Better Outcomes for People with Learning Disabilities – Transforming Care

Better Outcomes for People With Learning Disabilities Transforming Care Using Communication Technology Adam Hoare

 A project exploring the use of communication technology in support of person-centred care for people with learning disabilities

A collaboration with people, their families, carers, practitioners, technologists, academics and charities in pursuit of new models of care that utilise communication technology. Taking a practice-led approach to the development of the technology and considering the evidence required to demonstrate outcomes. The goal-to produce a transferable approach to evolving practice in cooperation with technology as a continuous learning process.

This was a £1m project funded by the Small Business Research Initiative in health administered by InnovateUK and Health Enterprise East.

SBRI Health

The project brought together a wide range of stakeholders in the support and care of people with learning disabilities to see how technology could form part of a person-centred approach to care provision.

Project Partners

Project Lead: Red Embedded Systems Ltd – provides v-connect, a video communications service. www.v-connect.co.uk

The v-connect service

Technology Partner: Rescon Ltd – provides Lincus, a data capture, storage and analytics tool.

Rescon Technologies

Care Provider: Hft – a charity supporting people with learning disabilities and their families.

Hft

Commissioner of Social Services: Sandwell Metropolitan Borough Council – a local authority covering 310,000 people in the West Midlands.

Sandwell Metropolitan Borough Council

Health Commissioner: Sandwell and West Birmingham CCG – Sandwell and West Birmingham Clinical Commissioning Group is a membership organisation involving 100 GP practices serving around 547,400 patients across the Sandwell and West Birmingham area. www.sandwellandwestbhamccg.nhs.uk

Sandwell and West Birmingham CCG

Service Development and Transformation: Changing Our Lives – a charity working with disabled people of all ages and backgrounds to deliver solutions to each particular need, and strive to achieve positive, individual-focused outcomes around rights, health and social inclusion.

Changing Our Lives

National Disabilities Charity: The DLF at Shaw Trust – The DLF brings together comprehensive knowledge of assistive technology with expertise of practitioners to provide information, advice, training and business tools. Working within the Shaw Trust, one of the largest, national third sector providers of welfare to work and social care programmes, the DLF can draw on the direct experience of people with learning disabilities and their community supporters.

Disability Living Foundation at Shaw Trust

Evaluation and Action Research Partner: The Bayswater Institute seeks to help organisations integrate human and social considerations with economic, structural and technical ones in the design and development of organisations and work.

Bayswater Institute

This project followed several years of developing communication technology in collaboration with practice and developing an approach to evaluation and evidence generation that would support its continued sustainable use. An example publication:

A Socio-technical approach to Evidence Generation in the Use of Video Conferencing in Care Delivery

Expert Support

Janet Cobb – an independent health consultant with considerable experience in learning disabilities.

David Atkinson – an independent consultant nurse and co-developer of the Health Equalities Framework.

Better Outcomes for People with Learning Disabilities – Transforming Care Project Overview

BOLD-TC Project Overview (PDF Link)

DOI 10.13140/RG.2.2.29687.52647

Towards an Understanding of How Policy Making Groups Use Indicators

Abstract:

Towards an Understanding of How Policy Making Groups Use Indicators Simon BellGroupthink is a known weakness leading to a number of problems relating primarily to false senses of consensus. But, positive group ‘wisdom’ is an ideal which many aspire to make happen but few manage to achieve in practice. The mystery of the group comes at a number of levels and raises various issues. What is the relative importance of how groups assemble? How they are motivated? The value of inducement? How can group work be assessed and how is a ‘good’ group identified? How is positive and not negative group working achieved? How is group working linked to what the group achieves? In the area of policy use of indicators the function of the group becomes more critical. In an age of transparency in decision making and calls for more evidence-based policy, the importance of good group work is becoming vital if the project is to succeed. Based on research undertaken around the European Union between 2009 and 2010 this paper explores some of these questions by providing a series of ‘rich pictures’ of indicator use, the meanings ascribed to the pictures by the group members and some insights regarding the dynamics of the groups that rest behind them and how this may have influenced the stories told by the pictures. We argue that in many ways the pictures represent a window to the understanding of the groups use of indicators.

