New Outcomes Stars for mental health

Introducing the new My Mind Star and a new, improved edition of the Recovery Star

My Mind Star – a much needed and timely tool for early intervention with young people

My Mind Star was developed in collaboration with managers, service users and professionals at leading UK children’s charity, Action for Children. It was also piloted by:

The results of the pilot were very positive, with 94% of young people agreeing that their complete Star was ‘a good summary of my life right now”.

94% of practitioners agreed that My Mind Star gave them a better idea of the support needs of the young people they support.

“Often young people have not been listened to or given control: completing the Star gives them space and lets them take the lead.” 

 Grainne Hart, Manager of the Choices Service, part of the My Mind Star pilot

Find out more about the My Mind Star here.

The Recovery Star (4th Edition)

This is a new and improved edition, drawing on independent research and feedback from service users, keyworkers and organisations.

The new edition retains the person-centred, strengths based approach of previous editions but with even more accessible language, incorporating trauma-informed thinking and fuller acknowledgement of the impact of external factors.

There is fuller recognition of the necessity of on-going support for enduring and severe conditions. It is backed by a report on independent research into the psychometric properties and a review of literature supporting the Journey of Change and choice of outcome areas.

Find out more about the new Recovery Star here.

Both Stars were launched at the Govconnect Mental Health 2019 Conference at the Royal Society of Medicine on 26th September.

If you have any questions about our new Stars, any queries about transitioning between the Recovery Star 3rd Edition and the new Edition, or you would just like find out more about how the Stars can support your service users, keyworkers and organisation, please contact us on info@triangleconsulting.co.uk or +44 (0) 207 272 8765.

An update on our redevelopment of the Star Online

Our progress so far and what we’re learning along the way

By Sarah Owen, Product Manager at Triangle

As we explained in our last blog post in June 2019, we’re currently in the middle of a big project to redevelop our widely used online system for the Outcomes Star, working with our partners QES.

With the bulk of the project kicking off at the start of this year, we now have just under 3 months before the new product will go live for those new to the Star Online (existing accounts will be migrated from the old system to the new between January and March 2020).

Work-in-progress preview of the new design and interface for the Star Online – with a streamlined homepage featuring easy-to-access actions and notifications

Making progress

During the last 9 months, we’ve made some significant progress:

  • Establishing an Agile process – using the iterative, user-focused development approach but in a way that fits with redeveloping an existing, established product already on the market
  • Weekly (and sometimes daily) sessions between Triangle and QES, to flesh out the specification and turn it into well over 100 user stories – a simple way of capturing what the system needs to do from the point of view of its users 
  • A high-level prototype of the key elements of the system, to ensure a shared understanding between everyone working on the development and to iron out key design decisions
  • A work in progress site, developed with over 10 sprints so far (a sprint is a two or three week chunk of time with planned goals and tasks) – iterated and improved as we go
  • Ongoing input and direction from a Think Tank made up of practitioners, managers and data analysts – reviewing key decisions and the prototype as it developed
Work-in-progress screen from the Star Online prototype – with a new Summary page for each person being supported with the Star

You can see screenshots of the work-in-progress prototype dotted throughout this blog – or download our new PDF ‘Coming soon…Introducing the new Outcomes Star Online’ here.

A work-in-progress example of the new Star data reports that will be available through the new system – focusing on distance travelled and the outcomes being achieved

What we’re learning

It has been a fascinating project for us so far.  As a social enterprise our expertise is not in software development, but in building tools that help organisations to create change and help people to achieve the outcomes that matter to them.  We knew that building an effective relationship with our new partner QES was vital both for the short and long term.

In the early stages, we had to learn how best to communicate our ideas and requirements. Taking the time to do this has paid dividends now that we are in the thick of the detailed development, with greater understanding from both sides. Our experience of working closely with our existing partners, Jellymould and TappetyClick, has also proved invaluable, especially as we balance continuing to support the current system and preparing for the new one.

Next steps

We are running a period of testing with practitioners, managers and commissioners, as well as our team across Triangle, into October.  We’ll then be busy incorporating that feedback and finishing the development up to the end of November.   

In parallel, our Helpdesk team will be working closely with organisations already using the Star Online, to share information and plan the migration of each account.

If you have any questions about the new system, please contact us on info@triangleconsulting.co.uk or +44(0)20 272 8765.

Exciting news about the Star Online system

Introducing our new vision for the digital home of outcomes-focused keywork

By Sarah Owen, Product Manager at Triangle

Screenshot of the existing Star Online system showing a Star visual with 2 sets of ‘completion lines’ representing 2 Stars completed with a service user over time

The Star Online web application for the Outcomes Star was first launched by Triangle in 2011. As the Star has grown in popularity and in use across different sectors and services, so has the Star Online. 

