What does ‘quality’ in human services really mean?

Thoughts on ‘empowerment’

Dr Simon Duffy of the Centre for Welfare Reform for Voyage Care

Quality can be a misleading term

Good human services are not really like…

Reliably manufactured widgets

A high quality banking service

A great meal in a restaurant

An honest taxi driver

Excellent surgical care

they are much more like…

A challenging career

Having an adventure

Cooking a meal for yourself

Being in a family

A great night out with your friends

Quality can create a strange sense of distance

between people

Good human services are not services. Staff are not servants and people are not served.

It’s important to remember that human services did not emerge as a rational response to need but as part of the eugenic panic.

Positive change has only happened where people got organised and created new forms of citizen action.

Citizenship is not something we acquire with a passport. It is how we acquire respect and reveal our dignity

There are community support organisations around the world working to advance citizenship.

Total 159

Designing services individually 111

Planning creatively with people 109

Matching staff to people 95

People and families make most decisions 104

Most recruitments involve person and family 61

Can manage their own staff 56

Use and ISF or protected personal budget 61

Can use full range of housing options 70

Individualised policies & procedures 94

People and families check quality 101

Supported by flexible contracting 35

Growing use of ISFs

Recently I spent time back at Inclusion asking people about what made it work for them…

Here are some examples of good support in practice

Measuring what matters

Proxies for citizenship• Relationships

• Control over life

• Distance from poverty

• Housing status

• Contributing roles

• Mental health

• Sources of support

The best single proxy for quality in my experience is how well are families involved

Commissioners in an age of austerity

Some service providers are beginning to change their whole way of working

• Quality in social care is a contested concept and there is an active tension between regulation and human rights

• Innovative organisations are becoming partners and community organisations - not ‘providers’

• In the UK the social care system is in deep crisis and there is no clarity about how this will be resolved