British Journal of Social Work, 35(7), October 2005, pp.1093-1106.
Publisher:
Oxford University Press
This paper reports on research funded by the Nuffield Foundation exploring the role of lay assessors in the care home inspection process in England and Wales. Lay people have been included in many care home inspections for the past decade. Similar lay involvement is included in other public service inspections such as the Office for Standards in Education (OFSTED) inspections of schools. The Board of the short-lived National Care Standards Commission (NCSC) controversially decided to dispense with such lay involvement in the inspection process. The replacement body, the Commission for Social Care Inspection (CSCI), intends to include lay people in the inspections of support services in the community but is hesitating about reintroducing them into care home inspections. This research project was able to explore the role taken by lay assessors in thirteen inspections of care homes for older people and for adults with learning disabilities. The research concluded that lay assessors had a significant role in communicating with residents and staff and observing care home life. Their role was particularly important, as inspectors were often so involved in paperwork and checking policy compliance with the national minimum standards that they were often able to spend little, if any, time talking to residents or staff. It is argued that there is considerable potential for a strengthened role of lay people in the care home inspection process.
This paper reports on research funded by the Nuffield Foundation exploring the role of lay assessors in the care home inspection process in England and Wales. Lay people have been included in many care home inspections for the past decade. Similar lay involvement is included in other public service inspections such as the Office for Standards in Education (OFSTED) inspections of schools. The Board of the short-lived National Care Standards Commission (NCSC) controversially decided to dispense with such lay involvement in the inspection process. The replacement body, the Commission for Social Care Inspection (CSCI), intends to include lay people in the inspections of support services in the community but is hesitating about reintroducing them into care home inspections. This research project was able to explore the role taken by lay assessors in thirteen inspections of care homes for older people and for adults with learning disabilities. The research concluded that lay assessors had a significant role in communicating with residents and staff and observing care home life. Their role was particularly important, as inspectors were often so involved in paperwork and checking policy compliance with the national minimum standards that they were often able to spend little, if any, time talking to residents or staff. It is argued that there is considerable potential for a strengthened role of lay people in the care home inspection process.
Working with Older People, 9(1), March 2005, pp.9-12.
Publisher:
Emerald
Explains how advocacy can empower care home residents and how these services are currently provided, and argues for better funding. Also briefly reports on a pilot study of local Age Concern advocacy schemes funded under the Nuffield Foundation's small grants programme in the autumn of 2003. The study highted different advocacy service models, numbers of referrals, types of referrals and funding problems.
Explains how advocacy can empower care home residents and how these services are currently provided, and argues for better funding. Also briefly reports on a pilot study of local Age Concern advocacy schemes funded under the Nuffield Foundation's small grants programme in the autumn of 2003. The study highted different advocacy service models, numbers of referrals, types of referrals and funding problems.
Subject terms:
older people, residents, advocacy, care homes, empowerment, financing;
The report seeks to examine the views, attitudes, perceptions and behaviour of older people who are in fuel poverty or who are concerned about heating their homes. The study offers an important new perspective on what should be done to ensure that older people in the UK live in warm homes during the winter months.
The report seeks to examine the views, attitudes, perceptions and behaviour of older people who are in fuel poverty or who are concerned about heating their homes. The study offers an important new perspective on what should be done to ensure that older people in the UK live in warm homes during the winter months.
Subject terms:
heating, older people, poverty, user views, health needs;
Social Policy and Administration, 38(5), October 2004, pp.488-503.
Publisher:
Wiley
Research, funded by the British Gas Help the Aged Partnership and carried out by the Institute of Gerontology, King's College London, explored the multidimensional issues of fuel poverty. A sample of older homeowners and private renters living in England, Scotland and Wales were interviewed in the Spring of 2003 to explore their experiences of keeping their homes warm in the preceding winter. It was found that almost half of the sample for whom full information was available were in fuel poverty. Government schemes failed to address some important issues. Grants were only available to those with “passport benefits”, excluding those who had minimal occupational pensions. Although most respondents had central heating, it was often old and ineffective, yet grants were not available to modernize them. Government schemes did not extend to paying for external and internal insulation for solid wall properties yet many older people live in such property. Several older people lived in rural areas not connected to mains gas. As mains gas currently provides the cheapest fuel, they faced high bills, yet government policies do not address the differential fuel costs in these areas. The culture of many older people in the study contributed to their living in cold homes. They lived frugally and usually turned heating off in daylight hours during winter. It was also a common practice to sleep in an unheated bedroom during winter and to keep the window open at night. Such practices are acknowledged to be unhealthy.
