Purpose:

The purpose of this part of SRI 2 is to help the people who use the service reflect on the recovery indicators and associated statements, through a structured process facilitated by the coordinator. These reflections generate discussion and scores that are fed into the SRI 2 website by the coordinator and used later in the creation of the action plan.

Data from the people who use the service is one of the three sets of information acquired through meetings and discussions, the other two being from service providers and informal carers.

The service user data collection sheets are printed from the SRI 2 website and used to record ratings and comments from people who use the service. You should print one data collection sheet per person. The first page of these data collection sheets contains the following guidance.

SRI 2 Data Collection Sheet - People who use the service

About this data collection sheet

This sheet forms part of the SRI 2 data collection process. Completing this sheet will help your service reflect on whether it is recovery focused.

We recommend that people completing this form have an opportunity to discuss their thoughts on each statement in a group setting prior to recording their individual response on this sheet. It is, however, also possible to complete this form individually without prior group discussion.

In noting a response we encourage that you protect confidentiality by ensuring information recorded is anonymous.

Gathering information

  • In the space provided write examples of how your experience matches the opening statement, e.g. 'We identify and address basic needs.'
  • Based on the extent to which the statement matches your experience make a judgement on a scale of 1 to 5, where 1 is strongly disagree and 5 is strongly agree. If the indicator is not applicable or relevant to your service circle NA.
  • The person co-ordinating should retain all completed sheets for later use. They will enter the scaled responses into the SRI 2 website. Supporting evidence and examples recorded on this sheet will be discussed during the action planning stage.

Recovery indicators and associated statements

There are ten recovery indicators to be considered. Each of these has an associated statement against which the individuals using the service rate their experience of the service. The first indicator is Basic needs are identified and addressed, and the associated statement is My basic needs are well met by this service. The recovery indicators and the associated statements are shown below.

IndicatorAssociated statement to consider and rate between 1 and 5
Basic needs are identified and addressed. My basic needs are well met by this service.
Goals are identified and addressed. My goals are considered when planning my care.
Personalised services are provided. I get a service that is tailored to my individual needs and circumstances.
Service is strengths based. My strengths, skills and abilities are considered by this service.
Service promotes social inclusion. This service helps me to feel connected to my community.
Service promotes and acts on service user involvement. People who use this service have a say in how things are done.
Informal carers are involved. If I want it, my informal carer is fully involved.
Service encourages advance planning and self management. I'm encouraged to plan for the future including periods of poor mental health.
Staff are supported and valued. The staff here seem satisfied in their work.
Practice is recovery focused. The staff are supportive, positive and approachable.

Guidance for Rating

The issue that is most commonly overlooked when people who use services are invited to comment on the service they receive is one of power. Specifically the power imbalance inherent in the service user and service provider relationship. The people using the service may not be used to being consulted about such matters and may feel uncomfortable about giving a critical appraisal for fear of losing the service or causing upset. This issue needs to be tackled by the SRI 2 coordinator and ways found to resolve such problems. Helping create a safe environment for the honest sharing of experiences is supported by taking a facilitative approach. Consideration may also be given to enlisting the help of an advocate, peer support worker, or other person who has the trust of the people who use the service and whose presence would be helpful in facilitating the process.

This section of the guidance will help the people who use the service rate it against the statements, and offers guidance as to what kind of factors influence the rating.

The degree to which people using services feel the service achieve the aspirations of the ten statements will be derived from their reported experience of the service, and this is supported by facts such as 'we did go and report my housing problems to the local council' for example. This scoring will be influenced by the person using the service's subjective experience at an interpersonal and relational level. It is known that staff attitudes, behaviour, level of friendliness, warmth, empathy and so on are key factors in how people experience and rate services.

The rating process is preferably supported via a group discussion. Respondents may need prompts and guidance as to what is meant by basic needs, strengths, community involvement and so on. The facilitator must be prepared to explain the point of reflecting on statements such as 'the staff here seem satisfied in their work'. This guidance document is designed to provide support in that process.

Following group discussion and reflection respondents should individually rate each statement on their individual data collection sheet where possible supported by relevant supporting evidence.

If it is impossible to arrange a group discussion, people can be given the data collection sheets to complete on their own. This approach is least favoured as it precludes healthy group discussion and debate, however if it has to be used preparation is vital, the support of an advocate or peer worker would be particularly helpful in this instance. People should not be abandoned with a set of questions that they may have difficulty in understanding or commenting upon.

