A new study published in the International Journal of Quality in Health Care is the first to ask Australian residents living in different models of long-term aged care to rate the quality of the care they receive.
Participants in the study, the majority of which had a diagnosis of dementia, rated the overall quality of care as higher in home-like (clustered) models of care. This more home-like model of care provided residents with greater flexibility and choice in their care routines, compared to the standard residential aged care model.
Dr Suzanne Dyer, a senior research fellow at Flinders University and an author on the study said that, “It is important that we know the view of the residents and their families about the quality of care.
The participants in our study rated the flexibility of care routines and being able to access the outdoors whenever they wanted as higher in a clustered, domestic model of care compared to those in more standard aged care homes.”
The introduction of consumer directed care has meant understanding quality of care in the residential aged care setting from the consumer perspective is critical. Previously, measures of the quality of aged care homes have largely focussed on a regulatory perspective based on clinical outcomes or processes of care from the perspectives of staff or independent assessors.
The published study titled “Clustered domestic model of residential care us associated with better consumer rated quality of care”, conducted at Flinders University, Department of Rehabilitation and Aged Care, used a simple questionnaire that they developed and validated called the Consumer Choice Index- 6 Dimension (CCI-6D), to enable assessment of the quality of care from the perspective of residents or their family members.
The questionnaire compared care services in standard residential aged care facilities with more home-like, domestic models of care that provided care for people living with dementia and measured care time, how home-like shared spaces and their own-rooms are, outside and gardens, meaningful activities and care flexibility.
Whilst the amount of the care time provided was rated as similar between the types of care homes, the residents and family members rated being able to get outside whenever they wanted and the flexibility of the care routines as better in the clustered domestic models of care.
Kathy Williams, who cared for her mother with dementia and is involved in the study, is not surprised that residents and families felt the home-like models provided a better quality of care.
“In a small home-like environment people are living with fewer people, they have an opportunity to access outdoor spaces on their own. They also have an opportunity to be involved in meal preparation and other activities, like they would in their own home.”
The results of this study are part of the larger, the Investigating Services Provided in the Residential care Environment for Dementia in Australia (INSPIRED) study, funded through the NHMRC Cognitive Decline Partnership Centre.
The research is written up in the International Journal for Quality in Health Care.