Key Findings & Lessons from Evaluation studies of SDS Test Sites in Scotland (WS64)
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Presentation on findings of evaluation of SDS local authority test sites in Scotland, including key findings and lessons from the study. Discussion about the wider implications for policy and practice in Scotland. Contributor: University of Lancashire
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Key Findings & Lessons from Evaluation studies of SDS Test Sites in Scotland (WS64)
- 1. Key Findings & Lessons from Evaluation studies of SDS Test Sites in Scotland DR JULIE RIDLEY & DR ANN ROSENGARD SOCIAL SERVICES EXPO – 19TH MARCH 2013
- 2. Purpose of This Session 1. To provide an overview of the test sites 2. To present key findings of our evaluation 3. To highlight emerging lessons for policy & practice Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 3. Overview of the Test Sites Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 4. Evaluation of SDS test sites in scotland Review of Test sites 2009-2011: Clarified development of 3 Test Sites, processes of implementation, and the impact of SDS Follow up study 2012: Assessed continuing development and longer term impacts, including the impact of financial context on SDS Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 5. Evaluation METHODS - 2009- 2012 Multi-method, participatory, developmental •Literature review & documentary analysis •Interviews •Learning Sets •Quarterly monitoring framework •Questionnaire survey of care managers Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 6. Samples Test sites : •22 national stakeholders interviewed •93 test site stakeholders interviewed •30 SDS case studies (service users, carers and care managers) •60 participants at Stakeholder event March 2011 Follow-up : •67 local & S-G stakeholders interviewed •213 questionnaire responses from care managers in 2012 Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 7. Different Entities Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 8. Leadership & Training • ‘Transformational’ change • Role of dedicated/ specialist resources • Training – issues include: breadth, depth; reach and resources Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 9. CUTTING ‘RED TAPE’ • Irony - more bureaucracy to reduce red tape... • ‘Light touch’ monitoring (CIPFA) overly bureaucratic Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 10. Bridging Finance • BF was valued by all test sites • But test sites struggled to use BF • Lack of clear information on specific changes Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 11. Structures, approach & reach of test sites DUMFRIES & GLASGOW HIGHLAND GALLOWAY Personalisation Team SDS Team managed via SDS Team managed by STRUCTURE Head of Mental Health Head of Children’s managed by Senior and Adult Support & Services Social Work Manager for Protection and Assistant Reporting to SDS Project Wigtownshire. Reporting Director of Social Care, Board mainly of local to Executive Group and Reporting to Health and authority staff. Social Care Policy multi-agency Development Committee. Personalisation Programme Board Part of existing plans to Built on IB Pilot in East Specifically aimed to APPROACH implement Glasgow with people with increase number of DP Personalisation; learning disabilities; recipients; Community development; Partnerships with Significant number of one organic; bottom-up; voluntary organisations off payments Developed separately Developed separately Developed separately from DP from DPs from DPs Adopted open criteria Targeted at people with Targeted at young REACH/SCOPE with test site initially learning disability in East disabled people in covering Wigtownshire of City but expanded transition. but covering whole of before end of test site. Not geographically region before end of test focused site Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 12. Promotion & awareness of SDS • Range of promotional activities • Increased awareness coupled with uncertainties and anxieties • Discrepancy between aspirational presentation and reality • Increasing promotion had implications for capacity of SDS Teams • Test site information aimed at learning disability • Whilst receiving training, care managers generally felt they were not suitably trained to access SDS Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 13. assessment • Systems - ‘too learning disability orientated’ • SDS & Single Shared Assessments • On-going development as SDS rolled out • Test sites developed supported self assessment & outcomes based support plans • Initially, little involvement of independent advocacy