29.
To address the Review’s first line of enquiry, the Review
Board sought to define and understand the term ‘seldom
heard’, and to identify who this term relates to.
The
ASCH Department defines seldom heard as:
30.
‘Seldom heard’ has replaced the term ‘hard to
reach’ (which can suggest that the problem lies within the
group, rather than within services’ approach to them) and
emphasises the responsibility of agencies to reach out to excluded
people, ensuring that they have access to health and social care
services and that their voices can be heard. Although this review
focuses on engagement with seldom heard groups, the Department
recognised the importance of enhanced engagement with, and
inclusion of, people from all communities and of all identities in
their work.
31.
The Board found that the Department had
carried out extensive work to understand the needs of its service
users and identify people it seldom hears from. This included data
gathering, internally and from partners from the voluntary,
community and social enterprise sector (VCSE), staff engagement
sessions and engagement with intermediaries representing seldom
heard communities.
32.
This work helped to identify key groups who may be less likely to
engage with services including people protected under the Equality
Act including:
- Older
people
- Unpaid
carers
- People
from ethnic minorities, particularly people who do not speak
English as their main language, or do not speak it
‘well’ or ‘very well’
- Disabled
people, including those with invisible disabilities, sensory
impairment or a mental health condition
- Lesbian,
gay and bisexual people
- Trans and
non-binary people
- Gypsy,
Roma and Traveller communities
- People in
rural areas
33.
Communities which are seldom heard due to social circumstances were
also identified, including:
- Homeless
people
- People in
prison
- People
with low levels of literacy
- People who
are digitally excluded
·
People in
recovery from drug and alcohol addiction, and their
families
·
People who
have experienced domestic abuse
34.
Community engagement for the new Adult Social Care Strategy
identified additional groups including men at risk of suicide,
people in the armed forces and veterans, and people with unmet need
or not yet eligible for ASCH support.
35.
It was agreed that seldom heard people may be different for each
service and/or department but the above list applies to most public
services. In light of the wide range of groups identified the Board
agreed, for the purposes of the review, to focus on a sub-set in
order to explore the lines of enquiry and identify potential
recommendations which may have broader relevance. The Board’s
research included, Gypsy, Roma and Traveller communities, homeless
people, ethnic minority groups and communities (including refugees
and asylum seekers), older people, adults who are digitally
excluded and unpaid carers.
36.
Other issues and barriers, which cut across several groups, were
considered more generally as part of the Review.
37.
Information provided by the Council’s Equality Manger
stressed that the people who are seldom heard may change over time
and that it was important to note the different layers of identity
and to consider intersectionality; how different aspects of
people’s identities (such as ethnicity, gender, age,
disability and so on) can interact and affect how we experience the
world and how we are seen and treated.
38.
ASCH communicates
with a number of groups through relationships with partners. The
Board questioned how the Department knew those partners were
reaching the right people in the community and heard in response
that, to mitigate the risk of over reliance on organisations to
communicate with groups, the Department uses a variety of methods
to engage, including through the use of a diverse VCSE sector and
District and Borough and Parish and Town councils, to ensure there
is not a singular reliance on any organisation. ASCH is continually
seeking to build upon these networks to ensure they are increasing
their reach in the community.
39.
Members recognised that who is seldom heard will change over time
and concluded that it would be important to continue engagement
work to not only address barriers, but to continue to identify
groups and people they seldom hear from, moreover engagement when
developing services was critical across the whole community.
Evidence from the Council’s Equality Manager and the ASCH
Policy Development Manager stressed the importance of ongoing
conversations with groups through the use of forums, advisory
groups and with external partners. This work needs to be considered
at the right stages of projects and service changes, and its
effectiveness monitored.
40.
Having reviewed evidence on the engagement undertaken to date, the
Board concluded that this had been extensive and had been thorough
in identifying potentially seldom heard groups. Moreover, this work
was informing ongoing actions. The Board therefore focused the
review primarily on the second area of enquiry, understanding and
addressing barriers. This was informed by the existing robust
analysis of seldom heard groups and sought to build on this and
gain a deeper understanding.
41.
Work to understand the barriers to residents engaging with ASCH is
ongoing, with the Department recognising that a minority of people
intentionally do not want to interact with public services. The
Board drew on a range of sources to assess and explore levels of
understanding, including information from staff, based on their
experience of working with clients and carers, case studies and
research locally and in other parts of the country, and by talking
to a range of people working with specific groups of people within
the county who may be seldom heard.
42.
ASCH staff engagement sessions highlighted a number of barriers
facing some residents, including:
- a lack of
trust in ASCH
- stigma
around accessing services
- poor
literacy skills
- digital
exclusion
- a fear of
social services/a lack of understanding about ASCH
- cultural
differences
- mental
health issues
- a lack of
plain English in communications/inaccessible forms
43.
