The view from within: “Good” care from the perspective of care professionals – lessons from an explorative study

The Austrian LTC system has made significant inroads in recent years towards establishing an own identity, distinct from the health and social care sectors. Nonetheless, ongoing debate surrounding vocational training, job profiles and the nature and scope of care services reflect the sector’s struggle to define itself and its core objectives with respect to meeting the needs of older users. 

One key aspect of LTC in need of revision is the approach to measuring and assessing quality of care. Borrowing heavily from measures and processes applied in healthcare, existing quality frameworks are inadequate in accounting for the specificities of LTC, e.g. the need to consider the quality of life of the user rather than just health status, the importance of the relationship between care professional and user, and the substantial role played by informal, family carers. 

This Policy Brief focuses on the question of how to more appropriately define and measure high quality LTC, summarising findings from the 2014-2015 European Centre project, “Good care from the care workers’ perspective”, commissioned by the Vienna Chamber of Labour (Arbeiterkammer Wien). The explorative study investigated how the numerous occupational groups working in LTC in Austria perceive quality of care and what they identify to be the main structural-, process- and outcome-related factors at play in improving care services. 

Applying qualitative methods, the study draws on interviews and workshops with representatives from various professional groups, as well as 24-hour carers and family carers, to construct a catalogue of themes and issues central to discussions of “good” care. The interviews and workshops reveal that while care professionals see a need for more frequent multidisciplinary dialogue, case management, time for actual interaction with users, and overall, a more holistic approach to care, certain framework conditions – notably, poorly planned staffing guidelines and fragmented financing and governance structures – currently impede development in these areas. The authors propose a set of policy recommendations for realising improvements at different levels of governance.