THE VOICE OF CONSUMERS IN HOME CARE: A PRACTICAL GUIDE - COTA Australia
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Your resource hub for new ideas
and choices in home care
THE VOICE OF
CONSUMERS IN
HOME CARE:
A PRACTICAL GUIDE
www.homecaretoday.org.au
An initiative of
This publication has been funded by the Australian Government Department
of Social Services. Visit www.dss.gov.au for more information.
Your resource hub for new ideas
and choices in home care
This guide is the 3nd edition of an original being technology and economic emphasis on
adapted (with permission) from a publication consumer involvement in private and public
produced by the Adelaide Women’s and organisations.
Children’s Hospital in 1996.
The ACH Group has generously shared this
The ACH Group version of the Guide was guide with Home Care Today to support other
originally developed in the late 1990’s by the organisations to engage consumers in a variety
Commercial Division. of ways in developing an approach to delivering
Consumer Directed Care (CDC).
This edition includes additions and
modifications to reflect current changes in September 2014
the home care sector as well as advances in
DISCLAIMER: This website provides some general practical avice for Home Care providers and is not intended as legal or financial
advice. This website should not be the only source of information for providers of Home Care. Home Care Today encourages anyone
who has questions about providing Home Care to get the relevant professional advice to discuss their organisation’s particular situation.
Home Care Today makes this information available on an as is basis. Home Care Today makes no representations or warranties of any
kind with respect to the contents of the information. To the maximum extent permitted by law, Home Care Today disclaims any such
representations or warranties as to the completeness, accuracy, merchantability or fitness for purpose of the information.
This work is licensed under a Creative Commons Attribution-Non-commercial-Share Alike 4.0 International License.
CONTENTS
PART I UNDERSTANDING THE CONTEXT: INTRODUCTION 1
1.1 WHY A CONSUMER ENGAGEMENT AND PARTICIPATION GUIDE? 1
1.2 UNDERSTANDING THE CURRENT NEED TO INCREASE CONSUMER ENGAGEMENT
AND PARTICIPATION IN HOME CARE 2
Why should organisations engage with consumers? 2
What is the policy context? 2
Growth of online social network platforms 3
Improving services 3
1.3 UNDERSTANDING THE TERMINOLOGY 4
Participation and engagement 4
Consumer 4
Quality 4
Co-production 4
1.4 WHAT HAPPENS WHEN CONSUMERS ARE ENGAGED? 5
Increase in knowledge 5
Empowerment 5
Loyalty 5
Innovation 5
1.5 EXAMPLES OF CONSUMER PARTICIPATION AND ENGAGEMENT IN SERVICE
PLANNING AND IMPROVEMENT 6
Advisory committees 6
Co-production of a Consumer-Directed Care (CDC) service model 7
Consumer and carer participation in staff selection, training and development 8
Series of focus group sessions using an independent facilitator 8
Consumer Directed Care 9
Consumers as evaluators 9
Consumers as training advisors 10
Local consumer forum 10
Consumers supporting board decisions: board conversations 10
Using social media platforms to engage consumers 11
1.6 WHAT ARE THE KEY SUCCESS FACTORS? 12
PART II GETTING SUPPORT FROM ACROSS THE ORGANISATION 13
2.1 WHY A TEAM APPROACH TO CONSUMER PARTICIPATION AND ENGAGEMENT? 13
2.2 WHAT TO CONSIDER BEFORE STARTING THIS PROCESS 14
Getting everyone’s support (buy-in) 14
Consider your assumptions 15
Clarify your intentions 15
Consider several options 15
Table: Pathways to consumer participation 16
Consider whether you need to access facilitation skills to assist in this process 18
2.3 HOW TO GET YOUR TEAM UNDERSTANDING CONSUMER PARTICIPATION AND
ENGAGEMENT 18
2.4 WORKSHOP ONE: UNDERSTANDING CONSUMER PARTICIPATION AND ENGAGEMENT 19
Workshop Outline 19
Workshop preparation 20
Instructions to facilitate workshop one 21
Worksheet 1: My hopes for consumer participation 22
Worksheet 2: What can be achieved by consumer participation? 24
2.5 WORKSHOP TWO: STRATEGIES FOR PARTICIPATION AND ENGAGEMENT 26
Workshop outline 26
Workshop preparation 26
Instructions to facilitate workshop two 26
Worksheet 3: Where are we now? 27
PART III PRACTICAL TOOLS 32
3.1 INTRODUCTION 32
3.2 CONSUMER PARTICIPATION PLANNING CHECKLIST 33
3.3 TOOLS FOR CONSUMER PARTICIPATION 36
3.3.1 Consumer directed care 36
3.3.2 Focus groups 38
3.3.3 Forums 40
Forum organising checklist 41
3.3.4 Committees 42
A checklist for consumer representatives 45
3.3.5 Consumer feedback 47
3.3.6 Survey and questionnaires 48
3.3.7 Networks and strategic alliances 49
Strategic alliances 51
3.4 FEEDBACK 52
3.5 ADDITIONAL REFERENCES AND RESOURCES 53
PART 1
UNDERSTANDING
THE CONTEXT
INTRODUCTION
1.1 WHY A CONSUMER ENGAGEMENT AND PARTICIPATION GUIDE?
The purpose of this guide is to support providers in service planning and service improvement
in establishing strong relationships with people processes. Each service should have a range
who are using their services and to assist in of ways in which to hear their consumer’s
developing a closer and more meaningful voice, so that consumers can participate at
engagement with existing consumers. the level with which they feel comfortable,
whether this is in directing their own care or
Home Care providers are aware of the
participating in the development of the Home
importance of consumer engagement and
Care service as a whole.
participation. However, it is clear that, at times,
it is difficult to put these ideas into day-to- Whilst we have developed this guide for
day practice. Often providers are so deeply people working in Home Care, it can also help
involved in the operations of their service that consumers willing to engage and participate in
there is little time to think about how to engage Home Care services. Therefore consumers may
with consumers in the shaping of that service, also find this guide helpful in developing ideas
beyond a person’s individual support planning. to engage with service providers.
