Category: Opinion

Why relational services matter

Posted on by Donna

Joy MacKeith shares her thoughts after the inaugural Towards Relational Public Services (TRePubS) Conference

How do you deliver public services that are relational – services that recognise and respond to the unique needs and circumstances of each individual?  That was the topic of the conference ‘Towards Relational Public Services’ that I have just had the pleasure to participate in. 

Sam Game and I gave a workshop which explored how the Outcomes Star helps to make ‘Enabling Help’ a reality in practice.  Working in a relational way is one of the six core principles of Enabling Help, Triangle’s blueprint for effective services.

Sam, who leads the implementation of the Parent and Baby Star in Health Visiting services in Warwickshire, described how using the Star has helped them work in a more relational, collaborative and strengths-based way.  Parents have responded incredibly well.  They are much clearer about the health visitor’s role and they love the way that Star helps them see what is going well as well as where they have needs.  And it isn’t just the parents.  It has also helped commissioners to understand and value the service.

Our workshop was one of more than 40 sessions which took place over two days at Newcastle Business School – part of Northumbria University. 

For me the highlight was Mark Smith’s presentation on service transformation work in Gateshead.  He described how they have implemented an approach to working with people with complex needs in which there are only two rules: ‘do no harm’ and ‘stay legal’.  In this ‘liberated method’ case workers have a low caseload and there are no limits on how long they can work with someone or what kind of support can be provided.  And case workers have budgets and the discretion to spend money to help solve pressing problems. 

What I loved about this approach was that the bureaucracy was stripped out, giving workers the chance to do simple things that could make a big difference and avert much greater problems down the line.

Mark is part of a growing movement of managers, practitioners and academics who are challenging the orthodoxies of New Public Management (sometimes described as the 3 Ms – Markets, Metrics and Management). They are making the case that outcomes emerge from many interacting factors and therefore cannot be ‘delivered’ or dictated.  In this complex environment, learning rather than prescription and control is the most effective management strategy.  And it makes more sense for commissioners to take a relational approach and to hold service providers accountable for learning rather than targets.  This new approach is called Human Learning Systems.

Toby Lowe, Visiting Professor of Public Management and the Centre for Public Impact closed the conference with a call to action – for all of us who want to see services that are more relational, responsive and effective to come together and work with a coalition of the willing to create a paradigm shift in public management.  It is an exciting vision, and one that I think the Outcomes Star, a tool with flexible, relational working at its core, can play a role in realising.

Joy MacKeith, Co-creator of Outcomes Star

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Watch Joy’s conversation with Toby Lowe about the synergies between Enabling Help and Human Learning Systems 

Find out more about Enabling Help here 

Find out more about Human Learning Systems here

 

 

Triangle reflects on attending the Scotland that cares – Scottish Parliamentary Reception event – 7th March 2023

Posted on by Outcomes Star

I’m Jim Borland, the Implementation Lead for Triangle in Scotland and it was my privilege to attend the recent Scottish Parliamentary Reception event hosted by Oxfam, promoting a new campaign ‘A Scotland that cares’.

The campaign is focused on why making a commitment to valuing and investing in care within the National Performance Framework is so vital to drive progress towards a Scotland that cares. The campaign has been launched to coincide with the first review of the National Outcomes framework in five years. It sets out the argument that to build a fairer and more resilient country, the Scottish government must set a National Outcome for Scotland to fully value and invest in all forms of care and all those who provide it. Too many carers face deep personal and financial costs, including poverty. With the cost-of-living crisis deepening pressures on those who rely on or provide care are increasing. Only once this standard exists, can we then all work together to create positive change for society.

A New National Outcome on Care

The campaign has created a blueprint for a new National Outcome on Care, but it requires public support and the political will to change the current situation and work towards improving the situation for those who experience and provide care across Scotland.

The event was organised by Oxfam Scotland and sponsored by Karen Adam, MSP for Banffshire and Buchan Coast. There were approximately 60 attendees’ from interested agencies, including staff from some of the 55 organisations that currently support the campaign. These included Carers Scotland, Carers Trust, One Parent Families Scotland and Scottish Care, as well as a variety of MSPs from constituencies across Scotland. I am proud to say that Triangle is also one of the supporting organisations.