Interviews with external partners undertaken by ASCH similarly
noted barriers of trust, stigma, feeling excluded from the wider
community, a lack of understanding of what services are available,
the inability to access services and/or frustrations with lengthy
processes.
44.
To further explore the local position, the Board discussed the
findings from the Activmob report East Sussex County Council,
Adult Social Care & Health: Experience during Covid-19
lockdown: What can we learn from population groups? A key
finding in this report was that the majority of participants
(people from ethnic minority backgrounds, younger people, older
people, and men) responded that they had ‘absolutely no idea
or very little awareness at all of what ASCH can offer’. For
those who did know, there was a negative view regarding accessing
support and many would only do so if someone told them to get help
from the service. The ASCH Policy Development Manager confirmed to
the Board that evidence suggested the main barrier to people
accessing services was a lack of awareness.
45.
The Board heard from a number of witnesses who were able to provide
greater insight into barriers preventing groups they worked with
from accessing services. Although not every seldom heard group was
represented, the Board were presented with a range of insights from
witnesses who work with specific groups in the community and it
became apparent to the Board that many of the barriers cited in
relation to specific communities shared similar themes and applied
to multiple groups. A systematic view of these barriers was
developed by the Department and grouped into four main
categories:
- Organisational
barriers - which
impacts on the seldom heard if they are unable to find, or have
difficulty accessing services, for example some clients may find
forms or fast paced meetings challenging, or have insufficient
funds to travel.
- Cultural
barriers -
including a stigma associated with using or needing
services.
- Practical
barriers - if there
are not practical steps in place to help people access services,
for example information translated into languages.
- Attitudinal/Behavioural
barriers - relating
to attitudes of people and staff, including unconscious biases.
This can lead to a relationship which is disempowering between
staff and clients.
Examples of
Organisational barriers
46.
The Board heard from the Head of the Homeless and Inclusion Health
Service (HIH), which provides outreach care for homeless people and
rough sleepers in Eastbourne. The HIH offers pop up services in the
community on a regular basis, aiming to build trust through
continuity of staffing and creating a friendly and safe space. The
Head of HIH felt that there was a general lack of knowledge and
awareness of ASCH within the homeless community, and amongst
related health professionals, which may prevent some people from
engaging with and accessing services. This included information
about who supports homelessness preventative initiatives, including
the Rough Sleepers Initiative and Changing Futures. The Board was
also informed of the need for local authorities to share
information to ensure continuity of care for transient communities.
Lengthy processes for referrals and delays in being offered an
assessment were also cited as significant barriers for this
transient population.
47.
This lack of awareness was also highlighted by the ASCH Practice
Manager in relation to support for the prison population. The Board
heard that the proportion of prisoners (at HMP Lewes) accessing
ASCH services is low, and although this is mainly due to basic
support for daily living being offered through the prison service,
it is also due to prison
officers not being consistently aware of the support available from
ASCH.
Examples of
Cultural barriers
48.
The Board heard from the Council’s Gypsy and Traveller Team
Manager who highlighted a range of issues affecting these
communities, including poor health, low levels of literacy, and
inequalities in access to healthcare (particularly mental health
services). Many within Gypsy, Roma, and Traveller communities
report feeling excluded from society, both at a national and local
level and, due to negative portrayals in the media, many find it
hard to build trust with people outside of their community. The
Board also heard that communication with these communities is
extremely difficult, and it often takes many years for teams to
build trust; this is additionally challenging when families and
individuals are likely to move and when staff change in teams or
roles are restructured.
49.
The Board asked about barriers facing people coming to the UK and
heard from a Senior Outreach & Community Engagement Officer at
Groundwork South about his own experiences as a refugee, as well as
working with refugees in East Sussex. He told the Board that
cultural differences impacted on some people’s opportunities
to integrate locally and utilise local services. Moreover, although
there is English for speakers of other languages (ESOL) provision
in colleges and schools in East Sussex, many providers do not
understand the background of these communities and the additional
barriers many are facing, including mental health problems and
trauma.
50.
Cultural barriers were also presented as a barrier to carers
accessing support. The Board heard from the Chief Executive of Care
for the Carers (CftC) about the role of carers in East Sussex.
Caring can involve taking on a number of supporting roles for
family, friends or neighbours for reasons such as frailty,
substance misuse, disability or mental health problems. Caring cuts
across all communities and every role is different; it is estimated
that unpaid carers match the number of NHS workers in the UK, with
most people taking on caring roles at some point in their lives.