Today the system is used by over 800 organisations and 45,000 frontline practitioners, to support over half a million people and to record nearly 900,000 completed Stars.

Listening and responding to feedback

Over the last 8 years, we have heard from many of the practitioners, managers and commissioners that use the system.  You told us that, although many aspects of the original design still hit the mark, there are frustrations with the system, such as the limited range of reports available and the lack of flexibility in how services can be configured.

Alongside this feedback, technology has improved exponentially since the original development, with digital service design now utilising cutting edge, user focused tools and programming approaches.   

To respond to this, we have committed to a significant level of investment in the Star Online, and since last year, we have been working with QES to completely redevelop the system. 

Collaborating with specialists and practitioners

Logo for QES – specialist developer of web based and offline apps

QES is a specialist developer of web based and offline apps, supporting secure digital data solutions to a diverse range of public and private sector clients. Other QES developments include the eCDOP (online recording, casework and reporting for child deaths) and Holistix Early Help case management system.

The development of the new system is well underway.  We’re retaining a focus on intuitive, simple design whilst also radically improving what is on offer – for example, with a complete overhaul of reports and tools for analysing Star data, and by introducing more options for how services, teams and people can be configured.  Throughout the process, we are collaborating with a small group of practitioners, managers and Star Leads – also known as our Think Tank – who represent a broad selection of organisations using the current system in the UK and in Australia, and who are reviewing our plans and testing out the system.  

Timings and next steps

Our timeline is to launch at the end of November 2019 for new users, and to support existing clients using the current Star Online to migrate over to the new system by March 2020.  We will have more information for existing clients soon and are working to make the migration from old to new as straightforward as possible.  We will of course be providing guidance and support throughout the process.

For more information

If you have any questions or any ideas you’d like to share with us, contact us on info@triangleconsulting.co.uk or +44(0)20 272 8765.

Triangle and our social enterprise model

Sara Burns, Director and Co-Founder of Triangle, and one of the authors of the Outcomes Stars™ explores what it means to Triangle to be a social enterprise.

By Sara Burns, Director and Co-Founder of Triangle, June 2019.

When we incorporated “social enterprise” into our name in 2009, it seemed entirely natural and obvious to me, yet I gave it little thought and there were few guidelines at the time. Fast forward 10 years and I find myself passionate about the concept and practice of social enterprise, as well as better informed and in a sector that is becoming more defined.

In our case, the expression of our social mission and our enterprise (business activity) are one and the same thing. There are many types of social enterprise, including those who raise money through a neutral business activity in order to fund a separate social mission. As Triangle, we develop Outcomes Stars and other tools and help organisations use them because we believe in their transformative potential. We witness time and again in many sectors how the right tool can support people to really listen, have good conversations, plan and deliver support, gather meaningful information and learn about what works. Like so many people, we are operating in a world where services and funding are severely squeezed, and our aim is to keep listening and learning, so we can continue to innovate and make a contribution.

So why am I passionate about social enterprise?

There are a number of reasons.

We make choices and decisions based on what is helpful at a sector level, not what will bring in the most money. This has been the case since we started. It provides a refreshing clarity and simplicity; even though the choices are not always immediately obvious, we are able to focus on the question of what will be most helpful. Somehow the big decisions and changes of direction over the years have always been made easily and harmoniously, and I believe that is because of this clarity of purpose.

Receiving an income from the expression of our social mission in the world, rather than relying on grants or other funding, gives us relative freedom and independence. Ultimately, the majority of our income from training and licenses can be tracked back to the UK government, we collaborate widely in developing Stars and other tools and respond as best we can to different needs and agendas. Yet, at the end of the day, we are the authors and can make decisions based on our learning and experience of what works. And we can plan ahead without the limiting factor of short term funding and the inevitable uncertainties that brings. 

Similarly, because we have an income and are committed to reinvesting at least half of the surplus each year, we have some freedom to be generous and experiment. We offer training and licenses at (often below) cost to enable small organisations to use the Outcome Stars if it’s right for them. We provide implementation support according to need, not based on what people pay. We take risks and invest in new developments before there is a market for them.

All this contributes to a working life that is more fun and meaningful. Money is powerful and I enjoy the potential it affords to be successful in making a contribution – to use the very particular expertise we have built up over the years for good.

