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your care rating 2016 survey

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2 | your care rating 2016 survey

contents foreword

04

your care rating survey

06

survey approach & coverage

08

survey insights

14

summary

26

technical note

28

development & aims

overall measures staff & care choice & having a say home comforts quality of life

07

15 18 20 22 24

2016 survey your care rating | 3

foreword


Your Care Rating: 2016 Survey

5

foreword

Once again, I am very pleased to introduce our annual report which contains the findings from the 2016 Your Care Rating surveys. The key objectives of giving residents and relatives a voice, assisting provider organisations in focusing on quality, and providing potential residents and their families with reliable and robust information remain central to Your Care Rating’s purpose. We are delighted that 35 provider organisations participated in 2016, covering 1,010 care homes and over 50,000 registered places. It is really pleasing to see the Overall Performance Rating (OPR) in the Residents’ survey increasing over the five years in which the survey has been operating. With a consistent methodology applied over this period, the report gives an increasingly useful picture of the trends in residents’ views. Last year’s report mentioned that one of the additional objectives for 2016 was to extend the scope of our relatives’ survey. This has been achieved and the results are included in detail in this year’s report. This is now called the Family and Friends’ survey and we will continue to expand this in future years,

providing an additional dimension to the Your Care Rating results. A further development for 2017 is the Staff survey. As with the Family and Friends’ survey last year, this is currently in pilot phase and once implemented, the results from the three separate but complimentary surveys will provide a unique insight into the performance of care homes in the UK. Sincere thanks go to all the residents, family members and friends who completed the surveys this year; response rates of 38% in the Residents’ survey and 47% in the Family and Friends’ survey are very strong. Thanks are also due to the Care Provider Reference Group (CPRG) who have helped to shape the future direction of Your Care Rating, and to the board members who have given up their time over the course of the year.

Douglas Quinn, Chairman Your Care Rating

Finally, I would like to thank the team at Ipsos MORI for their interest, expertise and support in continuing to develop Your Care Rating as the leading approach to capturing structured and objective feedback from residents, families, friends and staff.


your care rating survey



7

development & aims

In its fifth consecutive year, the Your Care Rating survey measures the views of residents and their family members and friends on the care provided in over a thousand UK care homes. Its inception in 2012 was the first time a syndicated survey had been conducted across providers of residential care (predominantly for older people), to produce comparable and robust measures of satisfaction at the care home level. The survey now extends to two audiences: residents living in care homes, surveyed annually since 2012, and their family members and friends, surveyed in 2015 and 2016. A separate survey of staff working in care homes is also in development, to be piloted in 2017. The idea of creating a standardised, large-scale survey for residential care homes stemmed from the ambitions of an independent Board of academics and representatives from the sector. Your Care Rating was designed to give residents the opportunity to express their opinions anonymously on a range of meaningful measures. The annual publication of results at the care home level - from 2013 onwards1 - commits participating providers to transparency. It

also gives the public access to detailed care home ratings which are available by searching for a care home or a particular area. Following the development of the Family and Friends’ survey in 2015, its results are now published each year alongside those of the Residents’ survey. In 2016, thirty-five providers participated in Your Care Rating overall, demonstrating the value of the surveys in providing insights to drive quality improvements, and as an important customer feedback mechanism. Benchmarking against an Overall Performance Rating for each care home allows care operators to assess each home’s performance in relation to others using a single score. Statistical analysis also gives insight into what is most important to customers in terms of driving satisfaction overall – a form of analysis that each survey’s large sample size affords. This focuses attention on the factors a care home might prioritise for improvement. It also shapes the statistical model used to produce the Overall Performance Rating for each care home, so that it reflects the factors most important to customers.

There are four ‘themes’ – groups of attributes – and in both surveys, attributes relating to the ‘staff and care’ theme are stronger drivers of satisfaction than ratings relating to ‘home comforts’, ‘choice and having a say’ and ‘quality of life’. These four themes are derived from statistical analysis which groups individual survey attributes according to how closely related responses are to one another – we refer to these themes throughout this report. The components of each theme are detailed in the Survey Insights chapter. The questionnaires for each survey were designed in close consultation with providers. For the Residents’ survey questions, the response scale and survey instructions were cognitively tested. Family members and friends are asked to give their views on a greater number of measures than are residents (for whom the cognitive testing indicated the appropriate maximum number of questions before participant fatigue). Where measures are comparable between the two surveys, the two perspectives can be viewed alongside each other in individual care home reports.