The Chief Executive of CftC informed the Board that there is often
a reluctance from carers to identify as a ‘carer’ (this
is even more prevalent in certain cultures) which results in some
people being unaware of the support available to them.
51.
The Board reviewed the report ‘Understanding unpaid carers
and their access to support’ by the Health Foundation
(2023), which suggests that only a small proportion of carers
request support from their local authority. Evidence suggests that
barriers facing many carers include feelings of isolation, cultural
stigma around care, and, for many, financial pressures.
52.
The Chair of East Sussex Seniors Association (ESSA) told the Board
that some older people were too proud to ask for help, feeling that
support was not for them. The Board heard that it is a struggle to
get information out, to break down this stigma and to make people
aware that support is available to everyone. The Chair also
informed the Board that some older people had moved to rural parts
of East Sussex to retire but had left social groups behind and now
felt isolated, especially those who had become carers or had been
bereaved. This isolation, coupled with difficulties getting online
or travelling into towns, often results in older people not being
able to engage with events and services.
Examples of
Practical barriers
53.
The Head of HIH highlighted a number of barriers facing the
homeless community including, for some, mental health problems,
substance misuse, and the significant barrier of not having a fixed
address. This can prevent some individuals accessing primary care,
including receiving medicine, and supporting this community is
increasingly challenging when individuals move around, including in
and out of local authorities.
54.
The Board noted similar barriers affecting other transient
communities like people from Gypsy, Roma, and Traveller
backgrounds, as well as an inconsistency of support when people
move across counties.
55.
The Board heard from the Senior Outreach & Community Engagement
Officer at Groundwork South that being unable to communicate in
English is a significant barrier for many refugees trying to access
local services. This language barrier, and lack of alternative
options, often results in people being unable to fill out
paperwork, or read information in letters and leaflets, and needing
to seek assistance from others.
56.
The Chair of the ESSA told the Board of her experiences of
supporting older people, including that only around 13% of
ESSA members were online, with many older people not trusting
online services (including banking). She indicated that in rural
areas many were now struggling to access in person services due to
a reduction in bus services and the closure of banks, and that a
lot of older people felt very left behind with rapid changes to
service delivery. She explained that when people don’t see an
associated phone number to access a service, and only a website or
email address, that can be the biggest barrier to asking for
help.
57.
The Board explored digital exclusion further and how being
digitally excluded may prevent some adults from accessing and
engaging with ASCH services. The Being Digital Delivery Manager
informed the Board that the ability to access ASCH services in East
Sussex was not reliant upon internet usage, however, people who
could use digital technologies would be able to access information
and advice more quickly and easily given that all the information
published in leaflets and factsheets is available instantaneously
on the ESCC website, removing the need to phone for information, or
obtain a paper leaflet.
58.
Conversations with witnesses highlighted that low levels of
literacy amongst certain groups further impacted on their
understanding and awareness of services, as well as acting as a
barrier to accessing those services. The Board explored this
further and heard from a Librarian who runs the ESCC Library
Service programme ‘Step into Reading’, which provides
one to one phonics reading sessions to adult learners. They heard
that the demographic of learners was varied, including people of
all ages, and sessions were taking place across the county. Most
learners had complex needs including a special educational need
and/or a neurodiversity issue which impacted on process and recall
of language.
59.
In relation to the prison population, security and systems can also
be a practical restriction on the ability to provide care to
prisoners, with incidents such as lockdowns preventing care workers
accessing clients. The Board heard that the Department was working
to increase the uptake of social care support by prisoners by
continuing to liaise with the prison’s inclusion officer and
using communication mechanisms that are in plain English and Easy
Read to help promote offers to the prison population, many of whom
have low levels of literacy. The Board suggested that relationships
could also be built with VCSE organisations working in the prison
to spread awareness of ASCH support.
Examples of
Attitudinal/Behavioural barriers
60.
The Board heard some examples of barriers relating to attitudes or
lack of representation in communications. For instance, HOPE G in
Hastings, who represent older people from ethnic minorities, had
reported to ESSA discrimination in that there can be language and
cultural barriers when accessing services, with some information
too complex or perceived as unrepresentative.
61.
A case study on Greater Manchester’s ‘Improving
access to health services in the LGBT community’
highlighted that previous discriminatory experiences with health
services had resulted in some LGBT people feeling reluctant to
access council services and that staff were not knowledgeable
enough of their specific needs. Lack of representation of LGBT
people in communications and promotional material also acted as a
barrier to accessing services in this study.
62.
The Board noted the feelings of being disrespected and
discriminated against that people from minoritised communities,
including those from ethnic minority backgrounds and LGBTQ+ people,
can face. These can impact negatively on people’s ability to
access services.
Lack of
trust and stigma around using services
63.