Statement 1 My basic needs are well met by this service

Basic needs include housing, nutrition, health, finance, safety, personal care and spirituality. The score awarded reflects the individual's view on how these needs have been addressed. The person's view may not accord with the perceptions held by the practitioners and it is acceptable for the facilitator or advocate to gently invite the person to say a bit more about their thinking behind the score. Obviously it would be inappropriate to argue the matter and confront the person with an opposing view. It is acceptable to respectfully explore what sort of things about the service (in their view) would need to change, to allow the person to offer the highest score. Such points for discussion can be recorded (anonymously) by the facilitator and considered at the SRI 2 action plan stage.

Basic Need: Housing

This might involve the person reflecting on how the service met their needs as fully as possible around issues such as:

  • Security of tenure.
  • Risk of homelessness or currently homeless.
  • Safety and security.
  • How they feel about their current housing.
  • Affordability.
  • Accommodation being wind and watertight.
  • Overcrowding.
  • Aspects of their housing situation that are a resource for wellbeing.

Basic Need: Nutrition

Food and recovery are closely linked and having a healthy diet helps promote good mental health. For this basic need the person will be reflecting on how well the service meets their nutritional needs with questions such as:

  • Have any cultural or religious aspects of nutrition been well met?
  • Have any other dietary requirements been considered?
  • Does the person enjoy the food the service provides?

Basic Need: Health

In rating this facet of service provision the person will be considering how well the service has met any needs around physical health including, smoking, drinking, drug use, sleep patterns, mobility, breathlessness, weight gain or loss, side effects of medication, and any other health concerns the person may have.

Basic Need: Finance

Money is a basic need, and the person using the service will be reflecting on how well the service met needs around income, benefits, entitlements, employability, income maximisation, and debt.

Basic Need: Safety

Safety is a basic human need and here the person is considering how any concerns they may have about their physical and psychological safety have been met by the service.

Basic Need: Personal Care

Personal care needs can include:

  • Cooking and cleaning.
  • Help with personal care like washing and using the toilet.
  • Transport or help with getting around.
  • Medical tasks like giving injections or changing a catheter.
  • Shopping, banking and paying bills.

The individual will reflect on how well any of these basic needs (if applicable) have been met.

Basic Need: Spirituality

The person using the service, like many other people, may not be able to articulate their spiritual needs. Prompts and suggestions will be helpful in encouraging the person to rate against the statement. Spiritual issues might include such things as prayer arrangements, visits from faith leaders, and access to scripture, or anything else that the person using the service considers to be a spiritual matter. Some might see their mental health experiences as having spiritual significance. Others may see mindfulness, meditation, music, and poetry as spiritual matters.

Statement 2: My goals are addressed when planning my care

The person using the service and may have personal goals and aspirations that they have never articulated. It may be that they did manage to name their personal self-set goals and they will rate the service on how well it has helped them address these. The score may not be connected to whether the goal was achieved or not, simply that the journey towards it was successfully started may be enough to for the person to give this the highest rating. On the other hand a very low score would be the result of aspirations neither being elicited nor addressed to any degree.

Statement 3: I get a service that is tailored to my individual needs and circumstances

The person will rate highly against this statement if they can see that their personal choices were routinely considered and addressed and that their personal preferences influenced the service provision.

A high score will be given if the person is aware that staff are willing to tailor the service where possible to their unique needs and circumstance rather than requiring them to fit in with a uniform approach to service users.

Statement 4: My strengths, skills and abilities are considered by this service

Strengths based practice is a relatively new sphere in mental health both to practitioners and to people who use services. For this reason people in general are not yet used to routinely naming their strengths in the way that they would be able to name their deficits. This phenomenon is amplified in the case of service users who may have been repeatedly assessed for deficits and problems. For this reason prompting may be required as to what constitutes strengths, skills, abilities and resources.

A high score would be given against this statement where the person was aware that staff had commented on their skills and abilities and then utilised these as a contribution to the recovery journey. The person may now be aware that skills they had previously taken somewhat for granted, such as having parented children, worked, looked after pets, sustained a tenancy, maintained relationships and so on are actually valuable assets that are transferrable to their current situation.

