Transformational change in adult social care

Better Outcomes Better Lives

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In Manchester, we are changing how we deliver adult social care. Better Outcomes Better Lives is our staff-led transformational programme that is embedding strengths-based practice across Manchester’s adult social care services.

We launched the programme in January 2021; during lockdown and when our staff were feeling the effects of a relentless COVID response. It would have been easy to press pause, but we knew strengths-based practice was part of the solution, so we took a leap of faith and haven’t looked back since.

It’s about changing practice first and foremost and investing in our staff, but by doing that we are open and honest that it will also achieve financial savings through more efficient working and better care outcomes.

Better Outcomes Better Lives is owned by our staff and we are seeing the real impact: better outcomes for citizens, more resilient adult social care through managing our current and future demand differently, and financial savings. It flows through everything we do in adult social care and it’s working because it is led by frontline practitioners, with the right support from senior leaders in Manchester.


Clear workstreams supporting practice

The programme is organised around a number of workstreams focused on:

  1. Strength-based practice and maximising independence – helping staff think in a strength-based way so citizens can build their independence
  2. Using the right short term and preventative support – to enable more people to stay well, at home for longer
  3. Ensuring commissioning is responsive to people’s needs – rethinking our relationships with organisations we commission services from
  4. Accessing the right support at the front door – looking at how we ensure citizens can access the right support easily
  5. Strengthened performance reporting arrangements – so staff can see what is working well and benchmark against other teams.

A staff led approach

Central to our approach are our Communities of Practice where teams come together to reflect, work through issues and come up with their solutions which we back. Unresolved issues are reported back into the programme, and we act upon them which has created real trust with frontline teams.

Some of the issues identified by practitioners are challenging to resolve. We have used a prototype approach in which we test solutions on a small scale, we learn, we test again, and we grow. We don’t wait to have all the answers before we try something, we work with what we know, and we continuously learn.


Outcomes so far

Most importantly, we know it is working. We are supporting people to be more independent in their own homes are starting to see improved outcomes for our citizens. We are preventing, reducing, and delaying the need for statutory services. Outcomes so far include::

  • 60%* of people are now leaving our reablement service with no ongoing care requirements. When the programme began in Jan 21, this was 53% (*average for past 3 months)
  • Across the city, we can see a reduction in the number of commissioned homecare hours – indicating more people are accessing our community offers enabling their independence
  • We’ve seen a 41% increase in Technology Enabled Care (technology designed to support work to keep people safe in the community such as falls alarms, sensors, GPS trackers and other systems) forms completed since the programme began, from 181 in Jan 21, to 256 in Oct 22
  • The reduction in residential placements exceeds the anticipated reduction.​

We are supporting more people to remain in their own homes. This tells us that we are creating better outcomes and better lives for our citizens by promoting their independence and supporting them to have more fulfilling lives.


Working across health and social care

Working as part of MLCO, adult social care works in partnership with community health colleagues so approaches from the programme are being used across our integrated teams in health and social care. Our aim is to enable the whole system to become strengths-based and deliver the health and social care integration journey Manchester is on.