Sheffield

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User Engagement Project

REPORT

By

Judy Parfett

August 2003

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Contents


Executive Summary…………………………………………………………………

Background…………………………………………………………………………………

Context………………………………………………………………………………………

Theoretical Framework………………………………………………………..

Project Aims……………………………………………………………………………

Methodology……………………………………………………………………………….

Findings………………………………………………………………………………………

Recommendations………………………………………………………………………

Bibliography………………………………………………………………………………

Appendix 1: List of agencies with whom the project had contact…………………………………………………………………………………

Appendix 2: SAAS Floating Support Scheme User Forum Report…………………………………………………………………………

Appendix 3: User Involvement Training: notes from the events…………………………………………………………………………………

Appendix 4: Evaluation of Training…………………………………….

Appendix 5: Comparative……………………………………………………….

Appendix 6: Methods……………………………………………………………..

Appendix 7: Lay Assessors……………………………………………………

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Acknowledgements

I would like to thank the following people for their help in producing this report:

Dinah Lane for being forward thinking enough to conceive the idea of this project.

Sharon Bromley for her unfailing support and guidance, Pauline Lord, Denise Eaton, Craig Pugh, Danny Antrobus and all my other colleagues and friends at VAS who have been so supportive.

Sheffield Supporting People Team

Zahid Hamid (Black Community Forum)

All the providers I had contact with, especially Nicola Smith and Barry Mark (SAAS), Michelle Hammond (New Era), Rachel Hague (SE Older People's Tenancy Support), Andy Wallace (SYHA).

Rosie James (Staffordshire Supporting People Team)


Executive Summary

Showing a commitment to service user involvement in Supporting People (SP), Sheffield SP Team funded a twelve-month half time post for a User Engagement Officer. The work focussed mainly on promoting good practice in user involvement issues to service providers, and on forging links with stakeholders to inform recommendations to the SP Team. The recommendations are both for the sustainability of user involvement at provider level and for SP strategy and service development.

The report includes results of a User Forum, and descriptions of various methods and approaches to user involvement, as well as the results of discussions that took place during user involvement training.

Findings

Recommendations

Background

The Supporting People programme was developed as a new integrated policy and funding framework to provide housing related support services for vulnerable people. Supporting People was planned as a working partnership between Local Government, the NHS, the National Probation Service, service users and support agencies. Supporting People “went live” in April 2003. The Supporting People Teams are based within each local authority; within Sheffield the team is located in the Housing Department.

A key element of the Supporting People programme is the requirement that both the local authority and the support provider engage with service users.

“For local authorities, this means that:

• Strategies should be developed and agreed through consultative processes, which involve those who use or are likely to use these services alongside other key stakeholders.

• The views and experiences of service users should be taken into account in evaluating and commissioning individual services.

Support service providers, on the other hand, should:

• Involve users effectively in all aspects of service planning and delivery to ensure effective, appropriate and responsive provision.

• Deliver services, which enable people to develop skills and capacities to live independently and to take increasing control over their own lives.”

Showing a commitment to fulfilling these requirements, Sheffield Supporting People Team funded a twelve-month half time post for a User Engagement Officer.

The work of Sheffield Supporting People Team is supplemented by one of the Planning and Partnership Officers at Voluntary Action Sheffield, who has a particular role in Supporting People to ensure that provider agencies are consulted and involved in the implementation process. The Supporting People Partnership agreed that work to consult and engage with service users would most appropriately be undertaken as an extension of this work with providers. As a result it was agreed that the post holder would be located at Voluntary Action Sheffield.

Part of the value of the Supporting People User Engagement Officer being located in the voluntary sector was that the needs of the service user would be given paramount importance when recommendations were made. Although the Supporting People User Engagement Officer worked closely with the Supporting People team, this independence was important to maintain the integrity of the project.

Context

“The vision for the monitoring and review of services under Supporting People is to develop a system that leads to the continuous improvement of services.”

A national framework has been developed for monitoring the quality of Supporting People services. Administering Authorities will collect quality and performance information from providers for contract monitoring and for service reviews. Administering Authorities will also carry out validation visits to check the quality of services provided. These visits are not the same as regulatory inspections and are instead `reality checks' to inform the contract monitoring and review processes. These visits must include communication with service users. In addition checks will be made on the performance data supplied by providers.

At a service level, providers will be able to self-assess their services against the Quality Assessment Framework (QAF) and the performance framework and develop mechanisms for continuous improvement. Properly involving service users will be an important part of improving services and making them more customer focused.

The Service Objectives are divided into four “Core” and thirteen “Supplementary” objectives. Core objectives are for use in the review of services that are operating under interim contracts - i.e. those undergoing their first service review. The supplementary objectives, together with the core objectives, are for use in subsequent service reviews - i.e. reviews of services operating under “steady state” service contracts. The purpose of dividing the QAF in this way is to allow providers time to adjust to new expectations and to evolve their practices accordingly.

There are five supplementary objectives directly related to involving service users. These are to ensure that the service:

Theoretical Framework

Terminology

Service user involvement is the term used in the Best Value requirements set out in the Local Government Act and is also the term used in Supporting People guidance issued by the Office of the Deputy Prime Minister (ODPM) “Service user” or “user” takes account of the fact that the people receiving housing related support may not be “residents” or “tenants” of the support provider.

“Involvement” is used as a way of attempting to encompass the different aspects of a process that may include providing accessible information and training, consultation, participation and partnership work.

