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CHOICE project

Care Home Organisations Implementing Cultures for Excellence (CHOICE)

The CHOICE project was funded by the Department of Health and Comic Relief, and was the final project of the UK-wide PANICOA (Prevention of Abuse and Neglect in the Institutional Care Of Older Adults) programme. The aim of CHOICE was to examine the links between organisational cultures and the care experiences of older people living in residential and nursing care.

ADS worked in partnership with the University of East Anglia, University of Stirling and Cardiff University to carry out 12 in-depth case studies of care homes across the UK. Positive and negative care experiences of older people in long-term care were analysed in relation to the contexts and cultures in which they occurred.

In designing the research, it was recognised that news stories often report mistreatment in care homes, while good practice gets little publicity. Mistreatment in many forms does occur, even though most staff and owners want to provide good care and despite systems of inspection of care homes. What is not known is how widespread it is or why it occurs in some homes but not others. Simple surveys, for example using questionnaires asking residents about mistreatment, do not provide a reliable picture.

In the CHOICE research, the case studies used observations, interviews and documentary collection to analyse the individual circumstances and organisational cultures, contexts and practices most likely to encourage or inhibit the provision of high-quality care. The starting point of each case study was an in-depth observation over a 2-day period using the PIECE-dem framework, which was developed by ADS in an earlier PANICOA research programme.

Findings from the CHOICE project will be of benefit to all those involved in providing and regulating care homes, and for families and potential residents purchasing care. The final product will be used to develop a web-based resource of examples, stories, questions and information to structure reflection about culture and practices of care.

A copy of the final project report can be found here and a project summary is also available.

The findings of this project showed 7 elements pf positive care cultures that made a difference to residents quality of life". These findings are integrated into all of our education and consultancy work and are discussed in detail within the latest edition of  Person-Centred Dementia Care: 2nd Edition: Making Services Better with the VIPS Framework by Dawn Brooker and Isabelle Latham - copies of which can be ordered here: Books and other resources

The CHOICE team at ADS consisted of Professor Dawn Brooker, Jenny La Fontaine and Isabelle Latham. Isabelle has worked extensively in the care home sector, specialising in safeguarding vulnerable adults, staff development and advocacy for older people.

If you would like further information please contact Isabelle Latham:
tel: 01905 542326