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Will we give them a choice?

Tuesday, June 15, 2004

Article for Progress Journal


Giving service users choice in social services sounds good, something that everyone should support. But social services cover many different areas of work, each with particular issues and challenges. Developing new services with choice and user involvement, whilst also alive to these differences, is difficult and complex. It’s helpful to consider these issues in two contexts - the processes involved and service provision.


People approach social services when they need help. It isn’t easy and they do so usually without understanding the processes. They face complex procedures involving impenetrable language, assessments, eligibility criteria and rationed resources. If the system isn’t understood, how can people make a choice about what they would like? We have to start by giving them basic information. All services should be obliged to set out in plain language who the service is for, how their entitlement is determined and the range of choices that are available.


Take an elderly couple, where one partner is caring for their spouse who is housebound. They approach social services hoping that the carer can have a break and that their spouse will receive the care they require. The information they need includes how they will be assessed, what will social services want to know about them, what services are available and how much influence they can have in the service they get. For example: can they choose to have someone to provide personal care as opposed to someone to do the cleaning? These are crucial questions and once social services are satisfied that the couple do need help, they should be open to these discussions.


For some elderly people and adults with learning disabilities, the professional view of appropriate services may be different from the service user, which again may be different from the person’s family. Involving advocates may be appropriate, who can explain the processes and help those involved put their views about services they receive. A number of voluntary organisations have become skilled in advocacy work but there is no reason why advocates shouldn’t also come from community and neighbourhood organisations. Local people can be trained in the relevant skills and they may also be in a position to offer support to people such as those with mental health or learning disability problems living in their community.


Service Provision


On the service provision side the local authority social services monopoly has gone. Co-operatives and mutual organisations provide a real opportunity for service users to have a voice in their operation. I visited a residential home run by West Midlands Co-op Ltd., and it was clear that staff and residents gained a great deal from the values of co-operation. Residents trusted the Co-op to provide care and to involve them in running the home. Staff felt more involved in the home than under previous private management and therefore had greater job satisfaction.


The important role of churches and community groups in providing low level services such as luncheon clubs and social groups should not be neglected. Often with minimal financial support, these organisations can alleviate the need for more expensive social services. They can check that elderly people are alright, ensure provision of adequate food and that vital, but often neglected, need for the company of other people. Similarly many organisations provide support for parents with young children or clubs and groups for older children. Not only do these help prevent problems occurring but they can be early warning systems for difficulties that could lead to social services involvement.


Finally all social services need to have good mechanisms for consulting with the various groups who receive their services. Many local authorities already do this but a requirement to consult would ensure that not only what is provided, but the way in which it is provided, better meets the needs and expectations of those who need help. For too long social services have held onto the power that comes from knowing how the system works. By involving service users and the wider community not only will they provide more appropriate services but ensure also better use of resources with more people supported and helped within their own communities.



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