The State of Quality for Care Services in Japanese Public Nursing Homes

Here in Japan, care services in nursing homes are often availed of by families for their elderly loved ones for the final stages in their lives instead of keeping them home. However, while public nursing homes offer convenience in reducing the burden and pressure of looking after an elderly family member, they have also been challenged with several difficulties such as a high turnover rate among caregivers and abuse towards the elderly.

Our study investigated the quality of care services of two major public nursing homes, Tokuyou and Rouken, located in the Gifu prefecture in 2014 using collected data from the Ministry of Health, Labour and Welfare website ( The Japanese public sector, including these nursing homes, has already started introducing a third-party evaluation system similar to those used by many for-profit companies which have positively accepted this kind of auditing system.

Our analysis showed that of their services offered, where Tokuyou has 123 items and Rouken has 119, fundamental care services, which is performed within most nursing homes, is accomplished satisfactorily by both Tokuyou and Rouken. These are items that include diet for the residents, changing their clothes, regular bathing and so on. On the contrary, services which require a relationship with the community as an ombudsman are a bit more difficult for both Tokuyo and Rouken to achieve. We also emphasized that mental care services, and not physical care services, are the ones that are unfortunately far from their intended goals. Finally, our cross tabulation revealed that nursing homes which conducted a “Questionnaire” for the elderly and the families at the beginning of their stay and made use of “Third Party Evaluation” have a much higher level of care services, even for those which are considered difficult items to accomplish as opposed to nursing homes
without them.

So far, this study has focused only in the Gifu prefecture and there are challenges that need to be cleared in order to interpret the quality of care services within the whole country. However, we can tell that at least 181 nursing homes in total within Gifu prefecture have a satisfactory level of essential care services, and that the more conscious nursing homes are with the quality of services they provide, the better and safer are their care services.