Satsifaction surveys exist to measure our relative pleasure or displeasure on some sort of sliding scale. So why would the options on a customer survey change from question to question and why would they place acceptable ahead of adequate in the scale of options?
Perhaps because it was a survey of customer care in a state-run hospital and unwell patients might not notice that marking down actually improved the rating.
Never believe research results if you haven't seen how they were collected. In the private sector, at least, you won't succeed by deluding yourself.