A discussion on the barriers to the meaningful involvement of homeless service users, from both a provider and service user perspective, and how to overcome them. This workshop will also examine ways of effectively engaging the

1
A discussion on the barriers to the meaningful
involvement of homeless service users, from both
a provider and service user perspective, and how
to overcome them. This workshop will also examine
ways of effectively engaging the hard to reach.

• Angwen Vickers, Charlie Moores, Geoff Shaw
• Manchesters Service User Network for Homeless
  People

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Themes for the day

• Introduction to SUN
• Service user involvement Benefits, Barriers,
  Engaging the hard to reach
• Workshops
• Tie up at end

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Manchesters Service User Network

• In 2004 the homeless Service User network (SUN)
  was set up with the help of Manchesters Multi
  Agency Homelessness Forum (MMAHF), to start the
  process of giving homeless people a voice in the
  design, delivery and evaluation of homelessness
  services in Manchester.
• MMAHF commissioned research which consulted
  homeless people and service providers about user
  involvement. This research identified a need for
  a city wide mechanism for all homeless people to
  make an organised and meaningful strategic input
  into the design, delivery and evaluation of the
  services they use.

• Following from the recommendations from this
  research a project outline was developed and
  funding for 3 years from the Big Lottery fund was
  achieved. This funding has enabled the
  recruitment of a Service User Network Coordinator
  post whose role is to facilitate the project,
  help strengthen the homeless Service User Network
  and promote user participation and involvement at
  both organisational and strategic levels.
• It is an independent project based within a host
  voluntary sector organisation NEARIS.

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SUN Aims and Objectives

• The project aims to ensure homeless peoples idea
  and opinions are valued and central to the
  design, delivery and evaluation of homeless
  services in Manchester.
• The project objectives concentrate on building up
  a strong and truly representative service user
  group who will be supported to work with agencies
  to set up new structures which allow the views of
  homeless people to be heard, to influence
  strategic developments and to promote change
  within individual agencies across the city.
• By the end of the first year the project aims to
  be
• Holding regular meetings of SUN with an expanded
  membership, which reflects the diversity of
  homeless people in Manchester.
• A new structure for MMHAF which incorporates the
  involvement of homeless people at all levels and
  the support structures to ensure that it is
  meaningful.
• A Compact agreed with SUN and service providers,
  outlining how user involvement will be
  implemented

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SUN Aims and objectives

• An agreement with the local authority as to how
  homeless people will be involved in the review
  and development of the citys Homelessness
  Strategy
• At least two consultation events to enable
  homeless people to be consulted on particular
  issues.
• Two conferences and training events for agencies
  to promote user involvement.
• Two mailings to all agencies working with
  homeless people promoting ideas about best
  practice in increasing user involvement.
• An evaluation report at the end of the first
  year, which would include feedback from both
  homeless people and agencies and recommendations
  for the development for the project for the
  following year.

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What is service user involvement?

• Enabling service users to participate in the
  development of an organisation (or a service
  within it) by informing them about the services
  they receive and developing a range of mechanisms
  whereby they can feed back their views on this
  service and influence its delivery.
• (Its Your Move)
• It is the involvement of service users in the
  management, design and delivery of services
• (Glasgow Homeless Network)

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What is service user involvement for?

• User involvement can lead to better outcomes,
  therefore is more economically efficient for the
  organisation longer term
• User involvement is often perceived as being
  solely beneficial to the needs of the
  organisation.
• It is also beneficial to the service user as
  services will potentially better meet users
  needs

• To change services or strategies as a result of
  what users want i.e. to meet users needs
• To determine peoples experiences of services
• To enable active listening and negotiating
• To give people a voice from the bottom up
• To empower people
• To make a difference to services etc
• To encourage political citizenship and democracy
• It is about encouraging activity and not
  passivity
• To increase choices
• To Consult
• To gain different ideas
• To develop mutual responsibility.
• To change and challenge attitudes

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Why is it important?

• Involvement furthers the goal of independence,
  through facilitating inclusion, encouraging the
  development of life skills and enhancing
  self-esteem.
• Involvement is a way of bringing people together
  to achieve mutually desirable outcomes and is
  potentially an empowering and cohesive force.
• Involvement ensures that services reflect needs
  and wishes of the people who use them and creates
  ownership if the involvement initiatives are
  sustained by action.
• Involvement can help to check that services are
  providing added value in terms of quality.
• Involvement adds value to service planning,
  development and delivery.
• Involvement enables effective use of peoples
  skills and capacities (e.g. of users in training
  staff)

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Involvement vs. empowerment?