evident • Emphasis should be on the process rather than forms Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 14. CARE MANAGERS’ PERCEPTIONS OF SDS ASSESSMENT LOCAL HELPFUL UNHELPFUL DON’T KNOW AUTHORITY D&G 32% (17) 54% (29) 14% (8) Glasgow 35% (37) 63% (67) 2% (3) Highland 42% (14 39% (13) 19% (6) Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 15. resource allocation • RAS (In Control) in D&G and Glasgow, equivalency model in Highland • Development of RAS highly complex • Challenge in terms of equity and system to meet different needs • Emphasis on transparency, however, D&G found upfront allocations stifled creativity • Systems still being tested • Strategic choices re risk Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 16. Summary findings - process •Promotion is critical and can increase uptake •Good quality information as well as flow and reach key to increasing control & choice •Strategic choices re implementation have import for processes and outcomes •Taking a ‘Project’ approach brings gains and limits •Pace of implementation affects processes/ experience •Need integrated collaborative approach, but slow movement – e.g. DP & SDS systems; SDS & AP; Cross- boundary working Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 17. OUTPUTS - individuals with sds packages T-S Evaluation Follow Up Number Overall 132 1,011 Client groups 64% learning disability 59% learning disability 23% physical disability 19% physical disability 7% older people 6% disabled child 3% mental health 3% older people 1% disabled child 2% mental health 2% other 11% other Gender 52% male 57% male 48% female 43% female Ethnicity All white British/Scottish 4.3% BME groups SDS option 107 DP 552 DP (could be multiple) 24 ISF 858 ISF Funding stream SW + client contribution SW + client contribution Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 18. service users and carers PERCEPTIONS OF PROCESS • 30 case studies • Assessment felt to be comprehensive & inclusive • Most service users and carers felt SDS expanded choice and control • However, may reflect extra resources during pilot? • Variation in flexibility- e.g. employing relatives, legitimate activities • Variation in cross-boundary/ joint working Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 19. SUMMARY FINDINGS – OUTCOMES & IMPACTS • Importance of independent advocacy to increasing control and choice • Inequalities of access - phase one, but slowly being addressed • Measuring SDS outcomes is complex - requires attention to monitoring • SDS may be strongly influenced by wider developments e.g. cuts and benefits changes • Financial constraints impact on SDS – need clarity, transparency, flexibility in managing resources Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 20. CARE MANAGERS’ VIEWS – IS SDS BEING USED TO MAKE CUTS? LOCAL SDS USED NOT USED DON’T AUTHORITY TO MAKE TO KNOW CUTS MAKE CUTS Highland 29% (9) 32% (10) 39% (12) (n=31) D&G (n=56) 13% (7) 54% (30) 34% (19) Glasgow 81% (84) 13% (14) 6% (6) (n=104) Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 21. CARE MANAGERS’ VIEWS – HAVE CUTS AFFECTED SDS? LOCAL CUTS CUTS DON’T AUTHORITY AFFECT DON’T KNOW SDS AFFECT SDS Highland 45% (14) 10% (3) 45% (14) (N=31) D&G (N=55) 20% (11) 27% (15) 53% (29) Glasgow 91% (96) 3% (3) 7% (7) (N=106) Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 22. SOME Key lessons • Implementing SDS involves transforming social care in a challenging and very uncertain context • Promotion and communications are critical and on-going issue • SDS expertise and capacity need to be developed to enable co-production • Must support and involve user led organisations • Sophisticated info systems needed to support/ capture SDS • Need clarity re funding and eligibility to support Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 23. Group Discussion What are the opportunities and challenges to implementing SDS in your area? Are these similar or different to the test sites? Each table is asked to agree on ONE key issue or to highlight an area you feel needs further exploration. Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
- 24. Further information Ridley, J., Spandler, H, Rosengard, A. et al (2011) Evaluation of Self- Directed Support Test Sites in Scotland - http://www.scotland.gov.uk/Resource/Doc/358197/0121078.pdf Ridley, J., Spandler, H, Rosengard, A. with Menhennet, A (2012) – Follow-up Evaluation of Self Directed Support Test Sites in Scotland - http://www.scotland.gov.uk/Resource/0041/00410610.pdf Contact Dr Julie Ridley: Email- JRidley1@uclan.ac.uk Tel - 01772 893402 Social Services Expo 2013 - Dr Julie Ridley & Dr Ann Rosengard
Editor's Notes
