SERVQUAL Applied to Home Care

By Michael Pasmore

BA (Hons) Business Administration

Northbrook College

Business School

August 2007

1

Acknowledgements

I would like to thank Graham Harrison for all of his tutorial support, Richard Sykes

for helping me with statistics and quantitative techniques, Colin Shaw for assistance

with research. Many thanks to Anne Godley and Dr. Chris Rainey for allowing me to

base my research on Home Care; all Home Care employees for taking the time to look

at my questionnaires; and Home Care service users for responding to my

questionnaires.

I would also like to thank my dad for supporting me and my mum (Home Care

manager) for assisting me in gaining access to research Home Care, offering opinions

and allowing me to interview her on many occasions. I would like to thank my brother

for the endless envelope stuffing he endured and finally thanks to my girlfriend for all

her support and for being understanding during frustrating times.

2

Abstract

The research examined Home Care’s, a care service that assists people with physical

and mental health problems, service quality using an adaptation of the SERVQUAL

model. The main findings were that Home Care is not meeting the expectations, of an

excellent care service, of its service users; responsiveness had the largest negative gap

score; Chi Square tests revealed that gender has no influence on service quality

judgement and that the length of time service users have used Home Care for has no

influence on service users judgement of service quality; the overall service quality gap

may be caused by gaps 3, 2 and 1 (of Parasuraman et al.’s 1985 gap model).

Methods used included questionnaires to Home Care service users, employees and the

manager. The manager of Home Care was also interviewed using both a structured

interview technique and an informal technique.

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Contents Introduction 6 Literature review 8 Hypotheses, aims and objectives 26 Methodology 27 Results 31 Demographics of Home Care service users 31 Demographics of Home Care employees 32 Gap 5 Perceptions minus Expectations 32 Chi Square Tests 35 Gap 3 Service Quality Specification – Service Delivery Gap 37 Gap 2 Manager Perceptions of Consumer Expectations – Service Specification 38 Gap 1 Consumer Expectations – Manager Perceptions of Consumer Expectations 39 Conclusion and Recommendations 39 Bibliography 44 Appendix 1 58 Appendix 2 59 Appendix 3 60 Appendix 4 60 Appendix 5 60 Appendix 6 61 Appendix 7 61 Appendix 8 61 Appendix 9 62 Appendix 10 62

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Appendix 11 62 Appendix 12 63 Appendix 13 64 Appendix 14 64 Appendix 15 65 Appendix 16 67 Appendix 17 68 Appendix 18 70 Appendix 19 71 Appendix 20 72 Appendix 21 72 Appendix 22 73 Appendix 23 74 Appendix 24 77 Appendix 25 78

5

Introduction

Home Care is a service that offers assistance to people with both physical and mental

health problems who can remain living in the community. Home Care has 160 carers

who visit service users to assist them with personal care and keep records of their

well-being. Home Care provides its services to approximately 400 service users over

Mid-Sussex.

Measuring the service quality delivered by Home Care is important as it will enable

Home Care to identify areas where they may be under or over performing therefore

enabling Home Care to adjust their service accordingly. The SERVQUAL model can

be used to identify five ‘service gaps’ by measuring expectation of service quality

against the perception of the actual service quality.

The particular area of interest is in services marketing. There are many studies of

service quality, especially in the public sector including: Curry, A. (2002), Assessing

the Quality of Physiotherapy service using SERVQUAL, International Journal of

Health Care Quality Assurance, (15:1); Donnelly, M., Kerr, N.J., Rimmer, R. & Shiu,

E.M. (2006) Assessing the Quality of Police Services using SERVQUAL, Policing an

International Journal of Police Strategies & Management, (29:1); Martin, S. (2003),

Using SERVQUAL in Health Libraries across Somerset, Devon and Cornwall, Health

Information and Libraries Journal, (20); Mahapatra, S.S. & Khan, M.S. (2007) A

Framework for Analysing Quality in Education Settings, European Journal of

Engineering Education, (32:2) and Kilbourne, W.E. et al. (2004) The Applicability of

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SERVQUAL in Cross National Measures of Health – Care Quality, Journal of

Services Marketing,(18:7).

The research carried out adds to previous studies by being more specific to Home

Care in Sussex. The main question to be addressed by this research was – does Home

Care deliver more than it promises? Specific questions have been based on the five

gaps identified by Parasuraman et al. (1985). For example gap 1 asks do management

perceptions of client expectations match actual expectations of the client? Gap 5 asks

is the client’s perceived service what they expect? Gap 4 asks are external

communications to client’s representative of service delivery? And gap 3 asks does

service delivery meet criteria set by service quality specifications?

7

Literature Review

Although services are considered to be a major part of the economies of the

industrialised countries (Bateson, 1989; Ginzberg & Vojta, 1981; Koepp, 1987;

World Bank, 1991) this was not always the case. When discussing services, and their

intangibility, Adam Smith described them as: “unproductive of any value” (Smith,

1977 [1776], p430). However Alfred Marshall (1890) challenged this view by stating

that the production of services was equally capable of producing utility to the user of

the service as the production of a tangible good and that without the services the

tangible products may not exist.

The definition of services has been the subject of much debate (Gronroos, 2000;

Lovelock et al., 1999; Palmer, 1994; Zeithaml & Bitner, 1996). Kotler and Armstrong

(1991) define services as: “…an activity or benefit that one party can offer to another

that is essentially intangible and does not result in the ownership of anything. Its

production may or may not be tied to a physical product.” (Kotler and Armstrong

cited in Palmer, 1994, p1). However Zeithaml and Bitner (1996) define services as:

“…deeds, processes, and performances” (p5). Gummerson 1987 defined services as:

“…something which can be bought and sold but which you can not drop on your

feet.” (Gummesson cited in Gronroos, 2000, p46). Gronroos (2000) defines services

as:

“…a process consisting of a series of more or less intangible activities that normally,

but not necessarily always, take place in interactions between the customer and the

service employees and/or physical resources or goods and/or systems of the service

provider, which are provided as solutions to customer problems.” (p46)

8

An interesting point, identified by Zeithaml and Bitner (1996) and Gronroos (2000), is

that services are not exclusively delivered by “service only” organisations such as

banks, HSBC, Natwest, insurance companies, Norwich Union, lawyers, accountants,

or dentists; they are part of the product offering by many manufactured-goods

producers. Administrative activities such as invoicing and handling claims are part of

the service according to Gronroos (2000). Zeithaml and Bitner (1996) use examples

such as car manufacturers offer of warranties and repair services or computer

manufacturers offer of warranties, maintenance and training. Therefore when

discussing services it is important to recognise that a wide range of industries can be

included. Although these definitions have nuances, they all state that services are

intangible. However since intangible services are not exclusive to ‘pure’ service

organisations, services and manufactured products tend to be placed somewhere along

the tangibility spectrum, as shown below (figure 1), with manufactured goods being

more tangible and services being more intangible (Lovelock et al., 1999; Palmer,

1994; Zeithaml & Bitner, 1996). Therefore it is the intangible services that will be

addressed in this research, as shown in the tangibility spectrum (figure 1) and for the

purpose of this research Gronroos’ (2000) definition of services, as quoted above, will

be used.

Tangibility Spectrum Figure 1

Intangible Dominant Tangible Dominant

Consulting Teaching

Investment management

Airlines

Fast-food outlets

Fast-food outlets Advertising

agencies

Salt Soft drinks

Detergents Automobiles Cosmetics

Source: Shostack, G.L., (1977), Breaking Free from Product Marketing, Journal of Marketing, (41), p73 – 80.

9

Although intangibility is one of the main determinants of services it is not the only

characteristic of services that differentiate them from manufactured goods (Lovelock

et al., 1999; Palmer, 1994; Zeithaml & Bitner, 1996). Others include Inseparability,

perishability, heterogeneity and lack of ownership (Gronroos, 2000; Hoffman &

Bateson, 2002; Lovelock et al., 1999; Palmer, 1994; Zeithaml & Bitner, 1996)

Pure services have no tangible properties. They cannot be touched, seen or tasted.

Goods can be touched, seen and tasted. Therefore services cannot be evaluated prior

to purchase (Hoffman & Bateson, 2002; Lovelock et al., 1999; Palmer, 1994;

Zeithaml & Bitner, 1996). According to Palmer (1994) this means that consumers of

services have less certainty about the outcome of services when choosing between

them. The level of uncertainty needs to be reduced via branding and the incorporation

of physical evidence (Palmer, 1994), such as HSBC’s bank statement folder or

Easyjet’s in flight magazine. Zeithaml & Bitner (1996) state that intangibility means

that services cannot be inventoried, creating difficulties in the management of demand

fluctuations. For example during busy periods demand for Ryannaire’s flights will

increase. To take advantage of this they may buy more planes. However when the

demand falls, they may have excess capacity. Services can easily be copied and

cannot be patented (Zeithaml & Bitner, 1996). Ryannaire did this by coping

Southwestern Airlines operation, to reduce their turnaround times. However Gronroos

(2000), Zeithaml & Bitner (2000) and Lovelock (1991) present a different view of

intangibility, stating that consumers do not always perceive manufactured goods as

tangible. For example a kilo of apples could be perceived in an intangible way as they

are going to be eaten the tangibility of the apple is lost and the consumer simply has

satisfied the need to eat.

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The intangible nature of services leads to a lack of ownership – the consumption of a

service leads to ownership of nothing (Palmer, 1994). The consumer simply buys the

right to use the service, for example using a train or eating a meal.

