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4 Aberdeenshire, Moray and Perth and Kinross Alcohol and Drug Action Teams Pilot Project Report
Overview
Support staff from Aberdeen-shire, Moray and Perth and Kinross DAT's agreed a proposal for a pilot "Peer Led" review of services using draft quality standards. The idea was that the two staff (review team) from outside the DAT area being reviewed would carry out the work and this would be repeated in the other two DAT areas. It was agreed that a service in Perth and Kinross would be the first in this pilot to go ahead. The Review Team felt that the draft standards they were going to use in a template produced for the pilot were quantitative and the need for developing a qualitative tool to run along side was essential. It was agreed to use staff, partner agency and service user interviews to gain qualitative information to supplement the draft standards template.
1. Initial Visit
It was felt important that an initial visit take place to introduce ourselves to the service manager, give him a set of draft standards that we would be using and reassure him that it was to be a supportive process. It was clear from this early visit that he had been told at the last minute about it and felt it was being imposed. This led to some initial resistance.
2. First Visit
The resistance was still felt at the beginning of the first visit. By going through the standards looking for evidence the service begun to see that this could be used as a tool for them to evidence that they required more resources. While most of the required information could be found it was difficult to ascertain if it was being used without further interviews. At the end of the first visit the service said that they were looking forward to the report being produced and submitted.
Staff and Service User Interviews
Due to workloads of the Review Team in their respective DAT areas it was going to be difficult to visit several times to carry out sufficient interviews. The Review Team in consultation with the Strategy Manager in Perth and Kinross DAT agreed that the service user questionnaires could be done by Scottish Drug Forum as an addition to some work that they had planned to do in the area. The use of "Survey Monkey", an online survey tool that does all the analysis for you, for the staff interviews was agreed. This would reduce the need for extra visits to one final visit to gather final evidence. The online survey proved effective for partner agency information but not for the service staff who did not participate. The reason for this was explained at the second visit.
Second Visit
A member of the Review Team visited Perth for a second time to interview service staff. He used a questionnaire based on the pilot SWIA required information. The interview was carried out in a friendly supportive way and proved extremely productive. The Review Team member felt that the areas covered by SWIA promoted good relationships and productive answers. As a result of this visit 31 draft action points were identified.
Difficulties with the pilot
Arranging dates was the major stumbling block. Staff sickness in both the service and the Review Team led to a delay in the follow up visit. Being done in kind as a peer led approach proved more difficult than at first thought to diary mutually agreed dates. This would not put the Review Team off from doing it again they would just ensure that all dates were agreed from day one.
Conclusion
The length of time spent on this review made it impossible to adequately check if the service was working at the required national standard. It was not possible, although initially planned, to observe practice. What this process did do was highlight issues that had been previously discussed anecdotally. It provided the information for the local DAT and services to come together using the recommendations to build the foundations for a better integrated care model. It provided the evidence that something had to happen. While the draft standards were useful without the qualitative element it would have been difficult to evidence any recommendations for change. What was loud and clear was the willingness of the service to change and the importance they placed on the recommendations happening. There fears were that the senior management would not take forward any of the recommendations. The Review Team would recommend to the Quality Standard Steering group that follow up visits be arranged after an inspection to ensure that DAT's and management are acting on recommendations and findings.
Example of Audit Tool
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