Determining the quality of care facilities

High-quality care promotes and preserves good health, well-being and life quality for people in need of care. The care and support should meet the needs, wishes and expectations of the people in need of care. 

Good care is characterized by factors such as the following:

• Professional expertise: the care staff have the necessary, up-to-date skills and abilities to properly look after the people in need of care.
• Individual care: The necessary care measures are discussed with the care recipients and, if necessary, their relatives. When planning the measures, the needs and wishes of the people in need of care as well as their right to self-determination are respected.
• Equipment and safety: The care environment is designed to support mobility, independence and the maintenance of social contact. The risk of accidents and injuries is reduced to the greatest possible extent.

Care must be provided in line with the latest scientific findings. These are summarized in the expert standards for care and should give care staff the knowledge they need to ensure the highest possible level of care quality. 

Certain basic conditions for care quality have also been legally established, for example in the German Social Code (Sozialgesetzbuch). Regional laws established by the federal states also regulate the operation of care facilities. This includes various aspects regarding care quality.

The quality of care provided in care facilities is regularly inspected. This is firstly done within the scope of an internal quality management process in the care facility itself. However, the Medical Review Board (“Medizinischer Dienst” – MD) or the inspection service for private health insurance providers (Careproof) also inspects the quality of care provided in care facilities at regular intervals.

Quality assurance within a care facility 

Since 2019, a legally required quality system for care facilities has been gradually introduced. According to this, care facilities are obliged to document certain data about the care quality during the past 6 months every 6 months. This self-assessment by facilities makes it possible to continually record the quality of the care services. The facility records information such as how mobile and independent the residents are, whether they have unintentionally lost weight, how often falls occurred and what the consequences of these were. They must also record any bedsores (decubitus) and the use of restraint measures such as bed rails or straps.

Inspections by inspection services

The inspectors from the Medical Review Board or the inspection service for private health insurance providers (Careproof) visit the facilities in person once a year. Care facilities with particularly good inspection results will subsequently only be inspected every 2 years. 

The inspection lasts 1 to 2 days. The inspectors assess the care situation on the basis of 9 residents selected at random. They talk to the staff, interview residents and review care documentation.

The inspections are intended to have an advisory character and to help the facilities improve their quality. 

How can I find out how a facility was rated?

The results of the internal and external inspections are published in quality reports online. These quality reports provide clear and extensive information that you can use to compare different facilities.

The quality reports include information about: 

• the equipment, the professional training of the care staff and the care services provided by the facility
• the quality of the care based on information about the residents’ condition (the facilities independently record this information every 6 months)
• the results of the quality inspections performed by the Medical Review Board or the inspection service for private health insurance providers

You can directly search for the quality reports for certain facilities on the following portals:

Care Navigator (Pflegenavigator) from the Federal Association of Public Health Insurance Companies (AOK-Bundesverband)
Care Guide (Pflegelotse) from the Association of Substitute Health Insurance Funds (Verband der Ersatzkassen – VDEK)
CareFinder (PflegeFinder) from the Federal Association of Company Health Insurance Funds (Betriebskrankenkassen – BKK)

The quality reports are just one factor in determining the quality of a care facility. It is always advisable to visit care facilities in person to see them for yourself and talk to the staff and other residents. 

Respite care stays and open days are other ways of checking out care facilities. 

When visiting care facilities, people in need of care and their relatives can pay attention to the following aspects:

• Does there seem to be enough staff to ensure that residents receive appropriate care?
• Does the facility appear clean and to observe hygiene standards?
• How are medical care and cooperation with doctors and therapeutic specialists managed?
• Are there plenty of things to do and enough leisure activities? What about at weekends and in the evenings?
• How good is the quality of care? Are individual needs considered?
• How satisfied are the residents with the facility?
• Are relatives involved when planning care? Are their wishes taken into account?
• Are the residents’ dignity, privacy and self-determination considered and promoted?
• Is the living environment pleasant, safe and attractively designed?

Specific information about how to recognize good professional care in a residential facility can be found in the guide provided by the Center for Quality in Care (Zentrum für Qualität in der Pflege – ZQP).

There are various points of contact that you can turn to if you notice deficiencies in care. It is useful to start by talking to the staff responsible to discuss the problems and find solutions. In some cases, this is all that it takes to rectify discrepancies. If the problems are particularly serious or organizational in nature, the care facility’s residential manager can be approached. If the problems cannot be resolved in this way, the care service and nursing home management are the next port of call. 

If it is not possible to directly resolve the issue in a satisfactory manner, people can contact the responsible inspection services and supervisory authorities with their complaints:

• The Medical Review Board (“Medizinischer Dienst” – MD) or the inspection service for private health insurance providers (Careproof)
• The responsible care home supervisory authority 

These bodies will record complaints, review the allegations and, where necessary, instigate measures to improve the situation.

Further information about complaint procedures in the event of deficiencies in care can be found in our article.

There are several advisory services able to assist with questions relating to the quality of care. One important point of contact is the local care support point. This offers individual consultations and assists with questions about care institutions and quality aspects.

You can search for care support points near you in the database provided by the Center for Quality in Care (ZQP).

The Medical Review Board can also assist with questions on the quality of care institutions.

Some consumer advice centers also offer legal advice and information about care. They can provide support with contractual issues and complaints.