The complexity of care services means that identifying the most appropriate policy approaches to drive long-term care quality can be challenging. This chapter and the next two review the approaches and policies used by OECD and EU countries to promote care quality. Three approaches are identified: 1) imposing external regulatory controls to safeguard and control quality; 2) developing standards to standardise care practice and monitor indicators to ensure that care outcomes match desired levels; and 3) stimulating quality improvement through the use of market-based incentives directed at providers and users, including the use of performance-based financial incentives and competition among care providers. This chapter focuses on external regulatory controls such as the development of minimum standards, licensing or accreditation of facilities and training requirements for workers. Standardisation policies and the use of incentives to drive quality will be analysed in the next two chapters.