Feedback from the Trial of Better Futures

PAPER 2

FEEDBACK FROM THE TRIAL OF BETTER FUTURES:

March – December 2011

Yvette Burgess,

Unit Director,

Housing Support Enabling Unit
8 - 12 Torphichen Street
Edinburgh
EH3 8JQ

0131 229 9468

January 2012

FEEDBACK FROM THE TRIAL OF BETTER FUTURES:

March – December 2011

This document is based on a report presented to the Better Futures Steering Group on 9th December 2011 by Yvette Burgess, Unit Director, HSEU

Background

The Better Futures system was launched on 8th March 2011 and became available for use on a trial basis up to 30th November 2011. During this time organisations could register on the system and use it free of charge with no further commitment. The objectives of the trial period were to:

• enable organisations to examine the system and decide if they would want to use it beyond November on the basis that they contribute to the running costs of the system
• enable organisations to prepare to use the system by integrating existing systems with Better Futures and organise training for staff
• enable organisations to input sufficient data into the system so that they can decide whether to continue using the system beyond November 2011
• attract at least 20 organisations to use the system beyond November 2011 on a fee paying basis

Gathering feedback

Throughout the period the HSEU has maintained contact with key contacts at each organisations registered with Better Futures. Bi monthly meetings have been held with key contacts so that feedback could be gained during the trial period. This has resulted in some further development of the system. In addition to these meetings the Unit has attended meetings in Argyll, Aberdeenshire and Inverness to hear about experiences of using the system at first hand. The Unit has also conducted a series of information sessions and training events and recorded key issues raised.

Access to the system

44 services registered to use Better Futures but four have confirmed that they do not wish to proceed on the basis of having decided to use other outcome measuring systems such as the Outcomes Star and a mental health outcomes system.

As at 1st December 41 organisations remained registered on the list (see Appendix 1)

In addition to this there are 3 local authorities who have access to the system as commissioners.

238 system users have access to the system out of a possible 975. This is somewhat lower than expected. Initially each organisation was allocated up to 20 system users. There has been a wide variation in the number of system users each organisation has requested. Many have only asked for one but others have asked if they could go beyond the 20 limit. For this reason the maximum limit has been increased to 30. Those organisations which decide to continue using the system are likely to request that more staff are given access to the system as the use of Better Futures widens out post-trial.

Use of the system

The use of the system can be gauged by the number of client records input by an organisation. Up to 1st December the following picture was built up by the Unit:

On the basis of these figures it looks likely that the target of 20 organisations deciding to use the system into December 2011 and contribute to the costs beyond November 2011 will be met. The above figures do include the 9 organisations that have registered more recently and will therefore not be charged until 31st March – these organisations mainly fall into the ‘0’ client record group.

Commissioners access to and use of Better Futures

Three local authorities have access to the system as commissioners. They are Aberdeenshire, Argyll & Bute and Renfrewshire.

At least 5 other local authorities have expressed an interest in using the system in this way.

The actual use of the system by commissioners has been limited during the trial. Only Argyll & Bute has run reports about services operating in its area. Aberdeenshire is currently focusing on using the system as a service provider and Renfrewshire Council has only recently gained access to the system.

Local authorities are currently showing greater interest in Better Futures in order to demonstrate the value of services they provide themselves rather than as a way of monitoring external services.

The scoring framework

The matrix scoring system has been developed over a period of 5 years and has gone through much consultation and some amendment during that time. Not surprisingly, therefore, it tends to be greeted positively amongst staff otherwise new to the system. The main concern about the scoring system has been how to ensure consistency. This was an issue which was discussed at both the Argyll and Aberdeenshire user groups. In one case staff acknowledged the importance of discussing the system within a staff group in order to agree how to approach scoring in a consistent way.

During training sessions there have been some ideas put forward for additional topics. These have included:

• personality disorder
• self harm (Moray Council is developing this and may be willing to share with others)
• obtaining furniture
• immigration and residency in the UK (the Scottish Refugee Council is developing this and willing to share with others)
• housing advice and private sector leasing

As organisations develop additional sections which they can then score under ‘Other’ within the 5 goals the HSEU can promote sharing of these sections and include them in the guidance manual subject to agreement by the user group.

Support planning and target setting

The Support Planning tool has generally been well received and the ability to set target scores has been regarded as useful by staff members at training sessions. Where organisations have reviewed their existing support plans and aligned them with Better Futures feedback has been particularly positive. This was evident at the launch of Better Futures when both Aspire Housing and Personal Development and Blue Triangle (Glasgow) HA explained that they had done this and as a result found they were saving staff time. Where organisations have not done this and have continued to use existing paperwork as well as Better Futures feedback has been less positive. One service, for instance, continues to use existing paperwork because its use of Better Futures is regarded to be a pilot. In this case staff have expressed concerns at the resources needed for recording keeping.

Reviews

The three types of review – baseline, standard and counterfactual – appear logical to those new to the system and require little explanation. Most discussion has focused around how to engage service users in agreeing a score which support workers agree with also – and what happens when there is a disagreement. The guidance prompts organisations to deal with this in an open fashion with service users or delay scoring more sensitive issues, such as addictions, until a service user feels comfortable in addressing them honestly with support workers.

Another issue which two local authorities have raised is that they work with some individuals very briefly and are concerned that:

a) they may not see an individual a second time to go through outcomes achieved, and

b) the resources needed to create a record

Better Futures was designed to show outcomes after involving individuals in support planning and at least 2 reviews – rather than after brief interventions. The Unit is aware, however, that some services are exploring this issue further and will consider the extent to which the Better Future systems can help record impact of a service through brief intervention.

Feedback from service users

Service users were involved in the launch of the system in March and expressed enthusiasm for it. These service users had been homeless and had been able to reflect on positive change in their circumstances and the way they had dealt with them. More recently a service user from Blue Triangle (Glasgow) HA has stated ‘it is a brilliant tool and great to see how I made progress. I didn’t think I made that much progress. The visual tool was great……The wheel and diagram had more of an impact than words would ever have had.’ Less feedback has been obtained from other groups of service users so it is not currently clear how older people, for instance, are relating to Better Futures. There is scope to gather such feedback in the future via organisations using it.

Some organisations have reported that they have difficulty in gaining consent from some service users for data about them to be recorded on the Better Futures system. Reasons for this include:

• mention of ‘personal and sensitive’ information on the data consent form
• general unease about the internet in the light of widely broadcast examples of unauthorised access to personal information and resulting theft or fraud
• concern about the access local authorities might have to personal information

In response to this the Unit has drawn up a general leaflet about Better Futures which the Super User Group finalised on 1st December. This leaflet will be printed and supplied to organisations wishing to use it.

Ease of use

Generally system users have been positive about the system during training courses and have commented that it appears logical and straightforward. Alongside this has been an acknowledgement that repeated us of the system helps to become familiar with it. Some additional guidance about how the various screens relate to each other can be developed to help users move between screens more quickly as well as some further editing of the ‘help text boxes’ accessed by each field name to ensure they relate to the Better Futures system rather than the wider Capita Support system.

Internet connection has been more of an issue for some organisations than anticipated. This has made the use of laptops in visiting support services problematic and even services where inputting is carried out at an office base connection can be interrupted or very slow. In one council office it took about 10 minutes for the system to move between 2 screens during a meeting.

There has been some interest amongst system users in new technology that does not depend on access to the internet all the time. A demonstration of digital pens took place for the Super User Group on 1st December. At this stage, however, the costs appear too high to be of interest to most providers.

Some system users have experienced frustration when they have mistyped usernames and passwords. The system blocks access after 2 failed attempts. The Unit is able to re-set the system during office hours. As system users become more familiar with the system this ceases to be a problem. It is typically associated with those accessing it for the first time.

Supporting national policy on social care and support provision

The Better Futures system provides a vehicle for organisations to demonstrate tangible progress towards goals as well as a way of measuring prevention. The recent report on the future of public services by the Christie Commission1 as well as the Scottish Government’s Rehaping Care for Older People strategy2 have reinforced the drive to reduce spend on acute services and focus more on prevention. Interest in the Better Futures system continues to be driven by this. In addition, the recent recommendations made to the Scottish Government relating to homelessness and supported housing3 have highlighted the role which Better Futures can play in charting outcomes of homeless services and the prevention of future homelessness. As yet organisations using the system have still to build up enough data over a longer period of time before most of the reports set up on the system will be informative. This is something the Unit is poised to provide users with further support on over the coming months.

Performance of the recording system

Most queries and bugs raised by the Unit since the launch of the system have been dealt with in a timely fashion although there have been delays associated with new releases. This meant, for instance, that a faulty print button on the review screen took more than 6 months to resolve. Some improvements have been made available to Better Futures as a result of requests made by users of the wider system. An example of this happening is the new facility to hide the names of other clients on the screen so that a service user can view their own review score set, support plan, outcomes wheel etc on the live screen.

Conclusions

The Better Futures system is being taken up enthusiastically by organisations, particularly in the voluntary and Registered Social Landlord sectors. Generally it has taken organisations longer to gear up to creating client records than anticipated. Where organisations have aligned their existing systems with Better Futures rather than treating Better Futures as an extra add on, duplication of record keeping has been avoided and staff are most positive about it. There remain technical issues for some organisations relating to their internet connection but these are not confined to their use of Better Futures. Whilst most organisations have not been using Better Futures long enough to demonstrate distance travelled it is anticipated that at least 20 will wish to continue using the system up until March 2012 to enable them to fully assess the extent to which Better Futures enables them to demonstrate the impact of their services.

1 Report on the Future Delivery of Public Services, http://scotland.gov.uk/Publications/2011/06/27154527/0

2 Reshaping Care for Older People and the draft National Strategy for Housing for Older People, http://www.scotland.gov.uk/Topics/Built-Environment/Housing/access/ROOPH/housing

3 Cross Sector Supported Accommodation Working Group Final Report and Recommendations, http://www.scotland.gov.uk/Publications/2011/11/10102232/0

APPENDIX 1

Organisations that registered with Better Futures before 21st September 2011

Aberdeenshire Council

Share Scotland

Aberdeen Foyer

Inverclyde Association for Mental Health

Balfield Properties

LinkLiving

Lothlorien (Rokpa Trust)

Voluntary Action Lochaber

Transform Community Development

C.H.A.I.

Quarriers

Eildon Housing Association

Argyll & Bute Council Housing Services

Clackmannanshire Council

Glasgow Housing Association

SeAscape

Blue Triangle (Glasgow) HA

HELP (Argyll and Bute) Limited

Renfrewshire Association of Mental Health (RAMH)

Orkney Blide Trust

Falkirk Council

East Renfrewshire Council

Renfrewshire Council

Kintyre Youth Enquiry Service

Dundee City Council

Southside Housing Association

Argyll Bute Womens Aid

Melville Housing Association

Action for Children

Queens Cross Housing Association

Aspire

Hayfield Support Services

Organisations that have registered with Better Futures since 21st September 2011

Sense Scotland

The Moray Council

Highland Home Carers

The Mungo Foundation

Scottish Refugee Council

Loretto Care

Kingdom Housing Association Ltd

Deafblind Scotland

HART (Helensburgh Addiction and Rehabilitation Team)

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