Research into practice

How do social care workers know whether they are doing a good job?
The obvious but not necessarily well-worn answer is to ask the
people who use services. Research from the Sainsbury Centre for
Mental Health¹ shows
the importance of gaining service users’ views on innovative local
practices they receive.

The Active Outreach Team was set up in a voluntary sector service
(Julian House, Norwich) with a remit to support people in
sustaining their own tenancies. Given that assertive outreach is
about engaging people who choose not to become involved with or
actively resist mainstream services, qualitative research with this
client group is difficult.

In attempting to assess the impact of the team on the quality of
life for service users, researcher Roberta Graley-Wetherell
conducted individual interviews with service users, held a service
user discussion group and spoke to family members and the staff
team.

Importantly – and this is something to be considered if
independently canvassing the views of any client group –
Graley-Wetherell herself has experience of using psychiatric
services. This proved invaluable in trust-building and arguably
delivered more honest and detailed findings.

Service users were positive about the pace of engagement, which was
deliberately pitched at individual requirements. Time is routinely
considered a luxury or restricted resource but, if the quantity can
be invested, quality returns are possible. Users reported that they
had in the past felt rushed or coerced into doing things they did
not want to do but, with the approach adopted by the outreach team,
they felt much more “in charge”.

Service users also appreciated the informality of meetings with the
team, something that traditional services seldom offered. Simply
chatting and listening proved most effective.

Most service users were happy with the amount of contact, although
some said they would have liked more. For a group that in the past
has proven difficult to engage, this was a clear indicator of
success.

The language used while working with service users was important in
sustaining engagement. The researcher reports that she was
surprised that, when asked, most service users said they did not
have any “targets” or “goals”. It later turned out that they had
but did not use such formal, jargonistic labels: they did, however,
have an understanding of what they were working to achieve.

Many users reported that their benefits had increased since the
team had become involved. More money can indeed improve one’s
quality of life, and two service users commented on how their
social life had improved thanks to the extra income. Of course,
this also leads to a reduction in sense of isolation, which in turn
improves mental well-being.

Service users agreed unanimously that the team delivered a service
that was different from anything they had received in the past.
They felt they had respect and time and were listened to. One said:
“They treat me as a person, not a number.” All but one thought
their quality of life had improved as a result of regular contact
with the team.

Perhaps the main, if indirect, message from this small but
effective piece of research is that it is important to tackle
evaluations of service from a service user’s experience. Indeed, if
users are to be truly at the centre of services, their views should
be central to any evaluations of those services.

1 Active Outreach: An Independent Service User Evaluation
of a Model of Assertive Outreach Practice, R Graley-Wetherell and S
Morgan, Sainsbury Centre for Mental Health, 2001, price £7
plus 70p p&p. Available from SCMH, 134-138 Borough High Street,
London SE1 1LB. Tel: 020 7827 8352. Fax: 020 7403 9482.