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					                    Personal Social Services
       User Experience Survey of people receiving
      community equipment and minor adaptations
               funded by Social Services
A fact finding survey was completed by over 80 councils in 2006 which looked at how equipment is provided
to service users. The results of the fact finding survey have helped determine that a user survey of
equipment users would be viable, but would need systems put in place at an earlier stage than for previous
user surveys.


In the three year rolling programme of user experience surveys this survey replaces the children‟s survey
which is now the responsibility of the Department for Education and Skills.

This survey has been developed as over £200 million is spent by councils on equipment per year and half a
million people receive it, however, very little is known on whether the equipment has helped the client to live
independently or not. Within the Department of Health (DH) and the Commission for Social Care Inspection
(CSCI) equipment is a key and important policy area as it is one of the services supporting the early
intervention policy.

Volunteers required for pilot

This initial guidance provides details of the new survey to enable councils to make an informed decision when
volunteering to participate in the pilot for the survey. Systems to collect information for the sampling frame will
need to be established by councils wishing to participate in the pilot survey during May. Further guidance will
be sent in June for the pilot survey.

The main points are:

   The survey for 2007-08 covers adult service users aged 18 and over who have had items of community
    equipment or minor adaptations funded by Councils with Social Services Responsibilities (CSSR‟s)
    during a three to six month period.

   This survey has been developed as there is a growing need to learn more about service users receiving
    equipment and minor adaptations and whether this is helping them to live safely in their own home.

   The survey will include around 15 compulsory questions. These questions will provide benchmarking
    information for councils. The questions will have been designed to identify issues that are important to
    service users and have been tested to ensure that they are understood by them.

   Whilst developing the survey it was discussed whether to also include community equipment funded by
    health. This would be an initial step to look at joint collections in an area where joint processes are
    already established at the front line. Although there was a willingness to do a joint collection around
    community equipment it was not deemed viable for practical reasons. However councils may wish on a
    voluntary basis to share the survey with their health colleagues and encourage them to carry out the
    survey for local use.



Information Centre for health and social care                                                April 2007




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Personal Social Services User Experience Survey of users receiving community
equipment or minor adaptations funded by Social Services
1.    Introduction

1.1   This document outlines the actions Councils with Social Services Responsibilities will need to
      perform in 2007-2008 to survey adult social services users and provide information to the Information
      Centre for health and social care (IC).


1.2   A fact finding survey on equipment services was completed in 2006-07 by over 80 councils. This
      provided an opportunity to find out more about how councils work with their health colleagues to
      provide equipments to the people that need it. The results from this survey are attached at Appendix
      A.


1.3   In 2003 the Social Services User Surveys Group was set up by the Department of Health (DH) to
      recommend a programme of social services user experience surveys, develop their content and
      advise on the methodology. The group includes DH policy leads, DH and IC statisticians, Council
      representatives, the Commission for Social Care Inspection (CSCI) and researchers. Further details
      about this group including its membership, terms of reference and papers are available at
      http://www.ic.nhs.uk/sigasc/ssusergroup.    Recommendations for which client group should be
      included in the next user experience survey were made by this group to the Strategic Information
      Group for Adult Social Care (SICASC). It has been agreed that in 2007-08 councils should undertake
      a survey of users provided with equipment or minor adaptations funded by Social Services.


2     Rationale for the proposed survey


2.1   It is important that CSCI, DH and the IC understand at the national level how well services are
      meeting users‟ and carers‟ needs. Information about services and the experience and views of those
      who receive them should be used locally to inform service delivery and to monitor and develop
      standards. We recognise that surveys are an important means for obtaining this information.


2.2   A large number of social services users have equipment or minor adaptations each year: this survey
      will enable understanding of whether the resources are being used to their full potential. It will also
      help assess the move to provide preventative services to help users live safely in their own home for
      longer.


2.3   It is hoped that from this process councils and PCTs will be able to gather data locally on a regular
      basis on equipment services and assess trends in effectiveness, user satisfaction etc.


2.4   As with previous user surveys PSSRU will wish to conduct an extended user survey with volunteer
      councils in order to develop outcome measures and contribute to measuring adult social services
      output.



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3.    Relationship with the Performance Assessment Framework

      Depending on the evidence from pilot surveys in summer 2007 (see section 7 below), it is anticipated
      that information from the full survey will be included as one or possibly two Performance Indicators in
      the PAF PI set for 2007-08, as with earlier home care surveys. The same principles about response
      rates and quality of data should be applied to this survey as the previous user surveys. These issues
      are particularly important if the data are to be used to compare the performance of councils.
      As with previous social services user surveys, because these surveys deal with service users, most
      of the survey work cannot be routinely sub-contracted to a third party without either getting selected
      service users‟ permission to pass their names and addresses to a commercial survey organisation or
      anonymising records before passing them to an organisation to analyse.