This guide offers a practical tool to help in
planning activities to engage with consumers
1
1.2 UNDERSTANDING THE CURRENT NEED TO INCREASE
CONSUMER ENGAGEMENT AND PARTICIPATION IN HOME CARE
Why should organisations engage meeting the needs of consumers and achieving
with consumers? greater social well-being. What matters in this
situation is what drives your decisions. It has
Over the years, organisations have increased
been proven that when the focus is on the
their interest in consumer involvement in all
consumer, the financial benefits inevitably flow.
aspects of their service, including service
However where the focus is purely economic,
design, planning, monitoring and evaluation.
consumer participation and engagement is
The reasons why organisations are more
less likely to succeed. It is now understood
interested in consumer involvement vary
that the benefits of developing and fostering
significantly. These variations can be influenced
strong consumer relationships is fundamental
by an organisation’s underlying motivation for
to achieving best outcomes in care and also
consumer engagement and participation and/
financial sustainability.2 ,3
or by practical reasons such as complying
with funding requirements, the need to meet
quality accreditation obligations or to achieve What is the policy context?
economic/revenue targets. For example, some
1
In the past years we have seen a number
see consumer engagement and participation
of government policy documents giving
as a marketing exercise. This is the case when
an emphasis on public participation.4
organisations engage consumers with the
objective of increasing revenue. On these In Home Care, the federal and state
occasions, financial reward may be the only governments have introduced a number of
motivation for consumer engagement. This is policies placing the consumer at the centre of
an organisational-centric approach. the service delivery. Examples include person
centred approaches in aged care and the
In other instances, organisations may
emphasis on consumer consultation in the
take a more socio-political perspective to
Community Care Common Standards. This
consumer involvement. This is the case when
shift from a service provider driven approach
organisations recognise the rights of people
to a collaborative consumer-provider based
to participate in the decision making process.
care relationship has culminated in the 2012
What motivates these organisations is their
aged care reforms which introduced the
belief in democracy and citizenship rights. On
Consumer Directed Care (CDC) approach to
these occasions, consumer participation and
Home Care.
engagement is sought as a means to achieve
greater social outcomes such as an individual This new approach places the consumer at the
and community empowerment. This is a centre of the consumer-provider relationship.
consumer-centric approach. With CDC the consumer and/or the person
who advocates on their behalf is able to decide
More often than not the reasons why
what type of involvement they will have in
organisations are seeking more consumer
managing the funds allocated to them, and
involvement in services are intertwined. This is
have control over their support arrangements.
especially the case in the not for profit sector
While funds will be held by the service
where financial viability is as important as
provider, they will work in partnership with the
2
consumer to deliver the support according to Improving the services
their preferences. There is an emphasis on re-
Improving the quality of their aged care services
establishing health and independence as much
has also motivated organisations to engage
as possible. The consumer directed approach
with consumers. For many years providers
must be adopted by all Home Care providers by
have been working with government standards,
July 2015, making consumer participation and
accreditation criteria, and other quality
engagement more important than ever in the
management and improvement schemes to
aged care system.
improve their services. Consumer involvement
is a constant in all quality improvement systems.
Growth of online social network
Many providers continue to question the role
platforms
of the consumer in quality improvement.
Another factor that contributes to the When engaging with consumers they face the
growing need for consumer engagement and barriers of frailty, lack of mobility and isolation,
participation is the multiplicity and availability all a constant reality among older people. In
of online information and people’s increasing addition, people already receiving services
interaction with social networking sites such as may be unwilling to criticise their service
Facebook and Twitter. The Internet is becoming provider, either because of the risk of appearing
a central point of information for a large part of ungrateful or for fear of the services being
the population with people of all ages using it withdrawn.
to exchange knowledge and information.
These factors create an uncertain environment
Some organisations have capitalised on this where the barriers to meaningful consumer
trend. In many industries, businesses are using participation, whether in the direction of
the Internet as an opportunity to grow their their own package or the development of
consumer base (market share). The talk now a provider’s service offering, can appear
is no longer of one-off contact but of on an insurmountable.
ongoing and meaningful relationship with the
Nevertheless, consumers can, and in regard to
consumer.5
publicly funded services should, be involved in
Despite the growth, at this point in time some quality improvement.
sections of the population do not have access
Despite the acknowledgement that consumers
to, or have limited knowledge of or trust in, the
have a key role in the quality improvement
Internet. However, as we work towards a future
process, their role in the development of Home
where the majority of older people are active
Care service across the sector remains a work
online it is perhaps time to start tapping into
in progress. A carefully thought out approach
this platform to establish greater consumer
is needed to facilitate consumer participation
participation and engagement in Home Care.
and create meaningful consumer-provider
In addition, family and friends may use social
relationships. When this becomes a reality we
networks to explore options for Home Care for
will move from a compliance driven to a service
their relative or friend.
excellence approach to consumer participation
and engagement. This will give consumers good
reason to choose you as their provider of choice.
