New model to rate aged care to the rescue

The Consumer Choice Index-6 Dimension (CCI-6D) questionnaire was designed by Flinders University’s Investigating Services Provided in the Residential Care Environment for Dementia (INSPIRED) team and funded by National Health and Medical Research Council (NHMRC) Cognitive Decline Partnership Centre.

It was developed to specifically evaluate the quality of care in aged care homes from a consumer perspective and can be used by organisations to properly evaluate the success of interventions and innovations to improve care from their customers’ perspectives.

One of the research team, Dr Suzanne Dyer from Flinders University’s Rehabilitation, Aged and Extended Care, College of Nursing and Health Sciences, says the questionnaire incorporates multiple aspects of care.

“Our research indicates several things are important to residents and their family members; the way staff provide care, respect for the individual as a person, the physical and social environment, and the level of autonomy given to individuals,” Dr Dyer says.

“Previous efforts to measure quality in aged care homes have focused mostly on the perspectives and opinions of staff or independent assessors.

“The CCI-6D bridges this gap, with a questionnaire that measures quality of care, developed from its inception from the perspectives of residents and family members.”

The questionnaire works by measuring six key characteristics of good quality care including:

• Formal caregivers are able to spend enough time attending to individual’s needs
• The shared spaces of the facility re home-like and non-institutional
• The individual rooms of the facility are home-like and non-institutional
• There is choice in access to outside and gardens
• There is access to meaningful activities individualised for the person
• There is flexibility in the time that care activities are undertaken

The developers suggest that the index could also provide a framework for national benchmarks and ratings in aged care, which if made available to the public, could help families make more informed choices about aged care providers.

With the hope of also providing an effective response to the Review of National Aged Care Quality Regulatory Processes, released last month, which called for better systems of information sharing on provider performance and consumer directed care in the aged care sector, the questionnaire has now been presented to the Senate Inquiry into the Effectiveness of the Aged Care Quality Assessment and accreditation framework.

A spokesperson for the Federal Department of Health says the department is “aware of Flinders University’s CCI-6D tool, which is a new instrument designed specifically to evaluate the quality of care in residential aged care facilities from a consumer perspective”.

The spokesperson also says the department notes that the Review of the National Aged Care Quality Processes (the Carnell Paterson Review) Recommendation 3 builds on the existing National Aged Care Quality Indicators Program by suggesting that performance benchmarking tools be developed, that ‘performance cards’ be issued to residential aged care facilities, and for new clinical and consumer experience tools to be piloted and validated.

“In terms of related work, the Department conducted residential and home care pilots of consumer experience and quality of life measures – and goal attainment for home care services – between February and June 2016, which included 480 residential and home aged care services and 2,470 consumers,” the spokesperson says.

“The pilots were well supported by service providers and interest in a tool to measure consumer experience and quality of life is strong.

“As a leading consumer peak body, the Council on the Ageing (COTA) have been engaged to lead a period of consumer-led consultation with the sector about quality assurance systems and indicators of quality in aged care, to help inform the future of the National Aged Care Quality Indicator Program.”

The spokesperson adds that this will be considered in the context of the Carnell Paterson Review recommendations and of broader aged care reform.

Chief Executive Officer of DPS Publishing Mark Ogden says the Adelaide based but nationally inclusive aged care publisher is also working towards implementing it’s own ratings system for aged care as part of their online resources.

“The conversation about industry and consumer ratings systems has become more prominent of late with DPS recognising the need for consumers to make decisions based on quality and performance,” Mr Ogden says.

“In response DPS is working closely with the industry to develop a performance based system so consumers know what they can expect from service providers based on other people’s direct experience.”

The Flinders University project’s paper – Evaluating the quality of care received in long-term care facilities from a consumer perspective: development and construct validity of the Consumer Choice Index – Six Dimension instrument – was recently published in Ageing and Society.