Measuring “Ageing Well”: Practical Outcome Measures Commissioners Actually Trust
“Ageing well” has become a central concept in adult social care commissioning, yet many providers struggle to translate it into measurable outcomes. Commissioners are increasingly sceptical of vague wellbeing statements and want to see evidence that is practical, proportionate and grounded in day-to-day delivery. Measuring ageing well requires selecting indicators that reflect independence, stability and quality of life, while remaining realistic about frailty and long-term conditions. These outcomes sit alongside independence and community inclusion and must be governed in a way that supports commissioning decisions and regulatory scrutiny. Further context can be found in Outcomes, Independence & Community Inclusion.
Why commissioners distrust generic outcome claims
Commissioners frequently encounter claims such as “improved wellbeing” or “supports ageing well” without supporting evidence. These claims are difficult to evaluate, compare or monitor. As a result, commissioners increasingly favour providers who:
- Define outcomes in observable terms
- Use simple, repeatable measures
- Link outcomes to specific support approaches
Effective measurement does not require complex tools. It requires clarity, consistency and honesty about what can and cannot be influenced by social care.
Principles for measuring ageing well
1) Focus on maintenance as well as improvement
For many older people, ageing well means maintaining current function and quality of life, not improvement. Commissioners recognise this, provided maintenance is clearly evidenced and linked to proactive support.
2) Use measures that relate to daily life
Indicators should reflect everyday experiences: mobility, routines, confidence, nutrition, social contact and safety. Abstract scores without context are less persuasive.
3) Combine quantitative and qualitative evidence
Numbers alone rarely tell the full story. Short narrative evidence explaining what has changed (or been sustained) adds credibility when combined with simple metrics.
Operational example 1: Measuring functional stability
Context: Mrs K (88) lives alone with multiple long-term conditions. The commissioner’s priority is preventing deterioration and avoidable hospital admission.
Support approach: Consistent routines focused on mobility, hydration and medication adherence.
Day-to-day delivery detail: Staff support Mrs K to mobilise short distances each visit, prompt fluid intake, and confirm medication routines. Any deviation (reduced appetite, increased confusion) is recorded and escalated.
How effectiveness is evidenced: Monthly reviews show stable mobility levels, no falls, and consistent medication compliance. Evidence focuses on maintenance over time rather than improvement.
Operational example 2: Measuring independence in personal routines
Context: Mr L (81) receives support with morning routines. The original package specified high support levels following illness.
Support approach: Enablement with periodic reassessment.
Day-to-day delivery detail: Staff document levels of assistance required for washing and dressing, using agreed categories. Reviews assess whether prompting can replace hands-on support.
How effectiveness is evidenced: Reduction in hands-on assistance over time is recorded. Care hours are adjusted with commissioner agreement, demonstrating value for money.
Operational example 3: Measuring social connection
Context: Ms M (77) reports loneliness following reduced mobility.
Support approach: Structured inclusion plan with achievable goals.
Day-to-day delivery detail: Staff support attendance at a local group once per fortnight and facilitate regular phone contact with family.
How effectiveness is evidenced: Attendance records, self-reported confidence, and narrative feedback demonstrate improved social connection.
Commissioner expectation: proportionate, comparable evidence
Expectation: Commissioners expect outcome data that can be aggregated and reviewed across a cohort, while still reflecting individual experience.
In practice: Providers should be able to report on themes such as maintained independence, reduced falls, or sustained community engagement, supported by individual examples.
Regulator / inspector expectation: accuracy and learning
Expectation: Inspectors expect outcome measures to be accurate, not overstated, and used to inform learning and improvement.
In practice: Evidence should align with care records, audits and incident data. Discrepancies undermine credibility.
Governance systems that support meaningful measurement
- Outcome definitions: clear, consistent across the service
- Recording standards: guidance for staff on what to record and why
- Review cycles: regular outcome reviews linked to care plan updates
- Management oversight: sampling and validation of outcome evidence
Key takeaway
Commissioners trust outcome measures that are simple, relevant and grounded in daily practice. By focusing on maintenance, independence and connection, and by governing outcomes properly, providers can evidence ageing well in a way that supports tenders, contracts and inspection.