Results calculation

Patient-Led Assessments of the Care Environment (PLACE) scores are presented as percentages, but the marks allocated, and the maximum possible marks, are also published.

The purpose of PLACE scores is to identify areas where improvements could be made, rather than for comparison of sites or year on year differences. It is intended that areas for inspection are rotated on an annual basis if the sites are sufficiently large so that over time every part is covered.

Due to the widely variable nature of healthcare environments, each site will answer a slightly different set of questions depending on the type and number of facilities available, both in terms of number of scorecards filled out and questions responded to. In addition, some questions have ‘not applicable’ options, and these will not count in the score calculation. Questions not answered do not count towards the maximum score that can be achieved, so the final percentage score is made on a different basis for every site and organisation.

There were very few changes made for the 2023 or the 2024 PLACE question set (since the previous collection in 2019).  Due to the extent of the changes to the 2019 question set, PLACE scores in 2019 and beyond are not comparable with those from previous years.   

Care should be exercised if making comparisons with anything other than responses to individual questions as the wards, areas and questions included in a PLACE assessment may vary from year to year.

There are different types of questions used in PLACE assessments: Pass/Fail; Pass/Qualified Pass/Fail; Yes/No; Multiple Choice (covered in the next section).

The allocation of scores for 2022 is as follows:

Pass   = 2 points

(Qualified pass = 1 point)

Fail     = 0 points

Yes answers = 2 points

No answers   = 0 points

Questions that are not applicable to the healthcare environment being assessed are not scored (that is, they don’t count towards the total possible points).

In all cases the top score is 2 and the bottom score is 0.

Scores for intermediate points on the scale depend on the number of options. For example:

If there are three options the scoring is 2, 1 and 0.

If there are four options the scoring is 2,  1⅓, ⅔ and 0.

If there are five options the scoring is 2, 1½; 1, ½ and 0.

If there are six options the scoring is 2, 1.6, 1.2, 0.8, 0.4 and 0.

Usually there are equal divisions as above but for a very small number of questions some options may have the same score where there is considered to be no difference in value between two options (for example, two zeros for equally undesirable options, or two middle scores). In this case, the scores for the other questions are spread equally across the remaining points.

The results at site level for each of the 6 categories or ‘domains’ (cleanliness; condition, appearance, and maintenance; privacy, dignity, and wellbeing – supportive environments; food and hydration; dementia-friendly environments; disability-supportive environments) are expressed as a percentage score. The food scores are broken down into organisational food and ward food (and in combination make up the food domain).

The percentage is calculated by reference to the score achieved expressed as a percentage of the maximum possible score for that site. The denominator for the calculation (the maximum possible score) will be different for each site, depending on the number of questions answered in total. The maximum possible score is the total number of boxes in which a response has been entered (excluding ‘not applicable responses and non-scoring questions) multiplied by 2 (2 being the maximum score for each question).

The online data collection system allocates each question response to the appropriate domain category/categories and calculates the score accordingly – rounding only once where the final score ends in a fraction.

Scores are presented at site, organisation, site type and national level. Calculation of scores at organisation, site type and national level involves weighting the site scores by the number of beds.

Annual PLACE scores are calculated in EFM. If you need to calculate a weighted score for your organisation in addition to the annual score (for example, for PLACE-Lite assessments), you can use the following calculation to get a score for each domain.

For example, for a weighted organisational score for dementia:

1. For each site, multiply the dementia score (which is the dementia score for the site divided by the maximum points available for dementia at that site) by the number of beds in that site.
2. Add the results of the above together to get a total for the organisation.
3. Divide that sum by the total number of beds in the organisation (that is, all assessed sites). This is the weighted score in points.

The following information describes which questions score towards each domain, together with their location (form, scorecard, and section, if applicable). Note that the ‘Patient Assessment Summary Sheet’ form, the ‘Ward first impression’ and the ‘Ward last impression’ sections in various forms do not have any scoring questions. 

