Volume 14 Issue 2 May 20 10

zo

MODERNISA nON

Moder'oising day services in Birmingha,m - taking service users with us

Jane lI"hakoordin Project Manager Da), Services Modernisation, Birmingham City Council

Rosina Service user

Elaine Service user

Abstract

' .. ',I

This artic le is an account of day serv ice modernisation in Birmingham, describing how a range of innovative approaches to consultatio n with service users played a key ro le in reshaping day services in the city.

Key words f'1odernisation; Day services; Service user part icipation; Consultation

Backgrou.nd The reason for change \vas nation~d social policy,

coupled Wilh a reporl presented to the City Cabinet's Scrutiny COJllmittee, which included a revie\v of

current day services mamlgect by Birmingham

CiLl' COlillcil. The review recolllmended a radical

lr3nsfoflnolion from the traditional model of

providing services \vithin cby centre buikling.s, to a

Illore personalised serv ice, focusing on supporting

people to maintain, or regain 'nonmd lives ' in their

10Gd cOIllIllunities. The review included CI propos:'ll

to close day centre IJLlildings and rephlce rl1em

with user-led socia l support resollrce hubs, sited in

communi!")' venues.

\'when we began this journey, we knew it would

be quite rmum~ltic for some people, especially those

who had been coming to day centres for years , and

hnd developed highly supportive friendship groups amLlnd thl.': bUilding.

1 O.5042/mhSi .201 0 .0238

Consultation What followed W::1S a .series of consultation processes

that involved service users both as participams

and facilitator.s. Wie contr3cted a local thi rd sector

organisarion La facilitate the first of three rounds of

consul t,nion, and this enabled service users - 111(111)'

of whom felt unsettled, anxious and fearful at the

potential loss of their serv ice - to express these

feelings to people who had a shared experience of

menta! health difficulries.

Innovalive ami creative methods of engagement

were used ro ensure rhat as many people as possible

had equal opportunities to pmlicipa te. These included

the follOWing.

II \Xforkshops and small group discllssions delivered

in people 's fi rst languages, if other than Eng!ish.

\We knO\v that many community langu<lges

do not have translatable phrases for mental

illne.ss, recovery and the many other potentially

MenIal FkHllh :md Soci~'tl InclUSion ., Vo lume 14 Issue 2 • IV!;l)' 2010 © Pier Professional Ltd

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Modernising day services in Birnlinghanl - taking service users with us

jargonistic words that we often use. Using trained and k-nowle'dgeab le facilitators who

spoke community languages, rather than relying

on interpreters, participants were able to fu ll y participate in the discussions.

• \,(lomen-only sessions, giving wome n the chance

to express themselves in the safety of a female­only environment .

• \'(/o rk-shops specifically run for minority ethnic

community groups, including those under­represented within services.

Service users were encouraged to work with the

project leam to work through the essential elements

listed in round one of consult<1tion into a new

service model. 'VIle did this by llsing person-centred planning techniques , Illost Significantly, a pathway

approach. This enabled people to sta rt w ith the vis ion, o r the dream about wha t the IllOSt inclusive

and successful day service could look like, and then

working backwards to list al l the essential steps

that we needed to take to achieve the d ream. Each participant was then able ta clea rl y see how the

ideas can be put into reality and , more importantly, see how each person ca n make an individual

contribution [0 the process.

\Xfha t was most sllccessful at this stage was

getting se rv ice use rs who regarded themselves ,IS

being ver)' much against <1I1}' of the new proposals to work closely with other service users who were

running the ir own services in the city and managing

their mvn budgets. By encouraging people ta look not just at what was already in place, but

innovative and eXCiting projects local ly and

region:1l1y, we began Lo increase the expecral'ions of people currently using services, or \vho might use

them in the fmure.

A multi-media approach Creativity has played a key role in the consu ltation

process, ~lIld has proven to be an effective tool in engaging people who traditionally have not had their

vo ice heard. 13y working with a visual artist both at consultation events and individual sess ions, service

users were able to express their views in <l less threarening way than speaking up in a large group.

j'l'lental Health and Social Inclusion .. Volume"J4 Issue 2 .. May 20'10 <C Pier Pro fess ional Ltd :n

22

Modernising day services in Birmingham - taking service lIsers vv'ith us

A media artist was also on hand to digitally

record the vie\vs of participants. These recordings

were then saved 011 to a DVD to ensure that the real emotional content of \vhat people said \vas

represented LO tl~e councillors \vhen they Illel to

approve the new personalised model. Digital stories were created with service users

who were already receiving a cOllllllunity-based

menta l health service. For example, a woman who receives direct payments for part or her support

package was able to convey how her quality

of life h<ls improved with increased choice and control over how she receives her support. Another

digital story t'lke.'> the rorm of ~I constructed case

study illustrating to staff and service users how one strand of the new service could operate.

It can be seen on YouTube (Simon 's Story -

Binllingham City Council: htlp :!/'\\~vw.yolltube.

com/watch?v= BsShgOezMAO).

'file n.ew STAR service mod.el The Support, Time and Hecovery (STAR) service

model created by service users, staff and representatives from partnership organisations

renected the views expressed during the consultation stages and this \vas crucial. 1t was

essential to show people in the new model th;:H we listened to their views and

renected this in the way that the new

service could operate.