I will use the term “service provider” or “provider” within this report to refer to organisations that are contracted under Supporting People (SP) to provide housing related support services.

Participation

When working with service providers we looked at a range of methods for involving service users guided by the ladder of participation reproduced below.

Quayoom's Ladder of Participation 1990

HIGH

Users have the authority to take decisions

Users have the authority to take some decisions

Users have the opportunity to influence decisions

User views are sought before making decisions

Decisions are publicised and explained before implementation

LOW

Information is given about decisions made

Supporting People is described as a partnership, with service users being one of the partners. Partnership suggests that power is shared equally between all partners. Croft and Beresford (1992) argue that power can be shared and that this can increase the influence of the people concerned. However they warn that participation and involvement can be used to give a false impression of transferring power when, in reality, power stays firmly with the same people.

There is an assumption by Government that such a partnership is achievable and desirable. The purpose of this report is to question such assumptions, but it cannot provide the answers to the questions posed.

There is also an assumption that service users want to be engaged and consulted on every aspect of their service, that they want to learn new skills and be empowered. Choice is the most important element of user involvement -the user's right to choose not to participate must be respected.

Project Aims

The aims at the beginning of the project were:

It was envisaged that a steering group made up of representatives from provider organisations and service users would contribute their expertise to the project. Part of the remit of the post was to set up such a group.

Methodology

Steering Group

Membership

A steering group was set up consisting of myself, Sharon Bromley the project manager, Kate Robertson, Supporting People Strategy and Development Officer, Andrew Wallace, Tenant Participation Officer for Supported Housing at South Yorkshire Housing Association, Michelle Hammond from New Era and Rachel Hague from S.E. Older People's Tenancy Support Scheme. Some service users were to be invited on to the steering group once it was up and running. An alternative to this idea was to have a separate user advisory group.

Role and Purpose

The function of the steering group was envisaged as being to provide guidance to the project and input from different areas of expertise.

Disbanding

It became clear after two meetings that the steering group was not useful enough to justify the amount of working time it would take up. It was also decided that it would not be good practice to invite service users onto the steering group. Engagement with service users must be carefully planned; the service users should have the opportunity to choose a venue, help set the agenda, have the knowledge and skills to engage with the relevant issues etc and this could not be achieved within this setting. If service users had been invited onto the steering group it would have achieved little and been a token gesture.

VAS line management and contractual arrangements as set out in the Funding Agreement required the presence of the line manager and Supporting People Officer at steering group meetings, leading to a possible conflict of roles.

Lastly the diversity of the client groups within Supporting People meant that it would be difficult to include expertise from all areas without making the steering group too large and unwieldy. It was decided that it would be more useful to draw on different specialisms and expertise at different times in the project -as and when appropriate. This would be in the form of one to one or small meetings.

Contact with service users

At the start of the project it was envisaged that there would be engagement of service users through a variety of approaches. The purpose of this was to inform the recommendations of this report and to consult on the Sheffield Supporting People five-year strategy. Engagement with users would have to follow good practice and be conducted in a sensitive and meaningful way; otherwise it would be token and time wasting. There are a variety of reasons why engagement with service users was minimal:

Networking with other Supporting People Teams

I contacted teams in the region to see what they were doing in terms of user engagement. I also put messages on the Supporting People website to try to network with other teams working on this area. See Appendix 5 Comparative.

Mapping existing user groups

I made contact with many different agencies in order to try to establish what user groups exist within the city. As it became increasingly clear that there is no housing related support focussed user group, I decided that the best approach was initially through the providers.

Telephone survey

My initial contact with providers was through a telephone survey which I conducted at the very start of the project, ringing a range of providers to establish the range of attitudes to service user involvement. The sample covered different client groups and types of provision, but was only a small sample, as it was not intended to be representative. The questions were not all encompassing but designed to provoke a response that would give some indication about the attitude to user involvement. For the results of the telephone survey see Findings

Contact with Providers

See Appendix 1 for list of providers that I had contact with over the course of the project. Some of these I visited, some I contacted and spoke to by telephone and others attended training sessions. For comments and questions that came out of face-to-face meetings see Findings. I produced a pack for all providers funded by Supporting People consisting of some tips for good practice and a resource and reading list (this is incorporated in the Bibliography).

User Forum

I acted as an independent facilitator for a user forum for Sheffield Alcohol Advisory Service (SAAS). SAAS agreed that in return for facilitating the session, I could ask some general questions around consultation for the purpose of this report. The forum took place in a relaxed environment that was familiar to participants, tea and coffee and biscuits were provided. I used flipcharts and post-it notes to provoke discussion. Once I had written the report I sent it to participants for confirmation that it was correct before producing the final draft.

See Appendix 2 for the full report.

Training

With my manager Sharon Bromley I delivered two training sessions for providers on user involvement. Having looked at the Supporting People training module for guidance, we initially delivered a half-day training session for twenty people. Although feedback was positive, many people including ourselves felt that it was not long enough, and taking this and other feedback we received into consideration, the second training session was a full day. Again we received positive feedback. See Appendix 3 for information on the content and results of the discussions, Appendix 6 for a description of the methods used and Appendix 4 for summary of the evaluation forms from each session.