My anecdotal impression is that some people who enter the social enterprise sector, while passionate about their social mission, feel ambivalence or even resistance to the enterprise/business aspect, to money and charging. Ultimately, this can result in lack of sustainability and good ideas not getting off the ground. When everything feels too tight financially, that can be stressful and less enjoyable. Being confident about embracing the enterprise aspect and charging realistically for services and products can open some space. Space is important for people to be able to move freely, take risks, be creative and innovate. That is the culture we seek to develop and maintain within Triangle, so that everybody working with us feels able to contribute ideas and enjoy the sense of purpose, clarity and independence, so that we can be as helpful as possible in the challenged world of health and social care.

Interested in finding out more about Triangle’s mission and values?

For more information on Triangle, please take a look at our Values. For more information on the Outcomes Stars and our licensing and training options please contact us: email Triangle at info@triangleconsulting.co.uk, or call on +44(0)202  7272 8765.

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Sara Burns: Sara is co-creator of the Outcomes Stars. She leads on and is continually inspired by developing new versions for new sectors, as well as overseeing all the other ways Triangle can be helpful and support people to use the Star well.

For more information on Triangle and the team behind the Outcomes Stars, please take a look at our About Triangle pages. For more information on the Outcomes Stars and the values that underpin each version, or explore the history of the Star at About the Star or please contact us with any questions: email Triangle at info@triangleconsulting.co.uk.

Introducing our new Managing Director

Triangle, the social enterprise behind the Outcomes Stars, has grown rapidly in the last few years, as more and more frontline services aim to support and measure change by implementing the Outcomes Star.

To help lead Triangle into our next exciting chapter, we have appointed Graham Randles in the new role of Managing Director.

 

Graham joins us from the New Economics Foundation (NEF). As Managing Director of NEF Consulting, Graham worked with organisations to prove and improve their impact by understanding and measuring outcomes, leading a team delivering consultancy, training and capacity building.

Graham brings to Triangle his significant experience in the fields of health and wellbeing, social care and environmental sustainability, such as his role in developing the first total contribution report for the Crown Estate and creating the 40-year impact report for the Prince’s Trust.  Throughout Graham’s varied career in the UK and internationally, he has focused on challenging the status-quo to unlock ideas and new ways of working.

 

 

Recently Graham has worked on projects to assess the implementation of the Public Services (Social Value) Act across the health and care sector for NHS England and to measure the value for money of FareShare, the UK’s largest charity fighting hunger and food waste.

Graham will work alongside Joy MacKeith and Sara Burns, co-founder Directors of Triangle and creators at the Outcomes Star, to lead our social enterprise – supporting our teams to support our licensed Star users, and building the presence of Triangle in the wider world.  Graham is an accomplished international public speaker with a focus on measuring impact, having recently spoken at the World Health Forum in Gastein and delivered workshops for Public Health Wales and the UK’s Care Quality Commission.

Graham has a BSc in business Administration and an MSc in Responsibility and Business Practice, both from the University of Bath, and he is also a trustee for the sight loss charity Sutton Vision.

 

If you have any questions about our new role, any queries about Triangle or the Outcomes Star or would just like to say hello, please contact us on info@triangleconsulting.co.uk or +44(0)207 272 8765.

The interplay of internal and external factors in creating change

In this blog Joy MacKeith, one of Triangle’s founding Directors, explores the interplay of internal and external factors, particularly in the context of austerity in the UK, and sets out Triangle’s approach to the Outcomes Star. 

The context of austerity
In the 12 years since the first version of the Outcomes Star was published, the political climate in the UK has changed dramatically; funding for services to support vulnerable people has been cut and both employment and housing are increasingly insecure. 

The Outcomes Star is a suite of tools which are designed to help service users and service providers work in a constructive partnership toward achieving greater well-being and self-determination.  They are designed to be used in the context of an adequately funded service delivered by well trained staff.  They are also rooted in the assumption that decent housing and employment are available.

Increasingly in the UK these foundations are not in place and that has understandably led to anger on the part of some service users and service providers.  Whilst we believe that the Outcome Star tools continue to have an important role to play in helping people to deal with the challenges they face we also recognise that personal change on its own is not enough and that addressing structural issues of poverty, poor housing, insecure employment and rising inequality are essential to creating a society in which everyone can thrive and contribute.

The agency of the individual
In a climate of cuts and reduced services, some may be sceptical about the benefit of services and tools that focus on the agency of the individual.  At worse it could feel like people are being asked to ‘pull themselves up by the bootstraps’ or even blamed for their difficulties without adequate recognition of the very real challenges that they face and the sense of despair that can build when the odds are stacked against you (Johnson and Pleace (2016), Friedli and Stearn(20 15)).  So how do skills, habits and attitudes – the main focus of the Star, interact with opportunity and life situation?  I think the Cycle of Action model presented by NESTA and OSCA in their report ‘Good help: bad help” helps to answer that question.