Evidence from interviews with external partners and witnesses, and
from broader case studies, suggested that stigma around accessing
services or identifying in a certain way, and a lack of trust in
government or council services were key barriers for many groups.
This lack of trust often stemmed from previous negative experiences
with services, societal discrimination, and/or a lack of confidence
in the Council’s understanding of cultural
differences.
64.
The Head of HIH reiterated that the issue
of trust in council services presents a barrier for many homeless
people, and it is important for professionals to engage with people
in the community through outreach.
65.
ASCH interviews with external partners, recorded in The Seldom
Heard People Report, included conversations with a number of
organisations working with marginalised groups. The issue of trust
featured in most conversations. Groundwork Together South, who work
with refugees and asylum seekers, suggested that
people were reluctant to speak openly with authorities due to past
experiences and fear that they may receive poor treatment, moreover
ESCC was viewed in the same way as all other government
organisations including the Home Office.
66.
The organisation African Community in Surrey and Sussex highlighted
the role stigma plays in some communities accessing support and
cultural differences in attitudes towards mental health. The Chief
Executive of Care for the Carers also noted that attitudes towards
care could differ amongst cultures, resulting in some people being
reluctant to seek support where caring was viewed as an expected
role within the family. Organisations, including ESSA, also cited
stigma as a barrier for many older people who could be reluctant to
ask for support, or fearful that engagement with social services
could result in being judged or moved from their home.
67.
The Board concluded that the more the Council understands about
different communities and potential barriers, the more work it can
do to address these.
68.
Witnesses and evidence presented to the Board suggested several
possible ways to further build on work to address some of the
barriers identified.
69.
The Board identified and explored the following key themes in these
approaches:
·
Community
engagement
·
Enhancing staff
knowledge
·
Effective and
inclusive communication
·
Inclusive
services
·
Knowledge and
data sharing
·
Relationships
with external partners
70.
Community engagement work has been conducted throughout the Council
through a variety of projects and with a range of communities. The
Board heard from the ASCH Policy Development Manager on the
community engagement work when developing the new ASC Strategy; the
Council’s Equality Manager on wider engagement work within
ESCC; the Gypsy and Traveller Team Manager on his team’s
continued engagement with Gypsy, Roma, and Traveller communities,
as well as ASCH’s work with partners.
Learning from a range of community engagement activities
demonstrated the importance of ongoing conversations and engaging
with groups in the most appropriate format and setting.
71.
Engagement work to inform the development of the new ASC Strategy
focused on listening to residents’ priorities through the use
of interviews, surveys and focus groups. This included work to
reach people who may need care and support in the future, or those
who needed help now but may not be getting it for a range of
reasons, to ensure their voices were also considered. Advice was
sought internally and from the VCSE sector to identify
communication channels, organisations, community spaces, and events
to help engage with seldom heard groups.
72.
The ASCH Policy Development Manager noted that an ongoing,
co-production approach is important with seldom heard groups, in
order to deepen engagement and to maintain connections, and that
time and resource needs to be allowed within projects for this. The
Board agreed that ongoing conversations with groups and partners
would help tackle some of the barriers identified.
73.
The Head of HIH also noted the benefits of reaching groups in
community settings; for the homeless community that means providing
health services where people can also access food and shelter. By
providing services in places where people feel safe, teams are able
to build trust and learn about the wider needs of the
community.
Recommendation
3
The
Department to involve, engage and include communities by reaching
out to them through community events with trusted partners in the
communities in order to record, and disseminate feedback about
effectiveness of services and policies within the Department to
embed learning.
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74.
Case studies on work carried out by other local authorities and
organisations also highlighted the success from community
engagement projects using trusted intermediaries, including the use
of ‘community connectors’ (residents with roots in
their communities who were recruited to address issues which may be
affecting the health and wellbeing of individuals), community
forums, and community workshops and events in partnership with
local organisations. The Board discussed the successful use of
community connectors at Wirral Council and suggested that this
model could support digital inclusion in the older population;
using older people who were more confident with digital technology
to advocate for it to older people who are less confident or unable
to access online services.
75.
The Department informed the Board of the current work of the People
Bank (145 residents, clients, carers who give feedback on
services), and it was suggested that there was potential to enable
these volunteers to be part of ASCH’s voice in the community.
ESCC elected Members could also play a key role in sharing
information about services to residents.
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Recommendation
4
The
Department to make use of links with people associated with ASCH
including Members, volunteers, People Bank and Citizens Panel
members and VCSE partners to support the sharing of information
about ASCH services and programmes with wider residents.
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76.
