SCOPING STUDY AND IMPACT EVALUATION – CITIZEN SERVICE USER AND CARER INVOLVEMENT IN SOCIAL WORK EDUCATION December 2020
Contents
CONTENTS
Foreword 2
Page 1
Executive summary
3
1. Introduction
5
2. Background
6
2.1.
Definitions
6
2.2.
Benefits
7
2.3.
Drawbacks
7
2.4.
Barriers
8
2.5.
Theories
8
2.6.
Legislation and Guidance
9
2.7.
Service users and the Teaching Partnership
9
3.
RESEARCH DESIGN
10
4. FINDINGS
11
4.1.
Organisation and Relationships
11
4.2.
Valuing the Service User Voice
12
4.3.
Benefits and Areas of Support
15
5. CONCLUSION
16
6. RECOMMENDATIONS
16
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FOREWORD Stop! Please don’t read this report if you are just going to jump to the recommendations. We do not want this to simply be another report to read and put down. This bold scoping report is a snapshot of what service user and carer involvement in social work education looks like in Suffolk. It is the first piece of research, in line with a two-year initiative jointly funded by Suffolk County Council and the University of Suffolk. The project considers how service users and carers are included in social work teaching and learning, with the hope to develop this collaboration and improve social work practices in Suffolk. The research brings together citizens who use social work services, educators, students and professionals with the aim of embedding partnership approaches and service user and carer involvement as core values.
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Chris Meggs and Jane Darke Social Work Voices members
FOREWORD
Historically, social work has grown out of philanthropist ideals resulting in a top down, professionally led, paternalistic approach. However, far reaching social changes, economic necessity and sheer weight of demand has led to a gradual shift in approach to one of partnership where we, as citizens want to have a voice in how we are treated and want our views taken into account. In social work, it is important to strive for mutual confidence in raising and seeking answers to difficult questions for our experiences, as service users and carers to be fully understood. This report has shown that Suffolk is open and brave to asking those difficult questions around service user and carer involvement about what is working well, and what still needs to be done. This is Suffolk’s starting point, a building block towards enshrining service user and carer involvement in social work education and we urge you and your organisation to consider “where are you?”
This report provides a glimpse into Suffolk’s commitment towards service user and carer involvement where the appointment of a Citizen Involvement Co-ordinator by members of the Teaching Partnership is a big step forward and demonstrates the University of Suffolk’s and Suffolk County Council’s dedication towards service user and carer involvement in social work education. We are grateful first and foremost to the service users and carers who took part in this research, along with the students, educators and professionals. We would also like to thank the research team, Aisha Howells, Sophie Walters and Nora Duckett, of the University of Suffolk for undertaking this important project. We hope that this research champions those voices which so often go unheard and helps to shape education and practice for both social workers, and the social workers of the future.
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EXECUTIVE SUMMARY Service user involvement is a key requirement within the field of social work education and how this is enacted varies throughout the country. This report reflects the voices and perspectives of citizen service users and carers, academics, students and professionals involved in social work education at University of Suffolk and Suffolk County Council. This Scoping Report came about because members of the Teaching Partnership considered it important to identify perceptions
of service user and carer involvement in Suffolk, on which to develop an evidence base to inform future developments of Social Work Voices, and service user and carer involvement in social work education. At this stage it was not possible to draw representations from Suffolk County Council, due to the timing of the research and the limited number of available participants. However, it remains a good starting point from which to work.
EXECUTIVE SUMMARY
Table 1: Summary of the qualitative findings Theme
Description
Organisation and Relationships
There was a need for clear, visible, and fair processes and structures to aid effective service user and carer involvement. This was alongside developing relationships which were of central importance across the participants and equipped learners in their future social work practice.
Valuing the Service User Voice
Involvement was seen as mutually beneficial. The learner drew value from including service users and carers voices in their education. At times, appreciating this over and above more formal learning. Sharing ‘real-life experiences’ provided opportunities for service users and carers to feel empowered and highlighted their significance in practice.
Benefits and Areas of Support
A range of personal and wider benefits were identified for service user and carers. As a result of their involvement in social work education, advantages were also experienced by students. This was alongside more nuanced areas of support that were needed for the individual service user and within the organisation.
Overall, participants described the different challenges and issues they faced when considering service user and carer involvement in social work education in Suffolk. In particular, service users and carers from the Social Work Voices (SWV) Group expressed that although there were many positives in their role, there was a need for improved formal structures that recognised and were more attuned to their unique position within the organisations. Although, there were some benefits to being involved, a need identified by service users and carers was that training would be beneficial to develop further skills and
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reflect the organisations’ commitment and value of service user and carer input. Furthermore, there was a strong relational aspect underpinning user involvement with a drive for developing positive relationships and connections between service users, students, academics and professionals. This approach both embedded learning more deeply for learners and also provided a vital social aspect, particularly for service user and carers. The most consistent message was that learning gained from drawing on the service user’s perspective was fundamental for improving the quality of social work education and future practice.
