Improving Quality of Life for Older People in Long-Stay Care ...

Long-Stay Facility Survey FindingsThis quantitative survey focused on the size and number of facilities, residents,dependency levels, staffing levels, provision of therapies and activities and thephysical environment. Key differences in staffing provision and physical environmentemerged between private and public facilities. Dependency levels were highest inthe public sector, with the exception of welfare homes which tended to cater for lessdependent residents. Staffing ratios were higher in public facilities than in private facilitiesand there was more evidence of therapeutic activity. However, physical environmentand infrastructure were generally better in the private sector than in the public sector.Residents in the private sector were also more likely to be given choice over whento get up and go to bed. The survey also found that there were a significant amountof activities going on for residents in both public and private long-stay facilities, thoughit was impossible to tell from the survey what value residents placed on these activities.It was evident from the findings of the survey that there were differences inresident quality of life both within and across sectors. Some were related tothe care environment, others to the dependency and personality of the resident.What was clear from the data was that management and organisational structureswithin long-stay care facilities matter for quality of life and can compensate for poorphysical environment in certain circumstances. The issue was less whether carewas delivered publicly or privately, more whether care was resident-centred andquality driven.29Qualitative Interview FindingsThe findings from qualitative interviews revealed four thematic domains of qualityof life: care environment and ethos of care, personal identity, connectedness tofamily and community, and activities and therapies. The study found that therewere significant differences in resident experiences across care study sites andsome differences between public and private study sites. The ethos of care inmany facilities did not facilitate resident inclusion in decision-making and routinecontinued to prevail in some facilities. This was more evident in the public sectorthan the private sector. The findings suggested that physical environment wasimportant as it constrained resident choice and, therefore, impacted greatly onquality of life. The physical environment was poor in some facilities, but moreso in the public sector than the private sector.