Triangle measures what matters at GO Lab’s Social Outcomes conference

Triangle’s Co-founder and Director contributes to GO Lab’s Social Outcomes conference programme to share learning from using the Well-being Star in a large social prescribing  programme and how vital it is that measurement approaches are designed with relationship building and behaviour change in mind.

Hosted by The Government Outcomes (GO) Lab, the Social Outcomes conference brings together researchers, policymakers and practitioners working to improve social outcomes. Joy MacKeith, Triangle’s Co-founder and Director features at this year’s virtual event; she will share learning from 20 years of measuring individual outcomes to contribute to a debate about how commissioning approaches and Social Impact Bonds in particular can help or hinder the achievement of social outcomes.

Joy Said:

“When people design a Social Impact Bond or any other commissioning approach, they need to be mindful of how it will impact at the front line because that is where the real change happens. Research tells us that the quality of the engagement between workers and service users is absolutely critical to behaviour change but sometimes payment mechanisms can unintentionally impact in a negative way."

"The Outcomes Star has been designed to provide service-wide outcomes data whilst at the same time supporting that collaboration and helping people take the small steps that together add up to achieving their goals.“

Joy Mackieth

Joy is joined by Tara Case, Chief Executive of Ways to Wellness ­– a large-scale social prescribing service and the first health service in the UK (and globally) with social impact funding. Ways to Wellness, with Bridges Fund Management as investors and Newcastle Gateshead CCG as commissioners, has been using the Well-being Star since 2015 as part of the support their service provides and to capture client-reported wellbeing improvements; the Star was specified in the outcomes-based funding contract for the programme.

Tara said:

“We have found that the Well-being Star helps to open up conversations that might have been hard to broach without it.  It helps our Link Workers take a holistic approach and make links between different aspects of someone’s situation. It helps services to tailor what they do to support the person whilst also providing a standardised framework for reporting results.”

The Well-being Star was created for people living with a long-term health condition, to measure their progress in living as well as they can, and support self-management, rehabilitation and person-centred approaches. Triangle recently conducted further validation work on the Well-being Star within the Ways to Wellness service and shared their findings.

GO Lab’s Social Outcomes Conference runs 1st-4th September. Triangle is contributing to “Back to the Future? Learning from the UK”s experience with impact bonds: what should we take with us and what should we leave behind?” which takes place 15.30–17:00 (UK BST) on Tuesday, 1st September. You can register to attend free of charge via Eventbrite.

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Triangle is the social enterprise behind the Outcomes Star™. Triangle exists to help service providers transform lives by creating engaging tools and promoting enabling approaches. Through the Outcomes Star, they work with services to promote and measure individual change and to enable learning at an individual, service, organisation and sector-wide levels. The Outcomes Star™ is an evidence-based management tool for both supporting and measuring change. For more information email info@triangleconsulting.co.uk.

Ways to Wellness is a service for people in the west of Newcastle whose daily lives are affected by certain long-term health conditions. GPs and their primary care teams use social prescribing to refer patients to the service. Ways to Wellness adds to and complements the medical support that people receive, to help them feel more confident to manage their long-term conditions and make positive lifestyle choices. For more information email info@waystowellness.org.uk.

The Well-being Star and The Family Star Plus are available to all organisations with a Star licence, and full training can be given for workers and managers. For more information on the Outcomes Star, please contact us on info@triangleconsulting.co.uk or +44 (0) 207 272 8765.

A real difference: How the Star is helping the Carers Trust prove its impact

In the increasingly competitive world of carer services, commissioners want robust outcomes data. For the Carers Trust, measuring outcomes has become crucial in its mission to improve support for unpaid carers – and the Carers Star is helping provide the evidence it needs.

Since the Care Act of 2014, local authority commissioners have had to assess carers and provide support where needed. This has given rise to bigger, multiple contracts for services helping carers – and a corresponding demand from commissioners for good outcomes measurement.Carers Star case study

 “The landscape now is that you need to demonstrate the difference that you’re making – it’s more and more competitive,” says Dr Richard McManus, insight and intelligence manager at the Carers Trust. “There’s a big difference in the way services are commissioned and ultimately how they’re delivered.”

The Carers Trust has a large network of partners, all operating in slightly different ways, so collecting and analysing robust outcomes data across the network is crucial. “The Carers Star is widely used throughout the network,” says Richard. “It’s a really useful tool, based on lots of research, evidence and testing, as well as engagement with the carers themselves.”

