Changing social care: an inclusive approach
People who use services driving culture change - Make involvement genuine
- Agree the process for and scope of involvement at the start of any planned change.
- Be clear about what can and cannot be expected from involvement on both sides, and acknowledge the potential benefits to individuals.
practice survey showed that user involvement,
particularly where change is led by user organisations,
can have a major impact on the lives of service
users . People report that having more of a say
in services leads to:
- better quality of life, and better services (e.g. through increased take-up of direct payments)
- more confidence, independence, and a feeling of empowerment and control (SCIE Knowledge review 17)
- If decisions have already been made, be open about this:
- Consider identifying champions within the organisation to encourage genuine involvement, but make sure they share their knowledge and expertise.
- Identify roles which could be undertaken by people who use services. These might include attending meetings and developing agendas, through to monitoring and evaluating performance.
- Make sure everyone is clear about their role. If people who use services are leading the development of participation, be particularly clear about the role of any involved professionals.
- Ensure everyone who has been involved is kept informed about the outcome. People often say that they never hear of the outcome of their involvement or any difference made as a result.
- Recognise that participation encompasses a wide spectrum and be honest about where your organisation is currently. Achieving the vision for social care means that we need to aim for a partnership, where services are shaped by customer wishes and experience, and people are supported to control their own lives.
- Explore the possibilities for co-production.
For more detail and discussion on co-production,
Research briefing 31: Co-production: an emerging
evidence base for adult social care transformation.
Achieving co-production, the ultimate aim within
adult social care, requires a number of fundamental
- seeing the people who use services as experts
- recognising that they have assets which can help improve services, including skills, expertise and social capital
- promoting and facilitating mutual support among those using services
- supporting front-line practitioners to understand and value this approach
- recognising that this will change relationships between the individual, the provider and the state, with the people using services at the centre of an equal partnership
- Support and enable people to use personal budgets. These help people to shape their own services in the most direct way. Changing your service to meet individual choices and needs is indicative of a strong commitment to supporting the transfer of power and control to the people who use the service.
Encouraging and enabling involvement was ongoing at Willowbank. Some examples included encouraging:
- continued learning to enable staff and/or service users to become board members
- users to outline the class rules at the start of each teaching course
- users to run and manage their annual service reviews
- users to undertake large-scale involvement in lobbying and activist groups
- users to be members of different consortia and commissions
- users to participate in Northern Ireland and EU politics (Fauth and Mahdon 2007
The In Control website has stories from a range of people who have taken control of their own care and support. These examples demonstrate the very significant difference that having this choice makes to individuals’ lives.
How we know this
- The main goal of participation is to give people a sense of ownership and empowerment over the services that are being delivered. Research shows that users appreciate ‘user-centred user involvement’ – i.e. where they are the drivers of change and improvement, rather than ‘management-centred user involvement’ where they take part in existing structures which decide how they should participate (Robson et al. 2003).
- The Audit Commission offers some useful guidance on consultation and connecting with users of services – see the Connecting with Users and Citizens - User Focus.
- Co-production is an emerging, evolving
concept that is one of the ultimate aims of the
transformation agenda. Acknowledged as both particularly
appropriate and particularly challenging for
adult social care, it has a simple definition – people who use services contributing to the production of services – but the interpretation varies widely. SCIE’s
recent research briefing (Needham et al. 2009)
discusses co-production in more detail and identifies
the following key features from the literature:
- people who use services are recognised as experts
- people who use services playing an active role in meeting their own needs
- the facilitation of mutual aid and support
- the involvement of the broader community.
- Personal budgets are part of the wider movement to empower people. The report from the individual budgets pilot found that people using individual budgets were significantly more likely to report feeling in control of their daily lives and the support that they accessed. For further detail see SCIE research briefing 20: The implementation of individual budget schemes in adult social care (Carr and Robbins, 2009).