An audit is described of a psychogeriatric assessment unit using data drawn from multidisciplinary patient records, symptom rating scales and postdischarge questionnaires. The results reported are from a pilot study which took place prior to general implementation across a large psychiatric hospital under the aegis of the Care Programme Approach. All patients who were admitted to the unit ( N = 60) over the course of a year had a care plan constructed detailing their principal problems and the interventions of the team, pre-post measures of patients' symptomatology, mental state and behavioural state, and a three-way (service, carer, patient) follow-up questionnaire at 2 months postdischarge taken in the form of a semi-structured interview. Data were also collected on a number of standard statements agreed by the team. Results showed clear evidence of positive symptom change and problem resolution following admission. Service providers rated their effectiveness significantly higher than clients and carers and particular difficulties were highlighted both in the identification of carers' needs and the involvement of 'users' in the care planning process. KEY WORDS-audit; care programme; outcomes; service evaluation This article describes one year's routine monitoring of clinical care in a psychogeriatric assessment unit at a large psychiatric hospital in East London, and reports on a method of drawing audit data from a multidisciplinary record of patient care. The record was introduced by the team as a means of documenting care for patients in line with the Care Programme Approach (Department of Health, 1990), itself an elaboration of previous advice on predischarge and aftercare planning (Royal College of Psychiatrists, 1989b; Department of Health, 1989: Henwood andWistow, 1994). Furthermore, an attempt was made by the team to link such care planning with clinical audit, typically defined as the systematic and critical analysis of the quality of clinical care, use of resources and the resulting outcomes for the patient (Department of Health, 1993).
There have been few reports of clinical or medical audit from departments of old age psychiatry in the UK (Jones, 1992). Even the functioning of 'psychogeriatric teams', viewed by