Benchmarking the prevalence of care problems in UK care homes using the LPZ-i: a feasibility study

Background: UK care homes have no mechanism for counting, collating or analyzing prevalence of care problems to benchmark quality of care. This study investigated the feasibility of the International Prevalence Measurement of Quality of Care (LPZ-i) for benchmarking in UK care homes and described facilitators and challenges to implementation. Method: The pressure care and incontinence modules of the LPZ-i were implemented in a purposive sample of UK care homes. Interviews and focus groups with regional co-ordinators, NHS and care home staff who had been involved in implementation. Data were analysed using a framework approach. Results: 26 care homes and 489 residents implemented the LPZ-I modules. 60 pressure ulcers were reported in 41 (8.4%) of residents.325(66% of residents were incontinent of urine, faeces or both. It was demonstrated that it was possible to use prevalence data to benchmark care between UK care homes and against homes overseas. 38 participants took part in focus groups and interviews which revealed the importance of existing relational working with care homes as a basis for implementation. Care homes reported improved identification and management of pressure ulcers and incontinence in response to the audit. However, care home staff could not interpret or analyse data from the audit or use it to drive quality improvement. Conclusion: Implementing the LPZ-i was possible, delivered data appropriate for benchmarking, was well received by care home and NHS staff, and appeared to lead to changes in practice. More widespread implementation of the LPZ-i is feasible, subject to improving the data and quality improvement competencies amongst care home staff.