Journal of Long-Term Care (Apr 2019)
Helping older people to use quality information to choose residential care
Abstract
Context: The availability of data about the quality of care homes has increased in England since the late 1990s, as in other countries, but it is widely underused by people choosing providers. Objectives: To examine older people’s understandings of a high-quality care home, their preferences for quality indicators, and how they would use comparative quality information about care homes to select one for themselves or a relative. Method: Five group workshops were conducted with 27 older people with experience of social care services and relatives of care home residents in three local authority areas in England. Different methods were used to collect data: an open discussion, a card sorting exercise, and use of a scorecard to compare fictitious homes. Findings: The most popular indicators among participants in the workshops were linked to residents’ quality of life. Indicators we may think of as being about clinical issues were valued the least. The value of some indicators was more widely recognised after discussion highlighted their relevance to choosing a care home for someone. Comparing quality information was said to be useful to shortlist homes to visit and inform visits, and many strategies were used to manage the data to select a home. Concerns were raised about the trustworthiness of some data and sources. Limitations: The nature and scale of the work mean we cannot claim it to be a representative sample and this limits the generalisability of the findings. The findings are, nevertheless, illuminating in terms of factors to consider when making available information to assist in choosing a care home. Recruitment challenges for the workshops and the implications of the difficulties participants had managing the data are discussed. Implications: Quality indicators are likely to be ineffective at promoting comparison across care homes unless older people are supported to understand their significance. Policymakers and providers of quality indicators need to be aware of user preferences, build in decision-making support, find ways to better communicate complex measures and encourage people to identify their own views before reviewing published indicators. Methodological implications for further work in this area are also considered.