• The terms involvement and empowerment are
  often used interchangeably. However, there is a
  difference in their meaning. Engagement does not
  require involvement i.e. users can be consulted
  but this does not necessarily mean that they are
  involved. Similarly, involvement does not
  necessarily empower a user, although the
  cumulative effect of involvement may eventually
  result in empowerment. Users are empowered if
  they have a say that directly influences the
  change.
• User involvement can be direct users play a
  role in making decisions, or indirect users act
  as a source of information that may or may not be
  used to lead to change. The vast majority of user
  involvement in the public sector is indirect
  (information is collected about users views
  which may or may not be acted upon).
• (J Tritter)

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Barriers to Effective User Involvement

• Practicalities
• Lack of resources (space/money/ time)
• Lack of structure
• Accountability
• Lack of control
• Lack of motivation
• Lack of information - isolation
• Lack of creativity
• Sustainability clearly developed structure
• Passing on / collating information
• Ways to challenge Apathy
• Involve people at the very start of the process,
  empowerment through listening
• Ask the service users what they want, dont
  presume you know this already
• Give the clients a sense of ownership if people
  feel they have a say you will gain their trust
  and confidence.
• Show you mean business and that change can happen

• Organisational restrictions
• Forced participation
• Being realistic
• Pseudo democracy
• Tokenism
• Boundaries
• Disparity of needs/wants
• Language/literacy
• Lack of confidence
• Users feeling unsafe
• Apathy
• Geographically dispersed
• Cultural differences
• Conflict arising
• No incentives/no point/ no change

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Some of the reasons why service users choose to
get involved or not

• Because somethings wrong and they want to fix it
  
• To decrease isolation i.e. to have contact with
  others who share similar experiences
• To make a difference
• Because they are motivated by a particular issue
• Due to a passion for social justice issues in
  general (they may or may not have a passion for
  the subject area)
• OR
• They may be put off by the method being used and
  potential time and effort involved.
• Because they dont think it will make a
  difference.
• Because theyre unsure about what it is they are
  signing up to.
• Vulnerability they fear there will be a
  consequence of voicing their real opinions.
• They are faced with barriers to participation
  e.g. cultural/language barriers, economic
  barriers (due to potential costs involved),
  disability barriers (i.e. communication
  difficulties, learning disability).

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What makes user involvement hard?

• The lack of knowledge and understanding amongst
  service providers and service users about the
  meaning of user involvement and how it can be
  implemented.
• The lack of adequate funding for user involvement
  activities.
• Difficulty in getting support from within your
  own organisation.
• Vulnerability from staff that user involvement
  will be used to formally complain about services
  or individuals.
• Misunderstanding from users, particularly in the
  public sector, about the services that are
  available and that they require.

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Setting up a user involvement group

• Why are you doing it?
• To show the visible presence of users in your
  organisational setting
• To demonstrate the organisations commitment to
  user involvement.
• To provide an ongoing source of users views to
  evaluate and assess service development
• To provide a source of ideas for developing the
  service
• Who is the group for?
• Who are the users to be involved?
• What is expected of them?
• How will they be appointed to the group will
  the group be advertised?
• How much of their time will the group involve?
• How much support will they have available?

• What role do people have in the group i.e. can
  they vote, participate etc.
• How does the group feed into the organisation?
• Will it influence decisions?
• What are the aims of the group?
• How will the groups aims fit into the
  organisations and users agendas?
• Who will lead the group?
• If a user is to lead the group, what kind of
  training is available to them?
• Where and when should the group meet?
• Who will book the venue (refreshments, arrange
  transport etc)
• Is the group open or closed?
• Who can attend and for how long?

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Benefits of User Involvement

• USER
• Build skills and confidence in making a
  contribution
• Allows users to see the difference they are
  making- feeling valued
• Allows users to feel part of service delivery
• -Including a role in day to day activities
• -Including a role in provider/ organisational
  management

• PROVIDER
• Promotes teamwork staff development
• Informs policy and service development
• Responsive to needs and change- in touch
• Improved communication ethos
• Reduces power inequalities

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HOW SERVICE USERS CAN BE INVOLVED

• Level 1 Exchange of Information
• Relevant information is provided to service users
• Service Users have the opportunity to say what
  information they will find useful
• Service users involvement in the development of
  information materials and accessible Formats
• Level 2 Planning Activities and Events
• Groups of service users can express their views
  and influence decision-making through a range of
  secondary, creative methods that meet the
  requirements of the service users.
• Level 3 Planning and evaluating services/
  policy development
• At a strategic level, service users can be
  involved in
• Service planning and development, shaping
  policies, staff recruitment and training,
  evaluating the scope and quality of provision
• Level 4 Involving service users in service
  management
• Service users/ tenants are involved in the
  development and management of housing support
  services
• Service users/ tenants are elected or appointed
  to serve on the service providers management
  committee

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Ladder of Participation

• HIGH 1. Your users have the authority to take
  decisions
• 2. Your users have the authority to take some
  decisions
• 3. Your users have the opportunity to influence
  decisions
• 4. You seek user views before making decisions
• 5. Decisions are publicised and explained to
  your
• users before implementation
• 6. Information is given to your users
  about l decisions already made
• LOW

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What factors facilitate user involvement?

