Developing outcomes indicators adjusted for factors beyond the control of local authorities

Transparency in outcomes: a framework for quality in adult social care was published in March 2011. This set out a new strategy for transparency, quality and outcomes in adult social care, and included an Outcomes Framework for social care which is a key element of the Government’s approach to accountability in both the current and future system. There are a number of measures included in the Adult Social Care Outcomes Framework (ASCOF) that draw upon the national Adult Social Care Survey (ASCS) which is conducted on a sample of service users by councils every year.

Social care‐related quality of life (SCRQoL) is a key outcome of social care services. The ASCS includes the Adult Social Care Outcomes Toolkit (ASCOT) measure of SCRQoL, which is one of the four proposed overarching indicators in the Outcomes Framework. In addition, two items from ASCOT that focus on specific outcomes (control over daily life and safety) also form part of the framework, as does a measure of satisfaction also from the ASCS. On their own, these measures give an indication of overall experience of outcomes, but the outcome state is clearly not completely attributable to services. To make fair comparisons between different authorities, it is important that outcome indicators are adjusted to reflect the contribution that services make towards the outcome state of an individual. This can be achieved by statistically adjusting each indicator to take account of factors beyond the control of the authority that may also influence the reported outcome state, for example disability level or receipt of informal care. Such adjusted indicators would go some way towards addressing the concern that an authority’s performance on an indicator may be a consequence of factors over which it has no control.

Aims

The aim of this work is to develop adjusted versions of the outcome indicators in the Transparency in Outcomes framework for social care: specifically, to develop adjusted indicators of the SCRQoL, safety, control over daily and satisfaction with services measures.

Methods

The work will involve detailed analysis of the ASCS and will draw upon regression methods, within the framework of multilevel modelling. It will also draw on the relevant literature, including the production of welfare (POW) framework, and developments in education and allied fields of social policy to develop the models and adjusted measures.

Timing and outputs

The project runs from September 2011 to March 2012. The results of the study should be valuable for helping policy-makers, local authorities and the public interpret and use the measures in the Adult Social Care Outcomes Framework. In particular, the adjusted measures should help users make fairer comparisons between authorities. The main output will be a technical report describing the methods used and the results. We will also produce summary ‘findings’ and papers that will help councils make best use of the results of the study, as well as at least one peer‐reviewed article.

Research team

Juliette Malley, José‐Luis Fernández, Ann Netten, Azusa Sato