Check how you can increase participation within your organisation by following the links below.
The importance of participationOpen
Participation means people playing an active part, having greater choice, exercising more power and contributing significantly to decision making and management.
Government policy requires local authorities and other service providers to involve local people in the development and delivery of their services. Involvement works at the individual level, maximising a person's involvement in their own support process, and at the organisational level, to enhance service quality and influence improvements.
The drive towards personalisation of adult social care emphasises the importance of inclusion and the involvement of those who use services.
Organisations that recognise the importance of participation and actively engage people who use their services in planning and improvement will be well prepared for the transformed health and social care environment.
User- and carer-led organisations have been at the forefront of changes to encourage local authorities to involve people who use services as 'expert' partners in the planning and improvement of services. User-led organisations have a key role in helping local authorities to deliver better personalised social care and improving engagement with hard-to-reach population groups.
A user-led organisation is run and controlled by people who use health and social care services. User-led organisations have their origins in the independent living movement of the early 1980s.
User-led organisations provide advocacy, peer support, information and advice on issues such as personal budgets, direct payments, self-assessment, support planning and employing personal assistants. They also work with statutory and other agencies to develop strategies for improving services.
Putting people first: Working together with user-led organisations was launched in 2009. It provides advice on how local authorities can help develop, and benefit from, user-led organisations and outlines support provided by the Department of Health and other organisations.
Co-production is a potentially transformative way of thinking about power, resources, partnerships, risks and outcomes. It emphasises that people are not passive recipients of services. They have assets and expertise that can help improve services.
To act as partners, both users and providers must be empowered. Co-production means involving citizens in collaborative relationships with frontline staff who are able and confident to share power and accept user expertise. Staff need to be trained in the benefits of co-production, supported in positive risk taking and encouraged to identify new opportunities for collaboration with people who use services.
The creation of new structures, regulatory and commissioning practices and financial streams is necessary to embed co-production as a long-term solution. For more information, see SCIE Research Briefing 31 on the emerging evidence base for co-production.
Involvement and CQC registrationOpen
To complete registration with the Care Quality Commission (CQC), providers must demonstrate that they meet essential standards of quality and safety across all the services they provide. The guidance applies to all health and adult social care providers. It focuses on the quality of outcomes for people who use services. See CQC guidance on compliance with new regulations for adult social care and health provider registration.
Providers are required to provide evidence of their practices around the involvement of people who use services as one of the three key features of the registration process. The other key features for which evidence must be provided are personalised care and treatment, and safety and safeguarding.
The following are some examples of the kind of evidence of involvement that providers should demonstrate:
- carrying out a user survey seeking the views of family, friends and other stakeholders on how the services are run and publishing the results
- having a system of consulting with people who use services and carers
- having publicised and accessible complaints procedures that people are encouraged to use
- making policies and procedures available and accessible to people who use services
- ensuring that people who use services are able to meet staff regularly and participate in discussions about the services
- enabling people who use services to be involved in staff recruitment.
National minimum standardsOpen
Emerging from the Care Standards Act 2000, the purpose of the national minimum standards is to ensure that care provision is fit for purpose and meets the assessed needs of people using social care services.
Although national minimum standards have introduced a general requirement to include people who use services in planning and improvement activities, it is open to providers to look at different ways of putting this into practice. Examples of ways of doing are:
- involving people who use services and carers at team meetings or other learning events, demonstrating that their views and experience are valued
- working with user-led organisations as partners in service development decisions (co-production)
- enabling people who use services to participate as a member of the selection panel in recruitment
- enabling people who use sevices to act as a mentor to new staff
- enabling people who use services to carry out part of the induction training for new staff
- enabling people who use services to discuss with managers where staff need to develop good practice.
The participation of people who use services and carers has become an increasingly important part of how care services are developed and delivered. Any organisation wishing to develop meaningful participation must first develop a positive attitude towards the process and begin to embed it into practice.
Embedding participation through a whole systems approachOpen
This involves looking at the organisation as a jigsaw consisting of four sections that link together. Participation needs to be addressed in each section:
- culture: the ethos of the organisation shared by all staff and people who use services which demonstrates a commitment to participation
- practice: the ways of working, methods for involvement, skills and knowledge which the people who use services and their carers experience.structure: the planning development and resourcing of participation evident in the organisation's infrastructure
- review: the monitoring and evaluation systems that enable the organisation to evidence change affected by participation.
