Shape up and listen

Stephen Ladyman’s “new vision for social care” is lacking one
important element: service user feedback. With the government now
answering critics by extending its consultation to service users,
the social care minister could do worse than heed the
recommendations of user group Shaping Our Lives.

This group, which has a database of hundreds of service users and
the organisations that represent them, has already submitted
initial evidence to the government to express its user-centred
vision for adult social care.

Its values and principles include the importance of a vision based
on social models of social care. The sector needs to acknowledge
and challenge the broader constraints, barriers and discriminations
that service users face and recognise their right to help shape
their own well-being.

 Shaping Our Lives also emphasises that social care needs to take
as its starting point a clear rights-based philosophy that:

•  Sees social care as having a central role in supporting and
  safeguarding people’s human and civil rights.
• Is based on an idea of independent living, which means
  providing the support that service users need to live on as equal
  terms as possible as non-service users.
• Builds on a holistic understanding of the individual within
  their community and society and seeks to support their involvement
  and inclusion.

  Shaping Our Lives draws attention to the evidence that shows
  service users value social care practitioners with the right human
  qualities as well as the necessary skills. This means workers who
  are open, honest, warm, empathetic and respectful and treat clients
  with equality. They recognise and address diversity, are
  non-judgemental and anti-discriminatory.

  The relationship service users have with service workers is a key
  determinant of good practice. This means ensuring minimal
  inappropriate turnover of social care workers, and continuity and
  choice in who service users have working with them.

  Shaping Our Lives argues for practice which values the direct
  experience of staff that have used social care services and which
  supports and encourages the recruitment of such people. The group
  challenges discrimination and encourages staff development and
  promotion based on the contribution of service users in
  professional education and training.

  Shaping Our Lives wants social care to prioritise equal access to
  support and acknowledge that clients want services that:

• Address diversity, whether relating to age, race, gender,
  sexuality, culture, class or disability.
• Recognise that although different groups have shared rights
  they may have different needs; and which supports a range of
  provision to meet these different needs on equal terms.
• Are based on systematic and comprehensive access policy and
  practice. This recognises that access is about more than physical
  access, although this is important. It means ensuring that all
  groups can contribute on equal terms, have equal access to
  appropriate services and support, and have equal opportunities to
  become involved. This particularly means ensuring physical,
  cultural and communication access for all.

  Shaping Our Lives makes the case for service users to have choice
  in the support they receive. This may be support provided on the
  basis of direct payments, which put service users in direct control
  of their personal care package. It may mean mainstream services,
  which seek to replicate the choice and control which has so far
  been offered to a few service users by direct payment schemes. And
  it may mean access to user-controlled services and support
  arrangements (which research shows service users particularly
  value) through greater government funding.

  Shaping Our Lives has called for social care which:

• Treats people as adults, rather than putting or keeping them in
  dependent and unequal relationships.
• Acknowledges its responsibilities to offer support and
  safeguard people’s rights, as well as restrict some people’s rights
  in order to safeguard those of others.
• Offers people real alternatives to residential services.
• Is evidence-based and includes service users’ research and
  service users’ knowledge as equal elements of its evidence
  base.
• Involves service users effectively and on equal terms, where
  such involvement leads to palpable change and improvement in the
  lives and prospects of service users.

To achieve such user-centred social care for the future, Shaping
Our Lives emphasises the need for monitoring and review based on
user-defined quality and outcome measures as well as those of
professionals and policy makers.

Most of all it re-emphasises the importance of government
adequately funding an infrastructure of independent,
user-controlled organisations. This provides the starting point for
effective and diverse involvement and provides a framework for
expanding user-led services and the extension of direct payments to
more service users. This is Shaping Our Lives’ vision. It is to be
hoped it will influence the government’s.

PETER BERESFORD is professor of social policy
and director of the centre for citizen participation at Brunel
University. He is a long-term user of mental health services and
chairs Shaping Our Lives.

He has a long-standing interest in the issue of participation as
actrivist, researcher, trainer and writer.

FRAN BRANFIELD is manager of Shaping Our Lives,
the national users’ network. She has been involved in the
disability movement for many years and is an independent consultant
and trainer on disability and equality issues. She has undertaken
user-controlled research in many areas, including service user
knowledge “Do Not Resuscitate” orders and disabled people and
service users’ perceptions of social care. 

A USER’S GUIDE

Shaping Our Lives is an independent national user-controlled
organisation, which works with, and comprises of, a range of adult
health and social care service users. It was establisted in 1996
and has worked nationally and locally to try to improve service
users’ involvement in and influence on health and social care, and
to improve the quality of support and services they receive.

ABSTRACT

This article takes as its staring point the decision of social
care minister Stephen Ladyman to develop a new vision for adult
social care and the failure so far to elicit service users’ views,
it reports evidence submitted by Shaping Our Lives,  the national
service user-controlled organisation. This highlights a vision of
soical care based on the social models of support and a
rights-based approach. It discusses the kind of practice users
value and a series of principles and values to underpin social care
for the future as well as ways to achieve
them.

FURTHER READING

• C. Barnes, C. Mercer and H. Morgan (2000) Creating Independent
  Futures: An evaluation of services led by, Disabled People,
  Disablity Press 2000.
• Shaping Our Lives, Black User Group (West London) Ethnic
  Disabled Group Emerged (Manchester) Footprints and Waltham Forest
  Black Mental Health Service User Group (North London) and Service
  Users’ Action Forum (Wakefield), Shaping Our Lives – From Outset to
  Outcome: What People Think of Social Care Services They Use, York,
  Joseph Rowntree Foundation/ York Publishing Services 2003. 

CONTACT THE AUTHORS

Fran Branfield can be contacted at fran@shapingourlives.org.uk