Utilising the power of service user involvement in Camden
The benefits of service user involvement were recently highlighted at the Change Grow Live Drug and Alcohol Service in Camden.
The Camden Service had recognised the values of service user feedback but the methods they were using to collect it generated only a few comments. Staff had created a paper form that service users would fill in and then post in a feedback box. The comments were collected periodically and discussed at team meetings.
One of the service users, Behar, became unhappy with this process. He felt that concerns were not being noted or addressed. He spoke to other service users who said that they were worried that if they wrote something negative, they would be told off. This meant feedback on key issues were not reaching staff. This led to a tension and a lack of communication between staff and the service.
Behar said the impression was of a ‘command and control’ culture, which reflected badly on the service. He felt that service users were seen as problematic and staff expected service users to be perfect, despite many of them coming to the service at a time when their lives were chaotic. He gave the example of service users who were turned away if they arrived more than 20 minutes late for an appointment and told to return to the service the next day to attend a ‘reconnection pod’. Service users felt they were being punished and, for many, this reinforced past experiences where they had been told that they were bad or unworthy.
Behar wanted to deliver feedback in an individual meeting (known as a pod) so that the feedback would become an opportunity for teaching rather than negative criticism.
When he spoke to the service managers they could see immediately that something needed to be done as the staff were not aware they were creating a problem. The staff were very busy but they were spending too much time ticking boxes rather than thinking about the person in front of them.
The service managers took the feedback very seriously and saw this as an opportunity to involve service users much more effectively in the delivery of treatment and support. They invited Behar to the team meeting introducing him as the service user expert in the room who the staff could learn from.
As a result of the feedback, the service got rid of the reconnections pod and instead began to talk to the service users about the reasons why they were late, the implications for this and the ways that this could be avoided in the future. This shifted the focus and changed the emphasis of the language to one of understanding and empathy rather than telling off.
Since these changes have been implemented the atmosphere in the service is more open and relaxed and as a result service users are more vocal about what they want and can contribute. This became part of their recovery. By encouraging honest face to face conversations, service users were able to deliver the best feedback in the moment.
Both staff and service users are now clearer on the difference between boundaries and rules. The context was explained and service users felt empowered because openness was now encouraged and they could take ownership of their destination.
Staff also learned a great deal from the enhanced feedback they received. Now, if they need a solution to a problem, they can ask the people who it affects the most and who often may already know the solution, which will enable processes to work more effectively.
As a result, both staff and service users are now highly engaged as a team.