The participation of adult service users, including older people, in developing social care
Practice example 20: Threshold (Richmond Fellowship)
Characteristics of service users involved
A therapeutic community for mental health service users in Northern Ireland which is part of a national voluntary organisation.
How service user participation within the organisation is ensured
Currently, service user involvement occurs much more at service level than at strategy level. For example, they neither serve on the agency’s committees nor on the board, though these are possibilities under discussion. The three main ways in which service users are involved are:
- on a daily basis - all the residential units are therapeutic communities and this means that residents are involved in most decisions about the house in which they live.
- when needed - service users are involved in adjudicating cases where a member has infringed the house rules and deciding whether a person should be given notice to leave.
- annually, the Threshold director meets all the residents on an annual 'awayday’ to hear their views.
At present service users are not involved in decisions about staff appointments.
What policies on service user participation has the organisation formulated?
Threshold has policies about involvement, the decision-making processes within the houses, and the rules that are made by the staff and residents together. Threshold is developing a strategy on which the residents will be asked for their views formally in a letter and by way of meetings.
How are service users supported?
Therapeutic communities have an underlying ethos on involvement that is part of the philosophy of care.
How are the effects of participation monitored, audited, and evaluated?
There is an annual audit called the Community of Communities (an international research project run by the Royal College of Psychiatrists into therapeutic communities). This assesses the agency against a set of standards, much of it to do with user involvement.
Teams of at least five residents and five staff go each year to audit and monitor communities in England, and similar teams come over from England to monitor and review communities in Northern Ireland.
For the past two years, residents have been completing the Wisconsin Quality of Life questionnaire which asks about the quality of their life over the last six months. Threshold is mapping what areas of improvement users are seeing in relation to their quality of life so that can services can be shaped to reflect the outcomes.
What makes organisations succeed in participation?
There has to be a respect for and a belief in people. The basic principle at Threshold is that people have equal value, though they may have different abilities.