Young Evaluators Inspection Report Produced by the members of Dartford and Gravesham Young Evaluators Project 2010 - 2011
April 2011
Contents Foreward 3 Introduction 4 Aims and objectives 4 Young Evaluator profiles 5 Teenage service standards 6 - 7 Preparing for the inspections 8 Our Findings 9 - 11 Our Recommendations 12 - 16 Acknowledgements 17
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Foreward Foreward Young peoples participation is central to the improvement of services that are provided to them in Dartford and Gravesham. Involving young people in decision-making results in many benefits for young people, staff and organisations. By actively involving young people in evaluating services young people don始t want to use. Dartford and Gravesham offer a range of sexual health and contraception services for young people across both boroughs, some of which have been highlighted regionally as good practice, but we must not be complacent. The Mystery Shopping Project was implemented as part of the larger Dartford and Gravesham Young Evaluators Project that focuses on the principles of peer research. It was agreed that as part of the training programme that a pilot piece of work would be carried out by The Young Evaluators in order to put some of the skills that the young people have learnt throughout the training as well as place them in controlled yet live situations. The Young Evaluators chose to inspect a varied range of services across the boroughs for this pilot piece of work and have provided overarching recommendations for service improvement that were common to all three services as well as service specific recommendations. This pilot piece of work and subsequent findings report whilst not commissioned are nevertheless the real experiences of those young people using the service and therefore their findings valuable for future service improvement guidance. The group has developed a set Teenage Friendly Service Standards which they felt their service inspections should be assessed against and those services meeting the standard should be awarded their seal of approval. I would like to take this opportunity to say thank you to all the young people taking part for their dedication and commitment to the training and the investment in their own personal development is commendable. I know that all of the group have gained experience, skills and confidence by participating and that taking on board the views of the Young Evaluators will enhance the skills and knowledge of service providers
Juli Dosad Juli Dosad Project Coordinator 3
Introduction The Dartford and Gravesham Young Evaluators Project were expected, as part of our training, to undertake a number of pilot inspections on young peoples services in Dartford and Gravesham. As a group we chose to inspect two areas of service, this report provides the findings of our inspections on our first area, sexual health services. The reasons behind undertaking pilot inspections was to give us experience in: • Preparing for inspections including selecting scenarios and rehearsals • Thinking of our feet and being prepared for all eventualities • Carrying out inspections in different circumstances, sometimes difficult or uncomfortable situations • Being observant to small detail and committing it to memory • Evaluating services against our criteria • Pulling together all information in order to provide a findings report with recommendations This process has enabled us to decide on basic inspection criteria that may help go towards developing teenage friendly services in the future, that agencies and services can sign up to across both boroughs
Aims and Objectives Dartford and Gravesham local childrenʼs trust boardʼs main objective was to establish a group of young people that could evaluate young peoples services on their behalf. As a result of this our aims and objectives for this piece of pilot work were to:
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• To gain new skills and develop existing ones • Develop a better understanding and awareness of sexual health services available to young people within Dartford and Gravesham • To establish the accessibility and quality of the services for young people • To develop a criteria to use for the inspections and evaluations • To identify the key issues that young people face when visiting sexual heath services and creating scenarios around these in order to test and evaluate the service. • To make recommendations which can be used for future service improvement and development 4
Young Evaluator Profiles Ten young people began the project, 4 girls and 6 boys and nine young people took part in the inspections, 3 from Gravesham and 6 from Dartford.
% of participants by age Age 14, 1 participant, 10%
Age 15, 2 participants, 20% Age 17, 5 participants, 50%
Age 16, 2 participants, 20%
1 particpant in care
1 participant with a known disability
5 participants, aged 16 or under 3 participants in an ethnic group other than White British
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Teenage friendly service standards !