The model was approved by the Council's Adults and Commu nities

Cabinet in OclOber 2009, and by

December, the majority of st<lff who had worked in the previous service

\vere converted into support, time and

recovelY (STH) workers to \vork within

the new STAH service. The adoption of the nationally recognised STR job

role rellected the need to deliver an

individually focllsed service. By ensuring that staff are trained in person-centred

working techniques, all STR workers,

whether senior or intermediate level, are

equipped ,rq ensure that each individual 's goals fOI~' ;'ecovery are identified and a

support plan is put into place. Regular

reviews ensure that the service is

individually focused. People who were once recipients of clay

services are now encollraged to becollle volunteer support, time and recovery workers to help staff

to run social drop- ins and group work. By lllc1king

more use of cOIl1J1ll.lllity facilit ies such .15 libraries, community centres and schools, opportunities for

service users to meet closer to their o\\'n home

is increased.

Change \:('e cannot pretend that this has been a smooth

journey ancl, '1S \vith any kind of change, there have been some who are not happy with it. But

we have tried to work in pannership with service users to create a new service model that takes the

best of the tradi tional model ~l!1d J1l~1rries it with

innov::ltive practice frolll across the country to create a community-based mental health service to

be proud o f. l-lere, a service user called Rosinel sh<lres her

experiences of being involved in the day services

moclernisation process.

' \·\'l/Jel1 I was invited to allend il1ifiaftal/?S on

tbe proposed /lew social model 10 lJIodemise

d(;~)} services, my initial reactioll was ol7e q/

scepticism. I had grown accl/sto/JIed 10 the

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Modernising clay services in Binl1ingham - taking service users ,vith us

cOI1~lorl ql6lttending my day centre (mel did

not welcome tbe sellse qf cha11ge, especia/(jI

the idea oImovil7g 10 6111o/ber builr:Nng.

l-Joweve/~ 011 rejlectlon, wben Ile6/1'I11 1I10re

about Ibe,Fl'I1cfion and plflpose q/ hubs

beillg setup I'll the local com1l1ul1i~)', the idea

slow(JI grew on me.

1 bad preViously 6111ell-ded tbe London

Development Cenlm Hub and on .fh:<;t

"impressions S61l/J 6{ set up tbal was warm

all-d./dend(ll. qtlerlng service users/ailb

and culturally sel1sif'ive services, tbe space

611761 time toji/Sl relax 6/1161 socialise with (he

added benefit o/education 61J?d training­

em oppOrl'llll'if:v to bllild a career- gradI/ClI(J!

appealed 10 '/lie.

To be able 10 shape a new service bas

been rea/~1 1 mwmding. Ilmowjiul1I my

e:",periences q/ (minil7g witb Ihe new wor/zers,

'be STAl? seIVice will qUer a much more

jJe~"Son centred way (!lworidng . I bave

been encouraged /0 receive some sbll-

based (/,aining 611161 now loolz./orward 10

implementing iI. '

Elaine, who helps Lo run a five clay a week social

support project, run by service llsers and funded by Birmingham Cit)' Counci l and NHS South

Birmingham speaks honesll)' abOl.ll her involvement

in the process and how she tried to give people

- who \vere used to llsing da)' centres - the

confidence to try things for themselves:

'] bave been involved with Iheforumfrom. the

beginning and we 6JI Sailley./ell fh6fl cuflli17g

it tbe '£'\Perls Forum ' was more appropriate

6/S we bad become e.'J..perls in this,Feld q(

designing and developing services tbal are

service user-led. This whole process bas been

velY imporlant to my own deuelopmel1t and

lor Ibe development qf Saltley. I am attending

Irail1il1g courses, evel1ls and cOI~/erel1ces thaI

will helj) us Clnd tbe cOlluHUJ1i~)J. I am. 611so

encolfraging 111)' fellow service users to {aile

up lbese OfJP011~/;1itje~ ;md to be ready/or

new ch(jfllenges and cbal1ges. '

For more information on the STAH service m(~cle1, \\'bich offers

suppOrL ~111c1 !:ime to enable recovery For pe()ple:- ,,,illl mental healrh

clillitLllties, ple<llse conta(.'t: Jane Thakoordin, Proj<:xt Manager Day

Services Mocit':rn'ikn'tiol1, Birmingham CiIY Council, telephone: 0121

30:' 6604; e-illail: jllllc.m.thakoorclin@hil:lnil1g'bHm.gov.uk

Jane Thakoorditt qUfllifi<::d as a Social \Xfork!.:'r 18 yeH.r~ ~Igo afrer a tareer as an un teacher. She has led this organisatinntd cbange for

the bst' three ye:·rrs.

ROSina is hoth ::t 'lIser of services ane! cmer for her brother who h;';ls me-nml he[.t!th (.1i1fiG'lIl('ie~. She h~l5>

heen in .... trumen\a! in encour~\ging some of the most marginalised pcopk' - Asian wom(:~fl and me11 - to

p~lrtidp::l\e not only in Lhis cons'lilmrion, bur in wicler forLlms 'tvhere their vie\\~S ~lre heing heard <'Ind

HtLeci upon.

Elaine .had Llsed i.l ll1elll' ~d he~dth clay service for 111(111)' ye~\J·s before it w~\s threatened with closur~ . Her

re5>ponr;e -;V::IS to join with others to run the centre themselves. 'l'hey nmv rece:hre a third 1)('Ctor grunl

ancl are an independent sodal support project open I-h·e clays per \Veek.

t ... lenlai He;]lrh and Social Inclusion • Volume 14 l ssuc 2 • I'l'lay 2010 © Pier Professional Ltd