Monitoring the outcome of case management and community care: the care programme approach support system (CPASS)

This study reports the findings of an audit of community care outcomes, for the seriously mentally ill, in one health district in the UK. An innovative community care and case management system for this client group was introduced in 1993. As part of that organizational change, data were collected continuously on the severity of client problems. A satisfaction survey of a random sample of clients and carers has now also been completed. This report is thus able to compare feedback on service performance using two methodologies. As both the problem rating scales and the satisfaction surveys were designed specifically to cover the same 12 domains of client problems, data from both can be integrated easily. The 12 domains also structure the assessment tools used by nurses and social workers, and form the basis of minimum standard specifications of community care provision. Selected data from the audits are presented, and the utility of these results for further local service developments are assessed. The methodology used can be recommended as a means of continuous audit of joint services for those with serious and enduring mental health problems.