title: Quality of life outcomes for residents and quality ratings of care homes: is there a relationship?
abstract: BACKGROUND
  quality ratings of care homes are used by decision makers in the absence of direct information about outcomes. However, there is little evidence about the relationship between regulators' ratings of homes and residents' quality of life outcomes.
  
  
  OBJECTIVE
  to capture social care-related quality of life (SCRQoL) outcomes for residents and investigate the relationship between outcomes and regulator quality ratings of homes.
  
  
  METHODS
  data were collected for 366 residents of 83 English care homes for older people inspected during 2008. Outcomes were measured using the Adult Social Care Outcomes Toolkit (ASCOT). Multivariate multilevel modelling was used to investigate the relationship between quality of life outcomes and star ratings of homes, controlling for resident and home characteristics.
  
  
  RESULTS
  care homes were delivering substantial gains in SCRQoL, but were more successful in delivering 'basic' (e.g. personal cleanliness) than higher-order domains (e.g. social participation). Outcomes were associated with quality ratings of residential homes but not of nursing homes.
  
  
  CONCLUSIONS
  the approach to providing quality ratings by the regulator in England is currently under review. Future quality indicators need to demonstrate their relationship with quality of life outcomes if they are to be a reliable guide to commissioners and private individuals purchasing care.
authors.affiliation: PSSRU, University of Kent, Cornwallis Building University of Kent, Canterbury CT2 7NF, UK. a.p.netten@kent.ac.uk
authors.forename: Ann
authors.initials: A
authors.lastname: Netten
authors.forename: Birgit
authors.initials: B
authors.lastname: Trukeschitz
authors.forename: Julie
authors.initials: J
authors.lastname: Beadle-Brown
authors.forename: Julien
authors.initials: J
authors.lastname: Forder
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Towers
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Welch
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000592:standards*; D004739:England; D015577:Geriatric Assessment; D006302:Health Services Research; D006299:Health Services for the Aged / Q000592:standards*; D006707:Homes for the Aged / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care / Q000592:standards*; D011788:Quality of Life; D058992:Social Participation; D012944:Social Support