3
1.3 UNDERSTANDING THE TERMINOLOGY
Participation and engagement This definition is to remind ourselves that
while using participatory methods we want
The words ‘participation’ and ‘engagement’
consumers fully engaged with services. The aim
are often used interchangeably. At times it
is to involve current and potential consumers in
is possible to use these words as synonyms.
a valued, trusting, effective and interdependent
However, in this guide we will treat participation
relationship.
as one step in the consumer engagement
process. That is, participation tends to produce
engagement. By this we mean that participation Consumer
is necessary to fully engage consumers in the
In this guide, the term consumer refers to
services. Participation may or may not result in
someone who uses a service. In any transaction
engagement; a person can actively or passively
in which you are providing something to
take part in an activity. However, the act of
someone else that person is the consumer
engagement requires greater effort from both
(or customer). Consumers in this context
parties. All involved must reach out to each
include the service recipients and their families,
other in a more interactive way. Therefore,
partners, carers and informal networks.
the word engagement will be used alongside
the word participation. In this guide we see
engagement as: Quality
This guide uses quality as a descriptor to mean
meeting or exceeding the valid requirements of
‘The intensity of an individual’s your consumers. Quality also means meeting or
exceeding professional standards.
participation in and connection
with an organisation’s offerings
Co-production
and/or organisational activities,
Co-production has been defined as “A meeting
which either the customer or the
of minds coming together to find a shared
organisation initiate. We argue solution. It involves people who use services
that (consumer engagement) being consulted, included and working together
from the start to the end of any project that
is composed of cognitive,
affects them.”7
emotional, behavioural and
* This guide does not cover the process of
social elements.’6
co-production in any depth, as this has been
elaborated extensively in other publications that
are included in the additional reference list at
the end of this guide. An example is included in
section 1.5.
41.4 WHAT HAPPENS WHEN CONSUMERS ARE ENGAGED?
The benefits of consumer engagement are Loyalty
many. Among these benefits are increases in
Consumers who participate and engage with
knowledge, consumer empowerment, loyalty
the organisation are more likely to:
and service innovation.
• stay with the service because of the belief
that their success is important for the
Increase in knowledge
organisation’s success
Where there is consumer participation and • perceive difficulties as challenges to be
engagement the amount of knowledge overcome
increases through:
• understand the organisation’s efforts to run
• the exchange of knowledge between a good service.
consumers and the service, and the
development of mutual understanding
Innovation
• mutual acquisition of information
Participation and engagement of consumers
• clarification of facts and information
can also lead organisations to greater
• improving the chances of creating new
development and innovation through:
knowledge when consumers and providers
work together on resolving issues. • consumer feedback — consumers want
services that are of good quality. When
engaged, consumers tend to make creative
Empowerment suggestions for improvement
When consumers are engaged with services, • involvement in service trials and testing of
the consumer: new ideas.
• feels comfortable discussing their needs and
wants and is more likely to give constructive
feedback
• takes part in discussions
• advocates for others
• is more likely to have realistic expectations of
the organisation.
51.5 EXAMPLES OF CONSUMER PARTICIPATION AND ENGAGEMENT
IN SERVICE PLANNING AND IMPROVEMENT
Advisory committees Customers are encouraged to lead the
advisory groups. They decide on the agenda
At ACH Group the establishment and promotion
and meeting times are set according to their
of Advisory Committees are highlighted as key
needs. To date, ACH Group customers have
to fostering a strong and influential customer
advised the organisation on a number of issues
voice within the organisation.
including advice on the information package
Some years ago, ACH Group established provided to new customers and code of
what was the then ‘In-Home Care Advisory conduct for staff. They have also taken active
Committees’. These committees were part in staff training and in explaining the
established to give customers the opportunity program to other organisations.
to provide advice on the development of the
Critical to the success of these advisory groups
various new programs. As the people on the
are attention to open and clear communication,
program had high support needs, the logistics
clarity of roles, careful attention to work
of bringing representatives together for a
processes and minimum staff interference.
meeting were carefully considered. In order to
accommodate for the various needs of people, In the residential care settings families and
the Committee met in each member’s home on customers are involved in the day-to-day lives
a rotational basis. Transport was provided and of people who live in ACH Group facilities or
staff provided personal care support as needed. who receive ACH Group services. Families are
regarded as a central authority in decision
These groups continue to play a key role at
making and staff encourage this through
ACH Group. Managers make every effort
invitation to functions, roles on advisory
to engage and give customers full control.
groups, contribution to gardening plans, input
People are supported all the way and if
to décor decisions and involvement in quality
necessary are trained on how to perform
improvement and feedback initiatives.
in an advisory capacity.
6Co-production of a Consumer- In addition to consumers and carers, these
Directed Care service model working groups had other key stakeholders’
representation: service providers, industry
The People at Centre Stage (PACS) project is
and government representatives. The working
a superb example of consumer participation
groups had specific tasks and these were
in the co-production of a CDC service model
allocated according to the participant type.
design. Their Interim Report: Development
They were all contributing to the discussion
Phase gives a thorough account of the
that led to the development of the CDC model.
methodology used in the whole project. The
following paragraphs provide you with only a Consumers and carers focussed on the
snapshot of the consumer engagement process.8 identification and discussion of service gaps;
identification and indication of the preferred
In the PACS project consumers were involved
CDC model; assistance to consider and discuss
at every stage of the model’s development.
potential features of a CDC model; and actively
Consumers and carers were from a variety
participating in the model’s design. The service
of backgrounds, health complexities and ages.
providers and government representatives were
Consumers were initially involved in focus group required to contribute to both the identification
discussions that aimed to explore attitudes of implementation issues/barriers and also
towards CDC in community aged care. In to provide ideas and potential solutions. The
order to give consumers and carers contextual advisory group was composed of industry peak
information, the team offered consumers an bodies, advocacy organisations, as well as local,
overview of ‘traditional case management’ and state, and federal government agencies with an
examples of a CDC model in operation. Over interest in consumer-directed service and staff.
the course of the co-production process the
Together, they worked to address consumer
PACS team gave practical examples of CDC
direction issues and barriers. In the end, the
in action to assist consumers and carers to
ideas and solutions were presented back to
understand CDC. A set of protocols guided
consumers and carers. After a series of intense
these focus group sessions. The whole process
negotiations, the model, guidelines and forms
was recorded and transcribed with the written
emerged. The model was trialled and after the
permission of all participants.
trial the model was refined.
