Information and choice of residential care provider for older people: a comparative study in England, the Netherlands and Spain

Abstract

This study compared how older people use quality information to choose residential care providers in England, the Netherlands and Spain (Catalonia). The availability of information varies between each country, from detailed inspection and survey information in the Netherlands, through to a lack of publicly available information in Catalonia. We used semi-structured interviews and group workshops with older people, families and professionals to compare experiences of the decision-making process and quality information, and also to explore what quality information might be used in the future. We found that most aspects of the decision-making experience and preferences for future indicators were similar across the three countries. The use of quality information was minimal across all three, even in England and the Netherlands where information was widely available. Differences arose mainly from factors with the supply of care. Older people were most interested in the subjective experiences of other residents and relatives, rather than ‘hard’ objective indicators of aspects such as clinical care. We find that the amount of publicly available quality information does not in itself influence the decisions or the decision-making processes of older people and their carers. To improve the quality of decisions, more effort needs to be taken to increase awareness and to communicate quality in more accessible ways, including significant support from professionals and better design of quality information.

Helping older people to use quality information to choose residential care

“…As a result, the selection of residential care provider is frequently made on behalf of the resident, with family members often taking on the role of decision-maker and 'consumer' in the process. These relatives may have different needs, expectations about quality, preferences for quality information and ways of using it to select a care home (Davies & Nolan, 2003;Milte et al, 2016;Trigg et al, 2018). If potential residents and their families are to take on a more active role in selecting care, it is essential that these issues are considered in policy design.…”

“…Despite the growing breadth of indicators and the best intentions of information publishers, evidence suggests that quality information is underused and the public finds it confusing and believes some data sources lack trustworthiness (Damman et al, 2009;Fischer et al, 2015;Konetzka & Perraillon, 2016). In both health and long-term care, patients, users of services and their families and carers are more likely to favour word of mouth recommendations and choose care providers based on non-quality related factors such as cost, location and availability of a place (Faber et al, 2009, Gadbois et al, 2017Ketelaar et al, 2011;Pesis-Katz et al, 2013;Trigg et al, 2018).…”

“…This is unlikely to change and, in most cases, relatives will probably remain key users of quality information about care homes. The pressure on the initial decision is also increased in England because, unlike in other countries such as Spain, residents rarely move if they do not like their first choice of home (Trigg et al, 2018).…”

“…The purpose of our paper is to contribute to the academic literature on older peoples' understandings of and preferences for quality indicators, with a focus on England, and with the aim of providing useful evidence for guiding further research and the development of indicators. This research was part of a larger international study of information and choice of care homes for older people which included three countries: England, the Netherlands and Spain (Trigg et al, 2018). This included a review of national policies and provision of quality information in each country, and one-to-one interviews with professionals involved in care home selection, and residents and relatives, as well as workshops (Trigg et al, 2018).…”

“…This research was part of a larger international study of information and choice of care homes for older people which included three countries: England, the Netherlands and Spain (Trigg et al, 2018). This included a review of national policies and provision of quality information in each country, and one-to-one interviews with professionals involved in care home selection, and residents and relatives, as well as workshops (Trigg et al, 2018). Here we focus specifically on England and describe and reflect in more detail on our data collection methods and report additional findings and implications for policy and practice in developing quality related information on care homes to inform public choice.…”