With nearly a third of the Carers Trust’s network partners now using the Star, Richard McManus is able to see the individual impact of particular services, but also to gather data on the collective impact across the network. It’s proving invaluable in securing bigger contracts, which the Trust bids for jointly with one or more network partners.

“Having the Carers Star is a really good way of demonstrating that we understand the needs of carers,” says Richard. “More generic charities might have less robust reporting and measurement in place. But with the Star we can show we have specialist knowledge and real expertise – and also for particular groups, like young carers, carers for people with dementia, or carers who also work.”

The Carers Trust is seeing benefits right across the network. “The network partners that use the Star really value it,” says Richard McManus. “It helps them with improving their services and transforming the way they deliver those services, based on real evidence and feedback from carers.”

“And of course, because of its robust design and methodology, it’s highly appealing to commissioners.”

For more detail about how the Star works both as a measuring tool and for carers themselves, have a look at the case study. Related blog: we also published a related blog; Carers Star makes collaboration count.

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The Carers Star is available to all organisations with a Star licence, and full training can be given for workers and managers. For more information on the Carers Star, please contact us on info@triangleconsulting.co.uk or +44 (0) 207 272 8765.

Year in review: Shining brightly in uncertain times

Joy MacKeith, one of Triangle’s directors and co-founders, and co-author of the Outcomes Stars, explores her year in review, and shares her thoughts on the impact and successes of 2019, including the new Star Online and new Stars.

It’s week one back in the office after my new year’s break. My inbox is surprisingly full and the office is already buzzing with activity. Not everyone has taken two weeks off it seems. Before taking a deep breath and diving into the patiently waiting emails I allow myself the luxury of a moment to reflect on a very busy 2019 and anticipate what 2020 has in store.

Star Online 2 is unveiled

For me 2019 will always be the year that we built our new, improved software system and 2020 will be the year that the one thousand organisations working with the Star Online started to use it. The initial feedback from those who helped us test it in development has been amazing. I know many of our clients will be particularly excited about the reporting capability, with new visuals, new customisation and new time period reporting options. Other new features will make it much easier to manage implementation and data quality.  The fact that we now have a state-of-the-art platform for further developments is also very exciting. An off-line app is high on the list of new features we have planned. The new system is now live for new clients.  A massive thanks goes to Sarah Owen, our team member, who has led the project and QES our software development partners.

Making an impact

I will also remember 2019 as the year we conducted our strategic review. Thirteen years since the publication of the first Star it was time to look at how well the suite of tools had stood the test of time and how Triangle and the Star need to develop to stay at the cutting edge of practice. As part of the review we carried out a summer survey of our clients to find out what difference the Star makes. I know that people love the Star, so I was expecting broadly positive findings, but the level of appreciation and impact took me by surprise. Here are a few highlights:

  • 87% of Star users report that their keywork is more effective as a result of using the Star
  • 81% said that Star data reports enabled them to monitor and report on their outcomes more effectively
  • 95% say that the Star supports good conversations and collaboration between staff and service users
  • 92% say that helps service users to get an overview of their situation
  • 93% say that the Star supports person-centered, strengths-based working
  • 92% say that the Star is motivating for staff and service users because it makes change visible.

There were so many stand-out findings that it is hard not to keep adding more, but you get the idea. Of course there are always things that can be improved, but it was heartening to hear that many of the developments people were asking for focused around the Star Online so it was wonderful to know that in just a few months those needs would be met.

Not only do the findings underline the positive way that the Star helps workers take an enabling, strengths-based approach, but they are also a powerful affirmation of Triangle’s decision to invest heavily in implementation support through our client services team, our trainers and our regionally based implementation leads.

Research shows that better results are obtained from good implementation of a poor tool than from poor implementation of a good one. We aim to provide both an excellent tool and excellent implementation support. It is so affirming to see that this powerful combination is really making a difference. 

The strategic review concluded that the Star is a tool whose time has now come because of the increasing recognition of the importance of person-centred, outcomes focused collaborative working. Although it is well known in some sectors and regions, it is still largely unknown in many others so the potential for further impact is substantial. A key theme for 2020 and beyond will therefore be doing more to communicate what the Star is, the way that it can transform service delivery and the wealth of research behind it.