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However, the need to engage with and hear more unheard voices, particularly from those that are marginalised and often remain overlooked, was a recurring point. Subsequently, a number of recommendations have been suggested. Table 2: Summary of the recommendations 1. To improve structures and processes including service user and carer feedback, training, skills and benefits. 2. To create more diverse representation across different service user and carer groups. 3. To strengthen service user and carer involvement in social work education across the Teaching Partnership, particularly throughout processes within Suffolk County Council.
ACKNOWLEDGEMENTS The research team would like to thank the students, academics and professionals who gave their time freely and whose responses helped in completing this project. Most importantly, we would like to thank the service users and carers of Social Work Voices. Without whom, this project would not have been possible.
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EXECUTIVE SUMMARY
4. To co-produce the second part of the research project in 2021/22 with service users and carers.
INTRODUCTION
1. INTRODUCTION A large proportion of service user and carer involvement literature originates from the United Kingdom and it is viewed as one of the leading countries in service user involvement in social work education1. However, the extent and depth of service user involvement varies across the country2 where participation can fluctuate in the design, delivery and evaluation of social work curricula as well as student selection. This can be due to a number of factors, but often depends on the commitment and value placed upon service user involvement by the corresponding organisation. Service user involvement is an official requirement within social work education3 and is a process which takes time to actively promote and sustain to be of value. As such, any involvement should be meaningful, helping to shape social work practice, and should take place throughout all levels of a student social worker’s and Newly Qualified Social Worker’s lifespan. However, service user involvement is often criticised for being ‘tokenistic’, uses a ‘tick box’ approach to participation or at times, an ‘afterthought’, leading to narrow understandings of service user knowledge and roles4.
As a result, it was considered important to identify the current landscape of service user involvement in social work education at the University of Suffolk and Suffolk County Council, drawing on the perspectives of students, academics, professionals and most importantly, service users and carers. Exploring the current situation and repeating the project again in two years was felt to be particularly beneficial to explore changing attitudes and behaviours. This report seeks to build an evidence base to inform and strengthen service user involvement in social work education. Consequently, this research aims to build stronger relationships between the University of Suffolk, Suffolk County Council and service users and carers, and enhance the quality and capabilities of social workers in Suffolk. This report reflects the voices of service users and carers involved with the Social Work Voices (SWV) group at the University of Suffolk, social work students and apprentices, academics and a professional within Suffolk in 2020.
Service user and carer involvement has been driven by service users, the value base of social work, along with policy and legislation from successive governments and regulatory bodies5. Research has found that there was widespread support amongst service users, student social workers and lecturers to involve service users in social work education6.
1.
Laging, M. and Heidenreich, T. (2019) Towards a Conceptual Framework of Service User Involvement in Social Work Education: Empowerment and Educational Perspectives. Journal of Social Work Education, 55(1), pp. 11–22.
2. Hatton, K. (2017) A critical examination of the knowledge contribution service user and carer involvement bring to social work education. Social Work Education, 36(2), pp. 154–171. 3. Department of Health. (2002). Requirements for social work training. PDF available online. 4. Campbell, P. (1996) The history of the user movement in the United Kingdom. In: Heller, T., Reynolds, J., Gomm, R., Muston, R. and Pattison, S. (ed.) Mental Health Matters. Basingstoke: Macmillan. 5. Irvine, J., Molyneux, J. and Gillman, M. (2015) ‘Providing a Link with the Real World’: Learning from the Student Experience of Service User and Carer Involvement in Social Work Education. Social Work Education, 34(2), pp. 138–150. 6. Robinson, K. and Webber, M. (2013) Models and Effectiveness of Service User and Carer Involvement in Social Work Education: A Literature Review. The British Journal of Social Work, 43(5), pp. 925–944.
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2. BACKGROUND 2.1. Definitions A ‘service user’ is commonly defined as someone who uses or has used social work and care services7. Although frequently used in social work literature it is recognised that language can be problematic and not everyone identifies with this term6. A ‘carer’ is “someone who, without payment, provides support to someone who could not manage otherwise because of frailty, illness or disability”8. It needs to be recognised that service users and carers are not a homogenous group and possess diverse perspectives, identities and needs9.
the report uses both citizen and ‘service user’ interchangeably as a broad phrase mirroring the language used in the project and in line with the vast majority of previous research
‘Social Work Education’ was initially defined as a set of core competencies that students must achieve to prepare them for field education. This was then broadened to include a more holistic view of capabilities which involved knowledge, skills and values as well as affective processes13. Put simply, it is the education of students to become qualified social workers or training whilst qualified and can involve service users involved in teaching and learning, designing and developing the curriculum, admission processes, quality assurance, development of materials and all aspects throughout the education process.
‘Involvement’ is also a broad term with multiple meanings commonly used to describe someone becoming active in their own care and in the care of others in similar situations6.
7.
Goossen, C. and Austin, M. (2017) Service User Involvement in UK Social Service Agencies and Social Work Education. Journal of Social Work Education, 53(1), pp. 37–51.
8. Fitzhenry, S. (2008) ‘Service user and carer involvement in social care and social work programmes’, Scottish Social Services Learning Networks. unpublished report. 9. Beresford, P. (2003) It’s Our Lives: A Short History of Knowledge, Distance and Experience. London: OSP for Citizen Press in association with Shaping Our Lives. 10. Duffy, J. (2006) Participating and Learning Citizen Involvement in Social Work Education in the Northern Ireland Context A Good Practice Guide. Publisher Unknown. 11. Ostrom, E., Parks, R.B., Whitaker, G. P. and Percy, S. L. (1978) The public service production process: a framework for analyzing police services. Policy Studies Journal, 7, pp. 381–9. 12. Social Care Institute for Excellence (2013) Social Care Institute for Excellence (SCIE) Co-production in Social Care: What It Is and How to Do It, SCIE Guide 15. London: Social Care Institute for Excellence. 13. Kourgiantakis, T , Sewell, K , Hu, R , Logan, J , and Bogo, M (2020) Simulation in Social Work Education: A Scoping Review Research on Social Work Practice 2020, Vol. 30(4) 433-450.
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BACKGROUND
Although, the term ‘citizen’ is favoured by the research team due to its links with constancy, rights and entitlements, and is more in line with the fundamental values of social work7,
‘Co-production’ refers to the role citizen’s play in determining the form, delivery and value of a service10. Co-production occurs when citizens involved in social work education are seen as people with assets and skills who are involved in a process which builds on their capabilities through reciprocity and mutuality11. This is achieved by breaking down barriers and effecting professional and service changes12.
2.2. Benefits
BACKGROUND
The importance of a service user perspective in social work education cannot be overstated as it brings an added dimension to theorising, knowledge and analysis14. Both service users and students have been found to benefit from service user involvement in social work15. For students and professional learners, it challenges preconceptions and brings theory to life whereas service users and carers benefit from having a valued role which builds their skills and confidence7. This is alongside the development of service user-led research which has also made a significant impact on the field of social work7 through a more egalitarian and holistic approach. Some of the benefits of service user and carer involvement are that learners gain a greater insight into the service user’s experience, they learn to challenge stereotypes, develop empathy and communication skills16. Students are also thought
to work more effectively in partnership with service users and make links between theoretical learning and practice. Service user involvement has challenged traditional social care provision by creating a more liberatory approach17. This approach emphasises the human and civil rights of people rather than defining them as people with needs who require outside help18. Service user and carer involvement is at its best meaningful, effective and can result in significant benefits for recipients of social work services, as those with lived experience provide essential knowledge and insight. Meaningful involvement of Service Users and Carers requires time, relationship building, planning and resources19. Service user involvement in the United Kingdom has been found to increase the confidence, skills, knowledge and self-esteem of those involved20.
2.3. Drawbacks It is more difficult to involve some marginalised groups such as children with learning disabilities or those who communicate non-verbally7. Global Majority service users may also be discriminated against21. Full power sharing in some scenarios such as assessment of students by service users and carers is reported to be difficult to achieve22. Service users and organisations often have
differing priorities and there is often an inherent power imbalance within the relationship23 with involvement often limited to mere consultation rather than partnership24. Student criticisms of service user and carer involvement are less well documented but include a lack of diversity within contributors25, reluctance to accept assessment by someone who is not an academic26 and judgements that accounts
14. Beresford, P. (2000) Service Users Knowledge and Social Work Theory: Conflict or Collaboration? The British Journal of Social Work, 30 (4) pp. 489–503. 15. Brown, K and Young, N (2008) Building Capacity for Service User and Carer Involvement in Social Work Education. The International Journal of Social Work Education 27 (1) pp. 84 - 96. 16. Tanner, D., Littlechild, R., Duffy, J. and Hayes, D. (2017) ‘Making It Real’: Evaluating the Impact of Service User and Carer Involvement in Social Work Education. The British Journal of Social Work, 47(2), pp. 467–486. 17. Beresford, P. and Croft, S. (2004) Service Users and Practitioners Reunited: The Key Component for Social Work Reform. British Journal of Social Work, 34, pp. 53–68. 18. Webb, S. (2008) Modelling service user participation in social care. Journal of Social Work, 8, pp. 269–290. 19. Lucas S.E, Morrison L, Bell J & Hussain-Ahmed S (2019) Service user and carer representation: exploring barriers to participation. UNITY. Available from UNITY 20. Moriarty, J., Rapaport, P., Beresford, P., Branfield, F., Forrest, V., Manthorpe, J. and Keady, J. (2007) The participation of adult service users, including older people, in developing social care. Practice guide for Social Care Institute for Excellence. Social Care Institute for Excellence 21. Kalathil, J. (2011) Dancing to our own tunes: Reassessing Black and minority ethnic mental health service user involvement. London, UK: Afiya. 22. Crisp, B. R., Lister, P.G. and Dutton, K. (2006) ‘Not just social work academics: The involvement of others in the assessment of social work students.’ Social Work Education, 25(7), pp. 723–34. 23. Social Care Institute for Excellence (2007) Building user and carer involvement in social work education. London, UK. 24. Rutter, D, Manley, C., Weaver, T., Crawford, M. and Fulop, N. (2004) Patients or partners? Case studies of user involvement in the planning and delivery of adult mental health services in London. Social Science and Medicine. 25. Anghel, R. and Ramon, S. (2009) Service users and carers’ involvement in social work education: lessons from an English case study. European Journal of Social Work, 12(2), pp. 185–199. 26. Advocacy in Action (2006) Making It Our Own Ball Game: Learning and Assessment in Social Work Education. Social Work Education, 25(4), pp. 332–346.
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given are too ‘professional’, ‘anecdotal’27 or overly focused on the negative. Service users sometimes report that their involvement is unproductive and
tokenistic28. Some believe that even years after the commitment to service user involvement was mandated, real change is still yet to be realised8.
2.4. Barriers The barriers faced in Service User and Carer involvement include the fact that payment of the individuals involved, particularly those on means tested benefits, is rarely straightforward29. Some service users may be too ill, too tired or physically unable to attend meetings; those that do make
it may have poor levels of concentration. There is also a reported absence of core texts on the subject of citizen involvement30. Some scholars also suggest that only a small number of service user and carers wish to be involved in social work education31.
2.5. Theories
Outcome-focused models enhance social work education by having citizens teach core values such as respect, partnership and equal relationships32. Such models acknowledge service user expertise. In order to have meaningful involvement in such a model there must be change or improvement for the people using the
services33. However, the disadvantage of these models is that there is a lack of outcome-focused research making it difficult to evaluate whether the aim is being achieved7. A theoretical framework which has been influential in the development of service user and carer involvement in social work is Arnstein’s Ladder of Participation34. While this remains the benchmark for many projects involving service user and carer involvement there are still inherent problems with this model including the failure to recognise that different tasks may require different levels of involvement and the assumption that full service user control is the goal which may not align with service users own reasons for engagement. There has also been a concern about ensuring fair representation of all service user and carer groups so that those who are least represented in society do not become the least represented in social work education35.
27. Baldwin, S.J. and Sadd, J. (2006) Allies with attitude! Service users, academics and social service agency staff learning how to share power in running social work education courses. Social Work Education, 25(4), pp. 348–359. 28. Campbell, P. (1996) The history of the user movement in the United Kingdom. In: Heller, T., Reynolds, J., Gomm, R., Muston, R. and Pattison, S. (ed.) Mental Health Matters. Basingstoke: Macmillan. 29. Turner, M. and Beresford, P. (2005) Contributing On Equal Terms: Service User Involvement and the Benefits System, Adult Services Report 08. Londo 30. Taylor, I. and Le Riche, P. (2006) What do we know about partnership with service users and carers in social work education and how robust is the evidence base? Health and Social Care in the Community, 14(5), pp. 418–425. 31. Levin, E. (2004) Involving service users and carers in social work education. Resource Guide 2, Social Care Institute for Excellence, London. 32. Shor, R. and Sykes, I.J. (2002) Introducing structured dialogue with people with mental illness into the training of social work students. Psychiatric Rehabilitation Journal, 26(1), pp. 63–68. 33. Beresford, P. (2005) Theory and practice of user involvement in research: Making the connection with public policy and practice. In: Hulatt, L.L. and I. (ed.) Involving Service Users in Health and Social Care Research. London: Routledge, pp. 6–17. 34. Arnstein S. 1969. A ladder of citizen participation. Journal of the American Institute of Planners, 35: 216–224. 35. Collins, K. and Ison, R. (2009) Jumping off Arnstein’s Ladder: Social Learning as a New Policy Paradigm for Climate Change Adaptation Environmental Policy and Governance 19, 358–373.
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BACKGROUND
There are a variety of models and theories surrounding service user and carer involvement in social work education. The model used within an organisation affects how service users and carers are recruited, how their involvement develops, what affect their involvement actually has and how it is evaluated24. The most common model of service user involvement are empowerment and partnership models. The advantage of these models is that they focus on the experience of involvement which was found to be meaningful in most instances24. However, this term is controversial as it implies an equality of power which some believe does not exist31.
2.6. Legislation and Guidance Explicit requirements for user involvement in social work care planning in the UK started with the Children’s Act 1989 and the NHS and Community Care Act 1990. These called for the involvement of service users and carers in a range of activities from assessments to planning, as well as complaints procedures18. Service users and carers are required to be involved in all qualifying and post qualifying social work programmes in the UK 7. This includes
mandated involvement of service users and carers in the admissions process, curriculum design and delivery, assessment and programme management. However, how this involvement should take place is not prescribed. The adult user perspective can be seen in the Valuing People White Paper36 and subsequent policy Valuing People Now37. The White paper highlighted the importance of choice and control over services and enshrined the concepts of rights, independence and inclusion.
BACKGROUND
2.7. Service users and the Teaching Partnership The University of Suffolk is responsible for undergraduate education of social workers38 whereas post-qualifying continuous professional development training generally takes place at Suffolk County Council39. The University of Suffolk has a long history of service user and carer involvement dating back over 20 years. In many instances in the past the University has led the way on this, such as with a landmark service user conference40. The Norfolk and Suffolk Social Work Teaching Partnership was established in 2016 and is an innovative and creative model connecting two universities and two local authorities, with the aim of better preparing students for practice41. However, this report focusses on the Suffolk organisations within the Teaching Partnership.
The creation of a new Citizen Involvement Coordinator (CIC) role aims to provide a specific individual to lead on service user and carer involvement at both the University of Suffolk and Suffolk County Council. A post funded jointly by members of the Teaching Partnership, University of Suffolk and Suffolk County Council. The aim is to enhance and develop service user and carer involvement; the first step in this process is the creation of this scoping report.
36. Department of Health (2001) Valuing People: A New Strategy for Learning Disability for the 21st Century. London: HMSO. 37. Department of Health (2009) Valuing People Now: Summary Report March 2009 - September 2010. 1st ed. Crown Copyright. 38. University of Suffolk (2020) BA (Hons) Social Work. Available from University of Suffolk. 39. Suffolk County Council (2020) Suffolk County Council. Available from: Suffolk County Council. 40. University of Suffolk (2018) “Can You Hear Me?” The Voice of the Service User. Available from University of Suffolk. 41. Bald, C. and Howells, A. (2019) Professionalising social work education without losing our soul: A critical reflection on the role and purpose of practice placements in the context of Teaching Partnerships. Journal of Practice Teaching and Learning, 15(3).
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3. RESEARCH DESIGN This exploratory study looks at what people think about citizen involvement and why. This type of “qualitative” research develops understanding through people’s words and meanings. The study involved the following ways to collect people’s views: 1. Anonymised SWV Member questionnaire asking about the service user and carer experience in social work education 2. Anonymised student questionnaire drawing on the student experience of service user and carer involvement in social work education
4. Semi-structured interview with a Suffolk County Council Representative to explore service user and carer involvement within education for qualified social workers The following four objectives were identified: A. To gather service user and carer, professional, academic and student/learner views about service user and carer involvement in social work education across University of Suffolk and Suffolk County Council B. To identify strengths and areas for development C. To repeat the project in two years to evaluate the impact of the CIC role D. To embed co-production with service user and carers within the research process
Limitations This research was not approved as a full evaluation of the CIC Role. The research was developed to understand the current landscape of service user and carer involvement in social work education across the University of Suffolk and Suffolk County Council. One further aspect which contributed to the overall research design was the current level of partnership working with service user and carers. At this stage, due to timescales and research training for SWV Members due to start in September 2020, the decision was made to involve SWV Members in elements of the current research study with the intention to co-produce the entire research process, from inception to completion in two years’ time. One individual from Suffolk County Council took part in this research. This runs the risk that their views and understanding may not be representative of all those working within this organisation. This was because there was limited involvement of service users in social work education at Suffolk County Council. While excellent initiatives such as the Children’s and Care Council do exist, they have not been included in this report as their primary focus is not that of social work education. The expansion of service user and carer involvement at Suffolk County Council is a primary target for the CIC and a greater focus on this organisation will be included in the second of these reports.
Ethical approval was granted by the University Research Ethics Committee in June 2020. The project involved voluntary participation and it was made clear to the professional and academics that there was a risk of participant identification due to the small number and specialist nature of their roles. Due to the CIC developing this project as part of their role, a potential conflict of interest was raised. To ensure the integrity of the research, this was addressed through identifying a research
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RESEARCH DESIGN
3. Semi-structured Interviews with University of Suffolk Tutors to explore service user and carer involvement within teaching
team. To reduce future issues of bias, the study will be co-produced with service users and carers.
4. FINDINGS 4.1. Organisation and Relationships Organisation and building cohesive relationships were consistently identified as key aspects of effective service user and carer involvement. Many participants, particularly service users and carers highlighted how vital connection was to them and the impact of this.
