Appendix 1
Report
of the Satisfaction Survey of Foster Carers who required support outside office
hours February – March 2004
Between 23rd February and 22nd
March a telephone satisfaction survey was undertaken of all Foster Carers who
contacted the Emergency Duty Service (EDS) and the Fostering and Adoption
Services Team (FAST), for support outside office hours.
The purpose of this report is to explain the
methodology of this survey, to bring together their results and identify areas
for improvement, in relation to the support of Foster Carers outside office
hours.
Rationale. The underlying principle of the EDS survey was to
test service Foster Carers responses against relevant SSI Inspection Standards
for Emergency / Out of Hours arrangements:
1.1 Public information is provided on the
emergency out of hours service, which includes access arrangements and any
eligibility criteria that apply.
1.2. Service user can access the emergency out
of hours service quickly.
1.3 Service users receive an appropriate
response which is effective in reducing risk and stabilising an emergency.
1.6 Service users express satisfaction with the
service provided and are positive about the outcome of their enquiry.
5.7 Service users say that they were treated
with respect and that services provided were appropriate to their particular
needs.
7.5 Information from complaints, both from
service users and other agencies, is used to review the effectiveness of the
service, and indicate any changes necessary.
Process. During the usual operation of the EDS, after responding to the presenting emergency, the Filtering Officer (Duty Manager) would ask the Foster Carer if they would be willing to be contacted by telephone for the purposes of the survey. FAST support Social Workers also forwarded details of those whom they had supported who were willing to be surveyed.
Details of the persons
willing to be contacted were passed on, the next working day, to a member of
staff of Direct Services who then telephoned the individuals and recorded their
responses to the survey questions and scaled their satisfaction with each
element of this experience. These
questions are detailed below under ‘survey results’.
Target Group and Sample Group.
During the period of the survey a total of 14
Foster Carers used the support services from the Fostering and Adoption
Services Team and 3 from the EDS. A
further 5 Foster Carers had contact with one or both of the services but 1 did
not want to be contacted and the remaining 4 were subsequently unavailable to
the person undertaking the survey.
The total number of
respondents that completed the survey into the EDS and FAST support was
therefore 17. This represented a sample
of 90% of the target group.
Telephone
Survey Results. EMERGENCY DUTY
SERVICE
|
Foster Carers that found contacting the
service VERY EASY |
3 |
|
Foster Carers that found contacting the
service EASY |
|
|
Foster Carers that found EDO telephone
number from FAST |
3 |
|
Foster Carers that found EDO telephone
number from WIGHTCARE |
|
|
Foster Carers satisfied with promptness
of response from Operator |
2 |
|
Foster Carers satisfied with promptness
/ response from FO |
3 |
|
Foster Carers satisfied with promptness
/ response from member of staff who visited (1/3) |
1 |
|
Foster Carers not visited but satisfied
with response (2/3) |
2 |
|
Foster Carers who said staff completely
understood the emergency being reported (1 ‘Partly Understood’) |
2 |
|
Foster Carers that said referral ‘completely’ appropriately dealt with by
EDS |
3 |
|
Foster Carers who would definitely
recommend this service to someone else |
3 |
|
Foster Carers who would consider
recommending this service to someone else |
|
Percentage Satisfaction Scores and Comparators. Below is a table that
gives the above results a percentage of those completing the survey, column
EDS. It also gives, for comparison, the
satisfaction rating given in response to similar questions in the two surveys
mentioned above.
In 1999 the DoH
commissioned research into a sample of eight Local Authorities emergency
arrangements the results of which were published under the title Open All
Hours. Satisfaction percentiles from
this study are in the column marked OAH.
