Short Breaks Outcomes Framework

Resources to help evaluate the impact of short breaks and respite care

This page is currently under construction

In this section of the website we have brought together a range of resources to help local authorities and their partners evaluate the impact of short breaks and the outcomes achieved.  These resources  have been developed by Shared Care Scotland in collaboration with local authorities, carers, service providers and users.  The  resources can be accessed from the menu on the right.  This page has been developed around the supporting paper entitled 'Measuring the Impact and Effectiveness of Short Breaks' which can be downloaded by clicking here. 

We hope this framework resource will be a useful starting point for those responsible for planning, commissioning and providing services.   The framework includes information on the relevant National Outcomes which set out what government wants to achieve over the next ten years, and which provide a reference point for the development of Single Outcome Agreements and other local strategic plans.  We have also suggested sources of national data information that might be helpful for developing baseline figures against which local progress in short break provision can be measured. 

Defining Short Breaks

In developing and implementing a performance measurement framework it is necessary to be clear what services and supports constitute short breaks and will therefore fall within the scope of the framework.   These would generally include any services or practical support specifically arranged to benefit the carer(s) by providing a planned break from their normal caring responsibilities, and benefits the service user by facilitating opportunities to spend some time, independently of their normal carer, doing the things they enjoy.  The period of time involved should be sufficient to allow both people a quality break.  Having a break from the routine together, with the help of some additional support, can also achieve good outcomes.

“The break might be for a couple of hours or for much longer.  It might involve the cared-for person having a break away from home, thus benefitting the carer.  Or the carer might have a break away with services being put in place to support the cared-for person.  Some people may want to have a break together with additional support to make this happen.”

The Scottish Government’s 2008 guidance on planning personalised short breaks provides examples of different supports that can enable a break.   The guidance states that a short break should be a ‘positive experience for both’, and that short breaks are effective in:

• helping carers to safeguard their health avoiding physical or emotional exhaustion, and enabling adult carers to continue caring; (While in the case of young carers, the overall aim is rather to prevent inappropriate levels of caring, short breaks have similar benefits of promoting health, wellbeing and social inclusion.)
• preventing social isolation - providing a break from their usual routine for people with care needs and carers, enabling them to take part in leisure or other activities;
• overcoming a crisis, such as the carer not coping, cared for person's health deteriorating, or bereavement;
• making time for carers to spend with family and friends; and,
• helping people (particularly those cared for by their parents) develop independence and prepare for the time when the carer cannot continue caring.

Involvement

Measuring the quality and impact of short breaks requires genuine involvement with carers, service users and other stakeholders, working together to determine what performance measures are appropriate and relevant.  This will also help to avoid misplaced assumptions that what has perhaps worked in one context can automatically be applied to another.

“Councils and NHS boards need to do much more to improve how social care services are planned, procured and  delivered through better engagement with users and providers and better analysis and use of information on needs, costs, quality of services and their impact on people’s quality of life .”

Linking Outcomes to Planning

The outcomes and indicators in this framework resource have been provided to support a more planned approach to outcome-based service planning around short breaks.  Some of the proposed measures are more quantitative or activity focused, in order to gauge the ‘extent’ of service provision, others are concerned with the difference the short break experience makes to the people involved.  (It is important to distinguish between the outcomes that are developed at an individual level, for example in care planning, and outcomes that are developed for the purposes of overall performance measurement and ongoing improvement – such as those proposed in this paper.) 

The responsibility for establishing the outcome performance framework will necessarily rest with the commissioning body – the local authority and/or Health Board most likely.  They will wish to evidence that the resources they are responsible for are being targeted effectively and delivering good outcomes for carers and service users.  Commissioning bodies may consider outsourcing information gathering and analysis, or seek advice from organisations with experience of outcomes evaluation.

Finally, it is essential that any information generated is linked back into future planning and commissioning decisions.  Too often feedback systems have failed to drive forward improvement because the information generated at one level has not been used to inform decision making at another.  From the beginning there must be a clear commitment to use the information to improve forward planning and consequently to improve future outcomes.  It is also essential that the methods and tools used to measure outcomes are thoroughly tested and kept under constant review.