Podcast Episode: Recording and measuring outcomes: Carr Gomm
What follows is a transcription of the audio recording. Due to differences between spoken and written English, the transcript may contain quirks of grammar and syntax.
AT - Andrew Thomson
J - Jill
L - Louise
Recent policy and practice shifts towards personal outcomes present a number of opportunities and challenges for those who provide human services in Scotland. Carr Gomm, which describes itself as a person centred organisation that supports people to lead their lives safely and to do the things they want to do, has developed its own conversation based outcome measurement tool. Their system is designed to capture and track the personal outcomes of the people they support and link these to the wider local and national outcomes. Later on we will hear from Jill who is supported in her day to day living by Carr Gomm. But first, Andrew Thomson, Business Development Manager at Carr Gomm, explains the story behind the system they have developed.
AT I guess in the mid-2000's we could see that the environment we worked in was changing a little bit and more and more of our partners, our commissioners, were speaking about an outcomes approach - and at that time many people were not clear or misunderstood what they meant. And so on behalf of Carr Gomm I started attending lots of events and different training sessions about what outcomes meant.
So within Carr Gomm I think we posed a fundamental question, and that was "whose outcomes were they?" And there are different answers to the question. The most important answer, in my opinion, is the person we are supporting - what are their individual outcomes. Secondly, our commissioner will have outcomes, and these tend to be in the form of contracted outcomes, and I think finally the Scottish government have outcomes - and part of that is about delivering effective and efficient social care services that deliver for people. And so you can see there is a complete circle from individual people, to local authority contracts, to the Scottish government.
The system we have created is based on some assumptions. So we assume that we are supporting people for a reason - and that is a fairly safe assumption. We assume that absolutely everyone we support will have a Support Plan or a Support Agreement of some kind - and again, that is a very fair assumption. Within that document there are clear goals or plans around about specific areas of someone's life, and that is the specific areas that we are involved with. For each of these there should be an outcome. What is the point? What are we trying to do? And we tied the link - what is the link between each element of the Support Agreement and outcomes. So it is very, very clear - why are we involved in people's lives? What is the expectations of everyone and how does that fit with our contract?
The next assumption that we would make is that we communicate with people and we have relationships with people - and I think that this is again core to what Carr Gomm does, how we adopt a person centred approach to every single individual person - we have individual relationships with people that are unique to them.
Our system works round capturing the essence of these conversations, having constructive conversations. Now if I ask you once and that is the only evidence I have, my evidence is poor. But if I ask you on a routine basis, my evidence is slightly stronger. If we have the same conversation with the key worker, or other workers in the person's team, then our evidence starts to grow and become stronger. If we ask people who are important to the person we are supporting what they think - where that is relevant, where that is the right thing to do, where the person is happy with that - our evidence grows further. If we capture this on a routine basis - every week, every month, every other month, it becomes stronger and stronger, more evidence based.
By capturing this information, very quickly, very easily through natural conversations, we are able to build reports, and these can prove massively important at review meetings, because it builds a picture of everything that has happened since the last review meeting. Because of the links to the contractual outcomes that we have already drawn, we can pull all the evidence together and report to the local authority on specific contracts - "here is all of the evidence brought together. It's clear, it's robust, it's evidence based, of how we are meeting the requirements of your contract". And that works for anyone we are supporting anywhere in Scotland, with any local authority, for any contract. Because we are doing it that way, we can also then report to the Scottish government and we can say "this is how Carr Gomm is delivering for the citizens of Scotland on the national outcomes of Scotland". That is powerful, powerful information, and yet so simple.
Next we will hear a short discussion between Jill, who receives support from Carr Gomm, and Louise, her support worker. Louise started by asking Jill what outcomes means to her?
J Being able to cook again, become more independent in the future and living out in supported accommodation in the community.
L Do you feel like that by the way we put together the support guidelines and keep you informed and involved in doing the guidelines together, like we have been doing - do you feel that that helps?
J I do, yes.
L Do you feel that helps you meet the outcomes of the support?
J Yes, it does. Be independent as a future outcome.
L For me, I always think, like when I'm working on your support agreement and when we're planning the different guidelines and everything, for me outcomes - I always think it is a really good way to see how far you have come, you know, so the support agreement documents go back for years, so to look at the guideline just now, how it is now that you have just came here, and then we will look at it again 6 months from now, a year from now, 5 years from now - it will be nice to see ... to look back how far you have come over the years. Do you agree with that?
J I do, yes.
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