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The purpose of this paper is to investigate the impact of nursing quality on Taiwan nursing homes, and differences of efficiency among different management types of nursing homes.

This study employs data envelopment analysis (DEA) to investigate the efficiency of nursing homes with and without quality variable. The impacts of nursing quality on the efficiency of nursing homes were studied. Finally, Tobit regression is used to explore the factors influencing efficiency in nursing homes.

The analysis shows that nursing quality has significant impacts on operating efficiency of nursing homes. When quality variables are included, all efficiencies were significantly improved, except scale efficiency of government-expense nursing homes (GEH); return of scale status of GEH decrease substantially; the licensed nursing staff can always improve efficiency; higher occupancy rate increase efficiency; private-operated veteran homes performs better than government-operated homes.

Nursing quality has a significant effect on the efficiency measures. Thus, the nursing quality cannot be ignored in assessing the performance of nursing homes. Otherwise, it may result in biased results. The efficiencies of private-operated nursing homes are better than the government operation. Government-operated nursing homes should take private nursing homes as the benchmark.

The paper demonstrates the nursing quality is an important factor in the efficiency measure of nursing homes. It also shows that privatized operation has higher efficiency than the government operation.

The purpose of this paper is to present findings from face-to-face interviews undertaken with 16 care and nursing home managers employed in homes situated in two English local authorities. The research sought to explore managers’ perceptions of the role of contract monitoring in the prevention of abuse.

Semi-structured interviews were undertaken with 16 care and nursing home managers.

Though personnel employed by the local authority who conducted contract monitoring were generally thought of positively by care home managers on a personal level, their effectiveness was perceived to be limited as a result of their lack of experience and knowledge of providing care, and the methods that they were required to use.

Though the research draws upon the experiences of only 16 care and nursing home managers in two local authorities, data suggest that current contract monitoring activity is of limited utility in determining the true nature of care and the presence of abuse.

Unusually, the paper explores care and nursing home managers’ perceptions of contract monitoring processes in terms of how they perceive their effectiveness in preventing abuse.

This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA.

This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially affect policy. An international comparative perspective was adopted to consider whether and how different social, political and economic contexts might shape scandals and their consequences.

This study found that for-profit residential care provision as well as international trends in the ownership and financing of nursing homes were factors in the emergence of all media scandals, as was investigative reporting and a lack of consensus around the role of the state in the delivery of residential care. All scandals resulted in government action but such action generally avoided addressing underlying structural conditions.

This study examines only the short-term effects of five media scandals.

While there has been longstanding recognition of the importance of scandals to the development of residential care policy, there have been few studies that have systematically examined the causes and consequences of such scandals. This paper contributes to a research agenda that more fully considers the media's role in the development of residential care policy, attending to both its promises and shortcomings.

Strategic socio-political views are notably scarce among contemporary discourses on the causes of abuse of vulnerable older people in care and nursing homes. This paper aims to catalyse higher order consideration and discussion of one socio-political characteristic that has relevance to the issue of abuse, that is, the market-like environment in which care and nursing homes in England operate. In doing so, the paper argues that the now firmly established but imbalanced “quasi-market” of care that has developed over many years fosters conditions under which both poor care and abuse are more likely to occur. The evidence presented in the paper focusses primarily on the rise to dominance of for-profit care home provision and the contraction of public sector provision. The paper does not examine in detail the characteristics and market presence of the not-for-profit sector because it has not held a numerically significant market share either historically or contemporarily.

Outcomes of the marketisation of the care home sector that has its origins in the political landscape prevailing in 1979 and thereafter, along with the concurrent development of its regulation and oversight, are narrated and analysed. From this, a mythos of the motives behind the transition to a market-like economy that has taken place over four decades is developed and used to explain how prevailing market conditions contribute to the perpetuation of poor care and abuse.

In the opinion of the author, there are identifiable consequences arising from the evolution of the current care economy that dispel the beliefs that providing care by means of current market-like arrangements is advantageous, that the independent regulation and monitoring of such a market is unproblematic and effective, and that the “consumers” in this market are exercising personal choice, in accord with classical economic theory.

The paper offers the opportunity for the reader to consider how the development of a “quasi” market of care and nursing home services that has come to be dominated by for-profit private providers, and that is subject to ineffective oversight, may have contributed to conditions where abuse is more likely to occur and endure.

This is a conceptual paper that explores the consequences of the creation of the market-like economy of care in which care and nursing homes now operate and suggests that it is time for prevailing market conditions to be re-visited and subjected to remedial strategic intervention.

The purpose of this paper is to explore how actors take on and ascribe the role of accountor and constituent in the process of giving and demanding of reasons for organisational conduct.

The on-going interactions in supervision meetings between the supplier of outsourced elderly care in Sweden and a local government administration were examined through a longitudinal study.