• Working together with users and representatives
  within the organisation
• Being open with users about the aims of their
  involvement
• Seeking feedback from delegates about the
  experiences of user involvement i.e. asking what
  would encourage them to participate again.
• Being clear about the needs of the organisation
  and the users and determining the most
  appropriate methods to match those needs.
• Funding
• Sharing knowledge, experience and good practice
  around user involvement with other organisations.
  
• prioritizing user involvement within an
  organisation could enable access to variety of
  different funding streams.
• multiple organisations could consider jointly
  funding an area of user involvement to meet a
  variety of different needs. It was felt that
  users would be more likely to participate in a
  larger study where there are potentially wider
  benefits.

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User involvement ideas

• Risk assessments
• Survey that looks at language and terminology e.g
  risk or well being
• Setting up a policy review group (including ex
  service users)
• Involving service users in their own risk
  assessments
• Complaints
• Complaints poster designed by users
• Graffiti board or post it sticker wall for
  complaints compliments
• Health and Safety
• Residents meeting about house rules/ visitors
• User accompanying staff in conducting HS checks
  and risk assessments
• Art group- design posters and leaflets about
  security, fire safety etc

• Support planning
• Photo project about support needs
• User discussion group about what are the
  immediate/ longer term Support Plan targets
• Exit interview- how did your support plan help
  you
• Person centred planning
• Equality
• Diversity groups e.g. cooking skills workshops
• Planning inter faith celebrations
• Combined user and staff training in harassment/
  anti-social behaviour
• Protection from Abuse
• Themed meeting to discuss labels and their
  meanings e.g. vulnerable, abuse and neglect
• User designed information leaflets about local
  support groups, counselling services
• Peer mentoring

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Involving service users for service
improvement Is the service what users
want? Does the service meet user needs? How
could the service be More effective? More
efficient? Better quality? Is there a genuine
opportunity to contribute (or lip
service?) What are you really asking? How does
this feed into strategic planning, and service
improvement?
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Methods of Consultation and involvement

• User led newsletter
• Feedback mechanism from Service user/ advocate/
  staff team to senior management team
• Person Centred Planning
• Internet chat room/ message board
• Art Competitions
• Drop Ins ( including ex users)
• Drama/ role play
• Mystery shopper
• User rep at staff meetings
• Peer research
• Peer mentoring
• Peer advocacy
• One to one in a support session
• Coffee mornings

• Questionnaires feedback surveys
• Exit interviews
• Video diary
• Photo project
• Suggestion Box/ post it wall
• Group work e.g. cooking skills, art, IT
• Social Events
• Complaints Compliments day
• Text
• Email
• Football
• volunteers
• Service user lead meetings

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Who are the need to reach?

• Hard to reach or need to reach clients are often
  defined as individuals who are
• homeless people
• people with alcohol and/or substance issues and
  addictions
• women escaping domestic violence
• vulnerable young people, often with histories of
  being in care
• people from black minority ethnic (BME) groups
  including gypsies and travellers
• people who have offended or may be at risk from
  offending
• those with complex needs (i.e. two or more of the
  above), and may be compounded by mental health
  problems
• However these definitions are not definitive and
  are merely an example, each organisation will be
  aware of individuals or groups of people who may
  not be accessing their services or whose services
  are not meeting their needs those are the people
  you will need to reach.

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The need to reach

• Identify groups or individuals you feel are not
  involved
• Look at why they are not involved
• People who are homeless and/or from vulnerable
  groups may have other more important priorities
  than being involved in traditional methods of
  consultation on strategic decision- making or
  just day to day involvement. This is particularly
  relevant if service-users are in crises, in which
  case it is important to recognise that more
  creative techniques will need to be employed.
• Look at ways that people can be involved and at
  what level
• Make sure it will be meaningful
• Ask them why its not working?
• See if they can suggest ways to be involved?
• What issues are meaningful to them?
• How can we do things better?

• Is it the way we do it?
• Try things out!
• Need organisational support including funding if
  possible
• Doesnt have to be costly
• Learning new skills to deal with challenging
  behaviour / conflict resolution
• Encouraging
• Recognising the right to non involvement
• Trying again and again
• Staff actively supporting
• Staff being trained and supported
• Enthusiasm and Persistence are prerequisites!

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Workshop questions

• Group 1 Benefits
• If you were a service user why would you get
  involved in your project and what
• would the benefits be for you?
• As a service provider what are the benefits to
  your service by involving service
• users?
• Group2 Barriers
• Choose a service what do you think are the
  barriers to involvement for service
• users who would use this service. Look at this
  from both the service user and
• provider perspectives? How could you remove these
  barriers?
• Group 3 Engaging
• People who are often regarded as hard to reach
  by agencies are often the
• very people agencies need to engage with in
  order to find out how best to
• provide a service that will support their needs.
  How could you engage and
• involve these people? Have you had experience
  where you have engaged with
• people you felt were difficult to reach and how
  did you do this?