What makes a nursing home homely? A Scottish based study, using Q methodology of the perceptions of staff, residents and significant others

Background: A 'homely' nursing or care home is of international interest and comes from a wide variety of academic disciplines and from policy makers and charities. However, 'homeliness' is a dynamic and complex concept and one worthy of further investigation. Aims: (a) To explore what is meant by 'homely' in the care home environment, (b) to explore whether a 'homely' care home is a priority in the expressed views of residents, staff and visitors, and (c) to explore features contributing to the creation of homeliness in the care home environment. Method: A mixed methodology was used - a narrative literature review, an environmental assessment using the Sheffield care environment assessment matrix (SCEAM) tool and Q methodology. Participants (n = 16) included staff, residents and their relatives from care homes in the west of Scotland. Results: The literature review generated eight themes: home as space; home as place, design features, homeliness, the outdoors, home and identity, dementia design and specific rooms. The SCEAM revealed that homely environments supported personalisation, safety and health, privacy, community, comfort and awareness, choice and staff accommodation. The Q method revealed three factors: standards driven, making the most of it and a sense of belonging. Conclusion: The results showed that staff and relatives placed priority on features included in national standards of care, while residents placed more importance on a feeling of belonging.