Research, funded by the British Gas Help the Aged Partnership and carried out by the Institute of Gerontology, King's College London, explored the multidimensional issues of fuel poverty. A sample of older homeowners and private renters living in England, Scotland and Wales were interviewed in the Spring of 2003 to explore their experiences of keeping their homes warm in the preceding winter. It was found that almost half of the sample for whom full information was available were in fuel poverty. Government schemes failed to address some important issues. Grants were only available to those with “passport benefits”, excluding those who had minimal occupational pensions. Although most respondents had central heating, it was often old and ineffective, yet grants were not available to modernize them. Government schemes did not extend to paying for external and internal insulation for solid wall properties yet many older people live in such property. Several older people lived in rural areas not connected to mains gas. As mains gas currently provides the cheapest fuel, they faced high bills, yet government policies do not address the differential fuel costs in these areas. The culture of many older people in the study contributed to their living in cold homes. They lived frugally and usually turned heating off in daylight hours during winter. It was also a common practice to sleep in an unheated bedroom during winter and to keep the window open at night. Such practices are acknowledged to be unhealthy.
Subject terms:
heating, income support, older people, poverty, social exclusion, social policy;
Ageing and Society, 23(5), September 2003, pp.603-624.
Publisher:
Cambridge University Press
Reports the findings of research funded by The Nuffield Foundation on older people paying the full cost of their long-term residential or nursing home care in England. The research had three stages; a national postal survey directed at the senior finance officer in social services departments, follow-up telephone interviews with a sample of them, and interviews in five case study areas. Those interviewed included social services staff (including a legal adviser), care home providers, self-funding residents and relatives. These self-funding residents were commonly relatively physically independent on admission to the care home. Despite central government directives that needs assessments should be available regardless of a person's means, it is a common policy to encourage older people in this situation to admit themselves directly to care homes without a needs assessment. Wide variation was found in local authority practice in respect to being prepared to make a contract with a care-home provider for older people able to meet the full costs of care.
Reports the findings of research funded by The Nuffield Foundation on older people paying the full cost of their long-term residential or nursing home care in England. The research had three stages; a national postal survey directed at the senior finance officer in social services departments, follow-up telephone interviews with a sample of them, and interviews in five case study areas. Those interviewed included social services staff (including a legal adviser), care home providers, self-funding residents and relatives. These self-funding residents were commonly relatively physically independent on admission to the care home. Despite central government directives that needs assessments should be available regardless of a person's means, it is a common policy to encourage older people in this situation to admit themselves directly to care homes without a needs assessment. Wide variation was found in local authority practice in respect to being prepared to make a contract with a care-home provider for older people able to meet the full costs of care.
Subject terms:
local authorities, long term care, nursing homes, needs, needs assessment, older people, residents, self-funders, user views, assessment, attitudes, charges, care homes, contracts, discrimination, financing;
Finding a fair and equitable system of paying for long term residential or nursing home care is a major policy issue. This report explores the experiences of older people who self fund their residential or nursing home care. It finds that for frail older people and their relatives, choosing and paying for long term care is fraught with confusion over the legal complexities. The study also finds: a wide variation in local authority policies and practices; conflicts between local authorities and independent sector care home providers; and a lack of impartial advice for older homeowners about the alternatives to care home admission and about the different types of care home.
Finding a fair and equitable system of paying for long term residential or nursing home care is a major policy issue. This report explores the experiences of older people who self fund their residential or nursing home care. It finds that for frail older people and their relatives, choosing and paying for long term care is fraught with confusion over the legal complexities. The study also finds: a wide variation in local authority policies and practices; conflicts between local authorities and independent sector care home providers; and a lack of impartial advice for older homeowners about the alternatives to care home admission and about the different types of care home.
