– Improvements in organisational culture are a common recommendation of enquiries into system failure and an aspiration of policy. The purpose of this paper is to explore an initiative to change culture in a low-secure service through the introduction of a self-advocacy group.
– An independent evaluation was carried out by a university research team. A theory-based methodology was deployed with qualitative data gathered through observations, interviews and focus groups.
– Culture change was reported by senior managers and clinicians in relation to the transparency of the service, decision making regarding resources, and engagement of patients in redesign. Self-advocacy group members reported a different relationship with senior management which in turn enabled greater influence in the organisation. Achieving these impacts relied on independent and skilled external facilitation, support from senior managers, and a calm and democratic atmosphere in the meetings. Ward staff were kept at an arms-length from the group and were less certain that it had made any difference to the way in which the ward operated.
– The research was only based in one organisation and the impacts of the initiative may vary with a different local context. Research in a wider sample of organisations and culture change initiatives will provide greater insights.
– Self-advocacy groups can lead to organisation culture change alongside benefits for individual group members but require funding, external and independent facilitation, and organisational endorsement and support.
– This paper adds to the limited literature regarding culture change in secure services and services for people with a learning disability in general and also to the understanding of the impact of self-advocacy groups.
