How can power be shared with people who draw on care and support? Explore how power imbalances within the social care system can lead to exclusion and inequality.
In an open access Evidence Review, groups of people with different experiences worked together to discuss and outline the five key changes needed in social care to unlock an equal life. The review has been co-produced by Research in Practice and Social Care Future.
The sharing power as equals chapter considers how we can work in ways that help to build confidence and empower people to ‘positively challenge things that impact on our lives’.
What is power?
Power can look and feel different depending on the situation. It's been argued that there is an in-built power imbalance in any contact between those who work in social care and those who need to draw on it. Supported self-assessment, sometimes called user or person-led assessment, can be one way of rebalancing power.
Sharing power is an involved process and involves trust and sharing information – giving people the knowledge to make decisions for themselves, with support where needed. It’s about being listened to, being taken seriously, having accountability and the ability to positively challenge things that impact on our lives.
When thinking about how power can be shared with people who draw on care and support, it’s important to consider the ways that processes within health and social care exclude people and what we can do to embed the four ‘Rs’: respect, recognition, rewards and representation.
Co-production is an integral aspect of sharing power, research suggests that people with care and support needs are often highly motivated to make things better for others in a similar position. A recent survey found that 93% of people in the UK who access services would be interested in opportunities to get involved in making services better.
Decision-making
To improve services, it’s important for organisations to be open to suggestions for change and to not be defensive. For local authorities, having an increasing number of complaints is frequently seen as ‘worse performance’, however, it’s argued that feedback, including complaints, should be welcomed as an opportunity to change things for the better.
If someone is asking a question, or making a suggestion, they are usually doing it on behalf not only of themselves, but also for others who don’t feel able to.
Co-production isn’t only about a process. There should be a product at the end of it which should be evaluated and reviewed. Research suggests that this evaluation may involve measurements that look different from established ways of evaluation and quality assurance and should include the whole co-production group rather than just professionals.
In the clip below, Iggy Patel explains the importance of 'pre-production' and 'co-production':
Facing fragmented or siloed services can be disempowering for people. People often have to repeat themselves, bridging the gap themselves between fragmented services. Research has found that as well as being frustrating, this can lead to bigger issues, including important information being lost, leading to inappropriate or distressing situations, with people having to explain themselves all over again.
Power as equals
Health and social care systems can be complex, simplifying processes is an integral part of sharing power as equals. In 2015, Public Health England found that 42% of working-age adults in England are unable to make use of everyday health information, this rises to 61% when numeracy skills are also required to understand the information.
Don’t just create an Easy Read version of something and think, ‘job done’.
Behaviour and non-verbal cues can carry as much weight as words do (and sometimes more). Research has found that including non-verbal communication and body language in social work education enhanced students’ empathy and helped their awareness of this type of communication in their own practice.
To share power, it’s necessary for practitioners to understand the type of power they hold, and how it is viewed by others. Sharing power can involve thinking about how choices are presented, giving time to talk through possible short and long-term consequences, and understanding what independence and empowerment means to individuals.
For professionals, working in care and support is a job. For people who rely on those services, it is their life. Power won’t be truly shared until those who currently hold it reflect on the full responsibility their current power gives to them.
An open access event on 22 March will provide an opportunity to hear key messages from the Evidence Review.
The online event, taking place as part of Social Work Week 2024, will bring together some of the people involved in the project to reflect on their experiences of co-production, and to share learning and insights around the enablers and challenges to effective co-production.
Sharing your changes
This article is part of a series on a new Evidence Review. Everyone is encouraged to find action points in the review that are relevant to them and consider how they can be achieved.
Research in Practice would like to hear from those who use the Evidence Review. In the spirit of co-production, you could contact us jointly with someone with care and support needs. We would be keen to feature your stories in podcasts and blogs.
