Evaluating the quality of care within residential services for older people
The quality of care within residential services for older people has been a source of concern within health and social care for some time. Several attempts have been made to develop a means of assessing the quality of care; however, the nature and quality of these varies enormously. The Quest process of evaluation, which was designed as a means of assessing service quality according to the structure and process of care, is presented as a possible means of improving upon current practice. The Quest system incorporates four measures: the Service Profile, the Support Questionnaire, the Observation Profile and the Occupational Stress Indicator. The Service Profile is essentially descriptive in nature, and the Occupational Stress Indicator is a published, standardised measure. The remaining Quest measures, however, were only recently developed and therefore lack evidence in support of their psychometric properties. The present study was designed to assess the validity and reliability of the Quest system within residential services for older people. The exploration of validity and reliability took several forms, incorporating both qualitative and quantitative methodologies. The overall findings of the discussion group and assessment of face validity advocated the credibility of the dimensions of support that underpin the Quest system. With regards to reliability, the findings supported the reliability of the Observation Profile but identified that further work was needed to ascertain the reliability of the Support Questionnaire. Issues relevant to the interpretation of the results were discussed along with the reasons why a number of formal assessments of validity could not be made. Further work to explore the psychometric properties of the Quest system was recommended before it can be confidently applied to residential services for older people.