Table 6 Drawbacks according to the managers (n = 3) of 3 homes during the maintenance phase

InterRAI-LTCF sometimes cannot detect specific syndromes

Time consuming.

Questions are too complicated

Sometimes interRAI-LTCF gives a trigger but it is not always clear if something needs to be done and what needs to be done.

The system is not always available.

Not completely in line with the care need indication

The translation of the outcomes is sometimes difficult to link to specific actions.

Sometimes difficult to interpret 6 monthly outcome reports.

The instrument needs revising for better use in practice

Sometimes the interRAILTCF system is not working on the computers

Not all medication is available in the system.

Scores on the benchmark reports are easily distorted when there are in practice only one or two worse cases in the facility

Outcomes of the benchmark reports are difficult to point to the specific residents.

The personal factor must be kept in mind. Not only focusing on the instrument itself, but listening and looking at the resident as well.