Consumer participation did not stop with the
The co-production was a resounding success.
focus groups sessions. Consumers’ and carers’
This model is now being trialled with Aboriginal
participation was deeply embedded in the
and Torres Strait Islander and culturally and
consumer engagement process. After the initial
linguistically diverse communities.
focus group sessions consumers and carers
became part of the working groups. These
working groups met over a long period of time
(15 sessions in a period of 12 months) to discuss
the results of the focus group discussions and
evidence from the literature.
7Consumer and carer participation Series of focus groups sessions using
in staff selection, training and an independent facilitator
development
Home Care packages support older people
In this example, consumers and carers are to remain in their homes as an alternative to
trained for involvement in staff selection. entering residential aged care. An essential
Consumers and carers participate in defining part of this service is to ensure that the care
selection criteria, staff selection (interview) and is planned around each individual consumer’s
periodic performance assessment reviews for needs and that they have a say in how the
staff. 9 care is delivered. That is, feedback about the
program in addition to the feedback given to a
The Northern Area Mental Health Service
care manager or program coordinator.
(NAMHS) has a Consumer Participation
in Staff Selection (CPSS) strategy, which At ACH Group, one program arranged a series
was initiated by consumers and developed of four focus groups over twelve months to
through cooperation between consumers and obtain feedback on four aspects of the service.
service management. The process began with Letters of invitation to consumers followed a
workshopping segments of meetings, facilitated verbal invitation. An independent facilitator
by the NAMHS consumer consultant, leading was used to run the groups and a minute
to a set of consumer-based selection criteria secretary took notes. Staff from the program
and a discussion paper outlining the potential were not involved in the groups, so consumers
usefulness of the strategy. A subsequent formal could speak freely about services they receive.
evaluation of the CPSS strategy after it was Generally, different consumers attended each of
introduced in 2000 found that it ‘appeared the sessions, but some chose to attend all four.
to have profoundly influenced the culture of Transport and refreshments were provided.
the service, including factors like the quality
While the majority of the feedback was positive,
of staff appointments, staff attitudes and
the groups raised the following issues for the
practices’. The initiative was also found to
program to consider:
have increased mutual respect and enhanced
relationships between consumers and staff. • late arrival and inflexibility of staff
• the need for staff to have more time
• consumers not knowing who to approach
if the coordinator could not deal with their
concerns
• the need for clear information to be provided
to consumers about the programme.
8Consumer Directed Care A number of other goals were set and achieved
with the flexibility of the consumer directed
Mrs B.’s devoted daughter was dissatisfied with
packages. This contributed to the daughter
the care arrangements at Mrs B.’s aged care
having a sense of full control over the situation
home. Despite the fact that Mrs. B. had high
and Mrs. B. had the benefit of having a more
support needs (diagnosed with dementia and
fulfilled life whilst living at home. This was a
bed ridden) she wanted to take her back home.
very successful example of carer/consumer
The daughter successfully applied for a Home
self managed care.
Care package and was able to transfer Mrs. B to
her home.
Consumers as evaluators
Making the most of the consumer direction,
the daughter (carer), on behalf of Mrs. B. A carer support service decided that it was
decided to fully manage the package. She was time to evaluate their programs and felt that
able to select the team that worked with her the best people to do the evaluation were
mother. She employed staff and changed the carers themselves. A group of five carers
roster when appropriate. There was a strong volunteered to be involved, and the manager
relationship between the staff and the family. and a community worker from a nearby
The agency was in the background to support, council supported them. This worker provided
provide encouragement and any other services initial training for the group on principles and
if needed. techniques of evaluation.
The daughter worked with Mrs. B and the care The group decided whom they would
provider on setting specific goals. Her first goal gather information from, and designed the
was to regain mobility. The daughter, as the questionnaires. They received training on how
care manager, contracted a neuropsychologist to conduct focus groups, then ran three focus
to work with Mrs. B. on a reablement strategy. groups for carers and volunteers. They also
The neuropsychologist using reminiscence conducted individual interviews with other
techniques, worked with Mrs B to restore service providers.
body movements. After several weeks Mrs B.
The results of the evaluation were both
once bed ridden, was able to get up, dress
enlightening and challenging. It has provided
herself, help with meals preparation with some
direction for the future of the organisation, and
assistance. The neuropsychologist worked
confirms that if we want to know where we are
with a range of health professionals who
going, we should always ‘ask the consumer’.
supported the reablement process. The health
professionals also involved the family to assist
Mrs. B. in the restoration of her mobility.
9Consumers as training advisors Local consumer forum
Mr. and Mrs. Hunt both receive services from A local council provides short term assistance
a community program. Mrs. Hunt phoned this to older people and people with disabilities
service to say she had read about a conference with home help, home maintenance and respite
called ‘Who Cares?’ The conference was to for carers.
be run by a registered training organisation
The council decided to convene a community
in conjunction with the Carers’ Association,
forum to provide information about the service
and focused on what consumers and carers
and gain feedback from those ratepayers who
had to say about the training of staff. She was
had used it. Invitations were sent to current
keen to attend and put forward her thoughts
and past consumers and others attended after
and feelings given her many years as a carer,
hearing about the forum by word of mouth.
and now also a recipient of services. She
Assistance with transport was offered and
successfully sought and gained the support
afternoon tea was provided.
necessary for her to attend.