Science Direct Link

Bell, S. and Morse, S. 2013. Towards an understanding of how policy making groups use indicators. Ecological Indicators. 35. pp. 13 – 23.

Being, Engaging, Contextualizing and Managing Matrix — a Means for Nonspecialists to Assess Group Dynamics? Embedding Technology in Practice

Abstract:

Being, Engaging, Contextualizing and Managing Matrix — a Means for Nonspecialists to Assess Group Dynamics? Embedding Technology in Practice Simon BellIn April 1999, academics from the Systems Department at the Open University in UK devised a matrix for assessing third‐level systems students—the matrix was based upon systemic practitioner behaviours taught in the course. It was based upon earlier methods that sought to understand and assess student progress based upon evidence of changing behavioural traits rather than the expression of learned responses or ‘right’ answers. This was the beginning of the being, engaging, contextualizing and managing (BECM) matrix. The European Union‐funded research project called Policy Influence of Indicators (POINT) made use of BECM as part of a process for exploring ways in which groups make use of indicators in several domains. This paper tells the story of how BECM was used in the POINT project to gain an understanding of group behaviour by observation of four segregated but linked qualities.

Wiley Online Link

Bell, S. and Morse, S. 2011. Being, Engaging, Contextualizing and Managing Matrix—a Means for Nonspecialists to Assess Group Dynamics? Embedding Technology in Practice. Systems Research and Behavioural Science. DOI: 10.1002/sres.1088.

 

Towards an Effective Multi-Stakeholder Consultation Process: Applying the Imagine Method in Context of Abu Dhabi’s Education Policy

Abstract:

Towards an Effective Multi-Stakeholder Consultation Process: Applying the Imagine Method in Context of Abu Dhabi’s Education Policy Simon BellThis paper is concerned with the many interleaving issues that emerge when engaging multiple stakeholders in decision-making. Whilst recognising the intrinsic value of group work and keeping in mind the numerous issues that obstruct group work (in- cluding multiple roles for participants, bias due to domination and distortion emerging from uneven group inputs), we applied the Imagine method to propose a new framework— the ‘Multiple Formation Consultation Framework’ (MFCF)—for organising effective multi-stakeholder consultations along the Policy Sciences Framework. Our proposed framework was applied in the context of education policy in the Emirate of Abu Dhabi, where 24 small group formations were tasked and assessed in a systemic manner. Evidence from the exercise suggests that: (1) when moving participants from heterogeneous to homogenous groups, the working of the groups became more focused and the outcomes gained greater clarity in terms of the thinking of group members. (2) Yet, when groups moved from homogenous formations to heterogeneous, they became more inquisitive and explored broader aspects of the tasks at hand. (3) A repeat of the process over 2-day period where different members of the groups experience both homogenous and heterogeneous formations back and forth (in order to capture the unique value emerging from each composition) have led to more efficient and effective working and outcomes of the groups.

Springer Link

Mahroum, S., Bell, S., Al-Saleh, Y. and Yassin, N. (2016) Towards an Effective Multi-Stakeholder Consultation Process: Applying the Imagine Method in Context of Abu Dhabi’s Education Policy. Systemic Practice and Action Research. 29, pp. 335 – 353. DOI 10.1007/s11213-016-9367-6

Imagine Coastal Sustainability


Abstract:

Imagine Coastal Sustainability
 Simon BellSince 2000 Coastal Area Management Programmes (CAMPs) supported by UNEP Mediterranean Action Plan (MAP) and the Priority Actions Programme Regional Activity Centre (PAP/RAC) have been engaging local communities in assessment of their coastal sustainability. The Methods used since 2000 have been based upon an evolving methodology which is now called Imagine.
In 2010 The CAMP Levante de Almeria began. “Imagine the future of our coast” is the slogan selected for this project which is intended to turn this area of southern Spain into a sustainability laboratory. The CAMP Levante de Almeria project is a test and a practical demonstration of how to implement Integrated Coastal Zone Management (ICZM) concepts in Spain in compliance with the ICZM Protocol (the seventh protocol in the framework of the Barcelona Convention). CAMP acts technically, environmentally and socially as a means to design and implement new practices, relating these to vertical and horizontal coordination between local and regional administration and public participation in decision-making processes related to the coastal zone. The fundamental objective of the project is to achieve wide scale agreement on the sustainable development of the coast.
Drawing upon the history of the various CAMP projects, this paper explores progress made so far in the application of the Imagine methodology in CAMP Levante de Almeria and, by contrasting it with sum- mary observations emerging from earlier Imagine applications in Malta, Lebanon, Algeria, Slovenia and Cyprus draws conclusions on the value of engaging coastal communities in sustainability self- assessment.