• all questions from the ‘Cleanliness’, ‘Cleaning’, and ’Hand-hygiene and equipment’ sections from all assessment forms that include these sections

• all questions from the ‘Condition/appearance’ section from all assessment scorecards that include this section
• all questions in the ‘Building and facilities’ section in Organisational Facilities scorecard except for the question in the ‘Cleaning’ section
• questions on clearly marked and sufficiently wide spaces, on drop off spaces on location of payment machines, and on covered and well-lit payment machines, in ‘Access and car parking’ section in Organisational facilities scorecard
• question on visibility of signs in the ‘Signs (within the grounds)’ section of the External Areas scorecard
• question on control buttons from the ‘Lifts’ sections of the Communal areas scorecard

• all questions from the ‘Privacy, dignity and wellbeing’ section from all assessment scorecards that include this section (except those questions on design of specialist dementia-care wards, on access audit / review, and on access review involvement in organisational facilities scorecard)
• questions on appropriate measures to support privacy and dignity, on support of patients with hearing or visual impairments, on appropriate signage of single sex toilets and question on generally available spacious toilet in ‘Access’ sections in all scorecards that include this section and these questions
• questions on travel plans including accessibility, on clearly marked and sufficiently wide spaces, on appropriate location of spaces for disabled users, on payment by exit, on clear information relating to parking, on car parking charge concessions on information on any concessionary scheme, on variety of payment options, on location of payment machines,  in ‘Access and car parking’ section in the organisational facilities scorecard
• all questions in the ‘Building entrances’ section of the external areas scorecard
• questions on safe outside spaces; outside seating; whether outside areas are well maintained; whether outside surfaces are level; whether the areas encourage usage; in ‘Social spaces’ section of the External areas scorecard
• question on effectiveness of signs in the ‘Signs (within the grounds)’ section of the external areas scorecard
• questions on signs inside lifts and on audible and visual announcements from the ‘lifts’ section of the communal areas scorecard
• all questions in ‘Ward social spaces’ section in the ward scorecards
• all questions in ‘Changing and waiting facilities’ section in the ‘Outpatient department’ scorecard

• all questions from the ‘Organisational questions: food’, and ‘Food: mealtime assessment’ scorecards

• all questions from the ‘Dementia-friendly environment’ section in all scorecards in which these questions appear
• all questions from the ‘Lifts’ section of the communal areas scorecard
• the question on design and furnishing of specialist dementia-care units in ‘Dementia’ part of privacy, dignity and well-being’ section of the ‘Organisational questions – facilities’ scorecard
• the ‘Grounds and gardens safety’ question in the ‘Condition/appearance’ section of the external areas’ scorecard
• the question on level surfaces in the ‘External social spaces’ section of the external areas scorecard
• all questions except the questions on support for patients with hearing or visual impairments from the ‘Access’ section’ in all scorecards in which this section appears
• all questions in the ‘Ward social spaces’ section of the ‘Ward assessment’ scorecards

From the ‘Organisational questions – facilities’ scorecard:

• questions on travel plan including accessibility; on clearly marked and sufficiently wide spaces, on appropriate location of spaces for disabled users, and on car parking charge concessions, in ‘Access and car parking’ section
• question on carers visiting in ‘Privacy, dignity and wellbeing’ section
• questions on access audit / review, on changing places toilet, and on review of access involvement in ‘Other’ section

From the 'External areas' scorecard:

• question on sufficient seating in the ‘Building entrances’ section
• questions on whether outside surfaces are level and on whether the area is wheelchair accessible in the ‘Social spaces’ section.
• question on visibility of signs in ‘Signs (Outside the hospital)' section

From the 'Communal areas and Emergency departments/Minor injuries units' scorecards:

• all questions in the ‘Lifts’ section

From the 'Emergency departments/Minor injuries units' scorecards:

• question on system to support patients with hearing / visual impairment in the ‘Privacy, dignity and well-being’ section
• question on large generally available toilet in the ‘Privacy, dignity and well-being’ section

From the ‘Organisational questions - food’ assessment scorecard:

• question on the Malnutrition Universal Screening Tool (MUST) from the ‘Patient nutritional screening’ section
• questions on the packaged foods purchasing standard and on the identification of vulnerable/at-risk patients who require assistance with eating from the ‘Food packaging and eating – patient support’ section
• question on representation in the food safety committee in the ‘Food safety’ section; Questions on the IDDSI framework meal auditing, registered dietician approved menu, understanding of menu meeting individual needs and on the provision of finger foods from the ‘Menu, choice, and meal timings’ scorecard

The following questions in the ‘Food: Mealtime assessment’ scorecards:

• whether there is a range of menus available
• whether patients were made ready for the meal service
• whether packaged foods were opened and placed on a plate for patients identified as having difficulty opening packages
• whether staff were clearly active and involved in food delivery and service
• whether suitable (including adapted) crockery and cutlery were provided
• whether patients have access to fresh drinking water at all times

Most of the disability domain is scored using relevant questions from other domains.

The following questions from the ‘Out-patient areas’ scorecard:

• all questions in the ‘Access’ section
• questions on consistent flooring, flooring colour, consistency of toilet door signs, pictures and text on toilet doors, clear tap markings, hanging height of signs, staff specific signs, display of day and date, visible large clock, and effective use of colour in the ‘Dementia’ section
• question on changing and waiting facilities in the ‘Changing and waiting facilities’ section

The following questions in the ‘Organisational facilities’ scorecard:

• whether the organisation has a travel plan including accessibility
• question on wide parking spaces
• question on location of parking spaces for disabled users
• question on car parking concessions
• question on changing places toilet
• question on access audit
• question on involvement of disabled people in access audit

The following questions in the ‘External areas’ scorecard:

• question on sufficient seating leading up to the building entrance area in the ‘Condition/Appearance’ section
• question on level surfaces in the ‘Social spaces’ section
• question on visibility of signs in the ‘Signs (within the grounds)’ section

The following questions in the ‘Communal areas’ scorecard:

• all questions in the ‘Access’ section except for the question on appropriate measures to ensure privacy and dignity at reception
• all questions in the ‘Lifts’ section
• questions on consistent flooring, clearly marked slopes, flooring colour, consistency of toilet door signs, pictures and text on toilet doors, clear tap markings and effective use of colour in the ‘Dementia’ section

The following questions in the ‘A&E/Minor Injuries’ scorecard:

• all questions in the ‘Access’ section except for the question on visibility of signs to the toilets from all areas
• questions on consistent flooring, clearly marked slopes, flooring colour, consistency of toilet door signs, pictures and text on toilet doors, clear tap markings, hanging height of signs, staff specific signs, display of day and date, visible large clock, and effective use of colour in the ‘Dementia’ section
• questions on system / process to support patients with hearing or visual impairments and on generally available toilet with sufficient space for wheelchair and carer in the ‘Privacy, dignity and well-being’ section

The following questions in the ‘Acute ward assessment’ scorecard:

• all questions in the ‘Access’ section
• questions on consistent flooring, clearly marked slopes, flooring colour, pictures and text on toilet doors, clear tap markings, clarity of patient signs, hanging height of signs, staff specific signs, visible large clock display of day and date, and adjustment of light levels in the ‘Dementia’ section
• question on seating provision for the range of patient needs in the ‘Ward social spaces’ section

The following questions in the ‘Mental health ward assessment’ scorecard:

• all questions in the ‘Access’ section
• questions on consistent flooring, clearly marked slopes, flooring colour, pictures, and text on toilet doors, clearly marked taps, clarity of patient signs, hanging height of signs, staff specific signs, visible large clock display of date and time, and adjustment of light levels in the ‘dementia’ section
• question on seating provision for the range of patient needs in the ‘Ward social spaces’ section

The following questions in the ‘Food’ scorecard:

• questions on the range of menus to meet patient needs, readying patients for meal service, opening of packaged foods, involvement of staff in delivery of food, provision of suitable crockery and cutlery, and access to fresh drinking water in the ‘General food assessment, service and presentation’ section

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