Over 100 people attended the two hour
Wanting to share her experience with others
meeting that consisted of a presentation about
receiving services she saw a get-together at
the programme and questions and discussion.
their home as a venue for this. She invited two
other consumers and their staff to come along, Feedback about the programme was very
not only to hear of her experiences but also positive, and a number of suggestions were
to discuss their thoughts about staff training made to improve the programme and council
and what in their terms makes a ‘good’ staff services generally. These will be taken up in
member. Staff were also encouraged to be future planning for the service.
active in the discussion. The consumers saw
this as an important part of the process. They
Consumers supporting board
spoke of the importance of mutual respect
decisions: board conversations
and obligation between the consumer, carer,
the worker and the service. This is an example of how an organisation’s
board can engage consumers in defining their
The overall feedback from this group was that
service delivery approach.
it takes more than a degree or a certificate
to work as a carer. One needs to have a Some years ago the ACH Group decided
vocation for this type of work and personal to move from being a traditional aged care
characteristics of loyalty, humanness, respect provider to become a ‘Good Lives’ promoter.
for older people, and compassion are also This change in approach was a direct result
necessary. Mutuality and common sense also of consumers influencing the organisation’s
rated highly, as well as learning on the job. strategic direction.
(The information provided by Mrs. Hunt and
her group is being used for staff training at a
local level and by the organisation’s Training
Reference Group).
10It all started with the organisation’s Using social media platforms to
commitment to being of service to customers engage consumers
and not just delivering a service to customers.
The majority of examples found in this area
With that in mind the ACH Group’s board
here in the private and corporate sphere.
decided to actively engage customers to
This is not surprising given that in order to
help the organisation to define what a ‘good
meet the expectations of consumers in the
life’ was from their perspective. The board of
fast-paced digital environment, organisations
governance organised then a series of customer
need to establish a high degree of operational
consultations, called board conversations.
coordination and responsiveness. This is an
People in their 70s, 80s and 90s were invited
effort that is often said to be resource intensive
to participate in these conversations. The
and out of reach for the majority of aged
initial conversations provided the board with
care consumers. There is an assumption that
a real connection to older people, carers and
older people are not interested in technology
the wider community. The board found these
which reduces the chances of social media
meetings illuminating— a direct link to customer
platforms being encouraged and used to
wisdom.
reach consumers.
These conversations have progressed
To a certain extent, this is a reality for the
further and customers, carers and the wider
current generation. However, we want to
community have continued their participation
remember that the voices of carers, families
in the organisation’s life. Their participation
or allies who may be of a younger generation
assisted the organisation to clearly define the
and future consumers, also need to be heard.
key attributes of a ‘good life’. These elements
The next generation of Home Care users will be
are the cornerstone of ACH’s service delivery.
confident internet users. Here are some tips for
The board conversations are now a permanent
you to start placing social media platforms into
feature of the organisation’s service design
your consumer engagement strategy:
approach.
Start small
TIPS
Perhaps a blog for those who are interested in online interaction.
Rotate responsibility within the organisation.
Start a Facebook page
Post news, photos of events, showcase different areas of the organisation on
a monthly basis. Rotate responsibility.
Discover how many consumers are using social media
Use your direct care staff to research. Engage them in helping you to design
the platform that best suits customers
Use your people who enjoy using social networks to help you
Consumers, families and allies, young staff, volunteers.
111.6 WHAT ARE THE KEY SUCCESS FACTORS?
The examples in the previous section feature
some common characteristics that we have
identified as key success factors:
Productive relationships
Building rapport and trust among people seems to be essential to encourage
participation and engagement in the service.
Enter the engagement space with an open mind
Ignoring accepted assumptions such as , “older people are tired and do not want to be
engaged’” or, “older people want things done for them’” encourages active participation
from both consumers and providers.
Focus on strengths
Believe that people want to be involved and be confident that participation and
engagement is possible. With your support, people can and will engage.
Build people’s capacity
Eliminate the fear of not finding people to join the conversations you want to have by
providing support to empower consumers to have a say in your service.
Value their involvement
Give consumers control in providing feedback and act on and respond to their
suggestions
12PART 2
GETTING SUPPORT
FROM ACROSS THE
ORGANISATION
2.1 WHY A TEAM APPROACH TO CONSUMER PARTICIPATION AND
ENGAGEMENT?
Consumer participation and engagement
requires commitment from the entire
organisation, from senior management through
to the direct care staff. The main
idea of participation and engagement is to
enable consumers to influence the service
through a range of means: on the phone, on a
visit, on the day-by-day, on email, online and so
on. Your consumers need to feel that you value
their involvement. This only becomes a reality
when everyone in the organisation embraces
participation and engagement.
132.2 WHAT TO CONSIDER BEFORE STARTING THIS PROCESS
Before starting to develop consumer Question 2
participation across your organisation,
What do you and your colleagues feel about the
it is helpful to think about the following:
value or potential of consumer input?
Getting everyone’s support (buy-in)
Question 1 Get together to look
TIP
Is there any acknowledgment in your through this guide with
organisation that consumer participation any colleagues who show
and engagement needs to improve? interest or enthusiasm for
engaging more actively with
consumers before you take
Using the guide takes staff the first step.
TIP
time and needs to be If there is a lot of doubt
identified as a priority for or negativity in your
your team. It is not organisation, it is important
advisable to add consumer to have a skilled facilitator
participation and to assist you to take the
engagement to an already first steps.
heavy workload without
creating the time and
committing resources to do
it well.
14Consider your assumptions It is important for you to explore as a team
or organisation your hopes for consumer
Assumptions shape how we engage with
participation. How consumers participate in
people and situations. We need to question
planning and improving the services you deliver
our assumptions before starting to think about
will mostly depend on:
consumer participation and engagement.
