DEVELOPMENT OF TOOLS TO MEASURE SERVICE USER AND CARER SATISFACTION WITH SINGLE SHARED ASSESSMENT
CHAPTER ONE INTRODUCTION
THE COMMISSION
1.1 The Scottish Executive commissioned Infusion Co-operative to develop "reliable methods for measuring user and carer satisfaction with single shared assessment and its outcomes".
1.2 A set of reliable methods "based on their [service users' and carers'] self-perceived needs and experience" was seen as an essential component of new monitoring systems for the Joint Future agenda of which single shared assessment was a key element.
1.3 Important aims of the commission were that account should be taken of recent developments in the difficult area of assessing "satisfaction" with social care interventions, and of developments in inclusive approaches to communication and consultation.
1.4 The commission required a staged 9 month programme, overseen by a Steering Group representing a wide range of relevant expertise. The required starting point was a review of existing practice in collecting service users' and carers' views of health and social care, across Scotland. The interim report on this review was also to set out the remainder of the programme. Final programme outputs were to consist of the methods, as developed and tested, and a report detailing this process, explaining any limitations in the methods, making recommendations for how they could best be used and also recommendations for further development work needed.
1.5 The exact objectives set by the Executive were:
i. to review existing practice in Scotland in relation to assessing user and carer satisfaction;
ii. to draw up a programme for developing and validating methods for assessing user and carer satisfaction with single shared assessment and its outcomes which states what can be achieved within the timescale of this project and what will require to be developed in the future;
iii. to develop and validate methods set out in the programme (referred to in objective ii), as agreed with the Project Steering Group;
iv. to consult widely with service users and carers on the methods as they are developed;
v. to ensure that the methods developed incorporate best practice in terms of modes of communication and use of communication aids;
vi. to make recommendations for deploying the methods across Scotland
Methods/approach by Infusion Co-operative
1.6 Following consultation with the Steering Group, the approach adopted was to develop a "Toolkit" which would provide a range of survey tools and guidance to enable an individualised approach to service users and carers consistent with the need for community care authorities to collect usable data. The approach fell into 5 main parts:
1. Researching the local contexts in which the Toolkit would operate: the questionnaire sent to statutory and voluntary organisations enquired about practice in consulting service users and carers, and about current and likely short term development of single shared assessment. The enquiry also invited involvement in later stages of the project.
2. Researching the wider context of involving service users and carers in developing community care services: a review of research literature and some expert consultation focused on both survey and communication methodologies.
3. Developing the tools with 3 groups of service users and one group of carers: the development groups met over a 3 month period, collectively setting out an evaluation framework of what was important to them in assessment, and helping to establish effective enquiry approaches across a wide range of perception and communication modes. The development groups' work was further refined through consultation with other service users.
4. Exploration of operational factors in implementing single shared assessment and the Joint Future changes and in monitoring them: 2 workshops of community care practitioners before and following the development groups sought practical information to inform the development process and to involve practitioners in the project.
5. Piloting or field-testing the draft Toolkit: pilot exercises were set up in 7 local authority areas to test
the performance of the various elements of the Toolkit in enabling service users in most care groups, and their unpaid carers, to express their views of single shared assessments and any outcomes experienced
how the Toolkit might be used most effectively to produce data needed by community care authorities.
1.7 The programme was designed to make service users' perspectives pivotal to development, engaging individuals and groups with issues raised by research elsewhere as well as reflecting on their own experience of single shared assessment and its outcomes within the development programme and in their own lives.
1.8 Whilst the pilot of the developed materials was set as the final test of their effectiveness and reliability, the programme as a whole was conducted to ensure that the following features were built in over the development period:
best available evidence of key issues in "measuring service user satisfaction" and any successful resolutions
good practice particularly in communication
flexibility to provide for practical variations in local areas, such as in the implementation of single shared assessment and in the resources available for monitoring.