Their model draws on the ‘COM-B model’ developed by Susan Michie, Director of the Centre for Behaviour Change, University College London.  It shows these internal characteristics in a dynamic interaction with a person’s life circumstances so that not only do difficult circumstances decrease confidence, purpose and ability to act, but also these internal states can also impact on outer circumstances.

The implication is that those disadvantaged by difficult life circumstances such as physical or mental health issues, poverty, discrimination or homelessness are likely to also experience less confidence and ability to act and that ‘good help’ which builds these aspects is likely to positively impact on life circumstances.  The report is at pains to stress that practical help is also necessary because the external barriers are very real.  But the right kind of help, that which builds confidence, sense of purpose and ability to take action, can create a positive, reinforcing virtuous cycle of change.  Whilst bad help does the reverse.

 

The Outcomes Stars have always focused on the agency of the service user.  For many of the original Stars, including those for use in the homelessness, mental health and family sectors, the model of change revolves around a shift from an external locus of control (“things happen to me and there’s nothing I can do”) to an internal locus of control (“I want things to be different and there are things I can do to make that happen”). 

However, as time has gone on, two things have happened. The first is that we have developed versions of the Star for service user groups who have less control over their circumstances, such as children or those with profound learning disabilities.  The second is that the service delivery climate has become more challenging and therefore the external barriers faced by many service users have increased.

For these reasons we increasingly recognise the importance of acknowledging and recording the external barriers as well as supporting the motivation and capability of the service user to overcome barriers. We do this in a number of ways including our guidance for workers on how to use the Star and in the introductions to the User Guides which are used directly with service users . The version of the Star that recognises the importance of external factors the most comprehensively within the tool scales themselves is My Star – the Outcomes Star for children in which some of the scales measure the child’s progress towards resilience and some of the scales measure the extent to which those caring for the child are providing them with what they need to thrive.

Although our intention is to keep the focus of the Stars on supporting agency and ability to act, new editions of existing Stars and new versions are developed with a heightened awareness of the importance of acknowledging the external barriers.

As the NESTA report (page 20) states:

 “‘Good help’ is not a substitute for addressing in-work poverty, structural inequalities or discrimination, but it has an important role to play in supporting people to manage the elements that are within their control.”

Our aim in that the Outcomes Star suite of tools enable good help, support people to manage the elements of life that are in their control and help service providers to point to the barriers that are getting in the way so that commissioners and policy makers can play their part in making change possible.

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Sources

Friedli, L. and Stearn, R (2015)  “Positive affect as coercive strategy: conditionality, activation and the role of psychology in UK government workfare programmes’ Critical Medical Humanities. This article does not mention the Outcomes Star but the authors are linked to Recovery in the Bin who have published the ‘Unrecovery Star’ ((https://recoveryinthebin.org/unrecovery-star-2/)

Johnson, G. and  Pleace, N. (2016)  “How Do We Measure Success in Homelessness Services?: Critically Assessing the Rise of the Homelessness Outcomes Star” European Journal of Homelessness.  The focus of this article is a critique of the Homelessness Outcomes Star

Wilson, R. and Cornwell, C. and Flanagan E. and Nielsen, N. and Khan, H. (2018) “Good and bad help: how confidence and purpose transform lives” NESTA and OSCA 

“Good Help” and the Outcomes Star™

From our experience supporting hundreds of frontline services to use the Star, we know that how services help people matters.

We were excited to see the “Good Help” report, which proposes a simple and powerful distinction between ‘Good Help’ and ‘Bad Help.

The report harvests the best of current practice in behaviour change programmes alongside a description of the historical development of  behaviour change, from Maslow’s hierarchy of needs and Badura’s work on self-efficacy to motivational interviewing and Susan Michie’s contemporary COB-B model.

Looking at the seven characteristics of ‘Good Help’, we were struck by how nearly all of these are hardwired into the Stars and the Journey of Change that underpins them.  To unpick this and to respond to the challenge in the report of putting ‘Good Help’ into practice, we’ve written a short piece demonstrating how the Outcomes Star can help frontline services to put these values into action.   Read our response here:  Good help and the Outcomes Star

We very much welcome the Good Help report and project, and believe that the powerful concept of ‘good help’ could help to focus a cross-sectoral movement for change which recognises that the most important ingredient in the change recipe is the goals, capabilities and motivation of service user themselves. We would like to add our voice to the Good Help movement and hope that the Outcomes Stars can be part of the toolkit that enables organisations to make that vision a reality.

