ABSTRACT
The promotion of quality was central to the objectives of the major changes in adult personal social services introduced in Britain between 1991 and 1993. The aim was to improve both the quality of services and the quality of life of the most vulnerable people in society. In effect the changes focused on both the process dimension of quality - how care is produced and delivered - and also its outcome dimension, in terms of a government commitment to extend opportunities for choice and independent living (Secretaries of State, 1989). The essence of the reforms is indeed a twofold commitment: to ensuring that people are able to live at home, or in “homely” settings in the community, rather than in residential settings; and to ensuring that care will be based not, as historically, on what services were available but on an assessment of individual needs and the provision of services tailored to meet those needs. The fundamental premise is that living in the community, rather than in residential settings, is what the overwhelming majority of people want. Thus, good quality social care was defined not merely in terms of the inherent characteristics of services and their providers but, more fundamentally, in terms of the extent to which individuals could choose to live in their own homes with the support of appropriate domiciliary care services.
