The participation of adult service users, including older people, in developing social care
Practice example 19: Swansea Directorate of Social Services and Housing
Characteristics of service users involved
Statutory local government agency for people with mental health problems living in the city and county of Swansea.
How service user participation within the organisation is ensured
Service user involvement takes place at individual, operational, and strategic levels. At an individual level, service users and carers are fully involved in development of the care programme and selection of the services to meet their needs. Each service provider holds service level user groups, where users are engaged in discussions about the service.
At an operational, or service level, there are a number of day service providers within Swansea. There is a scheme called Community Rehabilitation Employment Assessment Training Enterprise (CREATE), which is an umbrella organisation bringing together all the day service providers in mental health to work under one umbrella. It is overseen by a central management group.
At a strategic level, there are two organisations; one is the Cefn Coed (Psychiatric) Hospital Patients’ Council, the other is the Swansea Network of User Groups (SNUG), which is an umbrella organisation for all community based mental health services. SNUG is represented on the CREATE management group, so service user representation goes right through from the personal, through the service level up to the strategic management level. SNUG is also represented on the mental health planning groups and the development groups, all of whom are the policy and decision-making bodies within mental health in Swansea.
On an annual basis, there is a joint business planning exercise, which involves all the voluntary and statutory sector services and service users. It examines issues within the service, identifies gaps, and agrees an action/business plan for the following year.
What policies on service user participation has the organisation formulated?
At the personal level, key workers and care coordinators are responsible for ensuring service users’ participation in developing the care plan. Service managers are responsible for ensuring that the consultation process, the wider process within each service area, is implemented and information is disseminated there. There is an agreement with the Local Authority for a number of paid employment posts which are purely for service user use. Access to those posts is only through our employment team.
How are service users supported?
A development worker attached to SNUG accompanies service users to planning meetings. Travelling expenses, and out of pocket expenses are reimbursed. Service users with the employment service are assessed and agreements are made with the host department to offer them a fixed term appointment up to a maximum of twelve months. They are then supported by the employment team. During this time, the individual develops a work record and work experience on the payroll of the local authority so they can approach potential employers with a work record and references. Almost a third of the paid staff in mental health day services in the local authority are either current or ex-service users and this has been very successful.
How are the effects of participation monitored, audited, and evaluated?
At the personal level, the number of care plans issued agreed by service users are monitored. At the service level, meetings are recorded and minuted, and attendance of service users at strategic groups is included in the minutes. Measuring the effects of participation comes into the annual business planning feedback exercise where SNUG undertakes a survey of service users, and they then feed back opinion and issues from service users directly into the business planning.
What makes organisations succeed in participation?
Success in participation is probably having the basics of values and principles to start with. Service users are the most important part of the service, and services are there to support and assist them as individuals. This ethos is fairly well embedded in services in Swansea. The success of the employment service in helping service users to become paid members of staff breaks down the 'us and them’ barrier between staff and service users.