1 In its first year (2012), the results of the Your Care Rating Residents’ survey were not published at the care home level. Overall aggregate results were calculated using a different method and are therefore not directly comparable with the results from subsequent years of the Residents’ survey.





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Your Care Rating is designed for residents living in care homes primarily serving older people (aged 65 or over), and their family members and friends. The 2016 surveys were conducted across thirty-five providers, totalling 1,010 care homes and 50,500 registered places overall across the UK.

35 providers participated

across the Residents’ and Family and Friends’ surveys in 2016, totalling

1,012

care homes and

50,400

registered places overall across the UK

The two surveys are administered separately, with fieldwork conducted annually through Autumn and Winter. Each survey has its own questionnaire, with a number of comparable questions between the two, the results of which are presented together in published care home reports.

Surveying care home residents

The Residents’ survey uses a ‘pack distribution’ approach, where each care home receives a pack of questionnaires and freepost return envelopes – one for each registered place at the care home – and a set of instructions for how to administer the survey. Full guidance is provided to care home managers and residents, as well as volunteers, family members and friends, who may help residents to complete their questionnaire.

The guidance details the process for ensuring all residents who take part in Your Care Rating are able to provide informed consent to do so. It notes the essential role that staff play in assessing capacity to provide informed consent, but explains that staff should not be involved in helping residents respond to the questions. The guidance also conveys the importance of allowing residents to give their own personal views, particularly if they require assistance to record their responses, and of ensuring their completed questionnaires are sealed in the envelopes provided for anonymity purposes. Following the survey’s close, a set of detailed checks are carried out via analysis of results and response patterns, as well as telephone discussions with staff at a sample of participating care homes. This is referred to as the ‘validation’ stage, the purpose of which is to investigate any anomalies and remove the responses from care homes which did not follow the correct administration procedures.


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Surveying family members and friends

The survey uses a mixed method approach, offering the capability to participate via a postal questionnaire or online completion. Paper questionnaires were posted directly to (individual) named relatives and friends, with an invitation to complete the survey online issued by post and/ or by email. This approach allowed direct control over who was invited to take part and complete the survey. The details of individual family members and friends were provided by care operators. As part of the sampling stage, data were cleaned to remove duplicate records, records with insufficient postal addresses and records identified as individuals linked to residents in a professional capacity. Where more than one family member or friend was identified for a resident, and these individuals were living at the same address, only one was included in the survey. In the case of multiple family members or friends living at different postal addresses, all were included in the survey.

Survey response

In 2016, a total of 18,786 residents took part in the Residents’ survey – an unadjusted response rate of 38%2. Fieldwork was conducted between late August and late October 2016. The Family and Friends’ survey fieldwork was conducted between late September 2016 and early January 2017 – 10,963 responses were received in total (10,396 postal responses and 567 online), giving a response rate of 47%. These response rates remain strong despite an industry-wide decline across all methods.

2

Figure 3.1: Response rates for the Residents’ survey and the Family and Friends’ survey in 2016

38%

RESPONSE RATE FOR RESIDENTS

47%

RESPONSE RATE OVERALL FOR FAMILY AND FRIENDS (WITH A BREAKDOWN OF 95% POSTAL, 5% ONLINE)

The unadjusted response rate is calculated on the basis of the total number of responses, from the total number of registered places.



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Figure 3.2: Your Care Rating 2016 – map of participating care homes

Figure 3.2 shows the extensive coverage of care homes participating in the Your Care Rating survey across the UK. It is important to note that while this coverage is extremely widespread, it is not representative of all residential care homes. A majority of the care providers taking part in the 2016 surveys have also taken part in previous years, with the exception of some small and medium sized providers who participated in the surveys in 2016 for the first time3. The profile of participation in terms of provider size remains broadly similar over the years, and long term trends in results should be viewed in this context.

