Health in Mind care deeply about providing the best services possible to the people we support. Our Quality, Impact & Evaluation Officer, Carolyn Black, explains why it’s so important to have a clear framework for measuring success.

We need to show the people we support, and our funders, that we are doing the right things, in the right way. As Quality, Impact and Evaluation Officer, a large part of my role is to think about the questions we need to ask ourselves and the information we need to collect to do this. I will be exploring some of the work we do to measure what matters in a series of blogs. In the first of these, I’m going to share our progress on developing a new quality framework.

How good is our organisation?

Health in Mind are working in a difficult financial landscape. The demand for mental health services is increasing, while the money available to deliver these services is decreasing. We need to show that we are making the best use of the funds we do receive. This means that it is important that we have evidence that we provide high quality services that make a positive change in the lives of those we support.

So, we need to ask ourselves – how good is our organisation at what we do? This question is at the heart of quality measurement and was the starting point for the new Health in Mind quality framework.

It might be worth pausing here to think about what a quality framework actually is. Put simply, a quality framework is a set of guidelines, used to measure how well an organisation is performing, in a consistent way, over time. It does this by providing a set of agreed quality standards (the level of quality we aim to achieve) against which we can measure our progress.

There are a number of existing quality frameworks that an organisation can use, for example ISO 9001 certification, an internationally recognised set of quality standards, or the Trusted Standard, the NCVOs quality mark for charities. These frameworks, and others like them, have advantages and disadvantages depending on your organisation and the work that you do. However, the keys to success are making sure there is a shared understanding of what quality means, that you fully commit to putting it into practice, and that you give it time to become established.

Our approach

After exploring the existing options through a brief literature review, Health in Mind decided to create a bespoke quality framework. We aimed to achieve a number of things by taking this approach.

1. To create a set of quality standards tailored to what matters most to Health in Mind and the people we support.
2. To make sure the quality framework meets our ethical standards and is in line with our organisational values: Compassion, Integrity, Respect, Realising Potential and Inclusion.
3. To develop a framework that is realistic for an organisation of our size, making sure that it builds on our existing processes and data collection priorities.
4. To allow us to put the framework into place gradually, starting small and then building on this using a test and refine approach.

To develop our Quality Framework, we held a series of facilitated workshops with our staff to gather their views on what quality looks like for Health in Mind. The findings from these meetings were analysed thematically to draw out the common elements. The findings from this analysis were used as the basis for the development of the draft quality framework, alongside information gathered in the literature review previously mentioned.

The draft framework

The draft quality framework has a series of quality aspirations – the high level statements of the quality standard we want to reach. Each one has 4-6 more detailed elements that we would need to meet in order to achieve that broader quality aspiration. An example is included below:

Quality aspirations	Key elements
We have transparent and effective governance procedures.	Our Trustees have the skills and experience to perform their role, and are provided with appropriate training where relevant. Our Trustees and leaders have a shared understanding of the roles and responsibilities governing Health in Mind. We have transparent, evidenced governance procedures and processes. We provide Trustees with accurate, sufficient, and proportionate information for assurance.

We are taking a rounded approach to measuring progress to make sure we are not just ‘ticking a box’. Instead of looking at a single number or target, we will look at a wide range of evidence sources that gives a broader picture of quality at the Health in Mind. This means that we will use quantitative or numerical data, as well as qualitative or more descriptive data that adds context to the numbers. This would be further supported by any documentary evidence around our policies, procedures and guidance.

To demonstrate, we know from our annual survey of the people who we support that 90% agreed or strongly agreed that they have a better understanding of their mental health and wellbeing as a result of using our services. However, the context of how that understanding influences their experiences can only be fully appreciated in their own words:

Health in Mind had given me that light back in my life. I can understand my feelings and life much better that I did at the beginning. It’s not only helped and impacted my life but the people in my life too. I’m becoming the person I used to be.

Next steps

The draft quality framework is currently out for consultation with Health in Mind staff. The next stage will be to engage with people we support to get their views. The importance of including those we support in quality, impact and evaluation, ensuring that their voices are at the heart of measuring what matters will be the topic of the next blog in this series.