A similar, but smaller
study of 18 respondents, was undertaken as part of the Best Value Review of the
IW ‘Out of Hours Service’, published in March 2001. These results appear in the column marked BVR.
|
Subject of question |
EDS |
BVR |
OAH |
|
Foster
Carers that found contacting the service VERY EASY |
100% |
100% |
79% |
|
Or that found contacting the service EASY |
|||
|
Foster
Carers that found EDO telephone number from FAST |
100% |
63% |
59% |
|
Foster
Carers that found EDO telephone number from WIGHTCARE |
|
||
|
Foster
Carers satisfied with promptness of response from Operator |
66% |
83% |
48% |
|
Foster
Carers satisfied with promptness / response from FO |
100% |
95% |
70% |
|
Foster
Carers satisfied with promptness / response from member of staff who visited
(1/3 visited) |
100% |
100% |
N/A |
|
Foster
Carers not visited but satisfied with response (2/3 not visited) |
100% |
94% |
44% |
|
Foster
Carers who said staff completely understood the emergency being reported |
100% |
|
|
|
Foster
Carers that said referral ‘completely’ appropriately dealt with by EDS |
100% |
83% |
48% |
|
Foster
Carers who would definitely recommend this service to someone else |
100% |
|
|
|
Foster
Carers who would consider recommending this service to someone else |
|
|
|
Analysis. How
do these results compare with the outcomes required within the SSI Inspection
Criteria?
N.B. It must be noted
that this is a very small sample upon which to base any conclusions but,
combined with the results for the FAST support, a pattern of response does
emerge which allows for an improvement plan to be developed.
1.1, ‘Public Information’
etc. This survey shows that all of the
sample of Foster Carers have learned how to contact the EDS though previous
contact with their FAST support worker and or training.
1.2, ‘Quick Access to the
Service’. 100% of Foster Carers said
that they had found it easy or very easy to contact the Service and 66% were
very satisfied with the promptness of response from the Operator. However, 1 carer could not get through to
the operator first time. Arrangements
for contacting the EDS are based upon standards that are subject to constant
monitoring.
1.6, ‘Service Users
Express Satisfaction with Service and Outcomes’ and
1.3, ‘To Reduce Risk and
Stabilise the Emergency’. 100% of
Foster Carers stated that they were satisfied with the response of the EDS both
in the case of the FO dealing with the query or if a member of the EDS
visited. These responses compare very
favourably with the previous studies and indicate that expected response times
and thoroughness of the intervention are being well maintained with successful
outcomes implemented.
5.7, ‘Service Foster
Carers Treated with Respect and Services Appropriate to Needs’. The specific question regarding being
treated with respect was not asked but the survey results and the comments
made, see below, indicate that Foster Carers were satisfied in this
regard. 100% of Foster Carers stated
that their referral
was appropriately dealt with by EDS, i.e. ‘appropriate to their needs’.
7.5, ‘Learning from
Complaints’. All Foster Carers
responding to the survey were given the opportunity to make comments about the
service (see below) be they praise or complaints.
Comments.
All of the three Foster
Carers said they could not think of any improvement to the service with one
stating that they have “had no problems”, the second that they had received
“brilliant support” and the third stating that the “advice given was brilliant”
but she was “concerned about follow up” during the next working day.
Conclusion.
Whilst these satisfaction scores and comments are complimentary, they are based on a very small sample and, even then, there are two areas of concern expressed: not being able to get through to the operator promptly and concern about ‘follow up’ by day time services.
On the first point, upon follow-up, the carer stated that the telephone rang for longer than she expected. I was able to explain that sometimes a single operator has to complete their response to a user of the Community Alarm before answering the telephone. She confirmed that she received a satisfactory response when she was connected. This did not feature in the satisfaction score of any other carer.
The second concern about follow up by day time services related to a delay the Foster Carer had previously experienced in being contacted following involvement outside office hours. I am able to report that all transfer of information from the EDS to daytime teams has taken place within the standard, i.e. by 09:15 the next working day, usually well before then. Since the last survey a pro-forma has been introduced at the Children’s Services Center to ensure that there all out of hours reports are prioritized.
The delay experienced by the one Foster Carer would therefore be due to a higher risk case being prioritized by the daytime teams.
Telephone Survey Results. FOSTERING AND ADOPTION SERVICES TEAM
|
Users that found contacting the
FAST Support Worker VERY EASY |
9 |
|
Users that found contacting the
FAST Support Worker EASY |
4 |
|
Users that found contacting the
FAST Support Worker DIFFICULT |
1 |
|
Users that found contacting the
FAST Support Worker VERY DIFFICULT |
|
|
|
|
|
Users that found FAST OOH Support
telephone number from being told / known |
6 |
|
Users that found FAST OOH Support
telephone number from WIGHTCARE |
2 |
|
Users that found FAST OOH Support
telephone number from Induction, Meetings etc |
4 |
|
Users that didn’t know FAST OOH
Support telephone number |
2 |
|
|
|
|
Users satisfied with promptness of
response from OPERATOR |
10 |
|
Users satisfied with promptness of
response from FAST Support Worker |
10 |
|
|
|
|
Users who said staff completely
understood the emergency being reported |
9 |
|
Users who said staff partly
understood the emergency being reported |
4 |
|
Users who said staff did not
understand the emergency being reported |
|
|
|
|
|
Users that said referral
appropriately dealt with by FAST Support Worker |
9 |
|
Users that said referral was
partly dealt with appropriately by FAST Worker |
3 |
|
Users that said referral was not
at all dealt with appropriately by FAST Worker |
1 |
|
|
|
|
Users who would definitely
recommend this service to someone else |
11 |
|
Users who would consider
recommending this service to someone else |
3 |
|
Users who would definitely not
recommend this service to someone else |
|
Percentage Satisfaction Scores and Comparators. A comparator is again given with which to compare some the key results for the FAST survey. This is taken from a study of Foster Carer support that was published by Martin Smith, Hampshire SSD Performance Management Unit in 2002 and appears in the column marked HSSD.
These comparisons are affected by the small sample size of 14; the Hampshire study had a sample of 111. Please note that the wording of the Hampshire study was ‘Very Helpful’ rather than ‘Very Satisfied’ etc, as in the IW questionnaires.
Subject of question
|
FAST
|
HSSD
|
|
Foster
Carers that found contacting the FAST service VERY EASY |
65% 28% 7% |
|
|
Or
that found contacting the service EASY Or DIFFICULT |
||
|
Foster
Carers that had been given the telephone number by FAST |
44% |
|
|
Foster
Carers that were given telephone number by WIGHTCARE Telephone
number given at Inductions / meetings. Telephone number for FAST not known |
14% 28% 14% |
|
|
Foster
Carers satisfied with promptness of response from Operator |
100% |
|
|
Foster
Carers satisfied with promptness / response from FAST support worker |
100% |
|
|
Foster
Carers who said staff completely understood the emergency being reported Partly
understood |
72% 28% |
|
|
Foster
Carers who said that issue ‘completely’ appropriately dealt with by FAST Partly
appropriately dealt with: Not
appropriately dealt with: |
72% 21% 7% |
54% 24% 22% |
|
Foster
Carers who would definitely recommend this service to someone else |
79% |
|
|
Foster
Carers who would consider recommending this service to someone else |
21% |
|
Analysis.
Unlike the EDS results, there are no detailed national standards through which to appraise the satisfaction survey of FAST support. However, a useful focus for this appraisal, and for highlighting areas for improvement, is provided by the comments made by some of the Foster Carers.
Comments.
All of the critical comments were in relation to reporting Looked After Children as missing:
“Didn't have
a lot to do with FAST, mainly police, but they get fed up”.
“Only knew Wightcare number…..stress that is wasn't FAST’s fault, more the Police. The system itself (Ref. Missing Persons) needs improving”.
“FAST always throw things back to the Foster Carer”.
“Things haven't always been logged by the Operator (Ref. Missing Persons) but the FAST workers are fantastic”.
