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 tool in response to the Children Act 1989 to provide a measure of care in four areas: physical, safety, love, and esteem, on a bipolar continuum. This field trial was to assess its user friendliness and inter-rater agreement. METHODS 43 nursery children and 11 registered for neglect were each scored on this scale independently by two different raters (health visitor and nursery teacher or social worker). Their inter-rater 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; confidence interval (CI) = 0.850 to 0.948), safety (kappa = 0.894; CI = 0.854 to 0.933), esteem (kappa = 0.877; CI = 0.808 to 0.946), and a substantial level in love (kappa = 0.785; CI = 0.720 to 0.849). Mean time taken 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. CONCLUSIONS This scale appeared user friendly and provided grading of care with high inter-rater agreement. Its use in practice could provide an opportunity for useful comparison with other means of assessment of care, studying outcomes of different care profiles, targeting intervention, and monitoring change.