VOICES Stakeholder Survey 2016

VOICES – Voices of Independence Change and Empowerment in Stoke-on-Trent

Stakeholder survey report

October 2016

Prepared by Becky Rice

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Contents

Chapter Content

Page

1

Key findings and recommendations

3

2

Introduction

7

3

VOICES customer survey

8

4

Golden Ticket Services survey

13

5

Expert Citizens survey

24

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Key findings and recommendations

1.1

Introduction & methods

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1.2

As part of the local evaluation of VOICES, an annual programme of stakeholder surveys is undertaken. The findings presented in this report are from a survey of VOICES customers (20 respondents), a survey of stakeholders in partner agencies (54 respondents) and a survey of Expert citizens (nine respondents).

The surveys were all conducted during July and August 2016, the customer and Expert Citizens surveys were hard copy forms and the Golden Ticket services survey was administered online using Survey Monkey.

VOICES customer survey

Key findings  67 surveys were distributed and 20 were returned making the responses rate 30%. This is an improvement on the 24% achieved last year.  Respondents were asked about their overall satisfaction with VOICES. The results were hugely positive with all but one person stating they are ‘very satisfied’ and the remaining person being ‘satisfied’.  As in last year’s survey, the depth and number of open responses suggest people have given thoughtful feedback and are very engaged with the process of feedback.  Respondents were asked about changes in their lives since working with VOICES. These attracted very high levels of agreement with nearly all customers agreeing that they have support from a range of services, that some services better understand their needs, that they feel more fulfilled and confident and have a plan for the future  In spaces for comments customers referred to the difference that VOICES had made for them including, accessing services, having a place to live, having someone to turn to and talk to, and positivity and improved outlook on life.  Respondents were asked about the support they receive from VOICES. All or nearly all respondents agreed with statements about the support they get – including trusting their worker to arrange the support they need and to stick with them, and with statements about Service Coordinators providing an asset-based service.  Customers commented on the best things about having a VOICES worker.

Responses were varied but often referred to a sense of someone being there for them, sorting out practical things like accommodation and appointments and being part of moving forward and making positive changes in life.

Having someone like Leanne to help me will be one of the best things to happen for me in a very long time. It's hard for me to explain my problems as I have been locked away for so long, but I know with help I can live hopefully a normal life. It's all I want now

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When asked what they would like more support with the most common responses were around housing (support to retain tenancy or find more suitable accommodation) and money management and budgeting.

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Recommendations  The results are very encouraging and should be shared with the team to help them recognize the positive perceptions of customers.  Each year the team should try and increase the response rate to this survey to ensure as many customers vies as possible are collected. Before next year’s survey ideas for increasing the response rate should be gathered from a range of sources including Expert Citizens. The £5 voucher as opposed to prize draw offered should be retained for next year.  It may be helpful to try and target customers for feedback who have left the service or are finding it harder to engage and make progress. It might be that the survey method is not the best approach to this.

1.3

External Stakeholders survey

Key findings 

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VOICES used information from their contacts database held in Inform as well as targeted personal emails to distribute an online survey to as many external contacts working in partner organisations as possible.

This approach yielded a higher response rate than the previous years approach and should be repeated in 2017. Findings give insight into a range of views and experiences of working within partner agencies.

Over a three quarters (76%) of those responding to the survey were satisfied or very satisfied with the way that VOICES supports their service to work with people with multiple needs. Just over one in ten (12%) were ‘neither satisfied or dissatisfied’ and under one in ten (8%) were dissatisfied or very dissatisfied. The proportion of positive responses is far higher than in last year’s survey. The results last year may have reflected the limited time that VOICES had been in operation to impact services and the improved results this year are encouraging suggesting that over time stakeholder perceptions have improved.

Respondents were asked about the strengths of VOICES from their perspective and 35 people commented. Themes in the responses included the intensive, personalised and tenacious approach of the team, giving voice and influence to people with multiple needs and cross sector working and partnership including leadership.

Respondents were asked to indicate their level of agreement levels with statements about working in a VOICES partnership service. Statements attracting the highest level of agreement were ‘I am aware of the VOICES project’, ‘people with multiple needs face significant challenges when accessing services’ ‘I am confident I can identify when someone has multiple needs’, ‘I am aware of the VOICES project’ and ‘I understand what is meant my ‘multiple needs’ in the context of VOICES’. Either zero or one person disagreed with each of these statements.

Agreement with statements about VOICES influence on the direct work of others was lower. These statements were ‘VOICES has changed the way I work with people with multiple needs’ and ‘VOICES has raised the awareness of multiple needs at the service I work in.

There is a clear trend towards higher levels of agreements with the statements in 2016, when compared with 2015. The statements that

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attract lower levels of agreement saw particular improvements. For example, 18% more respondents this year agreed they have a good understanding of that the Expert Citizens do (70% agreement this year) and 22% more agree that VOICES has changed the way they work with people with multiple needs (41% this year).

Awareness of Expert Citizen Insight and 1001 stories was fairly low in the respondents group with most respondents unaware of these work strands.

