Why is it important?

Good practice suggests that assessments should be conversational in style and start with a discussion about the needs, concerns or problems most important to the person. Practitioners should aim to build rapport, facilitating openness about personal circumstances and minimising embarrassment or anxiety – enabling them to gather and record accurate, relevant proportional information about the person as a whole (FACE, 2011).

Innovators in social care are trying to change the culture of social work and part of this focuses on the use of language. Avoiding using words such as ‘assessment’, ‘referral’ and ‘services’ among others (TLAP, 2016 http://www.thinklocalactpersonal.org.uk/_library/Resources/TLAP/BCC/TLAPChangingSWCulture.pdf).

The principle of this is to have a proper conversation, ensuring the person is able to have their say and is, rather than a just having a chat or reading through a list of questions (Johnstone and Page, 2014).

Outcomes-focused conversations work best with the application of relationship-based social work. Getting the conversation right ‘from the off’ is critical to building relationships which are honest, open and trusting.  It is very important that everyone involved is clear about the purpose which in the main will be to:

• gather information out about their life and circumstances
• support them to identify what is good about their life that they don’t want to change and what is not good that they want to change
• build a complete picture of their needs, hopes, wishes and aspirations – understanding what is important to them
• identify where they want support or services to have an impact – their desired outcomes.

‘Through the conversational process, people become more aware of what they want, the strengths and abilities they already possess, the support networks and community supports around them, all of which come together to increase their motivation and expectancy that they can realise their hopes and aspirations.’ (Cook and Miller, 2012)

Essex County Council have looked at how they can change the culture of social work by taking a strengths- based approach to conversations based on community assets rather than a service-based approach. The purpose being to move away from service-led assessments to “proper conversations that listen to what people say.”

They have defined three different conversations and coached staff in how to have these:

The process of having the conversation is framed by the following ‘rules’:

• always start with the assets and strengths, knowledge and skills of people, their families and their communities and think about services last
• you can’t have conversation one effectively without knowing the communities and neighbourhoods of those people you are listening to
• you have to prove to your peers that you have exhausted conversations one and two before embarking on conversation three
• if someone is in crisis and having conversation two never plan long term. You must stick to them like glue for a short time to ensure the plan has a maximum chance of success
• you must really know what you are doing and the impact you are having through daily collection of data, and reflect on it and your practice all the time to keep learning.

Gollins T, Fox  A, Walker B, Romeo L, Thomas J, and Woodham G.(2016) Developing a Wellbeing and Strengths-based Approach to Social Work Practice: Changing Culture. London: Think Local Act Personal. Available online:  http://www.thinklocalactpersonal.org.uk/_assets/Resources/TLAP/BCC/TLAPChangingSWCulture.pdf

Tools

The range of tools below are to support all aspects of having outcomes-focused conversations.

Defining outcomes (PDF file 300KB).  Often, in practice terms such as outcomes, outputs, needs etc. can be confused or used interchangeably.  This tool defines outcomes and provides opportunities to explore what makes an outcome.

RiPfA customer guide: What is an outcome? (PDF file 355KB).  Accessible guidance for practitioners to use with people accessing services, families and carers, to help them understand outcomes.

Outcomes conversation tool (PDF file 159KB).  A tool designed to develop outcomes-focused conversation skills.  This tool is taken from the RiPfA Working with outcomes practice tool (2014).

Identifying outcomes (PDF file 185KB).  Support in identifying, enabling and reviewing outcomes as part of a conversation.  This tool is taken from the RiPfA Working with outcomes practice tool (2014).

Good enough outcomes (PDF file 222KB).  In many cases there will be a range of possible interventions that might support a person to meet their desired outcomes. This tool is designed to help practitioner’s weigh up which option delivers the outcome desired, in a way that is acceptable to the person in terms of their wellbeing, for the best value.

Quality of life wheel (PDF file 134KB).  A tool designed to be used as part of an outcomes-focused conversation.

Eric Battersby case study – Having the conversation (PDF file 198KB).  This case study provides a detailed account of an outcomes-focused conversation with examples of questions that support taking a strength-based approach.

 Powerful questioning (PDF file 365KB).  This tool considers what makes a powerful question, the value of powerful questioning and provides opportunities to design and ask powerful questions.

Active listening (PDF file 181KB).  Meaningful conversations are central to supporting people to identify and realise the outcomes they want to achieve. Active listening supports meaningful conversations, and this tool explores the different levels of active listening with examples for consideration.

 Ecogram (PDF file 443KB).  This tool can be used to depict the important relationships, resources and systems in a person’s life, not simply those connected with their family.

Family group conference (PDF file 434KB).  This tool sets out the process for a Family Group Conference. You can use it to plan and hold a conference.

Next: Recording conversations about outcomes