Skip to main content Accessibility help

Satisfaction with social care services among South Asian and White British older people: the need to understand the system



National surveys show that people from minority ethnic groups tend to be less satisfied with social care services compared with the white population, but do not show why. Research indicates that barriers to accessing services include lack of information, perceptions of cultural inappropriateness and normative expectations of care. Less research has examined the experience of minority ethnic service users after they access services. This study conducted in-depth interviews with 82 South Asian and White British service users and family carers, the majority of whom were older people. Thematic analysis was used. The key theme was understanding the social care system. Participants with a good understanding of the system were more able to adapt and achieve control over their care. Participants with a poor understanding were uncertain about how to access further care, or why a service had been refused. More White British than South Asian participants had a good understanding of the system. There was more in common between the South Asian and White British participants' experiences than might have been expected. Language was an important facilitator of care for South Asian participants, but ethnic matching with staff was less important. Recommendations include better communication throughout the care process to ensure service users and carers have a clear understanding of social care services and hence a better experience.


Corresponding author

Address for correspondence: Rosalind Willis, Centre for Research on Ageing, 58/4111 Social Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, UK E-mail:


Hide All
Adamson, J. and Donovan, J. 2005. ‘Normal disruption’: South Asian and African/Caribbean relatives caring for an older family member in the UK. Social Science & Medicine, 60, 1, 3748.
Ahmed, N. and Rees Jones, I. 2008. ‘Habitus and bureaucratic routines’, cultural and structural factors in the experience of informal care: a qualitative study of Bangladeshi women living in London. Current Sociology, 56, 1, 5776.
Barron, D. S., Holterman, C., Shipster, P., Batson, S. and Alam, M. 2010. Seen but not heard – ethnic minorities’ views of primary health care interpreting provision: a focus group study. Primary Health Care Research & Development, 11, 2, 132–41.
Bauld, L., Chesterman, J. and Judge, K. 2000. Measuring satisfaction with social care amongst older service users: issues from the literature. Health and Social Care in the Community, 8, 5, 316–24.
Bowes, A. 2006. Mainstreaming equality: implications of the provision of support at home for majority and minority ethnic older people. Social Policy & Administration, 40, 7, 739–57.
Bowes, A., Avan, G. and Macintosh, S. 2008. They Put Up With It – What Else Can They Do? Mistreatment of Black and Minority Ethnic Older People and the Service Response. Age Concern Scotland/University of Sterling, Edinburgh, UK.
Bowes, A., Avan, G. and Macintosh, S. 2011. Dignity and Respect in Residential Care: Issues for Black and Minority Ethnic Groups. Report to Department of Health, July, University of Stirling, Stirling, UK.
Braun, V. and Clarke, V. 2006. Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 2, 77101.
Bulmer, M. 1996. The ethnic group question in the 1991 Census of population. In Coleman, D. and Salt, J. (eds), Ethnicity in the 1991 Census. HMSO, London, 3362.
Chesterman, J., Bauld, L. and Judge, K. 2008. Satisfaction with the care-managed support of older people: an empirical analysis. Health and Social Care in the Community, 9, 1, 3142.
Collins, K. and Nicolson, P. 2002. The meaning of ‘satisfaction’ for people with dermatological problems: reassessing approaches to qualitative health psychology research. Journal of Health Psychology, 7, 5, 615–29.
Collins, K. and O'Cathain, A. 2003. The continuum of patient satisfaction – from satisfied to very satisfied. Social Science & Medicine, 57, 12, 2465–70.
Desai, S. 2012. Will it ever change? The continuing unmet needs of older black and ethnic minority people and social care. Diversity and Equality in Health and Care, 9, 2, 85–7.
Edwards, C. and Staniszewska, S. 2000. Accessing the user's perspective. Health and Social Care in the Community, 8, 6, 417–24.
Fanshawe, S. and Sriskandarajah, D. 2010. ‘You Can't Put Me in a Box’: Super-diversity and the End of Identity Politics in Britain. Institute for Public Policy Research, London.
