ISO 25557:2026

International
Standard
ISO 25557
First edition
Ageing societies — Care quality for
2026-03
older persons at home and in care
facilities
Vieillissement de la population — Qualité des soins prodigués aux
personnes âgées à domicile et dans les établissements de soins
Reference number
© ISO 2026
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Published in Switzerland
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Contents Page
Foreword .vii
Introduction .viii
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Context of the provider of care services . 6
4.1 Understanding the needs and expectations of interested stakeholders .6
4.1.1 General .6
4.1.2 Recommendations.7
4.2 Integrated care .8
4.2.1 General .8
4.2.2 Recommendations.9
4.3 Governing and guiding documents .10
4.3.1 General .10
4.3.2 Requirements .10
4.3.3 Recommendations.10
4.4 Quality system for care services .11
4.4.1 General .11
4.4.2 Requirements .11
4.4.3 Recommendations. 12
5 Leadership of care services .12
5.1 Ethos of the provider of care services . 12
5.1.1 General . 12
5.1.2 Requirements . 13
5.1.3 Recommendations. 13
5.2 Leadership and commitment . 13
5.2.1 General . 13
5.2.2 Requirements .14
5.3 Governance of care services .14
5.3.1 General .14
5.3.2 Requirements . 15
6 Risk management of care services .15
6.1 Strategy . 15
6.1.1 General . 15
6.1.2 Recommendations. 15
6.2 Prevention and handling of risks to the older person .16
6.2.1 General .16
6.2.2 Requirements .16
6.2.3 Recommendations.16
6.3 Prevention and handling of risks on organization level .16
6.3.1 General .16
6.3.2 Requirements .17
6.4 Emergency and disaster preparedness .17
6.4.1 General .17
6.4.2 Requirements .17
6.4.3 Recommendations.17
6.5 Effectiveness and efficiency .18
6.5.1 General .18
6.5.2 Requirements .18
6.5.3 Recommendations.19
7 Resources and facilities for providing care services . 19
7.1 Workforce: recruitment, governance, training, and development .19

iii
7.1.1 General .19
7.1.2 Requirements on the recruitment and governance of the workforce . 20
7.1.3 Recommendations. 20
7.1.4 Requirements on the training and development of the workforce .21
7.1.5 Recommendations.21
7.2 Promotion of health and safety of the care services workforce . 23
7.2.1 General . 23
7.2.2 Requirements .24
7.2.3 Recommendations. 25
7.3 Coordination of information transfer within the care services organization and with
external services. 25
7.3.1 General . 25
7.3.2 Requirements . 25
7.3.3 Recommendations. 25
7.4 Infrastructure . 26
7.4.1 General . 26
7.4.2 Requirements . 26
7.5 Accessibility . 26
7.5.1 General . 26
7.5.2 Requirements .27
7.5.3 Recommendations.27
7.6 Medical devices .27
7.6.1 General .27
7.6.2 Requirements . 28
7.6.3 Recommendations. 28
7.7 Assistive technology . 29
7.7.1 General . 29
7.7.2 Requirements . 29
7.7.3 Recommendations. 29
7.8 Artificial intelligence . 30
7.8.1 General . 30
7.8.2 Requirements . 30
7.8.3 Recommendations. 30
7.9 Maintenance and housekeeping .31
7.9.1 General .31
7.9.2 Requirements .31
7.9.3 Recommendations.31
7.10 Food safety .32
7.10.1 General .32
7.10.2 Requirements .32
7.11 Infection prevention and control . 33
7.11.1 General . 33
7.11.2 Requirements . 34
7.11.3 Recommendations. 34
7.12 Medication handling . 34
7.12.1 General . 34
7.12.2 Requirements . 35
7.13 Environmental stewardship. 35
7.13.1 General . 35
7.13.2 Requirements . 36
7.13.3 Recommendations. 36
8 Provision of care services .36
8.1 Public information . . 36
8.1.1 General . 36
8.1.2 Requirements . 36
8.1.3 Recommendations. 36
8.2 Initial procedures and assessment .37
8.2.1 General .37

iv
8.2.2 Requirements .37
8.2.3 Recommendations. 38
8.3 Agreements and contracts related to the older person and their families . 38
8.3.1 General . 38
8.3.2 Requirements . 39
8.3.3 Recommendations. 39
8.4 Admission procedures . 39
8.4.1 When receiving care at home. 39
8.4.2 When receiving care at a care home .41
8.4.3 Providing a welcoming and safe home-like environment .43
8.5 Social and community life . 44
8.5.1 Rights, diversity, integrity and participation . 44
8.5.2 Security and safety . 46
8.5.3 Communication and information .47
8.5.4 Activities and events . 48
8.5.5 Financial procedures . 49
8.5.6 Informal carers, people close to the older person and volunteers . 50
8.6 Health.51
8.6.1 Health promotion . .51
8.6.2 Health literacy .52
8.6.3 Assessment of care and support during ongoing care .52
8.6.4 Cognitive function and mental health . 53
8.6.5 Food, drink, meals, nutrition and dehydration . 54
8.6.6 Oral health, dental health and swallowing . 55
8.6.7 Bladder and bowel function. 56
8.6.8 Personal care, skin integrity and wounds .57
8.6.9 Pain . 58
8.6.10 Sleep .59
8.6.11 Medications .59
8.6.12 Palliative and end-of-life -care . 60
8.7 Documentation .62
8.7.1 Care plans .62
8.7.2 Records and documentation . 64
9 Assessment of provided care services .64
9.1 Assessment of activities and results . 64
9.1.1 General . 64
9.1.2 Requirements . 65
9.1.3 Recommendations. 65
9.2 User feedback . 66
9.2.1 General . 66
9.2.2 Requirements . 66
9.2.3 Recommendations. 66
9.3 Self-assessment . 66
9.3.1 General . 66
9.3.2 Requirements .67
9.4 Audits .67
9.4.1 General .67
9.4.2 Requirements .67
9.4.3 Recommendations. 68
10 Improvement of care services .68
10.1 Promoting quality improvement and innovation in care services . 68
10.1.1 General . 68
10.1.2 Requirements . 68
10.1.3 Recommendations. 68
10.2 Non-fulfilment of requirements and adverse events. 69
10.2.1 General . 69
10.2.2 Requirements . 69
10.2.3 Recommendations. 69

