in long-term care?

3.3 How can people using services be supported to participate in quality assurance in long-term care?

There has been an improvement across Europe in the involvement of people using services in quality assurance and feedback mechanisms, be it through satisfaction surveys or procedures to raise any issues or complaints. This is also facilitated by ombudspersons and regular inspections where users are able to express their preferences and expectations, or ad-hoc inspections in case of complaints.

Respondents to the ESN questionnaire reported on initiatives to involve people suing services and their families in:

• the design of care services (as illustrated in the example from Aviles, Spain), • the assessment of the quality of care or services (as we saw in the example of the care quality standards framework in Scotland, UK), • participation in functioning of residential care facilities (see the example below of Participation for Quality Assurance in Practice). Quality standards may request that service providers involve people who use services and their carers and families in the planning and development of their services as well as delivery. Involvement is embedded throughout the quality frameworks that have been developed to support implementation of national standards.

Regulatory inspections of care providers’ compliance with national standards may also include specific requests to assess users involvement, such as:

• pre-inspection questionnaires sent to care services for them to distribute to families, relatives, and service users, • online questionnaires implemented within care homes, • interviews with service users, families and relatives, and visitors, • anonymised comments within inspection reports to reflect people’s views.

Figure 10 provides an overview of mechanisms reported in the questionnaires to help ensure user participation in delivery of long-term care.

Figure 10 Involving users in quality assurance

0% 20% 40% 60% 80% 100%

Regular control visits

(Anonymous) telephone

Ombudsperson

Other

Participation for Quality Assurance in Practice: Hungary

In Hungary, residential self-government or participation in decisions related to the functioning of the facility can be established if more than half of the residents request it. The aim is to provide an opportunity for active participation of residents in the life of the facility to contribute to its running and operations.

This body decides how it operates and lays down the regulations for this purpose. They determine, e.g., how often meetings are held, who is delegated to an advocacy forum to advocate on their behalf, how decisions are made, and distribution of responsibilities.

Its members are chosen by the residents, who may also elected a president amongst them. Meetings are only attended by the residents who discuss issues that affect them, satisfaction with care, relationships with carers and management. The decisions they make are then transferred to the manager in the facility. The most relevant tasks of the self-government initiative are to promote:

• collaborative relationships with the managers and staff in residential facilities to improve the quality of care, • participation in integration efforts, • protection of residents’ interests and rights, • peer support, • self-organising community activities, participating in organising and running programmes, • external networking, • collecting, discussing and forwarding the suggestions of the residents.

With thanks to Zsófia Szőnyi, Directorate-General for Social Affairs and Child Protection, Hungary.