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INVOLVING OLDER PEOPLE: LESSONS FOR COMMUNITY PLANNING

CHAPTER ONE Summary

1.1 The study was commissioned by the Scottish Executive and CoSLA to provide information about the current ways in which older people are involved in the planning, delivery, monitoring and evaluation of public services throughout Scotland, and to draw some lessons for the future involvement of older people in the Community Planning process.

Main findings

Introduction

1.2 The Local Government in Scotland Act 2003 places a duty on Local Authorities to encourage community bodies in the local area to participate in Community Planning. The key principles underlying Community Planning promote the ideals of a shared strategic vision, integrated service delivery and, crucial to the successful implementation of these principles, community participation and involvement. Older people are just one of the communities of interest with which Community Planning partners are expected to engage.

Methodology

1.3 The study was qualitative and used telephone interviews and focus group discussions to capture the experiences of both professionals and older people in relation to the involvement of older people in shaping public services. Telephone interviews were conducted with a key informant within each Local Authority area. A total of four focus groups were held in two Local Authority areas. In each area a focus group was held with older people who had been involved in shaping public services and another was held with professionals with experience of engaging with older people.

1.4 Telephone interviews proved to be a very successful way to reach key informants in all areas within a very short period of time. This method of data collection should be considered for use in other studies which operate within a short time scale.

1.5 The research team acknowledges that the involvement of older people in this research process falls short of modelling good practice in this field. That is, it would have been valuable to have engaged with older people at the outset regarding the design and implementation of this work. Time and commitment to the involvement of older people in research needs to be considered as a priority in future work if research is to be relevant and meaningful to those who have a key role in implementing the findings.

Findings

1.6 Below are the findings from both the telephone interviews with professionals and focus groups undertaken with older people and professionals.

Sources of data

1.7 The study attempted to gather data through one key informant within Community Planning departments. It became apparent in the course of study that only a small number of authorities had an overview of involvement opportunities for older people across all agencies and often this information was not collated within each local authority area. In addition, it was not always clear who held such information or was responsible for involvement within and across Community Planning partners.

1.8 Several respondents within Community Planning felt that colleagues working in service delivery within the Local Authority were better placed to provide detailed accounts of the involvement activities undertaken. Most frequently this was personnel in Social Work departments. Therefore, many of the professionals' views reported here have been provided by personnel within the Local Authority and more specifically within Social Work departments.

Current approaches to the involvement of older people

1.9 The study found that there is a range of mechanisms currently in place to offer opportunities for older people to influence some aspects of public services. In many areas a mixture of 'generic' and 'older person specific', ongoing and one-off mechanisms were used to involve older people. There was no consensus about when 'generic' or 'older person specific' involvement activities should be undertaken.

1.10 There was a perception among professionals that older people are 'over represented' in some generic involvement activities. However, there is a lack of clarity about who is involved, on what basis they are involved and whether there are certain groups of older people whose views are not being represented.

1.11 Many of the involvement activities described were being undertaken within social work or community care settings. As a result, the older people who were being involved were often service users and aged 65 and over, that is, a minority of older people. A small number of examples of multi-agency co-operation were reported. These were mainly connected with involvement in community care or Joint Future initiatives. It was unclear whether community care involvement activities linked with the Community Planning process.

1.12 A number of authorities reported that the range and pattern of mechanisms used to involve older people had developed in an incremental and evolutionary fashion rather than as a result of strategic review. The view was expressed by both professionals and older people that there needs to be more co-ordination of involvement activities and that this needs to be more closely linked with Community Planning. There was evidence of a lack of mechanisms for communication about involvement between different levels both within organisations and across agencies.

Process and outcomes of involvement

1.13 A number of key elements were identified by participants as being important if effective involvement with older people is to be achieved. These included:

1.14 It is noteworthy that these are not specific to older people but applicable across communities of interest. Many professionals reported frustration that they could not involve older people more in shaping public services. They, along with older people, identified a number of barriers to involvement including negative attitudes towards older people, older people's low expectations of the effectiveness of involvement, and a variety of organisational barriers.

1.15 While older people and professionals were able to give some examples of outcomes that had been influenced by older people's input, there did not appear to be any systematic evaluation of outcomes or the process of involvement. Both professionals and older people said that at the very least it was essential to give people feedback on what has happened, or if it has not happened, give reasons why.

1.16 Despite high levels of awareness about hard to reach groups and several measures being taken to address the barriers faced by these groups, the majority of authorities still faced difficulties reaching certain sections of the community. That said, several examples of good practice were highlighted.

Building capacity for further involvement of older people

1.17 At present, there is an issue about the over-reliance of public services on a small number of committed activists when involving older people. Older people themselves are keen to build further links with other older community members, particularly those from hard to reach groups. As well as developing new groups, there is also a need to sustain current groups' activity.

1.18 Older people considered it to be important to be "in the know". They said that they welcome opportunities for self-development through education and information sessions and more informal approaches such as buddying and mentoring. Both older people and professionals felt that the term 'training' was inappropriate, particularly when the content of training was decided by professionals without any recognition of older people's skills and life experience. Joint training for older people and professionals was also seen to make a positive contribution to working in partnership.

1.19 There was little evidence of any specific educational opportunities for staff in relation to the involvement of older people. Many of the examples given of education for professionals tended to be related to service provision as opposed to involvement. There was some recognition that more education is needed to support more effective involvement generally.

1.20 There was variation in the resources available to agencies to support involvement activities. While professionals stressed that it can be costly to involve older people effectively, that is, meet their accessibility needs and give enough time for effective involvement, they also said that there are long-term benefits to involvement activities.

Conclusions

1.21 There are a number of key issues relating to the involvement of older people in shaping public services which are not being currently addressed because there is a lack of a strategic approach to involvement.

1.22 There is a danger that, without a strategic approach, a limited range of older people will have the opportunity to be involved in influencing a limited range of issues, that is, service users aged 65 and over being involved in decisions about community care services.

1.23 It is important that a strategic approach is taken and questions are asked about whether current mechanisms are the right ones for involving people in Community Planning, whether existing mechanisms are adequate or new mechanisms are required to involve older people. The location of groups within Community Planning activity needs to be considered as it may be appropriate for such groups to sit nearer the heart of the decision-making processes.

1.24 Much is known about the theory, ethics and practice of involvement. It is noteworthy that many of the elements of good involvement as identified by professionals and older people are not specific to older people but are transferable across communities of interest. However, despite high levels of awareness of the ideal, this appears to be having limited impact on actual practice.

1.25 Evaluation of process needs to be seen to be as important as evaluation of outcomes, particularly in relation to the future development and sustainability of people's involvement.

1.26 Further capacity building is needed for both older people and professionals to ensure successful involvement.

1.27 While some colleagues within Community Planning partners' organisations have been consulted in the course of this study, there are likely to be significant gaps in the information provided. As both joint work and involvement are core goals within Community Planning, future work will be needed to examine the wider partners' experiences of involving older people.

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