Values underpinning the Green Light Survey
Aiming for your service to be ‘reasonably adjusted’ is like aiming for a moving target. Like with many other worthwhile goals, it can always feel just out of reach. This keeps us ambitious, pressing forward for continuous improvement rather than relaxing after passing a particular milestone. The survey questions are designed to stimulate discussion and continuous reflection and improvement, rather than complacency.
Not the only thing
Bear in mind that, like other useful ideas, making reasonable adjustments works best when you keep in mind your other goals as well. Ensuring you provide a good mental health service to people with autism or learning disabilities is important, but so are the needs of other people. If you make the reasonable adjustments, not only do you meet a legal obligation, but you often improve your service for everyone.
Does my team have to do everything?
When you are answering questions in the Green Light Toolkit you may be unsure of how to answer if another team provides a service, rather than your own. Sometimes you may signpost people to the neighbouring team and relationships are so good that the person receives a seamless service. This means that you can use the survey questions to either ask the wider question, ‘Is this service available to everyone who needs it, irrespective of which team provides it?’ or to review the narrower role of your own team, by asking, ‘Is our team providing this, or should it do so?’ Both questions are good, but you need to be clear in a discussion that you are answering the same question as your colleague!
Green Light also recognises the importance of ‘capacity-building’ relationships between teams. The effective mental health team will be good at supporting autistic people and people with learning disabilities and will also recognise the additional expertise of specialist autism and learning disability workers. the team will establish a relationship with those specialists that helps the mental health service to grow in understanding and skill.
Conversation is more important than scores
Staff consistently told us that they were nervous of assigning scores at all, due to their negative experience of performance management through the punishing use of numerical benchmarks, rather than a shared search for real service quality. We are eager to underline that the true value of these survey questions lies in the conversation, action planning and service improvement that follows their use, rather than the scores on their own. Staff who feel safe and supported will be professional, reflective and aspirational; staff who feel constantly criticised will not. Here is the strength of a self-managed approach – it supports the team in taking ownership of the agenda, applying creativity to solving the problems they themselves identify and holding one another to account.
Survey and benchmark
The Online Survey 2022 helps teams to conduct a survey and then obtain a chart showing their results compared with a benchmark. Click here to explore this option.
Strengths and weaknesses of self-evaluation
The tools are designed for self-evaluation, and this is both its strength and its weakness. It is a weakness if you either over-rate or under-rate your activities. You might under-rate your activities if you are suffering from low morale or if you are highly ambitious and are determined to keep improving the service until everyone who needs a reasonable adjustment gets one. Alternatively, you might over-rate your activities if you are disinterested in the whole agenda and simply go through the motions of answering the survey questions because someone has said that you must, or because you want to gain competitive advantage over another team or obtain managerial approval.
One size for all?
Over the years we have received feedback from some people who wanted a tailored version for their own group, professional discipline, service sector or role. For example, some people wanted a survey that could be completed by autistic people who did not have a learning disability, while others were concerned that some of the questions were too difficult for some people with learning disabilities. Others asked for specialised questions for inpatient areas.
You may feel that the experience of one group of people using your service is quite different from another, so it would be better to segment your work and compare the subgroups. For example:
- Some adjustments made for people with learning disabilities need to be different from the adjustments made for autistic people.
- The experience of people with certain characteristics protected under the Equality Act may be different from the majority population. For example, people from Black and minoritised communities may have different views about the service compared to White British people.
- In another example, people with mild or moderate learning disabilities may have a very different experience of services compared to people with complex needs.
- Another group wanted to find out if people using the mental health service had similar views to the staff.
Each of these responses brings its own problems: we could not find a satisfactory way of assigning specific knowledge areas to particular individuals or teams; we felt that people ought to have some understanding of the whole picture; and we know that you will set aside or adapt any question that you find irrelevant to your situation, whatever we suggest here! You may want to add even more challenging items that we do not cover in detail. For example, the survey asks about equalities in general, but does not go into detail about whether autistic people from minority ethnic communities get appropriate support in mental health services. You may wish to ask these questions.
As a result of all these factors, the 2022 Toolkit contains a selection of survey questionnaires and invites readers to choose one or more as required and customise as necessary.
One or two people asked us for examples for each of the reponses, or more detail on the thresholds between one response and the next. For example, does it mean that some people get the adjustment under discussion, or everyone who needs it receives an adjusted service? People told us that services are in very different stages of development, and so setting a precise threshold could lead some teams to give up the challenge because it looks too hard, while others might become complacent. You may wish to keep a record of the process, including some of the local evidence that shows why you awarded a particular score, so you will be able to tell whether things improve over time. You could collect a folder of possible solutions and enacted solutions, along with evidence of their impact.
Design or retrofit?
Some services have been based on the principles of Universal Design, so only a few adjustments need to be made later on to accommodate unexpected or rare issues. This means that the best designed services will require fewer reasonable adjustments on a day-to-day basis, simply because they got it right first time. For example, the Corner House has low arousal areas and so does not need to change anything to create a quiet space.
The surveys have been designed to help you review how well your mental health service responds to three groups of people – autistic people, people with learning disabilities and autistic people with learning disabilities. In previous versions of the Toolkit the image of traffic lights was used to illustrate how well the mental health service was doing. In the 2022 version, the Title ‘Green Light’ has been retained as it is familiar, but the traffic light imagery has been abandoned as there are now four points on most of the survey tools instead of the three that used to correspond to the image of UK traffic lights.