Measurements of quality in social care services in the UK have generally been concerned with regularly measuring performance in terms of Quality Indicators or Best Value reports. Although these quality measures quite often involve user satisfaction surveys, the methodology does not allow for the user to give a holistic response about the service they have received nor is there any sense of client empowerment around measuring quality in this way.
What is not measured is the link between quality assurance, quality enhancement and client empowerment, nor whether empowerment is defined as a process, an intervention or an outcome. This paper utilises qualitative methodologies that enables users and carers to tell their own stories and suggests that client empowerment as a process is central to the future direction of quality assurance and quality enhancement policies in the UK and in an international context.
These studies of users' and carers' experiences of care in the UK and Eastern Europe involved over 500 individuals utilising an approach that allowed them to explain their experiences of the public care sector from their own perspective (Dowling 1997). In one follow up study, parents of children with disabilities designed the research tool and were involved in disseminating the findings from the research to social care organisations and the Social Care Institute for Excellence, (a government research organisation to promote innovative research that involves users and carers) (Dowling and Dolan 2001). The UNICEF research (2005) aims to utilise users and carers' experiences and views of their care to contribute to governments' polices concerning child disability and follow up qualitative research to this study is currently progressing in Bosnia, Bulgaria and Latvia.
Users of welfare services are the least powerful of groups in whichever country is being studied. In terms of age, gender, material resources, class, education, ethnicity and disability they are likely to be in the most excluded section of their society although professionals who work with them and the staff who organise and develop services are often under paid and have low status too.
The quality of social care services is considered in relation to three crucial issues: How can quality be measured? How can social service users and carers contribute to a quality service? How can the quality of services be improved so that innovative, participative and ongoing measurement of quality in social care organisations are developed through user and carer partnerships with social care managers and staff