Communication with service users about Supporting People

It was agreed at the second steering group meeting that this was not the responsibility of the project worker. However I offered to give advice on appropriate wording/methods of communication. I also obtained various leaflets and information about a video that Staffordshire Supporting People Team has produced (see Appendix 5 for Comparative).

Findings

Contact with providers, service users and other local authorities highlighted key issues in service user involvement. The findings illustrate the range of attitudes towards user involvement and some user views on consultation processes. Some of the concerns and comments have been addressed through training and information provision.

Telephone survey of providers

What mechanisms are set up to consult with clients?

What kind of things do you consult about? (E.g. living environment menus etc)

Did you know that it is a requirement of SP to give clients a say in services and reviews?

Monthly surgeries attended by the manager and any residents that wish to attend. House meetings when needed to address specific issue.

Limited choice of décor, carpets, kitchen units. Majority vote. Regional tenants' advisory panel takes place at different schemes to encourage attendance.

Yes, we do it anyway so it shouldn't be a problem.

Link group -tenants meet together with head of operations. Tenants associations. Formal complaints procedure.

Rent.

No

None. No say in food, décor or anything else. Someone recently made a complaint because it is her nature to moan and complain, we got fed up of her going on so we addressed it but usually no one complains

No, I am just the housekeeper. The committee are responsible for Supporting People

Regular key work sessions, residents' meetings, care plan reviewed after 3 months, plenty of informal opportunities to give feedback.

No consultation on living environment. Focus on independent living skills. Complaints procedure in place and complaints will be acted upon where appropriate

Yes

What mechanisms are set up to consult with clients?

What kind of things do you consult about? (E.g. living environment menus etc)

Did you know that it is a requirement of SP to give clients a say in services and reviews?

Regular monthly residents' meetings, reviews take place every 3 months by 2 members of governing body, 2 staff, and 2 residents. Views of residents/ complaints put in business plan.

Redecorate 6 times a year, residents' choice. Consulted informally on a day-to-day basis. Regular reviews. Support plans and key workers.

Yes, we are already working with the QAF.

Monthly house meetings with key worker. Key worker available at all times for support and advice. Complaints policy and suggestion box. Customer Care Committee meets every six weeks and 2 residents are on this.

Customers have a say in every aspect of their care. A care plan is used to focus on each client's need, what life skills they need to learn etc.

No because Supporting People is not the responsibility of the key workers, but confident that consultation in this organisation is thorough.

Monthly residents meeting attended by the committee. Chair of committee visits every day and residents are aware that they can approach him with any problems or comments.

Everything -from menu planning to how the house is run, and choice of what services users wish to receive.

No, but no concerns about it because doing it anyway.

Person centred planning approach. Observation skills and other user involvement techniques incorporated into staff training and induction. The support plan is written in the first person to include clip art and photos. Also some clients have life books to give staff information about their lives. House meetings.

Most things. We are looking at involving clients in staff recruitment. They currently have informal meetings between candidates and clients.

Yes

Internet café -teaching IT skills -provides relaxed environment to receive feedback.

Difficult client group to engage with, have shown little interest in any kind of involvement. Have successfully organised football games and pool tournament -hopefully a way in. Hoping to organise a user forum.

Yes

User Forum

The full report from this is in Appendix 2. The findings that relate directly to this project are below. The participants responded enthusiastically to being given an opportunity to have their voices heard and contributed positive feedback as well as offering criticism that would hopefully improve the service. As this was the only incentive to participation, it is worth noting that four out of five people invited came along.

What would encourage you to get involved in a consultation exercise?

What would put you off participating in consultation?

What kind of incentives would encourage you to get involved?

Questions And Comments from face to face meetings with providers

RECOMMENDATIONS

  1. PROVIDERS: Build on work done with providers (i.e. dissemination of information on good practice, training) to promote user involvement so that providers can show that they are using good practice by the time of their review. Resources could be set aside to:

      1. provide further training

      2. build a central resource containing literature and other material

      3. providing an independent facilitator to conduct user forums for providers (as part of a wider role).

  1. VALIDATION VISITS:

  1. Identify resources to do all or some of the following:

    1. Set up a Lay assessors scheme (see Appendix 6)

    2. Subcontract validation work with service users to community groups /other organisations with the expertise to engage with users

    3. Employ part time worker with expertise in engaging with service users

    4. Develop a range of materials to engage those service users who cannot communicate their concerns in a conventional way.

(ii) Draw up good practice guidance for all personnel working with service users.

  1. TRAINING FOR SP TEAM: Train review officers in service user involvement issues so that they can:

      1. develop an awareness of the barriers to engagement of Supporting People client groups

      2. develop an understanding of the range of methods, which providers may use to engage with users and reflect this in the range of acceptable evidence required in service reviews.

  1. STRATEGY: Members of the Supporting People staff team will not necessarily have the expertise, profile or time to liase effectively with service users. The team should focus on the long term aim of setting up sustainable consultation mechanisms through partnership work with Black Community Forum, existing user groups, community groups etc. It is important that users are approached by people like themselves or people with the knowledge and skills to be, for example, culturally sensitive. As the team will probably not be building up relationships with users over a period of time, it makes sense to work with those who have already built up such relationships. The Sheffield Supporting People Draft Shadow Strategy 2002-2003 states that areas of interest for users and potential users of services in the inclusive consultation process are:

Consultation with service users on these issues will be required for the annual update of the five-year strategy. Users themselves are not currently qualified to become meaningfully involved in service planning and delivery in this way. These challenges could be addressed in the following way:

Judy Parfett

August 2003

Bibliography

Books/ Reports/ Supporting People Documents

Change Picture Bank CD Rom

With over 500 pictures to make written material easier to understand. Available from Change -0113 243 0202 or www.changepeople.co.uk/bank.html

CVS Consultants, Raise the Roof -Supported housing user consultation, CVS Consultants, 1998.

