Does regulating private long-term care facilities lead to better care? A study from Quebec, Canada.
Improving the quality of public services, and long-term care (LTC) more specifically, has been central to the agenda of successive UK Governments since the late 1980s. This article focuses on the situation in England, where a variety of mechanisms have been implemented to achieve this end, including the introduction of quasimarkets, an independent inspectorate, national standards for care providers, a national performance management regime and a variety of other regulatory and guiding bodies for the workforce and practitioners. Given the investment in quality improvement, it is important to ask how high is the quality of LTC in England? To provide some background to this question, the first part of this article explores who the key players are, what measures are used and how these measures fit within the quality assurance (QA) framework. Then, the evidence about the quality of LTC for adults in England is critically reviewed. LTC for children is not considered – this is the responsibility of Children’s trusts, which are subject to different policies and are accountable to the Department for Education. Furthermore, the article does not look at the situation in the other three countries in the UK, where, since 1999, responsibility for long term care has been the responsibility of the devolved national administrations.