Quality Assurance – Development and Implementation

Meaningful Measures

 If you want to improve at anything (singing, golf, cooking, learning a language, leadership, child protection) what’s the most important thing you need to improve?

Timely feedback on your performance!

For our quantitative and qualitative measures to be meaningful they need to deliver feedback that grows learning for the people taking action – and it needs to as close to real-time as possible, so they receive the feedback when they are in action.

  • Parallel to the Signs of Safety practice are learning methods for managers, practice leaders and staff.
  • Group supervision for example draws on a questioning approach akin to Signs of Safety mapping.
  • All Signs of Safety learning methods are deigned to provide feedback loops to assist learning by managers, practice leaders and staff.
  • Real time learning based on actual practice can be scary – think of the range of dynamics in a group supervision or monitoring what actual practice is occurring in all cases in a team – so roadmaps have been developed for each and are available Signs of Safety resources in the Knowledge Bank.

Introducing the Dashboard for Case Management

 MTM have further developed the Signs of Safety quality assurance system to include a dashboard to monitor application of Signs of Safety practice in each case. It is emphasised that no-one element sits alone – it is multiple measurements that tell us what is happening, how good it is and what the impacts on outcomes are.

  • If we want to improve practice we first need to know what practice is actually occurring.
  • Over the years, the most effective teams have had a massive whiteboard where you would see in each case the aspects of Signs of Safety (eg, mapping, danger statements, work with children, networks, safety plans).
  • This reflects how Signs of Safety results logic comes together for each case and whole team.
  • The idea originated in Gateshead, England. Lincolnshire reports working with this in supporting Rotherham preparing for Ofsted, saying what was reflecting that they knew their cases well, had a social work as well as timeliness focus.

Signs of Safety Dashboard

What is the value of this? How could this improve implementation? What are the risks?

  • As a learning tool in supervision with the worker, these are aspects that need to be evidenced on the case.
  • Introducing this might be difficult but easier to swallow if introduced as a learning and reflective tool.
  • Useful for monitoring cases and implementation too.
  • Risk of team managers seeing it as a name and shame exercise – need to thoroughly understand and explain to the workforce.
  • This seems as though this is down the same road as recording how many visits, but not their quality – though can see it does not sit alone.
  • Can see how it will give you a sense of how far you are in terms of implementation but the risk is that we are replacing one set of measures with another such tick box – we are concerned that we use the right tool at the right time, and this may or may not mean the three houses at the point of the flow indicated.
  • The ‘tick box’ risk was shared widely, including by Eileen Munro and reflected MTM’s own internal debate.
  • Andrew Turnell summed this up saying it “worries me too as it could be used as disguised compliance on the one hand, but otherwise I have no clue how many people who are using the Signs of Safety tools”.
  • So, this is the tension we’ve all got to grapple with, it cannot be used as a ‘compliance thing’, it’s about shared knowledge, this is how we do our work, showing people is about constructive work not about compliance.
  • So, you can’t have someone coming it at another level using it to bash people’s heads.

Next steps in quality assurance

  • The introduction of the collaborative case audit in the first wave EIP has resulted in some take up of the tool but more broadly we have seen a shift towards participatory audit process.
  • In looking at how we make more progress making QA more participatory, the collaborative case audit tools need to be more tailored to English conditions, as has occurred in Ireland, and this is work that MTM want to do collaboratively with local authorities.
  • MTM consultants can work with local authorities to develop further the collaborative case audit in location with service managers and QA staff.
  • The dashboard is integrated with the Signs of Safety IT system, other local authorities may look to test the whiteboard approach with teams.
  • MTM’s guiding principle is to work collaboratively with local authorities to see how we can support managers more to support the practice.