Hibbert, Pam; Voices and Choices: young people participating in inspections, Barnado's 2002

Keeble, M.; DIY Training Pack for Supported Housing: a self-help pack for developing tenant Participation, TPAS 1997

Keeble, M.; SITRA Workbook on Tenant Participation in Supported Housing, SITRA.

Keeble, M; Just Do It! A Directory of Examples of user involvement in supported housing, The Housing Corporation, 2000

Novas-Ouvertures, Have we got views for you! Service user involvement in supported housing, Novas-Ouvertures, 2001.

ODPM; Supporting People: A Guide to User Involvement for Organisations Providing Housing Related Support Services.

www.spkweb.org.uk How It Will Work/Supporting People Overview/ Papers and Publications

ODPM; Quality and Monitoring: The Overview and Quality Assessment Framework www.spkweb.org.uk General documents and discussion/more documents>>>/Quality and Monitoring

Spugeon, L. and Howlett, A.; Involving tenants in the Framework for housing with support, National Housing Federation, 1999

TPAS; A Tenant's Guide to Involvement in Supported Housing -TPAS 1997

Social Services Inspectorate - www.doh.gov.uk/scg/assess.htm

APPENDICES

APPENDIX 1

List of agencies with whom the project had direct contact

Housing related support providers

Other agencies

Abbeyfield Society

Black Community Forum

Action Housing Association

Housing Corporation

Anchor Trust

Manchester Supporting People Team

Cherrytree

National Housing Federation

Domestic Abuse Floating Support

Northern Refugee Centre

Grace Tebutt House

Office of the Deputy Prime Minister

Johnnie Johnson Housing Trust

ROCC

Melrose hostel

Rotherham Supporting People Team

New Era, SYHA (Tenant Participation Officer)

SITRA

Oakdale House

South Tyneside Supporting People Team

Pitsmoor Youth Housing Trust

Staffordshire Supporting People Team

Refugee Housing Association

Swindon and Wiltshire Supporting People Team

Rethink

Worcestershire Supporting People Team

SE Older People's Tenancy Support

Sheffield Adult Family Placement

Sheffield Alcohol Advisory Service

Sheffield Care Trust

Sheffield Social Services

Shelter Older Person's Tenancy Support Scheme

Somali Mental Health Project

South Yorkshire Housing Association (Malinda Street),

STENCIL

Stonham Housing Association

Stothard Court

Support Care

Target Housing

Tinsley Help at Home Scheme

United Response

APPENDIX 2

SAAS Floating Support Scheme User Forum

Background

The Supporting People User Engagement Project is a time-limited piece of work promoting good practice in service user involvement, participation and consultation to providers of housing-related support. The report produced at the end of the project will make recommendations to the Sheffield Supporting People Team.

Sheffield Alcohol Advisory Service Floating Support Scheme has been operating since April 2002 when Barry Mark was recruited as Co-ordinator. As part of the funding bid there was an undertaking that a user forum would take place, facilitated by an independent chair. I was approached to do this and was happy to do so on the understanding that I could ask service users some general questions around participation for the purposes of the report mentioned above.

Aim

Method

1. Introductions. I asked people to give their name and the reason why they thought they were there. It was important to establish this because I had not invited people to the event, so I needed to know why they thought they were there.

I explained that I was independent and that although the event was part of the funding agreement, further funding was not dependent on the outcome of the day. I said that Barry and Nicola would welcome any criticisms as valuable tools for changing and improving the service where possible. I then showed participants a flipchart with the following information:

“The aim of the day is:

ALL THIS IS TO TRY TO IMPROVE THE SERVICE YOU RECEIVE”

I then facilitated discussion based on the following questions or topics, using the methods indicated to record the responses (see Appendix).

1. What support do you need generally? Post-it notes and flipchart.

2. Which of the above does the floating support scheme provide? Circled on flipchart.

3. Who else do you receive support from? Group discussion recorded on flipchart.

4. What else would you like the floating support service to provide? Post-it notes.

5. What support do you need that you are not receiving? Group discussion recorded on a flipchart.

6. How was the experience of transition from residential support to independent living? Group discussion recorded on flipchart.

7. Feedback/ Complaints Procedure. Group discussion recorded on flipchart.

8. Each participant was asked to write on a post it note one thing about the scheme that was good and one thing that could be improved.

9. What would encourage you to get involved in a consultation exercise? Group discussion recorded on flipchart.

10. What would put you off participating in consultation? Group discussion recorded on flipchart.

11. What kind of incentives would encourage you to get involved? Group discussion recorded on flipchart.

Recommendations for Sheffield Alcohol Advisory Service Floating Support Scheme

Discussion

I regret not having more control over people being briefed about the forum. At least two of the four were expecting to be having a one-to-one session. More importantly, people had obviously been told that the event was connected with the funding leading to an assumption that funding could be under threat. It was crucial that the purpose of the event was clarified, as some people thought that further funding for the service might be dependent on the outcome of the forum. If that had been the case participants would not have felt confident about mentioning any concerns and the integrity of the event would have been compromised.

