Service user and carer participation why nothing could be easier

1
Service user and carer participation why
nothing could be easier?

• Nick Andrews
• Swansea SSD

2
The apple pie concept

•  

3
That is often.

• Operationalised, before it is conceptualised
  (Sheppard 2001)
• Service user involvement is a complex and
  ambiguous idea. It is one of those aspirations,
  like partnership and empowerment, which can
  easily be degraded, diluted and devalued
  (Branfield et.al. 2006)

4
No participation is better than bad participation
5
Three peas in a pod!
6
Four key aspects to effective participation

• Defining what we mean by participation
• Ensuring that we address issues of equality and
  diversity
• Setting standards and associated indicators for
  participation
• Be clear about the benefits/outcomes of
  participation, and how we measure them

7
1. Defining what we mean by participation
8
2. Ensuring that we address issues of equality
and diversity

• Across the full age range
• Black and minority ethnic groups
• First language Welsh
• People with dementia
• Carers
• Frontline staff

9
3. Setting standards for participation
following Scotlands lead

• INVOLVEMENT we will identify and involve the
  people and organisations who have an interest in
  the focus of the engagement
• SUPPORT we will identify and overcome any
  barriers to involvement
• PLANNING we will gather evidence of the needs
  and available resources and use this evidence to
  agree the purpose, scope and timescale of the
  engagement and the actions to be taken
• METHODS we will agree and use methods of
  engagement that are fit for purpose
• WORKING TOGETHER We will agree and use clear
  procedures that enable the participants to work
  with one another effectively and efficiently

10

• SHARING INFORMATION we will ensure that
  necessary information is communicated between the
  participants
• WORKING WITH OTHERS we will work effectively
  with others with an interest in the engagement
• IMPROVEMENT we will develop actively the skills,
  knowledge and confidence of all the participants
• FEEDBACK we will feed back the results of the
  engagement to the wider community and agencies
  affected
• MONITORING AND EVALUATION we will monitor and
  evaluate whether the engagement achieves its
  purposes and meets the national standards for
  community engagement

11
4. Be clear about the benefits and outcomes of
participation, and how we measure them

• Whilst the service user movement has achieved
  much in terms of principle, it is less clear what
  changes in practice have resulted from it
• SCIE (2004)

12
Benefits for individual participants

• Improved self esteem of participants
• Increased self confidence and ability to take
  greater control over all aspects of life
• Increased awareness and understanding of own real
  interests, and how they relate to the needs of
  others
• An opportunity for self expression
• Greater social citizenship

13
Benefits for agencies

• Wider range of views brought to bear in decision
  making
• Provides a useful realty check for policy
  makers
• Political legitimacy and accountability to
  citizens
• More effective and person centred services

14
How do we pull all this together?
15
Standards based participation planning
16
Outcome based participation planning
17
VOiCE bringing together outcomes and standards
in participation planning
18
What is VOiCE?

• VOiCE is a database planning and recording tool
  designed to assist individuals and organisations
  to design and deliver effective community
  engagement.
• VOiCE builds on two widely adopted and effective
  tools
• National Standards for Community Engagement
• Learning, Evaluation and Planning - LEAP

19
Analyse, Plan, Do and Review

•   Using this structure, VOiCE
• asks key questions related to good community
  engagement that need to be addressed at each step
• provides a recording system for the engagement
  as it develops and
• enables evaluation and learning from experience

20
Using this structure, VOiCE

• Asks key questions related to good participation
  that need to be addressed at each step
• Promotes a collaborative approach to developing a
  common understanding of desired outcomes and how
  these might be achieved
• Is as much about learning as it is about planning
• Has outcomes evaluation built in from the start
• Provides a recording system for participation as
  it develops

21
Whose outcomes?
22
RCCH Standard Tool

• Resident centred care is dependent on the
  development and maintenance
• of positive relationships across and between the
  resident, their close
• relatives/friends and staff, often referred to as
  the relationship triangle
• Residents will judge their experience of life in
  a care home more positively if the homes owners,
  managers and staff are person-centred in attitude
  and behaviour toward them.
• Relatives and other close carers visiting the
  resident will judge their own experiences more
  positively if managers and staff recognise the
  roles of relatives and close carers and respond
  with understanding.
• Staff will judge their experience of working with
  older people as more satisfying and worthwhile,
  and be more person-centred in their work, if they
  feel valued by their employer and equipped to
  fulfil their caring roles in resident-focused
  ways.

23
Powys MtC Project Using VOiCE to help everyone
sing to the same hymn sheet

• In provider settings, e.g. care home, day
  services, dom.care etc.
• In multi-agency planning across health and social
  care, e.g. MARGs
• In wider citizen engagement, e.g Strategy for
  Older People

24
Start with an Outcomes Framework

• e.g. UDSET Quality of life outcomes
• Feel safe and secure
• Have satisfying things to do
• Have good social contact
• Stay as well as you can be
• Live where you want to, in an environment
  comfortable to you
• Have control over your daily life and routines

25
Identify Outcome Indicators 3 point checklist

• Start by thinking how you would experience a
  particular outcome being achieved
• Use the process of identifying indicators, as a
  learning exercise, in promoting a shared
  understanding and ownership of the outcomes
• Identify Primary Indicators usually 2 or 3
  headline indicators
• Identify Secondary Indicators everything else
  thats any good
• Identify data development agenda

26
Outcome Indicators 3 criteria for scoring and
selection

• Communication power does the indicator
  communicate to a broad range of audiences?
• Proxy power does the indicator say something of
  central importance about the outcomes?
• Data power can data be readily collected in a
  reliable and timely fashion

27
Final word
28
Final word

• No everything that can be counted counts, and
  not everything that counts can be counted
• Albert Einstein