1.2 Service users' views: Whose views?
Several questions arise about the kind of feedback from users that is most relevant for social care organisations to seek and respond to. What about people who are unwilling users of social care services? How important is it that their voices be heard? For example, people may come into contact with services as a result of formal detention in hospital against their wishes, under the Mental Health Act 1983. The views of children, adults and professionals have to be balanced. There are dilemmas in the real world of practice about compulsion and voluntariness.
Practitioners have to consider children's views and parents' responsibilities along with state thresholds for intervention. For example, when should families with children living at home be supported? In what circumstances should a child be removed? Care should be taken to ensure that skilled direct work enables children to communicate their wishes and feelings when professional judgements are made about their welfare. Managers are often very significant people when such balanced decisions based on complex assessments are made. The practice-led nature of the management role comes to the fore in situations such as these.
While some service users may have little choice about accepting services, they will still have valuable insights into the equity and fairness of the processes they experience. What about those people whose ability to communicate their views may be quite limited? What about listening to children? Are they always competent to give their views and who should decide? How useful are facilitated communication methods, which workers use to talk with severely disabled children and young people or older people experiencing dementia? How do managers work constructively with advocates? In finding out what people say about services, a frontline manager faces a complex range of views.
Although service users and informal carers often have common concerns and common views, this is by no means always the case. Therefore, it is important to distinguish between what service users say and what carers say. In general, this course concentrates on service users but remember that carers are increasingly service users in their own right and they may have a central role to play in a service user's life. This role has been recognised in legislation through the Carers (Recognition and Services) Act 1995 and the Carers and Disabled Children Act 2000. Various policy documents such as the national strategy for carers – Caring about Carers (Department of Health, 1999) – further emphasise the importance of the role of carer.
The research for the book from which this course is taken, included consultation sessions with groups of managers and service users. The views presented are those of the service users who took part and they echo much other research into what people want from care services. The consultations were structured around existing service categories such as learning disability, older people, children and families: an illustration, perhaps, of the influence of current models of service planning and delivery on consultation processes. The participants stressed that life is not neatly packaged in service categories. For this reason we have not always identified the group from which individual comments have come. At this point you might like to read the detailed account of this process and the people who took part, which was originally contained in the Appendix to the book.