Users and providers: different perspectives on community care services

Elderly clients usually express satisfaction with their services when they are asked. Surveys of clients and carers therefore have to take this tendency into account. It is important not to ask direct questions and to allow for positive, neutral and negative responses, otherwise positive responses will be overestimated. A survey of clients and carers served by a community psychogeriatric service indicated that the way a service is delivered can be more important than what is provided. The differences between staff and user perceptions of services are analysed. There are theoretical reasons for the differences connected with the combination of care and control exercised by service providers. There are also practical reasons in terms of staff perceptions, which are dominated by process, and client perceptions, which are more directly influenced by the services as they are actually delivered. Attempts to incorporate users' views into the processes of service delivery need to understand these differences and to acknowledge the limitations of user satisfaction surveys.