Standards in regulating quality of adult community health and social care: systematic narrative review

Purpose: The growing range and complexity of community care services require robust approaches to ensuring quality. Method: This review collated studies on the use of standards in regulating community health and social care using Social Care Online, MEDLINE and CINAHL databases. Studies were appraised by two reviewers and synthesized by study themes. Results: Sixteen studies were synthesized under three themes: standards in quality assurance and quality improvement; effectiveness of standards; and design of regulatory standards. Standards facilitate providers in self-regulation and enable regulators to support and monitor improvement. Effectiveness of standards depends on their language and interpretation, and on organizational factors. There was little evidence of scales within quality standards. Discussion: There is continuing debate about self-regulation versus external regulation. Social care service regulation requires more research. Conclusion: Regulatory organizations should take note of wider initiatives toward evidence-based practice in the design of quality standards.