Clustered domestic model of residential care is associated with better consumer rated quality of care.

<bold>Objective: </bold>To compare consumer rated quality of care among individuals living long-term in homelike clustered domestic and standard models of residential care in Australia.<bold>Design: </bold>Cross-sectional study.<bold>Setting: </bold>Seventeen residential aged care facilities in four Australian states providing alternative models of care.<bold>Study Participants: </bold>A sample of individuals with high prevalence of cognitive impairment living in residential care for 12 months or longer, not immediately in palliative care and having a proxy available to provide consent and assist with data collection. Of 901 eligible participants, 541 consented and participated in the study.<bold>Main Outcome Measure: </bold>Consumer rated quality of care was measured using the Consumer Choice Index-6 Dimension instrument (CCI-6D) providing a preference weighted summary score ranging from 0 to 1. The six dimensions of care time, shared-spaces, own-room, outside and gardens, meaningful activities and care flexibility were individually evaluated.<bold>Results: </bold>Overall consumer rated quality of care (Mean ∆: 0.138, 95% CI 0.073-0.203 P < 0.001) was higher in clustered domestic models after adjusting for potential confounders. Individually, the dimensions of access to outside and gardens (P < 0.001) and flexibility of care (P < 0.001) were rated significantly better compared to those living in standard model of care.<bold>Conclusions: </bold>Homelike, clustered domestic models of care are associated with better consumer rated quality of care, specifically the domains of access to outdoors and care flexibility, in a sample of individuals with cognitive impairment. Including consumer views on quality of care is feasible and should be standard in future evaluations of residential care. [ABSTRACT FROM AUTHOR]