An evaluation of community services being offered to persons with disability in Malta

Abstract

This research evaluated the current community services being provided to persons with disability through the CommCare Assessment Unit (CAU), which forms part of the Active Ageing and Community Care directorate (AACCD). This study aimed to provide a clearer picture of the levels of satisfaction the service users have with the current services. The services being evaluated were mainly provided directly through CommCare, however it was known that services offered through CommCare assessment, might have been mentioned by service users. It also aspired to divulge if the services are catering for the service users' needs and if standards are being maintained throughout. Most importantly, the findings of this research will be used to propose changes towards improvement of community services in Malta. The methodology employed for this study was a mixed method approach, based on philosophical assumptions of a pragmatic viewpoint, using an overarching transformative mixed method perspective and a convergent parallel mixed method design. Questionnaires were disseminated to gather the quantitative data. The participants for this included service users that made use of CommCare services and were reported as having a disability. The qualitative findings were obtained by using a semi-structured interview with two service providers and two service users in order to acquire data from different perspectives. The service users for this were chosen from two different professions, and that had the most experience working within CommCare. The service users for the interviews were chosen from the same sample used for the questionnaires, only they had to make use of more than one service. The major theoretical frameworks used for this study were the social model of disability, the client-centred model, and the transformative paradigm. The quantitative findings showed that service users were generally satisfied with the overall care, and standards of care. The issues that emerged from these findings were regarding frequency of service provided, and the time at which they were provided. The services that had issues with timing of services were those not directly offered through CommCare, namely nursing and carer services by the sub-contractor. The services of physiotherapy and occupational therapy were those that service users claimed should provide more frequent visits. The qualitative findings also exposed issues with timing of services and frequency. Timing was an issue with nursing and carer services of the sub-contractor, and frequency was found to be an issue with home help services, all of which are not directly provided by CommCare. There also was an issue with quality of service concerning the meals-on-wheels service. Other matters that arose from these findings included issues with human resources, communication, and time dedicated to service users, service misconceptions, interdisciplinary communication, and continuation of care. The findings of this study showed that there is a need for improvement in services, both at policy level and in deliverance of services. Specific needs of the persons with disability are not being met. In order to maintain professional and high service standards, re-evaluation of service must be implemented. The changes and improvements that have been suggested do not only include services, but also structural changes to external barriers which are limiting people with disability from enjoying their community. This instigates a change within a community perspective, that not only involves services and polices, but also structural and social.