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 article is an account of day serv ice moderni sation in Birmingham, describing how a r ange of innovative
approaches t o consultatio n wit h service users played a key role in reshaping day services in the city.
Key words
f'1oderni sation; Day services; Service user part icipati on; Consultati on
Backgrou.nd
The reason for change \vas social policy,
coupled Wilh a reporl presented to the City Cabinet's
Scrutiny COJllmittee, which incl uded 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 service, 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 social support resollrce hubs, sited in
communi!")' venues.
\'when we began this journey, we knew it would
be quite 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 service - 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 pmlicipate. 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 InclUSion
., Volume 14 Issue 2 IV!;l)' 2010
Pier Professional Ltd
n .. "n ,ml1 .", .. .. , .. ,n m .. " ... . ___ , '.
Modernising day services in Birnlinghanl - taking service users with us
jargonistic words that we often use. Using
trained and k-nowle'dgeable facilitators who
spoke community languages, rather than rel ying
on interpreters, participants were able to fu ll y
participate in the discussions.
\,(lomen-onl y sessions, giving wome n the chance
to express themselves in the safety of a female-
only environment .
\'(/ork-shops specificall y run for minority ethni c
community groups, including those under-
represented wit hin 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 with the
vision, or the dream about what 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 dream. Each
participant was then able ta clearl y see how the
ideas can be put into reality and, more importantly,
see how each person ca n make an indi vidual
contribution [0 the process.
\Xfhat was most sllccessful at this stage was
getting service users who regarded themselves ,IS
being ver)' much against <1I1}' of the new proposals
to work closely with ot her service users who were
running their 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 consultation
process, has proven to be an effective tool in
engaging people who traditionally have not had their
voice heard. 13y working with a visual artist both at
consultation events and individual sessions, 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 fessional 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 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 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:
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 Communities
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 ;'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 it with
innov::ltive practice frolll across the country to
create a community-based mental health service to
be proud of.
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
services, my initial reactioll was ol7e q/
scepticism. I had grown accl/sto/JIed 10 the
Iv\("nl:tI Heallh ;lnd Social Inclusion Volume 14 Issue 2 1vlay 2010 Picr Professional Ltd
>t
n
'O::>'SluaAa-iue::>lIl1eaY'MMM l!S!A asea1 s"Jua au",
::til, .l .. _ r
o }/oq :")1 ;/lUld ilIiI'I1 Wfj UOjlFWJOjU/
.... 'a);JJ OJ u{IM ION no nolO II 'JjUM" InO IF tiumq!'1lla 10
o J<oq {I'll "I"ald 'UOII"W10}U! I!'II '1S!"'lONOa nolOJ/
'ilI!ue6Jo;tM Jo s/!elap 'III'" no.( ill"pdn 0) pam iq ,few pUll
Modernising clay services in Binl1ingham - taking service users ,vith us
ql6lttending my day centre (mel did
not welcome tbe sellse qf cha11ge, especia/(jI
the idea oImovil7g 10 6111o/ber builr:Nng.
011 rejlectlon, wben Ile6/1'I11 1I10re
about Ibe,Fl'I1cfion and plflpose q/ hubs
beillg setup I'll the local 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 mwmding. Ilmowjiul1I my
e:",periences q/ (minil7g witb Ihe new wor/zers,
'be STAl? seIVice will qUer a much more
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 thaI
will helj) us Clnd tbe I am. 611so
encolfraging 111)' fellow service users to {aile
up lbese ;md to be ready/or
new ch(jfllenges and cbal1ges. '
For more information on the STAH service \\'bich offers
suppOrL !: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 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 She
heen in ....trumen\a! in some of the most marginalised pcopk' - Asian and me11 - to
not only in Lhis cons'lilmrion, bur in wicler forLlms 'tvhere their heing heard <'Ind
HtLeci upon.
Elaine .had Llsed i.l clay service for 111(111)' before it threatened with 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-he clays per \Veek.
t ... lenlai He;]lrh and Social Inclusion Volume 14 l ssuc 2 I'l'lay 2010 Pi er Professional Ltd