30 people responding had worked with a VOICES Service Coordinator one or more cases over the last six months. This compares with seven in the 2015 survey. Feedback on how this impacted on customers was more more consistently positive than in last year’s survey. This year nearly three quarters (22 people or 73%) of respondents said that the coordinators input has made a positive difference to the work they were doing. Nine in ten (90% or 27 people) agreed that the customer benefits from having a VOICES coordinator.

Open comments provided were overwhelmingly positive and one person commented on a perceived improvement since the previous survey.

Examples of how people feel their customers have benefited include support to prevent being recalled and helping people to access service and make positive changes. The approach of positive, ‘client-centred’ intensive and flexible work was repeatedly referenced.

13 respondents had attended VOICES training or master-classes in the last 12 months, including nine who had attended two or three. There was a broad consensus that the courses were useful and helpful in terms of the learners working with people with multiple needs and of high quality.

Respondents were asked if there are areas they would benefit from training on to help them work with people with multiple needs. The most common response (24 people) was ‘yes – but I am not sure what subjects in’. Suggestions made for training included Care Act training, a revamped Housing First course and mental health.

Recommendations 

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The survey for staff in partnership organisations yielded improved results and an improved response rate. The trend is encouraging as VOICES becomes established. Results should be used to encourage the team in their external facing work.

Next years survey should be undertaken in the same way utilising the Inform database as well as asking for general cascading from the team.

There are some suggested areas for consideration raised by open comments from this stakeholder group. For example, customer dependence versus independence – an issue which VOICES are aware and is important to keep revisiting, working out new strategies and reflecting on learning.

‘Sub brands’ of the main VOICES and Expert Citizen’s brands are not well recognised. On the basis of this, the management team could take steps to promote or merge concepts and brands to assist with communications.

There are a small number of people who use the survey as an opportunity to communicate their overall scepticism about VOICES. Awareness and openness to these views may help to achieve attrition of negative perceptions over time. When speaking about results or about the views of partners it may be helpful to indicate that while results are overwhelmingly positive there are areas for learning and on-going reflection.

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Expert Citizens survey

Key findings  Nine surveys were returned - eight fewer than last year, in contrast to the other surveys where response rates had improved.  The response rate is low and there are some clear gaps – for example no one responding is on governance groups. The promotion and distribution of next years survey should be explored ahead of go-live.  All respondents to the survey were satisfied with the way that VOICES supports the Expert Citizens overall – six were very satisfied and three were satisfied. In open comments about how VOICES is working well to support the Expert Citizens themes were around opportunities arising from the Expert Citizens group and empowerment.  Respondents were asked how far they agree with positive statements about the experience of being an Expert Citizen. Agreement was very high with each statement and only one respondent disagreed with two statements (these were the statements relating to getting the right support and training). All but one respondents agreed that they enjoy being an Expert Citizen. All respondents strongly agreed that the Expert Citizens are empowered by the VOICES project and all agreed that they were developing skills through their role as an Expert Citizen.  Statements about the impact of the Expert Citizens also attracted high levels of positive agreement. All but one of those responding felt that the Expert Citizens are improving things in Stoke-on-Trent and all respondents agreed that the Expert Citizens are listened to by VOICES staff, and managers and that ideas and feedback from the Expert Citizens are often acted in by VOICES staff.

Recommendations  The low response rate means that the findings from the survey, while very positive, should be treated with some caution.  Overall the feedback on the way that VOICES supports the Expert Citizens and the impact of the group are positive and this is encouraging.  The comments made in this survey are helpful but less detailed than those made by other respondent groups. It may be that the Expert Citizen’s group would benefit from further consultation or research to assess progress and satisfaction.

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Introduction

Becky Rice, an independent social researcher, is undertaking the local evaluation for VOICES. As part of the project, a regular programme of surveys is being undertaken with various stakeholder groups. The surveys represented in this report are: • Survey of project participants • Survey of Expert Citizens • Survey of staff in services who form part of the VOICES partnership.

The surveys were all conducted during July and August 2016. The questions were designed in 2015 for the first wave of surveys by the evaluator, Director and Learning and Evaluation Manager. The questions remained consistent for the 2016 survey with some very minor changes. This enables comparisons over time where appropriate.

The customer and Expert Citizens surveys were hard copy forms and the Golden Ticket services survey was administered online using Survey Monkey.

One local evaluation theme for 2016/17 is systems change and it is proposed that an online survey on this subject to key strategic contacts including board members is undertaken in 2016.

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VOICES customer survey

3.1

Methods

The customer survey was distributed to customers primarily via Service Coordinators by hand and then by post for a small number of people who were not seen face-to-face in the three-week distribution period. Service Coordinators were provided with guidance to ensure that they did not assist customers with the questionnaires. Instead they advised customers to seek help from a suitable person or contact VOICES to arrange assistance from an Expert Citizen volunteer if required. Staff members were briefed to remind customers about the survey and encourage responses. Each customer responding received a £5 Tesco’s voucher as an alternative to the prize draw in 2015.

67 surveys were distributed and 20 were returned making the responses rate 30%. This is an improvement on the 24% achieved last year. Given the nature of the service and the customer group this response rate is reasonable. 1 As only ten surveys were returned last year comparisons are kept to a minimum.

