Personal Outcomes Framework
We conducted research and consultation at the request of the Department of Health to develop a framework for outcome measurement for the proposed model of person-centred disability services. In 2016, our 'Outcomes for Disability Services' framework outlining nine outcome domains was approved by the Department of Health and the HSE.
An outcomes-based approach means that an organisation focuses on the individual goals that a person has in the various outcome domains and provides the supports and opportunities needed so that the person achieves what is important to him or her. Outcome measurement determines what kind of indicators are suitable to assess.
Consultations with persons with disabilities confirmed that they considered the proposed nine outcome domains as important ones to have a good life. They highlighted their need to access the supports necessary for them to attain their goals in the various outcome domains. This is in keeping with research and practice, which stresses the importance of appropriate individualised supports to attain personal outcomes.
In 2019, we developed a 'Discussion Paper: Outcome Measurement in evaluating the Quality of Disability Services', to explore the purpose, challenges and limitations of outcome measurement in disability services. It highlighted the need to align outcome measurement with the development of person-centred disability services. Such services provide tailored support and opportunities to each individual with a disability. In this way, each person is in a position to strive for his or her goals and attain a good quality of life.
That work was underpinned by an earlier international review of outcome measures, in our 'Review of International Outcome Measures in Disability Service Provision' report.
Outcomes and Quality Framework
The NDA supported Working Group 4 of the Transforming Lives programme to produce a Quality Framework: Supporting Persons with Disabilities to achieve Personal Outcomes.
The interplay between individualised services and supports and the achievement of personal outcomes is the focus of this quality framework. It was developed to identify the elements of services and supports that facilitate the achievement of outcomes by adults with disabilities.
These elements include person-centred planning, at the individual level, and leadership that promotes a culture of person-centredness at the organisational level.
The outcome predictors in the Quality Framework should support service providers to focus on continuous quality improvement, by establishing person-centred and personal outcomes approaches, and evaluating the presence and quality of the supports that predict personal outcomes.
The Quality Framework has not yet been published by the HSE.
Person Centred Principles and Person Centred Planning Framework
With the input of the NDA, the HSE developed a National Framework for person-centred planning in Services for Persons with a Disability to inform and guide the implementation of person-centred planning across services for persons with a disability in Ireland.
The framework notes that the nine quality of life outcome domains may be a useful reference point to support a person to set their goals and to understand how working towards goals may lead to positive outcomes. It also notes that person-centred organisational culture, structures and processes influence the quality of the person-centred planning process and the achievement of personal outcomes.
We supported the HSE to conduct research and develop the national Framework. The framework builds on our previous work published in 2005, the NDA Guidelines on Person-Centred Planning.
The Framework is also informed by research on learning in the intervening period. The three strands of research carried out to inform the framework for person-centred planning comprise:
- An analysis of 50 HIQA inspection reports to ascertain what they say about person-centred planning in residential services for persons with a disability
- A 360 degree look at a series of person-centred plans as case studies of current practice, along with interviews with key informants with knowledge of person-centred planning in residential services for persons with a disability
- A review of the literature since the publication of the NDA Guidelines on Person-Centred Planning in 2005 commissioned by the HSE and NDA titled 'A Literature Review to Inform the Development of a National Framework for Person-Centred Planning in Disability Services' available on the HSE website.
Staff Competencies and Skill Mix
We produced two reports on the subject of competencies and skill mix for staff in community based disability services.
The first report ‘Staff Competencies and Skills Mix for a Community-Based Model of Disability Services’ establishes what new competencies and skills would be required of staff, and how they might be achieved, in order to support persons with disabilities in newer, community-based more person-centred models of service.
The second report 'A Review of Competency Frameworks for Disability Service Staff' focuses on reviewing existing Irish and international disability services competency frameworks and examines similarities between them. The research will guide next steps, such as consideration of approaches to change management among staff, development of a national competency framework, and identification of good practice in staff rostering and skill mix in community dwellings.