Structure “I need to plan carefully so I do like to know well ahead of time when I am needed.” (Service User C)
FINDINGS
“Greater discussion between staff and service users as to how service users could be involved.” (Service User F) “Meetings need to be held at accessible times, for example to accommodate school pick-ups.” (Professional Y) Structure was recognised as an essential aspect by service user and carer participants’ in their role to allow them to plan their time, ensuring they can be involved in user activities at the university or council whilst also fulfilling their caring and other responsibilities. The responses across participants highlighted that there was a greater need for clarity for service user and carer involvement across social work education. Although attempts had been made to address this, it was clear from service user and carer participant responses that this was yet to be embedded. It was evident that formal organisation of service user involvement could not only support service user and carer participants on a personal and user-activity level, but also could help reinforce that contributions were not tokenistic. Moving beyond consideration of service user and carers’ abilities to provide cover for user-led activities and instead, towards being a fundamental part of the overall process as participants highlighted: “Clarity on when and where SU’s are currently being involved in programs.” (Service User F) “Make their position central.” (Tutor Participant 5)
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Consequently, organisational structure may need to change and adapt to accommodate new ways of working with people who have often been oppressed or marginalised. Frustrations with rigid processes were compounded by fixed systems and structures which exist in the organisations, that need to be flexible enough to adapt to service user and carer’s needs, as seen in tutor participants’ responses: “Also accommodating for fluctuations in service users mental and physical health and checking on them when they are less well.” (Tutor Participant 2) “This may involve a culture change.” (Tutor Participant 6) A need was identified for supportive, flexible, clear and consistent infra-structures, alongside professional and personal attention to meet service user and carer’s basic requirements. For example, ensuring that individuals were paid on time, a fair allocation of scheduled activities or feedback on tasks. “Adopting a “working in partnership” approach to allow Service Users to feedback what worked well and what didn’t.” (Student response) “I would like some feedback.” (Service User F) Structures of feedback allow all those associated in service user involvement to evaluate and think critically and reflectively about the processes that have taken place. This allows for the identification of areas of strength along with aspects that could be improved. It may help to build a service user’s confidence and self-esteem as well as allowing them to tailor their input more effectively to the student’s needs with the support of the Citizen Involvement Coordinator. Only half of the service user and carer participants had received feedback about their involvement and few of the tutor participants had kept student feedback from service user involvement in their sessions. This
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highlighted that opportunities to understand and improve experiences of user involvement are being missed.
provide a purpose and sense of belonging. Several service users also highlighted that they would like to increase the levels of connection taking place.
Participants across the project shared that in partnership with service users and carers, it would be helpful to have increased visibility of opportunities throughout the organisations with a lead person steering service user and carer involvement matters. This was alongside a structure that embedded the principles of coproduction as important for moving forward rather than simply allowing ad hoc opportunities for collaboration.
“More interface with students i.e. role plays/ round robin.” (Service User D)
“Remembering that people have a right to have a say in the systems that support them.” (Tutor Participant 6) “Having service users involved from the beginning
“The need for a dedicated person to organise service user involvement.” (Tutor Participant 6)
Connection “Contribution to my vision for a connected and influenced society.” (Service User A) “Being part of a group that value my contributions.” (Service User C) Connectivity to being part of something was a big driver for many of the service user and carer participants. Many of those that responded valued the relationship with students, other service users and academic staff. This connection seemed to
“The main aim is that they help to shape our practice. Citizens ensure that the different models of practice are still in touch with the reality of Social Work and that there is no disconnect.” (Professional Y) Connectivity may allow a more spontaneous creation of new ideas and a stronger service user presence within all aspects of social work education. It was clear that the theme of connection mirrored a key part of the social work profession, whereby relationships with service users and carers are of central importance. Student participants highlighted how service user and carer involvement in their education better equipped them to build relationships in their practice, where learning was brought to life in a much more meaningful way. “Experiences from a personal perspective really help in understanding situations.” (Student response) “A real-life perspective of what it is like to be a service user in many different areas of practice.” (Student response) “The service users were very open and honest, and I felt comfortable to ask some questions that maybe I wouldn’t have felt comfortable to ask in practice.” (Student response)
4.2. Valuing the Service User Voice The voice of the service user was well-known to be a central theme within social work education. Student participants valued service user and carer involvement in social work education for their knowledge and expertise around social care
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services, alongside service users who felt valued in their role which provided them with an avenue for their voice to be heard.