Due to the small base number figures are always presented in counts and not in percentages in this section of the report.

3.2

Overall satisfaction and outcomes

Respondents were asked about their overall satisfaction with VOICES. The results were hugely positive with all but one person stating they are ‘very satisfied’ and the remaining person being ‘satisfied’. As in last year’s survey, the depth and number of open responses suggest people have given thoughtful feedback and are very engaged with the process of feedback.

The reasons given for overall satisfaction were:         

Because I feel satisfied with what we have done so far.

Because I feel that I have built up a good relationship with all the members of staff.

Because I'm a little ray of sunshine since voices have been in my life.

Because I'm very satisfied with everything Rachel does for me.

Because she is down to earth, on the ball, doesn't talk shit or false promise.

She's AMAZING! Because since Voices took me on I had nothing to look forward to. Now I have you to help me with all my hopes and fears.

Because Tim has told me everything and mostly I didn't know everything's been sorted out for me.

Because Voices are like no other service I have worked with.

Helped me doing things I need to do. Shopping, paying bills, helped me into deto.x

1 Based on the evaluators previous experience, outreach, floating support and link worker

services working with people who have needs relating to substances, mental health, homelessness rarely achieve a third or higher response rate in contrast to building based services such as supported housing or hostels where higher response rates can be expected.

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I am very satisfied with my VOICES worker Leanne because every time I need her she is there for me.

I couldn't live without them, if it wasn't for Lauren I would be dead or back in jail. I have never had a service support my needs so well before I feel Liam is doing everything possible to help me.

I'm satisfied with it overall.

I'm satisfied with the way voices have pulled all other agencies together and got people listening again and then helped me to get my confidence bit by bit, day by day. But I feel in control of my life and know that I’ve got a massive range of support and everybody is listening but not too overwhelming because my worker helps to keep it simple.

Seem to be getting more suppor.t They fulfil my needs.

Very good.

Whatever help and support I have asked for or needed has been there for me.

Figure (a)

Overall satisfaction with VOICES

Satisfied, 1

Very satisfied, 19

Base: all responding, 20 Respondents were asked about changes in their lives since working with VOICES including whether they get better support from services, that some services better understand their needs, that they feel more fulfilled and confident and have a plan for the future. All but one respondent agreed that they get better support from a range of services. Similarly the other statements attracted very high levels of agreement. For these statements between one and two customers disagreed and there were a small number of neutral or ‘don’t know’ responses returned.

Customers were asked an open question ‘what difference has working with VOICES made in your life’. Themes in responses include accessing services,

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having a place to live, having someone to turn to and talk to, and positivity and improved outlook on life. Some examples of responses:   

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Everything. Housing, benefits, self-esteem. I probably would not be alive today if it weren't for VOICES. Having someone to turn to for help and support.

I am new to VOICES. The difference remains to be seen. But just to know I have someone now who is going to help me means more to me than I can say.

I have my own flat, they have made me more responsible, I have completed my first ever probation order in over 20 years.

I know what direction my life is going and she fulfils all my support needs.

It has given me confidence in myself and a better outlook on life.

Picked me up loads, lifted me from getting high on drugs to getting high on life!

Stop homelessness, stop crime, give me ambition.

That I can do things, makes me think about life in a good way.

Voices have helped me to get other services to listen to i.e. mental health and I now feel I am being treated for me, and not being judged by everyone. All agencies have been pulled together. I feel like I am in control for the first time in a long time.

Figure (b)

Level of agreement with statements about changing occurring since working with VOICES Strongly agree

Agree

Get better support from a range of services

13

6

Feel that some services understand my needs more

11

4

2

1

Feel more fulfilled in my life

12

4

1

1

2

Feel more confident

13

4

1

1

1

Have a plan for my future

14

2

3

3.3

Neither

Disagree

Strongly Don’t know disagree

1 1

1

1

Support received from VOICES

Respondents were asked about the support they receive from VOICES. All of those responding agreed that they trust their VOICES worker to arrange the support they need. All but one of the respondents agreed that they trust their VOICES worker to stick with them as long as they need (that person returned a don’t know response). All customers agreed that they talk about interests and plans as well as problems with their coordinator and all but one person that their VOICES worker knows what they are good at (the remaining person returned a neutral response). In each case most of those who agreed, did so strongly.

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I trust my VOICES worker to arrange the support I need I trust my VOICES worker to stick with me for as long as I need Me and my VOICES worker talk about my interests and plans as well as my problems My VOICES worker knows about things I am good at Me and my VOICES worker use my personal budget to help me move forward with my life

19

1

17

2

14

6

13

4

1

12

6

1

Don’t know

Strongly disagree

Agree

Neither

Disagree

My VOICES Service Coordinator

Strongly agree

Figure (c)

1

1

All but one of the ten respondents gave a positive open comment when asked the ‘best thing’ about having a VOICES worker. Themes in responses include a sense of having support and someone to talk to, practical help for example getting to appointments, and a sense of getting back on track or making positive changes in life as a result of accessing the service. Last year comments in this and other ‘open text’ sections raised the issue of customers possibly becoming over dependent on service coordinators. This is less prominent in this years survey but is still and area for the team to continually revisit given the huge part that VOICES and specific members of staff play in customer’s lives – for example several mentioned that the service gives them a ‘support network’. Service Coordinators often help customers develop relationships beyond their one to one case work, for example through peer mentors and Expert Citizens. This is one mechanism to help prevent dependency. Some examples of comments: 

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Because she is very dependable and gives me very strong telling’s off plus very good advice and she motivates me, myself and I to move forward with all I need or will do.

