We see examples of that on a small scale in most of the performance audit work that we do. In almost all public services, the quality of the service that is provided depends on the quality of the interaction between the person who receives the service and the person who provides it. Repeatedly, we see good examples of public sector workers of all sorts being encouraged to listen to what is important to the people they provide services to and to look at meeting their needs.
A couple of years ago, we published a report on self-directed support, which found good examples of people sitting down with a person with disabilities, listening to what would make a difference to that person’s life and thinking about how they could use the money and other resources that were at their disposal to provide tailored support to give that person the best outcomes and help them to develop their independence. However, we also saw examples of people not being encouraged or trained to take such an approach and of people not having the flexibility to do more than provide the services that the council already had available.
For the groups of people who were affected, the approaches were as different as chalk and cheese. A key recommendation in that report was that councils needed to understand better the approach that was being taken locally and to ensure that people were trained and supported and had the resources to do what was needed and to listen to the voices of people who were affected. However, we often see it from the other end, from third sector organisations that we talk to as part of our work. We do a lot of that engagement ourselves.
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For example, a leadership team from Audit Scotland spent some time talking to people from the Wheatley Group about the way in which its housing service takes a think yes approach, in which it looks to meet the needs of people locally. Where that can be done through the flexibility of the housing service itself or through things that it can easily put in place, it can work very well. We were told of an example of a gentleman with severe hearing problems who had the television turned up loud enough to disturb his neighbours. The housing officer was able to simply buy him a pair of wireless headphones, which meant that he could hear his TV and his neighbours were not bothered.
Equally, we heard examples of where what was needed was some involvement from the health service or from social care services. In some circumstances, it was much harder for the housing officer to engage local public services in asking what the person’s needs were and how they could best be met. Consistency, flexibility and innovation are needed in those situations to make a reality of self-directed support, which takes us back to the culture and the ways of working that we talk about in the briefing, and the sorts of evaluation that Fraser McKinlay was talking about—listening to people and seeing whether what matters to them is being delivered.
Nobody is saying this is easy. It is clearly complex, but those are the things that can make a difference.