Measuring and improving outcomes of social care
Most care home residents have dementia. Although we hear a lot about poor care, these homes aim to improve people’s quality of life, no matter how severe people’s problems. However, evaluating the impact of care services on people’s quality of life is important so that we can target resources where they have most effect and improve service quality.
To date, most measures of outcome have been either too focused on health or too broad to be accurate.
People with moderate or severe dementia have often been excluded from studies because they find it difficult to take part in questionnaires or interviews.
In response, Professor Ann Netten FAcSS and Ann-Marie Towers with colleagues at the University of Kent’s Personal Social Services Research Unit developed the Adult Social Care Outcomes Toolkit (ASCOT), for use in a variety of settings and with people with any disability. It contains a mixed-methods approach for use in care homes, including formal and informal observation as well as interviews with the resident (if possible), staff and relatives.
The toolkit, which requires training, provides both a measure and important insights into care provided and ‘social-care-related quality of life’ of residents, including basics such as food and drink and ‘higher order’ aspects such as control and occupation.
In addition to providing evidence about the impact of services, ASCOT is used by central and local government and increasingly by care providers and those responsible for evaluating, monitoring and commissioning services, nationally and internationally, to improve outcomes of the people using services. Following feedback from training and users of ASCOT, a ‘home level’ approach is being developed, to help commissioners and care home providers focus on quality of life when reviewing how homes care for all their residents.