Because we discussed support needs in a wider context, it became clear that some of people's unmet needs could not appropriately be met by floating support, and I was careful to point out that many of the services needed were not part of the remit of the scheme.

Appendix

There were 4 participants.

1. What support do you need generally?

2. Which of the above does the floating support scheme provide?

3. Who else do you receive support from?

4. What else would you like the floating support service to provide?

5. What support do you need that you are not receiving? Group discussion

6. How was the experience of transition from residential support to independent living? Group discussion

These comments all refer to participants' experiences before the Floating Support Scheme existed.

“When I was leaving Priory Road I was offered support, but was overconfident and chose not to take it. I am ok when it comes to practical stuff but realised that I need ongoing support with keeping off alcohol”

“ I walked into my room put my bag down and just felt desolate”. Other people agreed with this.

“I felt very restless towards the end and wanted to leave early so that I could start drinking again -I thought I'd be able to handle it.”

“ I feel very strongly that this kind of support has been needed for a long time. When I left Priory Road I was going back to visit all the time, I felt I needed more support than I was getting.”

“I was given 3 choices of accommodation and felt that none were suitable. I went to the Thursday Project and they helped me find somewhere”

7. Feedback/ Complaints Procedure. Group discussion

8. Each participant was asked to write one thing about the scheme that was good and one thing that could be improved:

GOOD

COULD BE IMPROVED

Consistency

Group support needed

A listening ear

A bit overpowering at times

Supportive and helpful

More support to access counselling

Supportive and understanding

Help gaining assessment quickly from Norfolk House

9. What would encourage you to get involved in a consultation exercise?

10. What would put you off participating in consultation?

11. What kind of incentives would encourage you to get involved?

Other issues that were raised during group discussion

APPENDIX 3

User involvement Training 9th May and 10th July 2003

Notes from the events

BENEFITS OF INVOLVING SERVICE USERS

-TO THE ORGANISATION

-TO THE SERVICE USER

WONDERWALL EXERCISE

Methods for involving service users

“Talk to them”!

User led newsletter or newsletter/ magazine with some articles by service user

Tea parties / coffee mornings

Feedback from key workers to team/ management

User board/ management committee/ steering group members

User forum with independent facilitator

Support plan with user involved/ person centred planning/ day-to-day planning

0800 phone line

Questionnaires

Social events that encompass different projects

Service user meeting -they set agenda

Internet café

Chat room on the internet

Needs assessment

Tackle a known issue to show commitment to change

Surgeries/ small forums

Video/ multimedia project/ video diary

Disposable camera to comment on service

Allocating tasks

Focus groups on specific topics

Cooking skills

Shopping trips

Acting on feedback promptly

Staff recruitment

Suggestion box / forms with a system set up to respond to suggestions

Consultation on change

Take people out of usual surroundings, to loosen up (e.g. coach trip -if consult on coach got “captive audience”)

Feedback sheets in user-friendly formats

Service user evenings/ get together informal meeting

Project groups consisting of staff and service users

Service user involvement in the wider community e.g. Attending voluntary Group meetings

Life skills programmes -to discuss for example rights and responsibilities

Decorating groups

Art competitions

Sports competitions -snooker, football etc

Phone Day - encouraging service users to ring and complain or compliment the service and suggest improvements

Jot down ideas on post-it notes!

Free activities programme - provide budget for users to organise

Accessible complaints forms and procedures

Drop ins

Participate in caring for accommodation

User representative to be elected to attend staff meetings (or part of) and feedback to users

Road shows

Exit interview / follow up surveys

Induction interview/ explain and consult on policies and procedures

Role-play

Structured opportunities to get involved in education, employment and leisure services

Mystery shopper

Taster sessions on different topics/ skills

Visiting other service users at different providers

Personal introductions to senior managers or buddying scheme.

WONDERWALL DISCUSSION

Method

Client group/ Type of scheme

Barriers

How can we

overcome barriers?

And/or advantages of method

Newsletter

(user led)

All with a creative approach, but especially useful for floating support and long stay schemes

Language - little or no use of English or lack of literacy skills. Jargon, content.

Resources, commitment, distribution.

Translations, pictures, photos symbols, audio tape, Braille etc

Plain language

Can make anonymous comments, producing it could be a social opportunity, quizzes, art competitions updates on ex-users.

Tea parties

(incorporating discussion)

Particular older people. Residential setting.

Appropriate venue

Travel

Resources

Time of day

None institutional venue

Travel expenses, minibus, etc, near to residence

Review of support plans/ exit plans

All, but not always popular with asylum seekers. Not always appropriate for sheltered. Good for floating support/ short stay

More pressing concerns

Lack of trust

Staff seeing it as criticism (esp exit plan)

Bad design

Doesn't reach hard to reach.

People leave without doing them.

Good practice should build trust

Reassure and show you value staff

User involvement in staff recruitment

More difficult for short stay

Frightening for staff

Training implications

Long process

Staff/ service user relationship potentially improved

User involvement in staff training

More difficult for short stay

Possibility of tokenism

Lack of confidence (users)

Staff awareness improved, users gain new skills and confidence

Suggestion box

All, especially short term project

Language/ literacy

Doesn't get used

No procedure for taking action/ giving feedback on suggestions

Make particular staff responsible.

