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Welfare Reform on the Web (March 2001): Care of the Elderly - UK

BLURRING THE BOUNDARIES: A FRESH LOOK AT HOUSING AND CARE PROVISION FOR OLDER PEOPLE

C. Oldman

Brighton: Pavillion Publishing, 2000

Very sheltered housing seems to be a more attractive environment than residential care, but there are structural or policy obstacles to the former replacing the latter. Consideration needs to be given to devising a system of regulation for very sheltered housing that is user-centred, does not threaten the concept of "your own front door", and is separated from the funding question. Separating issues of funding and registration would mean that people could continue to receive Housing Benefit if their scheme was registered. At present funding and registration are tied together so that if a scheme is registered people are automatically ineligible for Housing Benefit, and are left with a personal allowance of £15.45 per week. Study proposes that in all forms of provision older people could be charged individually for accommodation, living costs, and care and support, giving them greater choice and control.

CARE HOMES CRITICISE COUNCIL FEES

C. Hall

Daily Telegraph, Jan 8th 2001, p.6

Reports that local authorities are closing council-owned residential homes and transferring residents to cheaper private sector accommodation. At the same time they are refusing to pay private homes enough to provide good quality care for their elderly residents.

CASH IN HAND

N. Valios

Community Care, no.1352, 2000, p.18-19

Investigates why only a handful of local authorities have extended direct payments to older users of social care services.

DECLINE OF CARE HOMES ADDS TO NHS BED STRAIN

M. Hunter

Community Care, no.1351, 2000, p.10-11

The decline in local authority and private care home beds for older people means that many patients well enough to go home have to stay in hospital. The decline is due to homes becoming unprofitable because of additional costs arising out of the national minimum wage, the introduction of National Care Standards and the Working Time Directive being combined with low increases in fees paid by local authorities. Government is addressing local shortfalls by the encouragement of public/private partnerships to build new facilities and by the creation of a strategic group of stakeholders which will oversee a new concordat between councils and care home providers.

ELDERLY CARE INSURANCE SET TO BE REGULATED

N. Timmins

Financial Times, Dec 21st 2000, p.3

Government proposes that long-term care insurance products should be subjected to "Cat" standards which specify the costs, access and terms under which products are sold.

A FAIR PRICE FOR CARE

Registered Homes and Services, vol.5, 2000, p.113

Reports that depressed fee levels are leading to residential care home closures. Local authorities purchase around two thirds of care home places and are using their near monopoly power to depress fees paid.

THE HEALTH AND CARE OF OLDER PEOPLE IN CARE HOMES: A COMPREHENSIVE INTERDISCIPLINARY APPROACH

Royal College of Physicians, Royal College of Nursing and British Geriatrics Society

London: Royal College of Physicians, 2000

The organisation of health services for care home residents is haphazard and overshadowed by debates about costs and regulatory mechanisms. Report calls for an integrated interdisciplinary approach for health and care services for care home residents. Recommends: introduction of a gerontological nurse specialist for homes; introduction of specialist GP and pharmacist services for homes; improvement in care planning through the introduction of formal approaches; development of teaching nursing homes; and introduction of consultant visits to homes.

LOANS TO PREVENT ELDERLY LOSING HOMES

C. Hall

Daily Telegraph, Dec 21st 2000, p.1

Reports that under the Health and Social Care Bill elderly people will be able to apply for interest free loans from local authorities to pay for residential care instead of having to sell their homes. Councils will eventually recoup the money from the person's estate on their demise.

MORAL DILEMMAS AND THE MANAGEMENT OF PRIVATE RESIDENTIAL HOMES: THE IMPACT OF CARE IN THE COMMUNITY REFORMS IN THE UK

G.J. Andrews and D.R. Phillips

Ageing and Society, vol.20, 2000, p.599-622

Following the implementation of the NHS and Community Care Act 1990, residential homes have had to compete for a finite number of clients funded by limited local authority budgets. Based on a three-stage quasi-longitudinal survey of over 100 residential care homes in one county, paper considers changes in the overall size and structure of a local sector and discusses specific management strategies that have been adopted by proprietors. The withdrawal of guaranteed state support has impacted heavily on residential homes. Many have multiple vacancies and have been facing financial hardship.

SCOTS EMBARRASS BLAIR OVER CARE FOR THE ELDERLY

M. Nicholson and N. Timmins

Financial Times, Jan 11th 2001, p.5

The Scottish Parliament is considering providing free personal care for the elderly, while the Westminster government intends to provide free nursing care only.

TSAR QUALITY

F. Rickford

Community Care, no.1352, 2000, p.24

Report of an interview with Ian Philip, the first national director for older people's services. His remit is to implement the new National Service Framework for Older People's Services and to end age discrimination in the NHS. He places a high priority on integration of health and social care for older people, including introducing a unified assessment of their needs.

WHAT IS INTERMEDIATE CARE? LOOKING AT NEEDS

P. Enderby and J. Stevenson

Managing Community Care, vol.8, Dec 2000, p.35-40

Managing operational change using a whole-systems approach will be key to re-engineering intermediate care and rehabilitation services for older people. Article outlines an approach used in Sheffield based on eight categories of need.