Although community engagement work was noted as a key method to
hear from seldom heard groups, the Council’s Equality Manager
informed the Board that it was important to note that these groups
are often the most vulnerable, with limited resources, time and
capacity to engage. Engagement work needs to be properly planned
and funded, with groups being supported throughout the process and
their needs considered at all times.
77.
In response to evidence suggesting that engagement work should be
ongoing, the Board enquired how engagement work across the Council
could be shared to support continued engagement with groups in a
systematic way. The ASCH Policy Development Manager informed the
Board that findings and practical learning from the ASC strategy
engagement could be shared with colleagues in other parts of the
Council to help build wider understanding of needs and reduce the
potential for duplication. In addition, the development of a
community engagement framework could bring together good practice
examples and advice for engaging with seldom heard groups as well
as wider communities and partner organisations.
78.
The Board concluded that effective community engagement was key to
addressing barriers for seldom heard groups and people and
that, where possible, this engagement should be based on shared
learning and best practice to increase its impact, avoid
duplication and best support the needs of vulnerable
groups.
79.
In identifying solutions to barriers facing seldom heard groups, it
was noted that staff play an important role in addressing some of
these barriers. The Board explored ways in which staff can identify
and break down barriers.
80.
The Council’s Equality Manager informed the Board that staff
could develop their skills in this area using a variety of
resources, including formal and informal learning. It is important
to build understanding of why ESCC needed to hear people’s
voices and to develop a greater understanding of the impact
cultural differences may have in how people access services.
One
approach was peer learning, where staff were able to share
experiences and skills on, for example, how to ask equality,
diversity and inclusion related questions, or engage with
communities. The Board heard about communities of practice that are
being developed across the Council, looking at a variety of topics
and bringing colleagues together for peer learning practices. For
example, a data monitoring group bringing together data analysts to
share knowledge and experiences.
81.
The impact of increasing staff knowledge was considered in the case
study example from Greater Manchester where Pride in
Practice work had been launched to improve LGBT friendly
practices. Working with the LGBT Foundation and local NHS and
councils in the region, staff were given one-hour training covering
language and terminology, inequalities experienced by LGBT
communities in healthcare and offered practical advice on how to
develop inclusive services. Feedback from clients and LGBT
champions since the launch of this programme had been very
positive, with one woman reporting:
“staff
may ask sensitive questions about marital status or next of kin as
heterosexuality is not assumed. My wife is included in all my
health care decisions and is recognised as a carer. This is very
different than it was”
82.
Work to develop staff knowledge and skills within ESCC is
progressing: in ASCH and Children’s Services (CS) equality
champions and allies have been identified to share how teams are
supporting equality work and responding to issues; an ASCH
Equalities Allies Group, made up of equality leads in teams,
provides an opportunity to raise questions to support their work;
staff training now includes details of using peer learning; and
there are Yammer groups across the Council to facilitate
information and good practice sharing. However, it was noted that
more could be done to share good practice amongst wider
staff.
83.
The Board concluded that increasing staff knowledge and skills on
equality, diversity and inclusion would support the commitment to
an inclusive service and would help to develop understanding of
seldom heard groups and ways to overcome barriers to accessing
services. This would particularly help staff to learn about and
discuss emerging issues, for example recent increased media
coverage of issues relating to transgender people.
84.
Interviews with partners also highlighted the benefits of staff
receiving specialised training to enhance their knowledge of client
and family member needs and their ability to provide compassionate
care. For example, the Eastbourne Dementia Action Alliance
suggested increased dementia awareness training amongst staff to
build a holistic and person-centred approach to working with
clients. The LGA guide ‘Care and support and
homelessness’ recommends councils ensure staff not only
receive specialist training, but learn from each other to better
understand each other’s roles and responsibilities in order
to provide appropriate care.
85.
The Board discussed with the Department how equality, diversity and
inclusion training could be incorporated into staff Continuing
Professional Development (CPD) plans. The ASCH Assistant Director
for Planning, Performance and Engagement noted that training needs
to be responsive to changing local need.
Recommendation
6
The
Department to develop staff knowledge and skills through ensuring
appropriate provision for:
a)
the
development of peer learning opportunities to enable staff to share
knowledge and experience;
b)
embedding
knowledge and skills about working effectively with people from
seldom heard communities into ESCC equality, diversity and
inclusion training;
c)
developing
the equality, diversity and inclusion training offer to staff
through training by expert partners, incorporating this into staff
CPD, and ensuring that training is responsive to changing local
need;
d)
ensuring
managers support and actively encourage staff to attend equality,
diversity and inclusion training.
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Effective
and inclusive communication
86.
