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
Department defines seldom heard as:
‘Seldom
heard’ has replaced the term ‘hard to reach’
(which suggested that there is something that prevents their
engagement with services) 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 in their work.
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.
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
- Ethnically
minoritised people, particularly those who cannot understand
English fluently
- Disabled
people, including those with invisible disabilities, sensory
impairment and a mental health condition
- Lesbian,
gay and bisexual people
- Trans and
non-binary people
- Gypsy,
Roma, and Traveller communities
- People in
rural areas
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
Community
engagement for the new ASCH 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.
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.
Other
issues and barriers, which cut across several groups, were
considered more generally as part of the Review.
Information
provided by the Council’s Equality Manger stressed that the
people who are seldom heard may change over time and 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.
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 VSCE 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.
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.
Work to
understand the barriers to residents engaging with ASCH is ongoing,
with the Department recognising that some 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.
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
Interviews
with external partners undertaken by ASCH similarly noted barriers
of trust, stigma, feeling excluded from the community, a lack of
understanding of what services are available, the inability to
access services and/or frustrations with lengthy
processes.
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.
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 many
of the barriers highlighted appeared to be relevant across multiple
characteristics.
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 etc.
- 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
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 were
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.
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
The Board
heard from the Council’s Gypsy and Traveller Team Manager who
highlighted a range of issues affecting the community, including
poor health, low levels of literacy, and inequalities in access to
healthcare (particularly the mental health services). Many within
the Gypsy, Roma, and Traveller community 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 the community 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.
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 ability 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.
Cultural
barriers were also presented as a barrier to carers accessing
support. The Board heard from the Chief Executive of Care for the
Carers 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 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.
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.
The
Chair of 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 and 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
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.
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.
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 often results in people being
unable to fill out paperwork, or read information in letters and
leaflets, and needing to seek assistance from others.
The Board
heard from the Chair of the East Sussex Seniors Association (ESSA)
who told the Board of her experiences of supporting older people.
The Chair informed the Board 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 ask for
help.
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. However, the Board noted that those who are unable
to access information digitally can be excluded from what is on
offer.
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 men and women 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.
Prison
security and systems can also impact on the ability to provide care
to prisoners with incidents such as lockdowns preventing carer
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 can also be built with VCSE organisations working in
the prison to spread awareness of ASCH support.
Examples of
Attitudinal/Behavioural barriers
The Board
heard that HOPE G in Hastings, who represent older people of ethnic
minorities, have reported to the Chair of ESSA discrimination in
language and cultural barriers when accessing services, with some
information too being complex.
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.
The Board
noted the feelings of being disrespected and discriminated 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
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.
The Head
of HIH reiterated that the issue
of trust in council services presents as a barrier for many
homeless people, and it is important for professionals to engage
with people in the community through outreach.
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.
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.
The Board
recognised there may be some people for whom all of the identified
barriers apply, and that addressing multiple barriers carried
increased difficulty. The Council’s Equality Manager
reiterated the need to consider intersectionality; the Board heard
that it was important to note the different layers of identity, for
example the differences between older men and older women, or the
different experiences of men from ethnic minorities compared to
women from ethnic minorities. The Board also noted that it is not
just services that recognise these groups are seldom heard; ESSA
told the Board that some older people reported feeling
“not just seldom heard, but never
heard”.
The
Board concluded that the more the Council understands about
different communities and potential barriers, the more work it can
do to address these. They also noted that who is seldom heard will
change over time, so 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.
Witnesses
and evidence presented to the Board suggested several possible ways
to further build on work to address some of the barriers
identified.
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
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 the Gypsy, Roma, and Traveller community,
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.
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.
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.
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.
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Recommendation
3
The Department should reach
out to the communities where they are and through community events
with trusted intermediaries to engage with groups and record,
disseminate and share feedback within the Department to embed
learning.
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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 County 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.
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 Members could also play a key role in sharing information
about services to residents.
Recommendation
4
The Department to draw upon
the links with people associated with ASCH including Members,
volunteers, People Bank and Citizens Panel members to share
information about ASCH services with wider residents.
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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.
In
response to evidence suggesting that engagement work should be
ongoing, the Board enquired how engagement work across the Council
could be used to inform other work and continue to engage with
groups in a systematic way. The ASCH Policy Development Manager
informed the Board that findings from the strategy engagement could
be shared with colleagues to help people gain an understanding of
local people’s wants and needs and reduce the need for future
engagement exercises. Ongoing engagement with seldom heard groups
can be achieved through sharing lists of groups (and the barriers
they face) with staff, as well as information on stakeholders used
to engage with groups. The development of a local community
engagement framework would bring together good practice examples
and advice for engaging with seldom heard groups as well as wider
communities and partner organisations.