5 large providers (defined as having 41 or more care homes), 18 medium sized providers (between 10 and 40 care homes) and 12 small providers (up to and including 9 care homes) participated in the 2016 Your Care Rating surveys. In 2015 these figures were 5 (large), 15 (medium) and 10 (small). 3


12


Figure 3.3: Your Care Rating 2016 – table of participating providers

4

Care provider

Number of care homes

Number of registered places

Akari Care

36

1886

Anchor

121

5988

Avante Care and Support Ltd

9

622

Barchester Healthcare

199

12868

Borough Care Limited

10

431

Canterbury Care

9

334

Cornwall Care

16

645

Countrywide Care Homes Limited

30

1585

Embrace Group

58

2381

Forest Pines Care

3

245

Four Seasons Health Care

60

2892

Friends of the Elderly

14

476

Golden Manor Healthcare (Ealing) Limited

1

62

The Graham Care Group

8

555

Greensleeves Homes Trust

20

669

Hallmark Care Homes

15

1096

Helen McArdle Care

17

1089

High Trees Care

1

80

Jewish Care

10

656

L&M Healthcare

2

153

Larchwood Care Homes (North) Limited

26

1212

Larchwood Care Homes (South) Limited

35

1758

Maria Mallaband Care Group Limited

36

1799

Methodist Homes (MHA)

84

4334

NorseCare Limited

35

1428

Opal Care Homes

1

49

Royal Masonic Benevolent Institution Care Company

17

1095

Sheffcare Limited

10

438

Somerset Care Group

27

1410

Springhill Care Group Limited

3

248

Sussex Grange Limited

1

20

Sussex Housing and Care

4

140

The Abbeyfield Society

24

678

The Abbeyfield Society - Assisted Living4

61

740

The Brendoncare Foundation

9

338

Total

1012

50400

Results for The Abbeyfield Society Assisted Living are not included in the calculation of benchmarks due to the different care setting provided



13


survey insights


15


overall measures

Results from the Residents’ and the Family and Friends’ surveys are used to produce an Overall Performance Rating (OPR) – one for each survey audience. This is produced at the care home level, with an overall average OPR to benchmark against for each survey. The OPR is a single measure which is calculated at the individual respondent level. It takes into account ratings of all attributes in the Residents’ survey,

and ratings of those attributes which are directly comparable in the Family and Friends’ survey. This enables comparisons between the Residents’ and the Family and Friends’ OPRs, despite the latter survey’s questionnaire having more attributes. Expressed as a score out of 1,000, the OPR offers greater granularity than overall satisfaction (percentage) measures, which tend to be high

and stable. It is influenced by the strength of sentiment of responses (for example whether a participant ‘strongly’ or ‘tends to’ agree with each attribute). It is also weighted by the four themes, representing four groups of survey attributes, and their relative influence in driving overall satisfaction5. The four themes are ‘staff and care’, ‘choice and having a say’, ‘home comforts’ and ‘quality of life’ – each theme also has a score out of 1,000.

Figure 4.1: Overall Performance Rating 2013-2016 (Residents’ survey) and 2015-2016 (Family and Friends’ survey) - scores are out of 1000 residents

880

878

family & friends

2016

2015

872

2014

872

2013

828

833

Further information about the calculation of the OPR, the factor analysis carried out to derive the four themes, and the regression analysis used to establish the strength of drivers of overall satisfaction, can be found in the Technical Note. 5


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Overall, the benchmark OPR, derived from the Residents’ survey results, shows an upward trend since 2013 - rising from 872 to 880. Specific aspects of care accounting for this upward trend are considered further below. The benchmark OPR in the Family and Friends’ survey is 828 – below that of the Residents’ survey, as in 2015 (when it was 45 points below the Residents’ OPR). The same pattern has been consistently observed across all four themes since 2015 – family members’ and friends’ responses yield lower theme scores than the equivalent scores in the Residents’ survey, although the differences are small. Likewise, residents are more likely to be satisfied with the overall standard of the care home than their relatives or friends, although both results are extremely positive. Ninety-six percent of residents are satisfied, compared with 92% of family members and friends – both results in line with previous years. Over nine in ten residents also say that overall, they are happy living in the care home (92%).


