Placing service users at the heart of service development and delivery

Real and meaningful ways of engaging with service users are key to delivering services that clients want and need; the most effective agencies are delivering services in partnership with their clients. Understanding how involving clients in this way can assist them to develop a sense of self-worth, confidence, responsibility and new skills, is key to helping to create positive change in their lives. Placing service users at the heart of service development and delivery means understanding the diverse needs of your clients and how to meet them, making services truly responsive. Agencies will fit somewhere along a continuum:

What does success look like?

Agencies that place service users at the heart of their work listen to what clients have to say. It sounds simple – but it’s hard to do well. The Booth Centre in Manchester undertook a complete review of their services and involved service users in it. This six month process resulted in service users now providing many of their services: the day centre has four full time paid workers and thirty volunteers, half of whom are clients. Volunteers are trained to assess new clients and give basic advice. Involving service users in the review drove this; service users wanted to work, and decided how it would work in practice. Service users do not have access to each other’s files. There are very clear guidelines on confidentiality and not putting temptation in people’s way – there is no access to money. Volunteers do one session a week, and receive lots of training and support, including a catering qualification. Volunteers also repaint the centre annually and have a real sense of ownership of the building. Clients are also listened to on a day-to-day basis – suggestions for new courses are acted on. The most chaotic and difficult clients have been transformed through their volunteering – clients behave in a totally different way when they’re working. The Booth Centre does not have clients on the Board, as feedback from clients has shown that they do not enjoy or get anything from Board meetings. Other organisations have had a different response from clients and have board-level representation, such as St. Anne's in Leeds, Foundation Housing in Leeds and Carr Gomm.

Shekinah Mission in Plymouth deliver outstanding training and meaningful activity programmes for service users. Training programmes are designed following discussions with service users – for example, after one service user said they aspired to be a Ferrari mechanic, Shekinah developed links with a local garage to offer traineeships for service users. This has proven successful in practice as their training course completion rate is on average between 80 and 90% - including people who are currently rough sleeping on courses that require daily attendance over a period of weeks.

What factors can inhibit placing service users at the heart of service development and delivery?

• Lack of staff training on how to do it
• Fear about what service users might say
• Belief that staff have the right ideas and service users do not
• Belief that service users don’t want to be involved, and do not have the capacity to engage in a meaningful way
• Lack of knowledge of a framework to create safe involvement (including issues such as CRB checks, mental health etc)
• Lack of time and money to undertake surveys and other service user involvement techniques

What agencies can do:

• Make sure that they recruit and retain staff who have the competency of a person centred approach and a belief that clients are worth listening to, and who are able to do so. This should be embedded in the recruitment process and through regular learning opportunities both formal and on the job
• Offer regular ways for clients to tell staff what they think – in a way clients want to. This might be through regular discussions, complaints, comments and suggestion boxes, or just through having a good enough relationship with staff to talk on a day to day basis
• Enable clients to give feedback on service content and staff performance
• Undertake client audits and client satisfaction surveys
• Offer meaningful opportunities for service users to be involved in reviewing services using innovative methods like drama workshops
• Check that service user consultation is standard across the organisation and consider moving staff around to achieve this where possible
• Enable staff to talk to other agencies about what has worked for them
• Visit services that are doing it really well
• Contact the London service user network which is well attended and useful for members
• Work with client advocacy groups such as Groundswell to strengthen feedback

What Homeless Link can offer now:

• The homeless customer project – this is delivered in partnership with Cardboard Citizens. This drama group of ex-homeless people will come into a service and deliver a day workshop with clients and staff, looking at how services are delivered and developing an action plan for improvement. The Homeless Link Regional Manager then supports this over time to assist the agency to change.

Future Homeless Link projects to assist agencies:

• Training on effective methods of service user involvement
• A best practice briefing on service user involvement on our website
• National network for agencies to share best practice on service user involvement and client centred practice
• Opportunities to visit best practice organisations in every region of the country
• Client satisfaction surveys and client audits
• Benchmarking of client satisfaction surveys and client audits
• Peer research guidance

What partner organisations offer:

• Groundswell promotes practical solutions that involve homeless people, to tackle homelessness and social exclusion. Groundswell's work is about helping people to make informed choices about their lives and find solutions to their own problems.
• TPAS, The Tenant Participation Advisory Service for England, is the leading national tenant participation organisation working to promote tenant empowerment.
• Cardboard Citizens run free, weekly, open access, workshops for homeless and ex-homeless people, led by professional artists
• Carr Gomm offer consultancy to agencies to assist them in developing great client involvement techniques which work for their organisation

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