Statement 5: This service helps me to feel connected to my community

Social connectedness is a resource for health and resilience. People scoring this statement highly will be able to describe ways in which the service has helped them to remain connected to their community. This may have taken the form of support to maintain relationships, and the feeling of belonging to a community. The service may have supported connection to community resources that provide access to transport, housing, education, arts, sport, leisure, and recreation. There could also have been connections to church or faith groups, interest groups and non mental health community resources such as libraries, community centres and shops. The service may also have helped to prevent isolation and loneliness as these are known to be detrimental to recovery. A service that in the opinion of the person demonstrates a commitment to participation and citizenship will be highly rated on this indicator.

Statement 6: People who use this service have a say in how things are done

People using the service having a say in how things are done is commonly known as service user involvement. Service users rating this statement highly will have been empowered to participate in the plans, decisions, and actions that affect their care. Such people will have influenced the design and delivery of the service and experienced themselves as collaborators and partners. Having a say in how things are done may have helped them to work towards their aspirations and highest potential.

People able to be explicit about how, when, why and where they had a say in how things were done and how this helped, will score this statement highly. People might be able to describe mechanisms that supported their participation such as:

  • Questionnaires.
  • Suggestion boxes.
  • Awareness of a member of staff responsible for service user involvement.
  • Focus groups.
  • Exit interviews.
  • Regular reviews.
  • Being supported to participate in service user groups.
  • Having been involved in staff recruitment.

Statement 7: If I want it my informal carer is fully involved

People using services who highly rate this statement will be able to describe how the service sought their views on the involvement of their informal carers. Those who wished their informal carers involved would be able to describe how the service supported this to happen. Such individuals would have been made aware that informal carer involvement and participation is welcome and that mechanisms were in place to support this. They would have had it explained to them and the carer what the limits of confidentiality were, and their informal carer would have been invited to important reviews, case conferences and planning meetings and that their perspective was welcomed by the service.

Statement 8: I'm encouraged to plan for the future including periods of poor mental health

People who give this a high score will be able to describe how the service demonstrated its commitment to involving them in planning for the future including periods of poor mental health.

They may recall being provided with information about Advance Statements and how these can be used to cover treatment wishes and preferences.

They may be able to describe how they and their informal carers were informed about their right to make a 'personal statement' covering wider aspects of preferences such as arrangements for pets, contacting relatives, and so on.

Such individuals would be aware of what was in their plan, where it was kept, and how to access to it when needed.

People scoring this statement highly will have been provided with information on a range of self-management options including how to access planning tools such as for example WRAP(Wellness and Recovery Action Plan), which is a structured plan developed by the person using the service.

Statement 9: The staff here seem satisfied in their work

This statement can be seen at face value and is simply inviting the person using the service to rate staff satisfaction. Individuals wishing to give the highest score will be able to describe what aspects of the staff behaviour and attitudes lead them to that score. It may be that they experience the staff as highly motivated, optimistic, professional, willing to go the extra mile, and generally exuding an air of job satisfaction. Rating this statement highly does not require the staff to be cheerful and at peak performance all day and everyday, it is more to do with them being generally satisfied rather than constantly satisfied. This recovery statement acknowledges the parallel process whereby satisfied staff tend to create satisfied service users and that staff who feel supported and valued themselves are more likely to value and support the people using the service.

Statement 10: The staff are supportive, positive and approachable.

A high rating for this statement would indicate that the people using the service found the staff to be recovery focused in their practice. A score given against this statement indicates the personal experience of the service through the eyes of the people using the service. It may be that the person responding to this statement can describe specific behaviours and attitudes that led them rate it in the way they did, but equally just having the feeling that staff are supportive positive and approachable, without being able to articulate why, is still valid. Unlike hard evidence from written assessments for example, this statement does lend itself to subjective opinion and personal judgement. People who use services regard staff attitudes and behaviours as one of the most important influences on how they feel about the service.

Scoring and rating

Each statement will be considered and the highest score of 5 awarded where in the opinion of the person using the service the statement accurately reflects their experience of the service.

A score of one would result if in the judgement of the person using the service the aspirations of the statement had been not been met.

Arriving at a fair score between 1 and 5 is a matter of judgement based on reflection, discussion, and the application of reasoning regarding the quality and quantity of evidence.

The N/A (not applicable) option would be recorded in services where the statement is not applicable or relevant to the service or the person using the service.