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Understanding an outcomes approach

Learn how the outcomes approach focuses on improving well-being by understanding what matters to people and developing personal outcomes.

What are personal outcomes?

Personal outcomes describe what a person wants to achieve. These are realistic goals that the person receiving care and support, and their care worker or carer can work towards. They are usually based around supporting the individual’s wellbeing.

Outcomes will vary from person to person and child to child because they’re about what matters to that individual.

Some examples of personal outcomes are:

  • “I want to get to school on time like the other kids and have a clean uniform”
  • “To be able to go back home, build my confidence and live on my own like I did before”
  • “I want to see my brother, speak to him and spend time with him and not lose touch now we don’t live together”
  • “I want to go to swimming classes, but I need to know my husband will be okay and that someone will be there for him when I’m not.”

Personal outcomes should be:

  • driven by the person’s aspirations – they are unique to the person and their life
  • realistic – it can’t be the same as it was, so how can I adapt, manage, remain hopeful and feel in control?
  • achievable – what strengths have I got to deal with the future? What resources do I have within myself, my family, friends and community?
  • meaningful – addressing the person’s real concerns and dilemmas
  • evolving and changing – accepting that nothing stays the same.

Personal outcomes are not services or resources.

Some example of services and resources are:

  • A person might attend a parenting group
  • have a walk-in shower fitted
  • receive a home care service

These are the things the person does or is provided with (the inputs) to help the person to achieve their outcomes, but they are not an outcome in themselves.

Try this exercise to see if you can identify the personal outcome statements.

This booklet gives a summary of how to use personal outcomes:

Watch this video where trainer Rhoda Emlyn-Jones explains the background and principles of using an outcomes focused approach:

Watch this video where social worker Tina describes the values behind using an outcomes focused approach:

Why is an outcomes approach important?

By focusing on what matters most to people, we can improve their health and well-being. Working with people in this way is called an outcomes approach because this is how we support people to understand and achieve their personal outcomes.

The aim of an outcomes approach is to make sure that people who receive care and support and their family or unpaid carers are supported to live the best lives possible, building on their own strengths and capabilities. It also requires organisations to focus their resources on the impact they have, as well as the activities they carry out.

The Social Services and Well-being (Wales) Act 2014 requires us to focus on people’s well-being and put them at the centre of their care and support planning.

An outcomes-based approach is based on these principles:

  • People are experts in their own lives
  • They are best placed to tell you what’s important to them and what gives them a sense of well-being, but they may need help to do this
  • People want to do the things that matter most to them, in their own way
  • People’s strengths are important and need to be acknowledged
  • We start by identifying what the person wants to achieve, and then thinking through how to achieve that outcome and agree a plan to help them to do this
  • The person’s family, carers and local community can also contribute to this plan
  • Meaningful conversations are central to understanding a person’s outcomes
  • A personal outcome is the picture the person paints of what it is they want to achieve.

A sense of well-being comes from things like:

  • relationships
  • feeling loved
  • being respected
  • having a sense of purpose
  • making a useful contribution
  • the little things...that make life feel worthwhile.

This is the same principle for children, young people and adults, whether they receive care and support or not.

Listen to a parent explain how a practitioner taking an outcomes focused approach helped her to change the way she interacted with her children:

In this video, Mr Britton and his worker reveal how they worked together in an outcomes-focused way to find out what mattered to him.

This story highlights Andy’s journey which has been a difficult and long one at times but shows the positivity of collaborative working. Hear from Andy and the team of professionals who worked with him to achieve his outcomes.

How to find out what matters to people and agree their personal outcomes

An outcomes approach prioritises good conversations with people about what matters to them over gathering data for organisational purposes. The focus on personal outcomes provides opportunities for the person to reflect on their life, reduce the assumptions made by others and improve understanding between everyone involved.

The most valuable conversations are the ones where people feel really listened to. In being listened to, people often start to make sense of their own situation as they can put time and thought into it.

A good way to remember the core skills for having a good conversation with people is the word OARS:

  • Open ended questions
  • Affirm – notice strengths
  • Listen Reflectively
  • Summarise in an empowering way.

focus on people’s strengths is a key part of an outcomes-focused approach, but this means asking the right kind of questions and letting the conversation flow:

  • engage with people and help them explore their hopes and fears before putting a plan in place
  • explore the pro and cons – help people think and talk
  • help people build on their strengths and those of their family and community
  • help people notice their achievements and anticipate threats.

Remember to:

  • listen carefully and show empathy
  • explore concerns and aspirations
  • expect natural defensiveness
  • support the person’s sense of their own abilities
  • avoid arguments and confrontation.

Here is a resource that gives examples of strengths-based questions you can use at different points of the conversation. These hints and tips can help you build a good conversation, avoid traps and support people to focus on what is strong, rather than what is wrong.

The following videos show a worker having a conversation with a parent. This is their first conversation – it has been prompted by a referral received by social services.

The first video shows the worker focusing on paperwork and risk. This isn’t using an outcomes approach.

The second video shows the worker using an outcomes-focused approach, building trust and helping mum talk about what has happened.

How do personal outcomes link to the National Outcomes Framework?

The Welsh Government has a clear commitment to improving the well-being of people in Wales and places it as a central principle in all its policies.

The National Outcomes Framework is for:

  • any individual who needs care and support
  • carers, friends and family who need support
  • any services undertaking social services functions under the Act, such as local authorities, social enterprises, co-operatives, user led services, the third sector and the independent sector.

The Framework describes well-being and gives a consistent way to measure it. People will want to achieve outcomes that are personal to them in their own circumstances. However authorities will need to report these outcomes against national indicators, which are explained in the National Outcomes Framework.

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