The Organisation and Management of Social Care Services

Voice of the service user

26th April 2005

Lecture outline Feedback from last week’s task

Exercise 1 – us as consumers

Approaches of organisations to consumerism

What services users say

Levels of participation

Feedback from task set last week

Exercise 1

You are going into hospital for a minor operation. What issues would be important to you in arranging this process?

Why is it important to hear the voice of the service user? Contribution to knowledge about what is

good practice;

Improve services that they use;

Part of empowerment process.

Different paradigms or ways of understanding organisations

Scientific/Traditional

Consumerist- Market approach- Empowerment/democratic approach

Different approaches organisations can take towards consumers

Scientific/traditional approach

Organisations run in this way are characterised by professional assessments;expert approach, treatment approaches, standards, identifies individuals as problem. Prescribed provision such as child protection & mental health.

Different approaches organisations can take towards consumers

Consumerist approach: two-fold

Visible in the 1980s and 1990s govt. policy building on their notion of ‘consumer citizens’. NHS CC Act 1990 sets out need for LAs to consult users and develop a plan. Emphasis on complaints procedures.

Increasing involvement of users in service planning and delivery.

Consumerist approach-Market approach: Seeks to empower consumers through choice.

Individuals as citizens, able to chose and access services appropriate to their needs. Regular monitoring and evaluation.

- Empowerment/democratic approach: Recognises marginalisation of people, seeks to

give service users a voice and chance to change, sensitivity in provision, giving people control back in their lives. Direct Payments, user –led organisations.

To what extent do social care organisations adopt a consumerist approach and which one? Such approaches key to a learning

organisation; Tokenistic - Consult but no power? People need to be able to make a

choice, not all have the skills (Direct Payments)?

Does such an approach rely on individuals and ignore oppressive social structures and power?

Towards an empowerment/liberational model Set in a political context; Collective action; Focuses on people’s lives and

experiences within society as a whole; Moves beyond narrow focus of services; Personal growth and development; Higher levels of user participation.(Starkey, 2003)

What service users say…

What were the key messages from services users?

Do they differ from the issues we would raise as customers/consumers?

Ways of involving service users

Planning of services

Service development

Service delivery

evaluation

Levels of participation

Manipulation

Informing

Tokenism

Consultation

Partnership

Delegated power

Service user control

Specific reading

Article by Starkey, F. (2003)