• who you define as your consumers
On the one hand, if you assume older people
are sick and tired of the world, you may not • the value and priority you give to the
see the value of consumer involvement. On the experience and perspective of your consumers
other hand if you assume that as people grow • the difference you want consumer
older they continue to be interested in life, you participation to make (i.e. your team’s ideals
are more likely to value their involvement and for participation)
are more likely to make the necessary effort to • the barriers and opportunities they will
involve them in service planning and delivery. face in their journey to participation and
See the potential in people and assist them engagement.
to realise it.
Consider several options
Clarify your intentions Consumer involvement can take several forms,
Reading this guide suggests that you and the degree of involvement can also vary
have an interest in consumer participation from information, consultation, partnership,
and engagement in service planning and delegation or control. With the introduction
improvement. You need to think about what of consumer directed care and individualised
level of involvement and engagement you planning, consumer involvement takes the form
want to achieve across your organisation. You of directive control. At the service delivery
need to consider the possibility that what your level we should aim for full collaboration and
consumers need is not in place and you will only partnership. The table Pathways to Consumer
discover that if you work with your consumers Participation on pages 16-17 describes the
to find out. spectrum of consumer participation and
engagement.
15PATHWAYS TO CONSUMER
PARTICIPATION
Degrees of Participation
Low Level High Level
DELEGATED POWER
INFORMATION
NONE INFORMATION GIVING CONSULTATION PARTNERSHIP AND CONSUMER
SHARING
CONTROL
Consumers do not make any Consumers are informed Consumers are asked to give Consumers are consulted and Consumers make most of Consumers make the majority
significant decisions about the about the decisions others will their advice and opinion about are able to influence some the decisions relating to their of decisions.
service they receive. be making on their behalf. the service they receive. decisions. service.
Shifting some or all of the
Menu of services is provided Staff decide what consumers Information is sought and Consumer views contribute Provider joins with consumers decision making power
with no information exchange. need to know and given with no intended flow on to more appropriate and to make appropriate decisions. (including ‘control’ over
communicate it to them. to decision making. effective decision-making Partnership relies on common the resources) from staff/
about services. goals, mutual value and management to consumers.
respect.
EXAMPLES EXAMPLES EXAMPLES EXAMPLES EXAMPLES EXAMPLES
Consumers have no influence Staff/management decides Find ways to hear consumers’ Making a draft policy position Support individuals to take an Consumers decide on
about: service changes and informs stories of their experience paper available to consumers active role in planning their standards for the service and
consumers, e.g. changes of a service, e.g. survey, and asking for their comments. own care to the level with conduct reviews.
• What the service is
to service times, eligibility questionnaire, newsletters, which they feel comfortable.
Staff enable consumers A service or program is
• How the service is provided criteria, and the use of new feed back forms and
to define their needs for Joint planning process designed and managed by
technology. interviews.
• Where the service is information. involving staff and consumers. consumers.
provided Staff develop a consumer Invite consumers to participate
Focus groups on specific Involving consumers in A new service or project,
rights and responsibility policy, in a seminar or conference.
• When the service is issues targeted to specific designing and monitoring identified by consumers
information sheet or pamphlet
provided Provide consumers with a groups of consumers. ways for consumers to as priority is supported by
and ensure consumers are
summary report of your feedback their experience management and staff.
• Who the service is provided made aware of these. Consumer representative on
survey of consumer needs or of the service.
by. quality improvement or other A consumer manages their
Staff develop a strategic plan feedback.
decision-making committees. Accountability and evaluation own funding and employs
and inform consumers.
mechanisms which are their own staff.
Forums involving staff,
easily accessed by staff and
consumers and others to
consumers.
discuss specific issues or
services.
16 17Consider whether you need to access The facilitator should be a person who:
facilitation skills to assist in this • has experience of group methods of
process learning, planning and problem solving
It may be helpful to have an independent • is an initiator — able to suggest ideas and
facilitator to guide your group through the ways of working to help the group achieve
practical steps towards consumer participation. its tasks
The facilitator does not need to be an ‘expert’ • has summarising skills — the ability to pull
or trainer in consumer participation. Their role is together ideas, sum up what has been
to ensure that the group works together well. discussed and offer conclusions
• is able to handle conflict constructively by
drawing out the diversity of views rather
than smoothing over differences.
2.3 HOW TO GET YOUR TEAM UNDERSTANDING CONSUMER
PARTICIPATION AND ENGAGEMENT
This section offers detailed instructions on There is a step by step guide for the workshop
how to explore consumer participation and in the following pages.
engagement with your team. It is important
We encourage you to adjust this guide to your
to get them to develop a clear team
context and use it as flexibly as possible.
understanding of and commitment to consumer
participation.
You will need two one hour workshops for the
Remember that often a
TIP
exploration and planning necessary to decide
workshop is organised by
how you will involve your consumers in service
planning and improvement. The workshops may a senior manager or an
take less than one hour if there are fewer than 6 external facilitator while
people involved. the participants have not
expressed a need for the
These workshops should:
training.
• develop your ideals for consumer
Go back to the ‘buying-in’
participation in service planning and
stage and ensure that your
improvement
staff can see the need for
• be clear about the barriers to and
the session. The workshop
opportunities for consumer participation
must be perceived as an
which exist in your team or organisation
important step for them and
• explain the range of possible ways to involve
must meet staff needs.
consumers
• identify possible issues or opportunities for
consumer participation.
182.4 WORKSHOP ONE: UNDERSTANDING PARTICIPATION
AND ENGAGEMENT
Workshop Outline
Workshop one: Understanding participation and engagement
• Define who your consumers are
• Hear each team member’s view of what could be achieved by
Objectives consumer participation in planning and improving your services
• Summarise what is common and different in each other’s views
• Define your team’s ideals for consumer participation.
