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Chapter 5: Service User & Carer Involvement
Background
The CAT User & Carer Evaluation Group was set up in November 2003. It included members of Greater Glasgow NHS Board and Glasgow City Council Addiction Research Teams, Alcohol Focus Scotland and Scottish Drugs Forum. The aim of the Group was to aid in the planning, design, analysis and co-ordination of user and carer involvement and to ensure some consistency in approach to the process, especially as two distinct service user groups were identified i.e. drug users and alcohol users. The group agreed to examine four central issues: access to CATs, co-ordination of integrated services, assessment, and care planning.
Outcomes
Service user involvement
A total of 83 service users were involved in the evaluation process, which included 75 drug service users and 8 alcohol service users. Alcohol service user recruitment was problematic as this client group's contact with CATs tended to be from their homes instead of at the CAT department or clinics.
Carer involvement
Carer recruitment was unsuccessful. No carers were recruited between October 2004-December 2004, despite over 200 carer involvement information sheets being handed out.
Accessibility
Analysis summary
- The majority of service users did not experience problems accessing East or North East CATs, as both CATs were widely regarded as being accessible.
- Any problems experienced with access were related to service users being confused about the self-referral system now in operation.
- 75% of service users did not feel that having CATs located in a social work building was a problem.
- The majority of service users (71.1%) were not concerned about CATs sharing a reception or building with others who were accessing social care services.
- Families and carers were more likely to be contacted out-of-hours by service users than any other form of support.
- Almost half of service users (44.6%) believed that they needed help with training, employment or further education. Over two-thirds of service users (71.1%) reported that they had not been offered help around training, employment or further education
Implications for policy and practice
- Service users need to be made aware that they can now refer themselves to CATs and do not have to approach their GP first.
- As carers are more likely to be contacted by clients out-of-hours, CATs need to consider how to inform carers about the range of services available for service users when CAT departments are closed - perhaps by signposting where professional help could be accessed during these periods.
- CATs may need to be more explicit about the training and employment services they offer service users, to make sure that services users are aware of what help is on offer.
Co-ordination of Services
Analysis summary
- Three-quarters of service users had not been offered the choice of where they would be seen by a member of CAT staff.
- Half of the service user sample would prefer to be seen at home instead of attending the CAT department. Most alcohol service users wished to be seen at home, and 50% of the drug service users also wished to be seen at home.
- Nine out of ten service users had been offered the choice of a male or female worker. Almost one-third (31.3%) wished to be offered the choice of a male or female worker, whereas two-thirds did not feel this was necessary.
- Two-thirds of service users (65.1%) were unaware that addiction services had become integrated involving both health and social care addiction services, and 59% of service users believed it was very important to be aware of the professional identity of CAT staff with whom they were communicating.
- Over half of service users (60.2%) felt that they had been given enough information about which services were available to them.
Implications for policy and practice
- Although half the service users in the study preferred to be seen at home, home visits hold significant resource, operational, risk management and health and safety implications for CATs and could mean redesigning the care delivery process. Before this step is taken, further assessment is needed to find out why home visits are needed rather than attending the CAT base.
- CAT staff need to make sure that they routinely identify themselves as a nurse or social care worker in order to gain the confidence and trust of service users.
Assessment
Analysis summary
- The majority of service users (79.5%) were satisfied that health and social care services were able to share information about them if required.
- 85.5% of service users were satisfied with the way in which they were assessed.
Care Planning
Analysis summary
- Almost half of service users (48.2%) did not feel that they were involved in decisions about the type of help that was best for them.
Implications for policy and practice
- CAT staff should present treatment options to clients in an informed way, to help them feel involved in decisions about their treatment. This would allow clients to consider the range of treatment options or services available to them and contribute towards their agreed plan of care.
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