An organisation with a mission

As well as fact finding, our strategic review also involved some deep reflection and soul searching on Triangle’s role in the current service delivery climate. We are painfully aware that the service delivery landscape has changed since 2006 when the first version of the Star was published. Assumptions that if someone is motivated to change then the services will be there to support them no longer hold. Many services are now much lighter touch and can find it challenging to make the time for an in-depth conversation about needs and plans. This has resulted in requests for ‘lighter touch’ or self-completion Stars.

Should the Star stick to its original formulation as a comprehensive and reflective tool or adapt to new realities? There are no easy answers, but we have re-affirmed and sharpened our mission as an organisation that is committed to both advocating for an enabling approach to service delivery and helping service providers make this a reality in practice.

We now begin a new strand of work to shape the debate around what matters in service delivery through research, blogs, conference presentations and making links with the many others advocating for this kind of approach.

Drawing together the evidence base

The Outcomes Star was born out of practice rather than research and quickly took root because many organisations were hungry for a tool that would evidence the effectiveness of their work without getting in the way. When they discovered that the Star positively helped them achieve their outcomes, there was no stopping it. 

As a result, the formal research evidence for the Star lagged behind its use. 2019 was the year that changed and we were finally able to draw together a decade of work on validation to publish psychometric factsheets on nearly all versions (we are still collecting the data on very recently published Stars). 2020 will see the publication of a paper in a peer-reviewed journal setting out the psychometric properties of the Family Star Plus, the most widely used of the suite of Stars. This is an incredibly important landmark for us in establishing the Outcomes Star as a different kind of tool that straddles the aims of both promoting and evidencing change.

Hello and goodbye

Closer to home, 2019 has been an important year of hellos and goodbyes. Hello to our first Managing Director, Graham Randles, who joined us from the New Economics Foundation consultancy service, and goodbye to Paul Muir, our Operations Director who pioneered our work on implementation support and much else besides. Hello to Tamara Hamilton who will be covering Sarah Owen’s maternity leave this year and goodbye to Susan Goodbrand who covered Emily Lamont’s maternity leave. Goodbye also to Roxanne Timmis who has moved on to an exciting new role with Think Ahead, a charity that supports graduates into mental health social work. Best of all, we have said hello to four new babies including Ziya Nisi born on 28th December to Giorgia, one of the staff at Unique Outcomes, our Australian implementation partner.

And finally

Triangle also gave birth to five new Stars in 2019 in a year of unprecedented Star development activity. We now have a Star for preparing for the end of life. Together with our Parent and Baby Star this means the Stars really can take you from cradle to grave.  2020 sees the publication of our new 3-5 year plan, a project to build on interest in the Star in the USA, the full implementation of our new software system and much more besides. 

It is incredible to see how something that started as an approach for one organisation in one sector has evolved and flourished over so many sectors and countries around the world. As we approach a very uncertain new decade, it gives me hope that when people collaborate to address specific issues with commitment, persistence, flexibility and creativity, we really can make a difference.

Graphic introducing the Planning Star - linking to the Planning Star webpage
Image introducting the Preparation Star - linking to the Preparation Star webpage
Image introducing the Pathway Star with a graphic linking to a blog on how the Pathway Star is a person-centered tool
Graphic introducing the Recovery Star Fourth Edition, linking to a blog post on the new Star
Image linking to a blog post introducing the new My Mind Star for use with organisations supporting young people's mental health and well-being

If you have any questions about our new Stars, or would like any information on the new Star Online, or anything else, please contact us on info@triangleconsulting.co.uk or +44 (0) 207 272 8765.

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.

Protecting children and young people from relationship conflict

The Family Star (Relationships) was one of two new Stars published by Triangle in September 2018.  It is designed for services working with families where inter-parental conflict is a major focus, with the aim of protecting their children from the harmful effects and enabling them to thrive.  We recently interviewed Clare Burrell, Head of Strategic Commissioning and Policy for Children and Families at Essex County Council, who was one of the key collaborators spearheading the development, to find out why they invested in the development of this new Outcomes Star and to hear her thoughts on Triangle’s collaborative process.