For further information on the whole systems approach to implementing participation in practice, please see SCIE's Practice Guide 17: The participation of adult service users, including older people, in developing social care.
Involvement in practiceOpen
The way of increasing participation will differ according to the organisation and the circumstance it finds itself in. However, it will involve the entire workforce. By building participation systematically into plans and objectives, it is more likely to result in an inclusive and productive working culture.
Here are some examples of good involvement practices that can be applied:
- Select a staff 'participation champion' whose role it is to ensure that the perspective of people who use services is considered in all decisions. This role might be appropriate for people who use services, carers, volunteers and advocates as well as paid staff.
- Make greater understanding of participation a development objective for all staff and managers; embed and monitor this practice through supervision and appraisal.
- Allocate resources for the training and practice of involving people who use services, and staff.
- Consider how the expertise of people who use services may be harnessed to help staff development, for example people who use services acting as staff mentors.
- Ensure that evaluation on the effectiveness of involvement work is systematic and the outcomes are fed back to people who use services.
Participation has become a key 'target' in many service-level agreements for social care organisations, both voluntary and statutory. At times, this can lead to the participation 'box' being ticked by organisations because they can demonstrate that they have involved people who use services in a specific activity, rather than because they can provide evidence of change or improvement as a result of their participation. Outcome-focused evaluation is therefore an essential component of successful involvement practice.
The principles of participation (Social Care TV 2010) is a good starting point for understanding how a local authority has managed to put this into practice.
Involving children and young peopleOpen
There are a range of policy initiatives, such as Best Value, and Connexions, that require local authorities and other services to look at ways of enhancing young people's involvement in local decision making. There is also a widespread concern with young people's estrangement from the democratic political process and the need to redress this.
This sense of exclusion can be tackled by providing real opportunities for young people to have a say in decisions that have an impact on their lives and communities. There are four crucial stages in developing initiatives that involve young people:
1. Creating the right environment
Developing systematic, effective and meaningful participation of children and young people in the design, delivery and review of their services requires action. SCIE's Practice Guide 11: Involving children and young people in developing social care advocates focusing on a whole systems approach to participation. This approach, as suggested before, includes:
There are many good examples where this practice has worked successfully and these can be seen on the websites of the Children's Workforce Development Council; the Centre for Excellence and Outcomes in Children and Young People's Services (C4EO) ; A National Voice
Key additional resourcesOpen
- Action for Children (2007) The right choice: Involving children and young people in recruitment, London: Action for Children.
- Adams, R. (2008) Empowerment, participation and social work, Hampshire: Palgrave/Macmillan.
- Co-production: information about this can be seen on the Think local, act personal website.
- Department of Health (2009) Putting people first: Working together with user-led organisations, London: HM Government.
- Department of Health has a range of information on user-led organisations.
- National minimum standards for social care.
- Riddington, C., Mansell, J. and Beadle-Brown, J. (2008) Are partnership boards really valuing people?, Disability & Society, vol 23, no 6, pp 649-665.
- SCIE(2007) Developing measures for effective service user and carer participation , London: SCIE. (Doel, M., Carroll, C., Chambers, E., Cooke, J., Hollows, A., Laurie, L., Maskrey, L. and Nancarrow, S. (2007)
- SCIE 2007.Participation: finding out what difference it makes', Guide 20, London: SCIE.
- Carr, S. (2010) Personalisation: a rough guide, Report 20, London: SCIE.
- SCIE (2010) Allowing User-led groups to flourish, Community Care, 5 August.
- Doel, M., Carroll, C., Chambers, E., Cooke, J., Hollows, A., Laurie, L., Maskrey, L. and Nancarrow, S. (2007) Developing measures for effective service user and carer participation, Position Paper 09, London: SCIE.
- Wright, P., Turner, C., Clay, D. and Mills, H. (2006) Involving children and young people in developing social care, Practice Guide 06, London: SCIE.
- Needham, C. and Carr, S. (2009) Co-production: an emerging evidence base for adult social care transformation, Research Briefing 31, London: SCIE.
- Moriarty, J., Rapaport, P., Beresford, P., Branfield, F., Forrest, V., Manthorpe, J., Martineau, S., Cornes, M., Butt, J., Iliffe, S., Taylor, B. and Keady, J. (2007) The participation of adult service users, including older people, in developing care, SCIE Guide 17, London: SCIE.
- Principles of participation (Social Care TV 2010).
- Social Work Education Participation (website).
- User-led organisations: information can be seen on the Think local, act personal website.