Long-term care quality systems based on regulatory inspection frameworks

All the case study countries have developed and promulgated regulatory structures detailing the requirements and processes by which private-sector organizations, whether non-profit or for-profit, apply to become providers of long-term care services. However, there is considerable variation in how ongoing provider quality is monitored in the form of regular inspections and audits. We have identified four countries – Australia, England, Spain and the Netherlands – as having regulatory systems structured in such a way that there is a substantial emphasis on ongoing quality monitoring undertaken via inspection. This is not to say that this is not true of other countries as well, it is just that the other countries have some other feature which further distinguishes them, which is why they have been classified into another grouping. As the reader reviews the material in the next four chapters, it is useful to consider the aspects of quality monitoring built into the regulatory structure of the long-term care system in each of these countries. Another challenge common to these countries is the differentiation between social and health-based care models, since both exist in all these countries and are treated differently, in some cases under a common regulatory framework while in others completely differently.