
• …establish outcomes across education, health and social care based on the child or young person’s needs and aspirations
ICF Domain Example areas• Communication Using language, signs and symbols • Mobility Moving around, changing location• Sensory functions Hearing, seeing• Pain General or localised discomfort• Sleep Onset and quality of sleep• Interpersonal interactions and relationships Family and friends• Making decisions and choices Preferences• Neuromusculoskeletal and movement-related functions Gait, moving limbs• Self-care Diet, exercise, washing, dressing, toileting• Major life areas Education, work• Functions of cardio and respiratory systems Endurance and fatigue• Community and social life Recreation, sports and leisure• Other mental functions Consciousness, orientation, social skills, cognition, energy and drive• Temperament Behaviour, mood, emotion, anxiety, attention and concentration• Body structures• Genitourinary and reproductive functions Continence, enuresis• Functions of digestive system Constipation, swallowing, drooling
Plus- emotional wellbeing and gaining independence
ICF, International Classification of Functioning Disability and Health; ICF-CY, ICF Children and Youth Version.
Key Outcomes from research
• Communication,• Mobility• Pain• Self-care• Temperament• Relationships• Social life• Emotional well-being• Developing independence
Illustrative hierarchy of inter-relationships between aspects of health as perceived by parents.
Allard A et al. BMJ Open 2014;4:e004611
©2014 by British Medical Journal Publishing Group
Our mapping of parents’ perceptions of how ‘Community and social life’ is related to other aspects of health.
Allard A et al. BMJ Open 2014;4:e004611©2014 by British Medical Journal Publishing Group
Illustrative hierarchy of inter-relationships between aspects of health as perceived by children/young people.
Allard A et al. BMJ Open 2014;4:e004611
©2014 by British Medical Journal Publishing Group
Our mapping of children/young people's perceptions of how ‘Community and social life’ is related to other aspects of health.
Allard A et al. BMJ Open 2014;4:e004611©2014 by British Medical Journal Publishing Group
Relationships between outcomes
• It was evident …that children, young people and parents did not view health outcomes as a set of independent, stand-alone constructs. Rather, they viewed outcomes as inter-related, facilitating or inhibiting each other. Health outcomes were almost always spoken of in terms of whether they impacted on, or were impacted by, other aspects of health, and the overall impact this had on their lives and experiences.
• The research team analysed how the participants connected various health outcomes, and mapped the nature of interactions and inter-relationships. We perceive a hierarchical relationship between the different aspects of health: some outcomes appeared to be valued as much for their ability to facilitate or contribute to the achievement of other desired outcomes than necessarily as an endpoint in themselves. – For example, poorly managed pain would impact on the extent of attainment in other
aspects of the child's life, such as learning or participation in social activities. • However, achieving higher level outcomes is not necessarily dependent on the
achievement (in part or full) of all of the lower level outcomes.BMJ Open 2014; 4:e004611 doi:10.1136/bmjopen-2013-004611
Young person’s view
https://www.youtube.com/watch?v=WvN7QQqQbCg
A:Aspirations
& objectives
B: Special educational needs
F:Special educational provision
C: Health needs
D: S
ocial care needs
Longer into the
futureEnd of phase or stage
2 or 3 years
Over the next
year or so
E: Outcomes*
G: Health provision
H1:
Social care provision
(CSDPA 1970)
H2:
Other social care
provision
& objectives& objectives
Start here
Targets #
Targets #
Targets #
# EHC plan should specify the arrangements for setting shorter
term targets at school, service or institutional level. * For a young person over the age of 18, outcomes relating to education and training need to be set out separately from health and social care outcomes
A:Aspirations
&
Objectives
Objectives Objectives
B:Special
educational need
F:Special
educational provision
Healthneeds
C:Healthneeds Special
educational need
Special educational
need
D:
Social care
needs
Social care
needs
Longer into the
futureEnd of phase or stage
2 or 3 years
Over the next
year or so
Special educational
provision
Special educational
provision
E: Outcomes*
HealthprovisionG:
Healthprovision
H1:
Social care
provision
(CSDPA 1970)
H2:
Social care
provision
(any other)
Targets #
Targets #
Targets #
# EHC plan should specify the arrangements for setting shorter
term targets at school, service or institutional level. * For a young person over the age of 18, outcomes relating to education and training need to be set out separately from health and social care outcomes
A:Aspirations
& objectives
B: Special educational needs
F:Special educational provision
C: Health needs
D: S
ocial care needs
Longer into the
futureEnd of phase or stage
2 or 3 years
Over the next
year or so
E: Outcomes*
G: Health provision
H1:
Social care provision
(CSDPA 1970)
H2:
Other social care
provision
& objectives& objectives
Start here
* For a young person over the age of 18, outcomes relating to education and training need to be set out separately from health and social care outcomes
# EHC plan should specify the arrangements for setting shorter
term targets at school, service or institutional level.
Become independentTo get a job
To travel
1. Owen’s parents would like him to have a better understanding of social
relationships so he can make friends2. Owen is able to cope with change
Engage in group
work
Smooth transition
to secondary
school
Difficulty focusing and concentrating
Difficulty in coping with
new routines
Develop
friendships
Autism, social
communication
difficultie
s
Youth club and
short break
group activities
Smooth transition to secondary school
Difficulty in coping with new
routines and changes
CAHMS – one, 1 hour
session per week
CAHMS – one, 1 hour
session per week
Autism, social
communication difficulties
Develop awareness of
inappropriate social behaviour
Targets # Targets #
Targets #
The future….
• How will this new way of working change practice in your area of work?
• Who can you call on to support this change in both practice and culture?
• What will be the training and development implications for your organisation?
• Who will drive forward the changes?• What will you do first?
Sam
• Sam is 23.• He has cerebral palsy and is a wheelchair user.• He lives in supported accommodation with 2
other young people.• Sam needs 24 hour care.• Sam is passionate about wildlife- particularly
the big cats and elephants.• His dream is to go on safari in Africa.
Nasreen
• Nasreen is 2.• Nasreen has a profound hearing impairment
and limited sight in one eye.• She is making good progress in nursery and is
beginning to learn some signs.• She enjoys being around other children and
exploring her environment.• She has two brothers and a sister.• Nasreen’s mother is a surgeon.
Rishard
• Rishard is 18.• He lives at home with his mum and younger
brother.• Rishard has Down’s Syndrome.• He has a great sense of humour.• He desperately wants to be independent.• His speech is indistinct.• Rishard’s passion is the theatre.• His behaviour can be challenging.
Kat
• Kat is 8.• She has diagnoses of autism and adhd.• Kat will eat only a very limited range of foods
and is small for her age.• She repeats what she hears but rarely uses
language spontaneously.• She is very interested in washing machines.• Kat can play the piano to a very high standard
but cannot read either books or music.