Support the campaign

Jamie Livingston, the head of Oxfam Scotland opened the event describing his lived experience of caring for his sister who died after battling cancer.  He highlighted the practical issues facing those requiring care and those providing it, but also the issues for the carers once their caring role ends. He talked about his sister’s determination to be active in improving the situation.  Highlighting her efforts of contacting, all the political leaders in Scotland to raise awareness of the lack of support for all those needing and providing care. He has taken his sisters positive action through to this campaign. Whilst many current Scottish political parties already support future change, there is an opportunity for everyone, especially those who experience care and those who provide it to add their voice to the call by taking action via the campaign website: https://ascotlandthatcares.org.

Karen Adam MSP, then highlighted her own lived experience of being a carer, outlining the need for financial support and appropriate resources being made available to help individuals being cared for or fulfilling the very difficult carer’s role itself. She highlighted the need for the carers voice to be heard, valued and rewarded for the work that they do.

Jamie Livingston provided background information on the campaign, which started in 2021 during the Covid-19 pandemic. At the time, it was clear those being cared for, and their carers were excluded from many aspects of the pandemic recovery plans. This was highlighted by the fact care and carers are invisible in all 11 Scottish National Performance framework outcome indicators.  

Together with several partner agencies, the drive to change started with the intention to ensure a permanence to investment in the caring role.  Together with the development and publication of policy via a new National Outcome on Care. Working in conjunction with the University of the West of Scotland (UWS) the partnership developed a blueprint for a new National Outcome. It is hoped to be the basis for potential care indicators specifically linked to carers and the caring role in Scotland. Jamie also highlighted the upcoming consultation phase of the Scottish Government’s review of National Standards and urged individuals and organisations alike to be involved in this consultation and support change to the National Outcomes.

Seven new national indicators have been identified to measure progress:

  • The quality of life of carers, care workers and those experiencing care;
  • The quality of care for all;
  • The financial wellbeing of carers, care workers and those experiencing care;
  • The voice and influence of carers, care workers and those experiencing care;
  • Access to education and training;
  • The adequacy of funding for care;
  • The job quality of social care and childcare workers

Oxfam Scotland: “We want Scotland to fully value and invest in those experiencing care and all those providing it because… Scotland’s one million unpaid carers are the bedrock of health and social care, without whom the care system would collapse. Despite saving Scotland £10.9 billion each year, too often they experience poverty, loss of employment and ill health simply because they care. This must change!”

Satwat Rahman, CEO of One Parent Families Scotland, outlined the importance of this work, and why her organisation has been involved since its inception. Introducing four panel speakers, all with similar negative lived experience of the current support available. These experiences included:

  • The view that the carers’ role is predominately valued and seen as a priority only by family members, peers and caring services. General opinion was that there was little, or no value put on this role by external services, including education, employment, and financial services.
  • There was an expectation from external agencies that carers should ‘know what to do’, without any support.
  • Very limited support available for young carers, especially in the areas of education and finance – thus the carer’s own life and dreams have to be put on hold and suffer whilst they fulfil their caring role.
  • An overly complicated benefits system, which was off-putting to a lot of carers.
  • A lack of resources for those requiring care, or respite for the carers themselves. Demonstrating the need for infrastructure improvements in care provision as one size doesn’t fit all.

Consequently, the need for recognition around the importance of the carers role was emphasised.  Increased and appropriate funding for carers and carers services is needed, to assist carers to provide support and ensure the person requiring care is treated appropriately and with dignity.

Karen Hedge, deputy CEO of Scottish Care concluded the presentations highlighting the view that carers were seen as ‘Cinderella’ within Social Care services, and much more is required to support these individuals. She further emphasised the need for proper policy and legislation which in turn would require achievements to be measured to ensure compliance. Only then would Scotland be able to demonstrate we are a nation that cares.

I found all the personal stories and experiences very moving, particularly from the four panel members sharing their ‘lived’ experience.

As an organisation, Triangle is not directly involved in supporting individuals. We develop Outcomes Star’s for organisations who provide support to individuals in a wide range of social provision settings, including carers. The Carers Star was developed in partnership with the Social Enterprise in East Lothian (SEEL), The Carers Trust and funding from the Scottish Government. It provides a robust framework to assist practitioners work together with carers to help optimise the quality of their lives and assist them in their caring role.

