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Why are some care homes better than others? An empirical study of the factors associated with quality of care for older people in residential homes in Surrey, England
- Authors:
- GAGE Heather, et al
- Journal article citation:
- Health and Social Care in the Community, 16(6), November 2009, pp.599-609.
- Publisher:
- Wiley
Data from inspection reports (2002–2003) of all 258 care homes for older people in one county of England (Surrey) was analysed to explore whether the quality of care could be explained by care home or resident characteristics. The number of inspected standards failed in each home was used as the main indicator of quality of care. Independent variables (for each home) were: size, type, specialist registration, on-site nursing, ownership, year registered, location, maximum fee, vacancies, resident dependency, whether the home took publicly funded residents, care staff qualifications and managerial quality. Quality of care was modelled using a Poisson count maximum likelihood method. It was found that quality of care (as defined by failures on national standards) was statistically associated with features of care homes and their residents. A higher probability of failing a standard was significantly associated with being a home that: was a for-profit small business; was registered before 2000, accommodated publicly funded residents; and was registered to provide nursing care. Fewer failures were associated with homes that were corporate for-profit; held a specialist registration; charged higher maximum fees. A secondary analysis revealed a stronger model: higher scores on managerial standards correlated with fewer failures on other standards.
Factors associated with higher quality assessment tools in care homes
- Authors:
- WORDEN Angela, CHALLIS David
- Journal article citation:
- Journal of Care Services Management, 2(1), October 2007, pp.79-91.
- Publisher:
- Taylor and Francis
This paper investigates the relationship between the quality of assessment tools used in care homes and the different characteristics of care homes in part of North-West England. Using both single variable comparisons and multivariate analyses there were several home characteristics associated with the use of higher-quality assessment tools. Higher-quality assessment process were associated with homes being larger, part of a group or chain, provision of staff training and run by non-for-profit organisation or local authority. Poorer quality of assessment was associated with inspection reports indicating lower standards of management and staffing and generally poorer quality of the home. The findings raise the question as to whether government initiatives to improve assessment of older people should be extended to care homes, with a need to focus on certain types of home where assessment is less likely to be well developed.
Using quality standards to improve practice in care homes for older people
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2015
- Pagination:
- 9
- Place of publication:
- London
This resource explains how NICE quality standards can be used, and sets the improvement opportunities offered by the quality standards in the context of the Care Quality Commission's new framework for inspection. The resource outlines how quality standards fit with other improvement initiatives, and suggests ways they can be used to improve practice, including preparing for inspection. It also identifies which quality standard statements are likely to be most relevant for each of CQC's five key questions around safety, effectiveness, caring practice, responsiveness and good leadership. (Edited publisher abstract)
Regulating long-term care quality: an international comparison
- Editors:
- MOR Vincent, LEONE Tiziana, MARESSO Anna
- Publisher:
- Cambridge University Press
- Publication year:
- 2014
- Pagination:
- 519
- Place of publication:
- Cambridge
This edited book provides a comprehensive international survey of long-term care provision and regulation, built around a series of case studies from Europe, North America and Asia. The analytical framework allows the different approaches that countries have adopted to be compared side by side and readers are encouraged to consider which quality assurance approaches might best meet their own country's needs. Wider issues underpinning the need to regulate the quality of long-term care are also discussed. The book is aimed at policymakers working in the health care sector, researchers and students taking graduate courses on health policy and management. (Edited publisher abstract)
Living life with dementia: local Age UK and Age Concern contributions to quality outcomes for people living with dementia and their carers
- Author:
- CHANNA Harvinder
- Publisher:
- Age UK
- Publication year:
- 2011
- Pagination:
- 36p.
- Place of publication:
- London
The National Dementia Strategy (NDS) has, as a key priority, the improvement of outcomes for people living with dementia and their carers. Nine quality outcome statements are proposed which capture what people living with dementia and their carers aspire to. This guide describes a range of services for people with dementia and their carers which demonstrate some of the ways that local Age UKs and Age Concerns are contributing towards achieving these quality outcomes. The services are divided into different categories representing the NDS quality outcomes. Quotes from the service users are provided to bring to life the ways in which policy can be translated into action to make a difference to the lives of people living with dementia and their carers. The aim is to provide commissioners with ideas for support and services that contribute to the key NDS quality outcomes.
The quality of care services purchased by councils: 2010: technical report
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2010
- Pagination:
- 45p.