Having someone like Leanne to help me will be one of the best things to happen for me in a very long time. It's hard for me to explain my problems as I have been locked away for so long, but I know with help I can live hopefully a normal life. It's all I want now.

Helped me getting my life to a better way. Going into detox. Eating, shopping, paying bills but most of all got me my flat and looking at moving to a better one.

I know that my VOICES worker is there for me if I need her.

I've always got someone to turn to in a crisis It gives me a support network that gives me the confidence in daily life.

My VOICES worker has supported me throughout my troubles and has been a friend to me. She has bent over backwards to assist me in all

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areas of my life.

Nice, caring and very supportive and very nice to me.

She's good for my sanity, arranges my appointments. I wouldn't have survived without her.

She's so friendly, very supportive and the good thing about it we get on very well. She is there for me if she can.

Support and guidance.

Support network.

Taking me to my appointments.

The best thing about having a VOICES worker is moving forward with my life when I get out .of prison. Leanne is helping me with my interests in getting a job, joining a gym, helping me to budget and not come back to prison.

The support you get from non-judgemental service. The chance to get to talk to some who listens but can really help me to get my confidence back and also the fact is, when I didn't have a voices worker I was walking round like a tramp but because they have a budget they can have clothes and personal things that really help.

They are there for me.

Most respondents could not think of ways in which their VOICES Coordinator could improve the service they offer. Suggestions that were made included more visits or contact and one person said they would like quicker responses to text messages. One fairly new client responding from prison said they would like to see support with a range of things after they release to prevent them going into custody again. When asked what they would like more support with the most common responses were around housing (support to retain tenancy or find more suitable accommodation) and money management and budgeting.

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External Stakeholders survey

4.1

Methods

VOICES used information from their contacts database held in Inform as well as targeted personal emails to distribute an online survey to as many external contacts working in partner organisations as possible. This approach yielded a higher response rate than the previous years approach where managers in partner organisations were emailed surveys and asked to cascade them to staff. The 2016 survey yielded 54 responses compared to 21 returned in 2015.

45 of the 54 respondents provided the name of their organisation. The organisations represented in the results are as follows: Figure (d)

Organisation by number of responses

Name or organisation Arch Brighter Futures Citizens Advice University (not specified) Lifeline National Probation Service NHS (service not specified) North Staffs combined healthcare trust North Staffs MIND North Staffs Veterans organisation PM training Re-Solv Staffordshire Police Stoke-on-Trent City Council WVSC Total

Number of respondents

4 8 4 1 11 1 2 3 1 1 1 1 2 3 1 44

Notably some voluntary sector partners are not represented in responses – Salvation Army, Saltbox, YMCA North Staffordshire. It may be that these organisations are represented but people did not state their workplace.

34 people responding stated they work directly on customers’ cases (though not everyone answered this question) and 24 people stated that they manage staff in their role.

While the response rate is more than double that of 2015, the pool of potential respondents is very large. The survey provides the opportunity for a wide range of people to feedback but we cannot be sure that those who do are representative of staff in VOICES partnership services overall. Findings do however give insight into a range of views and experiences of working within partner agencies.

Some comparisons with last year’s data have been made in the analysis, however, due to the lower number of responses last year these should be treated with some caution.

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Overall satisfaction

Over a three quarters (76%) of those responding to the survey were satisfied or very satisfied with the way that VOICES supports their service to work with people with multiple needs. Just over one in ten (12%) were ‘neither satisfied or dissatisfied’ and under one in ten (8%) were dissatisfied or very dissatisfied.

The proportion of positive responses is far higher than in last years survey when a third (7 people) were satisfied and there was a higher level of neutral responses (a third, eight people) and also a greater proportion of negative responses (just under a fifth, four respondents). The results last year may have reflected the limited time that VOICES had been in operation to impact services and the improved results this year are encouraging suggesting that over time stakeholder perceptions have improved.

Figure (e)

Taking everything into account, how satisfied are you with the way that VOICES supports your service to work with people with multiple needs

Very dissatisfied 4% Dissatisfied 4%

Neither satisfied or dissatisfied 12%

Don't know 4%

Very satisfied 46%

Satisfied 30%

Base: 54

Respondents were asked about the strengths of VOICES from their perspective and 35 people commented. The volume and detail of responses to this open question are very encouraging showing engagement and recognition of the progress made by VOICES. There are more comments and also more detailed comments than in last year’s survey. Themes in the responses were:  The work with customers including the intensive, personalised and tenacious approach of the team.  Giving voice and influence to people with multiple needs and highlighting the issues.  Cross sector working and partnership including leadership.

