Getting to understand a local authority adult social care department can be immensely challenging – a classic example of trying to eat the proverbial elephant. A common starting point is to look at the various data points published – and there are lots. More often than not, these are presented as comparisons to other local authorities.
Many of these data sets are nationally driven, with a variety of aims in mind, most frequently about improving transparency and accountability, as well as driving learning from others and continuous improvement. Data is used in Local Accounts, strategies and self-assessments to help local citizens have some sense of the scale of the task facing an LA, or to help others quickly decide about comparators. We also see how comparison data is used to reassure or even defend local performance – no-one wants to be the outlier in a comparison set.
Frequently data is handed over with a generous spoonful of caution or scepticism. Sometimes there are so many caveats - different time periods, changes of cohorts, restructures, improvement programmes, versions from case management systems supplemented by spreadsheets - that it risks becoming an industry just to make sense of the data, let alone the picture it is supposed to be helping us build. And as often as not, the first play back to the LA on what you’ve found is met with a “well that’s not right!”
But despite these considerations, data is still a good starting point, because as well as trying to establish that numerical baseline, a focus on the types of information and crucially how that information is presented can yield many insights about the culture of the organisation, how it is setting its priorities, and its relationships with others. It can be one of the ways of really getting down to “the question” – what is the problem we really need to look at?
Four broad questions can be helpful as a guide:
How well do the data sets map against the well-publicised current and most pressing challenges for all of ASC – for example workforce, rising and more complex demand, transitions, integration? Any comparison of strategies or peer reviews from different LAs show a common set of themes. But data is often pulled from standard data sets and tells you little about the way in which each of these common pressures is playing out in an area.
How well does the data help the many stakeholders in a place-based area to balance those documented challenges and still prioritise truly person-centred approaches, where the person having to draw on support is a person first and not a set of needs defined by organisation or eligibility? A focus on data can so easily mean a focus on an internal process, or a specific transaction point, all at the expense of the end-to-end user experience drawing on support from multiple services.
How well does the data encourage LAs to focus on all social care in their area, on the whole customer journey? Does it encourage a view from the point at which an individual or someone else in their lives realises there might be a need for support all the way to that point long after the support ends – not just the narrow window of Care Act “compliance” or a local authority's own direct service provision?
How is the data presented, particularly as comparisons to others? We are thinking here less is it Power BI or Tableau, and more what is the motivation behind the comparisons? To compare is human. And organisations are the sum of the humans working in them. We compare to seek affirmation, or because we are feeling insecure and are seeking some sort of (re)assurance. We might compare as part of trying to establish a value for something. This might even be to feed our competitive natures. We might do it simply because we are curious. And we are all probably very aware that there can pros and cons in comparisons. We rarely know the full story, so we risk drawing the wrong conclusion. Or there is a risk that what we see and hear is influenced by our own or others bias or choice of what to present to the outside world.
So when you are presented with a data rich and visually pleasing report, look beyond the quantitative picture, and think about what can it tell you about the culture they are describing – is it safe or defensive, is it inward looking or collaborative? Is it affirming or curious? What are the relationships in play? And look for the gaps - the absence of data or data only for one player in a system can speak a thousand words.
The out turn from these discussions is critical in moving beyond the starting point to being able to plot where next - defining the “how might we define and see things differently” and the “where to” questions. And critical too in helping to reflect on the “how will we get there”? It takes us to the considerations beyond the project plan and Gantt charts, to the people, and the relationships and alignments between process and people and practice, which will become the factors of success in transforming adult social care.
Ben Collins is an Associate Consultant at Roretti.
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