- Place of publication:
- London
Councils spend nearly £8 billion each year on residential care and home care, which is over 70% of all their expenditure on adult care services. In November 2009, all 152 councils in England provided the Care Quality Commission (CQC) with data on the number of their residents for whom they purchased care in care homes in the period April to September 2009. This report links the data supplied to data on quality ratings for each care home. In addition, the councils reported to CQC in November 2009 on 317,000 adults for whom they had arranged home care with registered agencies in a week in the 6 months to 30 September 2009. The report provides a detailed analysis of the findings of these council returns. The data shows some variation in the quality of services purchased by councils. Councils purchased care for 230,000 adults in care homes. Eighty-six percent of these adults were living in care homes rated good or excellent. The percentage was lower (82%) for those in homes offering nursing care for older people. Ninety-three percent of adults whose home care was arranged or purchased by their council received a service from a home care agency rated good or excellent. Comparisons of the quality of care arranged by councils between September 2008 and September 2009 show that the percentage of people receiving care from services rated good or excellent has improved for both care homes and home care.
Evaluating the standards of nursing in residential care homes across one region
- Author:
- VEAL Haley
- Journal article citation:
- Nursing Times, 28.9.10, 2010, pp.18-20.
- Publisher:
- Nursing Times
An audit tool was developed to assess standards in care homes across the region of NHS Derbyshire County. The audit tool included: management of falls; end of life care; nutrition and hydration; and dementia and mental health. This article examines how the team used clinical audit to evaluate services and make recommendations for improving the quality of care.
The real cost of quality care and support
- Authors:
- NATIONAL CARE FORUM, COUNSEL AND CARE
- Publisher:
- National Care Forum; Counsel and Care
- Publication year:
- 2009
- Pagination:
- 8p.
- Place of publication:
- Coventry
The findings of a survey of National Care Forum (NCF) member organisations to explore the issues of quality and cost in the provision of care and support services are presented. A total 189 care homes and 21 home care services responded to the survey. The key findings are briefly summarised under the following themes: the views of people who use services and their families; putting relationship-centred care into practice; effective leadership and management; learning and development; valuing and rewarding staff; service innovation; and income and costs.
A hindrance or a help? The contribution of inspection to the quality of care in homes for older people
- Author:
- FURNESS Shelia
- Journal article citation:
- British Journal of Social Work, 39(3), April 2009, pp.488-505.
- Publisher:
- Oxford University Press
There has been no real attempt to explore the contribution and effectiveness of inspection as a catalyst for change and improving service provision. In England the Government is currently reviewing the way that one regulatory body, the Commission for Social Care Inspection (CSCI), operates and carries out its inspection functions in relation to care homes for older people. This article reports on a study carried out in 2004 that asked managers of care homes for older people about their views and experiences of inspection and ways to improve the process. The findings endorse inspection as a necessary intervention. Managers identified that the main purposes of inspection were: to ensure the well-being of residents; to achieve or comply with standards; to check that the home was running properly and to act as a double check against the homes own audits. The two most useful aspects of inspection were as a means of providing feedback and as support and guidance to managers. The expertise of the inspector needs to be better deployed to drive up standards of care and maximise their influence to promote an improvement in services and innovation in practice.
Standards of care in day hospitals and day centres: a comparison of services for older people with dementia
- Authors:
- REILLY Siobham, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(5), May 2006, pp.460-468.
- Publisher:
- Wiley
Current policy in England emphasises the importance of caring for highly dependent older people for as long as possible at home. It is therefore crucial that day care services are effective and widely available. This study aimed to compare the type and standard of care provided for older people with dementia in day centre and day hospital settings. A cross-sectional postal survey design was employed. Representatives from three-quarters of identified specialist day care services for older people with dementia in the North West of England provided information on a range of indicators including: basic structural features; delivery of care; service content; and quality measures. The results found day hospitals tended to have more day care places and a greater number of attendees, but lower occupancy rates than day centres. Day hospitals reported higher standards of care in relation to systematic assessment and care planning, promotion of rehabilitation, carer involvement and individualised provision of care. They were also more likely to employ building design features to encourage independence and choice for people with dementia. A higher proportion of day centres provided services exclusively to older people with dementia and a greater proportion of staff in day centres had undergone specific training in caring for people with dementia. Day centres were also more likely to have effective transport arrangements in place. It is concluded that the standards developed for the study were sufficiently reliable to allow for an acceptable estimate of quality. Day centres and day hospitals appeared to perform two distinct, but complementary functions. These results provide key material for shaping the provision of day care for older people with dementia, especially given the absence of national standards in this area.