User satisfaction

User satisfaction has not been comprehensively analysed by this study. The reasons are that the services have been established by policy makers relatively recently and many users are still adjusting to using the service. Furthermore, in many cases, service provision was delayed due to the need to put in place suitable units for offering the service.

EU funding support during the 2014–2020 period was available for improving the infrastructure for special care, with two calls for proposals, the second of which was only issued in 2017. This means most service units only became operational in the second half of 2021 or in 2022.

Analysing user satisfaction is very important and shall be undertaken separately, building on the present study. An interactive method of assessing user satisfaction needs to be used, as in many cases, direct interviews with users that use traditional interviewing techniques do not provide adequate results.

However, the two case studies included in the analysis involved interviews with users and those closest to them to assess their satisfaction and the added value of the initiative.

A. User satisfaction according to case studies

User satisfaction in the case studies is evaluated weekly, asking users how satisfied they are with their quality of life. A thorough interview with service users, family members and staff takes place annually, where all parties evaluate their satisfaction. Often the service user is the most satisfied, followed by their family members, with staff being most critical. The reason for this criticism lays in knowing that the full potential of the service may not be utilized at all times.

A very important step in evaluating the satisfaction of service users is the evaluation plan used for service users who are unable to express their satisfaction verbally. Four types of behavioural signs are taken into account: most satisfied is indicated by a state of calmness, followed by slightly displeased, heavily displeased and fully displeased, which may be reflected in aggressive attacks that require urgent responses.

The weekly evaluation is applied to all service users, interpreting non-verbal answers, based on which an evaluation is made and presented in the context of co-vision meetings, which are held regularly, generally once a month.

B. Satisfaction of service providers

1. Satisfaction at management level

Service managers have shown appreciation for the new service, seeing such interaction as necessary in order to prepare the person for independent living. They also see it as important to introduce tailor-made support, which may lead to yet further government-funded solutions for support.

The flexibility offered to users is, however, very complex and time-consuming, and comes with significant risk of losing qualified staff if the service is no longer needed, for example if a user returns home.

2. Satisfaction at staff level

The satisfaction level of staff was analysed by interviewing staff of the two providers featuring in case studies. Staff are often already familiar with the service users and their family members as both providers also offer other services focusing on early intervention and therefore know the user from a young age. However, there is a general shortage of staff in the care sector and individuals working in care tend to have a specific profile: some prefer to work only with children, and as a child grows and becomes an adult, different needs appear which might pose a challenge for these staff members.

In the context of the service provision environment, staff appreciate that the environment is new, fully accessible, equipped with suitable assistive technology and needed to take care of the service users with the highest level of support need.

The unsatisfactory level of income has already been addressed by the study. The hourly rate of €4.50 is not satisfactory, as even employees with lower levels of education generally earn €7–€10 for this kind of work where hourly rates are used and the need to step in is varied.