This article summarizes Birmingham City Council's modernization of its day services for those with mental health difficulties. It involved extensive consultation with service users through innovative engagement methods like workshops in different languages and women-only sessions. Service users helped develop a new personalized Support, Time and Recovery (STAR) service model focused on community support. While change was difficult for some, creative consultation and involvement of service users in leadership helped gain acceptance for the new model.

1. Volume 14 Issue 2 May 20 10

2. MODERNISAnON
Moder'oising day services
in Birmingha,m - taking
service users with us
Jane lI" ha koordin
Project Manager Da), Services Modernisation, Birmingham City Co uncil
Rosina
Service user
Elaine '.. ',I
Service user
Abstract
T his artic le is an acco unt of day serv ice moderni satio n in Birmingham, describing how a r ange of innovative
approaches to co nsultatio n wit h se rvice users played a key ro le in res haping day services in the city.
Key words
f'1odernisatio n; Day se rvices; Service use r participati on; Consultati on
Backgrou.nd Consultation
The reason for change vas nation~d social policy, Wha t followed W::1S a .series of consultation processes
coupled Wilh a reporl presented to the City Cabinet's that involved service users both as participams
Scrutiny COJllmittee, which incl uded a reviev of and facilitator.s. Wie contr3cted a local thi rd sector
current day services mamlgect by Birmingham organisarion La facilitate the first of three rounds of
CiLl' COlillcil. The review recolllmended a radical consul t,nion, and this enabled service users - 111(111)'
lr3nsfoflnolion from the traditional model of of whom felt unsettled, anxious and fearful at the
providing services vithin cby centre buikling.s, to a potential loss of their serv ice - to express these
Illore personalised serv ice , focusing on supporting feelings to people who had a shared experie nce of
people to maintain, or regain 'nonmd lives ' in their menta! health difficulries.
10Gd cOIllIllunities . The review included CI propos:'ll Innovalive ami creative methods of engagement
to close day centre IJLlildings and rephlce rl1em were used ro ensure rhat as many people as possible
with user-led socia l support resollrce hubs, sited in had equal opportunities to pmlicipa te. These included
communi!")' venues. the follOWing .
'when we began this journey, we knew it would II Xforkshops and small group discllssions delivered
be quite rmum~ltic for some people , es pecially those in p eople 's fi rst languages, if other than Eng!ish.
who had been coming to day centres for years , and We knOv that many community langu<lges
hnd developed highly supportive friendship groups do not have translatable phrases for men tal
amLlnd thl.': bUilding.
illne.ss, recovery and the many other potentially
1O.5042/mhSi .201 0 .0238
zo MenIal FkHllh :md Soci~'tl InclUSion
., Vo lume 14 Issue 2 • IV!;l)' 2010 © Pier Professional Ltd

3. n .."n ,ml1 .", ~<~.. 'rl·""n~."'nl.., ..,n """~~' m .." ... ~ •. ~ ___ , '.
Modernising day services in Birnlinghanl - taking service users with us
jargonistic words that we often use. Using ideas ca n be put into reality and , more importantly,
trained and k-nowle'd geab le facilitators who see how each person ca n make an indi vid ual
spoke community languages, rather than rel ying contribution [0 the process.
on interprete rs, participants were able to fu ll y Xfha t was most sllccessful at this stage was
pa rticipate in the discussions. getting se rv ice use rs who rega rded themse lves ,IS
• ,(lomen-onl y sessions, giving wo me n the chance being ver)' mu ch against < 1I1}' of the new proposals
to express themselves in the safety of a female- to work closely with ot her service users who were
only environment . running the ir own services in the city and managing
• '(/o rk-shops specificall y run for minority ethni c their mvn budgets. By encou raging people ta
community groups, including those under- look not just at what was already in place, but
represented wit hin services. innovative and eXCiting projects local ly and
region:1l1y, we began Lo increa se th e expecral'ions of
Service users were encouraged to work with the people currently using services, or vho might use
project leam to work through the essential elements them in the fmure.
listed in round one o f consult<1tio n into a new
se rvice model. 'VIle did this by llsing person-centred A multi-media approach
planning techniques , Illost Sign ificantly, a pathway Creativity has played a key role in the consu ltation
approach. This enabled people to sta rt w ith the process, ~lIld has proven to be an effective tool in
vis ion, o r th e dream about wha t the IllOSt inclusive engaging people who traditionally have not had their
and successful da y se rvice could look like, and the n vo ice heard. 13y working with a visual artist both at
working backwa rds to list al l the essen tial steps consu ltation events and individual sess ions, service
that we needed to take to achieve the d ream. Each users were able to exp ress their views in <l less
participant was then able ta clea rl y see how the threarening way than speaking up in a large group.
j'l'lental H ealth and Social Inclusion .. Volume"J4 Issue 2 .. May 20'10 <C Pier Pro fess ional Ltd :n

