Managing care



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‘(Beresford and Croft, 2003, quoted in Book 1, p. 23). A practice -led management model will include promotion of social inclusion, choice, improving quality of life and safeguarding people. This approach examines and works with inherent tensions such as improving services and outcomes with finite fiscal or practical resources, practicing with awareness of the juxtaposition of client and worker, agency and state. (Book 1, pp.

22-23[L4]) In course materials, Jane talked about a practice led approach within her role at Redcar and Cleveland MIND, acknowledging that she values the skills and contributions of her colleagues, however she views it as imperative that this is “not the only filter” to hear peoples views. Jane described wanting to “ensure genuine service user involvement was integral to that partnership, not bolted on” (DVD 1, Band 2[L5])

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Connelly and Seden, 2003 stress the importance of the ‘process’ of consultation with service user views being an integral part and is applicable to both groups and individuals, A number of methods of consultation may require consideration, being mindful that some are more accessible than others, ensuring recognition of who’s views it is hoped to be ascertained and in what context. Managers need to ensure that the feedback they obtain from service users is inclusive and they are able to distinguish between what service users and staff say about services (Book 1, p. 37).

It has become relatively commonplace to allocate seats to service users on planning committees but this should be well thought out, managers should be honest about the limitations, action and potential outcomes or this may be viewed as a tokenistic gesture which provides no real impact. Beresford and Croft, 2003 suggest several different levels of involving service users and argue that “personal knowledge and experience is collected, collated and integrated in a strategic way into the planning and development of policy and services more widely” ( quoted in Course Reader, p.

25[L6]) Practice led managers have the advantage of hearing service users views directly and can identify where there are gaps or failings within services, however there will also be competing and conflicting priorities and demands placed upon them by the service user, agency and state. Managers have to be ready to work alongside service users as opposed to for them and be practice led. This may lead to anxieties relating to the shift of power, resources and effectively involving service users.

Converse to this service users may not wish to participate, perhaps because they lack confidence, are unable to commit the time or have a lack of faith in the system[L7]. Beresford and Croft, 2003 argue that it is important to be clear about what the terms ‘involvement’ and ‘participation’ mean, arguing that the ‘chequered’ history of user involvement within public policy serves to remind us that this has not always been the case (Course Reader, P. 22)

In recent years two approaches to participation or user involvement have emerged and could best be described firstly on the one hand from ideas of service users as ‘customers and consumers’ of care and support, much as they are consumers of other commodities. This approach has, in the main been developed by the state and service system organizations with it’s primary goal being to; “improve the efficiency, economy and effectiveness of organizations and services by drawing in the ideas and experience of service users to improve management and decision making” ( Leggett et al, 1999, quoted in Course Reader, p.22)

This approach saw a move away from welfare state provision and greater emphasis placed upon the market and individual responsibility, including the purchase of services (the recognition of the current climate promoting a ‘commissioning model’ is noted here) and ideas of customer/consumer choice.

When considering this perspective it is important to acknowledge that in some instances individuals may not have choice to withdraw their ‘custom’, this is particularly so for those service users who are involved in services against their wishes for example adults sectioned under the Mental Health Act 1983(DoH, 2007) or Children Act 1989 (Office of Public Sector Information, 2008)|, children placed in secure accommodation. Nevertheless their views should not be dismissed as they could offer valuable insight into the equity and fairness of the processes and their personal experience.

On the other hand there is the democratic/citizenship approach, developed by users of health and social care and concerns itself with people as ‘citizens’ the emphasis being placed upon rights and entitlements of citizenship; ” bringing about direct change in peoples lives through both collective and individual action” (Priestly, 1999, quoted in Course Reader, p. 22). Some people may rarely or never utilize welfare services but feel they have rights as a ‘citizen’ and should be afforded opportunities to express their opinions about the kind of services that are provided and funded; these views may be in contrast to the views of service users..

It is also important to acknowledge that access to services is founded in a consumerist model[L8]. An obstacle for managers working within the ‘democratic or citizenship’ approach is engaging those who do not have a direct involvement with the services, those people may feel less motivated to be actively involved in the consultation. Whilst these two approaches vary in the means and ways they engage service users participation they have shared goals and outcomes to the effect that they wish to improve the services which they provide.

Enabling service user participation has assisted managers and government as they are able to use it as tool in measuring the quality of service being offered and highlights any practice or practical issues that may need to be resolved, upholding the requirements for accountability and best value[L9]. In summary; consulting service users remains high on the political agenda and continues to contribute to a growing body of evidence that ascertaining the views of service users is crucial; who better to seek out views from, than those that use the services?

Frontline managers and staff need to create environments/ and situations that allow service users to be involved in realistic and meaningful ways. Nevertheless, one will almost always encounter problems in terms of what local and national provision is available and what service users feel they need and want; the inherent tensions of need and economic ability to provide. Service users seek respect and the right to have a voice in decisions, a shared political goal, however in reality consultation is still viewed by some to be tokenistic and the service user’s voice is discounted or marginalized.

By working with approaches such as the practice -led management model or a user -led approach we can work to promote social work and service provision that is based on service users priorities, a practical basis from which to uphold their right to autonomy, participation and inclusion[L10]. Word count 1626[L11]

References Collins (1989) ‘Consultation’ in Collins Gem English Dictionary, W. M Collins and Co, Collins Clear-Type Press. Croft, S. Beresford, T. (2002) Service Users Perspectives, in Davies, M (ed), ‘The Blackwell Companion to Social Work’ Oxford, Blackwell Publishing.

Department of Health (2000b) A Quality Strategy for Social Care, London, Department of Health [chs 2,3, 7] Department of Health (2001b) Welcome to Valuing People, a new strategy for learning disability in the 21st century. WWW. Publications. doh. gov. uk/learningdisabilities/access [accessed 31. 10. 08] Department of Health (2007) Mental Health Act 1983, Available from www. dh. gov. uk/en/publicationsAndStatistics/legislation/ActsAndBills/DH_4002034. [Accessed 31. 10. 08]

Office of Public Sector Information (2008) Children Act 198 ,Chapter 41, Section 25, available from www. ops. gov. uk/acts/acts1989/ukpga_19890041_en_4#pt3-pb5_1g25. [Accessed 31. 10. 08] Open University (2003) K303 Managing Care in Context, Unit 1. 4 ‘Practice-led Management: a model for managing care, Milton Keynes, The Open University. Open University (2006) K303, Managing Care, DVD 1, Band 2. ‘A Meeting of Minds’ Milton Keynes, The Open University. Open University (2003) K303, Managing Care in Context, Unit 2. 3 ‘Service Users Views’ Milton Keynes, The Open University.

Open University (2005) K303, The Managing Care Reader, Chapter 3, ‘Involving Service Users in Management: Citizenship, Access and Support, Milton Keynes, The Open University[L12]. [L1]Good introduction in which you have set out how you are going to answer the set question. You do not need a question mark at the end of the last sentence. [L2]This needs further explanation as the quote appears to stand alone with nothing attached to it. [L3]Try to ensure you use paragraphs appropriately rather than `stand alone` sentences.

[L4]An important point but what does it mean? [L5]How did she achieve this? [L6]Again an important point but how is it achieved? [L7]What about service users who have communication difficulties or those potential service users in hard to reach communities; i. e. black ethnic minorities? [L8]Good overview of the issues. [L9]Again, take care to use appropriate paragraphing. [L10]A good conclusion in which you have drawn together some strong points raised above. [L11]Thank you for your word count which is within limits. [L12]Appropriate referencing.

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