FIELD TRIAL OF GRADED CARE PROFILE (GCP) SCALE - A NEW MEASURE OF CARE

Aim-The graded care profile (GCP) scale was developed as a practical t ool in response to the Children Act 1989 to provide a measure of care in four areas: physical, safety, love, and esteem, on a bipolar contin uum. This held trial was to assess its user friendliness and inter-rat er agreement. Methods-43 nursery children and 11 registered for neglec t were each scored on this scale independently by two different raters (health visitor and nursery teacher or social worker). Their inter-ra ter agreement was assessed by weighted kappa and user friendliness by time taken for and completeness of scoring. Results-An almost perfect level of agreement was achieved in physical care (kappa = 0.899; confi dence interval (CI) = 0.850 to 0.938), safety (kappa = 0.894; CI = 0.8 54 to 0.933), esteem (kappa = 0.877; CI = 0.808 to 0.946), and a subst antial level in love (kappa = 0.785; CI = 0.720 to 0.849). Mean time t aken for scoring was 20 minutes (range 10 to 30); of 54 paired scales, area of safety was not scored only in three by one of the raters. Con clusions-This scale appeared user friendly and provided grading of car e with high inter-rater agreement. Its use in practice could provide a n opportunity for useful comparison with other means of assessment of care, studying outcomes of different care profiles, targeting interven tion, and monitoring change.