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FINDINGS
to produce genuine co-production. So, to have a service user design the lecture.” (Tutor Participant 2)
“Would like to see more networking happening.” (Service User B)
Knowledge and Expertise “I have learnt the importance of listening to the true experiences of the service users. Their voice and expertise are often overlooked.” (Student response) “The views of service users and carers are the focus of social work. These experiences made me realise the importance of service users’ views to ensure they are empowered to talk about things that matter to them.” (Student response) “The reality of service users’ circumstances and what they face with services and professionals.” (Student response)
FINDINGS
Student participants valued service user and carer involvement in their education, sometimes over and above academic content, and acknowledged their wealth of unique personal experience and insight to social work education. The learning gained ranged from social work key skills, such as the importance of active listening and straightforward communication with people, to deepening knowledge around the impact of personal and professional values when collaborating with service users and carers. Considered as “experts by experience”, different service user perspectives enabled student participants to enrich their understanding which directly impacted their placement and future social work practice. Several student participants highlighted that service user involvement brought a “real-life experience” to people’s personal circumstances, helping them to embed some of the learning and realise how people feel when working with social work and care services. It was also clear that service user participants felt that their contribution was valued, as all of the participants shared that they felt listened to and valued at University of Suffolk. “More guest speakers from a wider range of social care instances.” (Student response) “The need to increase the diversity of service users.” (Tutor Participant 2)
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“BAME groups representation of whom would fit with the wider agenda of Equality and Diversity and Culturally Competent Care.” (Professional Y) The knowledge and expertise of service user involvement was appreciated across all the participants in terms of what they bring to social work education. One of the key areas where knowledge and expertise could be strengthened was through diversifying the service user group. Student, professional and tutor participants alike shared that there was a need for more representation across different groups of service users with a broad range of experiences. For example, student and tutor participants shared that they wanted to hear from service users whose voices tended to be unheard, such as those who were in prison, involved in sex work, people with mental health issues, people with ethnic minority backgrounds, people with learning disabilities, young people and children. Diversifying representation and the voice of those with direct ‘lived’ experience of social issues, rather than purely theoretical models, was repeatedly identified across participants as essential for student’s learning. It was seen as vital that students were given varied perspectives presented in different ways to better prepare them for practice. For example, increasing the diversity of the service user group would allow students to challenge assumptions and stereotypes they or others may encounter or hold. The risk is that by not reflecting the range of experiences and perspectives available within the community it may inadvertently continue to mirror the dominant barriers and exclusions present in the social world. “Social Work Theory is best applied in practice.” (Student response). “More guest speakers from a wider range of social care instances.” (Student response) “How different experiences can affect an individual in different ways and what is deemed important to service users in relation to their social workers.” (Student response)
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Social Justice “The University of Suffolk help me to have my voice. Also, it lets me teach the students what I know about what I want them to be like and how they should be as a social worker.” (Service User B) “Hearing valuable feedback from the service user’s perspective has allowed me as a student to reflect and take on board the comments within my practice. For example, I remember one service user saying to me that they found social work jargon very difficult to understand which would make them feel frustrated. I now ensure that my language is very clear when I talk to service users within my practice.” (Student response)
“Be able to influence the direction of service provided.” (Service User A)
This approach to empowerment was also reflected by the number of students who stated they would practice with respect, empathy and placing the service user at the centre of their practice. However, the question remained how to move from this position to one of action, which may require some further work around a change in structures and cultures. Participants from across the sample shared the need for meaningful involvement of service users. For this to take place the organisation, environment, mindset and frameworks all need to accommodate for individual and collective involvement, and active not passive action. Tutor participants reflected on the need to have a commitment and belief in the value of service user involvement where service users could lead on policy development, governance and co-production in order for social justice to truly emerge. “I have learnt the importance of listening to the true experiences of the service users. The voice and expertise of service users is often overlooked due to a variety of reasons. Therefore, its vitally important to actively listen and try and make sense of the service user views.” (Student response) “Putting social work values at the forefront. Listen to people more and how they feel they could be involved.” (Tutor Participant 6) “To make involvement meaningful. Including those who don’t have a voice.” (Tutor Participant 4)
42. Watts, L. and Hodgson, D. (2019) Social Justice Theory and Practice for Social Work, Critical and Philosophical Perspectives. Singapore: Springer Nature.
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FINDINGS
Social Justice was recognised as an area which underpinned service user and carer involvement in social work education. Social Justice is about the fair and equal relations between the individual and society, as measured by the distribution of wealth, rights and privileges42. One student explained that the most memorable moment of service user involvement was an individual who “explained his difficulty with disablement and poverty”. It was clear from the responses that future social workers need to be both alert and sensitive to such issues. Social workers engage in social and political action to promote equality, challenge injustice and expand opportunities. As a result, it was clear from many of the service user participants who noted the importance of working alongside a student social worker to effect change, assert their perspective and feel heard in their own right.
“I want to help to teach and change social work [sic] for the better for the social workers and for people who use them.” (Service User B)
4.3. Benefits and Areas of Support A range of personal and wider benefits were identified for service user and carer involvement in social work education, alongside areas of support for the service user and organisations.
