SETTING THE SCENE

The new performance and improvement framework for social services in Wales consists of the code of practice as well as a series of guidance documents that bring together a number of key elements into a single toolkit for local authorities to use in their understanding of how social care is delivered locally and nationally and the impact it has on the well-being of individuals in Wales.

The new Code of practice relating to the performance and improvement of social services in Wales comes into effect in April 2020. Produced by Welsh Government in collaboration with local authorities and social care stakeholders in Wales, it describes Welsh Government’s ambition to use a range of methods to collect, analyse and understand data and evidence on the delivery of care and support, and support for carers across Wales.

The Code of practice in relation to measuring performance and improvement of social services in Wales defines how local authorities must collect data and evidence and its relationship to the delivery and impact of social care to the people of Wales. The metrics developed in the new performance and improvement framework are simple single-sided counts of activity that collect data relating to local authorities’ exercise of their social services functions. Specific metrics have the ability to be combined to create measures that are able to quantify how well a local authority performed in relation to the requirements defined within the Social Services and Well-being (Wales) Act 2014.

The purpose of collecting data on performance and activity should not be considered in isolation of the other components within the performance and improvement framework. The data collected forms a part of the overall evidence base and should be used in conjunction with other forms of data and evidence to provide a complete picture and understanding of social care, both at local authority level and by Welsh Government at a national level.

This guidance relates to supporting the expectation that local authorities should gather their own data and evidence in order to better understand the context of local delivery of social care and what is most important to them at that point in time. This is to support and encourage local authorities to gain better insight into aspects of social care at a local level by further developing data extraction, analysis and reporting over and above the national requirements so they can fully understand the nature and impact of their work.

‘What counts as knowledge and whose knowledge counts?’

Hodgson and Canvin, 2005

What do we mean by effective evidence?

A longstanding debate in health and social care revolves around questions of how ‘evidence’ is defined and whose knowledge, or evidence, counts. For the purposes of this Resources Guide, we are using the following definition of effective evidence, which has been developed in discussions with local authority staff in Wales.

Taking a whole system approach

Sandra Nutley and her colleagues at the Research Unit for Research Utilisation, University of St Andrews[1], a team of well-respected academics who have published widely on ‘what works’ and the use of evidence in practice, suggest this is a complex task.

It requires taking a whole system approach to using evidence that gathers and applies evidence across three aspects of any organisation involved:

Practitioners: having evidence that is engaging and can be applied in practice.

Embedded systems: research evidence to design organisational systems, processes and environments in ways that allow practitioners to use and apply the evidence they engage with.

Organisational culture: having good learning environments within organisations that make practitioners feel valued, safe and able to experiment and try things out.

The Developing Evidence Enriched Practice (DEEP) programme, developed in Wales, has a range of tools and approaches to support taking a whole system approach to the generation and use of evidence. To find out more please look at the DEEP website.

Using evidence to inform practice is beyond the scope of this web resource, but some starting points to consider are:

‘Community of enquiry’

Community of Enquiry Guide. IRISS.

This provides a practical step-by-step guide to using a community of enquiry approach.

Developing Evidence Enriched Practice (DEEP).

Developing Evidence Enriched Practice: Improving Lives Through Story Telling.

Developing Evidence Enriched Practice (DEEP) approach in service and workforce development. A Handbook.

Effective evidence: a consensus definition

Effective evidence helps develop an understanding of phenomena and answers questions. It is contextual, relevant and timely, drawing on different sources of knowledge (e.g. research, lived experience, practitioner and organisational knowledge). Effective evidence is accessible, and all relevant individuals can engage with it. It is useful and can lead to improvement, but it is also open (transparent) about its limitations.

Research Into Practice examples

Below are case studies of evidence informed performance improvement.

How professionals and carers involved in the supervision of direct contact between looked after children and their birth families can achieve the best possible way of improving contact.

This study addressed the issue of how to improve contact for looked after children with their birth parents. Nine people (seven social workers and contact supervisors as well as two foster carers all in one urban social service setting) and analysed available research using group reflection as well as the researchers analysis. The aim of the interviews and research was to identify what were the common themes and issues. The process started from a conventional linear process but developed into a qualitative narrative with a high focus on reflection and the reconstruction of participant’s experiences. The outcome of the project was that a more attachment focussed model of assessing contact was needed that could reflect the narrative for looked after children and would be a step towards improving the outcomes for them.

SAE 2017/18

Refreshing Respite - gathering and using diverse types of evidence in a review of respite care.

In early 2019, the West Wales Care Partnership[2] decided to undertake a review of respite care services across the region. Working with the Wales School for Social Care Research in Swansea University, they began by exploring research evidence and organisational evidence about respite from other parts of the UK and then used this as a catalyst to gather local contextual knowledge from carers, practitioners and the people they support. They achieved this through Exploratory Talk[3] discussions in each of the three counties. These discussions were audio-recorded, transcribed and then analysed for key themes. These themes and many of the associated stories and quotes were then shared in a regional event involving a researcher, senior managers, practitioners, carers and the people they support. Participants at this event work collectively to identify a set of principles and priorities for development, which were then incorporated into the Refreshing Respite report and associated recommendations. Key themes raised during the day were also woven into a poem that was shared at the end of the event. This poem supported a connection between head and heart in what matters most. Members of the Partnership are currently taking some of these themes forward, including an exploration of how local hospitality services can contribute to providing short breaks for carers. Their dialogic approach to exploring and using diverse types of evidence had the additional benefit of building relationships and trust between carers, practitioners and managers.

North Wales Research, Innovation and Improvement Coordination Hub

The North Wales Research, Innovation and Improvement Coordination Hub is carrying out a review of innovations in health and social care that took place due to the Covid-19 pandemic. The work will use Most Significant Change techniques to capture people’s stories about the changes that took place and to learn from them. The findings of the work will be used to identify which changes we should keep and where we need to improve, particularly around integrated health and social care and the use of digital technologies.

Do you have a case study you would like to submit? If so please get in touch using the from below: