Objectives: To assess the feasibility of capturing older care home residents′ quality of life (QoL) in digital social care records (DSCRs) and the construct validity (hypothesis testing) and internal consistency (Cronbach′s Alpha) of four QoL measures. Design: Cross-sectional data collected in wave one of the DACHA (Developing resources And minimum dataset for Care Homes′ Adoption) Study, a mixed-methods pilot of a prototype minimum dataset (MDS) [1]. Setting: Care homes (with or without nursing) registered to provide care for older adults (>65 years) and/or those living with dementia. All homes used a DSCR system from one of two suppliers. Participants: Data were extracted for 748 residents. All permanent residents, aged 65 years or older, were eligible to participate, including those lacking capacity to consent. Temporary residents and residents in their last weeks of life were excluded. Outcome measures and analysis: The English language versions of: ASCOT-Proxy-Resident, ICECAP-O, EQ-5D-5L proxy and the QUALIDEM were added to the DSCRs. As there have not been any previous studies of the structural validity of the English language version of the QUALIDEM, ordinal Exploratory Factor Analysis (EFA) was applied for this measure only. Feasibility (% missing by software provider and measure), % floor/ceiling effects (>15% at lower/upper end of the scales), convergent or divergent construct validity (criterion of >75% of hypotheses accepted) and internal consistency (Cronbach′s Alpha ≥.7) were assessed for all four measures. Results: The ordinal EFA of QUALIDEM did not replicate the findings of previous research. A six factors (36 items) solution was proposed and used in all subsequent analyses. There were low rates of missing data (<5%) for all items, except ASCOT-Proxy-Resident Control (5.1%) and Dignity (6.2%) and QUALIDEM item 35 (5.1%). Ceiling effects were observed for the ASCOT-Proxy-Resident and two of the QUALIDEM subscales. None of the scales had floor effects. Cronbach′s alpha indicated adequate internal consistency (α≥.70) for the ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L proxy. There were issues with two QUALIDEM subscales. Construct validity for all measures was adequate. Conclusions: The findings support the use of EQ-5D-5L, ASCOT-Proxy-Resident and the ICECAP-O in care homes for older people. Choice of measure will depend on the construct(s) of interest. More research is needed to establish the psychometric properties of the QUALIDEM in an English care home setting.

The authors have no relevant financial or non-financial interests to disclose. Authors Towers, Rand, Allan and Smith are part of the developer team for the ASCOT. ALG has received honoraria from Gilead Sciences and Pfizer for consultancy work undertaken in relation to COVID-19 in care homes.

This project is funded by the National Institute for Health Research (NIHR) Health Service Research and Delivery programme (HSDR NIHR127234) and supported by the NIHR Applied Research Collaboration (ARC) East of England. AMT, ALG, BH, KS, GP, AK, and CG are supported by the NIHR Applied Research Collaborations in Kent, Surrey and Sussex; East Midlands; North East and North Cumbria; Yorkshire and Humber and East of England respectively. CG, ALG and KS are NIHR Senior Investigators. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

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The London Queens Square Research Ethics Committee gaved ethical approval for this work (22/LO/0250).

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