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All of the responses are provided below:           

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Very good at meeting a customer's immediate needs. Very good at getting further support for a customer.

A 'constant' in the life of the service user. Facilitates communication between all services involved with the service user.

Ability to reach across services and individual needs.

Able to work very closely with customers on a one to one work outside 9-5 Anti discriminatory values. Working in partnership. Empowerment of service users.

Caring compassionate.

Case coordination, intensive support packages, access to personal budgets, access to other services.

Engagement is massively increased with our customers who have further support from VOICES. Excellent support to customers who require support.

From my perspective, introducing me to people whose willingness to share their stories will, in turn, help me improve the service I can offer to others.

Give customers a VOICE, Expert citizens can influence the work and be mentors to customers. The team’s approach to problem solving is very creative, positively break down barriers. Very good at pulling together partners.

Extremely supportive to customers and their families.

Good knowledge of other service providers and able to establish good rapport with the customer.

Having the time to work with clients effectively and the clients having access to a budget.

Highlighting complex needs and lack of support in Stoke-on-Trent.

Intense 1-2-1 support, sharing experiences.

Its focus on complex needs and system change, the length of the programme which isn't focusing on quick wins but sustainable change.

Joint working with other services.

Knowledge and adaptability.

Knowledge, the time, commitment and resources to be able to support a variety of customers.

Outstanding leadership Depth understanding of issues. Collegiate styles of working Parallel working with statutory and third sector bodies. Integrated approach with lived experience Balance of pathology and competence based approach.

Partner involvement. Empathetic support model and staff.

Small caseloads and engagement service-user led model of care. Discretionary fund so can get people phones, short-term accommodation. Saves money from wider services e.g. A&E frequent attenders, police, mental health services so ultimately cost effective, however difficult to see due to silo funding.

Staff are knowledgeable with multiple service providers. Very flexible, easily contactable, communicate well, passionate about their clients well being.

Staff have personal understanding or working experience.

Tenacity, not ‘letting things go’ until they are sorted.

That it is so influenced by people with lived experience and challenges partners to change their practice.

The ability of coordinators to dedicate significant amount of time and skill on their clients and partner agencies. Unlike many other organisations I feel that having a dedicated coordinator works incredibly well.

The ability to pull multi agency professionals together on a regular basis and oversee the management of the most complex individuals in our society.

The original idea - meeting the demand that is clearly there.

The support workers have the time to give the client the extra support they need to help them in their recovery.

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They are very passionate about their customers. They bring the agencies together for the best outcome possible for their customers.

VOICES in Stoke is an exceptional team of people who genuinely give their time and expertise to support the people they are there for. They are dynamic, enthusiastic and deliver a service to a high standard. They have a vibrant "Can do attitude" which comes from their Manager, Bruno.

Working with the person across the divides, which often happen in service, splitting up the person into problem areas.

Respondents were also asked how VOICES could improve the service it offers.

26 people responded. There were few clear themes in these comments with very wide ranging ideas and suggestions made. Areas that two or more people remarked on were concerns about dependency and levels of customer responsibility, concerns about the personal budget/ allowance and that the team could be bigger or better resourced to help more people. In addition more than one person mentioned the idea of weekend working and / or a duty system and having drop in sessions or activities for customers.

A full list of comments is shown below:  

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A higher profile I think and use of less jargonistic (and sometimes impenetrable) language.

Benefits training as this seems to be very limited with what I have seen. Also, to be careful with regards to making everyone aware of the personal budget that the customer can have. Other customers of mine want to become a customer of VOICES so that they can access the 'personal budget' and not so much the support offered.

By being clearer about what it actually can do for clients. By taking on more clients.

By being less introspective and engaging more with partners and the area generally.

By having referral meeting more frequently.

By not having the personal allowance, customers only want to have a coordinator so they can access the budget , I am not aware of any success stories.

Create a hub for customers, activities and the like.

Define a philosophy and align this with practice. Random selection of approaches can cause confusion for customers, staff and partners.

Ensure staff have sufficient training and support to retain them, as discontinuity is bad for clients.

Extended funding more staff Have an on call service for evenings and weekends. Multiple needs does not only exist between 9-5 Monday to Friday) Voices could do better at understanding that rules and regulations with agencies are there for the health and safety of the voices customer, other customers and staff and if their customers are getting away with certain issues to do with health and safety or payment then this has a knock on effect for everybody as other customers feel that they can get away with it too.

I feel that there needs to be less emphasis on peer educators. By this I mean, there are people who are well equip to be a support worker for VOICES, even if they haven't suffered from complex needs themselves. They may have experience from working in health care settings, have relevant NVQ qualifications, but are not eligible because they have not personally suffered from mental health for example.

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Improve partnership working.

In-reach services Increase numbers. Drop in sessions I n areas / groups to inform people of programmes.

Increase the number of coordinators in order to take on more cases.

Increased staff members.

More funding, more customers can be helped More great staff, if that’s possible.

