AIM AND OBJECTIVE: This study aimed to elucidate the understandings and beliefs about quality held by family members of residents of Norwegian nursing homes. The objective reported in the study considers how family member judge factors that enhance or hamper high care quality. BACKGROUND: The percentage of those who will require care in a nursing home some time before the end of their lives will increase dramatically in the next 20 years. Therefore, anticipating this pressure to expand nursing home availability, it is urgent that these services are developed from a keen understanding of what creates the best value. Care quality from the family's perspective is just one piece of the nursing home experience that must be understood for optimal value in care to be realised. DESIGN: Qualitative methodology. METHOD: Three focus group interviews; purposive sampling was used to recruit the 16 family members of residents in nursing homes. RESULTS: Three domains emerged that served as anchors for a typology of family perceptions of the quality care continuum: resident contentment, suitability of staff and environmental context. Each domain was developed with categories describing high- to low-quality markers, which were then clarified by enhancing and hindering factors. CONCLUSIONS: This typology provides a family perspective framework that may be useful to nursing leadership at all levels of the nursing home organisation to identify important quality of care strengths as well as markers of poor care. RELEVANCE TO CLINICAL PRACTICE: Overall, the typology is offered to expand nurses' understanding of quality, both practically and conceptually, to provide the best value in nursing care.