Science Direct Link

Bell, S., Correa Pena, A., Prem, M. (2013). Imagine coastal sustainability. Ocean and Coastal Management, 83, pp. 39 – 51.

From Sustainable Community to Big Society: 10 Years Learning with the Imagine Approach

Abstract:

From Sustainable Community to Big Society: 10 Years Learning with the Imagine Approach Simon BellCommunity is a key word in the current UK political vocabulary. As part of Big Society or as a sustainable means to develop social coherence, community has been an area of focus that has attained UK political party interest since 2003. In 1999, the Imagine method was first hinted at in the Earthscan book: “Sustainability Indicators: measuring the immeasurable”. The approach allows citizens to learn about and self-evaluate their own sustainability by developing their own sustainability indicators in a manner which is participatory and evidence based. Communities could make use of the approach, not in an attempt to arrive at some “absolute” value of sustainability but in striving to achieve a self-knowing sense of how sustainable they are, by their own measured indicators, and to use this evaluation in discourse with other agencies such as local and national government. The tone of Imagine is to empower citizens to own their own sustainability and to plan for sustainable futures. The method, developed for spatial and temporal sustainability assessment, has been trialled by countries in the Mediterranean region within Coastal Area Management Programmes (CAMPs). Building off this engagement with geographically and culturally diverse communities, the method has been supported by the Homes and Communities Agency (HCA) in the UK and developed into a teaching module that has been subsequently tested at undergraduate, postgraduate, continuing professional development (CPD), Virtual Learning Environment (VLE) and working with practitioners, as a hands-on Masterclass. The resulting course Creating Sustainable Communities (CSC) has now been introduced to 20 UK universities and has seen use by seven of them. This paper tracks the development of the Imagine method, explores its major elements and sets out the learning impacts it has had to date.

Bell, S. 2011. From Sustainable Community to Big Society: 10 years learning with the Imagine approach. International Research in Geographical and Environmental Education. 20, 3, pp 247 – 267.

How People Use Rich Pictures to Help Them Think and Act

Abstract:

How People Use Rich Pictures to Help Them Think and Act Simon BellGroups of all kinds are complex organisations. To understand them and to facilitate them in process terms is a matter of rich and diverse discourse in varied fields from sustainable development to coastal ecology; from bandwidth in rural communities to health service provision. How to allow groups to discourse, problem solve and review their own issues and concerns? Diagrams in general and rich pictures in particular can be great means to allow groups to explore their subconscious, their occult sentiments and conflicted understandings. This paper explores and explains diverse use of pictures and shows how they can be applied and understood in group processes of all kinds.

Introduction

Our focus here is on the rich picture, a free form type of diagrammatic representation which has a wide role of functions within human artifice, but especially as a tool to help groups arrive at a consensual analysis of a situation. In a more extended work we have discussed the importance of the way in which groups of people make use of diagrams (Bell and Morse 2010). In this brief paper we will provide some background to the antecedence of rich pictures and to the way in which some have used them in groups and for group work. However, our main aim here is to describe in detail how rich pictures can be used to tell the inner most story of the group – sometimes the unconscious and occult story – and can help the group to move forward. Our proposition is that rich pictures are a valuable output in themselves and deserve far greater attention that we perhaps pay them when they are typically seen as but one step within a bigger process.

Springer Link

Bell, S. and Morse, S. 2013. How People Use Rich Pictures to Help Them Think and Act. Systemic Practice and Action Research. 26, pp. 331 – 348.