My personal experience - more feedback on the individuals managed would be better but not essential if I am honest.

Provide informal training/ attend team meetings to other services to show how to challenge decisions that may have a negative impact on customers potential outcomes. e.g. eviction appeals.

Shared caseloads could promote independence with customers as, in my experience, several customers have become personally attached to their coordinator which does not promote independence.

Small case-loads mean that It is focused on those with the highest need and there is potential for a much higher demand on the service model.

They could do what it says on the tin. If you say a time stick to it ... look at the impact the customer has on other people Visibility of work with wider partners. Ownership of cases and clearer prioritisation Waiting time for support are too long. Allowing client to take a little responsibility.

Weekend work.

When people are able give them more responsibility in their recovery.

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VOICES and my work

This section of the survey asked respondents about their experience of working in a VOICES partnership service including awareness of VOICES and the Expert Citizens, their knowledge and experience of working with people who have multiple needs, and whether VOICES has changed the way they are working. (Figure (g)) The statements attracting the highest level of agreement were ‘I am aware of the VOICES project’, ‘people with multiple needs face significant challenges when accessing services’ ‘I am confident I can identify when someone has multiple needs’, ‘I am aware of the VOICES project’ and ‘I understand what is meant my ‘multiple needs’ in the context of VOICES’. Either zero or one person disagreed with each of these statements.

While comparisons should be treated with some caution, there is a clear trend towards high levels of agreements with the statements in 2016, when compared with 2015. Overall the trend is encouraging as VOICES becomes more established.

The statements that attract lower levels of agreement saw particular improvements. For example, 18% more respondents this year agreed they have a good understanding of that the Expert Citizens do (70% agreement this year) and 22% more agree that VOICES has changed the way they work with people with multiple needs (41% this year).

The areas of lowest agreement are about VOICES influence on the direct work of others; ‘VOICES has changed the way I work with people with multiple needs’ and ‘VOICES has raised the awareness of multiple needs at the service I work in.

In open comments about respondents understanding of multiple needs (in the VOICES context) people described multiple needs in relation to the number of issues such as homelessness, mental health problems and addiction. Some examples: o o o

Problems in a variety of areas of life - housing, criminality, drug/alcohol misuse, mental health etc.

People with needs in multiple domains of life e.g. housing, financial, substance misuse, mental health, employment/educational needs.

Customers experiencing a number of different issues all at once.

Homelessness, substance misuse, mental health issues, trouble accessing services.

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CONFIDENTIAL DRAFT

VOICES and my work

People with mutiple needs face significant challenges when accessing services generally

100%

I understand what is meant by 'multiple needs' in the context of the VOICES project

98%

I am aware of the VOICES project

98%

I am confident I can identify when someone has multiple needs

96%

The service I work in is accessible for people with multiple needs

89%

I have a good awareness of the work the Expert Citizens do

70%

VOICES has raised awareness of multiple needs at the service I work in

59%

VOICES has changed the way I work with people with multiple needs

41%

People with multiple needs face significant challenges when accessing services generally I am aware of the VOICES project I understand what is meant by 'multiple needs' in the context of the VOICES project I am confident I can identify when someone has multiple needs The service I work in is accessible for people with multiple needs I have a good awareness of the work the Expert Citizens do VOICES has raised awareness of multiple needs at the service I work in VOICES has changed the way I work with people with multiple needs

% Disagree

100%

% Agree 2016

80%

Total

60%

Don’t know

Strongly disagree

40%

Disagree

20%

Neither

Agree

Strongly agree

0%

% Agree 2015

Figure (f)

39

15

0

0

0

0

54

100%

0%

81%

40

13

0

1

0

0

54

98%

2%

90%

35

18

0

1

0

0

54

98%

2%

90%

35

17

2

0

0

0

54

96%

0%

95%

34

14

5

0

0

1

54

89%

0%

86%

15

23

7

6

3

0

54

70%

17%

52%

16

16

14

3

3

2

54

59%

11%

43%

9

13

19

7

5

1

54

41%

22%

19%

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CONFIDENTIAL DRAFT 4.4

Expert Citizen Insight and 1001 stories

Respondents were asked if they know what the ‘Expert Citizen Insight Programme’ is. Over half did not know (54%) and only three in ten (30%) said they did know. Others did not answer or replied ‘not sure’. People were asked to describe what they thought the programme is about (if they said they were aware of it). While three people referred to the Insight evaluation programme specifically, most referred to the work of the Expert Citizens more generally and it was clear that they were not interpreting the question to refer to the specific Insight evaluation programme as intended in the survey design. The Insight Programme is yet to establish a strong identify as a ‘sub brand’ of Expert Citizens. Some examples of responses given are:  



People with lived experience supporting others with similar issues.

A multi-agency meeting where professionals meet on a regular basis to discuss the most complex individuals in society and those who are most vulnerable as a result of their needs. Each agency has a stakeholders in the pathways discussed for the individual.

Uses voices of experience to guide and direct services to ensure they are responsive to the needs of individuals with multiple needs.

Six respondents said they had had an Insight evaluation at their service.

A third (33%) of respondents said they had heard of 1001 Voices while the majority (63%) stated they had not. Some perceptions of this project from those who were aware of it were as follows:  



People telling their own stories of recovery and/or triumph over adversity in order to encourage others.

The use of people narrative around lived experience of bio psychosocial challenges and recovery to inform change and best practice. Awareness raising.

Stories of customer’s experiences and how they have managed to turn their life around.

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CONFIDENTIAL DRAFT 4.5

Working with VOICES

30 people responding had worked with a VOICES Service Coordinator one or more cases over the last six months. This compares with seven in the 2015 survey, which demonstrates the far greater reach of the more recent survey in terms of getting feedback from front line staff.

Feedback on how this impacted on the customer and the work undertaken with them is shown in (figure (g)). 2 The results are more consistently positive than in last year’s survey were responses were very mixed. This year nearly three quarters (22 people or 73%) of respondents said that the coordinators input has made a positive difference to the work they were doing. Four (13%) disagreed. Nine in ten (90% or 27 people) agreed that the customer benefits from having a VOICES coordinator. Three people (10%) disagreed with this statement.

Figure (g)

Strongly agree Agree Neither Disagree Strongly disagree Total

Working with a VOICES Service Coordinator The VOICES coordinator's input made a positive difference to the work I was doing with the customer

The customer benefits from having a VOICES coordinator

15

18

7 4 2

9 0 1

2

2

30

30

Open comments provided were overwhelmingly positive and one person commented on a perceived improvement since the previous survey.

Examples of how people feel their customers have benefited include support to prevent being recalled and helping people to access service and make positive changes. The approach of positive, ‘client-centred’ intensive and flexible work was repeatedly referenced. Two people made comments related to concerns over the clients independence when working with VOICES; ‘customer may rely to much on their VOICES worker to much and this in turn can disempower the customer as they become too reliant.’ ‘The VOICES worker rescues the client, I feel hindering the client to make decisions for themselves’. 



Accommodation secured by VOICES worker for prison discharge, meaning previously entrenched rough sleeper did not return to rough sleeping.

Always display a positive attitude and support other teams to provide

2 If a respondent had worked with more than one person alongside a VOICES Coordinator in

the last six months they were asked to consider only the most recent case in their answers

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  

 

 







 

 

best support to customers. VOICES coordinators will use their knowledge and experience to support teams to create action plans for customers who may not be on their case-load. Wealth of knowledge that is useful across all services within the sector. Evident that coordinators are working for the best interests of the customer group and awareness of the importance of coordination, supporting to remove barriers to support and long-term outcomes for customer group.

Always had the customers best interests at the centre of what they did.

Having general case coordination allows for client care to be pulled in and targeted utilising specialisms across the city.

Having worked with a VOICES Coordinator it is my opinion that without VOICES my client would have been recalled repeatedly and not given the opportunity to access support available in the community. VOICES Coordinator played a vital role in providing both practical support such as transport as well as ensuring that all support agencies were communicating well. In another case, the Coordinator has already made trips to Prison and has taken actions prior to release that I am unable to take due to work policy restrictions on prison visits and high workload of cases.

Helpful resource. Knowledgeable and understanding. A good option I feel that the VOICES coordinators are not skilled enough in dealing with multiple-needs, I feel that they ask us for advice and guidance on the customers.

I have five clients supported by VOICES I have worked with one VOICES worker who has supported a customer living in refuge, they have helped immensely with day-to-day things which may seem small but reduce stress for that customer.

I have worked with Ruth Wallbank and Di Rankin on two cases where customers had extreme complex needs, their input was valuable in relation to day to day support needs and also to give the customer a 'voice' and to get other agencies to engage and contribute to what was needed for the customer to turn their life around - to obtain a multiagency approach I have worked with several VOICES coordinators with my customers; some have made more of a difference than others. I feel that sometimes the customer may rely too much on their VOICES worker to much and this in turn can disempower the customer as they become too reliant. I find all of the VOICES coordinators very passionate in their roles and will fight hard for their customers.

Service co-ordinators have been vital to my understanding the needs of each individual. This is important as I can then adjust/tailor the way that I deliver the service offered. They are also vital in maintaining contact with the person and keeping me updated as to each change of circumstance. They facilitate and encourage a way of working cooperatively with all parties involved in order to obtain the best outcome for the person and, maintain a high standard of professionalism.

The VOICES worker rescues the client, I feel hindering the client to make decisions for themselves.

The way that the coordinators work has improved immensely in the past year. Changes in staff and support from line manager have facilitated this.

They are able to give wrap around support.

They're usually 'on the ball' with regard to a customer's current situation and needs. Their efforts increase chances of a customer being

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CONFIDENTIAL DRAFT 



4.6

supported when in need in emergencies, for example when they are without food or electricity. Coordinators are highly proficient at getting other services involved in a customer's support.

Voices coordinators give an important overview in multi agency working and will stay with an individual in the medium to long term. They have in my experience helped in the reduction of the individual’s chaotic lifestyle.

VOICES coordinators I have worked with are very knowledgeable and hardworking. They are not only supportive of the customer but also us as colleagues.

