In 2006 the landscape in housing, health and social care looked a little different to today. Measuring and managing outcomes was becoming a hot topic but the practice was patchy, confusing and not always with the service user in mind. Working with St Mungo’s to develop an outcomes measuring tool that eventually became the Outcomes Star, it became clear that it provided valuable benefits over and above other measuring tools. With support from the London Housing Foundation, we were able to unlock the ‘dual role’ of our unique methodology – a way to both support change and measure it. A way of working that meets the demands for data and monitoring whilst enhancing (rather than compromising) the service user and keyworker experience. A tool that understands the complexity of personal, sustainable individual change and provides a simple, engaging and consistent framework.
And over 10 years later, we can look back over our journey with the Outcomes Star and reflect on how popular that combination has proved to be. Our work with the Mental Health Providers Forum began in 2008, translating the methodology we had established in the homelessness sector into the field of mental health, illness and recovery. Since then we have responded to demand from many different sectors, and we now have over 30 different versions of the Outcomes Star, co-created with services and service users, with more in development as we speak. Today the Star is used by thousands of organisations in the UK and across the world, with over 500,000 completed Stars for over 300,000 service users submitted on the Star Online web application for the Outcomes Star.
Our journey with the Star has been, and always will be, an ongoing action research project, learning what works and what doesn’t over time and using that learning to continuously improve and develop. One key learning has been just how important it is to make sure the Outcomes Star is used well and as it is designed to be used.
We learnt fairly early on that although the Star looks like a simple and intuitive tool, being trained to understand the values behind it and how to use it properly is vital. Without training, the Journey of Change, the User Guides and the detailed descriptions of the scales (the numbers on the Star) can too often be put to one side, and the method of completing Stars collaboratively with service users to get co-reported readings can be ignored. Unfortunately, using the Star in this way undermines the meaningfulness of the data, and the benefits for keywork and the service user.
To reduce the likelihood of the Star being co-opted into bad practice, we have moved away from our original approach of making the Stars available to download for free. Since 2013 organisations have had to use the Star under licence and with training for all members of staff using the tool – our records show over 26,500 individual licensed and trained workers using the Star today. The income from this approach allows us to invest in providing hands-on support to services to use the Star well, for example by integrating the Star into keywork relationships and processes and ensuring the empowerment of service users is at the heart of Star practice.
For example, one project our team are supporting to use the Star is Voices, licensed Star users and an innovative partnership supporting adults with complex needs in Stoke-on-Trent as part of the Fulfilling Lives programme. For Voices and the people they work with, the Star’s focus on engagement, choices and actions is more useful than a tool that purely measure the severity of problems. Because the Journey of Change breaks down complex, personal change into small steps, it helps them to put the spotlight on the positive shifts and incremental progress that can often be overlooked. Being able to identify and celebrate the small steps that really do make a difference in people’s complex lives is seen as a key benefit of the Star for Voices – helping to counter-act any reliance on unrealistic expectations which can have a detrimental, demotivating effect.
In addition to people using the Star well, we have also learnt how important it is that people understand how Stars are created, and the depth of knowledge, research, articulation, iteration and piloting that each Star goes through for at least a year before publication. This is why we take a sector-wide approach – it allows us to make evidence-based, high quality, effective outcomes practice accessible to many, reducing the need for people to re-invent the wheel. A sector-wide tool will not work for everyone, but for frontline services providing holistic keywork, using the Star can be an invaluable way to embed outcomes practice in everyday work and to improve outcomes for service users.
Because the Star is widely used across the sector, services like Voices can benefit from easier communication, with the Star helping people from different agencies and roles to be on the same page, as well as with the sharing of completed Stars reducing the likelihood of service users being asked to repeat their story all over again when accessing different services. Although Voices have found that some practitioners may have had negative experiences of the Star as a pure performance management tool, investing in their training offer for the Star with internal Licensed Star Trainers has helped. It has equipped them with a deeper understanding of the theory and values behind the Star so that they can build this into their training and induction processes.
As we look ahead to the next 10 years and beyond, we want to make sure Triangle and the Outcomes Star continue to work alongside more services like Voices who support vulnerable people, and help them to survive and thrive in the challenging environments ahead, in the UK and across the world. Continuing our action learning approach, in May we published the new Tenancy Star, developed in collaboration with Loretto Care and designed to apply all the learning from the Homelessness Star into a lighter-touch tool for housing associations in managing sustainable tenancies. Through our social enterprise model, we plan to invest in the evidence underpinning the validity of the Star, in developing new tools for effective, outcomes-driven services and in becoming even more of a pro-active partner for organisations using the Star.
If you would like any further information about Triangle or the Outcomes Star, please visit our website www.outcomesstar.org.uk, email us on email@example.com or call us on +44(0)207 272 8765.
Thanks to Bruno Ornleas and Diane Rankin from Voices for their contribution to this article. See www.voicesofstoke.org.uk for more information about they work they do.
Free Outcomes Star event
Triangle are running a free event for the housing and homelessness sector on 14th November in London – “The Outcomes Star for homelessness and housing: 10 years on”. Register your interest and find out more here.