Implementation evaluation of the scale-up of Graded Care Profile 2

Last updated: 04 Sep 2018 Topics: Neglect

Evaluation of how we support organisations to deliver Graded Care Profile 2 (GCP2)

Graded Care Profile 2 (GCP2) is an assessment tool which helps practitioners measure the quality of care a child is receiving. We’ve evaluated the tool and found it to be effective in helping identify whether a child is at risk of neglect. We’re now making GCP2 available to other organisations so that more children and families can benefit from it (we call this scale-up).

We wanted to find out how well the scale-up process worked in practice, and identify ways we could make it easier for other organisations to implement GCP2. So we carried out an evaluation, involving a range of professionals who were implementing the tool.

Authors: Emma Smith, Robyn Johnson, Tove Andersson
Published: 2018


Key findings 

We carried out 46 interviews and 446 surveys with professionals who had a role in implementing GCP2 in their organisation. These took place straight after the GCP2 training and again 10 months later.

Our key findings include:

When the tool was well embedded, practitioners felt it improved their practice and that families had benefited from its use.

  • Practitioners felt that referrals were clearer and more likely to lead to actions that would support the child.
  • Some families were reported to make positive health and lifestyle changes as a result of the use of the tool.

Participants showed high levels of commitment to using GCP2 and there were strong indications that this would be sustained. Positive indicators included:

  • GCP2 being referenced in policies;
  • contracts for key staff being extended; and
  • the tool being promoted within the organisation.

Factors which seemed to make the scale-up process most effective included:

  • following a clear implementation plan;
  • having specific GCP2 related roles;
  • having GCP2 champions;
  • having management buy in and commitment; and
  • having appropriate support systems, such as refresher training.

Most professionals thought it was important to retain fidelity to the GCP2 model. Organisations that were continuing to roll out GCP2 appeared to be following its core principles.

Participants who had received post-training support from the NSPCC felt it was helpful. However, local support systems varied.

  • This may lead to participants feeling isolated and have a negative impact on their motivation to use the tool.

Despite the majority of practitioners feeling confident following training, only 48% reported using the GCP2 10 months later. Reasons for this included:

  • it not being appropriate for their role; or
  • they had not yet had any relevant cases.

However 92% of practitioners surveyed after 10 months said they still planned to use the tool within the next 6 months.

Barriers which hindered the implementation process included:

  • funding cuts and lack of resources for staff to attend training;
  • changes within the organisation and staff turnover (this meant that new staff had to be trained); and
  • resistance from practitioners and families. (Some practitioners were concerned that the GCP2 would add to their workload; however others felt that the additional workload was worthwhile due to the benefits for the families involved).

We’re taking steps to improve the scale-up process and address some of the barriers identified by professionals. We are:

  • Offering strategic workshops to encourage senior management to give their support.
  • Making sure organisations are aware of the resource implications of GCP2 from the start, and linking local authorities together so they can share resources.
  • Providing extensive training about the implementation process.
  • Advising that organisations allow people to volunteer as “GCP2 champions” rather than having a “compulsory champions” approach.
  • Making our trainers aware of any misunderstandings that can occur about some aspects of the tool, so they can address this in training and explain how practitioners can use the tool flexibly without compromising fidelity.

Quotes 

“I think the beauty was that because people are all trained together at the same time, they can actually support each other, so you actually create the support groups as you go along.”
(Implementation Lead)
“The school had concerns around parenting and made the referrals to all sorts of agencies but it was always just dismissed. Using GCP2 we were able to evidence it, that there is emotional neglect."
(Family Support Worker)
"One health visitor used GCP2 with mother on cusp of post-natal depression - she had no 'natural warmth' for her 10 week old baby. The health visitor and mum then did a very focused bit of work which also involved the dad. Six months (later) she was 'happy to get on the floor with her baby and be silly.' The health visitor said 'you know it's just absolutely lovely to be part of that.”
(Implementation Lead)

Citation

Please cite as: Smith. E, Johnson, R. and Andersson, T (2018) Implementation evaluation of the Scale-up of Graded Care Profile 2. London: NSPCC.