The paper proposes the concept of role attribution to characterise a strategy for handling complexity in public sector accountability processes. This complements previous research, which has described three main strategies for handling competing accountability demands: decoupling, structural differentiation and compromising. Role attribution was found to involve the supplier and purchaser of public services pursuing a specific resolution to an accountability demand by positioning themselves as jointly aligned with certain prospective constituents in the environment. Thus, while inter-organisational relationships can be a source of complexity for accountors, as already documented in prior research, the findings of this paper show ways in which the dynamic and situation-specific accountor and constituent roles can serve as a resource. The two organisations moved back and forth between cooperating to handle accountability demands from actors in the environment and assuming different accountor and constituent roles within their relationship.

The paper discusses the need to move beyond the taken-for-granted roles of accountor and constituent in analysing outsourced public service relationships. Specifically, the findings suggest that researchers interested in public sector accountability processes would benefit from designing their studies in ways that makes it possible to observe and theorise dynamic and situation-specific accountor and constituent roles.

The studied supervision meetings served as an arena where on-going accountability issues played out and were mediated through role attribution. Seemingly, there are possibilities to complement formal role descriptions and contracts with systematic processes for addressing on-going operational accountability issues within and beyond individual, formalised accountor–constituent relationships. From a societal perspective, it might be relevant to mandate more systematic procedural structures to support on-going accountability processes, for example, the creation and maintenance of interactive inter-organisational forums which can serve as a mechanism for systematic, yet situation-specific, handling of operational and strategic issues. At an organisational level, this paper shows a need that such forums merit on-going managerial attention and conscious staffing to secure both competence and stability.

The authors find a dynamic and situation-specific attribution of accountor and constituent roles, in contrast to prior research’s routine consideration of these roles as being predetermined by existing relationships of hierarchy and influence.

The performative approach views organizational routines as generative systems with internal aspects – ostensive and performative – and dynamics (Feldman and Pentland, 2003). The purpose of this paper is to better understand under which conditions the routine dynamics happens or not.

To deal with this issue, for 13 months, the authors conducted a comparative and longitudinal case studies based on the evolution of the organizational routines in absence management in two departments of a French hospital.

The results show contrasting dynamics in the studied organizational routines: one evolved, the other in contrast, seemed blocked. The authors suggest that the routine dynamics depends on the relative weight of its ostensive and performative aspects: a balance situation makes mutual adaptions possible and an imbalance situation leads to the conservation of defective routine. The research underlines also that, in the hospital context, the capacity of management and teams to discuss and to negotiate the implementation of external rules plays an important role in the balance of the internal dimensions of routine.

While the literature on performative approach focusses on the “how and why” the routine act as a source of continuous change, this research investigates more in depth the working of the routines dynamics itself. The issue of balance or imbalance introduces a new element in the framework of routine dynamics and can constitute an interesting focus for managers looking to transform their organizational routines.

Private equity has acquired multiple large nursing home chains within the past few years; by 2007, it owned 6 of the 10 largest chains. Despite widespread public and policy interest, evidence on the purported impact of private equity on nursing home performance is limited. In our review, we begin by briefly reviewing the organizational and environmental changes in the nursing home industry that facilitated private equity investments. We offer a conceptual framework to hypothesize the relationship between private equity ownership and nursing home performance. Finally, we offer a research agenda focused on the important parameters of nursing home performance: financial performance, and quality of care.

A distinction must be drawn between a dismissal on the one hand, and on the other a repudiation of a contract of employment as a result of a breach of a fundamental term of that contract. When such a repudiation has been accepted by the innocent party then a termination of employment takes place. Such termination does not constitute dismissal (see London v. James Laidlaw & Sons Ltd (1974) IRLR 136 and Gannon v. J. C. Firth (1976) IRLR 415 EAT).

The aim of this study is to investigate why many immigrants end up in uncertain employment.

The paper describes a qualitative case study of three nursing homes in Oslo (Norway), which investigates immigrant employment and recruitment-related practices. Practice theory is used as the theoretical and methodological framework. The study takes an ethnographic approach and combines participant observation, semi-structured shadowing, qualitative interviews and document review.

The recruitment practice, as it is accomplished, is different from the practice that is prescribed in the formal recruitment policy. The configuration of the recruitment-related practices locks in the recruitment practice and reproduces the social order. The net effect of the recruitment-related practices is that immigrant employees remain in uncertain employment.

A practice-theoretical approach, analyzing organizational practices as they are accomplished in space and time and not as isolated activities defined by their purpose, provides a richer understanding of the complexity and connectedness of organizational practices. Combining practice theory and institutional perspectives, the paper demonstrates how normative and regulative mediators order and align related practices. The study demonstrates the importance of examining the configuration of practices to understand how the net effect of related practices affects those who dwell in them, in this case immigrants pursuing secure and stable employment.

This study contributes to the field of diversity management by using practice theory to explain why measures for enhancing immigrant employment may not have the intended effect because they are interwoven in a nexus of practices with conflicting interests that (un)intentionally undermine the measures.

The Equal Pay Act 1970 (which came into operation on 29 December 1975) provides for an “equality clause” to be written into all contracts of employment. S.1(2) (a) of the 1970 Act (which has been amended by the Sex Discrimination Act 1975) provides: