Measuring the quality of care in homes for older people

Abstract

The aims of this dissertation are: • To analyse the current level of quality of care, taking the English National Minimum Standards as a benchmark; • Identify areas - thanks to information provided by managers or administrators of the homes and from service users - where more improvement is needed in order to increase the level of care; • Make recommendations that can help increase the level of care in residential homes and that can help those responsible in developing new care standards for Malta. In the literature review, other countries', mainly England, Scotland and France, National Minimum Standards for Care Homes for Older People are identified. The way that these countries regulate their residential homes is also described as are also different theories serving as background to regulation. The current situation in Malta regarding Homes for Older People is then identified. Fieldwork for this study consists first of all in semi-structured interviews with managers of every residential home in Malta owned by the Government, the Church and the private market. Two Government owned homes that are run by a private organisation are also included in the sample. These interviews were carried out to obtain information about the level of care that the homes provide. Observations also took place during every home visit. Semi-structured interviews were also carried out with a sample of service users to obtain their view regarding the services provided in the residential homes. The main results of this study are: • Most of the homes have friendly and dedicated staff; • Service users' wishes, especially with regards to religious functions are satisfied in most of the homes; • Most of the homes have weaknesses in the methods utilised to analyse the needs of service users and the way that care is provided; • Half of the residential homes in Malta have accessibility problems and most of the managers of these homes seem to be unaware of this problem; • There is lack of facilities for submitting anonymous complaints such as suggestion boxes; • Service users are not informed adequately about what they should do in case there is a fire in the home. There are lack of evacuation plans and simulation exercises of such plans; • There are lack of frequent activities organised in homes; • There is lack of training to staff. These results show that certain standards suggested by the English National Minimum Standards are not being met and the services given to the elderly are not optimal. For example, lack of accessibility does not permit a wheelchair user to live independently.