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Quality improvement over and above minimum standards: a study of providers of residential care for older people in England and Australia

2016 Conference Presentation

Outcomes and qualityResidential Care AustraliaEnglandUnited Kingdom

5 September 2016

Quality improvement over and above minimum standards: a study of providers of residential care for older people in England and Australia

Lisa Trigg, PSSRU, London School of Economics and Political Science, United Kingdom


Governments have experimented with different policy instruments to influence quality among providers of care for older people. There has been a trend towards the marketisation of care and policies with an expectation that this in itself will improve quality. At the same time, marketisation has also been accompanied by a significant increase in government interventions and activity to influence quality and efficiency from a distance. All of this activity is based on the assumption that government intervention can play a part in encouraging providers to both meet, and go above and beyond, minimum standards of quality. Studies in other sectors, principally concerned with environmental regulation, have found that, while regulation and other government actions play a part, alternative explanations for external influence on provider behaviour include economic pressures, political and social pressures and characteristics related to management and attitudes [1, 2].

This presentation will focus on residential care for older people, and reports from a study exploring what part external factors play in influencing the efforts of providers to improve quality ‘beyond compliance’, and what part do government activities and regulatory actions play. Semi-structured interviews were carried out with managers and other staff from a group of ten for-profit and not-for-profit providers and other stakeholders, drawn from a single local authority in England and a single planning region in Australia. The providers sampled were identified as being ‘high quality’ providers – a process which proved to be challenging as the definition of quality and the use of inspection ratings is different in England and Australia. The challenges of this process will be highlighted in the presentation. The presentation is part of a larger study comparing the regulatory systems in place in England and Australia and will highlight the similarities and differences between the two countries, as well as the differences between different types of providers.

1. Kagan, R.A., D. Thornton, and N. Gunningham, Explaining corporate environmental performance: How does regulation matter? Law & Society Review, 2003. 37(1): p. 51-90.

2. Thornton, D., R.A. Kagan, and N. Gunningham, When Social Norms and Pressures Are Not Enough: Environmental Performance in the Trucking Industry. Law & Society Review, 2009. 43(2): p. 405-435.