Training

13 respondents had attended VOICES training or master-classes in the last 12 months, including nine who had attended two or three. The most recent events attended by respondents included PIE, self-harm awareness and Housing First. Between 11 and 12 people respondents with feedback about the most recent course they had attended. There was a broad consensus that the courses were useful and helpful in terms of the learners working with people with multiple needs and of high quality. In each case all but two respondents agreed, and no negative responses were returned. A full breakdown is included in figure (i).

Figure (h) Feedback on the most recent training or masterclass attended by respondents

Strongly agree Agree Neither Disagree Strongly disagree Total

The course/ masterclass was useful

The course/masterclass will help me work with people with multiple needs

The course/ masterclass was of a high quality

I would recommend this course/ masterclass to others

7 5 0 0

6 4 2 0

5 4 2 0

5 5 2 0

0 12

0 12

0 11

0 12

Respondents were asked if there are areas they would benefit from training on to help them work with people with multiple needs. The most common response (24 people) was ‘yes – but I am not sure what subjects in’. 11 people had ideas for training that would be beneficial and 15 felt they did not need further training at this stage. Suggestions made were:   

Care Act training specifically for use with complex customers.

Housing first - experience based (different trainer than last time) Challenging social care, case coordination, vulnerable adults

23

CONFIDENTIAL DRAFT   

  

Meeting the criteria for social services support Mental health Perhaps not necessarily training, but opportunities for people from different service providers to meet and learn more about what they do and how they work so that support can become more holistic and joined-up Recognising different mental health categories and strategies to manage incidents Supporting people with housing needs/ homelessness Recognising different mental health categories and strategies to manage at live incident.

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CONFIDENTIAL DRAFT 5

Expert Citizens survey

5.1

Methods

VOICES reception staff handed hard copy surveys to all Expert Citizens attending the VOICES office over a three-week period. Nine surveys were returned - eight fewer than last year, in contrast to the other surveys where response rates had improved.

Most (9) of respondents were peer mentors and three were on the core group and the same number were educators. One respondent was an evaluator.

Smaller numbers were educators (3). None of this year’s respondents sat on the governance group compared to two last year. (Figure (i)).

Figure (i) Respondent profile – Expert Citizen roles, type of role Role

Number of respondents

Peer mentor

8

Evaluator

1

Core group

3

Educator

3

Governance group

0

Figure (i) cont. Respondent profile – Expert Citizen roles, number of role Number of different roles identified

Number respondents

One

5

Two

2

Three

2

Total

9

5.2

Overall satisfaction with support from VOICES

All respondent to the survey were satisfied with the way that VOICES supports the Expert Citizens overall – six were very satisfied and three were satisfied. In open comments about how VOICES is working well to support the Expert Citizens themes were around opportunities arising from the Expert Citizens group and empowerment. Some examples are: • • • • • •

They are empowering us to allow change With training, job opportunities, CV's.

The support I have received from VOICES, which enables me to work with the Expert Citizens.

Listening to members and supporting their needs.

Being professional.

Collaborating on lots of projects, enabling Expert Citizen's to achieve any aims, supporting Expert Citizen's wellbeing.

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Respondents were also asked about how VOICES could improve the service they provide to Expert Citizens. Three respondents commented on this. Two referred to wanting more communication and one person suggested more one-to-one support.

5.3

Being an Expert Citizen

Respondents were asked how far they agree with statements about the experience of being an Expert Citizen (figure (k)). Agreement was very high with each statement and only one respondent disagreed with two statements (these were the statements relating to getting the right support and training). All but one respondents agreed that they enjoy being an Expert Citizen, and one person returned a don’t know response. All respondents strongly agreed that the Expert Citizens are empowered by the VOICES project and all agreed that they were developing skills through their role as an Expert Citizen.

I enjoy being an Expert Citizen I get the right support for my role as an Expert Citizen I know what is expected of me in my roles (e.g. as a mentor, evaluator) I am developing skills through my role as an Expert Citizen The Expert Citizens are empowered by the VOICES project I have had the training I need for my role/s

5.4

6

2

6

1

5

4

7

2

5

4

6

2

1 1

1

Total

Don’t know/ not answered

Strongly disagree

Disagree

Neither

Agree

Being an Expert Citizen Strongly agree

Figure (j)

9 9 9 9 9

1

9

Making a difference

Statements about the impact of the Expert Citizens also attracted high levels of positive agreement. All but one of those responding felt that the Expert Citizens are improving things in Stoke-on-Trent (the other person returned a neutral response). All respondents agreed that the Expert Citizens are listened to by VOICES staff and managers and that ideas and feedback from the Expert Citizens are often acted in by VOICES staff.

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CONFIDENTIAL DRAFT

Don’t know

Strongly disagree

6

2

1

5

4

9

6

3

9

Total

Neither

The Expert Citizens are listened to

by VOICES staff and managers Ideas and feedback from Expert Citizens are often acted on by VOICES staff

Agree

I think that the Expert Citizens are improving things in Stoke-on-Trent

Disagree

Making a difference Strongly agree

Figure (k)

9

27