Encourage use of,

quick response, always give feedback

Method

Client group/ Type of scheme

Barriers

How can we

overcome barriers?

And/or advantages of method

User board members/ steering group members

All client groups.

Not short term projects

Formal

Accessibility

Too high expectation

Scary, user sidelined,

Could be token, Staff/ board confidentiality issues

Training, support, mentoring scheme, subgroup for users with shorter more accessible meetings, ex-service user on board, danger of tokenism

House meetings

Accommodation based support

Some people don't like groups, lack of trust

Child care

Appropriate venue

Repetitiveness

Lack of interest, communication barriers, potential for conflict, staff feel put on the spot.

Arrange at suitable time, non institutional, informal setting

Provide food/ activity; call it by a different name.

Exclude staff -invite in for specific issues only.

Event to show examples of available décor -fabric samples, kitchen units etc, coffee provided

Larger organisations with resources, longer term accommodation

Resources, travel

Encourage further participation, provides choice

Feedback from key workers

Schemes with key workers

Objectivity - it is key workers interpretation of users views

Is this “user involvement”? Not on its own, can only be part of the picture.

Internet Cafe

All

Resources

Inappropriate use of the internet

Relaxed atmosphere, people dropping in to access internet or gain IT skills -may open up to workers

0800 phone line

Larger/ national organisation

Training people to answer phone,

Resources,

Language

What would it be used for?

Free and confidential

Method

Client group/ Type of scheme

Barriers

How can we

overcome barriers?

And/or advantages of method

Role Play e.g. staff and users swap roles

Young people, people with moderate learning difficulties

If users uncomfortable could be damaging if not done properly

Lack of staff experience

Staff training

Increased staff awareness. Increased user confidence

Fun

User Forum

(independent facilitator)

All client groups

Medium and long stay.

Too formal

Finding independent facilitator

Language

Access

Suspicion of users about hidden agenda

Organisations could do this for one another.

Provide transport, non-institutional venue, reassurance, time taken to build up trust. Opportunity to talk more broadly about all services received.

Social Activities

e.g. sports tournaments, outings, parties etc

Most client groups, particularly families with children.

All types project

Choosing an activity that appeals to all

Some people don't want to be grouped under a label with others.

Staff motivation

Could be an opportunity to elicit views in a fun informal setting, change of environment

Exit survey

Not older people in long stay.

Short medium stay.

Communication, vested interest of staff intimidating, time, lack of objectivity, fear

Training for staff

Staff recruitment

Most with support,

Problematic for short stay

Lack of time, support, staff nervousness, User lack of confidence, Challenges power relationship, resources, legal concerns

Questionnaires /surveys

Not suitable for non readers, users with English as second language, but with creative approach could be used for all groups

Poor response, surveys set an agenda, staff fears, time, limited choice if using pictures

Low risk to board, make it accessible.

A choice of options can be helpful for those who are unsure of their opinion.

Creativity required

Method

Client group/ Type of scheme

Barriers

How can we

overcome barriers?

And/or advantages of method

Going out -one to one or group

Most

Mobility/ transport problems, agoraphobia, staff, resources

Support plans/ person centred plans/ diaries

All

Limited use as a user involvement tool

Video diary would work well as user involvement tool

Mystery shopper

Require confidence

Risk to user- out on a limb

Giving users disposable cameras to comment

All

Scary for staff

Focus groups

All

Language barriers

Communication problems, mobility, could be put off by name, venue, staff availability/ lack of skill

Get someone from the community to lead

Different name,

External facilitator

Website

or user chat room on web

Esp good for people with mobility problems, or those that don't want to be part of a group

Reliant on access to computers

Maintaining/ updating site

Literacy and computer literacy

Pcs at community centres

Opportunity to learn new skills

Inappropriate use

Video diary -Big Brother style

All

Intimidated by camera

Confidentiality issues

What will final product be used for?

Can't be swept under the carpet -could have negative implications for users as well as staff

Could be trained to operate camera/ edit

Could be a good thing that cannot be whitewashed.

Method

Client group/ Type of scheme

Barriers

How can we

overcome barriers?

And/or advantages of method

Introductions between senior managers and users

e.g. buddying scheme

Small organisations would find this easier

Suspicion of authority/ lack of shared language/ outlook etc

Breaking down barriers, finding common ground -understanding other perspective.

INCENTIVES

One of the groups had a long discussion around the issue of offering incentives to service users for their involvement. Below are a few notes from what was a heated discussion.

Someone pointed out the danger of offering a “free lunch” with no meaningful engagement. Should people be offered money or just have their expenses paid?

There was a strong feeling that incentives must be appropriate, and shouldn't be offered without careful thought.

Incentives could be incorporated into the event - a quiz, a raffle, a competition.

The discussion showed that there is no easy solution to this issue. Ideally, a service user should not be motivated to get involved only because they are being “bribed”. However, we know that if people cannot see clearly what they will get for their efforts, it may be hard to involve them. Some may have “consultation fatigue”, whilst other “hard to reach” people need drawing in. If we can get their interest there is an opportunity to show them why it is important that their voices are heard.

ADDITIONAL EXERCISE 10/7/03

The additional discussion that took place in the second training session involved sharing examples of good practice. These were either examples that people already knew of (these are incorporated in the Methods), or examples taken from Just Do It! or Supporting People: A Guide to user involvement for organisations providing housing related support services.