Subject terms:
home ownership, income, local authorities, nursing homes, older people, self-funders, care homes, financing;
British Journal of Social Work, 30(5), October 2000, pp.649-661.
Publisher:
Oxford University Press
A sample of 61 residents admitted during the preceding three years to 35 independent sector nursing or residential care homes in four local authority areas was interviewed. Five discrete roles for family care-givers in the care homes were described: checking the quality of care, companionship, handling the cared-for person's finances, giving the cared-for person practical help, and assisting the cared-for person with personal care. Although family care-givers described themselves as very satisfied with the care homes as a whole, as many as half were worried about some aspect of care. The research has implications for social workers, care home proprietors and registration and inspection units in encouraging care homes to adopt more 'relative friendly' policies.
A sample of 61 residents admitted during the preceding three years to 35 independent sector nursing or residential care homes in four local authority areas was interviewed. Five discrete roles for family care-givers in the care homes were described: checking the quality of care, companionship, handling the cared-for person's finances, giving the cared-for person practical help, and assisting the cared-for person with personal care. Although family care-givers described themselves as very satisfied with the care homes as a whole, as many as half were worried about some aspect of care. The research has implications for social workers, care home proprietors and registration and inspection units in encouraging care homes to adopt more 'relative friendly' policies.
Subject terms:
nursing homes, older people, relatives, residents, surveys, user views, attitudes, carers, care homes;
Social Policy and Administration, 34(2), June 2000, pp.191-205.
Publisher:
Wiley
Discusses the reasons why caregiving in the community had ended for a sample of dependent older people, two-thirds of whom had dementia. Comparisons are made between the situation of a spouse caring for a partner and a daughter or son caring for a parent in a separate household. Spouses in the study had often sustained a greater burden before caregiving collapsed than had daughters or sons. They were less likely, however, to have had support from the home care service. When caregiving in the community ended and the dependent older person entered a care home, family caregivers themselves often had a financial price to pay. Currently spouses have a legal liability to contribute to a partner's care costs. Because of the UK's means-testing rules, daughters and sons were often penalised because a parent's assets that they might have inherited had to be used to meet the care home costs.
Discusses the reasons why caregiving in the community had ended for a sample of dependent older people, two-thirds of whom had dementia. Comparisons are made between the situation of a spouse caring for a partner and a daughter or son caring for a parent in a separate household. Spouses in the study had often sustained a greater burden before caregiving collapsed than had daughters or sons. They were less likely, however, to have had support from the home care service. When caregiving in the community ended and the dependent older person entered a care home, family caregivers themselves often had a financial price to pay. Currently spouses have a legal liability to contribute to a partner's care costs. Because of the UK's means-testing rules, daughters and sons were often penalised because a parent's assets that they might have inherited had to be used to meet the care home costs.
Subject terms:
older people, poverty, admission to care, dementia;
The aims of the research were to explore and understand the significant issues arising when older home owners enter long term residential and nursing home care. The key people and organisations involved are the older home owners themselves, their relatives, local authorities and independent sector care home providers. Specific objectives of this research were to gain greater understanding of: local authority policies and practices in respect to home owner occupiers entering long term care homes; the concerns within authorities about those policies and practices; the consequences for older home owners entering care homes; significant issues for home providers accepting privately paying older people as residents.
The aims of the research were to explore and understand the significant issues arising when older home owners enter long term residential and nursing home care. The key people and organisations involved are the older home owners themselves, their relatives, local authorities and independent sector care home providers. Specific objectives of this research were to gain greater understanding of: local authority policies and practices in respect to home owner occupiers entering long term care homes; the concerns within authorities about those policies and practices; the consequences for older home owners entering care homes; significant issues for home providers accepting privately paying older people as residents.
Extended abstract:
Author
WRIGHT Fay;
Title
Capital offences: variations in local authority treatment of older home owners entering residential care: a summary of some key research findings.
