Towards Accountability in Social Work: One Year's Intake to an Area Office

Summary Monitoring one year's referrals to an area office of a socialservices department, we found that of the 2,436 referrals representing2,057 cases, about half were already known to the area office.Demographically the clientele fell largely into three groups—theelderly, young families and children. The main problem groupingsconsisted of those with physical disabilities or suffering fromfrailty in old age, those with financial and environmental problems,and families with disturbed relationships and child care problems.Most of the clients had short-term help and at the end of sixmonths only 11% of the referrals were still open. Distinctive profiles emerged when comparing the routes by whichclients with different types of problems reached the area officeand the help they got once they had passed its threshold: (a) The elderly and disabled, mainly referred by the healthservices, received predominantly practical help. (b) Those with financial and material problems, largely self-referred,received information, advice and referral to other agencies. (c) The disturbed families, referred by many different sources,received detailed exploration, assessment and casework. Those clients who were passed on for more extended help to thelong-term teams—some 10% of the intake—were mainlythe very vulnerable elderly and disabled persons, and childrenwho had been taken into care or who were in need of surveillanceand protection for other reasons. The study raises questions about the methods of service deliveryin response to the demands made on the area office and discussespossible changes in approach towards more community-orientedpreventive work.     

User satisfaction surveys and cognitive question testing in the public sector: the case of personal social services in England

Obtaining feedback from service users is a key element of the UK Labour Government's agenda for modernization of the public sector. This reflects a growing international trend in Europe and North America. Recognized difficulties in taking an approach to performance assessment based on the concept of user satisfaction are outlined. Ascertaining the views of people who use personal social services poses particular challenges which result from the levels of impairment and illness in the population, local variations in service provision and the 'care and control' functions of social care. It is argued that cognitive testing of questions, based on research knowledge about user views, provides a way of overcoming some of the pitfalls of traditional satisfaction surveys, while developing questions that are meaningful to respondents. The origins and principles of cognitive testing are described, followed by an example of their application in the development of a questionnaire for home care users. Strengths and limitations of the approach are identified.