Inseparability is where services are sold first and produced and consumed

simultaneously – they cannot be separated from their means of production (Hoffman

& Bateson, 2002; Lovelock et al., 1999; Palmer, 1994; Zeithaml & Bitner, 1996). In

contrast to this manufactured goods are separable since they are produced first and

then sold. The key principle to this characteristic is that there has to be interaction

between the producer and consumer of the service to be realised. For example service

users of Home Care cannot benefit from the service without being present throughout

the whole process of producing the service. Inseparability means that production of

services is radically different from the production of manufactured goods. For

example mass production is not possible meaning that economies of scale can not be

realised (Zeithaml & Bitner, 1996); the method of production becomes key to the

success of the service, where as production methods are relatively unimportant when

producing manufactured goods (Palmer, 1994); the consumer may affect the outcome

of the service (negatively or positively) for himself and other consumers (Zeithaml &

Bitner, 1996).

Another characteristic of services is perishability meaning that they cannot be stored,

resold or returned (Gronroos, 2000; Hoffman & Bateson, 2002; Lovelock et al., 1999;

Palmer, 1994; Zeithaml & Bitner, 1996). For example an unused ticket to see U2

cannot be reused, saved or resold, where as a television can be used, saved or resold.

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This means that demand for services has to be managed more closely than products

(Palmer, 1994). Forecasting for peaks and troughs, planning for capacity utilisation

and the ability to implement recovery strategies if things go wrong are all necessary

for the successful management of services (Zeithaml & Bitner, 1996). However

Gronroos (2000) argues that although this may be true it is possible to “keep

customers in stock” (p48). For example if a restaurant is full customers could be

asked to wait in the bar until there is a free table (Gronroos, 2000).

Heterogeneity refers to the view that as a result of the personnel, and other customers,

involved in producing the service the service that one customer receives is not the

same as service another receives (Gronroos, 2000; Hoffman & Bateson, 2002;

Lovelock et al., 1999; Palmer, 1994; Zeithaml & Bitner, 1996). For example it is

impossible to control the mood of employees producing the service, which may

change from day to day and affect service production (Zeithaml & Bitner, 1996).

Heterogeneity makes it difficult for service organisations to ensure consistent service

quality (Lovelock et al., 1999). The consumers themselves also impact on the

consistency of the service if they do not articulate their needs (Zeithaml & Bitner,

1996) or if they have problems using equipment of understanding guidelines that

others did not have (Gronroos, 2000). According to Gronroos (2000) heterogeneity

creates one of the major issues of service marketing; “how to maintain an evenly

perceived quality of services produced and rendered to customers” (p49). However

heterogeneity could be an advantage if it were used to personalise the service to each

consumers individual needs (Hoffman & Bateson, 2002).

12

It is these differences between services and goods that have led to the development of

service marketing (Palmer, 1994; Zeithaml & Bitner, 1996). However Wyckham et

al., (1975) argued that the differences between services and products are not sufficient

to explain the different marketing needs of services. They argued that in the case of

some products, such as tropical fruits, it may be difficult to ensure consistency of

product quality therefore heterogeneity may be present. However the cause of the

inconsistent quality in tropical fruit may not be the same as the cause in services (the

personnel/consumer impact). According to Palmer (1994) the usefulness of the

identified service characteristics is in recognising the nature of services. However

Gronroos (2000) argues that inseparability of services creates the need for a different

approach to services marketing. Gronroos (2000) states that since product

consumption or outcome consumption, where customers consume the outcome of

production – the product, has a gap between production and consumption marketing is

needed to bridge the gap. However in service consumption or process consumption,

where the customer consumes the process of production and the process of production

itself is the most important part of the service, since the outcome of the process

(arriving at a destination, or withdrawing some money form the bank) is taken for

granted, or cannot be differentiated from other service providers, or cannot be

evaluated by the customer, there is no gap between production and consumption so

marketing needs to take a different role (Gronroos, 2000).

The differences between approaches to the marketing of physical goods and the

marketing of services can be illustrated using the marketing triangles as developed by

Kotler (1994).

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Product Marketing Triangle (Figure 2) Marketing/sales staff

Firm

Enabling Promises Giving promises Continuous External marketing product Sales development Keeping promises

Product Market

Product features Source: Adapted from Kotler, P. (1994) Marketing Management: Analysis, Planning, Implementation and Control,

p470. In the product marketing triangle above (figure 2) the sides of the triangle represent

enabling promises, giving promises and keeping promises. Physical products are the

outcome of various resources, people, materials, technology, knowledge and

information being managed to include features that consumers in the target market

require (Kotler, 1994). This is a closed process that the customer has no part in and

customers are therefore seen as anonymous individuals. It is the task of marketing to

discover what features the market wants and to give promises about the feature to the

market (Kotler, 1994). Promises are fulfilled through product features as discovered

by the marketing. Promises are given via mass marketing and sales and enabled

through continuous product development (Kotler, 1994). However in the service

marketing triangle (figure 3) the firm has to be more flexible as a result of the

consumer not being aware of what it is he wants until he is participating in the service

process (Gronroos, 2000). Also since services are intangible and inseparable it is not

possible to pre-produce the product (Gronroos, 2000). Therefore “customer –

perceived valued follows from a successful and customer – orientated management of

resources relative to customer sacrifice, not from a pre-produced bundle of features.”

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(Gronroos, 2000, p55). In the services marketing triangle promises are given by sales

and external marketing; promises are enabled by continuous resource development

and promises are kept by the effective management of resources and interactive

marketing (where the firm interacts with the consumer to deliver the service)

(Zeithaml & Bitner, 1996).

Services Marketing Triangle (Figure 3)

Firm Full time marketers and salespeople Enabling Promises Giving promises Continuous External marketing development Sales Internal Marketing Keeping promises Interactive marketing Part-time marketers and customer-orientated technologies and systems

Personnel Technology Knowledge Customer’s Time Customer

Customers

Source: Adapted from Kotler, P. (1994) Marketing Management: Analysis, Planning, Implementation and Control,

p470. Gronroos (2000b) believes that:

“The heart of services marketing is how the service (production) process and service

consumption process match each other, so that consumers and users perceive good

service quality and value…” (p15)

Therefore one of the aims of services marketing is to produce a service that

consumers perceive as being good quality. Lovelock (1999) concurs with this view

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and believes that inadequate service quality leads to a competitive disadvantage.

Zeithaml & Bitner (1996) believe that one of the main challenges services marketers

face is how to improve service quality and Palmer (1994) believes that service quality

is one of the differentiating factors consumers use when evaluating services.

Service quality has become the focus of much research as it influences organisations

performance, costs, profitability, customer satisfaction and customer loyalty (Leonard

& Sasser, 1982; Cronin & Taylor, 1992; Gammie, 1992; Hallowell, 1996; Chang &

Chen, 1998; Gummesson, 1998; Lasser et al. 2000; Silvestro & Cross, 2000;

Newman, 2001; Sureshcandar et al., 2002; Guru, 2003). It has also been recognised

that services make up a large proportion of many of the industrialised countries

economies. For example in 1989, when service quality research was prolific, the

service sector accounted for 69% of the USA’s GDP, 60% of Germany’s GDP, 56%

of Japan’s GDP, 62% of the UK’s GDP, and 67% of France’s GDP (World Bank,

1991). The lack of research into service quality, since research had concentrated on

goods quality (Parasuraman et al., 1985; Gronroos, 1984), also prompted research

into the area.

Perceived service quality is defined as: “global judgment, or attitude, relating to the

superiority of the service” (Parasuraman et al., 1988, p16). Quality is defined as:

“consistently meeting or exceeding customer’s expectations” [of the service]

(Creedon, 1988; Lewis, 1989; Moore, 1987). Perceived service quality has also been

defined as: “the degree and direction of discrepancy between consumer’s perceptions

and expectations” [of a service] (Parasuraman et al., 1988, p17). Although

perceptions are never explicitly defined by Parasuraman et al., (1988) Teas (1993)

16

paraphrases Parasuraman et al., (1988) by defining perceptions as: “consumer’s

beliefs concerning the service received” (p18). Expectations are defined as: “desires

or wants of consumers, i.e., what they feel a service should offer rather than would

offer” (Parasuraman et al., 1988, p17). It is important to recognise that service quality

is not objective; it is defined by what customers want (Webster & Hung, 1994).

Since it has been recognised that service quality is an important element of services

marketing (Blackiston, 1988; Cound, 1988; Cravens, 1988; Gronroos, 2000;

Langevin, 1988; Lovelock, 1999; Palmer, 1994; Sherden, 1988; Zeithaml & Bitner,

1996) a number of service quality models have been developed. One of the first to be

developed was the technical and functional quality model (Gronroos, 1982). Based on

consumer behaviour literature and the effects of expectations of goods performance

on post – consumption evaluations (Anderson, 1973; Cardozo, 1965, Cohen &

Goldberg, 1969; Lewin et al., 1944; Oliver, 1977; Olshavsky & Miller, 1972)

Gronroos (1982) developed the idea that perceived service quality was the result of

consumers evaluation of what they expected to receive from the service compared to

their perceptions of what they did receive (a disconfirmation paradigm). Gronroos

(1982) stated that because this has been found to be the case in consumer behaviour

(Oliver, 1977; Hansen, 1972) it must apply to services also. This is known as

perceived service quality.

Swan and Combs (1976), in research into perceived product performance, stated that

there are two dimensions to perceived performance: instrumental and expressive

performance. Instrumental performance relates to the technical dimension of a

product, for example the picture a television provides, and expressive performance

17

relates to the psychological level of performance (Swan & Combs, 1976). Gronroos

(1982) argues that these sub – processes can be applied to services marketing as

instrumental performance (renamed technical quality for services) corresponds with

the out come of the service, arriving at a destination after using a train service or

receiving some money from an ATM after a bank has stored it, and expressive

performance (renamed functional quality for services) corresponds with the process of

reaching the outcome, the conditions of the train journey or the usability of the ATM.

Gronroos (1982) also stated that the image of the firm will influence consumer

expectations. Image is built up by the technical and functional quality of a firm’s

service (Gronroos, 1982).