As group we discussed what makes a good service, to do this we worked with a graphic template that set out all the different parts of a service that are important to young people. This graphic helped us to visualize the steps there were to cover within a service. An image if the graphic template we used can be seen opposite as well as a flow chart below to show showing our agreed teenage friendly service standards. Accessibility • Location o Is it easy to get to for me/young people? [including disabled users] • Timings o Are the times it is open going to suit young people or offer a range of good opening times? [time and days of the week] • Accessible for all users o Will disabled young people be able to use the service easily? o Is the support both disabled and non disabled young people using the service adapted to meet their needs so that they can take full advantage of all that is on offer? • Cost o Will I/most young people be able to afford it? [pocket money prices] • Clear signposting • Is the service well signposted and easy for me to get to once in the area or building?
Environment • Building • Does it look like a nice place to go? [does it feel/look safe, clean and welcoming and not intimidating] • Surrounding area • Is it situated in a place/area that I/young people wouldn’t mind being? [appropriate] • Reception area 1. Are the reception areas welcoming, friendly, relaxed atmosphere but also private? [where no one can over hear if you need to share private information] • Seating and waiting areas 1. Are the seats comfortable, arranged well so not facing others but not too open either? • Chill out areas [in a youth centre/ children’s play area in a health centre for example] • Are the toys/magazines/tv etc right for the age range and not scruffy/old/dirty and relevant to those people using it? • Poster and information leaflet displays • Are the leaflets up to date, in good condition and displayed properly, covering a variety of topics relevant to the people using the centre/service?
Phone services • Phone numbers • Is it a free-phone number and is there free ring back service in use? • Is the number easy to remember? • Continuity 1. Is the level of service and responses the same for all callers/users of the service? [do all users get the same info including the same as people who visit the service to use it as well as those over the phone] 3. Person at the end of the phone 1. Was my call answered quite quickly? 2. Was my first contact with a real person and not an automated service? 3. Were they friendly and able to put me at ease? [polite,genuine/interested] • Did they seem well trained and know what they are talking about? [not just reading from a script like a robot or are constantly having to put me on hold to get the answers for me] • Did they introduce themselves to me and ask for my name and remember it? • If they couldn’t help me did they pass me to someone who could or offer to call me back with the right information? • Was the information or answer they gave me clear in a teenage friendly format? • Did they call me back when they said they would? • Did they give me choices or options [if applicable]? • Did they make me feel empowered? [make me feel like I had some control]
Publicity o Advertising the service Are flyers displayed at places that young people go to? schools youth clubs night clubs bus stops train stations council reception areas Bluewater Doctors Connexions post office college 6th form common rooms o Leaflet design [if there is one] • Is the leaflet attractive to me? [Would it make me want to go to or use the service] 1. Is it clear and easy to understand, does it contain the right information and tell me about the service [what I would want or need to know] o Other advertising of the service • Is the service advertised on the radio or in magazines that young people read? • Is it advertised on social media sites or micro websites that young people would use? • Is the service advertised in PHSE lessons? • 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.
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What else do you think would help improve the service? What did you like about the service? What didnt you like about the service? Are young people involved in planning and reviweing the services? Was my experiance of using the service a positive one? if not why?
Procedures • • • • • •
• Reception and signage Were there clear signs on the reception desk [if relevant] • Personal information Did I have to give out just minimal personal information at the reception desk? • Form filling Was the level of form filling I needed to do kept to a minimum? • Sensitivity Were the procedures and services discreet when they involved sensitive issues? [ticket systems and names being called out] • Confidentiality Was I made aware of confidentiality procedures being in place? • Waiting time and being seen Did I have to wait longer than I was told or kept waiting unnecessarily? [punctuality]
Staff •
• • • • 1. 2. 3. 4. • • • •
• Appearance Did the way the staff dress make me feel like I could approach them? [were they wearing uniforms or casual clothes – were they presentable] • Introductions Did they introduce themselves, say hello and ask how I was and how they could help me to put me at ease? • Confidentiality If relevant, did they tell me about confidentiality and explain my rights? • Explaining information and procedures Did I feel like I had been part of a conversation if I needed to be told something and not feel like I have just gone through a big checklist? Was I given the right information and in a way that was easy to understand • Jargon Did they talk to me in a way that is easily understood by young people but won’t make them feel patronised? • Training Do I feel that staff were able to support me or meet my needs? [trained properly and had the right attitude] • Workers [when relevant] Did I get the choice of a make or female worker? Did I get the same worker [continuity of care] • Lasting experience Did I feel like the staff were judging me? Was I made to feel stupid or as though I was laughed and not taken seriously? Did they treat me with respect and were friendly, helpful, welcoming and reassuring so that I felt relaxed? Did I feel like they were interested in what I had to say and feel listened to?
