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Describes how the 1984 Registered Homes Act has been implemented at the DHA and operational levels, concentrating on the monitoring of care in private nursing homes. It can be seen that, perhaps due to the unspecific nature of the Act, there are significant differences between the DHAs, in terms of the degree of importance attached to quality of care. However, at the operational level, this issue was considered to be more salient, although still reliant on the discretion of each individual inspection officer. Puts forward a three‐point plan for strengthening inspection practices.

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