The participation of adult service users, including older people, in developing social care
Practice - Types of participation
Different people want to participate in different ways and there is widespread agreement that successful service user participation is based upon having varied and flexible approaches that allow this to happen (Collins, 2004; Truman & Raine, 2002; Waldman, 2005).
- Consultation through meetings, questionnaires and focus groups is probably the most frequently used model of participation, although it is most criticised by service users because there are concerns that consultation meetings may operate according to a fixed agenda and there is no guarantee that people’s views will actually be used to change a service (Carter & Beresford, 2000).
Ways in which organisations have tried to improve the quality of consultation meetings include:
- having meetings in which there is a formal system for accounting for decisions that have been taken and an opportunity for discussion and planning for the future;
See Practice Example for Swansea Directorate of Social Services and Housing.
- using different ways of collecting information, such as focus groups and questionnaires, in addition to formal meetings; and
- meeting at different times and in different venues
See Practice Examples for Southern Health and Social Services Board.
- The choice of venue is something that can make meetings simultaneously more inclusive for some groups and exclusive for others. For example, meetings in pubs can reach people who would not want to travel to 'official’ locations such as the town hall, but would exclude others who would not go to pubs on religious or moral grounds. This means that it is important consider carefully the choice of venue.
Do not assume a venue is accessible because the website says it is. Ask to see the access audit. Always visit the site with a suitably qualified person to check the access.
Make sure the venue is easy to find, accessible and on an accessible bus route and near an accessible station.
Make sure car parking can be reserved for service users who are not necessarily blue badge holders.
Give plenty of clear and accurate directions to venue.
Ensure that there are enough accessible toilets. Many service users need to use an accessible toilet not just wheelchair users. (Service user)
- Forums for specific service groups, such as national and local older people’s forums or local and regional forums for people with learning disabilities, may avoid some of the difficulties about power raised by consultations because they are run by service users for service users.
- Forums are more democratic in that they have a recognisable 'voice’ and they have been able to effect changes to services, despite barriers persisting for some people. (Barnes, 2005; Carter & Beresford, 2000).
- Campaigning organisations range from large national to small grassroots organisations.
- Larger organisations are sometimes seen as coalitions for service users, rather than of service users, although they can offer a less time consuming way of becoming involved, while creating a sense of solidarity and shared interests among their memberships. In addition, service users are able to increase their levels of involvement by becoming volunteers, paid workers or trustees. (Carter & Beresford, 2000).
- There are different models of advocacy services (Rapaport et al., 2005) but each share similarities in that they all aim to speak on behalf of another person or, in the case of self advocacy groups, to speak on behalf of themselves and fellow members.
- There are disagreements about what is meant by advocacy and the understandings and expectations of people who use advocacy services may not be the same as the service providers (Bowes & Sim, 2006; Forbat & Atkinson, 2005).
- While advocacy services are available in most parts of the country, not all service users have equal access to advocacy services. For example, advocacy services for people with dementia (Cantley et al., 2003) or people with communication difficulties (Lewington & Clipson, 2003) are less developed than those for people with learning difficulties or mental health service users.
See Practice Example for Adaab.
- Participation led by service user controlled groups or networks has the advantage of being more firmly rooted in the actual aspirations and preferences of service users but has often faced barriers in terms of funding (Beresford et al., 2006; Carter & Beresford, 2000).
- Consulting directly with service user led groups or networks, or asking them to undertake consultations on behalf of another organisation, has greater credibility with service users (Banongo et al., 2007) and leads to better quality results because of their greater experience and expertise in identifying what is important to service users (Evans & Carmichael, 2002; Fisher, 2002).
See Resources on Service User Researchers.
It is easy to forget that, for many people, the most meaningful participation is being able to take more control over their everyday lives.
It needs to be recognised that the bulk of service users’ participation is on a personal level based on individual situations and requirements. This is understandable and should not be considered negatively. Most people in the UK do not take an active role in developing services and strategic planning. (Begum, 2006, p19)
See Practice Examples for People in Action (Leeds), Swansea Directorate of Social Services and Housing, and Threshold.