Guest Blog: Using online reviews to choose care homes

This guest blog was contributed by Lisa Trigg, Research Officer at LSE Health and Social Care, at the London School of Economics and Political Science.

Last year, an Office of Fair Trading report highlighted the lack of information support for older people looking for care homes, and the recent Delivering Dignity report draws attention to the opportunity to help them with providing resident feedback on the internet. Last week’s White Paper, “Caring for our future: reforming care and support”, also included an announcement that the Department of Health will work with organisations to develop comparison websites for social care.

The Social Care Institute for Excellence (SCIE) recently identified over 30 websites dedicated to various listings and information on social care providers. Many of them provide links to the Care Quality Commission’s inspection reports, and some new sites, for example Good Care Guide, enable service users and their carers to post feedback on care homes. This function will also be available on SCIE’s own site Find Me Good Care, which launches later this summer. In addition, the Government recently awarded £160,000 to Patient Opinion, a publisher of online patient reviews on health care, to include reviews on social care providers.

TripAdvisor was set up in 2000 and contains over 60 million reviews on travel-related services such as hotels and restaurants. The idea of searching for feedback on the quality of products and services is increasingly common in service and goods industries. A website where people seeking care could go and access a range of opinions on care providers seems like a strikingly obvious service to provide.

However, Patient Opinion recently encountered a number of challenges when they introduced a pilot with two care home providers. A major problem arose due to the difficulty of protecting the anonymity of users. Care homes have far fewer residents than hotels have guests, so it could be easy for staff to figure out who posted negative reviews of a care home.

It is important for the identity of a frail, vulnerable resident of a care home to be protected to avoid the risk of poor care or even abuse. This also applies to care home staff. Hoteliers and restaurant owners have been subject to a range of personal accusations on TripAdvisor, ranging from racism to alleged assault and theft.

Patient Opinion also highlights the difficulties of motivating people to post reviews. Ratings websites like TripAdvisor are based on generating the ‘wisdom of crowds’. For care homes, this would mean that if enough people posted reviews, the average review would eventually give an accurate reflection of what the care home is really like.

However, many residents may not be able to post their own feedback, whether this is because of a lack of access or a lack of experience with using the internet, or because of the high proportion of residents who are living with dementia. For relatives and carers meanwhile, there is the concern about the knock-on effects if they post a poor review.

From a more practical perspective, residents are likely to live in residential care for many months or even years. For hotels and restaurants, customers will stay for as little as one night or one meal. This means there are enough customers experiencing the service to generate significantly more reviews. Even then, the number of reviews can be in stark contrast to the number of users. One study worked out that for the most popular Harry Potter book, only one in 1,300 purchasers posted a review on Amazon.

Despite all this, it’s important to recognise that people will increasingly look to the internet for information on care home quality. What people really want is to be able to find out what it’s really like to live in a particular care home.

The opportunity then is to harness resources and technology to manage the information process. For example, how can we capture larger amounts of feedback from residents, relatives and employees? And then how do we combine this with the views of organisations such as the CQC, local authorities or Age UK and present it to the public in a careful and sensitive way? Or alternatively, how can we use technology to put people in touch with each other when what they really need is to talk to someone like themselves who has experience of the home?

The focus needs to be on identifying the support and information people really need, and then developing creative ways of providing it.

Watch a video blog about the challenges of delivering care in care homes 

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4 thoughts on “Guest Blog: Using online reviews to choose care homes”

  1. Choosing a care home is such an important (and stressful) issue and yet there is so little information to go on in making the choice. To avoid the concerns mentioned here about the knock-on effects of writing a poor review, how about a Trip Advisor site that asks just one simple question: “what does this home do well? ” That could help to build up a useful picture over time, and in a way that gets round this problem. What isn’t said would be just as important as what is.
    Ideally we would also find a way of harnessing the views of professionals who have on-the ground views. I am thinking here of community nurses who are ideally placed to see it as it is.

  2. Hi Lisa, thanks for this interesting blog post.
    I’m James Munro, one of the team that runs Patient Opinion. We’re just starting work now on building Care Opinion, which will be like PO, but for adult social care.
    As you say, there are all kinds of challenges in making online feedback in social care work really well. It will take some time and persistence to over come them (just as it has in health care!).
    The focus of your post is very much on information to inform a choice. Yet we would also see honest and constructive feedback as something which can inform learning and change within the care setting. We see this happening in health care and I think it could happen in social care too.
    As well as choosing care, we think that online feedback can help in changing care – and culture.
    all the best

  3. Hi Ellen and James and thank you so much for your comments.

    Ellen, absolutely, it should be a priority to find ways of consolidating information from users, carers and professionals – even it might be impractical to provide names. There are many professionals who would be able to provide a great deal of insight into quality, although we would need to consider issues around impartiality and whether professionals can be seen to recommend providers.

    James, I agree that there is a great opportunity for providers to use information constructively to assist with quality improvement and cultural change. It underlines the need to make sure that reviews and other quality feedback and reports are consolidated to assist providers in collecting information and using it constructively. Providers – especially small providers – will need help to put processes in place if they are to use this information to develop their organisations. This is an area which I’m hoping to explore in further research and it would be great to discuss this in more detail.

  4. Great post, sorry i cant remember my initial response but it goes along the lines of… we need to remember that many people abuse the internet, many people use review sites to create fake persona’s in order to boost ranks/ratings. this is very likely to occur with caring homes, the older generation are not as technically competent which could result in the being misguided. You used the analogy of Trip advisor, well i know from experience soo many people abuse this system and create fake reviews for there own destinations. Surely this would happen with care homes due to the amount it costs?

    Nice topic


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