Regulation and accountability in the care home sector: expert commentaries

In this chapter, you will hear from several of the Re-Imagining Long-term Care team members who have studied accountability extensively. The team brings expertise from different disciplines and jurisdictions. They were asked to share some of the most salient lessons they have learned through their research. While there are interesting differences among perspectives, the lessons also reveal an important re-imagining of accountability. This is a vision of accountability where the reduction or elimination for-profit participation is understood to be a central regulatory concern. We encounter strategies to ensure transparency and enforcement. We also learn about the need to use regulation to support adequate staffing and training, recognising that the conditions of work are the conditions of care. In these commentaries, accountability becomes empowering rather than punitive. It is re-imagined as a two-way street, rather than top-down, with room for interpretive approaches that enable care workers to respond to residents’ needs and even collaborate with compliance inspectors.