4.    Relationship with the Research Governance Framework (RGF)

4.1   The Government is committed to enhancing the contribution of research to health and social care,
      and to the partnership between services and science. Research is essential to the successful
      promotion and protection of health and well-being, and to modern and effective health and social care
      services. At the same time, research can involve an element of risk, both in terms of return on
      investment and sometimes for the safety and well-being of the research participants.              Proper
      governance of research is therefore essential to ensure that the public can have confidence in, and
      benefit from, quality research in health and social care.      The public has a right to expect high
      scientific, ethical and financial standards, transparent decision-making processes, clear allocation of
      responsibilities and robust monitoring arrangements.


      The Research Governance Framework sets out standards that should be applied to all research in
      health and social care. Further details can be found at ###############


4.2   In respect of external research, it is the responsibility of the Council to check that it has been
      subjected to independent review of its ethics and science. For internal or „own account‟ research, the
      expectation is that the review process will be proportionate to the risks involved.


4.3   Before carrying out the pilot survey in summer 2007 the proposed questionnaire will need to be taken
      to an ethical review. Nationally the survey will be subjected to independent reviews. The Information
      Centre will coordinate the ethics and scientific reviews which will be completed at a national level.


4.4   Historically Social Services Research Group (SSRG) has recommended that staff responsible for
      undertaking the survey should produce a written proposal, outlining the questions to be used,
      methods of data collection and how the results are to be used within the Council. This should be
      placed on record. Councils may want to consider submitting proposals to local ethics/governance
      committees, where they exist, or to some other form of external scrutiny. For example, neighbouring
      authorities could ethically review each other‟s approaches. Failing this, some internal process should
      be established to assess any risks to participants from the research being proposed, and a record
      made of the nature of this scrutiny. In the absence of any more formal source of ethical review, it is



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     important that all those involved in the research process continue to use their best efforts to ensure
     the safety and well-being of research participants.


5.   Data sharing and protection

     The IC is awaiting guidance from the Department of Health around what processes will need to be
     put in place to ensure data protection guidelines are adhered to. This will be made available to the
     volunteer councils wishing to take part in the pilot survey and will be included in the final note to
     councils for the full National survey.


6.   A brief outline of the survey process


     The data collection instrument for most service users will be a self-completion questionnaire. The
     key stages in the survey will be:
          using your records to select a sample of eligible service users;
          checking the accuracy of the information about the people in the sample;
          entering selected details about sample members on a specially created survey database or
           spreadsheet which can be used to manage response to the survey and to issue reminders to
           respondents who do not return completed questionnaires;
          Identify whether methods of participation alternative to postal questionnaires will be needed for
           some service users;
          sending questionnaires which have been developed and tested with service users in pilot surveys
           to the people in the sample;
          sending reminders to people who don‟t return completed questionnaires by a specified deadline;
          keeping a record of or „booking in‟ returned questionnaires;
          entering details of respondents‟ answers to key questions in the questionnaires into a special
           survey database or spreadsheet;
          using data in the database or spreadsheet to complete the IC data return.


7.   When will the pilot survey take place?

         We are asking for volunteers to participate in testing this survey.        The survey forms will be
         distributed to users that have received equipment (excluding wheelchairs) or minor adaptations
         funded by the council in the last six months. The questionnaires will need to be sent out in late
         June and early July 2007. As this is a peak holiday time this notification should enable volunteer
         councils to plan the timetable. Data will need to be returned to the IC by late August.




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8.    When will the national survey take place?

      If the pilot survey is successful then the full national survey will take place in February 2008. Formal
      guidance will be issued to councils in September 2007.       This means processes for identifying the
      sample of users would need to be in place by September 2007. All councils will be expected to
      provide data to the IC by 31 May 2008 unless they do not fulfil the criteria for having a sufficient
      sample size. The sample size should be greater than 150 service users.



9.    Who should be covered by the survey?


9.1   The survey should cover a sample of users receiving community equipment or minor adaptations
      funded by social services up to six months prior to when the questionnaires are distributed. All
      eligible users should be included in the sampling frame, so if two people in any household have
      received a separate piece of equipment or minor adaptation they should both be included in the
      sampling frame. Where the equipment service is jointly funded - the focus needs to be on those
      where the social services department has assessed the person as needing equipment / minor
      adaptation or dealt with their needs through a screening process. Those where a health assessor
      has requested the equipment / minor adaptation should be excluded. Councils should ensure that
      not only mainstream equipment stores but also specialist teams issuing Social Services-funded
      equipment (eg. telecare items, specialist equipment for those with visual or hearing disabilities) are
      included in the sampling frame. Councils should include service users that have received the
      community equipment as a basic service (via an R2 contact) and service users who receive help
      with maintenance of old or replacement adaptations / equipment which should be excluded form
      this survey.