The Board heard evidence of a lack of knowledge about the ASCH
offer, and what support services may be available, amongst some
seldom heard people. Some people may find language used in
communication inaccessible and formats are not appropriate for
people’s varying needs. During the review, the Board
identified some ways in which inclusive communication could be
further developed, building on what is already in place.
87.
The Board heard that the use of the Council’s interpreting
and translation service could be maximised by raising awareness of
it amongst wider staff in the Department, to ensure effective
communication between clients and staff. The ESCC Sensory
Impairment and Reablement Team noted that interpreting and
translation services need to be responsive and consistent, with
staff understanding the importance of using translation and
interpreting, as well as understanding the process better. The
Refugee Buddy Project also highlighted the need to have clear,
simple information in relevant languages to tell people what
support is on offer.
88.
This was also highlighted in feedback from staff engagement
sessions where staff suggested that communication needs to be in
plain language and clear about what services are and who they for;
moreover, messaging needs to help breakdown stigma.
89.
The Board heard there is a need for a consistent approach in
ensuring best practice in communication and community engagement
which can be delivered through equality impact assessments and
staff forums. Digital inclusion should also be included in staff
inductions to raise awareness of these issues amongst new
staff.
90.
The Board heard that communication with adults with low levels of
literacy was more challenging, with most written information
inaccessible. The Librarian who delivers the Step into Reading
programme highlighted the need for non-text versions of
communication, for example through apps and social media or videos,
such as a video (click
here for the link) created
to communicate the Step into Reading programme to
learners.
91.
Communication should not only be accessible, but reflective of the
communities it is trying to reach. In the Greater Manchester LGBT
case study, feedback showed that when LGBT friendly posters were
displayed 24% of LGBT people were more likely to disclose their
sexual orientation and 21% their trans status. In doing this they
said services were much more likely to meet their
needs.
92.
The Board heard that when communicating with seldom heard groups,
it was important for staff to listen to the views of groups, as
well as informing them about services. This should be achieved
through ongoing community engagement work outlined
above.
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Recommendation
7
The
Department should ensure that it raises awareness about its
services and that communication is accessible and inclusive
by:
a)
undertaking
further work to promote and support the use of ESCC interpretating
and translation services to staff, and using this to respond to
changing local need;
b)
using a
variety of all available and appropriate communication media and
formats to target particular groups including non-text and
translated versions, and including providing newsletters and
information leaflets in different formats;
c)
communicating
clearly what the service and offer is in promotional
material;
d)
ensuring
that the priorities identified in the Digital and Technology in
Adult Social Care Review are considered in
communications.
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Inclusive
services
93.
Although ASCH already adapts services to meet access needs of
individuals, the Board explored how inclusion could be developed,
including through the location for service provision, consideration
of cultural differences and through building equality, diversity
and inclusion considerations into service design and commissioning.
Research by the Department suggested that some people would rather
approach the VCSE sector for help as community organisations could
be flexible and adapt their approach for different people’s
needs, whereas public services could be viewed as bureaucratic
rather than relational, demonstrating the need to develop inclusive
approaches and raise awareness of this.
94.
The Board heard examples of flexible approaches working in
practice. The Head of HIH highlighted the importance of offering
services in inclusive spaces that are welcoming to everyone; he
noted that support for homeless people was often situated in
churches which could act as a barrier to people from another
religion or none. However, offering
services in community spaces where rough sleepers were accessing
other services, including food, was very effective. This was
reiterated by the Gypsy and Traveller Team Manager who informed the
Board of the need to work with Gypsy, Roma and Traveller
communities outside of council buildings and bringing support, such
as Wi-Fi and education, to traveller sites.
95.
The Gypsy and Traveller team were providing a range of support,
including a community room on a traveller site to support client
appointments, as well as wider community work, which it was hoped
would address the issue of some people not wanting to enter council
buildings to access services. The Board heard that the community
room was providing a crucial space to allow external agencies, as
well as other council services, to engage with the community in
their own space, building trust and allowing for ongoing
conversations, for example with local police around hate
crime.
96.
The Board heard from Groundwork South the importance of taking time
to learn about and understand cultural differences and adapting
services to incorporate those differences. Examples included
considering the location of and time of meetings, and a recognition
of what may be considered culturally appropriate, such as in some
cases women members of staff interacting with women clients, which
would increase engagement.
97.
The Board was keen to explore how the Department could not only
adapt specific services to meet the needs of seldom heard groups,
but how it could embed equality, diversity and inclusion thinking
into all areas of work. The Council’s Equality Manager
highlighted that it is important for these considerations not to be
viewed as separate but integrated into day-to-day business. Elected
Members could support this process by asking questions about
accessibility and outcomes, ensuring that equality impacts have
been considered in decision-making, and modelling inclusive
approaches and respect for difference in their meetings and
engagement.