v
10.3 Suggestions and complaints . 69
10.3.1 General . 69
10.3.2 Requirements .70
10.4 Conformance assessment . .70
Annex A (informative) The holistic framework of health and care services in ageing societies .71
Annex B (informative) Assessment and assessment tools . 74
Annex C (informative) Conformity with requirements and recommendations .78
Bibliography .81

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Foreword
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The procedures used to develop this document and those intended for its further maintenance are described
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This document was prepared by Technical Committee ISO/TC 314, Ageing societies.
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.

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Introduction
This document supports the United Nations Principles for older persons:
— Older persons should be able to live in environments that are safe and adaptable to personal preferences
and changing capacities.
— Older persons should be able to reside at home for as long as possible.
— Older persons should benefit from family and community care and protection in accordance with each
society’s system of cultural values.
— Older persons should be able to utilize appropriate levels of institutional care providing protection,
rehabilitation, and social and mental stimulation in a humane and secure environment.
— Older persons should be able to enjoy human rights and fundamental freedoms when residing in any
shelter, care, or treatment facility, including full respect for their dignity, beliefs, needs and privacy and
for the right to make decisions about their care and the quality of their lives.
— Older persons should be able to live in dignity and security and be free of exploitation and physical or
mental abuse. Older persons should be treated fairly regardless of age, sex, ethnic background, disability,
or other status, and be valued independently of their economic contribution.
NOTE 1 The first article of the Universal Declaration of Human Rights states that “All human beings are born free
and equal in dignity and rights”. The notion of dignity is defined as the inherent and inalienable worth of all human
beings irrespective of social status such as ethnicity, sex, physical or mental state. Dignity is deeply embedded in
international human rights instruments.
This document is based on the concept integrated care that can be described as methods and strategies for
linking and coordinating the various aspects of care delivered by different care systems, such as the work of
general practitioners, primary and specialty care, preventive and curative services, as well as physical and
mental health services and social care, to meet the multiple needs of an individual older person or category
of persons with similar needs.
An integrated response to care covers health care, social care, care for cognitive diseases, palliative and
end-of-life care, respite care, rehabilitation, services provided at home, in the community, in hospitals or in
care homes, public or private-funded, informal care or care by volunteers.
Care is care, regardless of the environment and should be a seamless provision of health and social services
which are not divided up into silos.
This document adopts a person-centred approach, outlining that care is to be provided with the older
persons’ identity and preferences taking priority. Person-centred care planning is made in close consultation
with the older person, with a goal to improve, restore, and maintain health and wellbeing so the older person
can age with dignity, be respected, and determine how they will live their life while receiving care. For those
persons assessed as “lacking mental capacity” the care planning is made in consultation with appointed
chosen decision maker or representative.
Care providers are responsible for ensuring that the health and wellbeing of the workforce are protected as
this impacts the conditions under which care will be delivered to older persons.
Informal carers provide a high amount of care and support and are able to do so in culturally appropriate
ways that align with the older person’s values. The quality of life of the informal carer is closely linked to the
quality of life of the older person in need of care and support.
Care coordination is needed at a systems level. The integration between social care and health care, both
administratively and at the points of use, is crucial to providing high-quality care. The separation of
social care and health care services can result in fragmented coverage, gaps in the provision of care and
inappropriate use of acute services. This interferes with the rights of older persons to access the support
they need to live to their fullest potential.

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A well-supported infrastructure of an aged society includes a comprehensive, holistic framework of health
and care services. See Annex A.
There is also a need for a different approach in the way care and support is organized and a change in the
way older persons and ageing in general are perceived.
Care homes, also referred to as residential care facilities, assisted living facilities, retirement homes or
communities, are settings where the majority of older persons often live with complex care needs. They
provide a range of professional health services, lodging, food, and personal care (e.g. assistance with
everyday activities) for older persons 24 hours a day, every day.
NOTE 2 In some countries medical care is separated from care and is provided by organizations from the health
care sector. When this is the case, the care provider needs to have systems in place to provide medical services or
access to such when needed.
The concepts of healthy ageing and age-friendly environments stresses the importance of enabling the older
person in need of care and support to be involved and empowered to decide how their needs, expectations
and preferences can be met to live as autonomously as possible.
This document is based on the principle that care and support for older persons needs to evolve in light of
the current social situation. It is important to move away from care that focuses on meeting the basic needs
of older persons to challenge broader objectives such as ensuring wellbeing, meaning in life, and that older
persons feel respected.
As the birth-rate declines and the population ages, caregiving needs to fundamentally evolve to sustainably
meet the growing needs of older persons. The service providers can significantly contribute to promote the
older person’s autonomy.
The providers of care services are expected to develop new ways of thinking through digital technology,
including result-based quality improvement, productivity improvements that support sustainable systems,
and encourage self-determination for users.
To ensure that medical care is provided where people live, including in care homes, networking of medical
and care services in cooperation with health care and social care professionals, medical and care services
can be provided in an integrated manner in the community.
Care and support ought to play a sustained role in maintaining the functional abilities of older persons and
ensuring
...