However the most important part of Gronroos’ (1982) model is the perceived service

quality approach, which is based on a disconfirmation paradigm. According to

Parasuraman et al. (1985) managers of service firms and researchers (Churchill &

Surprenant, 1982; Lehtinen & Lehtinen, 1982; Lewis & Booms, 1983; Sasser et al.,

1978; Smith & Houston, 1982) agree that service quality is based on a comparison of

expectations and perceptions of a service. This has become the predominant approach

to service quality research (Gronroos, 2000) and is the foundation of the SERVQUAL

instrument (Parasuraman et al., 1988), which has been extensively used in many

settings (Asubonteng et al., 1996; Buttle, 1994; Lovelock et al.1999)

Parasuraman et al. (1985) developed the Gap model of service quality using the works

of Sasser et al. (1978), Gronroos (1982) and Lehtinen & Lehtinen (1982) and from a

qualitative research study that both defined service quality and identified the

dimensions that consumers use to evaluate the perceived service quality (Parasuraman

18

et al., 1985, 1988). Parasuraman et al. (1985) identified five gaps, which they state

can be major challenges to the services marketer. The gaps are consumer expectations

– management perceptions of consumer expectations (gap 1), management

perceptions of consumer expectations – service quality specification (gap 2), service

quality specification – service delivery (gap 3), service delivery – external

communications (gap 4) and expected service – perceived service (gap 5)

(Parasuraman et al., 1985). They believe that perceived service quality: “depends on

the size and direction of gap 5” (Parasuraman et al., 1985, p46) and that that depends

on the tendencies of the other four gaps so that: “gap 5 = f (gap 1, gap 2, gap 3,

gap4)” (Parasuraman et al., 1985, p46).

Parasuraman et al., (1985) also identified ten dimensions that consumers employ

when developing expectations and perceptions of services, which can be used across a

broad range of services. The dimensions were reliability, responsiveness, competence,

access, courtesy, communication, credibility, security, understanding, and tangibles

(see appendix 3 for definitions and examples) (Parasuraman et al., 1985). However

the dimensions were collapsed into five: tangibles, reliability, responsiveness,

assurance and empathy (see appendix 4 for definitions) (Parasuraman et al., 1988).

The last two dimensions were incorporated to represent seven of the original items

(communication, credibility, security, competence, courtesy, understanding/ knowing

customers, and access) that were not distinct after scale purification (Parasuraman et

al., 1988).

However Parasuraman et al (1988) were most interested in gap 5, perceived service

minus expected service, and in 1988 developed SERVQUAL. SERVQUAL contained

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two sections each having 22 items (statements) that consumers would agree or

disagree with to varying levels via the use of a seven point likert scale (Parasuraman

et al. 1988). The first section of the section was intended to measure consumers’

expectations of a service; the second measured consumers’ perceptions of a service.

These individual scores for expectations and perceptions would be subtracted from

each other to determine the gap score (Parasuraman et al. 1988).

In 1991 Parasuraman et al. developed SERVQUAL further in response to criticism

most notably from Carman (1990). The original SERVQUAL items were altered so

that they would not ask for normative consumer expectations (what customers

expected from a service they had consumed) but would ask for consumer expectations

of an “excellent service” (p422). Parasuraman et al. (1991) believed this would reduce

unrealistic expectation scores, overall means of 6.22 in their study of a telephone

company, which had been present when the word “should” (p422) had occurred in the

original expectations items. They also changed some of the wording for the

perceptions items to make them parallel to the expectations items (Parasuraman et al.,

1991). Parasuraman et al. (1991) changed negatively worded items to positively

worded items as they were confusing to respondents, since the standard deviation was

higher (2.07) (p442) than the positive items (0.77), were considered “awkward and

not as meaningful as the positively worded items” (p422) by managers who reviewed

them and had lower reliability coefficients (Cronbach’s alphas). Two original items,

one under tangibles and one under assurance, were replaced with new items to reduce

confusion as recommended by managers who reviewed the items (Parasuraman et al.,

1991).

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However according to Smith (1995) “such ad hoc procedures for amending the

original SERVQUAL instrument questions the utility of the thorough and detailed

process … as the basis for development” (p259) when considering the extensive

testing and piloting undertaken during the development of the original SERVQUAL

items. According to Morrison Coulthard (2004) many replications of the study have

failed to confirm the validity and application of SERVQUAL. Although Smith (1995)

comments that this may be the result of the failure to replicate the methodology of

Parasuraman et al. (1991). As suggested by Parasuraman et al. (1991) most

researchers adapt the instrument to make it relevant to the service they are studying

(Morrison Coulthard, 2004). However Babakus and Boller (1992), Babakus and

Mangold (1992), Bowers et al, (1994), Carman, (1990), Cronin and Taylor (1992),

Finn and Lamb (1991), Headley and Miller (1993), Lytle and Mokwa (1992),

McAlexander et al. (1994), O’Connor et al. (1993) and Taylor and Cronin (1994)

have found similar Cronbach’s alpha reliability coefficients for the five SERVQUAL

dimensions confirming the reliability of the scale items that make up the dimensions.

According to Asubonteng et al. (1996), Brown et al. (1993) and Sureschandar et al.

(2001) the 22 SERVQUAL items are good predictors of service quality.

However SERVQUAL has been subjected to a number of conceptual and

methodological criticisms (Buttle, 1996; Gronroos, 2000; Lovelock et al.1999;

Morrison Coulthard, 2004). As discussed earlier SERVQUAL (Parasuraman et al.,

1988, 1991) is based on the concept of perceived service quality, which is based on a

disconfirmation paradigm. Cronin and Taylor (1992) concur with Carman (1990) that

there is little theoretical or empirical evidence to support this and suggest that an

attitudinal paradigm should be adopted. They argue that while service quality has

21

been defined as an attitude it has been measured using a disconfirmation paradigm,

which was intended to measure customer satisfaction and is therefore inconsistent

(Cronin and Taylor, 1992, 1994).

Cronin and Taylor (1992) also suggest that there is evidence (such as Bolton & Drew,

1991; Churchill & Surprenant, 1982; Mazis et al. 1975; Woodruff et al., 1983) that a

performance based measure of service quality would be more appropriate, meaning

that only perceptions should be measured. They developed the SERVPERF

instrument to do this. Avkiran (1999), Boulding et al. (1993), Brady et al. (2002)

Hahm et al. (1997), Lee et al. (2000) and McAlexander et al. (1994), have confirmed

the superiority of perception only measures of service quality. However it has been

argued that when measuring perceptions alone respondents may consider their

expectations in answering anyway (Lolosa et al., 1998).

SERVQUAL has also been criticised for focusing on process or functional quality, as

identified by Gronroos (1982). Cronin and Taylor (1992), Mangold and Babakus

(1991) and Richard and Allaway (1993) have argued that that outcome quality or

technical quality (Gronroos, 1982) is missing from SERVQUAL. However Higgins et

al. (1991) argued that technical quality is measured in the reliability, competence and

assurance dimensions. Sureschander et al. (2001) state that SERVQUAL lacks crucial

elements of service quality such as the core service, standardisation of service quality

and the image that a service firm may seek to create. Brady et al. (2002) believes that

measures of service quality should include the value of service and uncontrollable

factors such as emotions. This may be evidence to suggest that SERVQUAL

encapsulates only some aspects of service quality (Morison Coulthard, 2004).

22

Another criticism of SERVQUAL is that there is little evidence that consumers use

perceptions minus expectations to asses service quality (Buttle, 1996). Babakus and

Boller (1992) found that perceptions scores were the dominant contributor to the gap

score as there is a tendency for consumers to rate expectations high. It could be seen

as obvious that consumers will rate expectations as high since they are unlikely to

desire poor service quality. Iacobucci et al. (1994) believe that consumers’

expectations may not be clearly enough formed to be used as criteria for evaluation of

service quality. Teas (1993, 1994) has examined the meaning of the gaps. The same

gap score, for example –1, can be obtained in six different ways. Does each gap

constitute an equal perceived service quality? (Teas, 1993, 1994). Teas (1993, 1994)

also states that a high perceptions score (4, 5, 6 or 7) in a component that is not

considered essential, where expectations scores are 1, 2 or 3, creates a situation where

a company is rated highly for a service offering that is not important. Smith (1995)

supports this position.

The use of Likert scales in SERVQUAL has also been criticised (Morrison Coulthard,

2004). Molenaar (1982) reviewed the number of scale points used and concluded that

between 5 and 9 scale points should be used. Krosnick and Fabrigar (1997) and

Preston and Colman (2000) concur with this however Danaher and Haddrell (1996),

Brown et al. (1993) and Brady et al. (2002) believe that five point scales are superior

and Babakus and Mangold (1992b) advocate the use of a five point scale as this

reduces respondent frustration, increases response rate and response quality. The

labelling, strongly agree/disagree, of Likert scales has also been commented on. Smith

(1992) stated that points that are labelled in SERVQUAL, points 1 and 7, are likely to

23

be overused and Krosnick and Fabrigar (1997) believe labelling all points may reduce

bias. However Andrews (1984) concludes that labelling all points could result in

poorer data than labelling just the end points.

While there are many criticisms of SERVQUAL it is important to remember that has

been, and continues to be, one of the most widely used and important, models of

service quality and measurement (Asubonteng et al., 1996; Brown et al., 1993; Buttle,

1996; Grapentine, 1998; Lovelock et al., 1999). SERVQUAL (Parasuraman et al.

1988, 1991) has been applied to many industries including health care (Babakus and

Mangold, 1992; Bebko and Garg, 1995; Bowers et al., 1994; Clow et al., 1995; Curry

and Sinclair, 2002; Kilbourne et al., 2004).

When researching elderly consumer’s evaluation of the service quality of a day care

centre using a SERVQUAL questionnaire, Smith (1993) found elderly respondents

did not tick a box if they disagree with a statement; where verbal labels appeared on

the Likert scale respondents were unsure of its meaning and therefore did not answer;

elderly respondents had a tendency to rate service elements highly since they were

reliant on the service provider and because they have been used to poor conditions in

the past and therefore have lower expectations than other consumer groups; the

elderly have difficulty in answering questionnaires as a result of poor eyesight,

arthritis, other health related illnesses, shorter attention spans, confusion, a tendency

to become emotional and due to learning disabilities resulting in an inability to read.