We often discuss the importance of enabling and empowering people by being person-centred and strengths-based and this Star will assist in identifying a carers strengths and challenges to identify support needs to improve the carers situation. However, as highlighted by most of the speakers, the current apathy towards the carer’s role and lack of resources and finance available to support this role directly impacts what is achievable by a person or supporting organisation.

The culture around current care services in Scotland requires change if Scotland is to demonstrate that it values and invests in all individuals experiencing or providing care.

The event gave me plenty to think about and I am personally committed along with my colleagues within Triangle to support this campaign and I would urge anyone reading this post to add their voice to the campaign.

Support the campaign

Please visit the campaign website: https://ascotlandthatcares.org and sign up to the campaign to create change for this vital cohort of our society. Everyone will need to be cared for at some point in their life: as a child, in later life, or due to additional support needs. If you receive care or are a carer yourself, please let our political leaders know why valuing and investing in care matters to you.

Further information

If you would like further information about the Carers Star, please email us at info@triangleconsulting.co.uk

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#SheMatters Conference Oct 2022

Posted on by Donna

I am Marie Buss, I support Triangles clients who are typically Local Authorities, NHS organisations, and charities, to use the Outcomes Stars well within their services across the South East of England.

I am also an ex-Probation Officer, so I was delighted to recently attend the #SheMatters conference on Oct 21st, 2022 as I wanted to hear about the current challenges the sector faces today and learn about the range of successful initiatives supporting women in Prison and the community.

The #SheMatters conference, organised by Imago Dei Prison Ministry, brought together a variety of front-line organisations working with women in prisons across the Southeast to talk about their work, and hear from many women who spoke about their ‘lived experiences’ of the UK’s criminal justice system. The conference celebrated the valuable work of front-line services and was an excellent opportunity for delegates to connect, network, learn from each other, and share experiences.

Here at Triangle, many of our service provider clients deliver support services to women and men in the criminal justice sector using a range of Outcomes Stars. Unsurprisingly, several speakers’ views chimed with our mission and values. They spoke with a real passion for women to receive trauma-informed care, about the importance of collaboration and transparency, and highlighted the importance of enabling help by giving women a voice and some control over how their sentences are delivered.

Abi Gardner, the Deputy Governor for HMP Send, spoke about the women’s journey in the criminal justice system much like we talk about the Journey of Change. Abi’s commitment to offering a range of interventions within the prison system and the recognition that every woman is an individual requiring a tailored sentence plan was inspiring. Abi spoke about the importance of delivering support to women at their own pace, based on their unique priorities and needs. She highlighted the need for women in Prison to feel connected, gain peer support and receive support from different agencies, and feel a sense of community and togetherness to create change. Abi also highlighted how critical physical activity is to human well-being. Particularly women (and men) in confinement.

When we develop Outcomes Stars with collaborators and the people on the receiving end of the support, having supportive networks, supportive relationships, a sense of community, and exercise is always vital for well-being. All these areas are conversation topics between the person receiving the support the support worker when using the Outcomes Star. 

When I completed Outcomes Stars with people on probation some years ago, I found that the Star enables better conversations about a person’s life and creates a shared viewpoint of where they were at, which led to better action planning, and ultimately more sustainable results. Abi echoed this approach as being the prison’s aspiration, Send Prison try to meet the women ‘where they are at’, while also mentioning the difficulty of developing creative solutions due to the restrictions within the CJS. Even so, I was grateful to hear Send Prison is taking steps to develop innovative solutions for women.

At Triangle, we often talk about the importance of enabling and empowering people by being person-centered, strengths-based, and using trauma-informed language. However, in the CJS field, several dependencies impact what prisons can achieve. The regular changes in Government strategy, change in Criminal Justice Ministers, priorities and funding streams changing so frequently often means plans aren’t seen through, meaning less focussed attention on what matters. As if to highlight this point, just twenty-four hours before Abi spoke at the conference, we saw the resignation of yet another UK Prime Minister. 

What does matter? Funding, staff recruitment, attainment of staff, and better sentencing solutions than we currently have.

Speakers from Kent probation spoke about how the sentencing delivered to women often sets them up to fail. In response, they have developed an innovative women’s project.

As an alternative to women attending a meeting in a Probation office which can often be triggering. Women were instead invited to a safe space, with their children, to meet other women, whilst getting support from the third sector, engaging in a range of holistic activities, and receiving relevant advice on a weekly basis. This project is achieving better results for women and their children experiencing the UK’s CJS.

I found this project an excellent example of innovative service delivery, developed after reflecting on the support they offered and identifying what does and doesn’t work. Triangle actively encourages and supports clients to use their Star data to highlight gaps or needs in service provision and provide Star data analysis support upon request.

My day at the conference ended with an unexpected encounter with a client, Advance Minerva, who use the Justice Star. They are funded to deliver the Commissioned Rehabilitation Service Provision (CRS) for women in Kent. They discussed how men built the (CJS) system for men and that female specialist services are sorely needed. We conversed about the need for gender-specific services and tools, which left me with plenty of thoughts to take back to our development team.

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More about our Stars for the Criminal Justice Sector

The Justice Star is designed for use with people serving a sentence, approaching release from  prison or in the community. Preview the Justice Star

For people with long custodial sentences, we recommend the Recovery Star Secure

Explore all the Stars available for the criminal justice sector

CAMHS National Summit 2022: The power of listening

Posted on by Donna
Headshot image of Karen Bodger

Karen Bodger, our new Implementation Lead for the North West region, reflects on the presentations at the CAMHS 2022 National Summit: Transforming Mental Health Services for Adults and children and shares some of the speakers’ insights.

Speakers noted the UK is in the grip of a mental health crisis, with children and young people suffering in particular. Referrals to NHS Children and Adolescent Mental Health Services (CAMHS) have increased by 180% during the last five years, creating significant pressure on services and raising the threshold for support and treatment. The Adverse Childhood Experiences (ACES) model is routinely used to tot up all the trauma children have experienced, creating feelings of bleakness for support workers. Still, the CAMHS summit were determined we have hope and talked a lot about harnessing the power of listening to help support.

Speakers acknowledged it’s grim out there for young people who are suffering. As Dr Harriet Stewart said, “young people’s mental health was worsening at an alarming rate before the pandemic. In the aftermath of Covid, children present at CAMHS with more complex needs. Staff are exhausted, burnt out, and leaving the service”. When Dr Stewart said, quite bluntly, “if we don’t get it right, we’ll ruin their lives, their opportunities,” it was hard not to feel like we are, as a society, failing our young people. But as she said, “we need to think we can do this.”

I also heard from young people like Katie Hickson, who spoke up about her experiences. She is a young woman who gets involved in conversations with the government and campaigns, making me feel hugely hopeful. Katie so eloquently reminded us, “young people already have a voice; they don’t need to be given it. It’s the job of the professionals, the service providers, and parents to listen to their voice and provide opportunities for them to be heard”.  

I also loved hearing Max Davie (who very impressively managed to squeeze in a reference to CBeebies’ Octonauts while debunking some of the myths around early help) talk about listening to the difficulties young people were experiencing as we’ve become a bit fixated on labels, but Max demonstrated the importance of listening first and diagnosing later.

Nicola Harvey, the author of Mindful Little Yogis, shows us how active listening can help young people feel psychologically safe and that without providing that psychological safety, we can’t expect young people to grow up resilient. Reiterating without listening first, we can’t expect better outcomes.

There was a lot of agreement around the need to fund early support hubs, that young people can access without needing a referral.

How can the Outcomes Star help your service?

The Outcomes Stars are listening and conversational tools helping services transform lives. They are keywork tools and measurement tools.  If your organisation provides early intervention mental health support for young people, My Mind Star has seven key outcome areas designed to open up conversations between support workers and the young person about their life. My Mind Star doesn’t assess how severe a mental ‘problem’ is. It explores where the young person is now and where they would like to get to in the future. It is a holistic co-production tool involving listening and discussing a young person’s life, situation, priorities, hopes and aspirations. Together the worker and young person co-create goals and action plans. Using the scales to measure the distance a young person travels through the journey of change over a period of time. Star data also helps managers assess workers caseloads to help reduce burnout. Star data also provides service improvement insight to analyse if the support provided is working, individual progression data and aggregated service level data to report impact to funders.

