Ensuring the repeatability of quality in social services and its comparisons The quality of social services has resonated in Slovakia as a topic for more than a decade. From the original theoretical discourses, it developed during this period into some practical applications of different focus. In the first years of promotion of this topic in Slovakia, a lot was written and spoken, especially about the reasons for which social services should be improved. In recent years, the dominance of reasons and their ethical or professional starting points is receding, and a logically related topic is starting to appear, and that is "how to ensure quality". Even if the first topic and the clarification of the term "quality in social services" were not methodologically exhausted in our opinion, the transition to the second topic seems to indicate that the requirement for the provision of high-quality social services is already generally accepted by the professional public.

The application of quality in social services has started in several directions. They could basically be divided into four basic ones:

  1. The quality and appropriateness of professional procedures for working with clients and the related quality and professional competence of the staff.
  2. Quality of the client's life and observance of his basic human rights and freedoms.
  3. Quality of infrastructure and environment for social service provision.
  4. Quality management of all activities, documentation of performance and ensuring controllability and repeatability of quality.

In 2008, Act No. 448/2008 Coll. on social services and on amendments to Act no. 455/1991 Coll. on commercial entrepreneurship (hereinafter referred to as the "Social Services Act"), which established the following obligations for social service providers in relation to the quality of the provided social service [1]:

  1. fulfill the procedural conditions, personnel conditions and operating conditions for the provision of social services according to Annex no. 2 letters A.
  2. Familiarize your employees and recipients of social services with the procedures, rules and conditions processed in accordance with Annex 2 letter A
  3. To enable the evaluation of the conditions of the quality of the provided social service and to provide cooperation in this evaluation.

These requirements are already well known to operators from the annex in question. Basically, they try to address the first to third quality themes we mentioned above. The fourth topic, how to introduce, manage, control, evaluate, ensure its repeatability and the possibility of comparison with other social service facilities, is addressed by quality management systems.

Quality management systems in social services

Similar to the topic of quality in social services, there is also a debate about whether quality management systems (hereafter referred to as SMQ) in social services are appropriate or not. The opinion that yes is starting to be accepted by the professional public. This is also helped by the obvious fact that within the European Union states, this is not a novelty, but a well-established and proven practice. Even in Slovakia, social service facilities that have one of the systems in place, mainly STN EN ISO 9001:2000 and the following, are no longer an exception. We predict that this trend will continue, and in the next decade, devices with established SMQ will be more prevalent. The discussion in this area is starting to move to the position of "how and which SMQ" or whether it is necessary to introduce a comprehensive SMQ or it is enough to apply some of their system elements "to begin with". What do quality management systems actually ensure in relation to social services? Standardized quality management systems applied in Slovakia are also based on eight principles of quality management: (1) Client focus; (2) Leadership (leadership); (3) Worker involvement; (4) Process approach; (5) Systems approach to management; (6) Continuous improvement; (7) Decision-making based on facts a (8) Mutually beneficial relations with suppliers. Ideally, each of the policies is applied across the social service provider and essentially implements one of the available SMQs. Together, they compactly ensure what we are looking for in the topic - the repeatability of good results and the possibility of comparison. Within Slovakia, there are two good options - STN EN ISO 9001:2008 and the EFQM model of excellence. Both models are available and applicable.

There is an objection that not every social service facility can afford to implement one of the SMQ models. This objection is acceptable. Indeed, not every social service facility in Slovakia has the personnel, material or financial capacities available for the entire SMQ implementation process. At least not immediately and in a short time. However, a good starting point is offered, i.e. a starting line.

Process approach and standardization of services

The starting line is the application of a process approach, which is a kind of "heart" of any quality management system suitable for social services. The application is less demanding in terms of time, personnel, material and also money, compared to the introduction of the entire SMQ. However, it will create good conditions for the full implementation of the selected SMQ in the future where it is not yet possible today.

A process is any activity (sequence of activities) that transforms inputs into outputs [2] and is defined by internal and external boundaries. The process approach is based on the examination of the equipment from the point of view of the performed activities and from the point of view of the management acts, i.e. the management activities performed by the operation management. It tries to harmonize all activities into a functioning whole, whose individual parts are identified, connected and managed [3]. Process approach applied together with the so-called managed documentation ensures a few important things to begin with:

  1. It reduces the risks resulting from the unbalanced position of the pair provider - recipient of the social service. 2. It reduces the risks of late detection of incorrect procedures in professional activities, which lead to hidden harm to the recipient of the service, manifested only in the future; other activities can reinforce this damage and develop its negative effects. 3. It contains an important element of protection for both the recipient and the social service provider. 4. It ensures the change of assumptions to the desired results and ensures the repeatability of good results. 5. It requires a clear definition of the operation's mission and goals, which can also be understood as a public commitment or a public declaration of the operation. 6. It supports the preservation of continuity of knowledge and procedures during employee turnover, which can be very critical in social service facilities, especially in positions of direct contact with the recipient of social services. 7. Forces the management of the social services facility to describe all their activities exactly and completely. This description provides a picture not only of what is done in the facility, but also of how it is done. He must name them, put them in relation to each other, determine their sequence and interaction, examine their legitimacy, expediency, suitability and effectiveness. This review reveals outdated, inertial and duplicative activities and the so-called white spaces - i.e. activities that must be performed but are not systemically captured and are repeatedly performed ad hoc. In the final result, not only can there be a clarification and harmonization of the activities of the facility, but also - and this is what we are talking about - a typology of the same activities of the same facilities within the framework of a large establishment. This can create a prerequisite for the implementation of another quality management tool, such as benchmarking. 8. In the next step, the process approach forces the management to rethink the competences and competence of the personnel, because it determines the owners of the process, the actors of the process and the interfaces of the process, which is ultimately a new view of the work contents. Here, too, it is possible to implement an appropriate typology of jobs and job duties, which will make the situation clearer, especially for larger operators, such as the Higher Territorial Unit or the city. 9. A significant benefit is the very precise identification of required inputs to processes (activities) and also required outputs. It is not only a matter of naming the output as such, but also of an exact description of its form and content, quality, quantity and measurability. The process approach requires not only measuring outputs, but also monitoring and measuring the progress of activities and validating the appropriateness of activities. Above all, this attribute of the process brings the desired dispelling of the myth that social services cannot be measured. The identification of requirements for inputs and outputs logically entails the identification of all stakeholders who either provide inputs or receive outputs. With this identification comes the identification of their requirements, thinking about communication with these interested partners and thinking about evaluating the fulfillment of these requirements. It also brings knowledge of which outputs produced do not have their next user and are therefore produced unnecessarily, "in a drawer", or vice versa, which outputs are required, but no activity in the equipment ensures them. This step also has an impact on work tasks and also on the organizational structure of the facility, respectively on competences. 10. The process approach forces facilities in the next step to determine criteria and methods to ensure the effective execution and management of these activities. Workers, process actors must think about their procedures, their expertise and methodology, the concept and also about the quality criteria, the desired state they want to achieve. 11. Since the processes and activities contained in them cannot be ensured without resources, a new evaluation of all resources takes place. The setting of the processes has a direct impact on the equipment budget, which can thus be compiled much more precisely and factually and is not based only on bare consumption from last year supplemented by emergency conditions and good management ideas. This procedure also results in resource planning based on the evaluation of the progress of the processes and the conformity or non-conformity of the outputs with the defined expectations.

It is likely that these approaches can dispel the notion that social services are a black hole of the economy into which any amount of funding can be stuffed and still not be enough. 12. The procedural approach requires a good knowledge of the determining documentation as a basic condition for its management. All procedures must meet the requirements of the determining documentation that is valid for the procedure. A critical review of the determining documentation of an internal nature can also bring about its adjustment. This point also contributes to reducing the risk of operating the so-called dangerous services, although some professional procedures in social work are not determinative, but only recommended. Given the scope and complexity of the legislation, it is not realistic to expect the senior management of the operation of social services to be able to maintain a complete and up-to-date overview of all legal norms affecting the operation of the facility. Therefore, it is necessary to consider what modus vivendi to choose to ensure this requirement. 13. Measurement, monitoring and validation in the process approach does not only have the task of statistically monitoring and evaluating activities, the quality and quantity of inputs and outputs, but is aimed at thinking about improvements. Suggestions for improvement seem to return to the beginning of thinking about processes, and properly should not close the imaginary circle of quality, but move it one level higher and thus create an upward spiral of quality.

Conclusion

A social service facility can approach the requirements for the quality of its services in basically two ways. He can decide to comply with the letter of the law in question at the lowest possible tolerable and inspection acceptable level, thereby ensuring some kind of "operational peace". Or will he understand that even the standard of the law wants to say that the quality of social services is not only our professional but also a general human obligation towards the recipient of social services, who is unfortunately dependent on receiving them analogously to receiving health services. If he decides to go with the second paradigm, a checked off check sheet will probably not be enough. In such a case, he has the opportunity to reach for quality management systems, or – if he is not currently in a position to do so, at least for some system segments, which can gradually and step by step lead him to a comprehensive system. This will also ensure a much higher quality than just meeting the requirements of the law. One of these system beginnings is the introduction of a process approach and the resulting controlled documentation. This procedure can also be called educational, because it leads the management step by step into the systematic management of all activities of its own operation, teaches them to ensure the repeatability of expected and good results and, last but not least, teaches them to compare themselves with comparable ones and adopt good practice from their colleagues within the region, state or internationally. Large founders, in turn, have the opportunity to standardize procedures, inputs and outputs, documentation as well as the overall system of management and organization of services within the scope of their founding authority and thus ensure systemic fulfillment of the requirements of the Act on Social Services in their territory.

Author: Ing. Ondrej Buzala List of bibliographic references

[1] Act no. 448/2008 Coll. on social services and on amendments to Act no. 455/1991 Coll. on commercial business as amended by the following regulations. §9, par. 6.-8. [2] STN EN ISO 9001:2008. Slovak Institute of Technical Standardization, 2009. [3] GRASSEOVÁ, Monika et al. 2008. Procedural management in the public and private sector. Brno: Computer Press, 2008. p. 6-8. ISBN 978-80-251-19.

The lecture was given at the scientific conference Social services in the region. Proceedings of the scientific conference, which took place on November 18, 2010 in Skalica and was published in the proceedings of this conference: MÁTEL, Andrej – KOVAĽOVÁ, Mária – ŠTEPANOVSKÁ, Martina (eds.) Published by the University of Health and Social Work St. Alžbety in Bratislava, ISBN 978-80-970567-0-4, EAN 9788097056704