To overcome these issues Smith (1993) suggested the use of structured interviews and

observation. However Hoinville (1983) believes that unstructured interviews should

24

be used, as elderly respondents are likely to have reduced concentration and

comprehension, although this will increase interviewer bias. Smith (1993) commented

on the problems of observation stating that it may be difficult to interpret behaviour,

especially when respondents may be suffering from physical and mental health

problems, although observation has advantages in addressing this consumer group as

they are more willing to discuss issues with “outsiders” (p18).

Smith (1993) also highlights the issue of friends and relatives who may be

gatekeepers (Hoinville, 1983) that restrict access to respondents by for example

answering on their behalf.

25

Hypotheses

• Respondent Home Care service users will rate Home Care’s service quality

highly.

• There will be no difference between male and female respondents in their

judgement of Home Care’s service quality in any dimension.

• The length of time respondent Home Care service users have used the service

for will not affect their judgement of Home Care’s service quality.

• Home Care employees will rate their service delivery highly.

Aim

• The main aim of this dissertation is to measure the level of service quality

provided by Home Care.

Objectives

• The dissertation will also evaluate possible reasons for Home Care’s

over/under performance of their service.

• The dissertation will examine links between classification data and response

data to further understand the level of service quality expected by different

groups based on geographical location and demographics of service users.

• The dissertation will also make recommendations as to possible areas for

improvement within Home Care.

• The dissertation will also make recommendations as to how Home Care can

improve its level of service quality.

26

Methodology The research took a descriptive path initially in order ‘to portray an accurate profile of

persons, events or situations’ (Robinson, 2002, p59) in terms of the level of service

quality delivered by Home Care. The research then became explanatory as it

attempted to identify the reasons for the levels of service quality being provided and

to identify relationships between variables (Saunders et al., 2007) in order to evaluate

the hypotheses. In order to meet the purposes of description and explanation the

research employed a survey strategy. This is deemed the most suitable approach for

descriptive and explanatory research, as it produced quantitative data that can be

analysed quantitatively using descriptive and inferential statistics, which can be

analysed to evaluate possible reasons for relationships between variables (Saunders et

al., 2007). Of the possible data collection methods used for a survey strategy,

structured observation, structured interviews, and questionnaires, observation is not

possible due to limited access granted for the study, it may have been time consuming

to carry out, financially expensive and require many ‘observers’, which are not

available. Therefore a structured interview and self-administered, delivery and

collection questionnaires were used. However in order to gain a full understanding of

Home Care a semi – structured interview was carried out with the manager of the

organisation.

This strategy is also convergent with the SERVQUAL model (Parasuraman et al.,

1988), which prescribes a questionnaire for measuring the consumers perceived and

expected service quality (gap 5). For the purpose of this research the questionnaire has

been adapted in order to increase reliability and validity, since in its present form

respondents may not have understood it (Smith, 1993). As Parasuraman et al.’s

27

(1988) questionnaire is considered valid and reliable (Babakus and Boller, 1992;

Babakus and Mangold, 1992; Bowers et al., 1994; Carman, 1990; Cronin and Taylor,

1992; Finn and Lamb, 1991; Headley and Miller, 1993; Lytle and Mokwa, 1992;

McAlexander et al., 1994; O’Connor et al., 1994; Taylor and Cronin, 1994), and as

they recommend that it is not altered radically, the main changes have been to the

language used, which has been simplified, in order to make it easy to understand. In

Parasuraman et al.’s (1988, 1991) original questionnaire they use a seven point Likert

scale, however this may confuse respondents (Smith, 1993). Therefore respondents

have been asked to state how strongly they agree or disagree with statements relating

to how they feel about the service provided and what they think the service should be

providing, by rating their opinions on a five point Likert scale (Danaher and Haddrell,

1996; Brown et al. 1993; Brady et al. 2002). This questionnaire has been pilot tested

by asking the manager and senior Home Care team for their evaluation of suitability

for Home Care service users. The questionnaire has also been given to people who

have received care from other providers, in order to test reliability and validity.

However Parasuraman et al. (1985) do not suggest methods for evaluating the other

service gaps (gaps 1, 2, 3 and 4) therefore it is necessary to consider methods for

evaluating of these gaps. Gap 1 measures ‘the difference between consumer

expectations and management perceptions of those expectations’ Parasuraman et al.

(1985, p44). Consumer expectations of Home Care’s service have been measured as

detailed above. Manager’s perceptions of consumer’s expectations of Home Care’s

service have been measured via a structured interview. This has been based around

the same SERVQUAL dimensions as those used for the consumers of Home Care’s

service – Tangibles, Reliability, Responsiveness, Assurance and Empathy

28

(Parasuraman et al. 1988, 1991). Statements in each service quality perceptual

dimension have been based around the same individual items, such as the quality of

equipment (tangibles), in order that the results are comparable. The manager has been

asked to rate what she believes consumers expect from Home Care’s service by rating

how strongly she agrees or disagrees with the statements provided on a five point

Likert scale. The interview questions were pilot tested by asking the manager to

evaluate the questions for suitability.

By using a structured interview there is high confidence that the correct person will

respond, the interviewer can ensure that statements are fully understood, therefore

increasing validity. However using a structured interview may lead to contamination

or distortion of the respondents answer by interviewer bias, where the way statements

are read or the non – verbal behaviour of the interviewer leads to interviewees

responding in a bias way (Saunders et al., 2007). However since this is a structured

interviews are standardised this will be kept to a minimum.

The results from the structured interview with the manager of Home Care have also

been compared to the service quality specification used by Home Care to measure gap

2 – the difference ‘between management perceptions of consumer expectations and

the firm’s service quality specification’ (Parasuraman et al., 1985). The service

specification has been analysed and evaluated under each of the SERVQUAL

dimensions.

The service quality specification, or quality standards (West Sussex County Council,

2003), has also been compared to the employees (care staff) perception of the service

29

they deliver in order to measure gap 3 ‘the gap between service quality specification

and actual service delivered’ Parasuraman et al. (1985). Where similarities exist

between the statements made in Home Care’s quality standards and statements used to

measure employees perception of the service quality (in the questionnaire) the

employees perception of service quality has been taken as representative of the level

of achievement of Home Care’s quality standards. The employee’s perception of the

service delivered has been ascertained through a delivery and collection

questionnaire, where respondents have been asked to rate how strongly they agree or

disagree with statements relating to service quality, on a five point Likert scale, in

terms of the five SERVQUAL dimensions. This has been pilot tested by asking the

senior Home Care team and manager to evaluate the suitability of the questions and

suggestions for any changes that may be necessary.

Gap 4 ‘the gap between actual service delivery and external communications about

the service’ (Parasuraman et al., 1985) has not been measured as Home Care service

users are referred to Home Care via social workers and Home Care does not pursue

external marketing activities, therefore this gap does not apply to Home Care.

The sampling method was census for the questionnaire to Home Care service users

and 240 questionnaires were sent out via Home Care carers; 11.25% responded. The

sample frame for questionnaires to Home Care carers was all those people who

worked for Home Care. The sampling method for this group was also census and 160

questionnaires were sent out in employees schedules of work with an accompanying

letter to explain what to do with them. The response rate for this group was 12.5%.

Quantitative techniques used were Chi Square tests to asses the null hypotheses –

30

there will be no difference between male and female respondents in their judgement

of Home Care’s service quality in any dimension and the length of time respondent

Home Care service users have used the service for will not affect their judgement of

Home Carers service quality.

Results

Demographics of Respondent Service Users

The age range of respondents was from 36 to 76+ years with one respondent stating,

without being asked, their age to be 95 years. Of the 27 respondent Home Care

service users 4% (or 1 respondent) were between 36 – 45 years old, 4% (1

respondent) were between 46 – 55 years old, 11% (3 respondents) were between 56 –

65 years old, 22% (6 respondents) were between 66 – 75 years old and 59% (16

respondents) were 76 years old plus (see appendix 4). 74% (20 respondents) of

respondent Home Care service users were females and 26% (7 respondents) were

males (see appendix 5). 9 respondent service users (33%) lived in Crawley, 4 (14.8%)

lived in Horsham, 3 (11%) lived in Billingshurst, 3 (11%) lived in Hassocks, 2 (7%)

lived in East Grinstead and 1 (3.7%) lived in each of the following: Southwater,

Steyning, Turners Hill, Crawley Down, Henfield and Hurstpierpoint (see appendix 6).

Respondent’s length of service use ranged from 2 weeks to 42 years. 30% (8

respondents) of respondents had used Home Care’s service for less than 1 year, 15%

(4 respondents) for 6 months to 1 year, 22% (6 respondents) for 1 year and 1 month to

2 years, 15% for 2 years 1 month to 6 years, 7% (2 respondents) for 6 years 1 month

to 12 years, 4% (1 respondent) for 12 years 1 month to 18 years, 0% for 18 years 1

month to 24 years and 7% (2 respondents) for 24 years plus (see appendix 7).

31

Demographics of Respondent Home Care Employees

The age range of respondent Home Care employees was from 25 to 75 years old. 5%

(1 respondent) was between 25 and 35 years old, 20% (4 respondents) were aged

between 36 and 45 years, 20% (4 respondents) were aged between 46 and 55 years,

45% (9 respondents) were aged between 56 and 65 years and 10% (2 respondents

were aged between 66 and 75 years (see appendix 8). All respondent employees were

female. 5% (1 respondent) of respondent employees were full time employees and

95% (19) were part time (see appendix 9). 35% (7 respondents) of respondent

employees were relief (employees that work when permanent staff are away due to

sickness of holiday), and 65% (13 respondents) were permanent (having fixed

contracted hours of work) (see appendix 10). The mean average years employees have

worked for Home Care was 14.85, the median was 15.25 and the mode was 31. The

manager was a female aged 46 – 55, working full time for approximately 3.5 years.

