Measuring and monitoring outputs in social care: the problem of measuring quality

The focus of this article is the measurement of quality within the context of a new approach to measuring government-funded social care services. The approach builds on principles set out in a UK review led by Professor Sir Tony Atkinson. At its heart are the concepts of capacity for benefit, describing the potential benefit to users from services, and quality, reflecting the extent to which the benefit is realized. We report on a study designed to explore the suitability of a weighted user satisfaction measure to measure quality, examining in particular its sensitivity to changes in the quality of social care over time. The study finds some problems with using weighted user satisfaction. We discuss potential reasons for these problems, including the possibility of gaming and the specification of the measure, and discuss a way forward in the context of the requirement to draw upon routine sources of data. Points for practitioners: the article describes a practical approach to measuring and monitoring outcomes and productivity in social care. Routine measures are used as far as possible, weighted to reflect outcomes for services users. The concepts of Capacity for Benefit and quality in this context potentially allow commissioners and managers to distinguish the impact on productivity of: the potential of services as they are currently configured, the dependency of service users, and the quality of delivery. The article identifies key issues and problems in using measures of satisfaction both as performance indicators and monitoring quality of services in the proposed approach