Adult social care support and community health: draft Scottish learning and improvement framework

6. Scottish Learning and Improvement Framework Outcomes

The outcomes we will use to track whether improvement has been made, have been developed using evidence from consultation with people with lived and living experience and are based on what matters to them. They focus and relate to the end result or impact of activities and support, and are aligned to the Health and Social Care Standards. They are intended to be used to support the tracking of impact, as well as the recognition of successes.

Outcomes for priority themes:

• Ensuring person-led practice and a human-rights based approach is embedded as the way care and support is delivered.
• Creating integrated systems and processes of care which enable rights-based delivery.
• Supporting people who provide unpaid care.

Improvement outcome:

People, including Unpaid Carers are enabled to live a good life as independently as possible in a place of their choosing.

Contributory outcomes support achieving the improvement outcome and three examples of these are:

• People are connected and supported through their local communities
• People have an active role in maintaining their health and wellbeing
• People experience coordinated care and support delivered by a workforce working effectively across the system

The outcomes are for:

• People who use services
• Unpaid carers
• Families of people who use services

Intermediate outcomes include:

• People experience quality, reliable, safe and consistent care and support that is right for them, through their life course.
• People are able to participate in community, employment and education, if they wish to do so.
• People experience flexible and responsive care and support to meet their needs, provided through quality relationships.
• People’s rights are protected, respected and upheld.
• People are actively involved in their care decisions, or the care decisions of the people they care for.
• Peoples’ journeys are integrated with smooth pathways.   
• Leadership and workforce are able to consider future needs in care planning.

How people feel – this is linked to the Health and Social Care Standards and includes:

• I have confidence in the people who support and care for me.
• I experience a high-quality environment if the organisation provides the premises.
• I have confidence in the organisations providing my care and support.
• I experience high quality care that is right for me.
• I am fully involved in all decisions about my care and support.

Outcomes for priority theme:
Supporting the workforce

Improvement Outcome:
The adult social care support and community health workforce is thriving.

Contributory outcomes support achieving the improvement outcome and two examples of these are:

• Workforce work together effectively across system boundaries.
• Workforce work in a system and culture that supports high quality, safe, human rights based care as standard.

Outcomes for whom:
The health and social care workforce

Intermediate outcomes:

• Workforce have autonomy within professional boundaries to respond to need.
• Workforce develop the knowledge, skills, competencies and confidence to deliver safe, effective and high quality care.
• Workforce are supported to contribute to planning, improvement and embedding change.

How people feel:

• Workforce feel valued, respected and empowered.
• Workforce feel adequately skilled, confident and supported to provide high quality, safe and human rights based care as standard.

Outcomes for priority theme:
Embedding Ethical Strategic Planning, Commissioning and Procurement

Improvement Outcome:
People, including unpaid carers, are enabled to live a good life, as independently as possible, in a place of their choosing.

Contributory outcomes support achieving the improvement outcome include:

• The adult social care support and community health system is continually improving and making best use of resources.
• Planners and commissioners work in ways that advance equalities and human rights.

Intermediate outcomes:

• Commissioning partners are working towards strategic aims and continuously learning.
• Assurance that what is commissioned meets need and supports sustainable service provision.
• Workforce have tools and processes to provide high quality, safe and human rights based care as standard.

How people feel:

• Professionals at all levels feel confident in data to inform decisions.
• Committed to the process of learning and improving.

A range of different types of data are required to be able to track people’s experiences and outcomes, and to adequately measure the extent that people’s quality of life is changing. This includes both quantitative and qualitative data. A discovery and testing phase is planned for the framework to develop a robust approach which provides meaningful intelligence at every level of the system.

Links with Getting It Right For Everyone (GIRFE) Principles

The Scottish Government is also currently working with pathfinders and partners to co-design Getting It Right For Everyone (GIRFE) with people with lived experience. The GIRFE principles align with the SLIF priority themes and improvement outcomes. These principles are set out in Annexe 3. The GIRFE approach strongly aligns with the PANEL principles and provides a model and tools that support the delivery of a Human Rights Based approach in practice.

While the SLIF intends to support all professionals and organisations working in adult social care support, social work and community health to capture intelligence around their improvement activities, and support the embedding of an improvement approach, GIRFE looks to provide a practice model and associated tools across all of health and social care, providing a more personalised way to access help and support when it is needed.

GIRFE is about placing the person at the centre of all decision making that affects them to achieve the best outcomes, with a joined-up, coherent and consistent multi-agency approach regardless of the support needed at any stage of life. The SLIF, by providing a framework to capture intelligence around improvement work, will also help demonstrate the impact of GIRFE across Scotland. By providing a common framework, it helps support teams across services to work together around the person to improve experiences of those using health and social care services, in keeping with the GIRFE approach.