- Three TS chosen, three themes Leadership and training The leadership and training theme would seek to develop a means of increasing awareness, knowledge and confidence about promoting self-directed support on the part of front-line staff, social work middle and senior management and local authority finance officials. Cutting red tape This theme will seek to enable a local authority to cut non-essential red tape surrounding self-directed support provision. This would allow more front line staff to concentrate on their core job and therefore improve the user experience, which we expect to help drive demand for self-directed support. A local authority would be expected to apply a “ light touch ” monitoring process. Investing to save This theme will seek to double fund buildings-based care within a local authority to enable remodelling of the care facilities, while encouraging those clients who use the facilities to adopt other forms of social care in the community, in particular, self-directed support. Local authorities have argued that additional funding is required to “ double fund ” facilities to enable the transition from buildings-based care to more personalised care. (From Letter to test sites from Deputy Director (Adult Care and Support) Primary and Community Care Directorate, December, 2008)
- Assess process and impact of SDS in Test Sites: Describe SDS policy, activity, and practice Develop tools and frameworks with Test Sites Examine implementation Assess impact Identify implications & lessons Assess continuing and longer term impacts: Assess continuing uptake Identify activities to further promote and increase awareness of SDS Identify system wide change Assess shift towards greater involvement and co-production Understand impact of wider financial context
- Literature review – published earlier this year Learning sets – attempt to involve those most closely linked with the test sites from different perspectives in reflecting on the test sites and making evaluative judgements. Quarterly monitoring framework – based on each test site ’ s action plan plus cohort form to capture info on individuals thru the test site Case studies – to explore direct experience of new processes Range of respondents/informants involved – Service users and carers – case studies, learning sets Test Site Project Teams/Programme Boards Heads of Service in LAs DP Teams in LAs and support organisations Care managers/social workers Finance & Adult Protection leads Commissioning staff Providers Service user and carer organisations National bodies including SPAEN, SDS Scotland, In Control, Independent Living Scotland, ADSW, People First, SCLD, Alzheimer Scotland, VoX, Community Care Providers Scotland
- Test Sites set own parameters – set own action plans. Evaluation tied into local plans Definitional issue re SDS – evolved during evaluation period Comparing different approaches Evolving approaches – need to focus on processes Not presenting league tables. By and large didn ’ t set targets – some set in relation to nos of people they would do SDS packages with but notional. not comparing apples with apples, but rather apples and oranges and pears! The TS were therefore unique although they were held together by the common focus on three themes.
- Impact depends on reach and engagement – some planning, resources, some to circumstances
- In time available not addressed Finance bound to be the big issue Does there need to be a different mechanism to BF?
- Talk about role of the specialist teams – promotion and awareness, designing new systems, support to practitioners, involved in cases, troubleshooting
- Cohort form to capture some client characteristics and as measuring SDS not just DPs, to record type of SDS option chosen as well as funding mix Not going into detail, an overview, info in the report 132 – D&G 35, Glasgow 57 and Highland 40. Each site had in the pipeline cases at early stages of SDS process engaging with around 100 people in each. Recruitment to TS different methods – geographical, specific groups, people self selecting – all of these will have impact. D&G adopted open criteria and had widest range altho ’ largest group LD. Gender – proportions differed between test sites with nearly twice as many men as women in D&G, while this reversed for Glasgow. Age – range greatest in D&G, more yp in Highland not surprisingly – 73% under 25 yrs All white no BME SDS option chosen predominantly DPs, ISF did not play a major part in the SDS packages despite the test sites adopting broad definitions of SDS. Few had mixed packages – only D&G recorded this. However the case studies showed more prevalent than the cohort form suggests.