What I personally like about the Outcomes Star approach is that it starts with listening and, when used well, puts young people at the centre of their journey. Rather than defining a young person by statistics, by how many ACEs they’ve experienced, or whether they are ‘unwell enough to warrant service or support, the Outcomes Star is a collaborative tool that supports and measures change. 

Learn more about My Mind Star

Guiding Stars: How the Outcomes Stars help build hope and self-esteem

Posted on by Outcomes Star

Having recently returned from a long holiday, I am re-engaging freshly with Triangle’s work, creating Stars, training and supporting people to use them well and sharing our wider vision of an enabling service delivery system.

Returning after a solo hiking along the beautiful Cleveland Way, I had the chance to see our work with fresh eyes, and ask myself the question, “After 20 years of working on the Outcomes Star, why does it still matter to me so much?”

The answer that came when I asked myself that question was this: Working with the Outcomes Star gives people access to a developmental framing of their situation. The Star presents their situation as a time of challenge, not a sign of failure. The fact that they need help is an opportunity for them to draw on their existing strengths and develop new ones rather than being a sign of weakness. For people who are so often seen as a set of problems, having access to this hopeful, growthful narrative really matters. It is a simple reframing but it can make all the difference.

The Star reflects the person’s life back to them; they see they are a traveller moving forwards on their journey in life, rather than someone who has come to a dead end. The endpoints or the tips on the Star point to the way things could be, and in some cases they show what is already working well, giving people something to celebrate as well as offering things to work towards.

Stars have always been a navigational guide and a symbol of hope. Outcomes Stars are aptly named because they do just that – offer hope and guide us in the right direction. They don’t tell us exactly how to get there or exactly what it will look like when we arrive. That is something only the person completing the Star can discover for themselves. But they do shine the light forwards and give us the self-belief and self-confidence to keep moving forwards toward a better life.

We all need to see ourselves as heroes in our own journey – facing challenges and setbacks, but achieving and finding a way through as well.

As I reflect on my 20 years helping guide Triangle through the many challenges and triumphs of our work, I feel proud to be able to play a part in helping others move forward on their life’s journey. Refreshed by my holiday I am as hopeful and excited as ever at the potential of the Outcomes Stars to support and embed an enabling approach to service delivery.

Joy MacKeith, Founding Director

To find out more about Triangle’s vision for service delivery read “Enabling Help: How the social provision can work better for the people it services”. You can download the report or watch this video of Joy speaking about the key ideas in the report.

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New ‘How to’ guide explains how the Outcomes Star can turn Human Learning Systems principles into practice

Posted on by Outcomes Star

Since the publication of our Enabling Help report last year, we have been working with Toby Lowe and colleagues at the Centre for Public Impact to articulate how the Outcomes Star can operationalise learning as a management strategy and other core components of the Human Learning Systems (HLS) paradigm.

Both HLS and Enabling help focus on moving on from the failings of New Public Management towards an alternative vision of supporting ‘human freedom and flourishing’ through creating flexible, relational, compassionate service delivery systems in which the role of measuring is to support learning for individuals, organisations and places.

The Star as a tool for turning HLS and Enabling Help principles into practice

We are delighted that the Star is one of the tools identified in the Centre for Public Impact’s recently launched guide: Human Learning Systems: A practical guide for the curious, commissioned by Healthcare Improvement Scotland and Iriss.  

 The guide highlights three different ways that the Outcomes Star can be used to put the principles of Human Learning Systems into practice:

  • Person level: the Star empowers people to take an overview of where they are, understand their life as a system, choose their goals and work out the next steps to achieve them
  • Organisation/place level: the Star enables meaningful purpose-aligned reflection and learning about what is and isn’t working within services, in order to better support those they serve
  • Connected learning cycles: the Star offers a way of collective sense-making between different actors within or across organisations, for example within a multidisciplinary team supporting an individual, or between commissioners and service providers

Read the Outcomes Star case studies included within the guide. 

