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Welfare Reform on the Web (September 2002): Care of the Elderly - UK

THE AGE OLD STORY

R Winchester

Community Care, June 20th-26th 2002, p. 31-32

Local authority services for older people are seriously underfunded, leading to reduced consumer choice. Community care services are often outsourced, and are inflexible because they are delivered to the letter of the contract. One way of addressing this problem is through greater use of direct payments so that older people can organise their own care. Problems will be exacerbated by demographic change and a burgeoning elderly population.

CALCULATING A FAIR PRICE FOR CARE: A TOOLKIT FOR RESIDENTIAL AND NURSING CARE COSTS

W Laing

Bristol: Policy Press, 2002

Concludes that fees local authorities currently pay are between £75.00 and £85.00 a week below the reasonable costs of running an efficient and good quality care home. Argues that local authority fees, backed by central government funding, should be based on the local costs of running a typical efficient home that meets minimum standards. Proposes a method for calculating a "spot" price for places based on staffing, non-staffing current costs and capital costs.

CARE HOME OWNERS URGED NOT TO PANIC OVER NEW GUIDELINES

S Morris

Guardian, July 3rd 2002, p. 6

Reports the case of Mrs Alice Knight who went on hunger strike and died after the care home in which she had lived for six years closed. The owner of this home claimed she had no option but to close it because she could not afford to have it upgraded to meet new standards brought in under the Care Standards Act 2000. The National Care Standards Commission which regulates homes has urged owners not to let fears over the new standards panic them into shutting down.

(See also Daily Telegraph, July 3rd 2002, p. 9)

CHANGING LOCAL GEOGRAPHIES OF PRIVATE RESIDENTIAL CARE FOR OLDER PEOPLE 1983-1999: LESSONS FOR SOCIAL POLICY IN ENGLAND AND WALES

G J Andrews and D R Phillips

Social Science & Medicine, vol. 55, 2002, p. 63-78

By examining the private residential care sector in England and Wales, this article demonstrates some of the potential problems of leaving long-term care to the market.

It considers changes in the overall size and structure of a local sector and discusses various management strategies that have been adopted by proprietors and the development of a purchasing and providing market culture.

FULLY EQUIPPED

Audit Commission

Audit Commission Publications, 2002

Finds that there has been little improvement over the past two years in provision of appropriate good-quality equipment for elderly and disabled people. The £270m made available by the government to improve equipment services appears to have got lost in the system or been spent on higher priorities. In community equipment, an implementation team has been set up to plan a single integrated service but improvement has been slow. Patients have to jump through eligibility hoops, equipment issued is forgotten, and there are long waits. Commissioning often does not reflect health improvement and modernisation programme objectives and does not look at the wider effects of not providing good services.

HEALTHCARE DELAYS ARE CRIMINAL

K Lewin

Registered Homes and Services, vol. 7, 2002, p. 24-25

Argues that almost every "misactivity" or misdemeanour in a registered care home, however minor, is now attended by the risk of criminal prosecution under the raft of legislation that came into force in April 2002. The message sent out is that care home owners cannot be trusted and are controllable only by the exercise of the most draconian powers.

INTEGRATING CARE FOR OLDER PEOPLE: NEW CARE FOR OLD - A SYSTEM APPROACH

C Foote and C Stanners

London: Jessica Kingsley Publishers, 2002

This book examines the co-ordination of medical, social and community services through systems thinking and looks at the effective use of on-going assessment evaluation, costing and information technology in the support of older people.

INVOLVING OLDER PEOPLE THROUGH TIME BANKS

D Boule

Working with Older People, vol. 6, June 2002, p. 9-11

Presents a case study of the practical application of a time bank among older patients at a GP surgery in Catford, South East London. Time banks encourage community involvement and participation by allowing people to provide each other with services using a system of time "credits".

LISTENING TO THE DEMENTIA WORKFORCE: LOCAL PROVIDERS' PERCEPTIONS OF DEMENTIA SERVICES

J Manthorpe and H Alaszewski

Quality in Ageing, vol. 3, June 2002, p. 22-29

Project explored provision for people with dementia in a particular local authority through a survey of practitioners and managers. Practitioners believed there to be a need for more specialist services for people with dementia. Existing provision at local level, such as day care, was believed to be particularly under-developed. The lack of experienced staff in residential homes was reported to be leading to unstimulating environments which home managers wished to improve.

MORALE AND QUALITY OF LIFE AMONG FRAIL OLDER USERS OF COMMUNITY CARE: KEY ISSUES FOR SUCCESS OF COMMUNITY CARE

C Patmore

Quality in Ageing, vol. 3, June 2002, p. 30-38

Paper reports findings about quality of life from a programme of in-depth interviews with older users of community care. A few interviewees expressed very low morale which appeared to substantially reduce their satisfaction with the help they received. While it is established that disability and isolation are linked to depression in older people, it is rare for service providers to systematically address these problems. Some practical strategies for this purpose are proposed as a result of the survey.

RNHA SAYS NURSING CARE COSTS £420 PER WEEK

Anon

Registered Homes and Services, vol. 7, 2002 p. 19

Argues that it is impossible to provide older people with health needs with appropriate residential nursing care for the present fees of £350-£400 a week paid by councils. The true cost is now more like £420 per week for 24 hour care.

SCOTLAND BLAZES A TRAIL ON FREE PERSONAL CARE FOR OLDER PEOPLE

C Jerrom

Community Care, June 27th-July 3rd 2002, p. 18-19

Free personal care for older people in Scotland was introduced on July 1st 2002. In practice any older person who was in a care home on April 1st 2002 is automatically eligible for free personal and nursing care, but will have to apply for it. Anyone who went into a care home after April 1st 2002, and people in the community who receive personal or nursing care will have to apply for a needs assessment.

THOUSANDS OF CARE PLACES COST

J Carvel

The Guardian, July 19th 2002, p. 9

The government was warned that Britain's network of care homes for the elderly is beginning to disintegrate after the loss of 64,000 places since Labour came to power in 1997. Independent analysts Laing & Buisson said 827 private and voluntary care homes closed last year while registrations of new homes dipped to a record low of 117. Leaders of the care home sector blamed tougher regulations and a squeeze on fees from local authorities. Property values have also affected the exodus.

WOMAN, 108, STARVES HERSELF TO DEATH

Anon

The Guardian, July 2nd 2002, p. 5

One of Britain's oldest women has died aged 108 after a month long hunger strike in protest about being moved to a new care home. Mrs Alice Knight had lived in Flordon House private residential home in Norwich for six years until its closure - blamed on strict new regulations - forcing a move to the nearby Laurel Lodge home. Flordon House was closed because the owners felt unable to meet the national care standards guidelines for residential homes which must be implemented by 2007.

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