Background: The objectives of improving effectiveness and efficiency require that we understand the impact of interventions but measuring and monitoring outcomes in social care presents particular challenges.

Methods: The developing adult social care outcome toolkit (ASCOT) incorporates nine domains of outcome that are weighted to reflect their relative importance using population preference weights. The full measure uses interview or observational techniques to establish current and expected levels of need in each domain. The measure can be linked to routine indicators to provide an indirect approach to monitoring the value of services in which we identify the potential value that could be delivered by a service or intervention: capacity for benefit; and the degree to which that value is actually delivered through a measure of quality.

Results and conclusions: While ongoing work is developing the measure, previous versions have proved reliable and been successfully applied across client groups in a variety of contexts.

Discussion: The results suggest that the measure should provide a theoretically grounded method of reflecting the full value of social care. Moreover, the capacity for benefit approach potentially provides a pragmatic basis for comparability—over time, between changing systems and across different countries.