Good care in policy and in practice - An ethnographic study of the Care Living Plan in nursing home

Summary In this thesis quality of care in nursing homes is studied by looking at how ‘good care’ is enacted in various settings. Good care is interpreted as a flexible concept that can harbour various norms and ideals about what good care is. More specifically, the use of a particular tool to improve quality, the Care Living Plan, is studied. The main research question links the notions of good care that are practiced in an everyday care setting to national policies regarding quality of nursing home care. This thesis studies good care and the Care Living Plan from an ethnographic perspective. Based on fieldwork conducted in a nursing home, it is studied how good care is enacted in everyday care situations. The results show that good care is indeed practiced in various ways, that may not always coincide with the notions appearing in formal visions in, for example, national policy documents. Autonomy and focusing on the well-being of inhabitants appeared to be notions present in every setting. In practice, inter-personal relations are considered more important than is assumed in policies and visions. Even though the underlying philosophy of the Care Living Plan was recognizable in everyday care, the Care Living Plan was not used intensively by everyone in practice.