Publisher
The Nuffield Foundation and Age Concern Institute of Gerontology, King's College London, 2000.
Summary
The aims of the research were toexplore and understand the significant issues arising when older home owners enter long term residential and nursing home care. The key people and organisations involved are the older home owners themselves, their relatives, local authorities and independent sector care home providers. Specific objectives of this research were to gain greater understanding of: local authority policies and practices in respect to home owner occupiers entering long term care homes; the concerns within authorities about those policies and practices; the consequences for older home owners entering care homes; significant issues for home providers accepting privately paying older people as residents.
Context
Government figures show that since 1951, numbers of old people have increased significantly, there has been a 61% increase in those aged 80-84 and an 81% increase in those aged 85 and over. As very old people are more likely than those who are younger to suffer physical and mental ill health, this has significant public expenditure implications for health and social services as well as for state pensions and other social security benefits. There are also implications for long term care costs. Although relatively few people above retirement age (approx 5%) live permanently in institutional care, over a fifth of those aged 85 or over do so. Unless the proportion of people entering care homes in the last phase of their lives declines, the issue of using a home to meet care home charges will continue to be a significant concern to older people and their relatives in the future.
Method
The study had three phases, (1) a national postal survey of senior finance officers in English and Welsh social service departments (response rate 77%). (2) Structured telephone follow-up interviews with a stratified sample of approximately one in four responding finance officers (28 interviews). (3) Case studies in five English local authority areas. Factors in choosing the five were the level of home ownership amongst older people and the level of deliberate deprivation of assets to avoid care home charges reported in the postal survey. Questionnaires were piloted in one of the case study areas. Each case study included interviews with: SSD staff involved in financial assessments of older home owners seeking care home admission; independent sector care home providers, 9 in the voluntary, and 19 in the for-profit, sector; residents recently admitted to independent sector residential or nursing homes who had previously owned their own homes; and relatives recently involved in disposing of property after an older home owner has been admitted to long term care. The postal survey and the structured interviews were analysed using Statistical Package for the Social Sciences. Data from qualitative interviews was analysed with Ethnograph.
Contents
This ten page booklet is divided into five sections. Section one gives background information on the numbers of older people in care homes, the means test for long term care and the issues surrounding selling a home to meet care home charges. Section two describes the aims and objectives of the research. Section three sets out the methodology and the research process. The fourth section is on the main findings of the study and is divided into eight parts each part dealing with the main findings, which are: variations in local authority community care packages; local variations in assessing financial situations; older home owners failing to obtain needs assessments; variations in obtaining a local authority contract; problems with entering a care home without a local authority contract; local variations in the treatment of a carer remaining in a property; a strained relationship between local authorities and independent sector providers; and a lack of impartial advice for frail older home owners. Section five draws together conclusions from the study. The appendix gives a summary of means-testing for residential and nursing home care, the current arrangements and government proposals for change.
Conclusion
"Most authorities operate ceilings to care packages in the community. In some areas these are very stringent. Older people needing significant support at home but with insufficient income or savings to purchase additional support privately will be pressurised into moving into care homes. Home owners are particularly vulnerable to these pressures as they will usually have to sell their homes and meet care home charges themselves."
15 references
Subject terms:
income, literature reviews, long term care, nursing homes, older people, pensions, care homes;
York Publishing Service/Joseph Rowntree Foundation
Publication year:
1998
Pagination:
154p.,bibliog.
Place of publication:
York
Uses interviews with over sixty carers to explore the consequences for relatives following a dependent persons admission to a residential or nursing home. Focuses on how a care home is chosen; the financial consequences for family members; and on the extent to which they wish, and are able to, engage in care giving activities in a residential setting.
Uses interviews with over sixty carers to explore the consequences for relatives following a dependent persons admission to a residential or nursing home. Focuses on how a care home is chosen; the financial consequences for family members; and on the extent to which they wish, and are able to, engage in care giving activities in a residential setting.
Subject terms:
nursing homes, older people, relatives, user views, carers, care homes, children;