Health and social care in an urban nursing home providing healthcare services and primary care's role: A qualitative study with residents, relatives and professionals

To identify the elements involved in adequate health and social care for old people living in nursing homes, determine their possible barriers and enablers and define primary care's role in it. Qualitative study with phenomenological approach. State funded private nursing home and its corresponding primary care center in the southeastern urban area of Madrid. Elderly residents, their relatives, and professionals from the nursing home and the primary care center. Five focus groups were conducted between November 2019 and January 2020, with semi-structured interviews based on the variables of analysis and themes related to the objectives. The sessions were recorded and transcribed. An open and axial coding was performed to identify categories after a triangulation of the data. The elements of adequate care identified are individualized care, promotion of autonomy, adequate information to residents and relatives, quality of services, coordination between professionals, and a continuous end of life care. The main barriers are the deficit of professionals, the differences in expectations between users and workers, and the organizational gap between the healthcare system and nursing homes providing healthcare services. The role identified for primary care is mostly bureaucratic. It is necessary to continue exploring these elements and to outline the role of primary care in nursing homes with different characteristics.