Adult social care services should meet the needs of all consumers in a way that is perceived as appropriate. The satisfaction surveys accessible via the Health & Social Care Information Centre show that there is a particular concern with satisfaction among certain Black and Minority Ethnic (BME) groups. For example, the 2012-13 Personal Social Services Adult Social Care Survey found that the Asian/Asian British and the ‘Other’ ethnic groups were the least likely to say that they were ‘extremely or very satisfied’ (54%) compared with 65% of the White group (H&SCIC, 2013). These figures raise concerns from an inequalities perspective, because services should be accessible and acceptable to the whole population. Furthermore, satisfaction is an important metric of service quality, because satisfaction is linked with greater compliance and future help seeking. The survey data cannot offer an explanation for the disparities, so we designed a qualitative study to understand why older people from minority ethnic groups might have different satisfaction levels to the majority population. This is the topic of our recent article.
We decided to focus on the service use experiences of two ethnic groups: one minority and one majority. We chose the broad South Asian ethnic group (referring to a culturally, linguistically and religiously heterogeneous group of people with an Indian, Pakistani or Bangladeshi heritage) because of the relatively large population around our study area (Southampton and Portsmouth), and also because this is a group that has been closely associated with assumptions and stereotypes around preferences for extended family care. We chose the White British group to represent the ethnic majority, and also to examine areas of similarity as well as difference.
Although many studies have examined the reasons for lower levels of awareness or rates of service use among BME groups, fewer have looked at the experiences of BME people who actually progress to use social care services. Our research takes the conversation beyond ‘Why do Asian groups not (want to) use services?’ and instead into ‘What is it like for an Asian person to use services?’ and ‘How are the experiences of Asian service users similar or different to White British service users?’
Furthermore, it is vital to not look at the experiences of one minority group in isolation; for a full understanding we need to be able to compare experiences between minority and majority ethnic groups. Otherwise we as researchers may make assumptions that all the findings are due in some way to the cultural or religious distinctiveness of our sample. It is just as important to recognise the shared experiences of ‘being disabled’, as it is to recognise how the needs of a person with disabilities might need to be met differently depending on their religious or cultural backgrounds.
With this in mind, we present our findings in two main sets: (i) reasons for high satisfaction with services, drawing out the reasons why people from South Asian backgrounds have had fewer opportunities to reach this satisfaction level; and (ii) service use experiences specific to South Asian participants, e.g. where having a minority religion or language impacted on how people interacted with services.
These findings enabled us to generate a set of recommendations for making social care services more understandable to all potential service users, and therefore potentially increasing their future satisfaction level.
Author: Dr Rosalind Willis, Centre for Research on Ageing, University of Southampton
Reference: H&SCIC (2013) Personal Social Services Adult Social Care Survey, England – 2012-13, Final release. Health and Social Care Information Centre, Leeds.