What does quality of care mean from a resident perspective thesis submission corrected?

Brennan, Jane

Abstract

Purpose: Despite substantial regulatory oversight, quality of care within the care home sector remains problematic. The aim of the research is to improve quality of care for residents by asking those who live in care homes what quality of care means to them. These findings will drive changes for commissioners in the collection of quality data from the care home sector. The research project will mark the start of a progression in partnership working to cultivate impetus, clinical resources and guidance that will support the commissioners and providers in improving the experience and the quality of care for residents residing in a care home, with the resident’s voice playing a central role to any potential changes in current practice.
When individuals move into a care home, they are essentially moving from one home to another. The word ‘home’ should mean something special; a place that is filled with hope, friendship, love, and laughter. Regardless of age, health condition, or the place we call home, we all desire a good quality of life, to be able to do the things that mean the most to us, and to feel appreciated and valued. This influenced the decision to study the quality of care from a resident’s perspective in the place they should be able to call home (Goodman et al, 2015). Therefore, this study will support the evidence base by exploring how to enhance the quality of care and experience of people residing in a care home, understanding what quality means to them, and ensuring that the residents voice is heard.
This study will seek to understand the perceptions of quality of care within a care home from those residing in care homes. Chiefly, that the present performance outcome measures are based on our clinical outcomes, but there is little emphasis on engaging in ‘what matters’ to residents which is the purpose of this study. The aim is to explore and understand the experiences, perceptions, of residents, which will start to bridge this gap and outline meaningful fulfilment. The hope is to learn how to create opportunities that afford each resident more control over what constitutes quality of care by listening, reflecting, and trying to understand their personal interpretations.
Research Aim: Define what ‘Quality of Care’ means from a resident’s perspective.
Research Objectives:
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To generate knowledge of what quality of care means to residents residing in a care home.
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To develop an evidence base of what matters the most to residents from a lived experience perspective.
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To generate knowledge to inform commissioners of resident’s perspectives of the quality of care in care homes.
Research Question:
‘What does quality of care mean from a resident’s perspective of living in a care home? A qualitative descriptive study’.
Design and Methods: The study will employ a Qualitative Description (QD) methodology. A Literature search will be adopted to extract terms, characteristics, experiences, and outcomes from relevant literature not just those solely related to nursing practice, in relation to improving quality of care within the care home sector. Following on from the literature review, the researcher worked with a third party (Health Watch) to conduct semi structured interviews with residents to determine what quality care means to them; with the intention of comparing the findings from
the literature review to formulate the discussion. Once the semi-structured interviews had taken place the data was analysed by adopting a thematic analysis approach as developed by Braun & Clarke, (2017), this method of analysis was chosen as it is an appropriate tool for analysing qualitative data, and provides structure and flexibility for the researcher, and offers a rich and detailed, yet complex account of acquired data.
Results to Date: In the UK, most of the long-term care for older people is provided by staff working within the care home sector. As older people with complex health care needs tend to require more intense care and support, which in the most is offered by care homes, these places should be considered their home in which their quality-of-life matters. In 2020, approximately 419,000 people were recorded as living in care homes (NIHR, 2020) although this population is projected to rise by 127 percent over the next 20 years. This represents 4 percent of the population aged 65 years and over, and 16 percent of those aged 85 or more (NIHR, 2020). There are more than twice as many people living in care homes in England and Wales than people staying in hospital. Yet, care professionals know far more about effective treatments in hospital and less about what works most effectively to improve care for older people residing in care homes.
According to NIHR (2021), the English care home market for the elderly comprises just over 9,500 care homes, which primarily aim to provide for those who live with dementia or the general population of older people (NIHR, 2021). Much of the supply comprises single home providers or small, multi-home organisations, although there are some large chains. Around 15 percent of the market is supplied by non-profit providers (Villaire & Walsh, 2017).
The challenge this brings to our region is that research has shown that those areas with the most care homes have a higher incidence of emergency hospital admissions for patients over the age of 75 (Laing & Buisson, 2023).
It is apparent that the voice of residents with regards to what quality of care means to them within the sector is usually not heard according to the literature. In fact, it emerged that when improving residents’ experience and quality outcomes, the focus is on the perspectives of professionals, policy makers and relatives, rather than those of the residents who live in the care home. The political saliency of nursing home quality remains uneven.
Implications: Quality of care in care homes is a major issue for which there is no simple solution. There is variation in practice, oversight, monitoring, and assurance processes of the quality of care within care homes. The consequence of not capturing what matters the most to residents is that we fail to deliver meaningful, quality or care.

Citation

Brennan, J. (2024). What does quality of care mean from a resident perspective thesis submission corrected?. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Oct 8, 2024
• Publicly Available Date: Oct 27, 2024
• Award Date: Sep 26, 2024