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Preparing for inspections Workshops: In order to prepare for inspections we took part in a number of workshops that helped us prepare for the evaluation visits. These sessions included: • • • • • • •
What makes a good service Talking about sexual heath issues that are important to young people Sexual health services, rights and services Researching services within the local area How to carry out undercover inspections/ mystery shopping Developing scenarios Rehearsals
After researching services within both Dartford and Gravesham we chose three services and decided that we would use a number of different methods in order to inspect the services including emails, telephone calls and visits. Scenarios: using discussions and group work we developed a list of scenarios, which we felt were realistic to experiences and concerns that young people would have. We then each chose a scenario and rehearsed them before putting them into action. Here are some examples of the scenarios we used: • “My girlfriend and I are both 15 and are planning to have sex and would like some information on contraception” • “I have been told that my girlfriend has been sleeping around and now that we have broken up I would like to be tested to make sure I havenʼt got any STIʼs before I have sex again” • “Me and my girlfriend what to have sex but I want to be tested for Chlamydia before we do” • “ I have has unprotected sex over the weekend and need the morning after pill, where can I get it from?”
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Our findings Our aim was to undertake undercover inspections on different occasions, using different methods with each of the agencies. In some cases we did not get to speak or meet with a member of staff therefore more than one attempt was made to make contact with these agencies. For the purpose of this report the services that we inspected will be referred to as service A, B, C and D The findings presented below reflect our views and our recommendation for young peopleʼs friendly services. All of the services we inspected had at least one face-to-face visit and a number of calls and emails with different scenarios. • 66% of the group carried out face to face visits • 77% of the group carries out telephone calls • 33% of the group contacted services via email Service A – Overall feedback The young people who accessed this service experiences were split down the middle. With half reporting a very positive experience whilst the other half reporting that the services fell short of their expectations. More specifically, the one to one service, once received, was reported as exceptional, however the written and telephone support provided by the service was, on these occasions, less than satisfactory. Here are a number of comments made by the young people who tested the services • “The actual experience and level of service that I received at service A was nothing but positive and I couldnʼt fault it - its just the other things that need to be sorted out that happen before you get to the one on one interview” • “ I waited so long, an hour and a half, that I couldnʼt wait any longer, I would have liked to have got one to evaluate” • “My call was answered quickly, in person, she was very polite and helpful and asked for my name, she gave me all the information that I needed and made me feel comfortable and relived” • “I doubt Iʼd go back unless I was desperate • “She told me that everything at the session would be confidential, I could tell that the person that dealt with me was well trained” • “I got a standard email response really quickly telling me about the sexual health clinic, including times, and saying I could drop in and speak to a worker, but it wasnʼt a personal response at all, which was very disappointing”
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Our findings Service B – Overall feedback The young people who accessed this service experiences were disappointed with how difficult the service was to access, and was not very young people friendly. Despite the fact that 5 of the group had intentions to visit the service, only one was able to obtain an appointment and be seen by a member of staff due to inappropriate opening times. However all 5 had telephone contact with the service and all reported that it was extremely unsatisfactory. Here are a number of comments made by the young people who tested the services • “Overall the experience wasnʼt that positive, there was too much hassle just to get a check up. The website states that I can get an appointment within 48 hours but I would have had to wait almost a week” • “The person at the end of the phone needs to sound as if they are interested in what you are