Scottish Government

Introduction

1. Background

1.1 In August 2004, the Executive issued revised guidance on care management. Its main purpose was to re-focus care management on people with complex or frequently changing needs and to extend the range of care managers. To support implementation of the guidance, to transform care management, and to reinvigorate assessment and care management to achieve the desired benefits, both the Executive and partnerships recognised the need to develop a comprehensive national training framework. A working group drawn from a wide range of professional backgrounds has developed this framework. It provides a comprehensive resource for managers, professionals and trainers across the community care spectrum. More importantly, it is innovative in its approach and is designed flexibly both as regards the learning media, and the learning process and timescales.

1.2 Because partnerships are at different stages of implementing both Joint Future generally and care management, the Group developed a package of flexible, modular training that gives local managers, trainers and professionals the scope to apply the framework according to local circumstances.

1.3 Care management is one of the key means of delivering better outcomes and faster access to services. The National Outcomes Seminar on 6 February 2006 and the Supporting Integrated Learning Network on 16 March 2006 reinforce the need for faster access to services, quicker decision-making and other key benefits identified in the Joint Future Group's report. Looking more widely, the Chief Nursing Officer recognised in the course of the national seminars that the management of long-term conditions - a key part of Delivering for Health - would build on our approach to care management. Re-invigorating and re-focusing care management is therefore a key part of the wider change agenda in community care.

2. The Care Management Training and Resource Pack

2.1 The Care Management Training and Resource Pack supports implementation of the new guidance on care management. The toolkit is flexible, adaptable and can be customised to meet local needs, while still providing consistency overall. Its focus is strongly on improving outcomes.

2.2 The training pack has been developed with extensive involvement of stakeholders in the field, along with relevant policy and professional interests and the Joint Improvement Team in the Scottish Executive. The Group also worked closely with the 21st Century Review of Social Work Services. It is endorsed by both the Scottish Social Services Council ( SSSC) and the NHS Education Scotland.

3. Principles Underpinning the Modular Training Approach

3.1 The framework reinforces that assessment and care management is a cyclical process, in which needs are assessed, services are delivered, and needs are re-assessed. Integral to this are the arrangements for care planning, monitoring and reviewing. The modular approach provides an overview of the whole system, while reinforcing the holistic person-centred approach to assessment and care management. It provides the baseline for more specialised training.

3.2 The framework recognises the overlaps between care management and case management. The training revolves around an integrated approach to care management, with local protocols reinforcing the existing care management roles of nurses, for example, in palliative care, mental health and learning disabilities.

3.3 The SSSC and NES has been consulted on the preparation of this pack. It recognises the important role that high quality multi-disciplinary training plays in ensuring the delivery of effective integrated services. This training meets the SSSC's post registration learning and training requirements.

3.4 The Mental Health Programmes and training officers with the SSSC are looking at the mental health social work award in light of the changes to the PQ consortium. They have also reviewed the training material.

3.5 The Mental Health Division at the Scottish Executive, through their training officer, has also confirmed the appropriateness of the training in terms of providing a baseline for practitioners in the field of mental health.

4. Structure of the Training Pack

4.1 The modular approach to developing the skills of practitioners covers assessment, care planning and care management. It breaks each down into the relevant components. The index to the pack shows the contents in detail. It uses particularly case studies and revision exercises at every stage to reinforce learning. The pack also incorporates extensive practical guidance for practitioners and managers respectively, updating that provided in 1991 when care management was first introduced.

4.2 The modular training covers:

• Outlines for each modular component.
• Tutor notes and training folder.
• Practitioners' training folder
• PowerPoint presentations
• Suggested exercises
• Additional handouts
• References and web links
• Resource pack (available on the Joint Future Unit website)
• e-learning component (available on CD Rom and on the Joint Future website)
• Competency framework
• Care Management Practitioner's Guide
• Care Management Manager's Guide.

4.3 The material can be added to as required and used as appropriate to meet individual or collective learning needs. The Practitioners' Training Folder in the pack facilitates this approach.

4.4 The pack also includes presentations on the need for change in care management and on using e-learning as part of the blended approach to learning in this pack.

4.5 Partnerships should be aware that the full pack of training materials is licensed for their use, and is protected by Crown Copyright.

5. Using the Training Pack

5.1 Local partnerships will be able to use the modular training pack flexibly, complementing and adding to the pack their own local procedures, protocols and examples of good practices. Partnerships will be able to draw on the training material as part of their overall training plan, identifying the relevant areas of training for individual practitioners from their local training needs analysis. The material can be added to as required and used as appropriate to meet individual or collective learning needs. The Practitioners' Training Folder in the pack facilitates this approach.

5.2 Practitioners and managers undertaking the modular training will be able to apply the knowledge and skills from their day to day practice. The training will contribute to their continuous professional development. The training should be delivered in a multi-disciplinary model, in order to maximise the learning outcomes.

5.3 The modular training approach encourages flexibility. Partnerships will determine both the most appropriate and effective ways to provide training and their timescales, bearing in mind the local demands on services and other training priorities. But given the need to re-focus and reinvigorate care management, this needs to have a measure of priority. The pack also includes an e-learning framework to support the modular approach, which offers even more flexibility.

5.4 We recommend that as pre-course material practitioners have a copy of the competency framework and the updated Practitioner's Guide for Care Management. Partnerships may also want to include in the practitioner's training folder, a copy of the Care Management Guidance 2004.

5.5 The Manager's Guide for Care Management will support managers to implement the new arrangements. This will be complemented by the Tutors' Notes Training Folder which contains the full range of training and resource materials.

5.6 It would be particularly beneficial if line managers and training officers were to provide post-training evaluation of the learning objectives. This would provide practitioners with feedback on their assessment and care management skills.

