title: Adaptation of the Quality Indicator for Rehabilitative Care (QuIRC) for use in mental health supported accommodation services (QuIRC-SA).
abstract: BACKGROUND
  No standardised tools for assessing the quality of specialist mental health supported accommodation services exist. To address this, we adapted the Quality Indicator for Rehabilitative care-QuIRC-that was originally developed to assess the quality of longer term inpatient and community based mental health facilities. The QuIRC, which is completed by the service manager and gives ratings of seven domains of care, has good psychometric properties.
  
  
  METHODS
  Focus groups with staff of the three main types of supported accommodation in the UK (residential care, supported housing and floating outreach services) were carried out to identify potential amendments to the QuIRC. Additional advice was gained from consultation with three expert panels, two of which comprised service users with lived experience of mental health and supported accommodation services. The amended QuIRC (QuIRC-SA) was piloted with a manager of each of the three service types. Item response variance, inter-rater reliability and internal consistency were assessed in a random sample of 52 services. Factorial structure and discriminant validity were assessed in a larger random sample of 87 services.
  
  
  RESULTS
  The QuIRC-SA comprised 143 items of which only 18 items showed a narrow range of response and five items had poor inter-rater reliability. The tool showed good discriminant validity, with supported housing services generally scoring higher than the other two types of supported accommodation on most domains. Exploratory factor analysis showed that the QuIRC-SA items loaded onto the domains to which they had been allocated.
  
  
  CONCLUSIONS
  The QuIRC-SA is the first standardised tool for quality assessment of specialist mental health supported accommodation services. Its psychometric properties mean that it has potential for use in research as well as audit and quality improvement programmes. A web based application is being developed to make it more accessible which will produce a printable report for the service manager about the performance of their service, comparison data for similar services and suggestions on how to improve service quality.
authors.affiliation: Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. h.killaspy@ucl.ac.uk.
authors.forename: Helen
authors.initials: H
authors.lastname: Killaspy
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: White
authors.affiliation: Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dowling
authors.affiliation: Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Krotofil
authors.affiliation: Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: McPherson
authors.affiliation: Unit for Social and Community Psychiatry, Newham Centre for Mental Health, Queen Mary University of London, London, E13 8SP, UK.
authors.forename: Sima
authors.initials: S
authors.lastname: Sandhu
authors.affiliation: North London Service User Research Forum, Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
authors.forename: Maurice
authors.initials: M
authors.lastname: Arbuthnott
authors.affiliation: Department of Geography, Durham University, South Rd, Durham, DH1 3LE, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Curtis
authors.affiliation: Bamford Centre for Mental Health & Wellbeing, University of Ulster, Northland Road, Derry Londonderry, Northern Ireland, BT48 7JL, UK.
authors.forename: Gerard
authors.initials: G
authors.lastname: Leavey
authors.affiliation: Unit for Social and Community Psychiatry, Newham Centre for Mental Health, Queen Mary University of London, London, E13 8SP, UK.
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
authors.affiliation: Centre for Mental Health, Maya House, 134-138 Borough High St, London, SE1 1LB, UK.
authors.forename: Geoff
authors.initials: G
authors.lastname: Shepherd
authors.affiliation: Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: King
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D006801:Humans; D008131:London; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008605:Mental Health Services / Q000592:standards*; D015588:Observer Variation; D011594:Psychometrics; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012112:Residential Facilities / Q000592:standards
keywords: Mental health; Quality assessment; Standardised tool; Supported accommodation