Care home quality ratings linked to the working conditions of staff

Olivia Miller
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Research led by Kent’s Centre for Health Services Studies (CHSS) and Brighton and Sussex Medical School (BSMS) has found that improving working conditions and reducing staff turnover can increase care quality and outcomes for care home residents.

The study published by Health Services and Delivery Research reveals that care home quality ratings are related to working conditions for staff such as training opportunities and wages, and are positively associated with quality-of-life outcomes for residents with the greatest needs.

Care homes are regulated by the Care Quality Commission (CQC), ensuring the quality of care provided and to inform public choice. Inspection reports and quality ratings are publicly available, with homes awarded a quality rating (‘outstanding’, ‘good’, ‘requires improvement’ or ‘inadequate’).

Over 425,000 older people in England live in care homes because they have significant long-term health problems. Those with the greatest care needs gain the most from homes rated ‘good’ or ‘outstanding’, especially with respect to social participation and feeling in control of their daily lives.

The study led by Dr Ann-Marie Towers at CHSS alongside Professor Jackie Cassell (BSMS) and a wider team of researchers, demonstrated the need for the systematic and consistent collection of data on residents’ outcomes as an important indicator of care quality. The researchers examined the relationship between care home residents’ health and quality of life, regulator quality ratings and the skill mix and employment conditions of the workforce to reach their conclusions.

Dr Towers said: ‘Strong leadership, a focus on continued quality improvement and a culture of care that gives staff time to listen to residents and meet their needs with compassion will go a long way in improving residents’ quality-of-life outcomes.’

Professor Cassell said: ‘The most recent CQC system rated around one-fifth of homes as ‘inadequate’ or ‘requires improvement’, but there is very little existing evidence concerning how well these ratings are associated with residents’ quality of life and the characteristics and employment conditions of the workforce. These are important factors contributing to the success of a care home, and should therefore be considered alongside other data.’

Their research paper titled ‘Care home residents’ quality of life and its association with CQC ratings and workforce issues: the MiCareHQ mixed-methods study’ is published by Health Services and Delivery Research. doi: 10.3310/hsdr09190