How to close down a care home in 24 hours: privatisation, fragmentation, and ambiguous quality regulation in senior long-term care in the Czech Republic
How to close down a care home in 24 hours: privatisation, fragmentation, and ambiguous quality regulation in senior long-term care in the Czech Republic

Summary/Abstract: Long-term care in the Czech Republic is characterized by workforce and service shortages; care homes often do not have a good reputation and are considered a last resort. What high-quality care should look like and how it can be ensured is controversial in this context. The paper studies these questions using the example of a small, private care home for Czech as well as German-speaking seniors that had been shut down abruptly with residents being moved to nearby institutions in less than 24 hours. Drawing on an in-depth analysis of the Czech long-term care regime as well as newspaper articles and interviews with different actors on the closure, the paper analyses the definition, implementation and assurance of care quality. It shows how responsibilities for defining, providing and controlling care services are divided between various public and private actors and how quality is understood as something to be implemented via standards and their control. We argue that the fragmentation of the Czech care system and its ambiguous quality regulations create a landscape that is difficult to navigate and, ultimately, resulted in a situation where seniors were moved around “like furniture”, as one relative put it.

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