Outcomes are the new targets

Over the weekend I had the pleasure of reading a proposed agreement between a County Council and care homes in their area. Riveting stuff as you can imagine – I will not bore you with the detail.

It again showed up some of the challenges Enterprise Britain faces when dealing with local authorities. Just to be clear, this particular agreement was for care homes for the elderly, not nursing homes, not homes for people with dementia or for people with learning difficulties. Simply a home for people getting on in age and needing some care.

The agreement was something to behold. If you signed up to it you would be filling in paperwork for the rest of your life – not the residents, but the people supposed to care of them. Most homes spend inordinate amounts of time on paperwork anyway, but this reached new extremes. The key words were ‘person centred care’ and ‘outcomes’ and in fact this is exactly where it all broke down.

Person centred care seems to mean three things – firstly it assumes that the ‘person’ has no ability whatsoever and can assume no personal responsibility at all, so the provider (whether a care home or a school or whatever else) is completely responsible until death do you part.

The second thing it seems to mean, judging from the documentation, is that the centred person is thick as sh.. and really only the authorities know what is best.

Lastly person centred care means ‘we will make you sign such a complicated agreement that we can trip you up at any time we want’.

So then they want ‘outcomes’. This is a new term to me, but last night, watching the stuff on the Tory conference it all became clear.

‘Outcomes’ are Dave and Nick speak for ‘targets’. Yesterday when listening to the Tory party reports some person was telling us how Labour focused on targets and thanks to the unstoppable efforts of Dave and Nick those days are thankfully over. It was now about outcomes so everything is much better.

Some of the ‘outcomes’ required in my exciting agreement:

  • Care worker sickness less than 5%
  • 100% of complaints brought to a satisfactory conclusion

These are obviously – to somebody not including me – not targets. They are outcomes. 

After reading the 9,000 words (about 26 pages) I was grateful and relieved that I was not party to this agreement and I sort of wondered why I had volunteered to assist a friend by reading it at all.

I am still really curious though what the difference is between a target and an outcome – or a goal, an aim, an objective, a milestone or whatever term the next job’s worth cooks up.

Personally I found it all rather insulting to the intelligence of the elderly and the people who care for them and I found it very threatening to Enterprise Britain – but then, I am getting used to that.

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