“Emergency late at night - could do with someone to pick up kids if police refuse to”
“FAST support worker didn't know about incident. Don't understand the system - didn't need talking, needed action”.
Praise for FAST.
“Contact could be shorter than through Wightcare. The team is fantastic and they can't do enough for you”.
“Always had 100% support and thank you to everyone. Always been given correct information by support worker”.
“No real problems ..good support, excellent”.
“Called her for a placement, support worker sent a card to thank her and rang to make sure she was okay.”
“Lost phone number, had to go through Wightcare. FAST support worker was excellent.”
“We didn’t get much in basic training on out of hours issues, I think we need extra training”.
Conclusion
As in the previous survey, the current one has been upon a fairly small sample, albeit one that had very recent experience of receiving support out of hours. The only two ways to increase the sample size would be to run a permanent survey of Foster Carers using the EDS and FAST services or to survey all Foster Carers at once. Please see recommendations.
Foster Carers are still reporting problems in understanding who to contact and how. All of the comments about going through Wightcare to access FAST support demonstrate that Foster Carers are still not familiar with these procedures despite many repetitions of this advice in the handbook and in the newsletter. The roles of the operator, the FAST service and the EDS are all clearly explained in a protocol, but this is not always being referenced. This is also included in recommendations.
It is not surprising that Foster Carers are experiencing most difficulties in the area of ‘missing persons’ (most are not actually ‘missing’). The respondent who said that “things were thrown back to them” was referring to this. Again, there is a clear protocol regarding risk assessment, triggers for procedures and areas of responsibility but this needs to be reinforced to Foster Carers.
It should be recognized that this can be a complex and anxiety-provoking issue for carers and it is unfortunate that some report feeling that they are not part of the multi-agency team that has to respond to such situations. The actions proposed under recommendations should help to improve this.
Despite these reported problems, many of which need not occur, it is reassuring to note that a large majority of Foster Carers surveyed are satisfied with the support services that they receive, most find them easy to access and report that most problems (72%) are resolved completely. There remains much to do to ensure that at the next survey this figure is closer to 100%.
Recommendations.
FUTURE SURVEYS
The dilemma for future surveys is whether to maximize the potential target group by a longer-term, or even permanent, survey or by opening it up to all Foster Carers. The first solution would be demanding of resources and would no doubt become onerous upon all concerned. The second, that has already been tried in last year’s postal survey, will not necessarily illuminate current issues as not all Foster Carers have regular contact with out of hours support. Thus responses will be tend to be historic and not of great assistance in shaping future services.
It is therefore recommended that an annual survey is conducted on those using both support services for a one month period during one of the summer months as these are usually busier in terms of the main issues of concern reported. If this survey exposes an additional issue of concern to carers it will be integrated into the training / communication agenda for the following year.
Outside of this survey period, an open invitation has been sent to all Foster Carers to contact the EDS Manager directly should they experience any difficulties in relation to specific incidents ‘out of hours’ at any time and this offer will be repeated in a future newsletter.
ACCESSING SUPPORT
Despite the attempts to clarify this over the past year it appears that some Foster Carers are still not familiar with the protocol and the chain of actions to undertake to receive appropriate support.
It is therefore recommended that all future induction training for Foster Carers should include a component on ‘out of hours issues’ and clarification of the support protocol.
Furthermore, there should be an annual training / communication agenda drawn up with current Foster Carers with the intention that they receive the best possible advice and development opportunities regarding ‘out of hours’ support. Wherever practical any training or development activities should be multi-agency.
MISSING PERSONS
These arrangements, based upon the Memorandum of Understanding with the Police, are currently being reviewed.
It is therefore recommended that the views expressed by Foster Carers in this survey and as reported during case discussions are fully taken into account during this revision. A member of the FAS Team will be in attendance at related meetings to help represent the views of Foster Carers and the revised protocol should be drawn up in consultation with carers, particularly those who have experienced problems.
Simon
Smith. Manager, Emergency Duty Service.