Benefits “Mentally challenging, maintaining communication and personal skills and making a positive contribution.” (Service User F) “It’s nice interviewing future students and getting an insight into their lives and thinking they would or wouldn’t make a good social worker and would I like them involved in my life.” (Service User E)
FINDINGS
“Providing structure to my time.” (Service User A) Service user participants had gained a lot from their involvement in social work education, where they shared a range of personal benefits about their role. For example, one participant found that being involved provided them with structure and routine throughout their day, whilst others found satisfaction in how their role could help others. This sense of ‘giving back and helping’ or reciprocal action associated with co-production, was a recurring theme in service user participant feedback. Having a say, being included in decision making and being listened to can all have therapeutic benefits of increasing self-esteem and confidence with many service users sharing notions of feeling empowered. When asked about the positives of being involved in social work education, service user participants were able to identify that their role also offered the opportunity to interact with others, improve relationships and develop skills. “Interface with lecturers and students.” (Service User D) “I would like to help the students.” (Service User B) “I am happy as it is.” (Service User C) It was clear from the feedback that service users felt valued and listened to within the University of Suffolk, where they contributed to developing student’s skills and attitudes shaping and improving future practitioners. However, more can still be done as one of the wider benefits
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of service user involvement is the creation of services that are more tailored and responsive to the needs of their recipients. As such, this highlights the vital aspect that service user and carer involvement in social work education plays in accountability and service improvement.
Needs “I wouldn’t like it to get too technical. I am just a stay at home mum who gave up my life to look after my daughter. I am a service user in the true sense of here and now.” (Service User E) “Easier wheelchair access to meeting venues.” (Service User D) It was clear from service user and carer participant responses that personal and access needs must always be considered sensitively when working with a diverse group of people to ensure that unintentional discrimination is not occurring, and that people are included without breaching confidentiality. Service user participants highlighted the importance of having information relating to involvement supplied in an accessible format to prevent the creation of barriers to involvement. Amongst the service user participants there was also an appetite for additional training with all identifying at least one area that they would like additional support and many identifying multiple areas. Training is important for building the service users skill set and providing additional benefits to their involvement, alongside payment. Service user participants seemed particularly keen to access training on Equality and Diversity, and Research Methods. In addition, service users and carers also identified that they would like access to resources that could help them feel valued, develop their skills and forge stronger connections to organisations. This would fit with the Teaching Partnership, University of Suffolk, Suffolk County Council and social work’s commitment to life-long education where learning can be embedded into all aspects of service user involvement in social work education. “Consolidation of group within and as part of access to the library University.” (Service User F) “Access to library facilities, journals, research and other learning facilities.” (Service User F)
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5. CONCLUSION range of perspectives to be brought into social work education, challenging the stereotypes and assumptions that students and staff might hold. It is also necessary to ensure that any developments ensure reasonable adjustments are made to support personal and access needs. Many of these findings would seem to be consistent with the wider literature on service user and carer involvement in social work education. One final area will be to consider forging stronger processes within Suffolk County Council, to ensure wider representative feedback in the future research project. We are hopeful this report and the findings within it will help to progress service user and carer involvement across the University of Suffolk and Suffolk County Council embedding a true process of co-production. We aim to lead the way on innovative and creative ways of involving a diverse range of service users and carers in a wide range of activities. This report will be repeated in two years in order to investigate the developments that have occurred during this time.
CONCLUSION
iii. To strengthen service user involvement in social work education across the Teaching Partnership particularly throughout processes within Suffolk County Council.
RECOMMENDATIONS
The aim of this report was to identify the current landscape of service user and carer involvement in social work education at the University of Suffolk and Suffolk County Council through the voices of a range of stakeholders. This report has highlighted the importance of structure and organisation with clear, visible and fair processes to aid effective service user and carer involvement. It has also demonstrated the benefits of connectivity and valuing the voice of the service user or carer, making clear that service users do feel that they are contributing meaningfully by influencing social work education and practice. Areas for development include the creation of formal feedback processes and many respondents highlighted the need for a role dedicated to service user involvement. This has been achieved through the employment of a Citizen Involvement Co-ordinator. However, as this is a temporary post consideration will need to be given to sustainability beyond the fixed term. Increasing the diversity of the service user and carer group is also a priority allowing a different
6. RECOMMENDATIONS i. To improve structures and processes, such as feedback to service users as well as training and benefits and making reasonable adjustments to enable access to events, library facilities and research development. This is important, so that the value of service user involvement is recognised, forging a stronger relationship between partner organisations, students and service users, whilst building individual service user skills.
iv. To co-produce this research project in 2021/22 with service users and carers, using the language of citizens.
ii. To create more diverse representation across different service user and carer groups. Hearing people’s different experiences will enrich student learning and allow for unheard voices to be heard.
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