6. Resource Pack

6.1 The resource pack has been collated from partnerships' experiences of care management. It can be found in the Care Management section of the Joint Future website - http://www.scotland.gov.uk/Topics/Health/CareJointFuture/Introduction.

6.2 Partnerships should continue to update these contributions in order to keep the resource pack relevant. They should send contributions to Judith King at judith.king@scotland.gsi.gov.uk.

7. Making it Happen

7.1 Given the history of care management in Scotland, and the new focus in the guidance issued in August 2004, it is imperative that local partnerships invest in training on care management. The modular approach we have developed with partnerships provides real flexibility for managers, for trainers and for practitioners themselves. Partnerships therefore now have the tools they need to implement fully the revised care management guidance.

7.2 The object of this training is to support front-line practitioners and their managers to deliver better outcomes for users and carers. A sound knowledge of and effective skills in care management are essential to make that happen. The quality of care management - and the benefits for individuals and for partnerships - is strongly influenced by the training and support provided to the workforce. This framework should provide a powerful lead on that, and at the same time provide a degree of consistency across Scotland.

7.3 The Executive is particularly conscious that care management needs to change markedly if it is to achieve its wider goals. The Executive will consider how to monitor progress, particularly in the light of the outcomes approach to joint performance assessment.

8. Contributors

8.1 This framework is the result of a collaborative effort, led by the Joint Future Unit, involving:

• The SSA Leads in partnerships.
• East Renfrewshire, Aberdeenshire, Aberdeen City, Clackmannanshire, City of Edinburgh, Renfrewshire, North-Ayrshire, Dumfries and Galloway, Glasgow, Lothian and North Lanarkshire Partnerships.
• ADSW Care Management Sub-Group and ADSW Standing Committee
• The Nuffield Database of Good Practice.
• The Carenap National Users Group.
• COSLA.
• Scottish Social Services Council and NHS Education Scotland.
• 21st Century Review of Social Work.
• Chief Nursing Officer and Nursing Directorate.
• Scottish Consortium for Learning Disability.
• The Learning Exchange.
• Policy divisions including Mental Health Division, Community Care Division, Older People's Division, Human Resources, Data Sharing and Standards Division, Carers Branch, Adult Support and Protection Unit, and Regeneration, Fuel Poverty and Supporting People Division.
• Joint Improvement Team.
• ISD.
• SWIA.
• The Care Commission.
• Brian Duffy from Renfrewshire Partnership Joint Care Consultative Body, Lillian Barrett, Clackmannanshire Partnership and Thomas Gourlay, Glasgow Partnership.
• Sandra Wallace and Christine Ford from Community Care Division at the Scottish Executive.

Joint Future Unit
March 2006

THE VIEW FROM THE CENTRE JOINT FUTURE UNIT, SCOTTISH EXECUTIVE

Extract from the Community Care Database Publication, Nuffield Centre at Glasgow University, March 2006.

Care management is one of the key means of delivering better outcomes and faster access to services. It has to change if it is to achieve that. The combination of the guidance in 2004 and the new training framework provide partnerships with the tools to do that. But leaders locally have to recognise the task before them and provide the drive to transform care management in the way that apparently everyone wants.

A working group drawn from a wide range of professional backgrounds has developed this training framework. It provides a comprehensive resource for managers, professionals and trainers across the community care spectrum. More importantly, it is innovative in its approach and is designed flexibly both as regards the learning media, and the learning process and timescales.

The toolkit is flexible, adaptable and can be customised to meet local needs, while still providing consistency overall. Its focus is strongly on improving outcomes.

The framework reinforces that assessment and care management is a cyclical process, in which needs are assessed, services are delivered, and needs are re-assessed. Integral to this are the arrangements for care planning, monitoring and reviewing. The modular approach provides an overview of the whole system, while reinforcing the holistic person-centred approach to assessment and care management. It provides the baseline for more specialised training.

The framework recognises the overlaps between care management and case management. The training revolves around an integrated approach to care management, with local protocols reinforcing the existing care management roles of nurses, for example, in palliative care, mental health and learning disabilities.

The modular approach to developing the skills of practitioners covers assessment, care planning and care management. It breaks each down into the relevant components. It uses particularly case studies and revision exercises at every stage to reinforce learning. The pack also incorporates extensive practical guidance for practitioners and managers respectively, updating that provided in 1991 when care management was first introduced.

The modular training approach encourages flexibility. Partnerships will determine both the most appropriate and effective ways to provide training and their timescales, bearing in mind the local demands on services and other training priorities. But given the need to re-focus and reinvigorate care management, this needs to have a measure of priority. The pack also includes an e-learning framework to support the modular approach, which offers even more flexibility.

Given the history of care management in Scotland, and the new focus in the guidance issued in August 2004, it is imperative that local partnerships invest in training on care management. The modular approach we have developed with partnerships provides real flexibility for managers, for trainers and for practitioners themselves. Partnerships therefore now have the tools they need to implement fully the revised care management guidance.

The object of this training is to support front-line practitioners and their managers to deliver better outcomes for users and carers. A sound knowledge of and effective skills in care management are essential to make that happen. The quality of care management - and the benefits for individuals and for partnerships - is strongly influenced by the training and support provided to the workforce. This framework should provide a powerful lead on that, and at the same time provide a degree of consistency across Scotland.

The training framework is the result of an extensive co-ordinated effort with professionals and partnerships. It is what they tell us they need to make care management work in the modern age of joined up working and service delivery. But it also needs leadership and encouragement locally if it is to re-focus and contribute to better outcomes. We believe that the framework and the guidance gives partnerships what they need to make that transition successfully. The status quo is not the answer, we know it and partnerships know it; and they now have the tools to make a difference. They recognise what needs to be done, but are they up for the challenge?

Joint Future Unit
March 2006