The
Council’s Equality Manager informed the Board of the desire
to adopt a One Council approach to this work; a recent Ladder to
Leadership project on engagement has provided an opportunity to
consider the recommendations from this Review alongside other work
across the Council on delivering our approach to community
engagement.
The Board
concluded that effective community engagement was key to reaching
seldom heard groups and people and that, where possible, this
engagement should be based on shared learning and best practice to
increase its impact and support the needs of vulnerable
groups.
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.
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 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.
The impact of
increasing staff knowledge was considered in the case study report
example of Greater Manchester Council who launched Pride in
Practice 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 reporting:
“staff
may ask sensitive questions about martial 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”
Work to
develop staff knowledge and skills as 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.
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
transgender issues.
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. The Senior Resource Officer for Older People Mental Health
Team reiterated the need for robust and regular Equality, Diversity
and Inclusion training and 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.
The Board
discussed with the Department how Equality, Diversity and Inclusion
training could be incorporated into staff Continuing Professional
Development 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 priority in the budget 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
The Board
heard about some seldom heard people not knowing what the ASCH
offer is and what support services may be available. Sometimes
language used in communication is inaccessible or complicated and
formats are not appropriate for varying needs of the
communities.
During
the Review, the Board identified some ways in which inclusive
communication could be further developed, building on what is
already in place.
The Board
heard that the use of the Council’s interpreting and
translation services 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.
This was
also highlighted in feedback from staff engagement sessions where
staff suggested that communication needs to be in plain English and
clear about what services are and who they for, moreover messaging
needs to help breakdown stigma.
The Board
heard there is a need for a One Council approach in ensuring best
practice in communication and community engagement which can be
delivered through EQIAs and staff forums. Digital inclusion should
also be included in staff inductions to raise awareness of these
issues amongst new staff.
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
created to
communicate the Step into Reading programme to learners.
Communication
should not only be accessible, but reflective of the communities it
is trying to reach. In the Greater Manchester Council 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.
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 communication about its services is
accessible and inclusive by:
a)
Promoting
and supporting the use of ESCC interpretating and translation
services to wider staff in the Department, and using this to
respond to changing local need;
b)
Using a
variety of all available and appropriate communication media,
formats and languages to target particular groups including
non-text and translated versions, including the publication of
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 Inclusion Review are
considered in communications.
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Inclusive
services
Although
ASCH already adapt 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.
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
the homeless was often situated in churches which could act as a
barrier to some minority groups. 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 the Gypsy, Roma and Traveller
community outside of council buildings and bringing support, such
as Wi-Fi and education, to traveller sites.
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.
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 female
members of staff interacting with women clients, which would
increase engagement.
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 into all areas of
work and learning. The Council’s Equality Manager highlighted
that it is important for these 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.
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.
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Recommendation
8
The
Department to increase inclusivity at initial contact to adapt
services, where possible, 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.
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|
Relationships
with external partners, including knowledge and data
sharing
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. ASCH works with a wide range of external partners to
engage with and support seldom heard groups.
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 the Gypsy, Roma and Traveller community, as there is
minimal national support and the role of councils in supporting
this community 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 and Hove and West Sussex Councils to provide support to
people coming in and out of the county from these areas.
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.
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.
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.
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 the cost-of-living crisis.
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
groups, 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 this group. 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.
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 and to invest in them so partners can
continue to operate to provide much needed services and support to
East Sussex residents.
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Recommendation
9
The
Department to develop a systematic way of working with a range of
VCSE partners by:
a)
Building
upon existing relationships and exploring new partnership work by
regularly reviewing and expanding the list of identified 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.
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|
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 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.
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 help overcome those
barriers. The Department will be using ‘Theory
of Change’ as a model to making an Action Plan based on
those recommendations and sharing it across the Council and other
partners across East Sussex to provide an opportunity for
learning.
The Board
considered that, where possible, engagement and learning should be
shared with colleagues across the Department and Council to
maximise its impact and make best use of resources, with colleagues
sharing data, experience, and best practice. This joined up
approach will also protect vulnerable groups from being asked to
engage multiple times unnecessarily.
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.
Appendix
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 ASC 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?
The Board wanted to reflect in the terms of reference that refugees
and migrants might form one of the seldom heard communities
considered in the review. However, this was expected to exclude
Ukrainian guests on the basis they are generally well known to
services and being actively engaged with.
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,
Equalities Manager ASCH, 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