Triple Task Method: Systemic, Reflective Action Research

Abstract:

Triple Task Method: Systemic, Reflective Action Research Simon Bell

This brief article introduces a new methodology for systemic action research — Triple Task (TT) — and sets out its rationale and initial progress in becoming an embedded method for group working. Arising from the authors previous work with soft systems approaches, the Imagine method for sustainable development assessment and action research in a variety of global locations, TT provides a means for groups to engage together in purposive work and, at the same time, for facilitators to understand how the dynamic of the group influences the groups output. TT is based on an ambitious concept and at the time of writing the results of TT applied in the context of an EU Framework 7 funded project are in their early stages but importantly, significant insights are already arising including the answers to some puzzling questions:

  • Do purposeful groups always produce the most insightful outcomes?
  • Do conflictual groups produce incoherent results?
  • What makes a ‘good’ group?

Background

Triple Task (TT) is a unique form of participatory action research in the sense that not only does it attempt to arrive at answers to research questions but also tries to understand what factors may have been at play in arriving at those answers. This attribute makes TT an advance on many other participatory techniques which are more focussed on delivering outputs (representing an apparent ‘consensus’) and less concerned (if at all) on the dynamic behind that ‘consensus’ and how the process may have influenced what was produced.

Participatory research takes many forms but the underlying philosophy is that all those involved—be they ‘researcher’ or ‘researched’—are involved in the design of a research process as well as the interpretation of findings. Power should be shared rather than being concentrated in the hands of a researcher. As a result the very process of doing the research can provide many insights and help bring about positive change. Hence the term ‘action research’; a research process that catalyses action.

Springer Link

PDF Link

Bell, S. and Morse, S. 2010. Triple Task Method: Systemic, Reflective Action Research. Systemic Practice and Action Research. DOI 10.1007/s11213-010-9171-7

An Approach to Comparing External and Internal Methods for Analyzing Group Dynamic

Abstract:
Beginning with the question, can a multimethodology explore the nature of group work from both the inside out (group participant self-analysis) and the outside in (facilitator observed analysis), this study presents the results of a statistical analysis comparing 2 different approaches to assessing group function: SYMLOG (A SYstem for the Mul- tiple Level Observation of Groups) and BECM (Being, Engaging, Contextualizing and Managing). SYMLOG is a quantitative internal assessment of group function made by members of the group, whereas BECM is a qualitative external assessment made by an outsider observing the groups. Together, it is argued, they provide a unique, triangu- lated assessment of the group dynamic. By using a “best subsets” linear regression technique it was found that some of the 26 characteristics of SYMLOG are related to BECM scoring (adjusted R2 0.82). This article discusses the reasons for this and the repercussions for such blending of approaches to understanding group dynamic. The article ends by discussing the relative advantages and disadvantages of the 2 ap- proaches and potential for further hybridizing of them in blended group dynamic approaches.

APA Link

Bell, S. and Morse, S. 2013. An Approach to Comparing External and Internal Methods for Analyzing Group Dynamic. Group Dynamics: theory, research and practice. 17, 4, 281 – 298.

Rich Pictures: Sustainable Development and Stakeholders – The Benefits of Content Analysis

Abstract:

Rich Pictures: Sustainable Development and Stakeholders – The Benefits of Content Analysis Simon BellThis paper concerns the interpretation of pictures that stakeholders draw in order to help them structure and understand complex situations. The pictures in question are called Rich Pictures (RPs) and the matter at the heart of interpretation is insight drawn from eduction (drawing forth). Insights relate to stakeholders of all kinds, be they the individual, the group, the context in which the individual and the group find themselves, or the means whereby the context can be made more sustainable or improved. RP drawing, often as a collaborative, stakeholder exercise, is a powerful activity that has the capacity to break down barriers of lan- guage, education and culture. Drawing upon research with RPs from around the world and spanning 50 years of our combined practice, this paper demonstrates RPs’ utility, universal- ity and resilience. We maintain that RP drawing enriches problem solving and, in the long term, saves time and resources being expended on erroneous and/or superficial tasks.
However, the interpretation of RPs is still in its infancy. By use of processes derived from various forms of content analysis (CA) we argue that RPs can be applied as a powerful tool in a variety of policy fields. Conclusions for application are drawn and suggestions are made for further research relating to the clearer interpretation of RPs.

Wiley Online Link

Bell, Simon, Berg, Tessa, and Morse, Stephen. (2016) Rich Pictures: Sustainable Development and Stakeholders – The Benefits of Content Analysis. Sust. Dev., 24: 136–148. doi: 10.1002/sd.1614.