The synergy between the Star and human learning systems

HLS started as an analysis of the problems within traditional approaches to public service management.  It has gone on to articulate an alternative framework and then look for practical ways of bringing that vision to life. 

The Outcomes Star, in contrast, started as a practical tool for service providers to evidence that they are making a difference in a way that really reflects and supports what they do. From there we articulated the vision of service delivery and public management that was implicit in the tool in our Enabling Help report. 

The convergence of these approaches, despite their different starting points, speaks volumes.  The time has come for this shift in thinking and practice.  We look forward to furthering collaboration with the HLS movement and others who share this vision.

Could your use of the Star inspire others?
Are you working with the Star as part of a wider HLS approach?
Please get in touch with our Research analyst, Dr Anna Good (anna@triangleconsulting.co.uk), as we are keen to create and publicise more case studies.  

Human Learning Systems – A practical guide to doing public management differently

Posted on by Donna

This article was originally published by the Centre for Public Impact.

Last year, we worked with several organisations to release an e-book – Human Learning Systems: Public Service for the Real World. This had one key message: if we want to achieve real outcomes in the world, then we need to do public management differently. That is, we need to plan and organise public service in a radically different way.

Back in 2016-17, when a few of us first began to explore this idea, this was a distinctly heretical position to take. The people that spoke to us for our first report did so on condition of anonymity. Fast forward five years. Now, not only do we have a good picture of what an alternative approach to public management looks like, we have over 50 case studies of that in practice from around the world. And those who have been at the vanguard of this practice, like Plymouth Council, are winning national awards for doing so.

At the same time, across Scotland’s health and social care system, there is a growing appetite to commission differently, to better focus on creating the conditions for people to achieve the outcomes that matter most to them. That’s why Healthcare Improvement Scotland and Iriss commissioned the Centre for Public Impact to create a practical guide for organisations who want to use a Human Learning Systems approach to public management. 

We’re excited that the guide, Human Learning Systems: A practical guide for the curious, is now ready for organisations to use. But, before we ask you to dive in, we wanted to share a little about the journey we’ve been on so far, the need for this resource, and what you can expect.

Recognising the complexity of our lives

Human Learning Systems begins with the recognition that real outcomes are created by the unique combination of actors and factors, and the relationships and interactions between them, that make up a person’s life.

Sturmberg, JP (2018) Health System Redesign How to Make Health Care Person-Centered, Equitable,and Sustainable. Springer, Australia. p238

The exact combination of relationships between actors and factors that create a desirable outcome in one person’s life will be different to another person’s. And, it will change over time, as our lives evolve, and the world changes.

Learning as a Management Strategy

Therefore, if we care about outcomes, we need a different approach to public management which recognises this complexity. We need Learning as Management Strategy. This is what our new guide to Human Learning Systems helps organisations get to grips with. Our guide enables those engaged in any aspect of social action or public service to organise themselves to have the best chance of creating genuine outcomes in the complex environments of people’s lives.

Learning as Management Strategy changes the focus of what can be planned and managed. Rather than trying to meticulously pre-plan and organise a programme of activity in someone’s life, it enables public facing workers to learn together with the people they serve. They can learn about the unique nature of each person’s life as a complex system – the key relationships and the driving factors in their life – and how all of those things interact. And then, when they have learnt together, it enables the workers and those being served, to explore and experiment together around what helps to produce better and different outcomes in people’s lives.

HLS Learning Cycle

All of this exploration and experimentation generates challenges for how systems at other scales are planned and managed – how teams, organisations, places and nations work. And so the managers at these scales need to undertake the same processes of learning and experimentation – to ensure that the action-learning which supports the creation of real outcomes happens rigorously, efficiently and effectively.

Human Learning Systems: A practical guide for the curious

All of these action-learning processes can be planned and managed.

Our new guide is designed to help people understand the practical actions they will likely need to take to plan, organise and undertake these action-learning activities.

The guide incorporates case study examples, written by Andy Brogan from Easier Inc, and Mark Smith from Gateshead Council, to illustrate the applications of the framework in real life. It draws on the richness of their experiences to explore the detailed methods they use, the obstacles they encountered, and how they responded to those obstacles, all while placing learning at the heart of their approach.