saying” • “The website is not great, but its not the worst either, its not aimed at young people – its just professional but is still usable. Itʼs a service for all. • “After I went for my test I didnʼt even bother to collect the results because I had to call them and I didnʼt have any credit and I wasnʼt going to all home” • “No one answered the phone when I rang so I went in and they said I couldnʼt get an appointment until the following Wednesday” • “I said I needed a check up that day but the couldnʼt fit me in. They made me feel stupid and uncomfortable” Service C – Overall feedback Only one young person chose to inspect this service because it was close to home and more easily accessible to any of the other services for him. However, given the fact that the service was operating on his doorstep he was not aware of it until entering this process. His over all experience was extremely positive and he felt that such a good service should be better advertised to young people in the local area. Here are a number of comments that he made after visiting
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• “The experience was an all round positive one and the service itself was faultless” • “Only open on Wednesday between 5pm and 7pm, which isnʼt really frequent enough for young people” • “It was well explained and they asked several times if I understood. When I took the test the man was friendly and explained everything” 10
Our findings Service D – Overall feedback The young people who accessed this service experiences were very positive. They reported that the service was well advertised through good young people friendly leaflets at school, that were clear to understand. No appointments were necessary and although the waiting room was daunting as it was open and lacked confidentiality, young people were advised that next time they visited they were just to ask for “Jill”. The group viewed this as a really good was of accessing a sexual health service no matter what the setting, in a confidential way. Here are a number of comments made by the young people that tested this service: • “ I would defiantly visit this service again, they were nice and friendly and treated me with respect so that I felt comfortable” • “They even discussed our families and safeguarding, I felt reassured”
Teenage Friendly Service Standard Rating Following inspections of all four services we have rated each of the services against our own “teenage friendly service standards” and have given each of the services a star rating. Any service which we feel completely meets these service standards will achieve our “Teenage Friendly Service Award”. This will be awarded once a three star rating has been achieved. None of the services in this particular set of inspections achieved this award but the other services were rated as follows: with good potential to achieve 3 stars
Service A Service B Service C Service D
0 with good potential to achieve 3 stars with room for improvement
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Our recommendations We thought it would be useful to provide two different types of recommendations, over all recommendations, ones that apply to all three services, relating to our criteria and service specific recommendations, those that apply only to a particular service. General service recommendations Accessibility These are the overall recommendations we concluded would be best for the three services in relation to accessibility. We consider ʻaccessibilityʼ to include; signposting, ease of access (finding out about the service), location, timings and cost. • Websites should be welcoming to young people and independent of partner sites, with their own identity to ensure that searches are easier. • The websites should only included links that work and all information must be accurate and up to date. • Opening times should be flexible to suit when young people are free. i.e. weekends when young people are not in school. Environment The environment in which sexual health services are set out in should be comforting to young people as for many itʼs a daunting experience. Environment to us is the building, surrounding areas, posters and information stands, reception and the waiting area. • Leaflets and posters need to be within the waiting area as well as relevant to young people and interesting and updated regularly. • Waiting areas need to be more comfortable and clean. If there are procedures to follow (i.e. paperwork) there needs to be tables at a comfortable height. • If the reception is shared with services for other age groups, service providers should recognise that this could be intimidating for young people. Reception areas should preferably be private and discrete yet still well sign posted.
