1. The Organisation and Management of Social Care Services Voice of the service user 26 th April 2005

2. Lecture outline Feedback from last weeks task Exercise 1 – us as consumers Approaches of organisations to consumerism What services users say Levels of participation

3. Feedback from task set last week

4. Exercise 1 You are going into hospital for a minor operation. What issues would be important to you in arranging this process?

5. 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.

6. Different paradigms or ways of understanding organisations Scientific/Traditional Consumerist - Market approach - Empowerment/democratic approach

7. 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.

8. 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.

9. 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.

10. 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?

11. Towards an empowerment/liberational model Set in a political context; Collective action; Focuses on peoples 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)

12. What service users say…

13. What were the key messages from services users? Do they differ from the issues we would raise as customers/consumers?

14. Ways of involving service users Planning of services Service development Service delivery evaluation

15. Levels of participation Manipulation Informing Tokenism Consultation Partnership Delegated power Service user control

16. Specific reading Article by Starkey, F. (2003)