Perspectives of Nurses and Managers on the Standards and Quality of Care in eThekwini District’s Long-Term Care Facilities, South Africa: A Qualitative study

Abstract Background: Long-term care facilities (LTCFs) aim to help residents to maintain physical, mental, and psychosocial well-being; prevent a decline in the resident’s condition; maintain and improve residents’ health and rights. Nurses and managers play a major role in running LTCFs and ensuring that care provided to each resident meets the standard and quality required. This study explored the perspectives of nurses and managers on the standards and quality of care in eThekwini district’s LTCFs, South Africa.Methods: An explorative, qualitative study was conducted with a purposively sampled set of Nurses (N=12) and Managers (N=12) from three LTCFs in the eThekwini district. Data were collected through group interviews (GI), focus group discussions (FGDs), and dyad interviews (DI). The audio-recorded GI, FGDs, and DI were manually transcribed verbatim and exposed to a thematic analysis.Results: A total of five main themes (standard of care, human resources, management and responsibilities, resident centred care and technology), and 29 subthemes. Nutrition and medication safety were unique subthemes related to the standard of care for nurses, and infection control and accountability for managers, but standard operating procedures, falls, and uniformity of care emerged from both nurses' and managers' data. Job security, job satisfaction, and salary were unique subthemes related to human resources for nurses, and scope of practice for managers, but grievance, staff ratio, and terms of employment emerged from both nurses' and managers' data. Teamwork, marketing, and performance review were unique subthemes related to management and responsibilities for managers, but training and development, incentive, and infrastructure emerged from nurses' and managers' data. An individual care plan was a unique subtheme related to resident centred care for nurses, and stimulation, adjustment, and micro-society rules for managers, but continuous assessment and psychological well-being emerged from both nurses' and managers' data. Access and communication and filtering of information were unique subthemes for managers related to technology, but documentation emerged from both groups. Conclusion: This study’s findings suggest the need to improve the standard and quality of care provided by LTCFs in eThekwini district’s LTCFs, South Africa.