Francis, J. and Netten, A. 2004. Raising the quality of home care: a study of service users’ views. Social Policy & Administration, 38, 3, 290305.
Hall, J. A. and Dornan, M. C. 1990. Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis. Social Science & Medicine, 30, 7, 811–8.
Hausmann, L. R. M., Gao, S., Mor, M. K., Schaefer, J. H. and Fine, M. J. 2013. Understanding racial and ethnic differences in patient experiences with outpatient health care in Veterans Affairs Medical Centers. Medical Care, 51, 6, 532–9.
Health and Social Care Information Centre 2013. Personal Social Services Adult Social Care Survey, England – 2012–13. Final release, Health and Social Care Information Centre, Leeds, UK.
Henwood, M., Lewis, H. and Waddington, E. 1998. Listening to Users of Domiciliary Care Services: Developing and Monitoring Quality Standards. Nuffield Institute for Health, Leeds, UK.
Hills, R. and Kitchen, S. 2007. Toward a theory of patient satisfaction with physiotherapy: exploring the concept of satisfaction. Physiotherapy Theory and Practice, 23, 5, 243–54.
Hubert, J. 2006. Family carers’ views of services for people with learning disabilities from Black and minority ethnic groups: a qualitative study of 30 families in a south London borough. Disability & Society, 21, 3, 259–72.
Katbamna, S., Ahmad, W., Bhakta, P., Baker, R. and Parker, G. 2004. Do they look after their own? Informal support for South Asian carers. Health and Social Care in the Community, 12, 5, 398406.
Manthorpe, J., Iliffe, S., Clough, R., Cornes, M., Bright, L., Moriarty, J. and Older People Researching Social Issues 2008 a. Elderly people's perspectives on health and well-being in rural communities in England: findings from the evaluation of the National Service Framework for Older People. Health and Social Care in the Community, 16, 5, 460–8.
Manthorpe, J., Iliffe, S., Moriarty, J., Cornes, M., Clough, R., Bright, L., Rapaport, J. and OPRSI. 2009. ‘We are not blaming anyone but if we don't know about amenities we cannot seek them out’: black and minority older people's views on the quality of local health and social services. Ageing & Society, 29, 1, 93113.
Manthorpe, J., Moriarty, J., Rapaport, J., Clough, R., Cornes, M., Bright, L., Iliffe, S. and OPRSI. 2008 b. ‘There are wonderful social workers but it's a lottery’: older people's views about social workers. British Journal of Social Work, 38, 6, 1132–50.
Mason, J. 2002. Qualitative Researching. Sage, London.
Modood, T., Berthoud, R., Lakey, J., Nazroo, J., Smith, P., Virdee, S. and Beishon, S. (eds) 1997. Ethnic Minorities in Britain: Diversity and Disadvantage. Policy Studies Institute, London.
Murray, U. and Brown, D. 1998. ‘They Look After Their Own, Don't They?’ Inspection of Community Care Services for Black and Ethnic Minority Older People. Social Services Inspectorate, Department of Health, London.
NHS Information Centre 2011. Personal Social Services Adult Social Care Survey, England 2010–11. Final release, NHS Information Centre, Leeds, UK.
NHS Information Centre 2012. Personal Social Services Adult Social Care Survey, England 2011–12. Final release, NHS Information Centre, Leeds, UK.
NHS Information Centre Adult Social Care Statistics 2009. Personal Social Services Home Care Users in England Aged 65 and Over, 2008–09 Survey. Health and Social Care Information Centre, Leeds, UK.
Nicoll, M., Ashworth, M., McNally, L. and Newman, S. 2002. Satisfaction with respite care: a pilot study. Health and Social Care in the Community, 10, 6, 479–84.
Office for National Statistics 2012. 2011 Census: Key Statistics for Local Authorities in England and Wales. Office for National Statistics, Titchfield, UK.
Owens, D. J. and Batchelor, C. 1996. Patient satisfaction and the elderly. Social Science & Medicine, 42, 11, 1483–91.
Patel, N. 1990. A ‘Race’ Against Time? Social Services Provision to Black Elders. Race and Policy Series Number 1, The Runnymede Trust, London.
Thompson, A. G. H. and Sunol, R. 1995. Expectations as determinants of patient satisfaction: concepts, theory and evidence. International Journal for Quality in Health Care, 7, 2, 127–41.
Townsend, D. and Kosloski, K. 2002. Factors related to client satisfaction with community-based respite services. Home Health Care Services Quarterly, 21, 3/4, 89106.
Williams, B. 1994. Patient satisfaction: a valid concept? Social Science & Medicine, 38, 4, 509–16.


Satisfaction with social care services among South Asian and White British older people: the need to understand the system



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed