Changing social care: an inclusive approach
People who use services driving culture change - Work in partnership
- Understand and use the social model of disability to begin to establish a more equal relationship with the people who use services.
- Recognise the importance of effective leadership and management across the organisation. It is essential in supporting the workforce to take a partnership approach in meeting the needs and wishes of those who use services.
- Be aware of the tendency to see participation as an add-on. Adopting a whole systems approach means that you will need to think about what changes might need to be made to culture, practice, structure and systems of review to achieve genuine involvement. See below for more details.
Example: 'Willowbank is now an organisation that is controlled by people with disabilities that works with and for people with disabilities. Willowbank sees a person with a disability as a person with a ‘solution’ if they are encouraged, enabled and empowered to articulate what they want and need to help overcome the barriers' (SCIE Knowledge review 16)
Example: 'Some people, particularly those in leadership positions, and especially user leaders, play a central role in supporting the development of change. One mental health day centre user group said the manager of the resource centre was seen as having played a key role in the way the centre had developed' (SCIE Knowledge review 17).
How we know this
- User participation initiatives require an awareness of the context of power relations in which they are being conducted. Structures, institutional practices and professional attitudes will always affect the extent to which people who use services can influence change. Power sharing can be difficult in established mainstream structures, formal consultation mechanisms and traditional ideologies (Carr 2004).
- Carr (2004) notes that the priorities of people who use services and professionals may be different. Power relationships are unbalanced and people who use services may not be taken seriously.
- Other barriers to participation that reflect an unequal balance of power include the timing of meetings to suit providers rather than people who use services, the use of jargon, the structure of meetings and other interpersonal processes (Hodge 2005).
- The idea of champions to support involvement and change was seen as important by both people who use services and professionals in the practice survey. In one area the user group said that the continuation of change was the result of the support of particular staff (Robson et al. 2003).