4. Modernising day services in Birmingham - taking service lIsers vv'ith us
essential to show people in the new
model th;:H we listened to their views and
renected this in the way that the new
service could operate.
The model was approved by the
Council's Adults and Commu nities
Cabinet in OclOber 2009, and by
December, the majority o f st<lff who
had worked in the previous service
vere converted into support, time and
recovelY (STH) workers to vork within
the new STAH service. The adoption
of the nationally recognised STR job
role rellected the need to deliver an
individually focllsed service. By ensuring
that staff are trained in person -centred
working techniques, all STR workers,
whether senior or intermediate level, are
equipped ,rq ensure that each individual's
goals fOI~' ;'ecovery are identified and a
support plan is put into place. Regular
reviews ensure that the service is
individually focused.
A media artist was also on hand to digitally People who were once recipients of clay
record the vievs of participants. These recordings services are now encollraged to becollle volunteer
were then saved 011 to a DVD to ensure that the support, time and recovery workers to help staff
real emotional content of vhat people said vas to run social drop- ins and group work. By lllc1king
represented LO tl~e councillors vhen they Illel to more use of cOIl1J1ll.lllity facilit ies such .15 libraries,
approve the new personalised model. community centres and schools, opportunities for
Digital stories were created with service users service users to meet closer to their o'n home
who were already receiving a cOllllllunity-based is increased.
menta l health service. For example, a woman who
receives direct payments for part or her support Change
package was able to convey how he r quality :('e cannot pretend that this has been a smooth
of life h<ls improved with increased choice and journey ancl, '1S vith any kind of change, there
control over how she receives her support. Another have been some who are not happy with it. But
digital story t'lke.'> the rorm of ~I constructed case we have tried to work in pannership with service
study illustrating to staff and service users how users to create a new service model that takes the
one strand of the new service could operate. best of the tradi tional model ~l!1d J1l~1rries it with
It can be seen on YouTube (Simon 's Story - innov::ltive practice frolll across the country to
Binllingham City Council: htlp :!/ '~vw.yolltube. create a community-based mental health service to
com/watch?v= BsShgOezMAO). be proud o f.
l-lere, a service user called Rosinel sh<lres her
'file n.ew STAR service experiences of being involved in the day services
mod.el moclernisation process.
The Support, Time and Hecovery (STAR) service
model created by service users, staff and ' ·'l/Jel1 I was invited to allend il1ifiaftal/?S on
representatives from partnership organisations tbe proposed /lew social model 10 lJIodemise
renected the views expressed during the d(;~)} services, my initial reactioll was ol7e q/
consultation stages and this vas crucial. 1t was scepticism. I had grown accl/sto/JIed 10 the
22 Iv("nl:tI Heallh ;lnd Social Inclusion • Volume 14 Issue 2 • 1vlay 2010 © Picr Professional Ltd