Gap 5 – Perceived Service Minus Expected Service

As discussed in the literature review SERVQUAL measures service quality by

subtracting the consumer’s expectations of an excellent service from their perceived

service (both rated by the consumer on a five point Likert scale) to produce a gap

score (Parasuraman et al., 1988; 1991). Appendix 11 shows graphically item scores.

The mean average gap score for all items measured (see appendix 12 &13 for items)

was –0.30 (or –6.35%) indicating that respondents felt the service quality offered by

Home Care was slightly below what they would expect from an excellent care service.

32

This means that the hypothesis that respondent Home Care service users will rate

Home Care’s service quality highly has been disproved.

When breaking the overall service quality down into the individual dimensions,

tangibility, reliability, responsiveness, assurance and empathy (Parasuraman et al.,

1988; 1991) (see appendix 14 for gap scores for each dimension), responsiveness had

the largest negative gap, -0.44, indicating that Home Care service users felt Home

Care employees were less willing to help them and provide a less prompt service than

an excellent care service would. However within the responsiveness dimension item

10 “staff of an excellent care service will tell service users exactly when they will

perform the service” had the largest negative gap of –0.64 indicating that service users

felt this aspect of the service was below their expectations of an excellent care

service.

The tangible dimension had the next largest negative gap of the 5 dimensions, -0.38,

indicating that respondent Home Care service users felt the quality of the physical

facilities, equipment, and appearance of personnel (Parasuraman et al., 1988; 1991)

was below what they expected from an excellent care service. However part of the

tangibles dimension is item 3 “staff will be of neat appearance”. This item had a

positive gap score of 0.07 indicating that respondents felt Home Care were exceeding

their expectations of an excellent care service. This may lead to the conclusion that

the other areas addressed by the tangibles dimension - that an excellent care service

has modern effective equipment, which is not out of place in their homes and satisfies

service users needs- are considered to be below the service users expectations of an

33

excellent care service. These items had negative gaps of –0.64, -0.32 and -0.64

respectively.

Reliability had the third largest negative gap of the dimensions, -0.37; meaning that

respondent service users felt that Home Care’s “ability to perform the promised

service dependably and accurately” (Parasuraman et al., 1988; 1991) below their

expectations of an excellent care service. However within the reliability dimension

item 9 “an excellent care service will insist on error free records” had the largest

negative gap score of all 22 items at –0.68, indicating that respondent service users

felt that Home Care’s service quality was below their expectations of an excellent

care service in this item more so than any other.

Empathy had the fourth largest negative gap score of –0.22. This shows that

respondent service users felt Home Care’s service quality was below their

expectations of an excellent care service, however to a lesser degree than the

dimension mentioned above. Of the 5 items incorporated in this dimension item 19

“an excellent care service will provide its services at a time convenient to service

users” had the largest negative gap of –0.64 indicating that respondent service users

felt this was an area Home Care could improve on.

Assurance scored the lowest negative gap score of –0.08 indicating that respondent

service users felt this was the area Home Care was offering service quality close to

what they would expect from an excellent care service. Within in this dimension the

largest negative gap score was –0.25 for item 15 “service users of an excellent care

service will feel safe in their dealings with staff” showing that respondent service

34

users felt Home Care’s service quality was below their expectations of an excellent

care service. However item 16 “staff of an excellent care service are polite to service

users” and item 17 “staff of an excellent care service will be able to answer questions

from service users” had positive gap scores of 0.04 and 0.07 respectively. This shows

that respondent service users felt Home Care was offering service quality that exceeds

their expectations of an excellent care service.

Chi Square Tests

The null hypothesis that there will be no difference between male and female

respondents in their judgment of Home Care’s service quality in any of the

SERVQUAL dimensions was tested using a Chi Square test (x2). Chi Square tests

were carried out for each dimension and for the overall service quality (see appendix

15). When testing for a relationship between gender and the tangible dimension x2 =

0.021560081. With a degree of freedom of 1 the critical value was 1.32 at a 75%

probability of a relationship meaning that the null hypothesis could be accepted as x2

was less than this meaning that there was no relationship between the variables (see

appendix 15). When testing for a relationship between gender and the reliability

dimension x2 = 0.02 and the degree of freedom was 1 meaning the critical value was

1.32 at 75% probability of a relationship. Since x2 = 0.02, and is therefore less than

the critical value of 1.32 the null hypothesis could be accepted as there is no

relationship between the variables (see appendix 15 for workings). When testing for a

relationship between gender and the responsiveness dimension x2 = 0.00480167. This

is less than the critical value, at 1 degree of freedom, of 1.32 at 75% probability of a

relationship indicating that there was no relationship between the variables and the

35

null hypothesis could be accepted. x2 = 0.07076587 when testing for a relationship

between gender and the assurance dimension. The degree of freedom was 1 resulting

in a critical value of 1.32 at 75% probability of a relationship. As x2 = 0.03521474 the

null hypothesis could be accepted since x2 was less than 1.32 indicating that there was

no relationship. x2 = 0.03521474 when testing for a relationship between gender and

the empathy dimension. The degree of freedom was 1 resulting in a critical value of

1.32 at 75% probability of a relationship. As x2 = 0.03521474 the null hypothesis

could be accepted since this is less than the critical value of 1.32 meaning that a

relationship was unlikely to exist.

The Chi Square test result for a relationship between perceived service quality and

gender was x2 = 0.31532774. The degree of freedom was 1 meaning a critical value of

1.32 at 75% probability of a relationship. Since x2 = 0.31532774 below the critical

value, 1.32, the null hypothesis was accepted as there was no relationship present.

A second Chi Square test was carried out to test the hypothesis that the length of time

respondent Home Care service users have used the service for will not affect their

judgement of Home Care’s service quality. The Chi Square test result (see appendix

16) for this was x2 = 0.162665419. The degree of freedom was 6 therefore the critical

value was 7.84 at 75% probability of a relationship. Since x2 = 0.162665419, less than

the critical value of 7.84 it is unlikely that a relationship exists between the variables.

Therefore the null hypothesis could be accepted.

36

Gap 3 – Service Quality Specification – Service Delivery Gap

Home Care’s service quality specification (Parasuraman, 1985) or Quality Standards

(West Sussex County Council, 2003) are a set of statements describing the intended

outcome of the service in different areas of operation. There are 27 standards in total,

which can be seen in appendix 17 however only 12 of them corresponded with the

items given in the questionnaires used to measure employee perceptions of service

quality (see appendix 18). The mean average of the employees’ perceptions of service

quality that corresponded with Home Care’s Quality Standards was 4.656 (out of a

possible 5). If Home Care’s employees believed they were delivering a service that

met their Quality Standards they would be expected to perceive Home Care’s service

quality as high, therefore scoring it as 5 on average (the highest possible score).

Therefore there was a gap between Quality Standards and service delivery (gap 3).

The lowest employee perception of service quality mean average score was 4 for

Quality Standard 22 “service user receive a consistent, well managed and planned

service”. This was related to items 7, 8 and 10 (see appendix 19). Although employee

perceptions of service quality were relatively low for these items (see appendix 18 &

20), items 8 and 10 were rated, on average, 4, indicating that employees felt this was

an area of the service that was not being performed well. The highest employee

perception of service quality scores related to Quality Standards 14, 15, 25 and 27,

which all received scores of 4.95 (see appendix 18); higher than the average by 0.29

indicating that employees felt service quality is high in these areas.

37

Gap 2 – Manager Perceptions of Consumer Expectations – Service Specification

Gap 2 refers to situations where managers understand consumer’s expectations but

“the perceived means to deliver to expectations… do not” (Parasuraman et al., 1985,

p45). In applying this to Home Care it was expected that managers perceptions of

consumer’s expectations would match or exceed consumers actual expectations but

consumers expectations would still not be met or exceeded resulting in a negative gap

score. Appendix 21 shows the difference between the manager’s perceptions of

service users expectations, service users expectations and gap scores derived from

service users perceptions of Home Care’s service minus their expectations of an

excellent service. The manager’s perceptions of service users expectations exceed

service users actual expectations for items 1, 3, 4, 15, 20 and 21. Of these item three

was the only one where service users gap scores were positive, 0.07, indicating that

Home Care were exceeding service users expectations of an excellent service. Items 1

and 4 had gap scores of –0.64 indicating that service users felt Home Care were not

meeting their expectations of an excellent care service; item 15 had a gap score of –

0.25 indicating that service users felt Home Care were offering service quality close

to their expectations; item 20 had a gap score of –0.04 indicating that Home Care

were very close to meeting their expectations and item 21 had a gap score of –0.07

also indicating that service users felt Home Care were offering a service close to their

expectations. Therefore the main areas were Home Care’s manager understands

service users expectations but cannot deliver to them are items 1, which relates to the

use of modern and effective equipment, and 4, which relates to the equipment

supplied satisfying service user needs (both relating to the tangible dimension). This

38

may correspond with the lack of acknowledgment of tangibles items in Home Care’s

Quality Standards.

Gap 1 – Consumers Expectations – Manager Perceptions of Consumer Expectations

As discussed in the literature review Parasuraman et al. (1985) stated that managers

may not always understand what constitutes high service quality to consumers, which

will have an impact on service quality as seen by consumers. Appendix ** shows

Home Care’s managers perception of consumers expectation and consumers

expectations. The first thing to note about this graph is that Home Care service users

clearly expected more from “an excellent care service” than the manager perceived

they would indicating that Parasuraman et al.’s (1985) hypothesis was correct. The

mean average for service users expectations was 4.72 however the mean average of

the manager’s perception of service users expectations was 4.23, which is 10.38%

lower. Therefore this is likely to have a negative impact on Home Care’s service

quality.

Conclusions and Recommendations

In conclusion most respondents were between 66 and 76 +, 81%, with 22% being

between 66 and 75 years and 59% being 76+ years, indicating that the majority of

service users fell into the older age ranges. 74% of respondents were females and

although respondents came from a wide geographical spread, 33% lived in Crawley.

67% had used Home Care for up to 2 years, with the 30% having used Home Care for

less than 1 year. 45% of respondent Home Care employees were aged between 55 and

66 years and 10% were aged 66 to 75 years indicating that the majority of employees

39

fell into the older age ranges. All respondent employees were female, 95% worked

part time and on average (mean) employees had worked for Home Care for 14.85

years indicating that employees tend to remain employed by Home Care for some

time.

The SERVQUAL analysis of service users perception – expectation gap scores

revealed that service users felt that the level of service quality delivered by Home

Care was lower, by –0.30 or –6.35%, than they would expect from an “excellent care

service”, therefore disproving the hypothesis that Home Care’s service users will rate

Home Care’s service quality highly. When breaking the overall service quality down

into individual dimensions responsiveness was had the largest negative gap score, -

0.44 indicating that Home Care should improve service quality by improving

communication with service users about their service, giving a prompt service, being

more willing to help service users and having more time with service users. When

taking into account the individual item scores within the responsiveness Home Care

should pay particular attention to improving communication with service user about

when they will receive their service as this item had the lowest negative gap score of –

0.64.

The tangible dimension had the next largest negative gap of the 5 dimensions at -0.38.

When examining the individual item scores Home Care should concentrate on

improving equipment so that it is modern, effective and meets the needs of service

users (these items, 1 and 4, received negative gap scores of –0.64).

40

The next largest negative gap score was –0.37 for reliability. The specific areas Home

care should concentrate on in this dimension are improving their record keeping,

which had the largest negative gap of all items at –0.68, and performing the service at

the time they promise to do so, which had a negative gap score of –0.61.

Empathy had a gap score of –0.22 indicating that Home Care was closer to service

users expectations in this dimension. However Home Care could improve this area by

providing service at a time convenient to service users; this item had a negative gap

score of –0.64. However this may not be possible due to time constraints and when

considering that it is likely that all service users might expect to receive their service

at the same time the human resource are probably not available.

Home Care have performed most closely to what service users expect in the assurance

dimension, which had a gap score of -0.08. Within this dimension Home Care should

improve service quality by making service users feel safer when dealing with staff;

this item had a gap score of –0.25.

Chi Square test results confirmed the null hypotheses that there would be no

difference between male and female respondents in their judgement of Home Care’s

service quality in any dimension and that the length of time respondent Home Care

service users have used the service for will not affect their judgement of Home Care’s

service quality.

Analysis of gap 3, the service quality specification to service delivery gap, showed

that there is a gap between the service quality specification and service delivery. This

41

is because Home Care employees mean average score, for items that corresponded

with statements in Home Care’s Quality Standards, was 4.656 and (making the

assumption that) if employees perceived they were delivering the standards they

would have scored them as 5 out of 5. However although this may be a cause of

reduced service quality (Parasuraman et al., 1985) it may be difficult to improve due

to the variability of employee performance, which is characteristic of services because

of inseparability, and heterogeneity (Hoffman & Bateson, 2002; Lovelock et al.,

1999; Palmer, 1994; Zeithaml & Bitner, 1996).

Analysis of gap 2, the gap between manager perceptions of consumer expectations

and the service specification, revealed that there might be areas of service quality that

where the manager understands service users expectations but does not have the

means to deliver to them. The main area this applies to is tangibles, which is not

mentioned at all in Home Care’s Quality Standards, and in specific the provision of

modern effective equipment that meets the needs of service users.

Examination of gap 1, the gap between the manager’s perceptions of service users

expectations and service users expectations, shows that the manager perceived

consumers would expect less from an excellent care service than they did (since the

managers perception of consumers expectation was 4.23, out of 5, compared to

consumers expectations score of 4.72, out of 5, on average. This may result in reduced

service quality through a poorly designed service quality specification, meaning that

Home Care would be aiming to achieve service quality at a lower level than what is

expected by consumers. However if the Home Care manager recognises that

42

consumers have high expectations, she could alter the specifications and improve

service quality.

43

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57

Service Quality Model (Appendix 1)

Source: Parasuraman, A., Berry, L.L. & Zeithaml, V.A., (1985) A conceptual Model of Service Quality and its Implications for Future Research, Journal of Marketing, (49), p44.

58

Definitions and Examples of Dimensions (Appendix 2)

Source: Parasuraman, A., Berry, L.L. & Zeithaml, V.A., (1985) A conceptual Model of Service Quality and its Implications for Future Research, Journal of Marketing, (49), p47.

59

SERVQUAL Dimensions (Appendix 3) Dimension Definition Items in scale Tangibles Physical facilities, equipment and appearance of

personnel. 4

Reliability Ability to perform the promised service dependably and accurately. 5

Responsiveness Willingness to help customers and provide prompt service. 4

Assurance Knowledge and courtesy of employees and their ability to inspire trust and confidence. 5

Empathy Caring, individualised attention the firm provides its customers. 4

Source: Adapted from Parasuraman et al. (1988).

Age of Respondent Service Users (Appendix 4)

4%

4%

11%

22%59%

36 - 4546 - 5556 - 6566 - 7576+

Gender of Service Users (Appendix 5)

74% 26%FemaleMales

60

Area of Residence of Respondent Service Users (Appendix 6)

0123456789

10

Crawley

Horsha

m

Southw

ater

Steynin

g

Billings

hurst

Hasso

cks

Turners

Hill

Crawley

Dow

n

Henfie

ld

Hurstpi

erpoin

t

East G

rinste

ad

Area

Num

ber o

f Ser

vice

Use

rs

Length of Service Use (Appendix 7)

30%

15%

15%

7%

4%7%

22%

Less 6 months6 months to 1 year1 Year 1 month to 2 years2 years 1 month to 6 years6 years 1 month to 12 years 12 years 1 month to 18 years18 years 1 month to 24 years24 yeas +

Age of Home Care Employees (Appendix 8)

0

2

4

6

8

10

16 - 24 25 - 35 36 - 45 46 - 55 56 - 65 66 - 75 75+Age

Num

ber o

f Em

ploy

ees

61

Number of Home Care Employees Working Full/ Part Time (Appendix 9)

0

5

10

15

20

Full Time Part Time

Num

ber o

f Em

ploy

ees

Number of Employees that have Relief/Permenant Contracts (Appendix 10)

02468

101214

Relief Permanent

Num

ber o

f Em

ploy

ees

Mean Average Gap Scores for Gap 5 - Perception minus Expectation = Service Quality (Appendix 11)

-0.80

-0.60

-0.40

-0.20

0.00

0.20

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

Item

Gap

Sco

re

62

Items Used to Measure Perceptions (Appendix 12)

1. Home Care has modern and effective equipment. 2. Equipment supplied by Home Care is not out of place in your home. 3. Home Care’s staff are of neat appearance. 4. The equipment supplied by Home Care satisfies your needs. 5. When Home Care promise to do something by a certain time, they keep their promise. 6. When you have a problem, Home Care will show a sincere interest in solving the problem. 7. Home Care performs the service right the first time. 8. Home Care provides their services at a time they promise to do so. 9. Home Care insists on error free records. 10. Home Care staff tell you exactly when they will perform the service. 11. Staff of Home Care gives prompt service to you. 12. Staff of Home Care are always willing to help you. 13. Staff of Home Care are never too busy to respond to your requests. 14. The behaviour of staff of Home Care instils confidence in you. 15. You feel safe in your dealings with Home Care staff. 16. Staff of Home Care are polite to you. 17. Staff of Home Care are able to answer questions from you. 18. Home Care gives you individual attention. 19.Home Care provides its services at times convenient to you. 20. Home Care has staff that give you personal attention. 21. Home Care has your best interests at heart. 22. The staff of Home Care understand your specific needs.

63

64

Items Used to Measure Perceptions of Home Care (Appendix 13)

1. An excellent care service will have modern and effective equipment. 2. Any equipment supplied by an excellent care service will not be out of place in the service users home. 3. Staff will be of neat appearance. 4. The equipment supplied by an excellent care service will satisfy the service users needs. 5. When an excellent care service promises to do something by a certain time, they keep their promise. 6. When service users have a problem, an excellent care service will show a sincere interest in solving the problem. 7. An excellent care service will perform the service right the first time. 8. An excellent care service will provide their services at a time they promise to do so. 9. An excellent care service will insist on error free records. 10. Staff of an excellent care service will tell service users exactly when they will perform the service. 11. Staff of an excellent care service will give prompt service to customers. 12. Staff of an excellent care service will always be willing to help service users. 13. Staff of an excellent care service will never be too busy to respond to customer requests. 14. The behaviour of staff of an excellent care service will instil confidence in service users. 15. Service users of an excellent care service will feel safe in their dealings with staff. 16. Staff of an excellent care service will be polite to service users. 17. Staff of an excellent care service will be able to answer questions from service users. 18. An excellent care service will give service users individual attention. 19. An excellent care service will provide its services at times convenient to service users. 20. An excellent care service will have staff that give service users personal attention. 21. An excellent care service will have service users best interests at heart. 22. The staff of an excellent care service will understand the specific needs of their service users.