The guide was also tested with public sector and voluntary organisations across Scotland who supported us in further iterating and developing it so it can support experimentation in different contexts. 

How can you help?

This is just the beginning. We’re keen to keep testing and iterating the guide and keep asking the question: “what help do people need to adopt a Human Learning Systems approach?” We’ll be seeking feedback from everyone who downloads it – was it useful? How could it be better? Do write to us and tell us how you’re using the guide. With your help, we can truly create something extraordinary.

Explore the guide

We’ve worked with partners to develop a practical new guide to help you apply the Human Learning Systems approach to your work. Download the guide to begin your journey towards more human public services.

Download the guide
This article was originally published by the Centre for Public Impact.
Written by:
Toby Lowe Visiting Professor in Public Management

Chandrima Padmanabhan Senior Associate, Europe
View biography

Ways to Wellness: The Well-being Star within social prescribing

Posted on by Outcomes Star

Ways to Wellness recently published a report we contributed to, celebrating six years of their innovative and internationally recognised social prescribing service. 

The service supports people aged 40-74 years old with specific long-term conditions, many of whom have complex medical, practical and social needs. GPs refer patients to receive support from link workers for 18 months and the Well-being Star is used to assess clients at baseline and then approximately every six months. So far, over 4,500 patients have completed two or more Well-being Star readings. 

Triangle are always keen to encourage learning from Star data and we were encouraged that Ways to Wellness recognise the value of ‘analysing impact data and using findings to inform adjustments to the service’. We supported Ways to Wellness to go beyond the outcomes measurement required by the funders, to explore in more depth the needs and progress of their clients. The Star data reports shown in their report are based on those provided by our recently upgraded web application, ‘The Star Online’.  They showed that 86% of clients moved forward in at least one outcome area, with the highest proportion progressing in ‘Your lifestyle’ – an area most frequently identified as needing work by clients.  

Ways to Wellness are a good example of an organisation that shows a commitment to getting the most out of the Well-being Star.  We have also worked with them to explore how consistent and accurate their link workers were in applying the Well-being Star scales, finding good ‘inter-rater reliability’.  

Click here for more information about the Well-being Star including a case study of the use of this version of the Star in health settings and psychometric validation. 

If you would like more information or support about the use of the Well-being Star, please get in touch with us at info@triangleconsulting.co.uk or +44 (0) 207 272 8765.

Making change visible: The Outcomes Star captures important achievements that could be missed by focusing on hard outcomes

Posted on by Donna

As the creators of a suite of measures capturing distance travelled towards ‘hard outcomes’ we are sometimes asked whether there is evidence that Star readings correlate with or predict outcomes such as offending or employment. In some cases, we hear there is resistance to using the Star and instead commissioners, managers or funders are only interested in how many service users have ticked the box of meeting these hard outcomes. This misses out on capturing important achievements, ignores the role of internal change in maintaining concrete achievements and disincentives working with those most in need of support.

This briefing describes some of the evidence we have of the ‘predictive validity’ of the Star – that it does in fact predict outcomes such as school attendance, employment, training and accommodation status. This includes findings reported in two articles recently published in peer-reviewed journals.

In it, we also explain the value of the Outcomes Star in measuring the full journey leading up to and including changes in behaviour or circumstances.

The author of this briefing, Dr Anna Good, draws on her expertise in behaviour change theory to summarise the strong evidence base supporting the importance of the changes assessed by the Star. It is clear from the research literature (and our extensive experience of working with service providers), that early steps on the Star’s ‘Journey of Change’ such as acknowledging problems and accepting help are often essential to subsequent change in hard outcomes. Moreover, change in skills, confidence and beliefs are often key factors in the maintenance of life-changing improvements.

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Please download our new briefing, ‘The Outcomes Star captures important achievements that could be missed by focusing on hard outcomes’.  If you would like more information or support about the use of Star data, please get in touch with us at info@triangleconsulting.co.uk or +44 (0) 207 272 8765.

The importance of listening

Posted on by Donna
Headshot of Tom Currie against a white wall
Ahead of Samaritans Awareness Day this Saturday, 24th July, Trainer and Implementation Lead Tom Currie reflects on the power of listening and why it is so important in relationships that are committed to supporting change.

