Long-term care recipients are demanding greater flexibility, more choice, more autonomy and better service quality. These demands and public stories of inadequate standards of care pressure governments to increase transparency over the quality of care delivered to frail and disabled elderly. This chapter provides definitions and a framework for looking at long-term care quality in this report. Three key domains that are generally accepted as being critical factors underpinning care quality are considered: i) effectiveness and care safety; ii) patient-centredness and responsiveness; iii) care co-ordination. Three structural outcomes instrumental to delivering good quality care are also identified, namely: i) staffing and management; ii) care environment; iii) information and communication technology and other assistive devices.