I was flicking through my old Phone book the other day when I noticed Eircom’s Customer Charter--their commitment to continuously improving the service. Eircom undertook to refund you £20 if they failed to connect your new line within 15 working days of your order. If there should be a fault with your line at any time, they would refund £10 if the line wasn’t cleared within two working days.
This would have impressed me if this was 1970 or if I lived in a remote mountain area, but was not so impressive in the city, where the mobile shop around the corner could hook me up with a new number within the hour.
Of course, if my phone line were down it’s possible that Eircom would have it fixed within the hour. But they don’t guarantee that.
Families who use disability services have lived with few guarantees. Many parents believed that, having cared for their son or daughter over many years, when the time came to leave home, the state would ensure that he or she would have somewhere to live. For many parents, that expectation was never met. Now, in the wake of the Celtic Tiger, the situation is improving. This year and next, more than 1020 people will be provided with a place to live.
It is difficult to talk about quality in the absence of service. As long as families were desperate for a service, as long as there were shortages, the old charity ethos lingered: the notion that you don’t have a right to a service, that you’re lucky to get a place at all. Younger parents are less tolerant of all of that. Access to the courts has brought the notion of rights–forcing the state to provide appropriate educational services, for example.
Alongside the improved quantum of service, we need to embed the notion of quality. While ensuring minimum standards, we must maintain the aspiration to excellence. When nurses, therapists and other staff have so many opportunities to work elsewhere, it is not minimum standards that will attract them to our services, it is our commitment to excellence.
And so, alongside the necessary safeguards around health and safety, the abuse guidelines, the fire drills, the lifting procedures, we must challenge staff to see and love the individual whose quality of life depends so much on our support. This is the challenge that services face when they search for a quality system that will support the values of their agency and promote excellence in the services they deliver.
In this Current Issue we have invited people intimately involved in the development and monitoring of quality within their services to give us some insight into the system they are using. These systems vary from the well-established commercial systems that are now being adapted for human services–ISO 9001 and the Q-Mark Award, which is linked to the European Business Excellence Model–to the systems developed specifically for disability services: the CQI in Supported Employment, the S1/95 Standard for Vocational Training Centres, the How Are We Doing Evaluation developed by the Brothers of Charity, and the Council on Quality’s Personal Outcome Measures.
Whatever system is used, there is a considerable investment of staff time involved. Its value should be judged by the differences it makes to the lives of the people who are supported by the service. It is one thing to put in place an efficient monitoring system; it is a much bigger job to develop an excellent service. And as services get bigger, the job gets harder.
Of course, improvements in the quality of service to individuals or their families don’t have to wait for a quality system to be in place. A fundamental aspect of any quality system is listening to the customer. Especially when customers express dissatisfaction. As one service user had put it: ‘To me, quality means that when I say something, people take me seriously.’ The National Association, NAMHI, have produced a very useful Standards of Care booklet which sets out standards in relation to complaints and appeals procedures, the rights of service users and parents, an individual programme plan for each service user, and advocacy training. Any service meeting all of these standards would be well on the road to delivering a high-quality service.
When I opened my new phone book, I looked to see whether the Eircom Charter had changed. It had! Connection time was down to 10 working days. In addition, there was a £10 refund if they failed to show up on the morning or afternoon agreed. Getting better every day!