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Personal Social Services Research Unit
Cornwallis Building
George Allen Wing
University of Kent
Canterbury
Kent
CT2 7NF
01227 824967
ascot@kent.ac.uk
www.pssru.ac.uk/ascot
This second version of ASCOT has incorporated the results of research and feedback that we have received, particularly through training and workshops. While the basic measure is and will remain the same, our aim is to improve the associated guidance, and to provide additional information and tools that enhance and extend the applicability and aid interpretation of results. Here we summarise those areas where ongoing and/or planned work will hopefully feed into future developments.
Much of this work is being carried on through the the Department of Health-funded Policy Research Unit on Quality and Outcomes of Person Centred Care (QORU), which was established in January 2011 (www.qoru.ac.uk). The programme of work includes support for ASCOT, and other methodological work that potentially could feed into future developments.
Benchmarking and interpreting the data
The inclusion of the SCT4 version of ASCOT in the annual Adult Social Care Survey (ASCS) provides national comparative data and a means of monitoring how SCRQoL changes over time for publicly-funded social care service users. The data for the 2011 and 2012 ASCSs are available on the Information Centre website. The 2013 ASCS is now in the field. Data about general population norms gathered from the OSCA study are available from our website.
The ASCOT team is planning to do more work around the interpretation of ASCOT scores to aid the use of the measure in practice. In addition, as data start to become available, other work is being conducted by QORU to facilitate application and use of measures of outcome by commissioners, providers and service users.
Estimating outcomes using the self-completion instrument (SCT4)
The ASCOT team is being funded by the Department of Health under the Identifying the Impact of Adult Social Care (IIASC) study to develop a method for estimating outcomes from the data collected in the national Adult Social Care Survey. The study draws on the method used for the self-completion version with three levels of response options (SCT3) to estimate outcomes, and on work investigating methods for developing a measure of SCRQoL that is adjusted to take account of factors beyond the control of services that affect an individual’s SCRQoL. The IIASC study will be reporting in 2014, and revised data entry instruments will be available shortly afterwards.
Developing improved methods for establishing outcomes for a wider range of people
The Engagement theme for QORU is focusing on developing versions of ASCOT that are accessible to a wider range of people, and includes the development of an Easy-Read version, a version for completion by proxy, a mixed-methods version (based on the care home version) suitable for use outside of institutional care environments, and a version that uses a semi-structured interview approach to help those who struggle with highly structured interviews and questionnaires to express how they feel about their quality of life.
Care homes
There has been a lot of interest in the care home multi-method approach (CH3) to establishing outcomes for residents. We strongly recommend training, and are providing this for those who express an interest. As a result of this and feedback from users of the toolkit, we have already made some amendments, and anticipate further updating the guidance to reflect people's experiences of putting it into practice. Owing to increasing demand for bespoke training at the organisational level, we have applied for funding to film new clips of good practice in care homes, and will be including these in a ‘Train the Trainer’ course from 2014. This will eventually enable organisations to train their own staff in-house.
In some instances, users of the toolkit have been using the methods as a basis for an outcomes-based approach to quality assurance, rather than as a measure of outcome. The approach yields a wealth of qualitative evidence, in addition to measuring outcomes for residents.
We are also planning a piece of work to adapt the existing care homes measure and develop a care homes’ quality indicator based on social care-related quality of life. We hope to have a pilot methodology and measure available for testing in 2014.
Carers
Carers should be included when measuring the outcomes of social care: in their absence we are not measuring the full value of services and support. A self-completion instrument for measuring carers’ SCRQoL, which builds on the ASCOT domains, is included in the national carer experience survey (Link to http://www.ic.nhs.uk/article/2214/User-survey-guidance-Carers-2012-13). This self-completion instrument has three levels of response options.As part of the Identifying the Impact of Adult Social Care (IIASC) study, funded by the Department of Health, further work is being undertaken to develop a self-completion and interview version with four levels of response options . If you are interested in finding out more, please contact the ASCOT team (ascot@kent.ac.uk).