Evaluating and replicating local accountability platforms for residential care homes and social care services.

More people aged over 70 live in developing countries than in developed countries and many of these people need social care. It is sometimes assumed that families in developing countries are more willing and able to offer this support, without recourse to the private sector. In fact, the evidence says otherwise. Over the past decade or so, there has been a very rapid expansion of private provision, including care homes, in many developing countries. Many of these care homes are subject to little, if any, regulation, and there is evidence that service quality is very uneven. Government capacity to enhance regulation is limited and the issue has remained a low policy priority (at least until the Covid-19 pandemic).

Following research in the Argentina city of La Plata, we worked with local organisations, including care home directors and a community group run by older people to develop an innovative, locally-owned project for improving information sharing and quality accountability. Launched in 2019, it consists of a simple, interactive information-sharing platform (http://www.redmayorlaplata.com/).

The site provides information about local care homes that have agreed to a published set of quality principles. It enables service users to provide feedback about providers. Complaints are investigated and providers removed from the site if they are confirmed. The site has other features, including general information for service users to support the selection and assessment of social care providers. By the end of 2019, the site was receiving over 12,000 hits a month and had received over 50 messages about service quality. These included examples of abuse, which were followed up and led to the exclusion of the providers in question.

We feel there may be benefits in extending this activity to other cities in Argentina and beyond. Before promoting this approach, we require more robust evidence about how it was developed, how well it is working, what effects it has had and how easily it may be replicated elsewhere. Part of the funds we are requesting are to support this evaluation.

The Covid-19 pandemic is hitting care homes in Latin America hard and there is growing interest in new ways to improve quality and accountability in the sector. Since we submitted the preliminary proposal, several organisations in Argentina and elsewhere have committed to developing new projects in different cities, based on our experience in La Plata. Part of the funds we are requesting will be to observe and conduct a light-touch review of these new extension activities in Argentina. We will use funds from a separate grant (already awarded) to support similar work in Brazil.

We will present the results of our analysis in a number of different formats, both for academic audiences and for other types of audience with potential to apply these findings to future extension activity in Argentina, Latin America and beyond.