We have been working together to take forward The National Carers’ Strategy, published in 2008 alongside the promotion of more personalised support and sustained independence. This paper is the fourth in a sequence of short reviews designed to stimulate debate and improve support for carers. It links closely to Commissioning for Carers . The focus of this paper is to help us all to tackle the following question: How will you, carers, and people more generally know if you have improved outcomes for people who give and receive care and support? It is a question not easily answered. This paper outlines an audit approach that we believe may help. It is a resource to be drawn upon alongside others; for example, those on the IDeA website. We also explore the potential of Outcomes Based Accountability models. We can also see some advantages in the use of model carer feedback resource materials, as a way of improving the systematic collection of information on outcomes. The paper points to the importance of Total Place and the need to link what we do to Joint Strategic Needs Assessments4 and wider partnership working. We have also made links to the current performance assessment framework in the Care Quality Commission’s Commissioner Assessment Guide5 . This framework will be changing from next year and we hope this paper will be seen as a contribution to its development.