{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T04:30:28Z","timestamp":1772771428554,"version":"3.50.1"},"reference-count":52,"publisher":"Emerald","issue":"2","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAP"],"published-print":{"date-parts":[[2019,3,28]]},"abstract":"<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Purpose<\/jats:title>\n<jats:p>In most European countries there is a range of quality control system mechanisms, however, poor quality and institutional violence can be found in the residential sector. Taking Portugal as an example of a country that uses an inspection-only approach, this paper focuses on the monitoring system for controlling the quality of care in nursing homes. The purpose of this paper is to analyse how mistreatment of older people is identified and dealt with by the national social security services. In particular it looks at what the indicators are with which to assess poor quality care and mistreatment (how it is perceived and defined), which factors affect mistreatment of older people and intervention outputs (i.e. what are the sanctions to prevent and combat this).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Design\/methodology\/approach<\/jats:title>\n<jats:p>An exploratory approach was based on a mixed method, using a database of 3,685 complaints reported to the social security inspection services. To understand the context of the complaints and the assessment of institutional violence, focus groups were carried out with inspectors from the National Inspection Service.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Findings<\/jats:title>\n<jats:p>The focus groups identified severe situations of poor care, mistreatment of older people and loss of human rights and dignity. Some indicators were found in key areas of care and the factors associated with this were based on Kamavarapu\u2019s typology (2017): physical conditions of facilities; closed organisational models; difficult working conditions; and perceived concerns of residents. Monitoring and inspection systems are still based on minimum standards focusing on structural and process quality, devoting little attention to the human rights situation of older persons and clinical issues.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Research limitations\/implications<\/jats:title>\n<jats:p>The number of participants in the focus groups was limited in size but the uniqueness of this exploratory method draws a dark picture of non-licensed nursing homes in Portugal.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title content-type=\"abstract-subheading\">Originality\/value<\/jats:title>\n<jats:p>An exploratory analysis was useful to identify institutional violence and discuss potential implications, in terms of effectiveness of quality care control, which calls for special attention by policy makers and researchers when monitoring the human rights of older persons.<\/jats:p>\n<\/jats:sec>","DOI":"10.1108\/jap-09-2018-0018","type":"journal-article","created":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T06:53:22Z","timestamp":1552287202000},"page":"126-143","source":"Crossref","is-referenced-by-count":13,"title":["Quality procedures and complaints: nursing homes in Portugal"],"prefix":"10.1108","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6728-7689","authenticated-orcid":false,"given":"Ana Paula","family":"Gil","sequence":"first","affiliation":[]}],"member":"140","reference":[{"key":"key2020092413113432400_ref001","volume-title":"Focus Groups in Social Research","year":"2001"},{"key":"key2020092413113432400_ref002","unstructured":"Bonnie, R.J. and Wallace, R.B. (Eds) (2002), Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America, Panel to Review Risk and Prevalence of Elder Abuse and Neglect. Committee on National Statistics and Committee on Law and Justice, Division of Behavioral and Social Sciences and Education, National Research Council of the National Academies, The National Academies Press, Washington, DC."},{"issue":"1","key":"key2020092413113432400_ref043","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1177\/0969733008097996","article-title":"Elder abuse and mistreatment in residential settings","volume":"16","year":"2009","journal-title":"Nursing Ethics"},{"issue":"1","key":"key2020092413113432400_ref042","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1177\/0969733010385529","article-title":"Violation of ethical principles in institutional care for older people","volume":"18","year":"2011","journal-title":"Nursing Ethics"},{"issue":"4","key":"key2020092413113432400_ref003","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1177\/0733464813492583","article-title":"Elder abuse in residential long-term care-an update to the 2003 national research council report","volume":"34","year":"2015","journal-title":"Journal of Applied Gerontology"},{"issue":"1","key":"key2020092413113432400_ref044","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1108\/14668201311299872","article-title":"Defining the \u2018perpetrator\u2019: abuse, neglect and dignity in care","volume":"15","year":"2013","journal-title":"Journal of Adult Protection"},{"key":"key2020092413113432400_ref004","volume-title":"Abuse, Neglect and Loss of Dignity in the Institutional Care of Older People","year":"2009"},{"issue":"11","key":"key2020092413113432400_ref005","first-page":"1145","article-title":"The quality of care \u2013 how can be assessed?","volume":"121","year":"1997","journal-title":"Archives of Patology & Laboratory Medicine"},{"key":"key2020092413113432400_ref006","volume-title":"Older People in Residential Care Settings: Results of a National Survey of Staff Resident Interactions and Conflicts","year":"2012"},{"issue":"6","key":"key2020092413113432400_ref007","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1093\/geront\/gnq047","article-title":"Measuring person-centered care: a critical comparative review of published tools","volume":"50","year":"2010","journal-title":"The Gerontologist"},{"key":"key2020092413113432400_ref009","volume-title":"Respect My Rights, An ENHRI Toolkit on Applying a Human Rights- Based Approach to Long-term Care for Older Persons","author":"ENNHRI","year":"2017"},{"key":"key2020092413113432400_ref008","unstructured":"European Commission \u2013 DG Employment, Social Affairs and Equal Opportunities (2010), \u201cPeer review: achieving quality long-term care in residential facilities\u201d, Short report by Murnau E., 18-19 October."},{"key":"key2020092413113432400_ref010","unstructured":"Ferreira, V. 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