A discussion on the barriers to the meaningful involvement of homeless service users, from both a provider and service u

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 Manchester�s Service User Network for Homeless People

2. Themes for the day Introduction to SUN Service user involvement: Benefits, Barriers, Engaging the hard to reach Workshops Tie up at end

3. Manchester�s Service User Network In 2004 the homeless Service User network (SUN) was set up with the help of Manchester�s 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.

4. SUN: Aims and Objectives The project aims to ensure homeless people�s 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

5. 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 city�s 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.

6. 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. (It�s Your Move) It is the involvement of service users in the management, design and delivery of services (Glasgow Homeless Network)

7. What is service user involvement for? To change services or strategies as a result of what users want i.e. to meet users� needs To determine people�s 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 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

8. 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 people�s skills and capacities (e.g. of users in training staff)

9. 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)

10. 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, don�t 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

11. Some of the reasons why service users choose to get involved or not Because something�s 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 don�t think it will make a difference. Because they�re 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).

12. 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.

13. 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 organisation�s commitment to user involvement. To provide an ongoing source of user�s 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 group�s aims fit into the organisation�s 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?

14. 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

15. 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 user�s 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 provider�s management committee

16. 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

17. 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.

18. 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 H&S 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

20. 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

21. 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.

22. 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 it�s 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 Doesn�t 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!

23. 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?