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Modernising clay services in Binl1ingham - taking service users ,vith us
cOI1~lorl ql6lttending my day centre (mel did Elaine, who helps Lo run a five clay a week social
not welcome tbe sellse qf cha11ge, especia/(jI support project, run by service llsers and fu nded
the idea oImovil7g 10 6111o/ber builr:Nng. by Birmingham Cit)' Counci l and NHS South
l-Joweve/~ 011 rejlectlon, wben Ile6/1'I11 1I10re Birmingham speaks honesll)' abOl.ll her involvement
about Ibe,Fl'I1cfion and plflpose q/ hubs in the process and how she tried to give people
beillg setup I'll the local com1l1ul1i~)', the idea - who vere used to llsing da)' centres - the
slow(JI grew on me. confidence to try things for themselves:
1 bad preViously 6111ell-ded tbe London '] bave been involved with Iheforumfrom. the
Development Cenlm Hub and on .fh:<;t beginning and we 6JI Sailley./ell fh6fl cuflli17g
"impressions S61l/J 6{ set up tbal was warm it tbe '£'Perls Forum ' was more appropriate
all-d./dend(ll. qtlerlng service users/ailb 6/S we bad become e.'J..perls in this,Feld q(
and culturally sel1sif'ive services, tbe space designing and developing services tbal are
611761 time toji/Sl relax 6/1161 socialise with (he service user-led. This whole process bas been
added benefit o/education 61J?d training- velY imporlant to my own deuelopmel1t and
em oppOrl'llll'if:v to bllild a career- gradI/ClI(J! lor Ibe development qf Saltley. I am attending
appealed 10 '/lie. Irail1il1g courses, evel1ls and cOI~/erel1ces thaI
will helj) us Clnd tbe cOlluHUJ1i~)J. I am. 611so
To be able 10 shape a new service bas encolfraging 111)' fellow service users to {aile
been rea/~1 1 mwmding. Ilmowjiul1I my up lbese OfJP011~/;1itje~ ;md to be ready/or
e:",periences q/ (minil7g witb Ihe new wor/zers, new ch(jfllenges and cbal1ges. '
'be STAl? seIVice will qUer a much more
jJe~"Son centred way (!lworidng . I bave
been encouraged /0 receive some sbll-
based (/,aining 611161 now loolz./orward 10
implementing iI. '
For more information on the STAH service m(~cle1, 'bich offers
suppOrL ~111c1 !:ime to enable recovery For pe()ple:- ,,,illl mental healrh
clillitLllties, ple<llse conta(.'t: Jane Thakoordin, Proj<:xt Manager Day
Services Mocit':rn'ikn'tiol1, Birmingham CiIY Council, telephone: 0121
30:' 6604; e-illail: jllllc.m.thakoorclin@hil:lnil1g'bHm.gov.uk
Jane Thakoorditt qU fllifi<::d as a Social Xfork!.:'r 18 yeH.r~ ~Igo afrer a
tareer as an un teacher. She has led this organisatinntd cbange for
the bst' three ye:·rrs.
ROSina is hoth ::t 'lIser of services ane! cmer for her brother who h;';ls me-nml he[.t!th (.1i1fiG'lIl('ie~. She h~l5>
heen in ....trumena! in encour~ging some of the most marginalised pcopk' - Asian wom(:~fl and me11 - to
p~lrtidp::le not only in Lhis cons'lilmrion, bur in wicler forLlms 'tvhere their vie~S ~lre heing heard <'Ind
HtLeci upon.
Elaine .had Llsed i.l ll1elll' ~d he~dth clay service for 111(111)' ye~J·s before it w~s threatened with closur~ . Her
re5>ponr;e -;V::IS to join with others to run the centre themselves. 'l'hey nmv rece:hre a third 1)('Ctor grunl
ancl are an independent sodal support project open I- ·e clays per Veek.
h
t...lenlai He;]lrh and Soc ial Inclusion • Volume 14 l ssuc 2 • I'l'la y 2010 © Pier Professional Ltd