98.
The Board concluded that work was already in place to further
develop the integration of equality considerations into day-to-day
business in ASCH and across the Council. In terms of specific
services, the Board noted that, where possible, the Department
should adapt service delivery and maximise flexibility as there was
evidence that could help meet the needs of users and increase
engagement with seldom heard groups.
|
|
Recommendation
8
The
Department to increase inclusivity at initial contact by adapting
services to support the needs of communities and individuals,
considering:
a)
how to
support people to access services;
b)
the
location, timing and staffing at meetings to support different
needs, including being sensitive to cultural and religious
values;
c)
how
information is presented to and gathered from
people.
|
|
Relationships
with external partners, including knowledge and data
sharing
99.
Effective working with partners was discussed at all meetings with
most witnesses and evidence suggesting that this is critical to
help build trust with seldom heard groups and to continue to
develop engagement. As described earlier, ASCH works with a wide
range of external partners to engage with and support seldom heard
groups.
100.
The Board explored the challenges of supporting transient groups
through sharing information with other local authorities. The Gypsy
and Traveller Team Manager acknowledged the difficulty with this in
relation to Gypsy, Roma and Traveller communities, as there is
minimal national support and the role of councils in supporting
these communities varies across authorities; many only provide
provision for sites and enforcement and do not support with health
and wellbeing. However, ESCC works positively with councils in
Brighton & Hove and West Sussex to provide support to people
coming in and out of the county from these areas.
101.
The Board heard that there was no formal arrangement for local
authorities to connect and share information in relation to
homeless people moving between areas. However, work was ongoing
with other authorities and the Local Government Association to
improve support to transient communities. The Being Digital
Delivery Manager informed the Board that ESCC will be taking part
in a pilot on developing the use of Plexus, a data tool which will
provide relevant staff with access to a person’s Shared Care
Record. However,
there is currently no function allowing other local authorities to
view information about clients moving in and out of the
county.
102.
The Board explored the opportunity to increase joint working with
partners. The ASCH Policy Development Manager informed the Board of
the importance of strong relationships with VSCE groups and
partnership boards to maintain conversations with seldom heard
communities. The Council’s Equality Manager noted the
successes of good partnership work in supporting vulnerable people,
citing the work of the cross-sector Financial Inclusion Group which
is responding to cost-of-living.
103.
The Board heard evidence that to engage with adults with low levels
of literacy, relationships with external partners, as well as
communication to friends and family, was key to gaining referrals
and building trust. However, it was important to raise awareness of
this issue with partners first, as many adults were able to mask
problems with literacy, making it more difficult to identify the
need for support. Guidance has been created by the Library Service
to increase staff awareness of the potential complex needs of
learners and to increase staff confidence in talking about literacy
needs.
104.
The Board also learned of the potential to use partner volunteers
to signpost and refer people to services as described by the Lewes
District Food Partnership. A suggested script, or training package,
could support volunteers who come across a safeguarding case, and
enable them to refer for support.
105.
Case Studies considered by the Board also highlighted the value of
working with partners. Nottingham City Council for example,
explored a place-based approach to engaging with ethnic minority
people, working with community groups, networks, and charities to
host a series of workshops to identify which ethnic minority
networks, groups and organisations existed in the area and to
understand the key issues for each community. Gateshead County
Council also worked with partners to communicate with refugees and
asylum seekers. This partnership not only built trust with the
refugee community, but also aided with translation
needs.
106.
The Board recognised the importance of strong working relationships
with a range of partners and agreed that the Department does this
very well. It was noted that this engagement needs to be ongoing so
the Department would need to continue to build new, and develop
existing, partnerships so partners can continue to provide much
needed services and support to seldom heard East Sussex
residents.
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|
Recommendation
9
The
Department to develop a systematic way of working with a range of
partners in relation to seldom heard groups by:
a)
building
upon existing relationships and exploring new partnership work by
regularly reviewing and expanding the list of identified VCSE
partners to help build trust with seldom heard
groups;
b)
supporting
partners to facilitate equality, inclusion and diversity
conversations through guidance;
c)
where
possible, sharing data with other local authorities and groups to
support people moving in and out of East Sussex.
|
|
107.
The Review has considered a broad range of evidence and Members
concluded that there is a strong commitment to providing an
inclusive and equitable service, and that the Department is working
hard to expand its reach to seldom heard groups. The Review Board
recognised that this work needs to adapt constantly to respond to
changing need, including who is identified as seldom heard, and
therefore work on this needs to be ongoing and
sustainable.
108.
The Board heard that lack of trust, stigma around using services,
and a lack of complete understanding of what services ASCH offers
are the biggest barriers for seldom heard people and communities.
