A Multiple Case Study Exploring Person-Centred Care in Care Homes

Abstract

Background: There are 14,228 care homes in England with a population of approximately 372,035 residents, many of whom are living with frailty or multiple and complex comorbidities. Policy and international literature advocate that care homes provide high-quality person-centred care that meets each person’s specific needs. This study aims to provide an exploration of person-centred care in care homes in the South West of England from the perspective of all those involved.

Methods: A qualitative multiple case study design was used across seven care homes in a region of South West England. Semistructured interviews were conducted with 61 participants (residents, family and health and care professionals). Nonparticipant observations were undertaken in communal areas to understand the practices and cultures of the care homes. All data were analysed using reflexive thematic analysis.

Findings: The findings are presented as six themes, they are adjusting to the transition into a care home; people at the centre of care; the place we call home with the people we call family; working across the boundaries of care; supporting, valuing and empowering care home teams; and managing complex and challenging moments of care.

Conclusion: This study demonstrates a whole system understanding of person-centred care across seven care homes. The main components of person-centred care appear to be relational. These relationships take place in cultures and systems that are complex and challenging with care boundaries that need to be navigated. Navigating these care boundaries requires a people-centred care approach built on partnerships and mutual respect.