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Published in: Health and Quality of Life Outcomes 1/2019

Open Access 01-12-2019 | Care | Research

A cross-sectional study exploring the relationship between regulator quality ratings and care home residents’ quality of life in England

Authors: Ann-Marie Towers, Sinead Palmer, Nick Smith, Grace Collins, Stephen Allan

Published in: Health and Quality of Life Outcomes | Issue 1/2019

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Abstract

Background

The quality of life of people receiving health and social care is an important indicator of service quality, but the relationship between patient experience and outcomes and regulator quality ratings in England is unknown. In 2013, the health and social care regulator in England, the Care Quality Commission (CQC), introduced a new ratings system and by February 2017, all social care services were inspected and awarded new quality ratings (outstanding, good, requires improvement and inadequate). This study aimed to explore whether quality ratings were associated with residents’ quality of life, controlling for confounding variables.

Methods

We conducted a nested, cross-sectional study, collecting social care-related quality of life (SCRQoL) data for 293 older care home residents in 34 care homes (20 nursing and 14 residential) in the South East of England. CQC ratings and other resident and home-level variables were also collected for the analysis. Multilevel modelling explored whether residents’ social care-related quality of life (SCRQoL) was associated with regulator ratings, controlling for confounding variables.

Results

Outstanding and good homes were collapsed into one category and compared with homes requiring improvement. Nationally, only 2 % of care homes for older people are rated as inadequate and it was not possible to capture sufficient numbers for the analysis. We recruited one but it was re-inspected during the fieldwork period and its rating changed to requires improvement. The random intercept multilevel model, which accounted for 16.93% of the differences in SCRQoL within homes and 69.80% between, indicated that better SCRQoL was significantly associated with being female, better functioning, no dementia diagnosis, fewer communication difficulties, and living in a care home rated as outstanding/good by CQC. Size of home and registration category were not significant predictors.

Conclusions

This study found evidence that quality ratings are associated with residents’ SCRQoL. As well as aiming to improve quality and ensure minimum standards, quality ratings have the potential to inform user choice and help the public compare care homes based on quality. Future research to establish the generalisability and replicability of the results is required.
Literature
1.
go back to reference Buisson LW. Care of older people: UK market report 26th Edition 2013/2014. London; 2014. Buisson LW. Care of older people: UK market report 26th Edition 2013/2014. London; 2014.
5.
go back to reference Care Quality Commission. The state of adult social care services 2014 to 2017 Findings from CQC’s initial programme of comprehensive inspections in adult social care. 2017. Care Quality Commission. The state of adult social care services 2014 to 2017 Findings from CQC’s initial programme of comprehensive inspections in adult social care. 2017.
6.
go back to reference Trigg L. Using online reviews in social care. Soc Policy Adm. 2013;48:361–78.CrossRef Trigg L. Using online reviews in social care. Soc Policy Adm. 2013;48:361–78.CrossRef
12.
go back to reference Care quality commission. A new start. Responses to our consultation on changes to the way CQC regulates, inspects and monitors care services. October 2013. London: Care Quality Commission; 2013. Care quality commission. A new start. Responses to our consultation on changes to the way CQC regulates, inspects and monitors care services. October 2013. London: Care Quality Commission; 2013.
18.
go back to reference Department of Health. The adult social care outcomes framework 2013/14. Handbook of definitions. London: Department of Health; 2013. Department of Health. The adult social care outcomes framework 2013/14. Handbook of definitions. London: Department of Health; 2013.
23.
go back to reference Von EE, Altman DG, Egger M, Pocock SJ, Peter C, Gøtzsche P, et al. Guidelines for reporting observational studies Strengthening the reporting of observational studies in epidemiology ( STROBE ) statement : guidelines for reporting observational studies. Br Med J. 2007;335(October):19–22. Von EE, Altman DG, Egger M, Pocock SJ, Peter C, Gøtzsche P, et al. Guidelines for reporting observational studies Strengthening the reporting of observational studies in epidemiology ( STROBE ) statement : guidelines for reporting observational studies. Br Med J. 2007;335(October):19–22.
25.
go back to reference Mental Capacity Act. Mental capacity act: London Station off; 2005. Mental Capacity Act. Mental capacity act: London Station off; 2005.
26.
go back to reference Luff R, Ferreira Z, Meyer J. Care homes: methods review 8. London: NIHR School for Social Care Research; 2011. Luff R, Ferreira Z, Meyer J. Care homes: methods review 8. London: NIHR School for Social Care Research; 2011.
31.
go back to reference Morris JN, Fries BE, Mehr DR, Hawes C, Phillips C, Mor V, et al. The MDS cognitive performance scale. J Gerontol. 1994;49:174–82.CrossRef Morris JN, Fries BE, Mehr DR, Hawes C, Phillips C, Mor V, et al. The MDS cognitive performance scale. J Gerontol. 1994;49:174–82.CrossRef
33.
go back to reference West E, McGovern P, Chandler V, Banaszak-Holl J, Barron D. The quality of life in UK care homes: a systematic review. In: International handbook of positive ageing. London: Routledge; 2016. West E, McGovern P, Chandler V, Banaszak-Holl J, Barron D. The quality of life in UK care homes: a systematic review. In: International handbook of positive ageing. London: Routledge; 2016.
38.
go back to reference IBM Corp. IBM SPSS statistics for windows. Version 24.0. 2016. IBM Corp. IBM SPSS statistics for windows. Version 24.0. 2016.
39.
go back to reference Snijders TAB, Bosker RJ. Multilevel analysis: an introduction to basic and advanced multilevel modeling; 2011. Snijders TAB, Bosker RJ. Multilevel analysis: an introduction to basic and advanced multilevel modeling; 2011.
40.
go back to reference Malley J, Towers AM, Netten A, Brazier J, Forder J, Flynn T. An assessment of the construct validity of the ASCOT measure of social care-related quality of life. Health Qual Life Outcomes. 2012;10:21.CrossRef Malley J, Towers AM, Netten A, Brazier J, Forder J, Flynn T. An assessment of the construct validity of the ASCOT measure of social care-related quality of life. Health Qual Life Outcomes. 2012;10:21.CrossRef
41.
go back to reference Tabachnick BG, Fidell LS. Using multivariate statistics: Pearson/Allyn & Bacon; 2007. Tabachnick BG, Fidell LS. Using multivariate statistics: Pearson/Allyn & Bacon; 2007.
43.
go back to reference Smith N, Towers A, Palmer S, Beecham J, Welch E. Being occupied: supporting “meaningful activity” in care homes for older people in England. Ageing Soc. 2017. Smith N, Towers A, Palmer S, Beecham J, Welch E. Being occupied: supporting “meaningful activity” in care homes for older people in England. Ageing Soc. 2017.
Metadata
Title
A cross-sectional study exploring the relationship between regulator quality ratings and care home residents’ quality of life in England
Authors
Ann-Marie Towers
Sinead Palmer
Nick Smith
Grace Collins
Stephen Allan
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2019
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-019-1093-1

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