Figure 4.2: Overall Performance Rating and Theme scores (2016) – Residents’ survey and Family and Friends’ survey results residents

family & friends 928

880

877 828

OPR

867

859 802

staff & care

890 838

801

home comforts

choice & having a say

quality of life


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Figure 4.3: Overall Satisfaction 2013-2016 (Residents’ survey) and 2015-2016 (Family and Friends’ survey)

2013 95%

very satisfied fairly satisfied 2014 95%

2015 96%

2016

2015

family & friends

2016

2015

2014

2013

residents

very satisfied fairly satisfied 2015 93%

2016 96%

2016 92%

Overall % satisfied (%very/fairly satisfied)

Overall satisfaction

Family members and friends are asked to give their views on a number of attributes of care which are not included in the Residents’ survey questionnaire6. Among these are the extent to which their loved one’s care home provides value for money – seven in ten agree that it does (71%). Results vary according to funding type though – 62% of family members and friends of residents who are fully self-funded agree that the home provides value for money. This figure rises to 78% of family members and friends of those

who are part-funded by the Local Authority, and 82% where residents are fully funded by the Local Authority. This variation by funding type is even more marked among those who ‘strongly agree’ the care home provides value for money. Nearly nine in ten family members and friends think the home is good at keeping them informed about matters relating to their relative or friend (88%); this figure was the same in 2015. In both surveys, participants are

asked how likely they would be to recommend the care home if somebody they knew needed similar care, using a scale from zero (‘not at all likely’) to ten (‘extremely likely’). A Net Promoter Score’ (NPS) is produced, indicating the proportion giving a score of 9 or 10, minus the proportion giving a score of 0 to 6. Overall, the benchmark NPS calculated from residents’ responses is +49, an improvement of four points since 20137. It also exceeds the average NPS of +41 in the Family and Friends’ survey (+44 in 2015).

Cognitive testing helped establish the maximum number of questions reasonable to include in the questionnaire for care home residents, for whom survey length and respondent fatigue proved an important factor to consider in questionnaire design. 7 The average NPS in the Residents’ survey was +47 in 2015, +44 in 2014 and +45 in 2013. 6


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Staff & care

As the strongest driver of overall satisfaction, the ‘staff and care’ theme – and its constituent attributes – have the strongest bearing on the OPR calculation. Higher scores on these measures are therefore even more likely than other survey attributes to contribute to a higher OPR. Very positive ratings of staff and care also mean residents and family members and friends are more likely to be satisfied overall. Residents and their family and friends feel strongly that staff provide care with kindness, dignity and respect8. Nearly all residents say this about their own care, and this measure has consistently achieved the highest positive ratings within the staff and care theme between 2013 and 2016 (ranging between 97% and 98% who agree). Over this time period, positive sentiment has also strengthened, with the proportion of residents who ‘strongly agree’ with the statement increasing from 72% in 2013, to 74% in 2014. The opinions of family and friends mirror these findings; 96% (in both 2015 and 2016) agree that staff treat their loved one with kindness, dignity and respect, with 61% ‘strongly agreeing’ in both years.

one percent of residents say that staff are sensitive to how they are feeling, and the proportion who strongly agree with this statement has grown, from 52% in 2013 to 56% in 2016. These findings tell a consistently positive story about the day-to-day manner of care staff. Ninety percent of residents agree that staff are usually available when they need them, and there has been an upward trend in the proportion who ‘strongly agree’, from 52% in 2014 and 2013, to 55% in 2016. However, a smaller proportion of residents agree that

staff have time to talk to them (86%), and less than half strongly agree this is the case (46%). The views of family members and friends on staff time and availability are less positive than those of residents. Three quarters of family members and friends agree that staff have time to talk to their loved one (74%), while only 33% strongly agree. When asked the extent to which they agree there seem to be enough staff to meet the needs of residents, 57% of family members and friends agree, and only 20% strongly agree.

Just over nine in ten relatives and friends say that staff have a professional manner (92%), and an even higher proportion say they are made to feel welcome when they visit the care home (96%). NinetyIn the survey of family members and friends, the wording of this statement changed very slightly, from ‘Staff treat residents with kindness, dignity and respect’ in 2015, to ‘Staff treat my relative or friend with kindness, dignity and respect’ in 2016. 8



Attributes in this theme include ratings of the capability and availability of staff; the time that staff have to talk to residents; the extent to which staff treat residents with sensitivity, and with kindness, dignity, respect; access to medical professionals and followup on concerns and complaints.

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Staff treat me with kindness, dignity and respect Staff treat my relative or friend with kindness, dignity and respect residents

% strongly agree 72%

2013

72%

2014

74%

74%

61%

61%

2015

2016

family & friends

% strongly/ tend to agree (2016)

97% 96%

Staff have time to talk to me Staff have time to talk to my relative or friend residents


% strongly agree

The staff make the home what it is. Everyone from domestics to the managers are friendly, caring and happy. This is a genuinely caring environment.” Resident

44%

2013

45%

2014

family & friends

46%

46%

34%

33%

2015

2016

86% 74%


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Choice & having a say

Residents’ views on their ability to exercise choice and input into decisions about their care show some signs of improvement. Eighty-five percent of residents agree they have a real say in how staff provide care and support to them, making this the lowest scoring attribute in the Residents’ survey, but one which is improving. This figure has increased by two percentage points between 2013 and 2016, and the proportion who strongly agree they have a real say in their care has grown from 47% to 52% over the same time period. The majority of family members and friends agree that if they are the person who has authorisation, they have the opportunity to be involved in decisions about their loved one’s care, including end of life care (92%). Eightyeight percent agree that staff appreciate their input into their relative or friend’s care, but only two thirds agree they are given the opportunity to comment on the running of the home (67%). Ability to speak to senior members of staff when needed is a positive for residents as well as their relatives and friends. Although only 86% of residents think staff have time to talk to them, a greater proportion (92%) can speak to senior staff when needed, and two thirds (66%) strongly agree this is


I can speak to senior members of staff if I need to I can speak to senior members of staff if I wish to residents


% strongly agree

63%

62%

2013

2014

64% 66%

2015

family & friends

66% 65%

2016

92% 94%


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the case. Ninety-four percent of family members and friends say the same, with 65% who strongly agree. Residents are more likely than family and friends to have positive views on their ability to choose what time they get up and go to bed. Ninetytwo percent of residents agree they are able to choose this (65% ‘strongly agree’), while 75% of family and friends agree that residents can choose (39% ‘strongly agree’).

I can choose what time I get up and go to bed My relative/friend can choose what time they get up and go to bed residents


% strongly agree

61%

2013

62%

2014

family & friends

Across all aspects of care in this theme, residents’ views have become more positive over time, both in terms of the proportion who agree with the statements overall, and the share who strongly agree. In comparison, the opinions of family members and friends appear more stable between 2015 and 2016.

64%

65%

39%

39%

2015

2016

92% 75%

This theme includes input and involvement in decision-making about residents’ care; ability to speak to senior staff; choice about what time residents get up and go to bed and easy access to a garden or outdoor space.


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Home comforts

Views on the tidiness and cleanliness of the care home are consistently very positive among residents and family and friends alike. Each year from 2013 to 2016, 97% of residents have rated their care home positively on this, the majority with a strong opinion (71% strongly agree their home is clean and tidy). This is also the top-scoring measure in the ‘home comforts’ theme for family members and friends – 93% think the home seems clean and tidy. Catering within the care home attracts less positive ratings among both residents and family members and friends. Eighty-nine percent of residents think that food served at mealtimes is of good quality, while 87% say the menu offers a good variety of choices each day. These figures are 84% and 80% respectively when relatives and friends are asked the same questions; a similar pattern has emerged each year. When asked whether they think food seems to meet special individual needs (for example modified for dietary or cultural reasons), three quarters of family members and friends agree (75%). Alongside open-ended comments relating to the variety and type of food available in care homes, the survey also captures a large number of comments about the laundry service (sometimes, for example, noting items of clothing that have gone missing). Overall, residents’ views of the laundry service in their care home have improved over time – 90% say their


The home is clean and tidy The home seems clean and tidy residents

% strongly agree

69%

68%


71% 58%

2013

2014

family & friends

2015

71% 60%

2016

97% 93%

The laundry service is good The overall laundry service seems good residents

% strongly agree

55%

55%


58%

35%

2013

2014

family & friends

2015

60%

38%

2016

90% 77%


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The care home is excellent. They offer fantastic food and there are always activities going on.” Family member

Attributes in this theme relate to the quality and choice of food available to residents; the quality of the laundry service and the cleanliness and tidiness of the care home. laundry service is good, compared with 88% who said this in 2013. The proportion of relatives and friends who agree with this statement is lower, at 77% (78% in 2015). Ninety-two percent of family members and friends agree that the home’s facilities are suitable to meet residents’ individual needs, for example relating to visual impairments, wheelchair use and living with dementia. A similar proportion (91%) agree the building and outdoor space is well maintained.


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Quality of life

Relative to attributes belonging to other themes, ratings for the ‘quality of life’ aspects of care are high, and have been throughout the life of the surveys. This is largely driven by extremely positive views on flexibility surrounding visitors and personal belongings; two attributes for which the views of residents and their family members and friends are also very closely aligned. The proportion of residents who agree that they can have visitors when they want to is higher than for any other measure. As in


previous years, nearly all residents agree this is the case (99%), and most of these strongly agree (85% overall). Likewise, 99% of family members and friends agree they can visit when they want to (83% strongly agree). Being able to have enough of their own things around them (for example photos and ornaments) attracts similarly positive views. Ninety-eight percent of residents agree this is true, and the same proportion of relatives and friends also agree.

When residents and their relatives are asked about having the opportunity, means and encouragement to take part in activities and hobbies, their views are more divergent. Over nine in ten residents say they can take part in activities or hobbies if they want to (93%), while only 74% of relatives and friends agree that residents can take part if they want. Similar proportions think the care home helps their relative or friend stay as physically and mentally active as they can be (73%), and think it offers a range of activities suited to their individual needs (72%).

This theme includes views on enabling residents to have visitors when they wish, to have enough of their own possessions around them and to take part in activities of interest to them. It also includes views on the extent to which the care home feels safe and secure, and respects residents’ privacy.


I can have visitors when I want to I can visit my relative or friend when I want to residents

% strongly agree 85%

85% 85%

85%

84%

83%

family & friends


25

It is like a home away from home, I feel safe and my family are always welcome.” Resident

99% 2013

2014

2015

2016

99%

I can take part in activities/hobbies if I want to My relative/friend is encouraged to do hobbies should they wish to residents

% strongly agree

65%

2013

65%

2014

family & friends


66%

67%

36%

36%

2015

2016

93%

I am always made to feel welcome when I visit my brother. Staff are always on hand to help him and are very understanding and very friendly to him.” Family member

74%


summary



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summary

The Your Care Rating surveys have been designed to robustly capture views on the aspects of care which matter most to customers. The strong response rates achieved since the inception of the surveys, and the reach of media coverage of the results each year, are testament to the importance of hearing these customer viewpoints on care. Extremely high scores are achieved across all aspects of care rated in the Residents’ survey and in the main, family members and friends also hold very positive views of their loved ones’ care. Ratings of comparable measures between the two surveys are typically lower among family and friends than among residents, but the differences are small. Further, the scores for the majority of measures rated by residents have improved between 2013 and 2016. Aspects relating to ‘choice and having a say’ in particular show noticeable increases. Results from both surveys show a consistent pattern, year on year, of similarities and differences in opinions on comparable measures. Residents and their family and friends are very positive in relation to the kind, respectful and sensitive manner of staff. The results from both

surveys are also closely aligned (as well as extremely positive) in relation to the cleanliness and tidiness of the home, and the ability for residents to have visitors when wanted, and to have enough of their personal belongings around them.

These differing perceptions highlight the value of measuring customer opinion on these measures, and sharing the results in a transparent manner to identify areas of focus for quality improvement – the central aims of the Your Care Rating surveys.

Respondents are consistently less positive about the quality and variety of food available at mealtimes, and the amount of time staff have to talk to residents (though a majority give a positive rating overall for these attributes). Residents’ opinions differ from those of their family and friends on specific aspects of care, a consistent pattern since the Family and Friends’ survey started. The greatest differences in views relate to the extent to which residents are able to choose when to get up and go to bed. Family members and friends are less likely to agree that their loved one can choose. Family and friends are also less likely to agree that residents are encouraged to take part in hobbies and activities of interest to them. Such variations could be related to expectations, but also to the information available to those with a relative or friend in the care home, compared with first hand experiences.


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technical note survey were included in validation interviews. Interview questions covered survey administration procedures such as assessment of informed consent and assistance provided to residents. The survey leads interviewed were also asked for their feedback to inform improvements to the survey process in subsequent years. Three care homes were excluded from benchmark calculations following the validation process.

Survey of family members and friends

Your Care Rating is conducted on behalf of care home providers by Ipsos MORI. It covers care homes that primarily serve older people (aged 65+). However, where younger adults live in such care homes, they are also included.

Survey of residents

monitoring fieldwork, including email and telephone follow-up with care homes to verify receipt of survey packs, and reminder communications throughout fieldwork. It also involves a review of response rates and results to identify patterns in the data which are unusual and may require further investigation.

In order to maintain the rigour of the survey and address any issues arising during fieldwork, the Residents’ survey incorporates an extensive validation stage which takes place during and after fieldwork. Validation involves

Ipsos MORI’s trained telephone team conducted telephone interviews after fieldwork close with the survey lead at approximately 90 care homes (this equates to around 10% of homes participating in the Residents’ survey). The selection of care homes for these interviews was based on a review of data and response rates as well as information collected during fieldwork. Care homes from all providers participating in the

Fieldwork was conducted between late August to late October, 2016. A total of 18,786 residents participated in the survey, across 914 care homes.


Fieldwork was conducted between late September 2016 and early January 2017. A total of 10,963 family members and friends took part in the survey across 643 care homes. 10,396 postal responses were received, and 567 online responses.

Presentation of results

Results are shown for all valid responses (excluding blank responses to questions). Results presented in this report are based on analysis of data for individual care homes receiving five or more responses, excluding those removed from the data following the validation stage of the Residents’ survey. The Residents’ survey benchmark results also exclude data from The Abbeyfield Society Assisted Living, due to the different care setting provided. The total number of participants eligible for benchmark calculations


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for each survey in 2016 is 18,600 residents and 10,821 family members and friends. For each individual question, any homes receiving fewer than five valid responses to that question are also excluded from the calculation. All overall results are presented as the average result achieved by these care homes rather than the overall result of all respondents. When interpreting results from Your Care Rating, it is important to note that all results are subject to sampling tolerances and therefore not all differences are statistically significant. The participants who took part in the surveys are, in the main, a sample of the total “population” of residents and family members and friends, so we cannot be certain that the figures obtained are exactly those that would have been reached if everyone had responded (the “true” values). Data are unweighted. The OPR and theme scores are shown out of a possible total of 1,000. Percentage scores are shown out of 100%. Where figures do not add up to 100%, this is due to computer rounding. An asterisk indicates a score less than 0.5%, but greater than zero.

Calculating the OPR

OPR and theme scores are shown out of a possible total of 1,000. The OPR is calculated using factor analysis and regression analysis. It offers greater granularity and


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basis for comparison than would the measure of residents’ satisfaction with the overall standard of their care, which is expressed as a percentage. Consistent factor analysis and regression analysis models are applied to comparable attributes in both surveys. The factor analysis combines aspects (such as food and laundry services) which are most closely correlated into underlying “themes”. These themes are created automatically as a result of the analysis and the relationship between individual aspects. Within each theme, every aspect has an associated weight, dependent on the degree of ‘importance’ it has within the theme. Having identified these themes, regression (key driver) analysis is used to identify the importance of each theme in shaping an individual’s likelihood to be satisfied with the care home overall. 30 | your care rating 2016 survey

The regression analysis finds the combination of responses which can best explain the dependent or target variable - in this case, satisfaction with the standard of the care home. In this way, it identifies the statistical relationships between each theme and overall satisfaction, and how much influence each theme has in shaping overall satisfaction. Each participant has a score calculated for each theme. This is based on their responses for each aspect within the theme, weighted by their ‘importance’ within the theme. Each resident then has their OPR score calculated using their four theme scores. Staff and care is the most ‘important’ theme as it has the greatest influence over a resident’s likelihood to be satisfied with the care home overall, so it has the greatest contribution to the OPR score. OPR and theme scores for care homes are calculated as the average of each individual resident score.

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ABOUT IPSOS PUBLIC AFFAIRS

Ipsos Public Affairs works closely with national governments, local public services and the not-for-profit sector. Its c.200 research staff focus on public service, policy and reputation issues. Each has expertise in a particular part of the public sector, ensuring we have a detailed understanding of specific sectors and policy challenges. This, combined with our methodological and communications expertise, helps ensure that our research makes a difference for decision makers and communities.

By taking part in the Your Care Rating survey, care providers are demonstrating very tangibly their commitment to: • Hearing the views of residents • Improving further the quality of their services To recognise this, Your Care Rating will allow them to use the Quality Mark. For further information visit www.yourcarerating.org 32 | your care rating 2016 survey