9.2   You should take care to exclude ineligible users, for example those that who have died. See
      paragraph 10 „Checking the sample for accuracy‟.

10.   Checking the sample for accuracy


      Sufficient time needs to be allocated within the survey timetable for checking the records of selected
      users to make sure that client details are up to date and accurate. The level of checking required
      will depend on how confident you are of the information that you hold centrally. This process will
      also offer another opportunity to remove ineligible users from the sample, in particular anyone who
      has died. Exactly how long the checking process will take will depend both on the size of your
      sample of users and on the way records are organised and if there is a joint equipment store, but a
      minimum of two months elapsed time should be allowed for.


11.   Managing the sample of users


      It would be advisable to extract all relevant information about the selected users in the survey – the
      date on which their assessment was completed, their birth date, service user type, other services on
      care plan, gender, ethnic group, address, telephone number, delivery date of the equipment,

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       whether or not they are likely to need a telephone interview, a face to face interview, an interpreter.
       If they are excluded from the sample from the client database a note should be kept of the reason
       for exclusion (e.g. mental incapacity, mental health problems, known to be seriously ill etc). This
       would be put in a special survey database or spreadsheet for the user group. Each person on the
       survey database or spreadsheet will need to have a serial number. Each serial number must be
       unique to each user and should include a code for your council as well as for each respondent. You
       could consider building other pieces of information that would be useful to you into the serial
       number, for example local area or social work team codes, the store that provided the equipment.


12.    Additional information it would be useful for a council to have during the survey process.


       Exactly how each survey is managed is up to you, but there are some pieces of data that are
       essential for the purposes of monitoring fieldwork and assessing the quality of your data:
          the sample size;
          how     questionnaires were administered to selected users – i.e. by post, face-to-face or by
           telephone;
          the names and addresses of people in each wave of the survey ( this is needed to make sure
           that reminders are sent out to the right people at the right time);
          which questionnaires were returned by the time the first reminder in each wave was sent out;
          which questionnaires were returned by the time the second reminder in each wave was sent out;
          the final number of questionnaires returned.


13.    Confidentiality


13.1   The inclusion of a statement about confidentiality at the beginning of the model questionnaire is
       important. It is necessary to assure users that staff within a council could not find out whether or not
       users in the survey sample had completed their questionnaires, and if they had completed them
       how they had answered the various questions.


13.2   In order to achieve the confidentiality commitment you will need to consider how information is
       handled within the council. In particular there is a need to ensure minimal access to the list of users‟
       details used to send out the questionnaire and linked to their answers by means of the numbering
       system. Computer files need to be passworded and only those involved in mailing out the
       questionnaire and responsible for either precoding the questionnaires or setting up codes for the
       analysis should have access. Also completed questionnaires should be kept securely, in locked
       cabinets etc. The questionnaire will allow the respondent to identify themselves should they wish to
       raise concerns about their care and to have the council contact them to review their needs and
       services.


14.    How to get the questionnaires to service users


14.1   Questionnaires for the survey will be designed to be completed by the majority of respondents in
       self-completion mode.

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14.2   All service users should be sent the questionnaire under cover of a letter signed by the Director of
       Adult Social Services or Chief Executive. It should contain a brief description of the survey and
       asking for their cooperation in completing the questionnaire: a variety of alternative methods should
       be offered for them to respond. These include with help form a family member, friend or care staff,
       by telephone interview or through a visit from an advocate. The letter should explain how the
       results will be used and offer a summary of these results. The letter should make it clear that
       participation in the survey is voluntary and should provide the name and telephone number of
       someone who has been briefed to deal with queries and with arranging for staff to telephone or visit
       to help with the completion of the questionnaire. The term “Social Services” may be substituted with
       another term that is more meaningful locally if councils wish.


14.3   You should also where possible ensure that this survey does not coincide with other similar
       surveys, perhaps managed by their stores or customer relations teams, resulting in the users
       getting several requests for cooperation and feedback at around the same time


14.4   The February 2008 survey: Advance publicity

       Response can be improved if the survey is given positive advance publicity in the local press or
       through relevant local user group networks as this leads potential respondents to expect to receive
       a questionnaire and gives them some idea of what the survey is trying to achieve.           Advance
       publicity could include a commitment on behalf of the council to publish the results of the survey in
       the local press or in a council newssheet. A leaflet given to those receiving equipment or minor
       adaptations when the equipment is delivered which provides advance warning of the
       possibility of being contacted for feedback in due course may encourage people to respond.




       Information Centre
       April 2007




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