Hopefully we all know how important listening is. Really listening. Listening fully to what is being said and what is not. In relationships that are committed to supporting change listening is essential, literally, the essence of the purpose of the relationship is to listen. Yes, the listener may need to speak at some point but, when they do, what they say will be a lot more valuable if it is informed by good listening first. What they say is also much more likely to be heard when spoken to someone who has first experienced being fully heard.

In the almost 200 courses that I have led in using the Outcomes Star, listening is always talked about. Usually brought up by practitioners when talking about effective work with clients. They know how important it is to their work.

The Outcomes Star is a relational tool that supports change in keywork relationships. It helps practitioners and their clients to have better conversations. It does this by helping create a better quality of listening. There are three ways that it does this: by creating permission, by providing frameworks and by opening a space for sharing.

Creating Permission

Each Outcomes Star has between 6 and 10 points. Each point describes an Outcome Area, an aspect of life that contributes to the client fulfilling their potential. This holistic model provides a framework for the conversation between keyworker and client that helps create permission to discuss a range of aspects of life that the client may otherwise not have brought into the conversation. It also helps the keyworker build a fuller, more rounded picture of the client and their life, to go beyond the presenting issue and work to support the whole person.

A practitioner working with a Probation Trust to support prisoners through the gates and help them find accommodation told me that the wide-ranging conversations she had with her clients when discussing Outcome Areas like ‘positive use of time’ and ‘mental health and well-being’ helped her build a fuller understanding of them and their interests. This not only meant that she gained an understanding of what would be right for them but helped her, when finding them a new place to live, to present a better account of them to prospective landlords.

Providing Frameworks

All Outcomes Stars are underpinned by the Journey of Change. The Journey of Change is a model that outlines the stages people go through when making sustainable change in their lives. The attitudes and behaviour at each of the points on each scale are clearly defined. There are five different types of Journey of Change. Being able to create a shared language for where someone is and where they have not yet got to on their journey through life is a useful step in helping them get there.

I was delivering training to two women who set up a charity supporting parents of children who developed a neuro-degenerative disease that is sadly commonly fatal before the child reaches adult hood. They use the Support Stars – for use with parents, children and young people facing serious illness – which we developed in partnership with CLIC Sargent.

When supporting parents through these difficult times, they said the Journey of Change was key to helping parents make sense of what they were going through. It helped them to acknowledge the overwhelming nature of the shock of the diagnosis, to take in their new reality and begin to engage with how they might navigate the challenges they faced. As human beings we need to make sense of the experiences we face and be able to own and author the narratives of our lives – listening plays a key role in enabling us to do that.

A space for Sharing

The Journey of Change is a universal model that resonates with all the people I have shared it with and provides new insights about our own part in the challenges we face. This creates the opportunity for keyworker and client to meet on a more human level and share more honestly about their own experience, moving beyond the usual paradigms of service provider and service user to a space that is more human, more healing and more hopeful.

In my own life, taking time to reflect on where I am in my own journey through the lens of the five stage Journey of Change often provides me with new insights on ways that I am stopping my own progress, whether by not asking for support or hanging on to outdated behaviours that no longer fit with who and where I am. It helps me to listen more deeply to my own truth.

So, for all these reasons, I celebrate the Samaritans Awareness Day as a chance to champion all those who support people to change by offering the generous, supportive, curious and subtle art of listening. Let’s all listen to each other (and ourselves).

*****

Tom is a member of Triangle’s Training Team and provides support to our clients across London and the South East, including 18 London Boroughs, a number of County Council services and a couple of national charities. He lives near Oxford and is a trustee for Spark Inside, an organisation delivering coaching programmes in prisons, where he leads on impact and evaluation.

The Support Stars were developed for use with children and young people who are facing serious illness. The Support Star (Parents) is designed to support their families.

“Tom is a fantastic trainer, very engaging and entertaining. We are on break at the moment but can honestly say it’s been flawless from start to finish”
Dewi Richards-Darch
Dewi Richards-DarchCurriculum Coordinator, Itec Training Solutions Ltd, Cardiff, July 2021