Quality in long term care homes for people with dementia: an assessment of specialist provision

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Abstract

There has been debate for some years as to whether specialist facilities offer the best model of care for people with dementia or whether integrated service provision is more desirable. Research into this field is limited and continued uncertainty exists as to the benefits of particular care regimes for people with dementia. The National Service Framework for Older People (Department of Health, 2001a) however has recommended that social services departments encourage the development of specialist residential care for this service user group. This paper considers data from long-term care facilities in North West England, collected via a postal questionnaire, that provide some degree of service to people with dementia. Of the 287 homes that responded (a 73% response rate) 56 per cent (n=162) described themselves as specialist services for older people with mental health problems (known as EMI). It was envisaged that the EMI homes would score more highly than the non-EMI homes on a number of standards measuring service quality for people with dementia, developed from research and policy documents. However, statistically significant differences were detected in only a minority of indicators and non-EMI homes scored more highly than EMI homes on a small number of measures. Both home types achieved high results on some standards. On many measures both EMI and non-EMI homes were found to be performing to a low level. Overall services described as EMI did not appear to offer a distinctively different service to those described as non-EMI homes.

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