 

To join the mailing list for the latest news about the Good Help project from OSCA and NESTA, sign up here.

 

 

The Star made a massive difference to me because it showed me that there were things I could do to become the person I wanted to be: a more rounded person with a more rounded Star. The Outcomes Star showed me that there were goals I could achieve. When you’re ill, the thought that you can be well seems very daunting but the Star breaks it down into baby steps and you start to feel yes, I can do this. That really built my confidence and gave me hope.” Young person

 

 

Social accounting using Outcomes Stars™

A guest blog from Anne Lythgoe, Social Audit Network

Understanding the outcomes for the stakeholders in your organisation or service, and how this might create longer term beneficial impacts is the main purpose of using an Outcomes Star. But Outcomes Stars can also be used as part of a framework which helps your organisation better manage the outcomes and impact that it makes.

Social Accounting and Audit allows a third sector organisation or community business to build on existing monitoring, documentation and reporting systems to develop a process to account fully for social, environmental and economic impacts, report on performance and draw up action plans to improve on that performance. Through this process an organisation can understand its impact on the surrounding community and build a role as a catalyst for local benefit.

Widely used across the social economy, social accounting builds from use of tools like the Outcomes Star to really embed social benefit into your organisation.

The framework is built around 4 steps, as shown in the diagram opposite.

Organisations produce social accounts and social impact reports using this process.

For more information about social accounting, please contact the Social Audit Network (SAN), which is a not-for-profit organisation that facilitates the exchange of information and experience between practitioners of social accounting and audit in the social economy, community and voluntary sectors.

SAN holds regular meetings, events and an annual conference at venues around the UK, distributes a monthly SAN circular to its email network.  www.socialuditnetwork.org.uk

SAN was incorporated in 2003 by members of a national network of co-operative, social business and community development practitioners which had existed since the mid 1990s in the UK.

Behind the scenes with Housing and Care 21

On 15th and 16th March, Triangle spent some time filming in Oldham, UK, at an extra care housing scheme run by Housing and Care 21.    Over the two days, we learnt a lot from residents Dougie, Margaret and Dorothy, and Jodie (Court Manager) and Laura (Support Services Manager), about how the Independent Living Star is used in practice.

We’ll be sharing some videos very soon but in the meantime, here are some behind the scenes photos of our two days together.

   

 

 

All the news from our 10th anniversary event in London

On 14th November 2017, we marked over 10 years since the publication of the original Outcomes Star for homelessness with a free information and learning event in London, UK.

Over 100 people came together on a Tuesday morning, including new faces and people who have been instrumental to the success of the Star s0 far.  The purpose of the day was to share what Triangle have learnt from over a decade supporting frontline services to prove and improve outcomes, and to hear from people’s own learnings and experiences of the Outcomes Star – watch our short video of the morning in action:

First up, our directors, Sara and Joy, presented their thoughts and learnings, looking back to 2002 and the beginnings of the Outcomes Star, and looking ahead to what the future may hold for outcomes, impact and the Outcomes Star.  See the presentation from Joy and Sara, creators of the Outcomes Star and directors of Triangle, here.

To mark over 10 years of the Outcomes Star, we’ve pulled together some interesting facts and figures, showing the scale of Star use across the UK:

Later that morning, we heard from two representatives of organisations using the Outcomes Star in their day-to-day practice.  Claire Richardson, commissioner with the West Mercia Police and Crime Commissioner team, told us how they had worked closely with service providers to help them get the most out of the Star.  Mick Carroll, Head of Coaching at Restore, an Oxford-based mental health charity, took us through the 7 things, if you really want to implement the Star as badly and ineffectively as possible, that you absolutely must do!  You can hear both Claire and Mick, as well as Paul Richards, a Support Worker and Licensed Star Trainer from St Basils, a charity supporting young homeless people or young people at risk of homelessness in the West Midlands, tell us a bit more about their use of the Star in our short videos, here.

Lastly, before lunch, attendees were invited to join one of ten discussion tables, each focusing on different aspects of the Outcomes Star – from the Star Online web app, to action planning with the Star, sharing the Star with commissioners and specific Stars, such as the Tenancy Star and Young Person’s Star.  Feedback from the day was really positive about this format, so we’re hoping to run some more information sessions in this style in the New Year across the UK, and maybe even beyond!

Thank you to all that attended the event!  For more information about our 10 year anniversary, read our article here. If you are interested in attending an information event in the future, or have any questions about any aspect of the Outcomes Star, please contact Triangle.