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 well-being.

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

Examples of personal outcomes:

• “I want to get to school on time like the other kids and have 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 that we don’t live together”
• “I want to go to swimming classes, but I need to know that 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 within the context of 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.

A person might attend a parenting group, have a walk-in shower fitted or have 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.

By responding to what matters most to people, we can improve their health and well-being. Working with people in this way is called an outcomes approach.

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 provides the legislative framework for us to do this. It 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 that helps 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, such as:

• 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 for children, young people and adults whether they receive care and support or not.

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

Personal outcomes 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.

The Social Services and Well-being (Wales) Act 2014 recognises that the workforce and their skills are an important resource. Often it is the best resource we have to offer people.

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

Maintaining a focus on people’s strengths is a key part of an outcomes-focused approach, but this means asking the right kind of questions and allowing the conversation to 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 express empathy
• explore concerns and aspirations
• expect natural defensiveness
• support the person’s sense of their own abilities
• avoid arguments and confrontation.

The following training videos show a worker having a conversation with mum. 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.

Here are some resources that can help you understand the principles of an outcomes-focused approach.

The principles of the Social Services and Well-being (Wales) Act 2014 include:

• an emphasis on promoting well-being
• a preventative approach
• greater voice and control for the individual
• working co-productively with individuals and their families and friends

The IAA service makes an important contribution to meeting these principles. In particular, the ‘what matters’ conversation sets the scene for establishing a positive and co-productive relationship with people who are requesting support.

Conversations that happen within the IAA service will have a particular emphasis on helping people think about their outcomes and identify their strengths and those of their family and community.

We have developed a training pack for those working in IAA Services to enable them to have better conversations.

People in Wales, including those with complex care and support needs, want to live in their own homes and communities with the support they need, when they need it. Domiciliary care is one way of supporting people to stay at home.

We’ve developed a training resource to help domiciliary care staff take an outcomes-focused approach to their practice.

The resources are designed so they can be used in any order and might be useful for: supervision, team meetings, training and peer support. 

The resource can also be used to support staff who are undertaking the All Wales Induction Framework for Health and Social Care (AWIF). We have identified where they align with the AWIF in the guide.

Contact us for the full downloadable pack.

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Balancing rights and responsibilities can be difficult as risk is often seen as something to be avoided and that is controlled by professionals, instead of being part of a shared decision-making process.

In reality, taking some risks is an important part of everyday life that supports people to do what matters to them.

We have commissioned a study to help understand how professionals who support people can move towards shared decision making. The study found that decision-making should be:

• Balanced - recognising the potential for benefit as well as the risk of harm, and considering the possible emotional, psychological and social impact of each option as well as the physical
• Defensible - well-founded, justifiable and recorded proportionately, not defensive or driven by the need to protect ourselves and our agencies
• Collaborative - with people who use services, their families and other professionals, using all available resources to achieve the outcomes that matter most to people.

You can read the full report below.

There are at least 370,000 carers in Wales. At 12 per cent, Wales has the highest proportion of carers in the UK, many of whom provide more than 50 hours of care a week. Census records tell us that there are over 30,000 carers under the age of 25 in Wales, 7,500 of whom are under the age of 16.

The Social Services and Well-being (Wales) Act 2014 ensures that all carers have a right to an assessment where it appears they may have needs for support. The assessment must consider the outcomes the carer wants to achieve, which is why a ‘what matters’ conversation needs to happen right at the very beginning of any interaction with a carer.

We’ve developed a toolkit of four resources to help practitioners assess carers’ support needs. 

The resources will help practitioners carry out good quality carers’ assessments and will guide practitioners in working with carers and families to find out what really matters to them and enable them to achieve their outcomes.

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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 all people who need care and support and carers who need support, their families and friends, and for all 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.

It describes well-being and provides a consistent approach to measuring it.

People will want to achieve outcomes that are personal to them in their own circumstances, however reporting by authorities will be against the national indicators as explained in the national outcomes framework.

These resource pages are continually being developed. We will be launching more resources and information soon, so please share this with your colleagues and check back regularly.

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