APPENDIX 4

Evaluation on User Involvement Training

Training Event 1: Quaker Meeting House 9th May 2003

20 people (the maximum number) took part. Topics covered were:

Participants were enthusiastic about the subject and some lively discussion took place.

Networking between support providers was encouraged. There was a demand for independent facilitators for user forums. I suggested that providers could perform this role for one another with support and advice from myself.

Evaluation forms

12 forms returned.

Length of course; 10 said it was “ideal length” or “about right”. Two said it was “too short”.

Quality of training material; 1 “excellent”, 8 “goods”, 2 “fair, 1 did not circle.

Meeting expectations; 3 “completely”, 5 “mostly”, 4 “partially”.

Comments - More time to discuss wonderwall, more about getting service users involved in groups “which was delivered over coffee”, more examples of ideas already taking place, good opportunity to share knowledge but nothing new, not quite enough time to explore ideas.

Rating the trainers; 4 “excellent”, 8 “good”

Rating the course overall; 2 “excellent, 8 “good”, 2 “fair”

What did you find useful? Networking opportunities, new ideas for user involvement, wonderwall -bouncing off ideas, looking at new ways of working which have worked for other groups, confirming good working methods, discussion generated by the wonderwall, pre-course information, mix of services [providers?], feedback, all discussions, sharing ideas, idea about making residents' meetings more fun.

Skills ideas or areas of understanding acquired; different approaches/ methods, exit interviews, newsletter, greater understanding of issues around service user involvement, less fear and more idea of positive outcomes, not really, made me think more about service I am providing and how I can improve it.

How to improve course; more time, not on a Friday, follow-up day, fine as it was, develop bit about ideas to practical application, more control over individuals monopolising conversation, 4 hours instead of 3, more specific advice, what training would be required for residents to be involved in steering groups etc.

How many VAS training courses have you been on?

None - five, 1-2 - three, 3-4 - two, 5-6 - one

One uncircled.

Any other ideas for training

Independent user forum facilitator training.

Training event 2: St Mary's Community Centre, 10th July 2003

17 people took part. Topics covered were:

Participants seemed to have less knowledge and experience than those on the first session, a lot more spoon-feeding needed. On a positive note this felt less like preaching to the converted.

It was a very hot day which affected people's ability to concentrate, but even though it felt less successful in terms of people' contributions to discussion, the feedback was even more positive than last time.

Evaluation forms

15 forms returned

Length of course; All said it was “ideal length” or “about right”.

Quality of training material; 2 “excellent”, 12 “goods”, 1 “fair”

Meeting expectations; 5 “completely”, 7 “mostly”, 3 “partially”.

Comments - “not enough new ideas”, “expected more on SP requirements but actually glad there wasn't”, “Excellent day, I feel that user involvement is critical in the development of services, more training is necessary”, “I would like the session to cover practical aspects of user involvement, making things work”, “second session was quite negative”, “didn't have any clear expectations but felt very positive afterwards”

Rating the trainers; 6 “excellent”, 8 “good” 1 “fair”

Rating the course overall; 3 “excellent, 11 “good”, 1 “fair”

What did you find useful? Discussion, meeting other providers, sharing ideas, pros and cons of different methods, handouts, examples, other people's ideas. The overwhelming response was that people valued the opportunity to share ideas and experiences.

Skills ideas or areas of understanding acquired; “more than when I first came”, service objectives, ability to actively promote user involvement, different methods for people with communication difficulties, greater awareness, website and forum ideas.

How to improve course; 2-day course, cooler venue, more brainstorming, more exercises.

How many VAS training courses have you been on?

None - eleven 1-2 -four

Any other ideas for training - mental health, Direct Payments Scheme

APPENDIX 5

Comparative

At the start of the project I contacted other Supporting People Teams in our region to see where they were up to in terms of user consultation. At that stage (September 2002) there was little happening. I also tried to contact other teams across the country through the Supporting People website. The information I received is below.

Swindon and Wiltshire

There is a Wiltshire and Swindon Users network which has been funded by the Supporting People team. They were also appointing a part-time user involvement worker, organising a series of local user led meetings to find out about Supporting People geared around different groups of users and running two conferences to help explain Supporting People.

South Tyneside

The team produced a draft user involvement strategy in 2002.

Worcestershire

The team appointed a User Consultation Officer who has devised leaflets to inform users about Supporting People, delivered training to frontline staff and organised a county wide event to inform a User Involvement Strategy and the five year Supporting People Strategy.

Staffordshire

I attended an event for service providers and their users organised by Staffordshire Supporting People Team. The event included an interactive exhibition which visitors were guided through with the use of a personal tape player. The exhibition included photos taken by users to show what they do and don't like about their scheme, with simple wording next to the photos. The event was also to launch a video made with some service users and aimed at all service users giving simple accessible information about Supporting People. The film was being screened at half hourly intervals and visitors were provided with free popcorn or nuts to give the feeling of being at the cinema. The event was very accessible for service users and will be taken around the county in a road show style.

APPENDIX 6

Methods

The following is a list of methods used by the project and/or suggested to or by providers. Each method is not discrete; many can be used effectively together. The list is not exhaustive and some of the more traditional methods such as suggestion boxes or questionnaires are not included, not because they are seen as redundant but because the aim is to generate new ideas. For a longer list of methods generated during user involvement training refer to Appendix 3

Service users as board members

Appointing service users as members of steering groups/ boards/ management committees can work. As seen in Quayoom's ladder of participation, a high level of participation means that users have decision-making powers and this should ultimately be an aim of user involvement. However to impose such a role even on a willing service user could backfire and be a token gesture without the proper training and support. There are examples of successful ways of achieving user involvement at board level in the Supporting People User Involvement Guide. Alternative models such as a parallel structure to the board for service users developed by Leonard Cheshire are also described.

