Changing social care: an inclusive approach
People who use services driving culture change - Plan carefully and consider the practicalities
- Consider how to enable participation at all stages of change, including planning, decision-making and implementation.
- Make sure that people who use services are involved at the beginning of any process of change, before plans are drawn up and any decisions made.
- Communicate your thoughts and ideas clearly, avoiding jargon, and present any materials in a reader-friendly and accessible format.
- Make sure that practical arrangements enable involvement, including:
- accessible venues
- timings to suit users
- financial help if users need money for transport to attend meetings, or to meet the cost of personal assistants to support their involvement
- other forms of help users might need (e.g. carers may need replacement assistance so that they can attend meetings).
- Acknowledge that it takes time for changes to have any effect, and that this may be frustrating.
A group of mental health service users believed that change had come about through regular and thorough consultation with people who use services: ‘It is important to hold meetings regularly so that people are more confident when giving their views – breaking down barriers and boundaries and sharing a two-way open relationship – recognising that everyone is human(SCIE Knowledge review 17).
How we know this
- Participation has been seen as the key to change in services (Shaping Our Lives et al. 2007) and 7 per cent of users participate on an occasional or regular basis (Birchall and Simmons, 2004).
- User involvement needs to be effectively planned and managed, and services need to be responsive to users. Good practice guides emphasise that people at all organisational levels need to be committed to the process. ‘Champions’ are needed to make the consequences of involvement stick and it takes time to change people’s thinking (Robson et al. 2003).
- Other aspects of good practice have to do with practical arrangements.
- A number of problems have been repeatedly described. Influence may be limited because people who use services are often consulted on plans and priorities that have already been devised rather than being involved in drawing these up in the first place (Shaping Our Lives et al. 2007).
- New services are frequently developed by people other than those who use them, and departmental fragmentation may not reflect the reality of service users’ lives (Joseph Rowntree Foundation 2005). Rummery (2006) points out that proposed mergers between health and social care organisations may not be successful due to the omission of service users’ perspectives: partnership working is not automatically supportive of service user participation, and may deflect attention away from it.
- Some of the professionals interviewed for the practice survey also questioned the effectiveness of meetings as a way of involving users and suggested that this needed to be investigated in order to find ways to improve .People who use services are increasingly involved in meetings where decisions are made and those involved have pointed out the need for accessible venues, timing, materials and documents, all of which have been frequently problematic. Consideration needs to be given to particular requirements, such as replacement assistance, materials presented in particular formats and so on. Informal processes are also important in that people who use services need to be made to feel welcome and that their input is valuable (Shaping Our Lives et al. 2007).