The Board has made a number of recommendations to support ongoing
work to help overcome those barriers.
109.
The Board considered that, where possible, data, experience, and
best practice should be shared with colleagues across the
Department and Council to maximise its impact and make best use of
resources. This joined up approach will also protect vulnerable
groups from being asked to engage multiple times unnecessarily.
110.
There are a number of positive initiatives and projects already
underway, including good examples of peer learning and
relationships with external partners; this should be developed
where possible. Learning from partners, as well as case studies of
work carried out by other local authorities, provides new
opportunities to consider how to engage with seldom heard groups
and encourage them to use services.
Terms of
Reference
On the recommendation of the Scoping Board, the People Scrutiny
Committee agreed that this review should explore
how the Department engages with seldom heard communities and
whether residents of all backgrounds know
how to access ASCH services.
Members agreed that this would be explored through the
following
key lines of enquiry:
1. Defining
and engaging with seldom heard groups
a)
Who
are the key communities in East Sussex that ASC seldom hears from
in its engagement but should?
b)
How
could the Department improve its engagement with those
groups?
2. Accessing services
a)
Building on
previous research, what is the level of understanding and awareness
of ASC services among residents, including those from seldom heard
groups, and are there ways this can be improved?
b)
If
residents, including those in seldom heard groups, are aware of ASC
services but choosing not to access them, why is that?
c)
Are
there barriers preventing residents, including seldom heard groups,
approaching ASC services?
i.
Is
lack of trust or confidence in services a barrier?
ii.
Is
use of digital communication and services a barrier?
iii.
If
there are barriers, how could they be addressed?
Review
Board Members: Councillors John Ungar (Chair), Penny di Cara, Nuala
Geary and Trevor Webb.
The
Project Manager was Rachel Sweeney, Senior Policy and Scrutiny
Adviser with additional support provided by Kaveri Sharma,
Strategic Commissioner (Equality and Inclusion), and Lucy Owen,
Policy Development Intern.
Paul
Hussey, Interim Assistant Director, Planning, Performance and
Engagement, Sarah Russell, Assistant Director, Planning,
Performance and Engagement, and Justin Foster, Team Manager Waste
Services provided ongoing support to the Board throughout the
review.
Scoping
Board meeting – 1 July 2022
First
Review Board meeting – 28 February 2023
Second
Review Board meeting – 22 March 2023
Third
Review Board meeting – 3 May 2023
Fourth
Review Board meeting – 13 June 2023
Final
Review Board meeting – 26 June 2023
Witnesses
providing
evidence
The Board
would like to thank all the witnesses who provided
evidence:
ESCC
officers
Alex
Callaghan, Being Digital Delivery Manager
Bill
Hargood, Policy Development Manager ASCH
Sarah
Tighe-Ford, Equality Manager
Mark
Hendricks, Head of Partnerships ASCH
Jim
Alexander, Manager Gypsy and Traveller team
Emily Taylor, Librarian
External
Witnesses
Dr Neil
Singh, GP (Homeless Inclusion Health Service)
Jennifer
Twist, Chief Executive, Care for the Carers
Pierre Matate, Outreach and Engagement Officer, Groundwork
South
Lin Neeve,
East Sussex Seniors Association
|
Item
|
Date
considered
|
|
Overview
of ASCH Equality and Inclusion strategy
|
01/07/2022
|
|
ASCH
Equality and Inclusion strategy
|
01/07/2022
|
|
ASCH
Equality and Inclusion Action Plan
|
01/07/2022
|
|
Seldom
heard people: What do we know about them in East Sussex?
|
17/02/2023
|
|
Executive
summary – Activmob research
|
17/02/2023
|
|
ASCH
presentation on barriers and community engagement
|
22/03/2023
|
|
Insights
into barriers facing GRT community
|
22/03/2023
|
|
ESCC
Equality Work presentation
|
03/05/2023
|
|
The Health
Foundation Understanding unpaid carers and their access to
support
|
03/05/2023
|
|
ESCC
Digital Inclusion presentation
|
03/05/2023
|
|
National
Research (Case Studies)
|
13/06/2023
|
|
ASCH
presentation on potential solutions to barriers
|
13/06/2023
|
|
Interview
with Emily Taylor (Step into Reading)
|
13/06/2023
|
|
LGA Care
and support and homelessness
|
13/06/2023
|
|
ASCH
Report Seldom Heard People interviews with partners
|
13/06/2023
|
|
Centre for
Public Scrutiny Men Behaving Badly Report
|
13/06/2023
|
Contact
officer: Rachel Sweeney, Senior Policy and Scrutiny Adviser
E-mail: rachel.sweeney@eastsussex.gov.uk