Residents meetings

Provider feedback suggests that the term “residents meeting” or “house meeting” does not attract service users, so a change of name may encourage both attendance and motivation to find less traditional and more interesting formats for such meetings. Consultation with users could inform what would encourage them to attend. Users need to feel they own these meetings and that the agenda is theirs. Staff may not always be welcome for the entire meeting. Providing food or making it more of a social event could encourage attendance. Other methods mentioned can be used in this forum.

Example: Whine and Dine evening - two different users each month prepare and cook a meal for other users and staff, and take the opportunity to discuss issues which have arisen over the month.

Multi-media

E.g. video, photography, art, drawing, audiotape can be used both to facilitate communication, encourage involvement and develop new skills.

Example 1: In a large organisation users may not have the confidence to voice their concerns directly to management even if given an opportunity to do so. They could be supported to make a video in which some people could act out scenarios that affect users. Those who do not have the confidence to appear in front of the camera could learn video or editing skills. Such a video could also be used to raise awareness in staff training.

Example 2: Disposable cameras are often used as a tool for feedback, with users taking photos to illustrate what they do and don't like about their service.

Example 3: User produced newsletter could include art competitions, quizzes, `gripe of the week' and `praise of the week', as well as information on past service users achievements as an incentive.

Example 4: One organisation used a video diary modelled on the Big Brother Television show to engage their users

Social events incorporating user feedback

Example 1: Internet Café - A drop in service where users can socialise, learn IT skills, use the internet and talk informally with staff about any problems they may have.

Example 2: Day trip with a quiz on the journey to provoke discussion and feedback on how people like to be involved.

Example 3: Sports tournaments such as pool or football can be a good first opportunity to engage with users and find out what would encourage them to get more involved. Tournaments between users and staff or members of the local community could help to break down barriers.

Service user involvement in staff recruitment

This can take place in varying degrees, from users meeting candidates informally or having an input into the person specification to having a user on the interview panel.

Example: Carr Gomm set up a working party to look at this area and identify examples of good practice. Tenants were then involved in interviewing two staff members as a pilot project and evaluating the experience. Guidelines developed as a result of this process included ensuring that those involved in interviewing received training in equal opportunities, confidentiality, person specifications and interview techniques.

User forum/ interview with independent facilitator

This can be a valuable way for an organisation to gain a fresh perspective on the experiences of their service users. If a small number of users are participating then an individual with experience in participative techniques can facilitate a discussion group e.g. See Appendix 2

Alternatively an external organisation with the same client group can be brought in to conduct interviews; East Thames Housing Group use People First, an advocacy organisation of people with learning difficulties to conduct interviews with their service users.

Participation in choosing and maintaining surroundings

Service users can be offered the opportunity both to choose their own colour schemes/ fixtures and fittings etc and be involved in decorating and maintaining their own environment thus encouraging independent living skills.

Example 1: One large service provider who were refurbishing their properties, organised a drop-in event with refreshments, where fixtures and fittings such as carpets, curtains, kitchen units etc were on display. Residents could choose their preference and the opportunity was taken to recruit people to other user involvement initiatives.

Example 2: Funding was identified by YMCA Housing to give service users an opportunity to decorate their own home in groups and in the process acquire both decorating skills and negotiation skills. Tensions developed because some people worked harder than others; residents themselves proposed a solution to this in the form of points earned for work done, which could then be spent on activities.

Involving users who have no or few verbal communication skills

Staff training is particularly crucial if people with limited communication skills are to be meaningfully involved in their service. Close observation of people's responses and facial expressions is essential. If people have had no opportunity to make choices previously, the concept should be introduced gradually with a limited number of simple choices gradually expanded.

Example 1: Leonard Cheshire gave clients an opportunity to try out new experiences such as a dance group in the safety of their own space, to see whether they enjoyed it before taking them out to such a group.

Example 2: The Sharing and Caring project (Sheffield Mencap) have developed Life Books for people with severe learning difficulties. These provide valuable information for staff and carers on a service user's past as well as their likes and dislikes and are regularly updated.

Methods used in User Involvement Training for providers

Ground rules for the day were suggested by the participants.

Warm up exercise: During registration period, participants were asked to fill in a survey containing provocative and generalised statements about user involvement. The statements were then used in a warm up exercise. Each side of the room was allocated “agree” or “disagree” and participants were asked to go to the appropriate part of the room based on their feelings about each statement. Between statements participants were asked to comment on their reasons for their decision. This led to some interesting discussion as well as illustrating the limited value of surveys and of generalising about user involvement

Benefits of user involvement: Split into two groups -one discussed and wrote on flipchart the benefits from the point of view of the service user, and the other the benefits from the point of view of the organisation. The flip charts were swapped over for the other group to add anything extra.

Wonderwall: Post it notes were handed out for participants to write down as many methods of user involvement as they could think of (whilst the song Wonderwall was played). Particiapants were asked to stick the post its onto two “walls”. The group separated into two and were asked to discuss the different methods using the following questions: