Evidence of effects of regulation in aged and dementia care help target valuable resource allocation


As one of the CDPC’s initial projects approaches its final stages some interesting findings are emerging. This three year study aimed to examine the role and effects of regulation in aged and dementia care and gain a greater understanding of why we regulate care.

During the early stages of research, regulatory systems were mapped to reveal the uneven spread of regulation throughout the system, showing how regulation clusters around particular individuals, care sites and care-related activities.

This clustering takes place in four ways:

  1. Through the overlap and duplication of different government responsibilities, jurisdictions and regulatory authorities.
  2. By accretion as more regulation has been added over time in response to risk, scandal and system failings.
  3. The interplay of multiple regulations at care transition points.
  4. Differing levels of regulation depending on the care activity.

While these findings may come as no surprise to those involved in aged and dementia care, they provide evidence on where resources and efforts to improve care amidst regulation are best targeted.

Our research is now using and expanding these findings to explore the different ways aged care organisations respond to the regulatory environment. Interviews with senior managers, facility managers and care workers (PCA or equivalent) across a range of residential care settings have been conducted.

Responses reveal how the interpretation and application of regulation differs at three distinct levels of the organisation. The various organisational and operational strategies developed to translate regulation into action are currently being examined, and will form the basis of planned dissemination activities. Significantly, future publications will outline how organisational strategies and approaches to regulation reveal what is specific about dementia care and thus its regulation.

The final stages of the project will focus on the experience of care-users, and collect information on what this stakeholder group see as the pros and cons of regulation. This stage of the research, alongside ongoing work with the industry partners and other stakeholders, will help to shape a series of policy and practice recommendations.

Overall, the most important message of our research is that debates about more versus less, good versus bad regulation fails to capture the complexity of care governance, the need to balance various stakeholder interests and the various ways regulation can both enable and prohibit different aspects of care practice.

Moreover, ‘good’ regulation should leave room for innovation while maintaining the ‘intent’ behind regulatory rules.

In the context of proposals for a lighter touch approach to regulation we would do well to recognise the critical role of regulation in mixed economy care and recognise both its benefits and drawbacks.

More information can be found in two Research Insight documents produced by Professor Simon Biggs and Ashley Carr.

Ashley Carr, Activity 7 Project Officer