Target Group Define who needs to be involved.
Set the date and time to maximise the participation of those
Date & Time
you want involved.
• Copies of pages 21-23
• computer/data projector
• butcher’s paper/flip chart or whiteboard
Materials • timer
• A4 paper
• pens and markers.
19Workshop preparation Step 3
We are listing here the process as ‘steps.’ Obtain the necessary whiteboard markers and
However, these steps are not intended to be other coloured pens.
rigid. We are using this terminology to illustrate
the process. Step 4
Photocopy enough copies of the following for
Step 1
each participant:
Decide who should be at the first meeting.
• Examples of consumer participation in
Consider carefully who will take part:
service planning and improvement (page 6)
• All members of your team?
• My hopes for consumer participation?
• Some key members of your team? (page 21)
• What makes them “key?” Are they broadly • What be achieved by consumer
representative of the range of views within participation? (page 24)
your team?
• Your senior manager? Step 5
• Some consumers (internal and external) of Arrange for no interruptions and ask people
your services? to turn off their mobile phones during the
workshop.
Step 2
Book a workshop room which has a large
whiteboard or use flip chart, butcher’s paper, etc.
20Instructions to facilitate Workshop One Group activity
2.2
Step 1
As a group, share your answers and compile a
Sharing current examples of consumer list, on the whiteboard or the butcher’s paper,
participation and engagement of your consumers. If your list is a long one, talk
briefly about whether some consumers have
Ask each person to read through the sheet
priority.
Examples of Consumer Participation in Service
Planning and Improvement (page 6). It may Note — You may want to talk about the word
be important to briefly discuss how consumer ‘consumer.’ In what ways does the word
participation and engagement is defined ‘consumer’ comfortably describe people who
through these examples and how it is similar or receive your services? Are there other words
different from the day-to-day interaction staff you would prefer?
have with consumers.
Step 3
Step 2
My hopes for consumer participation
Who are our consumers?
Individual activity
Individual activity
3.1
2.1 Hand out the Worksheet: ‘My hopes for
Ask each person to think for a minute (without consumer participation’ (page 22) to each
talking) about their answer to the following participant and ask them to spend a few
question: Who are our consumers? minutes (without talking) to complete it.
Possible answers include:
• people who use our services
• particular segment(s) of the community
• internal (e.g. other teams or services of the
organisation)
• members of the community
• external service providers or agencies.
21WORKSHEET 1
MY HOPES FOR CONSUMER
PARTICIPATION
Make a note of your/your service’s current consumer participation projects or activities which are
working well.
Consider the questions:
What is the ideal difference consumer participation could make in planning and improving our
services?
What would be different if consumer participation was really working well? It may help to focus
your answers on what would be different in or for:
• work practices
• consumers (internal and external)
• our team or our service.
22Reconvene As a group discuss the following:
Group activity Question 1
As a group, briefly identify current consumer Are any of the hopes you identified in step 3
participation projects/activities and what they not represented on the worksheet?
have achieved. The focus of this discussion
should be on what has been achieved. Beware
Question 2
of getting bogged down in discussion about the
history or details of any project. Has completing the worksheet pointed to any
gaps in your group’s thinking about consumer
participation?
Process ideas for this
TIPS
Question 3
segment
Are there any changes/additions you want to
Ask each person, in turn, to
make to your list of ideals developed in step 3?
tell the group their view of
the ideal difference consumer
Group activity
participation could make.
Using the three headings from Ask people to spend a few minutes in group to
the worksheet, record on the discuss the question ‘what can be achieved by
whiteboard the main themes consumer participation?’ (page 24). Distribute
from people’s views. the worksheet (page 24) and ask them to
identify which statements reflect their group
Note — Don’t gloss over major
discussion.
differences in views. Conflict or
lack of agreement within your
unit about the value or purpose
of consumer participation could
prove to be a major barrier to
the success of any consumer
participation strategy you
choose.
23WORKSHEET 2
WHAT CAN BE ACHIEVED BY
CONSUMER PARTICIPATION?
The literature tells us that through consumer engagement and participation we can achieve:
1. Informed decisions
• what consumers need and want can be identified more accurately
• information about what works well and what needs improving can be received first hand from
staff who provide services and from consumers who use them
• different or opposing views about services can be openly considered
• proposals can be tested during development and refined making sure they will work well in
practice
• unforeseen consequences of a particular decision or direction can be detected
• the support of consumers to implement changes can be gained
• ongoing communication or partnership with consumers can be developed.
2. Sound management
• improved efficiency through a better match between what services are provided and what
consumers need and want
• closer links with consumers to enhance service quality
• increased consumer confidence in the service through open and genuine communication.
3. Equal partnership
• opening channels of communication between the service and consumers
• creating opportunities for consumers to participate in decisions that affect them
• increasing consumers’ awareness of their rights and responsibilities
• being actively and openly accountable to consumers (e.g. by reporting service achievements and
gaps, seeking and acting on feedback from consumers)
• improving people’s access to services by increasing the relevance and responsiveness of services
and programmes
• working cooperatively with individuals or groups who represent the interests of consumers.
24Step 4
Summary It may help to have thought,
TIPS
Ask one or two people to put together a before the meeting, about
short, clear statement of your team’s ideals who you would like to do
for consumer participation. this task. You may need to
develop two statements —
What we want consumer participation to
one for internal consumers
achieve in our service:
and another for external
consumers.
CONSIDERATION: Your hopes
for consumer participation
may not be the same as the
hopes your consumers have
for participation. It may be
important to think about
how you can find out their
perspective.