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Our recommendations Publicity Publicity is important to ensure that services get to the young people theyʼre designed for. In our opinion publicity is how services are advertised in the form of leaflets and fliers, online and other forms of raising awareness. • Websites need to be publicised more through promotional materials and campaigns e.g. Ask Frank • Websites need to advertise sexual health services prominently • Leaflets need to have attractive designs and appeal to young people, yet still have the correct information. • The best promotional hotspots for young people are: youth centres, schools and colleges, mobile health services, young people events, cinemas, nightclubs and social networking sites (for young people to donʼt access mainstream school) just to name a few. Phone services Young people increasingly prefer to make calls to enquire about services as this gives instant answers as opposed to trawling through irrelevant information online or waiting for hours for an email to be replied to. Good phone services are determined by; the type of number, consistency and the person on the phone. Our recommendations are: • Free phone numbers, that are easy to remember, for both prior to and after accessing sexual health services. • The phone should be answered within a reasonable time. • Callers should not be left waiting for long periods (especially when the numbers are not free). • Call back when they say they will. • The person on the phone should: o have good knowledge of the service so that young people are not left confused. o volunteer information as first time caller may not know what they really need. o have the right skills to put the young person at ease. o be empathetic and able to build a rapport with the young person.
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Our recommendations Staff The manner of the staff and the way they make young people feel can determine the overall experience and if they reuse the service. Staff should offer introductions, have an appropriate appearance and be well trained to deal with all situations. • There must always be a choice of staff e.g. male or female • Staff must be well trained to deal with queries on the phone and in person Procedures The procedures that services implement will either positively or negatively impact the experience of the young person. We refer to procedures to include; personal information, form filling, sensitivity, confidentiality and waiting times. Our recommendations are: • Young people should be informed about confidentiality as well their rights. • There should be minimal form filling required as well requests for personal information at reception particularly in public, open spaces. • Waiting times should be less than 30 minutes for drop in services. • Young people should be seen at the time of their specified appointment time and not kept waiting.
Young persons participation One of the areas that we were keen to know about was whether or not young people are involved in the design and evaluation of the services. Clearly this is not something that can be determined in a mystery shopping exercise but we would always recommend that young people were actively involved in helping shape the service as well as in its review so that providers can be sure that it meets the needs of young people
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Our recommendations Service Specific Recommendations Service A Our recommendations for service A, in addition to those outlined in the “general recommendations” section are as followed. • To have its own website, email addresses clearer on the website and provide an easy to find sexual heath section • Email responses must be personal and specifically respond to the questions asked in the email (not everyone can visit) • There should be sufficient advice staff available every day of the week after school for visits, so that everybody who turns up can be seen, as well as being available to give advise over the phone at all times • Signposting to the service need to be put into place once in the building and the reception staff need to be better informed and form filling area needs to be more private Service B Our recommendations for service B, in addition to those outline in the “general recommendations” section are as followed: • To ensure that appointments are offered within the specified time shown on their website • There should be a drop in clinic or similar that operates everyday after school hours (possibly extend existing service to weekends) • People at the end of the phone service should be better trained to deal with young people as well as make call backs when promised and not keep young people waiting on the phone when the phone services isnʼt free. • The reception area should be more private
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Our recommendations Service C Our recommendations for service C, in addition to those outlined in the “general recommendations” section are as followed” • Improve accessibility of the service through advertising the services in schools, colleges and other local young peoples services/places they go as well as the internet Service D Our recommendations for service D, in addition to those outlined in the “generally recommendations” section are as followed: • • •
Better signposting at reception to the service Advertising leaflets should specify “ask for Jill” Reception area should be less open and more confidential
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Acknowledgements Thank you to Dartford and Gravesham Local Children始s Trust Boards for supporting the project and to Juli Dosad, the project coordinator for supporting us through our training and beyond. A special thanks to all the young people who have taken part in the project
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Becca !Christian !Remmy !Tom !Dan ! Libby !Tunde !Tolu !Eddie
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The Dartford and Gravesham Young Evaluators Project Project coordinator Juli Dosad E-mail: juli@banter.uk.net Mobile: 07834473384 Web: www.banter.uk.net This report was co-written by Becca Cooney, Tolu Oluwadare and Libby Carter