Gap Scores for each Dimension (Appendix 14) Dimension Mean Average Gap Score Tangibles -0.38 Reliability -0.37 Responsiveness -0.44 Assurance -0.08 Empathy -0.22 Overall Perceived Service Quality -0.30

Chi Square Tests (Appendix15) Tangibles Obs Exp o-e o-e-.5 = A A2 A2/e Males 4.785714286 5 -0.214285714 -0.285714 0.08163249 0.016326498 Females 4.661764706 5 -0.338235294 -0.161765 0.02616792 0.005233583 0.021560081 x2 Reliability Obs Exp o-e o-e-.5 = A A2 A2/e Males 4.8 5 -0.2 -0.3 0.09 0.018 Females 4.6 5 -0.4 -0.1 0.01 0.002 0.02 x2 Responsiveness Obs Exp o-e o-e-.5 = A A2 A2/e Males 4.428571429 5 -0.571428571 0.071429 0.0051021 0.00102042 Females 4.6375 5 -0.3625 -0.1375 0.01890625 0.00378125 0.00480167 x2 Assurance Obs Exp o-e o-e-.5 = A A2 A2/e Males 4.928571429 5 -0.071428571 -0.428571 0.1836731 0.03673462 Females 4.9125 5 -0.0875 -0.4125 0.17015625 0.03403125 0.07076587 x2 Empathy Obs Exp o-e o-e-.5 = A A2 A2/e Males 4.771428571 5 -0.228571429 -0.271429 0.0736737 0.01473474 Females 4.82 5 -0.18 -0.32 0.1024 0.02048 0.03521474 x2 Percieved Service Quality Obs Exp o-e o-e-.5 = A A2 A2/e Males 4.821428571 5 -0.178571429 -0.321429 0.1033166 0.02066332 Femeles 4.733125 5 -0.266875 -0.233125 0.05434727 0.010869453 0.031532774 x2

65

67

Chi Square Test - Length of Service use will not affect Judgement of Service Quality (Appendix 16)

Length of service use

Number of Service Users

Obs Average Gap Score Exp o-e = A A2 A2/e

Less 6 months 8 4.9734375 5 -0.0265625 0.00070557 0.000141113 6 months to 1 year 4 4.7125 5 -0.2875 0.08265625 0.01653125 1 Year 1 month to 2 years 6 4.570833333 5 -0.429166667 0.18418403 0.036836806 2 years 1 month to 6 years 4 4.75 5 -0.25 0.0625 0.0125 6 years 1 month to 12 years 2 4.9125 5 -0.0875 0.00765625 0.00153125 12 years 1 month to 18 years 1 4.525 5 -0.475 0.225625 0.045125 18 years 1 month to 24 years 24 yeas + 2 4.5 5 -0.5 0.25 0.05 0.162665419x2

Quality Standards of Home Care (Appendix 17) User Focused Services

1. Current and potential service users and their relatives have access to comprehensive information, so that they can make informed decisions on whether the agency is able to meet their specific care needs.

2. The care needs and requirements of service users and their personal or family careers when appropriate are individually assessed before they are offered a personal domiciliary care service.

3. Service users, their relatives and representatives know that the agency providing their care service has the skills and competences required to meet their care needs.

4. Each service user has a written individual service contract or equivalent for the provision of care, with the agency, except employment agencies solely introducing workers.

5. Service users and their relatives or representatives know that their personal information is handled appropriately and that their personal confidence is respected.

6. Service users receive a flexible, consistent and reliable personal care service. Personal Care

7. The care needs, wishes, preferences and personal goals for each individual service user are recorded in their personal service user plan, except for employment agencies solely introducing workers.

8. Service users feel that they are treated with respect and valued as a person, and their right to privacy is upheld.

9. Service users are assisted to make their own decisions and control their own lives and are supported in maintaining their independence.

10. The agency’s policy and procedures on medication and health related activities protect service users and assists them to maintain responsibility for their own medication and to remain in their own home, even if they are unable to administer their medication themselves.

Protection

11. The health, safety and welfare of service users and care and support staff is promoted and protected.

12. The risk of accidents and harm happening to service users and staff in the provision of personal care is minimised.

13. The money and property of service users is protected at all times whilst providing the care service.

14. Service users are protected from abuse neglect and self harm. 15. Service users are protected and are safe in their home. 16. The health rights and best interests of service users are safe guarded by

maintaining a record of key events and activities undertaken in the home in relation to the provision of personal care.

68

Managers and Staff

17. The well – being, health and security of service users is protected by the agency’s policies and procedures on recruitment and selection of the staff.

18. Service user benefit from clarity of the staff roles and responsibilities. 19. Service users know that staff are appropriately trained to meet their personal

care needs. 20. The personal care of service users is provided by qualified and competent

staff. 21. Service users know and benefit from having staff who are supervised and

whose performance is appraised regularly. Organisation and Running of the Business

22. Service user receive a consistent, well managed and planned service. 23. The continuity of the service provided to service users is safe guarded by the

accounting and financial procedures of the agency. 24. The rights and best interests of service users are safeguarded by the agency

keeping accurate and up to date records. 25. The service users rights, health, and best interests are safeguarded by robust

policies and procedures which are consistently implemented and constantly monitored by the agency.

26. Service users and their relative or representatives are confident that their complaints will be listened to, taken seriously and acted upon.

27. The service is run in the best interests of the service users.

69

Gap between Service Specification (Quality Standards) and Managers Perceptions of Service User Expectations (Appendix 18) Quality Standard Questionnaire Item Employee

Perception Score out of 5 (mean average)

2.The care needs and requirements of service users and their personal or family careers when appropriate, are individually assessed before they are offered a personal domiciliary care service.

22. Employees understand service users specific needs.

4.65

6. Service users receive a flexible, consistent and reliable personal care service.

10. Service users are informed of exactly when staff will perform the service. 11. Employees provide prompt service. 12. Employees are always willing to help service users. 13. Employees are never too busy to respond to service users requests.

4.00 4.25 4.95 4.65 Av = 4.46

7. The care needs, wishes, preferences and personal goals for each individual service user are recorded in their personal service user plan.

9. Staff insist on error free records. 18. Employees give service users individual attention. 22. Employees understand service users specific needs.

4.25 5.00 4.65 Av = 4.63

8. Service users feel that they are treated with respect and valued as a person, and their right to privacy is upheld.

12. Employees are always willing to help service users. 13. Employees are never too busy to respond to service users requests. 16. Employees are polite to service users.

4.95 4.65 5.00 Av = 4.86

14. Service users are protected from abuse neglect and self -harm.

15. Employees make service users feel safe when caring for them. 4.95

15. Service user are protected and are safe in their home.

15. Employees make service users feel safe when caring for them. 4.95

16. The health, rights and best interests of service users are safe guarded by maintaining a record of key events and activities

9. Employees insist on error free records.

4.25

22. Service users receive a consistent, well managed and planned service.

7. Staff perform the service right the first time. 8. Staff provide care services at the time you are scheduled to. 10. Service users are informed of exactly when staff will perform the service.

4.25 4.00 4.00 Av = 4.08

70

24. The rights and best interests of service users are safeguarded by the agency keeping accurate and up to date records.

9. Staff insist on error free records.

4.25

25. The service users rights, health, and best interests are safeguarded by robust policies and procedures which are consistently implemented

21. Employees have service users best interests at heart.

4.95

26. Service users and their relative or representatives are confident that their complaints will be listened to, taken seriously and acted upon.

6. When service users have a problem, staff make every effort to help them. 4.90

27. The service is run in the best interests of the service users.

21. Employees have service users best interests at heart. 4.95

Items Used to Measure Home Care’s Employees Perception of Service Quality Delivered (Appendix 19)

1.The equipment you use is modern and effective. 2. Equipment supplied to service users is not out of place in their homes. 3. When working you are of neat appearance. 4. The equipment you use satisfies service users needs. 5. When you are scheduled to perform a task at a certain time you do. 6. When service users have a problem, you make every effort to help them. 7. You perform the service right the first time. 8. You provide care services at the time you are scheduled to. 9. You insist on error free records. 10. Service users are informed of exactly when you will perform the service. 11. You provide prompt service. 12. You are always willing to help service users. 13. You are never too busy to respond to service users requests. 14. You behave in a way that instils confidence in service users. 15. You make service users feel safe when caring for them. 16. You are polite to service users. 17. You are able to answer questions from service users within your boundaries. 18. You give service users individual attention. 19. You provide care services at times convenient to service users. 20. You give service users personal attention. 21. You have service users best interests at heart. 22. You understand service users specific needs.

71

Home Care's Employees Perceptions of Service Quality Delivered (Appendix 20)

0.00

1.00

2.00

3.00

4.00

5.00

6.00

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22Items

Scor

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t of 5

Managers perceptions of Consumers Expectations, Sevice Users Expectations and Gap between Service Users

Perceptions and Expectations (Appendix 21)

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Managers Perception of Service Users Expectation of an Excellent Care Service (Appendix 22)

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Questionnaire to Home Care Service Users (Appendix 23) Dear service user, My name is Michael Pasmore. I am a business student in my final year of study. As part of my studies I have to undertake a dissertation, which includes doing some research into a specific business problem. Therefore I have decided to research Home Care’s service quality, as assessed by you the service user. I have enclosed a short questionnaire, which I would be very grateful if you could complete. The questionnaire should take you approximately 5 minutes to fill in and full instructions are given at the top of each section. You do not have to complete the questionnaire if you do not want to, but it would be a great help to me if you could. Once you have completed the questionnaire hand it back to your carers who will pass it on to me. The cut off date for the questionnaires is Friday 3rd August. The information you provide will not be used for any commercial gain is anonymous and will only be viewed by myself, my tutors, and members of West Sussex District Council who are overseeing the research. I would like to take this opportunity to thank you for taking the time to read this letter and look forward to analysing any information you provide. Yours sincerely, Mike Pasmore.

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Questionnaire to Home Care Service Users Section 1 Directions: Based on your experience as a service user of Home Care, please think about what kind of care company would provide excellent quality of care service. Please state the extent to which an excellent care service would have the feature described by each statement. If you feel a feature is not at all essential for an excellent care company circle number ‘1’. If you feel a feature is absolutely essential to an excellent care company circle ‘5’. If your feelings are less strong circle one of the numbers in the middle. Disagree Agree 1 2 3 4 5 1. An excellent care service will have modern looking equipment. 1 2 3 4 5 2. The physical facilities will be visually appealing. 1 2 3 4 5 3. Staff will be neat appearing. 1 2 3 4 5 4. The appearance of the physical facilities of an excellent care

service will be in keeping with the type of service provided. 1 2 3 4 5 5. When an excellent care service promises to do something by a

certain time, they keep their promise. 1 2 3 4 5 6. When service users have a problem, an excellent care service

will show a sincere interest in solving the problem. 1 2 3 4 5 7. An excellent care service will perform the service right the first

time. 1 2 3 4 5 8. An excellent care service will provide their services at a time

they promise to do so. 1 2 3 4 5 9. An excellent care service will insist on error free records. 1 2 3 4 5 10. Staff of an excellent care service will tell service users exactly

when they will perform the service. 1 2 3 4 5 11. Staff of an excellent care service will give prompt service to

customers. 1 2 3 4 5 12. Staff of an excellent care service will always be willing to

help service users. 1 2 3 4 5 13. Staff of an excellent care service will never be too busy to

respond to customer requests. 1 2 3 4 5 14. The behaviour staff of an excellent care service will instil

confidence in service users. 1 2 3 4 5 15. Service users of an excellent care service will feel safe in their

dealings with staff. 1 2 3 4 5 16. Staff of an excellent care service will be polite to service

users. 1 2 3 4 5 17. Staff of an excellent care service will be able to answer

questions from service users. 1 2 3 4 5 18. An excellent care service will give service users individual

attention. 1 2 3 4 5 19. An excellent care service will provide its services at times

convenient to service users. 1 2 3 4 5 20. An excellent care service will have staff that give service users

personal attention. 1 2 3 4 5 21. An excellent care service will have service users best interests

at heart. 1 2 3 4 5 22. The staff of an excellent care service will understand the

specific needs of their service users.

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Section 2 Directions: The following set of statements relate to your feelings about Home Care’s care service. For each statement please show the extent to which you believe Home Care has the feature described by the statement. Once again circling a ‘1’ means that you strongly disagree that Home Care has that feature and circling a ‘5’ means that you strongly agree. You may circle any of the numbers in the middle that show how strong your feelings are. Disagree Agree 1 2 3 4 5 1. Home Care has modern looking equipment. 1 2 3 4 5 2. Home Care’s physical facilities will be visually appealing. 1 2 3 4 5 3. Home Care’s staff will be neat appearing. 1 2 3 4 5 4. The appearance of the physical facilities of Home Care are in

keeping with the type of service provided. 1 2 3 4 5 5. When Home Care promise to do something by a certain time,

they keep their promise. 1 2 3 4 5 6. When you have a problem, Home Care will show a sincere

interest in solving the problem. 1 2 3 4 5 7. Home Care performs the service right the first time. 1 2 3 4 5 8. Home Care provides their services at a time they promise to do

so. 1 2 3 4 5 9. Home Care insists on error free records. 1 2 3 4 5 10. Home Care staff tells you exactly when they will perform the

service. 1 2 3 4 5 11. Staff of Home Care gives prompt service to you. 1 2 3 4 5 12. Staff of Home Care are always willing to help you. 1 2 3 4 5 13. Staff of Home Care are never too busy to respond to your

requests. 1 2 3 4 5 14. The behaviour staff of Home Care instils confidence in you. 1 2 3 4 5 15. You feel safe in your dealings with Home Care staff. 1 2 3 4 5 16. Staff of Home Care are polite to you. 1 2 3 4 5 17. Staff of Home Care are able to answer questions from you. 1 2 3 4 5 18. Home Care gives you individual attention. 1 2 3 4 5 19.Home Care provides its services at times convenient to you. 1 2 3 4 5 20. Home Care has staff that give you personal attention. 1 2 3 4 5 21. Home Care has your best interests at heart. 1 2 3 4 5 22. The staff of Home Care understand your specific needs. Please tick the appropriate box that applies to you. Gender: male female Age: 16 – 24 25 – 35 36 – 45 46 – 55 56 – 65 66 – 75 76+ Area you live in: Haywards Heath Burgess Hill Hassocks Crawley Horsham Length of time Home Care have provided a service to you: Less than 6 months 7 months to 1 year 1 to 2 years

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Structured Interview to Home Care Manger (Appendix 24) Directions: The following set of statements relate to your feelings about what Home Care service users expect from an excellent service. Please show the extent to which you believe service users expect the feature described by the statement to be present in an excellent care service. If you feel that Home Care service users do not expect the feature described from Home Care circle ‘1’. If you feel that Home Care service users expect the feature described from Home Care circle ‘5’. You may circle any of the numbers in the middle that show how strong your feelings are.

Disagree Agree 1 2 3 4 5 1. The use of modern and effective equipment. 1 2 3 4 5 2. Equipment supplied to service users that is not out of place in their

homes. 1 2 3 4 5 3. Home Care employees of neat appearance. 1 2 3 4 5 4. The equipment used should satisfy service users needs. 1 2 3 4 5 5. When staff are scheduled to perform a task at a certain time they do. 1 2 3 4 5 6. When service users have a problem, staff make every effort to help

them. 1 2 3 4 5 7. Staff perform the service right the first time. 1 2 3 4 5 8. Staff provide care services at the time they are scheduled to. 1 2 3 4 5 9. Staff insist on error free records. 1 2 3 4 5 10. Service users are informed of exactly when staff will perform the

service. 1 2 3 4 5 11. Employees provide prompt service. 1 2 3 4 5 12. Employees are always willing to help service users. 1 2 3 4 5 13. Employees are never too busy to respond to service users requests. 1 2 3 4 5 14. Employees behave in a way that instils confidence in service users. 1 2 3 4 5 15. Employees make service users feel safe when caring for them. 1 2 3 4 5 16. Employees are polite to service users. 1 2 3 4 5 17. Employees are able to answer questions from service users within

their boundaries. 1 2 3 4 5 18. Employees give service users individual attention. 1 2 3 4 5 19. Employees provide care services at times convenient to service users. 1 2 3 4 5 20. Employees give service users personal attention. 1 2 3 4 5 21. Employees have service users best interests at heart. 1 2 3 4 5 22. Employees understand service users specific needs.

For the following questions please tick the box that applies to you or write in the answer where appropriate. Gender: male female Age: 16 – 24 25 – 35 36 – 45 46 – 55 56 – 65 66 – 75 76+ Do you work: full time part time You are a permanent relief member of staff Approximately how long have you worked for Home Care? ………………. Do you provide care for the same service users: some of the time most of the time all of the time

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Questionnaire to Home Care Employees (Appendix 25) Dear care assistant/senior, My name is Michael Pasmore. I am a business student in my final year of study. As part of my studies I have to undertake a dissertation, which includes doing some research into a specific business problem. Therefore I have decided to research Home Care’s service quality, as assessed by your service users and you. However I have a problem in distributing the questionnaires to the service users, as I do not have access to their names and addresses for reasons of confidentiality. For this reason I would really appreciate it if you could do the following:

• Give each service user a questionnaire (which will be enclosed with your weekly programs) if you think they have the ability to complete it.

• Collect the questionnaires as the service users complete them and hand them

in with your weekly time sheets. The cut off date for the collection of questionnaires is Friday 3rd of August. As well as the service users questionnaire I have printed a short questionnaire on the reverse of this letter, which I would be very grateful if you could complete. The questionnaire should take you approximately 5 minutes to fill in and full instructions are given at the top of each section. You do not have to complete the questionnaire or deliver and collect the service user questionnaires if you do not want to, but it would be a great help to me if you could. I would like to take this opportunity to thank you for taking the time to read this letter and look forward to analysing any information you provide. Yours sincerely, Mike Pasmore

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Directions: The following set of statements relate to your feelings about the service you and Home Care as a whole provide. For each statement please show the extent to which you believe Home Care has the feature described by the statement. If you feel that Home Care does not have the feature described circle ‘1’. If you feel that Home Care provides the feature described circle ‘5’. You may circle any of the numbers in the middle that show how strong your feelings are.

Disagree Agree 1 2 3 4 5 1.The equipment you use is modern and effective. 1 2 3 4 5 2. Equipment supplied to service users is not out of place in their homes. 1 2 3 4 5 3. When working you are of neat appearance. 1 2 3 4 5 4. The equipment you use satisfies service users needs. 1 2 3 4 5 5. When you are scheduled to perform a task at a certain time you do. 1 2 3 4 5 6. When service users have a problem, you make every effort to help

them. 1 2 3 4 5 7. You perform the service right the first time. 1 2 3 4 5 8. You provide care services at the time you are scheduled to. 1 2 3 4 5 9. You insist on error free records. 1 2 3 4 5 10. Service users are informed of exactly when you will perform the

service. 1 2 3 4 5 11. You provide prompt service. 1 2 3 4 5 12. You are always willing to help service users. 1 2 3 4 5 13. You are never too busy to respond to service users requests. 1 2 3 4 5 14. You behave in a way that instils confidence in service users. 1 2 3 4 5 15. You make service users feel safe when caring for them. 1 2 3 4 5 16. You are polite to service users. 1 2 3 4 5 17. You are able to answer questions from service users within your

boundaries. 1 2 3 4 5 18. You give service users individual attention. 1 2 3 4 5 19. You provide care services at times convenient to service users. 1 2 3 4 5 20. You give service users personal attention. 1 2 3 4 5 21. You have service users best interests at heart. 1 2 3 4 5 22. You understand service users specific needs.

For the following questions please tick the box that applies to you or write in the answer where appropriate. Gender: male female Age: 16 – 24 25 – 35 36 – 45 46 – 55 56 – 65 66 – 75 76+ Do you work: full time part time You are a permanent relief member of staff Approximately how long have you worked for Home Care? ………………. Do you provide care for the same service users: some of the time most of the time all of the time Thank you for taking the time to answer this questionnaire.

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