Arrange to make copies of your work in this
workshop, including these statements, to
distribute to each participant. You may wish to
make copies available to people who could not
attend this first workshop
Decide when you will have the next workshop
and who will attend.
Briefly outline what people can expect to
be achieved at the next workshop (see
‘Workshop Two: Strategies for participation and
engagement’ on page 26).
252.5 WORKSHOP TWO: STRATEGIES FOR PARTICIPATION
AND ENGAGEMENT
Workshop Outline
Addressing barriers and choosing strategies for
consumer participation and engagement
• Identify existing barriers and opportunities to consumer participation
Objectives • Choose consumer participation strategies appropriate to your team
• Identify possible issues or areas for consumer participation.
Target Group Define
Date & Time Define
• Copies of pages 27-29
• computer / projector
• butchers paper / flip chart
Materials
• timer
• A4 paper.
Workshop preparation Instructions to facilitate workshop two
Make sure that all meeting participants have a
Step 1
copy of the statement of the team’s ideals for
Review achievement of Workshop 1
consumer participation developed at the last
meeting. Briefly summarise what was achieved in the first
workshop.
Make enough copies of ’Where are we now?’
(pages 27-29) and ‘Pathways to consumer
Step 2
participation’ (page 16) and bring them to the
workshop. Individual activity
Hand out the worksheet: ‘Where are we now?’
(pages 27-29). Ask people to spend a few
minutes (without talking) to complete the
worksheet according to the instructions at the
top of the sheet.
26WORKSHEET 3
WHERE ARE WE NOW?
Each of the following ten items are commonly held in the literature to be keys to successful
consumer participation. Complete this checklist by rating each of the following along the scale from
0 to 10. Your rating should most closely describe the current situation in your team.
Organisational support
The value and validity that the organisation places on consumer participation should be clear and
are reflected in policies, structures and processes. Some examples include:
• organisation goals and values statements which specifically point to consumer participation
• job descriptions which include consumer participation responsibilities
• decision-making about services being devolved to the service delivery level (i.e. rather than all
decisions being made centrally or at the top)
• management or advisory committees comprising consumers.
No organisational support for Full organisational support
consumer participation
0 5 10 for consumer participation
Being open rather than closed to information from consumers
There are a range of indicators of openness, including:
• willingness to break down the boundaries between your team and other teams
• staff members recognising and valuing the knowledge and experience of consumers (talking
about consumers as experts)
• the service creates opportunities to hear consumers’ experience of the service
• there are examples of changes being made to services as a result of feedback from consumers.
Completely closed Completely open
to information
0 5 10 to information
Common goals
A clear definition of the ideals or purpose of consumer participation in your team is the basis for
action. Within each team there should be agreement about:
• the team’s main service improvement issues
• which areas of the team’s operation fall within the scope of consumer participation and which
do not
• the roles of staff and consumers in achieving service improvement.
No agreement on Full agreement
common goals
0 5 10 on goals
27Agreed processes
There should be clear processes for getting information from consumers about their experience of
the service. It should be clear (to providers and consumers) how consumers’ issues can be placed
on the agenda, how discussion will occur and how decisions will be made. The complex processes
of most providers are often difficult for provider staff to understand, let alone people from outside.
Processes are unclear There are clear
or non-existent
0 5 10 processes
Different strategies for consumers and different purposes
Generally, consumer participation is most effective when it is focused on a particular issue or a
particular group. Different strategies will be appropriate for different issues and different consumers.
The strategies used need to be appropriate both to the goals for consumer participation and the
individuals, groups or organisations involved. The influence on consumer participation of factors
such as ethnicity, age, ability and consumer’s time and interest need to be carefully considered.
We always use the We use difference strategies
same strategy
0 5 10 for different issues/people
Resources
Developing and maintaining consumer participation requires staff time. This must be supported
by service management as a legitimate part of people’s work. Other forms of support may also be
critical to ensuring consumer participation works.
Examples include:
• workshop venues • administrative costs
• developing information materials which • resources for interpreting
are easily understood by consumers
• respite care and/or personal care support • transport.
Resources are completely Resources are completely
inadequate
0 5 10 adequate
28Modelling participation behaviour
Openness and non-defensiveness are essential requirements for consumer participation. This means
working well with people who have points of view different from your own, being open to doing
things differently, being willing to make mistakes and actively sharing knowledge and skills with
others.
The effectiveness with which your team works together is crucial to your effectiveness in
developing and maintaining consumer participation.
Staff are closed and Staff are open and non-
defensive with each other
0 5 10 defensive with each other
Use language that everyone understands
For many consumers, the language of particular professions or services is full of mystery and jargon.
It is important to:
• discuss with consumers their needs for information and the relevance and appropriateness of the
information provided by the team
• identify terms that are jargon to consumers and avoid their use or explain them
• think about what will make sense to consumers in pamphlets, reports, invitations to participate
and other documents
• ensure that your information is presented well and easily accessible.
Our language is inappropriate Our language is appropriate
and inaccessible to our 0 5 10 and accessible to our
consumers consumers
Appropriate measures of effectiveness
Some measures of effectiveness such as service usage or unit costs may assess consumer
participation work as an inefficient (and therefore inappropriate) use of resources. The effectiveness
of consumer participation should be measured in relation to the goals of that participation. This
may require quite different measures of effectiveness from those currently used.
We have no appropriate We have appropriate
measures to assess the
0 5 10 measures to assess the
effectiveness of consumer effectiveness of consumer
participation participation
Use available technology
The participation of consumers can be supported by the use of communication technology.
Available technologies include email, teleconferencing, skype and social media.
We maximise the use of
We don’t use technology
0 5 10 technology for consumer
for consumer participation
participation
29You can also read