Clare, could you tell us a bit about your role and how you first came across the Outcomes Stars?
I lead on Early Intervention where, like others, we take a holistic approach to our work.  Five years ago, we set up our Family Innovation Fund which is delivered by voluntary and community providers across Essex.  It is important for commissioners to understand and know that the right outcomes are being delivered and to evaluate the impact of the work.  It was then we took the decision to ensure that all the providers of these services would use the same outcomes tools, so that we could measure apples with apples rather than apples with pears!  The aim was that doing this would strengthen the case for what works and help us develop the economic case for early intervention.  Our intendent evaluators, Traverse, reviewed the outcomes tools available and they recommended we adopt the Outcomes Stars.  As a result we prescribed the Family Stars to our providers and over time, they have come to realise the potential and usefulness of them as tools.

How did your focus around inter-parental conflict develop?
The primary outcome of our work was family stability and through our work with whole families, it became increasingly evident within the early intervention space that if we were going to improve outcomes for children, we needed to focus more sharply on parental relationships.  At the same time, we became one of 11 Local Authorities working with the Department for Work & Pensions, to develop the evidence for what works to reduce inter-parental conflict.  It was then that we partnered with colleagues at Hertfordshire County Council and with DWP, to commission an Outcomes Star that would support our work in this area.  We needed something different to any of the Stars which already existed, to take in the specific intricacies of relationships.

Did you find anything challenging about the collaborative process to develop a Star?
Inter-parental conflict is a relatively underdeveloped area of practice, so there was quite a bit of interesting discussion and some challenges for everyone to agree on the focus and content for the Star. A couple of providers decided not to continue with the process and pilot because the Star didn’t fit with their way of working with families – they didn’t have enough time with parents in conflict or were solely focused on getting an agreement for contact with children rather than working holistically, for example. It was helpful to have a provider with vast experience and knowledge of domestic abuse – they made an invaluable contribution to ensure that the Star didn’t inappropriately stray into that space and that it was clear where practitioners using the Star would draw the line.

What would your top tips be for anyone considering collaborating with Triangle to develop a Star?
I would say there are two main areas.  The first is getting the right people around the table.  It can be hard at times, but it is important that the right voices and heads are in the room for the key Star development sessions.  I focused on the ‘unusual suspects’ – people who came from all different perspectives but who would challenge and mix up our thinking.  It was also important to get people who were committed to the whole of the process, as it takes a considerable amount of time – over a year in our case.

The second is to plan your pilot upfront and think about how you will get buy-in from practitioners.  It’s more than just being in the sessions, it’s about committing to piloting the tool and feeding back throughout the process.  We piloted with our commissioned providers, and some of our in-house services.  This particular Star brought a challenge because it was used only as and when an inter-parental conflict focused case came up, so that limited the amount of data and feedback and made it more difficult to evaluate in a meaningful way, beyond case studies.  That said, practitioners love the new Star and are using it in their work, including in unexpected circumstances – as an example one practitioner has recently used the Star to support a teenager and parent in conflict.

And lastly Clare, what are your hopes for the Family Star (Relationships)?
My plan is that this Star is embedded in practice.  Essex is a big place, but we are doing a lot to make sure that our practitioners know about this Star and that it is part of their toolkit to use with families and that they can draw on it when inter-parental conflict is the main issue for a family they support.

 

Many thanks to Clare for her time for this interview.

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The Family Star (Relationships) is designed for practitioners working to identify and support the resolution of inter-parental conflict so that outcomes for children and young people are improved. It was developed by Triangle in 2017 – 2018 in collaboration with Essex County Council and Hertfordshire County Council.  Please see the Family Stars page for more information about the new variant for supporting parents to manage conflict: the Family Star (Relationships).

94% of practitioners piloting the Star indicated they found the Family Star (Relationships) described the situation, strengths and needs of the service users they worked with either well (either fairly or very well). 80% of parents who completed feedback about the Family Star (Relationships) said it helped them understand what they needed in the way of support.¹  For more information about how Stars are developed, and Triangle’s collaborative process please see our Star Development page.

For an example of Star data in action, please see the recently published evaluation report from OPM Group for Essex County Council’s Early Help Programme, the Family Innovation Fund (FIF). FIF used the Family Star Plus and My Star as primary evaluation tools, with practitioners completing Stars in collaboration with service users, as an integrated part of the Early Help support being provided. Star data was used to demonstrate change, as part of an economic evaluation, and to make the case for early help provision.

Contact Triangle at info@triangleconsulting.co.uk or +44(0) 20 7272 8765 for more information.

[1] 44 initial Star readings were completed during the 6 months pilot period, in frontline services in Essex and Hertfordshire.