Measuring quality in social care services: theory and practice

Measuring and assessing service quality in the social care sector presents distinct challenges. The 'experience' good properties of social care, for instance, and the large influence played by subjective judgements about the quality of personal relationships between carer and user and of process-related service characteristics make it difficult to develop indicators of service quality, including those of service impact on final outcomes. Using some of the key features of the 'Production of Welfare' approach, the paper discusses recent developments in the UK of the theoretical and practical frameworks used for assessing quality in social care and for understanding the final impact of services on the wellbeing of their recipients. Key current and future challenges to the development of such frameworks include difficulties in disentangling the impact of social care services on final outcomes from the often dominating effects of other, non-service related factors, and the generalization of consumer-directed care models and of the 'personalization' of care services. These challenges are discussed in the context of the different possible applications of quality indicators, including their role as supporting the service commissioning process and their use for assessing the performance of service providers.