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.